BA (Hons) Midwifery Practice Programme

Transcription

1 BA (Hons) Midwifery Practice Programme Mentor Preparation Handbook 2017/2018

2 CONTENTS Aims of the Sign-off Mentor Preparation 3 Equality and Diversity 3 Programme Philosophy 4 Programme Structure and Content 5 UNICEF UK Baby Friendly Initiative 6 Overview of the Programme 7 Clinical Practice 8 Roles and Responsibilities 11 Electronic Ongoing Achievement Record (EOAR) found in PebblePad 14 How to use PebblePad 15 Responsibilities 21 Contract Interviews 23 Intermediate Interview 23 Final Interview 24 Record of Experience & Feedback 26 Stage One Process for Grading and Assessing Practice 27 Stage Two Process for Grading and Assessing Practice 28 Stage Three Process for Grading and Assessing Practice 29 Changes to Midwifery Supervision 30 Guidance for Student Midwives when Caring for a Friend, Relative or Colleague 32 Local Register of Sign-off Mentors 33 Mentor Updates, Mentor Preparation and E-Portfolio Sessions 34 References 35 Appendix 1 Summary of Key Focus of the Midwifery Competency 36 Appendix 2 Practical and Clinical Training Requirements Definition 38 Appendix 3 Example of EU (mandatory) and Non-EU Practical and Clinical Training 40 Requirements Appendix 4 Contact Details 41 Appendix 5 Baby Friendly Initiative 5 Themes 43 2

3 Aims of the Sign-off Mentor Preparation As a result of attending a mentor preparation session, the sign-off mentor will: Understand the Standards to support teaching and assessment in practice (NMC 2008) Be aware of the philosophy behind the course and the clinical assessment of students; Be familiar with the programme structure and the planned academic and clinical activities; Be instructed in the correct use of the Electronic Ongoing Achievement Record (EOAR) (learning contracts, descriptors for midwifery competencies and essential skill clusters, documenting student progress), practice skills document and EC requirements; Understand the role and responsibilities of students, sign-off mentors, learning facilitators, cohort leader, module leader, personal supervisor, Link Lecturer and the Lead Midwife for Education, in relation to the assessment of students. Know who the lecturers are, their link areas, and how to contact them. Equality and Diversity The Department of Health Sciences has a Single Equality working group, which advises the management board on ways of tackling potential disadvantage and discrimination within the Department. For further information visit: Equal opportunities The Department is committed to the active pursuit of an equal opportunities policy which addresses the need and right of everyone to be treated with respect and dignity, in an environment in which a diversity of backgrounds and experiences is valued. It aims to ensure that no student should receive less favourable treatment on any grounds that are not relevant to academic ability and attainment. For further University policy information visit: Religious observance The University has developed a policy for students on Religion, Belief and Non-Belief which covers facilities and services, dress code, food requirements, prayer facilities, teaching, learning and assessment. The policy can be found at: If you wish to request time out of theory for religious observance this should be discussed with your personal supervisor and then negotiated with your module leader. Should you wish to request certain shifts or days off for religious observance, this request should be made to your mentor or appropriate person in your placement area. Requests will be considered on a case by case basis. Placement providers are not obliged to agree to student requests but will give due consideration where those requests are reasonable. 3

