Barriers and Enablers to Failure to Fail in Nursing

Journal Club Article: Hughes, L. J., Mitchell, M. L., & Johnston, A. N. (2020). Moving forward: Barriers and enablers to failure to fail–A mixed methods meta-integration. Nurse Education Today, 104666. [abstract]

Objectives: The aim of the study was to explore and further understand assessors’ experiences of failure-to-fail of nursing students within work-integrated learning (WIL).

Background: There is however an increasing body of evidence suggesting that there is an apparent reluctance by assessors to fail students within their WIL. Importance of WIL in enhancing skill acquisition and developing student nurses’ professional identity. Assessors are seen as the ‘gatekeepers’ of entry to the profession.

“Allowing a student who does not meet fitness for practice standards to progress in a nursing programme is a significant concern and could be seen as a breach of ethical responsibility and professional credibility on behalf of the assessor and educational provider.”

“Failure to fail occurs because it is challenging for assessors to fail students. Failing students in WIL is an emotional experience for assessors, requiring confidence as well as personal, professional and organisational support.”

Methods: A sequential, exploratory. mixed methods desigm conductedin three phases. Invitational Theory (the theoretical framework), this programme of work included an integrated systematic review, one-on-one and focus group interviews, and finished with a survey.

Results: Themes Identified that enabled or inhibited an assessors ability to award a failing grade were:


  • Assessor supports – with appropriate support to support assessor and learner.
  • Programme flexibility – to be responsive to the needs of the learner to allow more time to develop skills and experience.
  • Organisational culture – to support the assessors in performance management processes.


  • Grade inflation – Assessors indicated that they sometimes gave the benefit of the doubt and passed underperforming students.
  • Inappropriate student responses – “students providing formal complaints to the university; inappropriate responses, including aggression or violence; posting inappropriate comments on social media sites; accusing the assessors of harassment and/or bullying; and rating the assessors poorly in their course and/or teacher evaluations.”
  • Organisational processes – “The appeals process was often highlighted as a process that supported students rather than academics and professional integrity.”
  • Workload – limited allocated assessment time and too many students allocated to assessors.

Implication for Practice Guidance: Building strong, collaborative and supportive relationships and environments across the two sectors is vital to ameliorate failure to fail.