ADVANCED CERTIFICATE/POSTGRADUATE CERTIFICATE IN NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING

Transcription

1 UNIVERSITY OF ULSTER PROGRAMME SPECIFICATION ADVANCED CERTIFICATE/POSTGRADUATE CERTIFICATE IN NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING 1 AWARD INSTITUTION: UNIVERSITY OF ULSTER 2 TEACHING INSTITUTION: UNIVERSITY OF ULSTER 3 LOCATION: JORDANSTOWN 4 ACCREDITED BY: NURSING MIDWIFERY COUNCIL 5 FINAL AWARD: ADVANCED CERTIFICATE/POSTGRADUATE CERTIFICATE IN NURSE INDEPENDENT/SUPPLEMENTARY PRESCRIBING 6 MODE OF ATTENDANCE: PART-TIME 7 SPECIALISMS: NONE 8 COURSE CODE: F501PJ/F502UJ 9 LAST UPDATED: JUNE EDUCATIONAL AIMS OF THE COURSE (Please note: throughout this document where the term nurse independent/supplementary prescriber is used, this reference includes nurses and midwives). The aim of this programme is to prepare prepare nurses, midwives and specialist nurses to be able to incorporate into their practice safe, appropriate and cost-effective independent and supplementary prescribing. This programme is available at both undergraduate (3) and postgraduate (M) levels to take account of the mix of academic achievement in the target population. The knowledge base is the same but those studying at postgraduate level are expected to demonstrate a higher level of the intellectual skills of analysis, synthesis, and evaluation than those at undergraduate level. This is reflected in the Learning Outcomes for the two levels. Within this overall aim the course is designed to enable students to: Demonstrate understanding of the legislation regulating non-medical prescribing; Review the implications for their professional practice of undertaking the extended roles of independent and supplementary prescribing and practice within a framework of professional accountability and responsibility; Use diagnostic reasoning skills on the data acquired from history and health assessment to achieve appropriate diagnoses; Apply knowledge of pharmacology in prescribing appropriate drugs to achieve defined health outcomes; Prescribe safely, appropriately and cost-effectively within the administrative arrangements in operation; Evaluate and document the effectiveness of drug therapy; Empower patients/clients through education for safe and effective self-management of drug therapy with recognition of their right to make their own decisions; Collaborate with others in the health care team in prescribing, supplying and administering medications; Utilize up-to-date information from a range of sources in decision-making about prescribing. Demonstrate theoretical knowledge relating to all aspects of nurse prescribing, including the genesis and development of non-medical prescribing in the United Kingdom; Comprehend and apply their existing and new knowledge of pharmaco-therapeutics, health assessment to the practice of nurse prescribing; Develop the academic skills to assimilate, synthesize and evaluate information at an appropriate level for each student and the elected level of study; Exercise sound judgement in the decision making processes that are central to safe nurse prescribing practice.

2 11 MAIN LEARNING OUTCOMES ADVANCED CERTIFICATE IN NURSE INDEPENDENT/ SUPPLEMENTARY PRESCRIBING The Learning Outcomes presented in this section integrate Subject Related Qualities, Intellectual Qualities, Professional/Practical Skills and Key/Transferable Skills. The course provides for students to achieve and demonstrate the following learning: 11K KNOWLEDGE AND UNDERSTANDING OF SUBJECT K1 Demonstrate a critical knowledge of the theoretical basis of nurse prescribing K2 Critically consider the historical foundations and evolution of non-medical prescribing K3 Demonstrate an appreciation of the goals of professional and monitoring bodies and how they govern public protection in prescribing, regionally and nationally K4 Demonstrate knowledge and critical understanding of research, theory and practice in relation to prescribing practice K5 Be able to articulate the links between theory and evidence-based practice Teaching and learning methods: Formal lectures, guest lectures (e.g. prescribing advisors, CSA representatives), seminars, practical workshops, case studies, topic centered guided reading, Assessment methods: seminars / workshops, tutorials, practical work, unseen written examinations, multiple choice questions examinations, short answer questions, numeracy testing, reflections, competency workbook completion 11I INTELLECTUAL QUALITIES I1 Safely apply the current relevant legislation to the practice of nurse/midwife prescribing I2 Critically reflect upon their knowledge of drug actions in prescribing practice I3 Prescribe safely, appropriately and cost effectively I4 Debate the dilemmas arising in decision-making for prescribing Teaching and learning methods: Formal lectures, seminars, practical workshops, case studies, independent study, Assessment methods: Unseen written on-line examinations, multiple choice questions examinations, short answer questions, assignments, and clinical workbook completion (with reflections on practice). 11P P1 P2 PROFESSIONAL/PRACTICAL SKILLS Practice within a framework of professional accountability and responsibility Undertake a thorough history, including medication history and current medication (including over-the-counter, alternative and complementary health therapies) to inform diagnosis

3 P3 P4 P5 Assess and consult with patient/clients, clients, parents and carers Understand the influences that can affect prescribing practice, and demonstrate understanding by managing prescribing practice in an ethical way Develop a clinical management plan within legislative requirements (supplementary prescribing only) Teaching and Learning methods: Formal lectures, Discussions and debate, independent study Assessment methods: Written assignments, examinations, reflections, clinical workbook completion (with reflections on practice).

