The Myth of good character: assessing the performance of nursing and midwifery pre-registration students using a modified Delphi approach

Abstract

The requirement for pre-registration student nurses and midwives to demonstrate good character is detailed in the Nursing and Midwifery Council (NMC) quality assurance framework for higher education institutions (NMC, 2016a). This study used a qualitative methodology, interpreted through a post-modern lens, to examine the perspectives of decision-makers when assessing the good character of nursing and midwifery preregistration students in relation to their continued fitness to practise. Participants were purposively sampled from higher education institutions in the United Kingdom. All participants were qualified nurses or midwives and had experience of making decisions about students’ good character. Thirty-three participants agreed to take part in a qualitative three-round study based on a modified Delphi approach. Twenty-two participants completed all three rounds. Qualitative data from all rounds were analysed using thematic analysis. A final overall analysis and interpretation was undertaken to synthesise the perspectives of this group of participants. The use of vignettes in round one enabled the participants to have a professional asynchronous conversation and contributed to their professional development through the opportunity to engage in reflection. The myth of good character is presented within the discourse as the good and caring nurse or midwife who abides by the Code (NMC, 2015a). The myth hides the underlying discursive practices that exist within the discourse to control behaviour, which was witnessed in this study through the assessment of the students’ ability to operate technologies of the self, as described by Foucault (1988a). Technologies of the self were assessed by the student’s ability to demonstrate self-awareness through insight, reflection and remorse, and honesty and integrity through self-surveillance in relation to a duty of candour. The decision-makers indicated that students were assessed upon their performance and their ability to learn how to be good rather than any fixed notions of character.