4 Programme Philosophy The central tenant of the curriculum is the philosophy of skilled companionship. Student midwives should aspire to the role of skilled companion (Campbell 1984), accompanying women on a journey to parenthood whilst recognising the transient nature of the relationship. In recognition of the students transition from lay person to professional, the educational philosophy reflects Carper s (1978) fundamental ways of knowing. The student s learning experience supports the process of knowledge acquisition throughout the programme recognising the influence of personal experience, values and beliefs on the development of the student s professional identity. The programme provides academic and clinical education, to equip the qualifying student with the skills to work in partnership with women and their families, and to offer safe, contemporary evidence-based practice. The role of skilled companion combines these key elements with the development of effective interpersonal skills to provide sensitive, compassionate, woman-centred care. For most women, pregnancy, birth and parenthood are normal life events through which they should be able to exercise choice and control. For some, this is a challenging time which might threaten both their own and their babies health and wellbeing. As advocates for women and the proponents of normal birth, student midwives should act in collaboration with others to ensure the safety and wellbeing of women and newborns through the provision of responsive and effective midwifery care for women with diverse needs. In order to be responsive to the evolving, complex nature of contemporary society and meeting individual need, student midwives should understand and respect the unique circumstances of each woman within her social context. As such, the midwife s role in meeting the needs of the public health agenda involves improving the health and wellbeing of women and their families, and reducing health inequalities (Marmot Review 2010). Women are central to the planning, provision and evaluation of their maternity care taking into account their diversity, hopes and expectations. The programme philosophy reflects the need for student midwives to develop their role as practitioners, partners and leaders in shaping the future of maternity services (Department of Health 2010a). To achieve this, women need access to high quality information about the services that are available to them in a form that is meaningful to them as individuals. Underpinning this process is the need for student midwives to be able to identify and appraise appropriate evidence, to keep abreast of new innovations, and maintain and develop their knowledge and clinical skills through lifelong learning. Skilled companionship facilitates the development of trusting, respectful, reciprocal relationships between midwives, women and their families. Thus the programme is designed to enable students to achieve the role of skilled companion, be eligible for professional registration as a midwife, equipped for contemporary practice and fit for academic award. 4

5 Programme Structure and Content Introduction The BA (Hons) Midwifery Practice Programme spans 156 weeks (three calendar stages) divided evenly into theory and practice-based learning. There are seven weeks of annual leave each stage, normally timetabled at Christmas, Easter and during the summer. The student will be exposed to a range of educational activities during the programme. The theoretical aspects of the programme will involve the student in formal classroom based learning, guided study activities and self-directed learning opportunities. Where appropriate, the student will engage in shared learning opportunities with student nurses, medical students and social work students. This will enable the student to consider issues from a range of professional perspectives. The student will be assigned to a Home Trust where they will receive most of their practice-based learning. The student will have the opportunity to gain further practice-based learning in an Away Trust which will offer them the opportunity to experience midwifery care provision in a different setting. Programme Learning Outcomes On successful completion of the Programme, graduates will be able to: Work as lead professionals, providing competent, evidence-based midwifery care for women and their families across the child-bearing journey from antenatal support, through birth, to post-natal provision. Apply a holistic, compassionate, woman-centred approach to midwifery care. Manage the risks associated with complex pregnancies and work within multi-disciplinary teams to deal appropriately with obstetric emergencies. Develop excellent relationships with women and their families, and with colleagues, through advanced communication and interpersonal skills that respect individual diversity. Promote the safety of women, babies, and their families by working effectively within multiprofessional health and social care teams, and as autonomous, accountable practitioner. Critically evaluate the impact of public health policies and agendas on maternity provision locally, nationally and internationally. Apply theories of leadership and change management to lead and innovate midwifery care. Reflect critically on their midwifery practice, in the context of their professional networks, to enable their ongoing professional development. 5

6 UNICEF UK Baby Friendly Initiative In May 2018 the University of York s Department of Health Sciences will hopefully be re-accredited for the internationally recognised Baby Friendly Initiative (BFI) Award for the high levels of education in breastfeeding provided to students on the undergraduate midwifery programme. The University Award recognises that as an institution it has implemented best practice in breastfeeding training and has passed an external assessment by a UNICEF, BFI panel. Previous students have achieved outstanding results during the assessment process. The BFI has reviewed the learning outcomes and in line with the changes to Trust assessments and accreditation has developed five themes that students need to learn. These can be found in Appendix 5. This means as a University we have agreed to implement and maintain the following standards: All students must be equipped with the knowledge and skills to support breastfeeding mothers. Minimum standards are set for the experience students must gain in helping mothers to position and attach their babies for breastfeeding, hand express breastmilk and avoid and overcome common breastfeeding problems. Students should be able to teach mothers how to position and attach their babies effectively for breastfeeding and how to hand express their breastmilk. Students will need to be able to answer questions on breastfeeding and lactation management correctly. Provide teaching without involvement, sponsorship or promotional materials from the artificial feeding industry. Materials provided by the artificial feeding industry (i.e. by manufacturers of infant formula, other breastmilk substitutes, bottles, teats and dummies) should not be in use in the department, except as necessary examples for teaching purposes. 6