4 11T TRANSFERABLE SKILLS T1 Critically appraise, use sources of information/advice and decision support systems in prescribing practice T2 Demonstrate an understanding of the roles and relationships of others involved in prescribing, supplying and administering medicines Teaching and learning methods: Formal lectures, guest lectures (e.g. prescribing advisors, CSA representatives), seminars, practical workshops, case studies, topic centered guided reading. Assessment methods: seminars / workshops, tutorials, practical work, unseen written examinations, multiple choice questions examinations, short answer questions, numeracy testing, reflections, clinical workbook completion Undergraduate programme learning outcome map Please note: The matrix displays only the measurable programme outcomes and where these are developed and assessed within the modules offered in the programme Modules K1 K2 K3 K4 K5 I1 I2 I I4 P1 P2 P P T1 T Prescribing in Practice x x x x x x x x x x x x x x Pharmacotherapeutics in Prescribing x x x x x Applied Health Assessment for Prescribing x x x x x x x x x MAIN LEARNING OUTCOMES POSTGRADUATE CERTIFICATE IN NURSE INDEPENDENT/ SUPPLEMENTARY PRESCRIBING The learning Outcomes presented in this section integrate Subject Related Qualities, Intellectual Qualities, Professional/Practical Skills and Key/Transferable Skills. The course provides for students to achieve and demonstrate the following learning: 11K KNOWLEDGE AND UNDERSTANDING OF SUBJECT K1 Critically review the theoretical basis of nurse prescribing K2 Critically consider the historical foundations and evolution of non-medical prescribing K3 Evaluate the goals of professional and monitoring bodies and how they govern public protection in prescribing, regionally and nationally K4 Appraise the available knowledge and critical understanding of research, theory and practice in relation to prescribing practice K5 Be able to articulate the links between theory and evidence-based practice Teaching and learning methods: Formal lectures, guest lectures (e.g. prescribing advisors, CSA representatives), seminars, practical workshops, case studies, topic centered guided reading, Assessment methods: seminars / workshops, tutorials, practical work, unseen written examinations, multiple choice questions examinations, short answer questions, numeracy testing, reflections, competency workbook completion

5

6 11I INTELLECTUAL QUALITIES I1 Safely apply the current relevant legislation to the practice of nurse/midwife prescribing I2 Critically reflect upon their knowledge of drug actions in prescribing practice I3 Prescribe safely, appropriately and cost effectively I4 Effectively debate the dilemmas arising in decision-making for prescribing Teaching and Learning methods: Formal lectures, seminars, practical workshops, case studies, independent study, Assessment methods: Unseen written on-line examinations, multiple choice questions examinations, short answer questions, assignments, and competency workbook completion 11P PROFESSIONAL/PRACTICAL SKILLS P1 Practice within a framework of professional accountability and responsibility P2 Undertake a thorough history, including medication history and current medication (including over-the-counter, alternative and complementary health therapies) to inform diagnosis P3 Assess and consult with patient/clients, clients, parents and carers P4 Demonstrate the ability to discriminate and evaluate the influences that can affect prescribing practice, and demonstrate understanding by managing prescribing practice in an ethical way P5 Develop a clinical management plan within legislative requirements (supplementary prescribing only) Teaching and Learning Methods: Formal lectures, Discussions and debate, independent study Assessment methods: Written assignments, reflections, clinical workbook completion 11T TRANSFERABLE SKILLS T1 Critically appraise, use sources of information/advice and decision support systems in prescribing practice T2 Demonstrate a critical appreciation of the roles and relationships of others involved in prescribing, supplying and administering medicines Teaching and learning methods: Formal lectures, guest lectures (e.g. prescribing advisors, CSA representatives), seminars, practical workshops, case studies, topic centered guided reading, Assessment methods: seminars / workshops, tutorials, practical work, unseen written examinations, multiple choice questions examinations, short answer questions, numeric testing, reflections, clinical workbook completion Postgraduate programme learning outcome map Please note: The matrix displays only the measurable programme outcomes and where these are developed and assessed within the modules offered in the programme Modules Prescribing in Practice Pharmacotherape utics in K 1 K 2 K 3 K 4 K 5 I 1 I 2 I 3 I 4 P 1 P 2 P 3 P 4 T 1 T 2 x x x x x x x x x x x x x x x x x x x

