title: A descriptive analysis of the impact of moral distress on the evaluation of unsatisfactory nursing students.
abstract: BACKGROUND
  Nurse educators assume a difficult role when evaluating unsatisfactory students, including those at risk for failure in clinical and classroom settings. While the decisional dilemma inherent in evaluating unsatisfactory students has been well documented in literature, little is known about how moral distress impacts the nurse educators' decisions regarding whether to pass or to fail unsatisfactory students.
  
  
  OBJECTIVE
  This article aims to provide a descriptive analysis of the moral dilemmas and the potential impact of moral distress experienced by nurse educators when evaluating the performance of unsatisfactory students in clinical and classroom courses.
  
  
  METHODS
  Nathaniel's theory of moral reckoning guided the descriptive analysis of six studies to understand how nurse educators work through moral dilemmas, make decisions, and provide justification for their decisions when evaluating the performance of unsatisfactory students.
  
  
  RESULTS
  Nathaniel's theory has been shown to be helpful in discussing the dilemma of evaluating unsatisfactory students, and it is a suitable framework for nurse educators in working through their dilemmas as a form of structured reflection.
  
  
  CONCLUSIONS
  The outcomes of this descriptive analysis highlight the need for educational administrators to provide support to undergraduate nurse educators experiencing moral distress in this type of situation.
authors.affiliation: School of Nursing, McMaster University, Hamilton, ON, Canada.
authors.forename: Maria
authors.initials: M
authors.lastname: Pratt
authors.forename: Lynn
authors.initials: L
authors.lastname: Martin
authors.forename: Ann
authors.initials: A
authors.lastname: Mohide
authors.forename: Margaret
authors.initials: M
authors.lastname: Black
mesh_terms: D004508:Education, Nursing, Baccalaureate / Q000592:standards*; D004521:Educational Measurement / Q000592:standards*; D005181:Faculty, Nursing; D006801:Humans; D009014:Morals; D009742:Nursing Theory; D013338:Students, Nursing / Q000523:psychology*
keywords: Education; nursing theory; professional issue