7 Overview of the Programme At the beginning of the programme the student will study modules which will provide them with foundational knowledge and skills relevant to midwifery practice. Following a short orientation period the student will begin clinical practice in the community and later in the year they will experience hospital based clinical practice. During this later placement the student will have the opportunity to gain general medical or surgical experience. Whenever the student is in clinical practice they will be allocated a named sign-off mentor. During this year the student will focus on the development of their self-awareness and interpersonal skills to enable them to engage with women and their families. The modules studied will provide a firm foundation of human physiology and how this changes throughout pregnancy, birth and postnatally. The student will also learn a range of clinical assessment and care skills, participating in documentation and evaluation. To support their understanding, the student will be introduced to the concept of evidence based practice and how to find the appropriate evidence to inform the care they provide. Stage Two By Stage Two the student will have a good understanding of the role and responsibilities of the midwife. During this year the modules the student will study will enable them to confidently care for women and their babies when the antenatal period, birth and postnatal period are progressing normally. In the later part of the year the student will begin to study the identification and midwifery management of complications that might occur to child bearing women. During this year the student will be given the opportunity to receive practice-based learning in community and hospital settings in another maternity unit and practice-based learning in their Home Trust. During Midwifery Practice 4 the student will have the opportunity to gain experience in settings such as the Special Care Baby Unit and Antenatal Day Assessment Unit. In the Summer Vacation term a four week period has been identified as an elective placement which enables the student to negotiate obtaining midwifery experience in a setting of their choice (this might be a period abroad). Stage Three By the end of Stage Three the student should be confident and competent to practice as a midwife. During the final year they will study modules that will enhance their ability to be a skilled companion to women and their families, enable them to consolidate their midwifery knowledge and be an effective lead carer in midwifery practice. Two modules have been included in the curriculum to support the student in their final transition to qualified midwife. At the beginning of Stage Three the Emergency Management in Midwifery Practice module will develop the student s communication, leadership and management skills in relation to high-risk situations and childbirth emergencies in a variety of settings. This module emphasises the role and responsibilities of the midwife in emergency situations and encourages the student to consider the importance of working partnerships with other health professionals. The module Preparing for Professional Practice is an opportunity for students to consolidate their learning, particularly around leadership and management skills in practice commensurate with a newly qualified midwife. The student s clinical practice will be based in their Home Trust where they will have the opportunity to gain experience within hospital and community setting. The student will be allocated sign-off mentors for both the hospital and community setting at the beginning of Stage Three who will encourage them to develop a caseload during the year. 7

8 Clinical Practice The student will undertake six practice modules as a part of their midwifery programme. The Programme is fortunate in having a range of student placement opportunities within three Hospital Trusts. Each of the Trusts offers different learning environments and opportunities for student midwives. An overview of the clinical placements is given below. These three Trusts span over a large geographical area of North Yorkshire enabling students to experience midwifery practice in a variety of settings. Home Trust The student will have been allocated a home Trust which reflects their stated preference at interview. They will spend most of their clinical time within their home Trust. The time spent within the home Trust enables the student to build professional relationships with members of the multidisciplinary team and become a member of this team. Away Trust During the second year the student will have the opportunity to experience clinical practice within another maternity setting. This will enable the student to experience a different learning environment and offer them the opportunity to broaden their understanding of midwifery practice and the context of care. The sequence of clinical placements has been selected to underpin the student s theoretical progression through the programme. They will be allocated a named sign-off midwifery mentor in each placement. The mentor will be responsible for coordinating the clinical experience and be responsible for the student s clinical assessment. The student is expected to contact their named sign-off mentor prior to the commencement of their placement to agree a date, time and place to meet for their orientation to the placement and the negotiation of their learning contract. It is the student s responsibility to ensure they can travel either by private or public transport to any of the placement areas. If this is difficult on a daily basis to meet clinical commitment, they may prefer to book themselves temporary accommodation near to the placement. Whilst in clinical practice the student will be encouraged to experience different shift patterns under the supervision of an appropriately qualified member of staff. This may include early shifts (which might commence at approx 7am; late shifts which might finish approx 10pm; weekends, bank holidays and night duty. Alternative working patterns can be accommodated by negotiation with their mentor. 8