7 Prescribing Applied Health Assessment for Prescribing x x x x x x x x x 12 STRUCTURE AND REQUIREMENTS FOR THE AWARD The duration of this course was originally intended to be 6 months. It was extended to one academic year after the first cohort completed in Autumn The course is offered only as a part time option with students expected to devote 12 practice days (or equivalent) to develop their prescribing skills. The structure enables undergraduate students to exit with an Advanced Certificate in Independent and Supplementary Prescribing, and post-graduate students to exit with a Post-Graduate Certificate in Independent and Supplementary Prescribing. The course consists of 2 modules of study (except for those students doing health assessment who will undertake 3 modules of study) taken over the academic year in a web dependent learning design which incorporates e-learning and face to face contact with lecturers. The course design is compatible with the Credit Accumulation and Transfer System so that students will earn 40/ 60 credits at either level 3 or level M, depending upon entry status. It was anticipated when this course was conceived that students could elect to either exit with the award of Advanced Certificate/Post Graduate Certificate in Independent and Supplementary Prescribing or carry credits forward into further study should they so wish. STRUCTURE AND CONTENT OF PROGRAMME INTRODUCTION (The module and related competencies in Applied Health Assessment for Prescribing are detailed separately to meet NMC requirements for professional award, as considered below). It has been agreed that, to provide adequate time for students to achieve the necessary level of knowledge and competence to ensure public safety, the course will last a maximum period of one academic year part-time (including practice placement days). This will consist of a minimum of eight face-to face taught days, excluding assessment. In addition students must be given 10 days protected learning time and a minimum of 12 days practice placement. (The remaining 8 days will be divided between self-directed learning, face-to-face learning days and assessment). During this time students will develop their knowledge and competencies in relation to nurse prescribing through theoretical learning and clinical experience. Time commitment and allocation Prescribing in Practice Pharmacology for Prescribing Contact time Plus 12 days practice minimum COURSE STRUCTURE E learning Total time Student effort 24 hours 12 hours 36 hours 144 hours Additional protected time 24 hours 12 hours 36 hours 144 hours N=10 days* The academic course consists of three 20 credit modules of study: 1. Prescribing in Practice. 2. Pharmacotherapeutics in Prescribing.

8 3. Applied Health Assessment for Prescribing The modular structure of the undergraduate programme: Figure 1. Module Title Credit level Credit points Module status Prescribing in Practice 3 20 Compulsory Pharmacotherapeutics 3 20 Compulsory in Prescribing Applied Health 3 20 Available for Assessment for those who Prescribing require it On successful completion Academic Professional achievement award Short course V300 (+ 2 modules above=certificate) Academic Award after completion of all three modules is the Advanced Certificate in Nurse Independent/ Supplementary Prescribing V300 The modular structure of the postgraduate programme: Figure 2. Module Title Credit level Credit points Module status Prescribing in Practice M 20 Compulsory Pharmacotherapeutics M 20 Compulsory in Prescribing Applied Health M 20 Available Assessment for for those Prescribing who require On successful completion Academic Professional achievement award Short course V300 (+ 2 modules above=post graduate Certificate) V300 it Academic Award after completion of all three modules is the Postgraduate Certificate in Nurse Independent/ Supplementary Prescribing Students also complete the equivalent of 12 days clinical experience under the supervision of a Designated Medical Practitioner (hereafter referred to as DMP). Students will be required to achieve all the clinical competencies applicable to their level of study. Theoretical modules may be studied at level 3 (pass mark 40%) or level M (pass mark 50%) depending on the students previous qualifications. In order to study the programme at level M, the student is expected to already hold a degree. Graduates may also elect to complete the programme at Level 3. It is anticipated that arrangements for updating recorded Nurse Prescribers will be facilitated through employers and in-service consortia. 13 SUPPORT FOR STUDENTS AND THEIR LEARNING Induction process The course committee is expected to put in place, in accordance within University and Faculty policies, arrangements for student support and guidance, in particular student induction studies advice and access to staff

9 student consultation In addition, in those programmes within Nursing which include placement, students also have: support provided by their link lecturer support to deal with any technical problems through Campus One. Guidelines on Student Induction were endorsed by the Teaching and Learning Committee of the University in May The following expectations in relation to induction of students in general exist: Student expectations of the campus and the course on which they enter should be accurate. Visiting teachers, careers advisors and family members are important clients of the University and should receive accurate and relevant information about the institution. Induction activities should familiarise students with the campus and its support services. Induction activities should clarify students academic obligations and the obligations of the staff to the students Induction activities should support the development of those independent study habits suitable for Higher Education. Induction events should, where possible, provide the foundations for social interactions between students Induction activities should promote the development of good communication between staff and students Induction processes should provide students with opportunities to learn about the characteristics of a healthy life-style. The University issues all students with a University Handbook and Course Directors are made aware of the range of Central Support resources available to contribute to induction and to which students may be referred. These include: Accommodation Service: Careers Service: Counselling and Guidance Services: Disability Awareness: Induction ensures that students receive and understand how to use the resources available for learning. Induction to Post-Registration Nursing Programmes The main induction for these students will be provided by the team and beginning in Registration week and continuing throughout the first semester. General information about the University and the resources available is provided. Information Services Information about programme Study Skills The Course Director

