Pass/fail grading in radiography clinical assessments: Insights from clinical practice educators

Direct observation clinical assessments are used to verify student competence in Radiography. Guidance on grading these assessments is lacking. While pass/fail grading is increasingly adopted in medical education, its application in radiography clinical education remains unexplored.

This cross-sectional, case design study explored Clinical Practice Educators' (CPEs) perceptions and experiences of implementing a pass/fail grading system in radiography clinical assessments. A total of 30 CPEs affiliated with undergraduate and graduate entry radiography in a single Irish university were recruited. Six semi-structured focus groups (n = 5 per group) were used to collect data. Deductive thematic analysis was applied.

Findings are presented under four main themes: (i) Benefits of pass/fail grading in radiography clinical assessments (ii) Drawbacks of pass/fail grading in radiography clinical assessments (iii) Impact of grading approach on students and (iv) Recommendations to enhance the implementation of pass/fail grading in radiography clinical assessment. Perceived benefits of pass/fail grading compared to letter grading include enhanced grading consistency, reduced examiner bias, and increased efficiency. Pass/fail grading was valued for its fairness and potential to reduce student stress, fostering a collaborative learning environment. It was also considered more congruent with the competency-based nature of radiography practice. However, concerns were raised regarding its limitations, including insufficient differentiation between student performance levels, challenges in tracking progress, and diminished engagement with feedback. Strategies such as structured feedback practices, and enhanced training for CPEs were recommended to address these challenges.

The study offers valuable insights into the perceived advantages and limitations of pass/fail grading compared to traditional letter grading in radiography clinical assessments.

Findings are particularly relevant for academic institutions contemplating the adoption of pass/fail grading systems for radiography clinical assessments.