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JCPSLP Volume 15, Number 2 2013 61
In contrast, other students lack awareness or insight into
their difficulties, may be angry at their failure and are not
ready to use it as a learning experience. It is likely that the
personal characteristics and skills students bring to each
placement influence whether they are ready or not to learn,
whether from failure or success.
Minimising the number of students failing clinical
placements, particularly in their final year, would help
reduce the number of students who suffer these negative
consequences. As noted by Dowling (1985), one way to
achieve this goal is the early identification of students at risk
of clinical failure.
Predictors
The development and assessment of clinical skills of SLP
students on clinical placements have been more widely
researched (McAllister, Lincoln, Ferguson, & McAllister,
2010; McAllister et al., 2011) than the impact of clinical
failure on the students. Ideally, we need to assist students
as early as possible to allow time for development.
However, to do this we need a greater understanding of
predictors of success or failure to develop clinical skills.
Presently there is little research in this area available in the
field of SLP. There are some broader studies in medicine,
nursing and allied health fields that may provide some
guidance on important factors for success and failure.
Literature search method
To conduct this narrative review, the initial search strategy
was developed by identifying relevant keywords and
searching Ovid, ProQUEST and Google Scholar. Search
terms included: student learning, clinical success, clinical
education, allied health, SLP, physiotherapy, occupational
therapy, health, students, medicine and nursing. The
articles were scan-read by the first author and excluded if
they did not address SLP clinical education or predictors of
clinical success in any of the health sciences fields noted. In
addition, further articles were identified through review of
reference lists.
Impact of clinical failure on
students
Failing a clinical placement may have a number of
consequences for students. These consequences have not
been widely explored in the literature. However, our team
has observed that failure may impact on students in a
variety of ways (outlined in Figure 2). Failing a placement is
usually distressing for the student and may lead to personal
consequences, such as loss of confidence or family
censure. Students may experience negative financial
consequences from this failure. For example, they may be
required to pay for the subject again if it is repeated or may
risk losing a scholarship if its continuance is dependent on
both academic and clinical success. It some cases,
students may need to extend the length of their studies or
even to consider an alternative career. There may also be
intense family pressure to succeed or maintain high
standards of success. Failing a final-year clinical placement
when the student “should be better” or are “nearly there” is
observed to be particularly difficult, and leaves little time for
improvement. Dowling (1985) also observed “the agony
experienced by clinicians who have had successive clinical
failures and then have to select an alternate career late in
their academic and clinical programs” (p. 54).
Despite this range of negative consequences, SLP
students have differing responses to clinical failure (Nemeth
& McAllister, 2010). Nemeth and McAllister (2010) observed
that some students are ready to learn from failure and go
on to do so with the support of their clinical educator (CE).
Figure 1: Variables in clinical skills development
Figure 2: Consequences of failure
Figure 3: Themes among predictors of success
a student’s clinical performance, as shown in Figure 1,
will be discussed with specific emphasis on student
characteristics.