Role Strain, Faculty Stress, and Organizational Support for Clinical Nurse Faculty Assigning a Failing Grade

Background:  Nurse Educators remain obligated professionally and ethically to uphold safe clinical practice (Rosenkoetter and Milstead, 2010).  Yet, failure to fail remains a significant issue in nursing education (Duffy, 2003; Larocque & Luhanga, 2013; Sprinks, 2014).  The clinical experience enhances students' learning and affords students opportunities to synthesize learning, and build on previous knowledge and skills with actual patients in complex care environments (Killam, Luhanga, & Bakker, 2011; Stokes and Kost, 2005). Assurance that clinical learning outcomes are met is imperative for patient safety and success of the nursing program (Amicucci, 2012; Larocque & Luhanga, 2013; Oermann, 2004).  Evaluation of the students' learning is the responsibility of Clinical Nurse Faculty (CNF) who ultimately determines if a student successfully met clinical course objectives required to progress in a nursing program (Amicucci, 2012; Glasgow, Dreher, & Oxholm, 2012).  This can be a difficult and stressful experience (Lewallen and DeBrew, 2012).

Purpose:  The purpose of this correlational study was to explore the relationships between role strain (RS), faculty stress (FS), and perceived organizational support (POS) for Clinical Nurse Faculty (CNF) who faced the decision to assign a failing grade to a clinical nursing student. 

Design: A cross-sectional design was used; a national sample of 390 undergraduate and graduate CNF were recruited through social media and direct email solicitation.  Neuman's system model served as a theoretical framework.

Methods: Data were collected online using the Role Strain Scale, Faculty Stress Index, Survey of Perceived Organizational Support, and a demographic inventory.  Descriptive statistics, t-tests, Pearson r correlations and regression analysis were used to analyze the quantitative data; qualitative data collected in an open-ended question were analyzed using conventional content analysis.

Findings: Strong correlations were identified; inverse relationships between role strain and perceived organizational support (r = -.601, p = .000), and faculty stress and perceived organizational support (r = -.613, n = 390, p = .000) whereas a strong positive relationship between role strain and perceived organizational support (r = .822, p = .000) were identified. The shared variance in role strain (69.2%) was from faculty stress and perceived organizational support.  Perceived faculty stress accounted for nearly twice the variance.  Higher degrees of role strain were reported by full-time CNF, those responsible for both didactic and clinical areas, and those enrolled in a doctoral program.  Nearly half the participants (46.9%) reported changes to the teaching practice following the deliberation to assign a failing grade.

Conclusions: Assigning a failing grade is distressing for CNF.  Perceived organizational support is foundational to the process and a critical factor influencing both undergraduate or graduate CNF's perceived role strain and faculty stress.  CNF identified ten areas where change in teaching practice was necessary.

Clinical Relevance: As Deans and administrators raise their awareness of the issues surrounding the struggle to assign a failing grade, efforts need to focus on providing adequate organizational support and developing explicit evaluation instruments and processes affording rigorous student evaluations to maintain the graduates are competent and safe to practice.