9 Elective Practice Placement At the end of Stage Two the student will have the opportunity to undertake a four week elective practice placement. It is an opportunity for them to gain experience of an alternative model of maternity care provision, either in this country or abroad. The student must arrange and self-fund this placement and are therefore advised to make plans early to ensure all details are in place for a valuable and rewarding experience. If working in an NHS setting, the student will be under the direct supervision of a named midwifery mentor, and will normally be insured to practice, however this is at the discretion of the individual placement provider. If they choose to gain experience in a private capacity or outside the country, they must not provide direct care as they are not insured to do so. However much can be gained from an observational placement and witnessing care from another perspective. The student will agree a set of personal learning outcomes for the elective with their personal supervisor and provide feedback to the student group and an invited audience of lecturers and clinical colleagues during the next academic term. The programme will comply with the University s Code of Practice on elective placements. The students will record their elective experiences within their Electronic Ongoing Achievement Record (EOAR). Case Loading In order to consolidate the student s experience and to encourage the development of the role of lead carer, the student will be encouraged to identify a case load of women during the third year of their education programme. This model of care encourages the student to build a dedicated relationship with the mother and her family. The purpose of a case load is for the student to provide total care throughout pregnancy, birth and the early postnatal period (as far as is practical). During the antenatal period the student will plan a programme of care with their women and negotiate to take time out during Midwifery Practice 5 to provide this care. During Midwifery Practice 5 the student will be encouraged to make contact with the community midwife who will mentor the student in Midwifery Practice 6. The community mentor will enable the student to approach these women in the early stages of pregnancy to be part of the caseload. The student will organise to be present for all antenatal examinations, be present at the birth if possible and undertake the postnatal care of these women. While providing care during Midwifery Practice 5 the student will provide care under the supervision of a midwife. Further women can be approached towards the end of the Midwifery Practice 5 if the community mentor feels the student has the required skills and capabilities to increase the case load. The student case load should not normally exceed five women at any one time. At the beginning of Midwifery Practice 6 the student may wish to approach one or two more women to be part of the caseload who are likely to birth before the end of their educational programme. The student should aim to provide care to the case load women under indirect supervision of the mentor during Midwifery Practice 6. This will occur once the community mentor is confident the student has the capabilities of being a lead carer. The student is encouraged to evaluate their practice through feedback from their case load women. Testimonials from women can be sought by either the student or mentor and recorded in their Case Loading Handbook. The student is encouraged to reflect on these testimonials to evaluate how and why care could be improved. 9

10 Attendance in Practice All students will ask their mentor, or the practitioner who is working with them, to authorise their attendance in practice on a daily basis via a paper timesheet that will be uploaded to their EOAR. The student will be responsible for uploading this paper timesheet to their EOAR on a monthly basis. Absence from Practice If the student is unable to attend placement, they must notify the placement area and Student & Academic Services Team preferably before the start of duty on the first day of absence. The student should record their absence and the reason for it on their timesheet. The student must inform Student & Academic Services Team when they are fit to return to practice. On return from absence the mentors must verify this period of sickness on the students timesheet. As a mentor, if you have any concerns about a student s pattern of attendance please contact the student s Link Lecturer (see Appendix 4 for contact details). Students are required to make up any time missed from practice by the end of that practice module. The Link Lecturer and mentor can support the student with an action plan to reduce any deficit of hours but a student should not work in excess of 48 hours per week. 10

