Guide to the Assessment Documents and Frequently Asked Questions.
Assessment of practice is extremely important, so important it accounts for 50% of the pre-registration nursing programmes . This presentation offers some guidance notes for the pre registration nursing programmes assessment documentation and assessment process. These documents will be used by all the nursing students from Leeds Metropolitan University and the University of Leeds. It is recommended you read these notes and FAQ, in conjunction with the copy of the documents which, can be found at www.practiceplacements.leeds.ac.uk The assessment documentation has 2 elements to each stage of the assessment process:-
1. The Assessment of Practice document. This document has been
developed around the NMC Outcomes for Branch Entry (CFP) and Proficiencies for Entry to the Register (Branch). These statements are divided into four domains, Professional & Ethical Practice, Care Delivery, Care Management and Personal and Professional Development. Each part of the domain has guidance notes for mentors & students to enable them to consider how each section could be completed in that placement setting. The document also has a development/action plan page to enable on-going development needs to be carried forward and met within the next placement area. The levels of learning in practice are divided up into 3 stages:Stage 1 = CFP (novice) Stage 2 = First part of Branch (able to deliver care to client & family/carer, non complex cases) Stage 3 = Final part of branch (able to deliver plan, delivery, evaluate and alter as appropriate care to group of clients & families/carers for complex cases, lead care teams, work in multi-disciplinary teams The length of these stages depends on the programme of study. The assessment process includes:Preliminary interview – Students will normally come with an agreed development plan identifying personal and professional learning outcomes, and the focus for the placement/part of the programme. At the preliminary interview agreement will be negotiated for the learning outcomes for the placement and an action plan devised to achieve these. Intermediate interview – to review progress re-define/progress learning outcomes, identify and areas of concern and update action plans (for placements longer than 4 weeks) Final Interview – to verify or “sign off “–completed proficiencies and skills and evaluate progress.
The clinical liaison tutor/link lecturer must be involved where the student is failing to meet agreed outcomes/appropriate level of proficiency for that stage of learning.
2. The Skills Workbook . This document identifies common skills required for all
branches (CFP document) and specific skills required for the named branch (branch document). These are integral to the Assessment of Practice document in that a student cannot be deemed proficient in a domain without demonstrating proficiency at the skills required to achieve that domain.
FAQ
When will the students using this documentation access the placement areas? The new cohort of students commencing any pre-registration nursing programme at LMU or UoL from September 2006 will use the Stage one (CFP) document. In addition any pre-registration nursing student who commences their branch programme from September 2006, will use the Stage two documentation. Students who have already commenced their branch programme will continue to use the existing documentation. The table below can be used as a quick guide Yellow indicates existing profiles (Performance Criteria), Purple indicates the new assessment document. Academic year Semester 1 Cohort *A & B 01/04 09/04 01/05 09/05 01/06 Sept 06 – Jan 07 A A &B A A&B A 2006-07 Semester Semester Semester 2a 2b 1 Jan 07-May June 07Sept 0707 Sept 07 Jan 08 Completed programme Completed programme 2007-08 Semester 2a Jan 08May 08 Semester 2b June 08Sept 08
Completed programme Commence Branch
09/06 A & B
Commence programme A = University of Leeds Students, B = Leeds Met students
What should staff in the placement areas do to prepare for the Assessment of Practice and Skills Workbook documentation? Visit the www.practiceplacements.leeds.ac.uk web site to review the mentor update presentation, which gives you the background to the development. Staff should also access the web page, which lays out the new documentation, so that you can map through the type of experiences, knowledge and skills available to the student, which will facilitate their completion of the domains. Also consider what related experiences you could guide the student to, which will facilitate a wider and deeper understanding of care delivery and management for your client group. Click here for an example
How are students assessed on placement? The assessment process involves the mentor and student agreeing an action plan at the preliminary interview outlining the learning experiences available in your area, which will meet some, or all of the domains required to be completed in that placement. Where a student is required to complete parts of the domain, this will be clearly outlined in the development plan agreed with the academic lead for that part of the programme. The intermediate interview allows the opportunity for the mentor and student to agree domains, which have been successfully completed, and action plan to complete those remaining. The final interview is the point at which the mentor assesses if the student has successfully completed all of the domains and skills required to pass the placement. An action plan for future development may also be agreed within the development plan to take forward to the next placement. What is the difference between a development plan and an action plan? The development plan is a plan agreed between the student and the programme manager or module manager at the relevant university and directs the student as to which domains must be completed in that placement. It may also identify a particular focus the student must also consider during that placement i.e. focus on carer’s needs or referral procedures. An action plan is the agreement between the mentor and student as to how the domains (and any other requirement i.e. carer’s needs) can be achieved through all the learning opportunities available in the placement and related placement areas, and will identify other professional disciplines the student could access whilst in that placement. These can be updated at any point in the placement, but must be commented on at the intermediate interview. Additional action plans may be required if the student is struggling to meet the standard required and you must involve the Clinical Liaison Lecturer/Link Lecturer in these action plans. See linked section on competency and proficiency, and what to do if a student is failing to meet the required level How do I assess the student is competent/proficient at the domains and skill? Learning has 3 elements, cognitive (knowledge) affective (feelings & values) and psychomotor (physical skills). Students need to demonstrate proficiency within these 3 elements, this means they are able to demonstrate the knowledge which underpins what they are doing, they recognise related values and attitudes, and have the physical dexterity to perform the required task. The level and depth required depends on the student’s stage of the programme.