10 The Course Director is responsible to the Board of the Faculty for the organization and management of the course. In particular the Course Director: oversees the selection of suitable applicants in accordance with the University's admission policy, the allocation of link lecturers who also act as studies advisors to students, ensuring consistency and continuity of student support. This is also facilitated by making arrangements for student induction programmes, including the preparation and distribution of course handbooks and other material to students; ensuring that students are adequately informed of both general health and safety matters and those specific to their course of study and for communicating relevant information to them. In addition the course director manages general aspects of student progress. Adviser of Studies Advisers of Studies: All students are appointed with a lecturer who acts as studies adviser, and links with the practice placement, visiting students a minimum of once and more as required. Personal Development Planning Students on this programme are required to maintain a competency workbook, although staff are keenly aware of professional development planning and its utility for students. Career Development Centre The career development centre and its services are available for all students. Almost all of the (mature) students on this programme are in established careers in nursing. Information Services Department New students are strongly encouraged to participate in a series of inductions at the beginning of the academic year. The initial sessions are offered jointly by IT User Services and the Library and will introduce new students to the services offered by both divisions of Information Services. It is important that new students attend the induction sessions since this facilitates access to the PCs in the University of Ulster and hence Web access to all web-based services and resources in the University, including all Library and IT services and resources. I.T. User Services: Web-based training materials cover areas such as file management, Internet, presentations, , word-processing and spreadsheets. Training sessions are flexible and can be tailored to suit the specific requirements of a course. Schools are now being encouraged to facilitate their students in development of IT skills before commencing the programme. Those undertaking Access or Bridging Courses also cover IT skills within their programme. However, anyone commencing these programmes will be provided with support to achieve competence in these essential skills. Student Support Department Students can avail of student services for advice on health, counselling and guidance, careers and all other aspects of welfare whilst enrolled on the programme Sport and Recreation Department Every aspect of sport and recreation is open to students on this programme. They are encouraged and reminded of the value of physical exercise for their physical and mental health.

11 International Office The international office is an active element of University life for any international student and would be used as a vital resource in the event of international students entering this programme. Students Union The University is proud of the tradition of the service to students provided through the Student s Union. This offers a wide range of services and support. Chaplaincy Service Pastoral care for students of all denominations is provided by the chaplaincy service. Student s with no religious affiliation are also welcomed into the chaplaincy activities. 14 CRITERIA FOR ADMISSION ADMISSION CRITERIA The aim in selection of students to undertake the programme is to identify those who will successfully complete the course, demonstrate the necessary competencies, and be able to carry out the role of a nurse independent supplementary prescriber within her/his normal work. The following admission criteria have been stipulated by the NMC (Directly from Standard 1.1 Standards for admission to programmes to be awarded a qualification to prescribe, (2006) as follows: Nurse prescriber candidates must be a registered first level nurse, midwife and/or specialist community public health nurse (and therefore already meet NMC standards for good health and good character). Nurse prescriber candidates must have at least three years full time experience (or equivalent) as a practicing nurse, midwife or specialist nurse and be deemed suitable by the employer to undertake the programme. Of these three years, the year immediately preceding application to the programme must have been in the clinical field in which the intention is to prescribe, e.g. neonates, mental health. Part-time workers must have practiced for a sufficient period to be deemed competent by their employer. A clinical need for prescribing exists within the registrant s role to justify becoming a nurse prescriber. The applicant has sufficient knowledge to apply prescribing principles taught on the programme of preparation to their own area and field of practice The applicant must be able to demonstrate appropriate numeracy skills (to be further developed within the context of prescribing and assessed on the course). NMC advises that employers should not put registrants forward if they haven t demonstrated the ability to diagnose in their area of specialty. (It is suggested that continuing professional development (CPD) reviews within the workplace might act as the vehicle for identifying such skills). Nurses must be assessed by their employers as being competent to take a history, undertake a clinical assessment and make a diagnosis. For example, they must be able to carry out a comprehensive assessment of the patient s physiological and/or

12 psychological condition, and understand the underlying pathology and the appropriate medicines regime. It is: - The combination of expertise in the condition being treated - Appreciation of the patient s particular manifestation of it and - The medicines which will be effective; that make a proficient and competent prescriber. Employers must provide the higher education institution with evidence of a clean criminal records check on candidates conducted within the three years prior to admission Candidates must provide evidence via the Accreditation of Prior and Experiential Learning (APEL) process of the ability to study at minimum academic level three (degree). This may be demonstrated through any of the following: Undergraduate level Successful completion of the equivalent of three modules (60 credits) of study at level 2 in the subject area of Life Sciences. This will include evidence of the skills necessary for the implementation of evidence-based practice*. [This requirement of 60 credits at level 2 could be met through the Preparation for Specialist Practice Programme offered by the In-Service Education Consortia, an Advanced Diploma, a Diploma in Higher Education, or a number of individual modules including the use of APEL.] Postgraduate level Pre-registration degree in Nursing or Midwifery Post-registration degree in Nursing, Midwifery or Health Studies/Sciences Degree in other relevant subject area In addition, candidates will need to have written confirmation from: 1. His or her employer of their support for the student to undertake the preparation programme. 2. A DMP who meets eligibility criteria for medical supervision of nurse prescribers and who has agreed to provide the required term of supervised practice. 3. The programme lead (Course Director) about the candidate s selection onto the preparation of prescribers education programme. This will be given to the candidate and the employer via the usual faculty mechanisms. CATS and APEL Anticipated CATS The University of Ulster has accepted procedures for dealing with Credit Accumulation and Transfer, and Accreditation of Prior Learning with the School of Nursing has a CATS Committee to deal with applications in relation to any specific programme. 15 EVALUATING AND IMPROVING THE QUALITY AND STANDARD OF TEACHING AND LEARNING Views of students as expressed through staff/student consultation [and the University student