11 Roles and Responsibilities Student Responsibility A student will be exposed to a variety of practice placements throughout the pre-registration programme. They are encouraged to access all learning opportunities to achieve their practice learning outcomes/needs, competencies and essential skills. At all times a student is expected to behave in a professional manner, demonstrate good communication and time management skills, adhere to dress codes/uniform policies and follow the placement providers policies and procedures. Other student responsibilities include: Prior to meeting with the sign-off mentor the student should be familiar with the practice learning outcomes, assessment requirements and identify any personal learning needs. To get an overview of the practice area the student may wish to visit the Practice Placement Profile (if appropriate). Working in partnership with the sign-off mentor to identify the optimum learning opportunities, completing practice documentation. Completion of self-assessment and reflection sections of the EOAR. A willingness and commitment to participate in a range of learning opportunities. Maintaining comprehensive records of attendance, EU requirements, learning needs, feedback / evaluation. Bringing to the attention of the sign-off mentor and Liaison/Link Lecturer any issues that may impinge on them achieving their learning outcomes Contributing to practice evaluation to assist in the development of practice learning. Acting in a professional manner by being honest, trustworthy and demonstrate good conduct, behaviour and attitude (NMC 2008). Present evidence of clinical skills development / competence to sign-off mentor Sign-off Mentors (This refers to a named midwife who has been prepared for and accepted the responsibility of formally planning, assessing and documenting a named student s clinical achievement in accordance with the validated assessment strategy for the BA (Hons) Midwifery Practice programme). In brief, a mentor is responsible and accountable for the following: - Facilitating and co-ordinating student learning activities in practice. Supervising students in learning situations and providing them with constructive feedback on their achievements. Setting and monitoring achievement of realistic learning objectives. Assessing total performances including; skills, attitudes and behaviour. Providing evidence as required by programme providers of a student s achievement(s) or lack of achievement(s). Liaising with others such as other sign-off mentors, mentors, liaison/link Lecturers to provide feedback, identifying any concerns about student s performance and agreement of an action as appropriate. Providing evidence with regard to making decisions about achievement of proficiency at the end of the placement. Ensuring the student works with the Sign-off mentor an allocated mentor as part of the team and is supernumerary. Maintaining comprehensive, accurate and legible records. Ensuring there is an auditable trail to meet NMC standards. Demonstrating continuing professional development and having current knowledge of NMC approved programmes. (NMC 2008) 11

12 Role and Responsibilities of Lecturer in Midwifery: As Cohort Leader Oversees the smooth running of the entire 3 stage programme in relation to all theory and practice issues. As Module Leader Co-ordination of module specific learning activities Provide academic supervision regarding the module specific content. Responsible (with members of the module team) for marking module assessments Responsible for producing the module handbook. As Personal Supervisors Hold supervisor meetings regularly within each term to check how well a student is doing provide encouragement and support. Talk through the student s academic and personal progress, discuss their feedback and assessment scores and help identify opportunities for them to develop their personal skills. Be a student s first point of contact for academic and personal problems which may impact on their studies. Signpost students to other sources of help, advice and support for any issues or problems which go beyond a supervisors experience or knowledge. Talk to students about their life at University and encourage them to take part in non-academic activities. Encourage students to start planning their career and offer advice on accessing the Careers and any departmental resources to build skills and gain experience. As Link Lecturers Monitor the practice assessment process of students to ensure validity, reliability and compliance with University regulations and ordinances. Liaise with named clinical areas on all matters concerning the education and assessment of students in practice. Provide support and advice to sign-off mentors and associate mentors as required. Monitor the appropriateness of the clinical placement as a learning environment. 12

13 The Lead Midwife for Education (LME) Each educational institution has a Lead Midwife for Education (LME). The LME is the person named to receive correspondence from and liaise with the NMC in relation to midwifery education. Liaise with the local supervising authority and supervisors of midwives in order to identify the educational needs of midwives. Liaise with students, sign-off mentors, personal tutors, service managers and university officers in situations requiring significant alteration or suspension of education. Oversee and monitor standards of midwifery education. Learning Environment Manager (LEM) The Learning Environment Manager (LEM) is a senior midwife responsible for allocating student placements within their clinical setting. LEMs work closely with ELPs and Link Lecturers to support students on their clinical placement. Educational Leads for Practice (ELP) The Educational Lead for Practice (or ELP) is a senior member of practice staff, based in an NHS Trust, who has a role in promoting the quality of the learning environment for healthcare students. ELPs cover all placements within a geographical area and there is at least one ELP for each of four placement regions. The ELPs work closely with the mentors and managers within placements areas and provide a valuable link with the Department. The ELPs lead initiatives to support student learning and can be contacted for information and advice. They may also be involved in educational audit of placements with service staff and the Link Lecturers. Contact details for local Trust ELPs can be found at the following web address: 13

