title: 'Failure to fail' in nursing - A catch phrase or a real issue? A systematic integrative literature review.
abstract: 'Failure to fail' is the allocation of pass grades to nursing students who do not display satisfactory clinical performance. This issue can have significant implications for individual students and assessors involved, as well as for nursing professionalism and patient safety. The aim of this systematic integrative literature review was to determine what is currently known about the issue of 'failure to fail' within undergraduate nursing programs. A literature search of five databases up to May 2015 was conducted to identify primary research papers. The search yielded 169 papers of which 24 met the inclusion criteria. The majority of papers had moderate or good methodological rigour, with most of the literature originating from the Northern Hemisphere. Five main themes emerged: failing a student is difficult; an emotional experience; confidence is required; unsafe student characteristics; and university support is required to fail students. The results suggest that 'failure to fail' is a real issue in tertiary facilities, with many complex facets. Given the costs of nurse education and the potential social and professional costs of poor quality nursing graduates, further rigorous research is required in this area.
authors.affiliation: Griffith University, School of Education and Professional Studies, Mt Gravatt, Qld, 4111, Australia. Electronic address: Lynda.Hughes@griffithuni.edu.au.
authors.forename: Lynda J
authors.initials: LJ
authors.lastname: Hughes
authors.affiliation: Griffith University, School of Nursing and Midwifery, Nathan, Qld, 4111, Australia; Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Nathan, Qld, 4111, Australia; Nurse Practice Development Unit, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, Qld, 4102, Australia.
authors.forename: Marion
authors.initials: M
authors.lastname: Mitchell
authors.affiliation: Griffith University, School of Nursing and Midwifery, Nathan, Qld, 4111, Australia; Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Nathan, Qld, 4111, Australia; Gold Coast University Hospital, Emergency Department, 1 Hospital Bldv, Southport, Qld, 4215, Australia.
authors.forename: Amy N B
authors.initials: AN
authors.lastname: Johnston
mesh_terms: D002983:Clinical Competence; D004508:Education, Nursing, Baccalaureate; D004521:Educational Measurement / Q000379:methods*; D004644:Emotions; D005181:Faculty, Nursing / Q000523:psychology; D006801:Humans; D013338:Students, Nursing
keywords: Fitness for practice; Grade inflation; Undergraduate nurse; ‘Failure to fail’