Question Stephen Health

The Implications of Failing to Fail Students

Kathline Duffys failure to fail students and the implications of this

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A vital aspect of nursing training is assessing a student’s fitness to practice, which requires nursing students to demonstrate clinical and theoretical knowledge and skills, in accordance with professional standards (Duffy, 2003; Nursing and Midwifery Council, NMC, 2015). The NMC (2008) lays out clear guidelines for mentors in the assessment of student nurses’ clinical practice, to ensure that students not fit to practice, are offered further support and if no improvement is made, disallowed from being registered. However, in practice, mentors’ willingness to fail students has been recognised as problematic (Watson et al. 2002), with student nurses being allowed to pass clinical assessments despite evidencing sufficient competence. Such concern prompted Kathleen Duffy (2003) to undertake qualitative research, to understand from the mentors’ perspectives, the phenomenon of ‘failure to fail’. As Darzi (2008) highlights, ensuring safe and high quality care is a nurse’s duty of care. However, where the nursing workforce comprises of nurses that lack the key skills and knowledge required, patient care quality is compromised, placing patients’ lives at risk (NMC, 2015).

Duffy’s (2003) research findings corroborate other researchers’ concerns in regards to mentors failing to fail incompetent nursing students (McAleer & Hamill 1997; Duffy & Scott 1998). Lankshear (1990: 37) evidenced that nursing assessors failed to fail students due to fears of possible repercussions, reporting “a distinct feeling that failing a student opens up a hornets’ nest”. Mentors reported not wishing to be responsible for terminating students’ careers and consequently allowed them to pass (Duffy & Scott, 1998). As Duffy (2003) highlights however, inevitably there will be students that cannot meet the required standards of practice. Therefore, mentors must demonstrate professional accountability in prioritising the patients’ best interests, by failing these students, to ensure safe and high quality care is universally delivered (NMC, 2015; Edwards, 2009).


Darzi, L., (2008) High quality care for all. London: HMSO

Duffy, K., & Scott, A., (1998) Viewing an old issue through a new lens: a critical theory insight into the education-practice gap. Nurse Education Today. 18, 183-189.

Duffy, K., (2003) Failing students: a qualitative study of factors that influence the decisions regarding assessment of students’ competence in practice. Doctoral dissertation. Glasgow: Glasgow Caledonian University

Lankshear, A., (1990) Failure to fail: the teacher’s dilemma. Nursing Standard. 4 (20), 35-37.

McAleer, J., & Hamill, C., (1997) The Assessment of Higher Order Competence Development in Nurse Education. Belfast: National Board for Nursing, Midwifery & Health Visiting for Northern Ireland.

Watson, H.E., & Harris, B., (1999) Supporting Students in Practice Placements in Scotland. Glasgow Caledonian University: Department of Nursing and Community Health.

Watson, R., Stimpson, A., Topping, A., & Porock, D., (2002) Clinical competence assessment in nursing: a systematic review of the literature. Journal of Advanced Nursing. 39 (5), 421-431.