13 questionnaire on teaching and other questionnaires] Views of graduates in the National Student Survey Views of employers Views of external examiners Student performance data and career progression University processes for initial approval, periodic re-approval and annual monitoring. Professional Body (Nursing and Midwifery Council) accreditation 16 REGULATION OF STANDARDS Advanced Certificate The following shall be the minimum percentages acceptable in determining the overall gradings of candidates. Pass with Commendation 60% Pass 40% The Board of Examiners shall recommend the award of a Pass with Commendation to a candidate who achieves an overall mark of at least 60%, provided that a module mark of at least 60% has been achieved in modules amounting to 30 credit points. Postgraduate Certificate The following shall be the minimum percentages acceptable in determining the overall grading of candidates. Pass with Distinction 70% Pass 50% The Board of Examiners shall recommend the award of a Pass with Distinction to a candidate who achieves an overall mark of at least 70%, provided that a module mark of at least 70% has been achieved in modules amounting to 30 credit points External Examiner The External Examiner system is a key aspect of the quality assurance mechanisms of UK Universities and all courses offered or franchised by the University have specified external examiner(s) working within the University Code of Practice. External Examiners are academic subject or professional experts appointed from outside the university. It is their duty to moderate the examination papers for each module, to consider student answer scripts and other assessed material, to attend Board of Examiners meetings and to consider administrative and other arrangements as well as issues of student progress. Their reports are an essential element in the maintenance of standards and receive consideration at various university committees (including the course Committee and the process of Annual Subject Review). The same external examiner has traditionally acted for both UU and QUB; it is anticipated that this arrangement will continue. 17 INDICATORS OF QUALITY RELATING TO LEARNING AND TEACHING

14 The small team responsible for delivering the course includes a member of staff with professional qualifications in ISP. The present programme builds on the experience of delivering the programme since April 2003 and largely comprises the same staff. The School of Nursing achieved a grade of 23 (the level of excellence) in the most recent QAA evaluation of provision. All lecturers are encouraged to avail of professional development opportunities, endorsed at Head of School level, and as indicated from Page 50 forward, these opportunities are enthusiastically taken.

15 B2 COMMENTARY ON COURSE DELIVERY B2.1 Revalidation-Changes to Existing Provision Lessons gained from delivery of the first validated programme are incorporated as far as possible into the revalidated document. These include: 1. Retaining the student seminar and associated assignment in the module Prescribing in Practice. Students and staff engaged in this exercise found this to be a very valuable learning tool and so the curriculum planning team decided to attempt to keep this element, despite the challenges imposed by the introduction of other assessment elements. 2. The pre-existing multiple-choice examinations in the module Pharmacotherapeutics for Prescribing are retained as a formative means for students to check on their progress. 3. Pass rates on this programme at both level 3 and level M reflect the successful studies advice governing students decisions in respect of their chosen level of study. This also endorses the need to continue to offer the programme at both levels. 1. It is pertinent at this point to explain the rationale behind the two level anomalies as many other faculties in higher education may view it. In addition to the statement above, each of the modules are offered at levels 3 and M because: A) Nurses are the only professional group studying for an additional professional award that may enter academic study without already possessing a degree. Other allied health professionals such as physiotherapists and occupational health colleagues have generally already studied to degree level. B) Possession of a degree does not automatically mean that students coming onto the NISP programme are enrolled onto the postgraduate level. All students are enrolled on level 3 to begin with, and after informed discussion and studies advice, those who are eligible and want to do level M studies, may then transfer onto level M. C) Module descriptors with learning verbs designed to reflect the level of study, word limits and different pass marks are only an example of the differentiation of study levels. Past experience shows that pass rates and marks within levels 3 and M provide evidence of discrimination (as published in the University of Ulster Annual Course Reviews for the Independent and Supplementary Prescribing programme). D) Many of our students are senior, experienced practitioners who may not have undertaken recent study, and so the dynamics of study groups at different levels in learning exercises, proves to be valuable in the fusion of experiential and knowledge based learning. E) The external examiner reports from Ms Jane Harris consistently refer to the quality output of students at the two levels of study. In her latest report for the academic year 2005/6 there were no issues of concern raised for the course committee to address. B2.2 Progression, Coherence and Choice To achieve the professional award the programme involves two compulsory taught modules, Prescribing in Practice and Pharmacotherapeutics in Prescribing, each worth 20 credits. The course has high internal coherence and within permissible academic regulations, allows for academic progression (see page 35). During Semester 1 students embark on both

