Help for clinical instructor

[LilyRN99]

I am a clinical instructor for an LPN program. We give numerical grades on a variety of categories such as organization, critical thinking, cultural sensitivity, reporting issues to staff and me, safety etc.. I find it very difficult to give students grades when I don't have the chance to observe all they do on each clinical day. When I am passing meds with one student the others are doing am care. Once I decide on a grade the students complain and want an explanation about how I came up with that grade especially if I didn't see them do am care that day. I can have up to 10 students. I realize that students will complain unless they get a perfect score but I wish I knew how to better explain how they earn a score with minimal observation. Any suggestions from students or other clinical instructors?

[HouTx, BSN, MSN, EdD]

Check with your dean/director for specifics. You must follow those policies and practices. You're smart to be concerned about liability for yourself & your school.... it's a very real concern.

"Grading" should ALWAYS be based on very specific measurable criteria, particularly for high stakes evaluations such as clinical performance. You should have a list of criteria for each observation... and these will describe exactly what "success" looks like. These criteria must be applied exactly the same for each student, no matter how much you like or dislike them.

For instance - for passing meds - Because you're dealing with students, the criteria may include providing a detailed explanation of each medication prior to entering the patient's room & then the bedside criteria would include the usual 'wash hands', 'use two patient identifiers', 'informs patient of name of each med', 'provides education if needed', .... depending on the environment, it may also include bar code scanning, use of pyxis, documentation in the EHR, etc. Helpful - but not essential - load copies of all the checkoff documents onto a tablet so you have these references at all times.

When dealing with students, take the time to actually schedule the various check-offs with each one. Make sure that these activities are clearly communicated. Inform your students that they are not permitted to do participate or perform any new tasks without your prior approval. It is their responsibility to inform you if they have the opportunity to participate in a new activity. Arrange your day around the scheduled events - then use the remaining time to respond to student requests & formal observations.

As an educator, I have always followed the "red face" rule. If I could not justify or defend any actions/decisions without getting flustered and embarrassed (red face), they are probably not the correct ones.