Example – Novice, stage one – able to undertake measurement of vital signs and record and report these to you, will be able to record measurements under supervision.
Stage two – able to recognise deviations from the norm and some possible reasons for this, will record these and report them under indirect supervision, may be able to suggest appropriate nursing interventions and with guidance record these in the care plan. Stage Three – recognise deviations from the norm, possible reasons for this and be able to demonstrate understanding of underlying pathophysiology to the immediate condition/disease process, be able to recognise possible problems for related physical and emotional systems, propose appropriate change to nursing intervention and rationale underpinning that decision. Able to record and report under indirect supervision. How can I facilitate the student to move through these stages? Students will normally acquire knowledge, initially in discrete areas (novice) then with guidance; start to make connections between these areas (stage two) to finally able to draw on knowledge gained from a variety of sources and apply to the situation at hand. Use of question and answer technique helps guide the student through the knowledge they have, and to make links. They also help the student to identify areas where their knowledge is lacking and further research/reading is required. Skill development is fostered through observation in the first instance, as you guide the student through the skill, highlighting the knowledge, which underpins the skill. The student will then have the opportunity to practice this skill whilst under direct supervision. Once you and the student agreed they understand what is required, the student should then be offered the opportunity to undertake the skill under indirect supervision, but that you check the completed work. Once confident that the student can perform the skill competently and demonstrates the required knowledge, which underpins the skill, the student is deemed competent. Further practice will facilitate proficiency at that skill.
All team members, mentors, and associate mentors may be involved in facilitating the student’s learning, however it is the mentor who is responsible for the final assessment and completion of the assessment documentation.
You must remember that as the registered practitioner you are accountable for the learning process and you must have confidence in your judgement, i.e. you are sure the student can do what is required to a competent level, before your pass the student. If you feel there are circumstances, which makes it difficult for the student to achieve the required level, you must make that known to the clinical liaison tutor/link lecturer so appropriate support can be offered. You must not pass the student by giving them ‘the benefit of the doubt’. What is meant by ‘supernumary’ and how important is attendance and hours? The NMC states the required number of hours within a nursing programme that must be worked within a placement area. Each programme will ensure that over the three years these hours are met. It is vital that the student’s attendance is monitored and recorded accurately to ensure these hours are completed. The NMC requires that the students are supernumery, which means they cannot be counted as part of the workforce for the placement staffing numbers. This allows the student to follow through learning opportunities which would otherwise be lost if they were counted in the staffing
numbers (i.e. follow a patient through to theatre, go with a client to an out patient appointment). However to meet the requirement of both the NMC and DoH criteria for proficiency the student must experience care provision throughout the 24 hours and 365 days per year – that means they must work shifts, nights and weekends. There is an agreement that the students do a maximum of 1 in 3 weekends per 12 week placement. When the Practice Placement Unit (PPU) sends out student information, they will identify how many days the student is required to work in the placemen. This is based on the norm of one day = 7.5 hours i.e. an 8 hour shift which includes a half hour break. The student may wish to work a night shift to gain experience, however it will be identified within their development plan when the university expects the student to work night shifts. The maximum number of hours the student can work is 10 hours, (the student MUST discuss and get agreement from the programme manager for any shift patterns which are longer than this). A long day may involve being on duty for 11 hours, the number of hours is calculated by taking the overall time minus the 1 hour (or 2 x ½ hours) breaks i.e. 10 hours. Short comfort breaks would count as part of the hours. This may mean that the shift patterns do not easily add up to the required hours for one week, in this case the hours can be calculated over a 2 week period i.e. (an example only) 3 days/week in placement = 3x 7.5 = 22.5 22.5 hours x 2 weeks – 45 hours split into Week 1 2 long shifts (20 hours), week 2 1 long shift (10 hours) 1 x late shift (7.5 hours), 1 early shift (7.5) (click here for example of Attendance Record Sheet) Students are not under any obligation to work long days. Student’s shifts must also comply with EU working time directive in that there must be a minimum of 11 hours between the end of one shift and the start of the next shift. This may require slight alterations to their start and finish times. You can contact your clinical liaison lecturer/link lecturer if you have any questions regarding placement hours
What do I do if the student is failing to meet the required level? You must contact the Clinical Liaison Tutor/Link Lecturer so that an action plan can be put in place and the student offered the support required to facilitate ac hievement. This is called the tripartite partnership, and the Clinical Liaison Lecturer/Link Lecturer will continue to support you and the student through to the end of the placement. Should the student not achieve the required level then the student fails the placement. Each university will have a mechanism by which the student has the opportunity to redeem that fail within the next placement.