16 modules. The design of these modules and their delivery together is based on NMC guidelines and good academic practice that subscribes to the marriage of education and practice. This requires attention to the empirical basis for all aspects of prescribing in professional areas. The module Prescribing in Practice will include coverage of the basic principles involved In dealings with clients, the fundamental importance of evidence based practice, the relationship between nursing and cognate professions, and ethical relationships between nursing and allied health professional to execute safe effective prescribing. The module Pharmocotherapeutics in Prescribing builds upon students existing knowledge base of pharmacology and its application to prescribing within the context of safe patient care. Students will be permitted the opportunity to study in-depth the actions interactions and side effects of drugs within their scope of professional practice. The module Applied Health Assessment for Prescribing is designed to facilitate a high level of skills in physical examination and reasoning. All modules are compulsory within the course structure. B2.3/4 Transfer to and from Other Programmes of Study The course committee for subsequent programmes of study is responsible for decisions regarding movement to linked programmes. As stated (please see Student Choice in Regulations) efforts are made as far as possible to give students prospects to link into future study at UU. The nature of the content and practice objectives directs the design of the programme, as governed by NMC guidance (2006), although NMC recognises that where need is identified, the higher education institution may wish to provide specialist practice modules alongside the NISP programme. Two distinct packages have been devised to give students good leaving prospects. The academic package is specifically designed to give students the opportunity to gain a certificate/ postgraduate certificate with the additional 20 credits achievable by successful completion of the appropriate module Applied Health Assessment for Prescribing. The professional award only programme consists of 40 credit points and can be used towards a relevant academic award at the discretion of the Course Committee of that awarding programme B2.5 Professional Statutory and Regulatory Bodies Relationships with nursing regulatory bodies already exist at all levels of nursing study where professional accreditation is required. The University of Ulster has a tradition of working closely with agents of NMC (formerly NIPEC, since 1 st April, 2007, HLSP) in continued efforts to maintain and enhance the quality of educational provision for nurse prescribing practice. It is anticipated that this relationship will strengthen in future. (Please see Section A3 above Internal/external review. As is evidenced throughout this document the professional and statutory bodies have made extensive recommendations in the interests of public safety. These recommendations have been tightly adhered to in attempting to bring both a professional and academic package that appeals to students and employers). B2.6 Employability All students entering this programme must be in current employment in a role where nurse prescribing is a relevant aspect of their work. The competency workbook provides clear evidence of work-based learning through the composition of learning contracts and sign off procedures. B2.7 Teaching, Learning and Assessment Strategies PRINCIPLES Introduction

17 The strategies from which students are expected to develop the knowledge, understanding and skills appropriate to the course are: Utilising the E learning platform on a regular basis and participating in on-line discussions, case studies and where appropriate multiple choice examinations Listening and note taking in lectures; Private study, initially guided by recommended reading; Preparation and presentation of assignments using a range of media; Design, execution and analysis of a range of methods of enquiry; Observation monitoring and participation in professional/clinical practice; Exploration, acquisition and analysis of data; Taking responsibility for gaining appropriate advice and guidance from relevant sources; Articulating the relevance of their learning for their own personal development. The following fundamental principles have been agreed in relation to preparation of nurses for an independent/supplementary prescribing role. 1. The link between theory and practice must be paramount. 2. There will be a strong focus on development of clinical competence. 3. The educational programme must impart a sound body of knowledge on basic pharmacology as related to diagnosis and treatment of disease (therapeutics). 4. The programme will build on previous knowledge and experience of professional issues and how they relate to nurse prescribing 5. The programme should prepare students for contemporary and future prescribing activity 6. The programme must have a strong focus on risk assessment including safe prescribing practice and the application of risk assessment and decision-making models Access is facilitated through using a web dependent learning approach to present part of the theoretical content. A variety of teaching methods and learning environments are utilised to provide students with the best opportunities to study to develop of skills and expertise, produce coursework and prepare for examination. Assessment strategies are closely mapped to the aims and objectives of individual modules, but similar types of assignment are assessed and given feedback by standard methods, to promote consistency across modules, and to meet NMC requirements. The various methods of teaching include those listed below. E-learning: A proportion of the learning materials for this web dependent programme are available on-line as indicated. Students will be provided with the necessary guidance to use this approach effectively in the induction days of the course. They will have ample time to log-on to the programme and explore the tools available for the different modules with support and supervision from technical and academic staff. Students will be issued with the necessary ID and passwords to enter the site and informed about access to technical support. The staff involved are also receiving adequate training and support in using this method of teaching. The University of Ulster, has moved to a new E learning platform recently; WebCT Vista. On entering the site students will be provided with information about the course as a whole, offered by the designated E learning tutor and the course team. They will then be able to select a module; the amount and type of material available on line for each module will vary. Support for students until they gain confidence in this learning medium will be ongoing. Students are also encouraged to attend basic IT skills training via their employer prior to coming onto the programme. Students will be given the opportunity to engage in formative on-line class tests and case study examinations.