14 Electronic Ongoing Achievement Record (EOAR) found in PebblePad What is PebblePad? PebblePad is the e-portfolio used by Health Sciences students at the University of York. It is a wellestablished online portfolio software package used by many UK universities. It is particularly suited for healthcare related programmes. The PebblePad portfolio provides the student with a space to record experiences, activities, achievements and reflections during practice experiences and contains all the mandatory documents that are required to be completed during each practice experience. Within the portfolio there is a space for mentors and Link Lecturers to record their assessment of the student s progress and feedback on performance in practice. For more information on how to use PebblePad please see page 15. Where can I get help with PebblePad? If you require any further assistance in using PebblePad please contact our E-Portfolio Learning and Support Team on or us on dohs-practiceeducationsupport@york.ac.uk. The office hours are 08.30am 4.30pm, Monday to Friday. If no one is available, then please leave a message and we will respond as soon as possible. Instructions for Use The e-portfolio is an important document. Its correct use will assist the student in diagnosing and achieving learning needs, planning appropriate clinical activities and applying the theoretical aspects of the course to clinical practice. The e-portfolio will also provide the essential evidence of progress needed to pass the summative assessment of each practice module; demonstrate that the minimum amount of clinical experience required by the NMC has been achieved and by the end of the programme that the student has been assessed as competent in accordance with the European Legislation (80/155/EEC) and as amended by European Union Directive (89/594/EEC) and the Standards for pre-registration programmes (NMC, 2009). 14

15 How to use PebblePad Please keep your password to yourself as this acts as your digital signature within the system. If you have forgotten or misplaced your password, go to the login page and click on 'Forgotten your password?'. The following page will prompt you to enter your username (which is the same as your work address). PebblePad will then send a link via your work to reset your password. If an account has not been created for you, please send a request for a new account to dohspracticeeducationsupport@york.ac.uk. Please include your name and work area details. Once we have verified your position on the mentor register we will be able to create an account for you. 15

16 How to find your student s practice record Your PebblePad account will be linked with your current work area. When a student is allocated to your work area, they will join your work area set providing you with access to all their work. To find your students work, please take the following steps: 1. Login to PebblePad at Click on here to access the dashboard 2. This will open your homepage. Once on the homepage you will see the workspaces of which you have access to. Each workspace contains the work of the different midwifery cohorts and will be named after them. You will need to know which cohort you student belongs to and then choose their workspace from the list: 16

17 3. This will open the Submissions area. You will then select your student s current stage. To do this left click on the drop down arrow in the You are viewing area (highlighted below) and choose your students current stage: 4. To find your student, enter their name in the Filter the submissions search bar: 5. You will be presented with a link to your students work. The students name should be in their EOAR title so you will know that you have the correct record. Left click on the link to open. 17

18 6. The EOAR will open in a new browser window: The contents of the students workbook can be accessed by clicking here or here 7. The submissions menu in ATLAS will stay open in another browser tab. You can move between the EOAR and the menu by clicking on the relevant tab: Multiple copies of the workbook can be opened in different tabs which may help if you want to refer to different pages at the same time. Midwifery Workbooks and ATLAS Submission Areas The students electronic ongoing achievement record (EOAR) is divided into three PebblePad workbooks which are completed by the student, mentor and Link Lecturer. The workbooks contain the students practice record for each stage of the programme. Although the formatting may vary the content of each record remains the same as the original paper CAP document. Below are the details of the submission areas and the records you will find there. ATLAS Submission Area Stage 1 Stage 2 Stage 3 Workbook BA (Hons) Midwifery Practice Stage One 1 st year work BA (Hons) Midwifery Practice Stage Two 2 nd year work BA (Hons) Midwifery Practice Stage Three 3 rd year work 18