How often should I give feedback to the student? There are obvious points, such as the intermediate interview, but the student should be making time to see you every 1-2 weeks, to go through the evidence the student has written up to demonstrate achievement of the domains. This gives you the opportunity to review work to date and what is still out standing. It is also an opportunity to comment on progress so far. You should aim to work with the student for at least 40% of the time they are allocated to your placement area, which again gives you time to discuss learning to date, and to encourage the student’s learning through positive challenges (i.e. Q & A session). Obviously if there are concerns about the student’s progress (either you have experienced the issues or feedback from other team members indicates that there is a concern) you would need to meet the student, discuss the problem and agree an action plan to help the student overcome the problem. How do I formulate an action plan? You first need to decide what the issue is, try to avoid side issues, who said what to whom or any emotions and feelings, which may hinder your ability to get to the bottom of what is the problem. This will then make it easier for you to decide a step-by-step plan, which will address the issue. The plan may have several stages to it, i.e. student lacks confidence to ‘hand over’ (to be able to communicate relevant information about a patient/client to another member of the team to enable continuity of care) clients. Step 1 – student to ‘hand over’ 1 client to mentor, step 2 – student to ‘hand over’ known client at shift hand over, Step 3 student to ‘hand over’ 3 clients at end of shift. Each stage must have a time frame so that there is a clear re-evaluation point. If the issue is such that the student may fail the placement, you must involve the Clinical Liaison Tutor/Link Lecturer in the action planning, (click here for example).
When should the final interview be completed? This interview arrives a lot quicker than you first thought. So if you are able it’s a good idea to agree a time and date at the intermediate interview. The final interview should take place in the final week; it does not have to be the final shift. You need to set aside at least half an hour to sign off remaining evidence and skills and to discuss the learning that has taken place, identify areas/skills the student has not had the opportunity to undertake, identify areas which require further work, areas/knowledge/skills the student does well in and plan for future development.
Are there any other changes to the pre registration nursing programmes commencing in September 2006? Leeds Met – Changes to the newly approved BSc (Hons) Nursing The undergraduate programme remains as three years of full time study and training. There is also now a part-time route for this qualification which has up to six years for completion. The new programme is future focussed and supports the documents ‘Your Health, Your Care, Your Say’ (DOH, 2006) and ‘Ten High Impact Changes – Making them relevant
for Mental Health’ (NIMHE, 2005), and is consistent with the ‘Making Leeds Better’ agenda. As such it equips students with skills in managing long term conditions, advanced assessment, and is service user centred taking full account of Patient and Public Involvement. The Adult Health branch has moved the focus of care delivery into the community, and the Mental Health branch is values based. The future in Leeds is one where new way of delivering services in partnership with other providers such as voluntary, private and charitable organisations are central; the new programme addresses this future model through both theory and practice. University of Leeds The Advanced Diploma now incorporates a block of theory at the beginning of each semester. The main change to the nursing modules is that they now integrate aspects of biology, psychology and sociology into nursing practice. There have been minor changes only to the pre registration degree programmes theoretical content. The theoretical component of the Post Graduate Diploma in Nursing is remaining the same. The major change however, in all the pre registration programmes is the assessment of practice. Practice will be assessed by an OSCE (see below) as well as on placement. What is an OSCE? An OSCE is Objective Structured Clinical Examination, where the student is examined within a formal setting i.e. a clinical skills lab on aspects of skill proficiency, and/or management of a given scenario. They may involve the use of actors to play clients/carers/families. Dependent on the programme, students may ask for specific help in the development of skills (i.e. clinical, managerial, teaching), which they will be examined on at the end of that semester.
Where can I get help of further information? There is further information on student placements and mentor information, mentor up date sessions etc. on the placement web site www.practiceplacements.leeds.ac.uk Information or help with placement allocation contact the Practice Placement Unit (PPU) 0113 3431375 You can also get help and further information from your Clinical Link Tutor/Link Lecturer. Alternatively you can contact the Programme Manager/Contact person University Branch LMU Adult/Mental Health Programme Contact Sarah Burden Frances Chapman Telephone 0113 2832600 ext 4346 0113 2831912 ext.4368 Email s.burden@leedsmet.ac.uk
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Audrey Reed Melanie Robbins Joe Cortis Maxine Robshaw Steve Howarth Sue Baldwin
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Sheila Kane Julie Killips Meriel Best Julie Laxton Heather Burkinshaw Eileen Padmore
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sheila.kane@leeds.nhs.ac.uk Julie.killips@lmh.nhs.uk m.i.best@leeds.ac.uk j.c.laxton@leeds.ac.uk h.l.burkinshaw@leeds.ac.uk e.padmore@leeds.ac.uk