18 Lectures are widely used to engage students. They can facilitate learning through creating enthusiasm for the subject, and communicating knowledge coherently in the presentation of material. Bearing in mind the profile of nurse prescribing students (i.e. mature experienced practitioners who may have been away from study for a considerable period of time, often working in demanding jobs, with family responsibilities and keen to succeed); the blended learning approach challenges them to learn independently and manage their time. For the above reasons the distance learning aspects are used alongside face-to-face learning. This also orientates students towards the core learning resources available at UU. Seminars will be arranged in most modules. We anticipate that the group size of around 35 allows seminars and group work to operate within that especially effectively. Most will be student-led in the sense that they take the form of student presentations relating to the curriculum for group discussion. Seminars are valuable in promoting students presentational skills and their ability to articulate arguments. Students have in the past found these activities a valuable aspect of learning. Students will be encouraged to set up peer study groups, and to support each other in their learning. Again this has happened to great effect, particularly as students may also coincidentally operate as professionals in close clinical contact. The learning resource centre has bookable rooms for student study which students are permitted to book for periods of time. Assessments will be used that are suited to the course objectives. Those employed include the following: Essays: these provide for the written development of the skills of clear articulation and argument. This can happen as a formative assessment for giving students confidence in their growing skills Unseen written synoptic examination: Written papers assess not only fundamental aspects of knowledge but the student s ability to write and articulate arguments, a key transferable skill. A synoptic examination is now a professional requirement for the NMC Case studies: Students will study and evaluate case studies in both modules, and will also formulate their own case studies. They will be formative in the sense that feedback is given. Many skills that are important to professional prescribing, such as identification of issues, discrimination of evidence, selection of products and adherence to ethical codes of practice, are developed in this undertaking. The elements of assessed coursework are defined at the outset and are included in the module schedules given to students at the start of the programme. Students can expect as a matter of good practice to receive feedback and provisional marks three weeks after submission of coursework. Multiple choice question examinations: On line examination feedback is available, immediately for practice tests. OSCE The Objective Structured Clinical Examination (OSCE) is an examination that focuses on outcomes that contribute to clinical competence. The student s practice is assessed in a number of simulated clinicalscenarios. It is important to note that OSCE s are conducted within the students own sphere of practice. Competency workbook: The Competency Workbook, which is maintained by students throughout the programme including their time on placement, provides students with the opportunity to demonstrate the acquisition of NMC competencies and skills. The Designated Medical Practitioner is ultimately responsible for assessing whether a student has achieved the NMC competencies. Students are guided in the use of the competency workbook to drive and tailor their learning experiences and to meet any deficits in expertise through the use of learning contracts. The competency workbook maps the students journey from novice to baseline competent prescribers. The skills needed to use the competency workbook are re-

19 visited at regular intervals with students, in class and during practice visits. Reflections on practice from beginning at mid-point and towards the completion of studies will provide invaluable material for students to mark their journey through this programme. The reflective diary, which is a formal part of the competency workbook, is submitted at the end of the placement period. Assessment rules Modules are assessed by coursework and examination. All modules contribute to the final award. Internal Moderation All University examination scripts are anonymous. The nature of on line learning and examination however requires that student identity be matched to examination work via the use of passwords. The accuracy and consistency of marking both examination scripts and other assessed materials is monitored internally by the practice of staff whose role is to moderate marks for that module (the sample comprises a range of abilities and includes all firsts and all fails). In order to ensure consistency in marking across modules, standard assessment criteria have been developed for coursework, together with standardised feedback sheets. Designated Medical Practitioners: The DMP participates from the outset and to the end of the programme in assisting students to meet their learning objectives, including the task of taking responsibility for signing off the successful student at the end of their course of study. TEACHING AND LEARNING Methods of Learning Students will be expected to take responsibility for their own learning, with the support of academic staff and DMP. Teaching methods have been selected which will: Facilitate acquisition of the knowledge required for safe practice Require application of theory to practice Enhance access to the programme by a strong focus on blended learning methods. Placement Placement is organised by the student in negotiation with the employer and DMP, and in consultation with the higher education institution. In most cases placement will be confined to the student s place of employment. In cases where students cannot gain the skills required in their place of work the main objective will be to seek the experiences within another suitable environment. (One example of where this has been effective was for two prescribing students working within the prison service, who in order to expand opportunities for learning, designed learning contracts and utilised visits to a local GP surgery, to gain the required experience). Placement is central to the development of the safe prescriber and the educational input and support of the DMP is crucial to the development of the necessary competencies. Clinical placement of 12 days which equates to 12x7.5 hour (6.5 hours excluding breaks) days, is a compulsory part of this programme during which students develop their clinical skills under the supervision of a DMP to be able to undertake their new role safely. During their clinical experience students are expected to:

