Moving forward: Barriers and enablers to failure to fail - A mixed methods meta-integration.

BACKGROUND:Many academics and clinicians who assess nursing students as part of their work-integrated learning experiences encounter difficulties with awarding a failing grade to students who do not meet fitness for practice standards. OBJECTIVES:The aim of this study was to explore and further our understanding of assessors' experiences of failure-to-fail of nursing students within work-integrated learning. DESIGN:This aim was achieved through an exploratory, sequential, mixed methods research project. METHODS:Guided by Invitational Theory, this programme of work included an integrated systematic review, one-on-one and focus group interviews, and finished with a survey. RESULTS:The results of each of the phases of this mixed methods study were integrated to provide a greater understanding of the enablers and barriers for assessors managing poor performing students to ameliorate failure to fail. Enablers identified included: assessor supports, programme flexibility, and organisational culture. The barriers included grade inflation, in appropriate student responses, organisational processes and workload. CONCLUSIONS:This comprehensive integration of a mixed methods study provides new and deeper understanding of the phenomenon of failure to fail. It provides clear recommendations for practical application by tertiary and clinical facilities to enhance the enablers and minimise the barriers to failure where it is warranted.