Grade inflation in the assessment of clinical practice

Assessment of performance and achievement in the work place is integral to pre-registration midwifery programmes. The value of hands-on clinical care is so essential to midwifery practice that the professional regulatory body, the Nursing and Midwifery Council (NMC), stated that practice should be graded and contribute to the final award (NMC, 2009). The NMC confirmed the importance of work based learning by stating that a minimum of fifty per cent of a full time course must be situated within the practice environment compared with a minimum of forty per cent in theory (NMC, 2008). Assessment of student performance will be a key component of any programme that has a large work based element (Wilson & Scammell, 2011). The grading of practice in midwifery at this institution contributes to half of the final grade and thus the overall degree classification (NMC, 2009). Assessment in healthcare education is becoming increasingly important for public accountability and safety (Holomboe et al, 2010). As educators, we must therefore seek to reassure ourselves, students, professional regulators and the public that the assessment processes we use are valid and reliable.