20 1. Apply the theoretical knowledge acquired in assessment, diagnosis, treatment and care of patients; 2. Demonstrate clinical skills of assessment, diagnosis, and appropriate referrals and the ability to document these in a clear, concise manner using the appropriate documentation; 3. Develop efficacious and cost-effective pharmacotherapeutic regimes for patients across the life span relevant to their own area of practice; 4. Use their professional skills in providing appropriate education and empowering patients to make appropriate choices about treatment; 5. Monitor and evaluate the efficacy of prescribed regimes and amend as necessary; 6. Recognise and deal appropriately with ethical and professional issues that arise; 7. Collaborate with members of the multidisciplinary team involved in the management of prescribing, dispensing and monitoring care; 8. Become comfortable and proficient in their new role as an independent and/or supplementary prescriber; 9. Practice should include all aspects of medicines management. Time should be spent with a range of non-medical prescribers, dispensing pharmacists and pharmacy technicians, as well as medical prescribers where possible. Prescribing In Clinical Practice This experience runs for the duration of the programme. Initially students will observe and then practice, under the close supervision of the DMP, the complete process of consultation, establishing options and prescribing effectively within context. As the student becomes more experienced, the DMP will gradually withdraw from close observation but findings and decisions will continue to be discussed with the DMP who will monitor the student s progress. During this clinical experience, the DMP will assess progress in the different aspects of the competencies shown in the Competency Workbook. The Placement Environment The placement setting will be the workplace for each student. The suitability of each setting as a learning environment will be audited using the general audit procedures of the University of Ulster (and shared with Queen s University, Belfast). Additional information will be obtained on a specific NISP form (Appendix 9). In the course of the audit visit consideration will include the suitability of the learning resources, and breadth and relevance of the learning experiences available. Proposed DMPs will be expected to sign a declaration of eligibility prior to a student being accepted onto the programme. Monitoring Of Placement The suitability of the placement will be verified in the form of a written statement prior to the student coming on the programme by the employer to the Higher Education Institution. At the end of the programme, students will be asked to complete an evaluation form which will include evaluation of the placement experience, including the mentoring provided. Academic Support for Students and DMPs In accordance with the expectations of Standard 7 (NMC, 2006, p16), the course director holds an NMC recorded teaching qualification. In addition the pharmaco-therapeutics module

21 co-ordinator(s) possess higher qualifications which address pharmacology and one member of the university team is a V300 qualified nurse prescriber with relevant field experience. The module co-ordinator for Prescribing in Practice is also a midwife responsible for education, acting closely with a professor of midwifery at the University of Ulster. To date the collaboration between both Higher Education Institutions as regards the division of commissioned students has utilised all available expertise. In any event there exists a body of teaching staff at the university capable of resourcing the necessary support for students. Each student will be allocated a personal tutor (NMC terminology) known at UU as a link lecturer. This university lecturer will be the liaison point for the DMP and student and will be responsible for checking that the necessary Educational Audit is undertaken and that DMP preparation is offered. A visit to the placement setting will be undertaken on one occasion during the programme. Students or the DMP may also request a visit or identify an issue requiring resolution in a face-to-face meeting. The Competency workbook will also be reviewed with students. Assessment Strategies The assessment strategy developed has to measure students knowledge and understanding of the content of the programme, but of equal importance is the ability to apply these within practice, (NMC Standards of Proficiency for Nurse and Midwife Prescribers, 2006, Appendix 12). Assessment methods must examine the acquisition of theoretical knowledge and its application in practice, and the development of the clinical skills necessary for safe and costeffective practice as a nurse prescriber. Academic Assessment A variation of assessment methods, reflecting the differing demands at level 3 and level M, will be used in the different components of this programme and are discussed in more detail in the module outlines. Postgraduate module assessment requires students to demonstrate a higher level of the intellectual skills of analysis, synthesis, and evaluation than those at undergraduate level (NMC guidance on assessment of nurse prescribing students is contained in Appendix 12). Map of Assessment (Curriculum Planning team incorporated diet of assessment from NMC guidelines: Appendix 12) Elements of programme Coursework Final synoptic examination Module: Prescribing in Practice Seminar presentation & paper OSCE s applied to prescribing Numeracy exam (100%) Weighting 100% 0% Must achieve 40/50% Pass Module: Pharmacotherapeutics inprescribing Assignment 20 short answer & multiple choice questions (80% Pass mark) Weighting 60 (L3) 80% (LM) 40 (L3) 20%(LM) Must achieve 40/50% Pass Practice placement Satisfactory completion of placement; competency workbook with sign off by DMP If a registrant fails to answer correctly any question that may result in direct harm to a patient/client they must be referred (failed) (Directly extracted from NMC, 2006)