19 Save Your Work You must make sure that you save your changes by left clicking on the save button at the bottom of the page. Answer History Please note that PebblePad will record your name, date and time for each entry that you save. This acts as your digital signature within the record. A history of the text entered into an assessor fields is available by left clicking on the Answer History button which is adjacent to each assessor field: The student will be notified once you have made an entry in their record. Marking Grids Each marking grid page contains a list of performance outcomes and each outcome has a grade range from Both the student and mentor will complete their own version of the grid (this will be indicated in the page title). Both the student and mentor pages are similar, so please make sure you are working in the mentor version. You will be able to view the student s version once they have completed it. 19

20 Each marking grid is divided into 5 sections with three outcomes in each section. Once you have entered a score for each outcome, you will need to add the section totals together and divide by three. The overall average mark for each section is then entered on the record. Once all the section marks have been recorded you will need to enter an overall mark and declare that the student has passed or failed the required performance outcomes. This is recorded at the bottom of each marking grid page. 20

21 Responsibilities It is the student s responsibility to produce evidence that the assessment criteria have been met. It is the sign-off mentor s responsibility to consider the validity and reliability of any evidence presented and to advise on any additional evidence required for appropriate assessment. When the available evidence does not clearly demonstrate achievement of the set criteria, the mentor should discuss the outcome with the Link Lecturer. It is the Link Lecturer s responsibility to monitor the assessment process in clinical practice ensuring valid and appropriate assessment of practice. The Link Lecturer will support the assessment process through tripartite practice placement interviews. If a student fails the practice placement the Link Lecturer will inform the personal supervisor. Record of Clinical/Educational Experience The student is required to record brief details of educational and clinical activities undertaken as a part of the programme. This information will be used to demonstrate the engagement in sufficient clinical and educational activities to warrant the academic award. It will also be used to assist in identifying factors which may be hindering the student s progress. The Learning Contract During the programme the student will undertake six practice modules. A new learning contract will be negotiated at the beginning of each module. The learning contract is negotiated between the student and the sign-off mentor. The main purpose is to ensure the student gains appropriate clinical experience, allowing the development and assessment of clinical skills directly related to the aspects of midwifery theory being studied. The contract is divided into four activities: Identify learning needs: the student should complete activities this section prior to the commencement of the placement. Learning opportunities: should be identified by the student and sign-off mentor together at the start of the placement. Development plan: should be completed by the student and sign-off mentor together at the start of the placement. Preliminary action plan: should be negotiated by the student and sign-off mentor together at the start of the placement. A statement is provided at the beginning of each activity which should help both the student and sign-off mentor consider the student s individual learning needs and plan clinical activities accordingly. 21

22 Performance and Skills Outcomes For each stage of the programme a series of Performance and Skill Outcomes (PSOs) have been developed under the headings of the 23 Midwifery competencies. Also incorporated under these headings are the relevant Essential Skills Clusters (ESCs) and Professional Behaviours and Conduct (PBC) as described below: Midwifery Competencies (MC) The midwifery competencies are specific standards which a student must achieve to be entered onto the NMC register as a midwife. The competencies relate to professional clinical care and fitness for practice to ensure that on registration a student can assume responsibility and accountability for their practice as a midwife. (See Appendix 1 for a summary of key focus of competencies). Essential Skills Clusters (ESC) The ESC were developed to clarify the expectations of the public and ensure pre-registration student midwives on registration are fit for practice; capable of safe and effective practice. It should be noted that the NMC continue to review the existing ESC and future additions may be made. The ESC is not a definitive syllabus and they do not encompass all the skills a student may be exposed to in practice. However, they do provide the public with assurance that specific areas of skills are assessed prior to registration. Professional Behaviour and Conduct Based on Standards of Conduct Performance and Ethics (CPE) The nursing and midwifery council (NMC) require that midwives ensure the highest standards of professional behaviour and conduct ( Although these standards are for qualified midwives it is good practice for the student and sign-off mentor to review and consider a student s professional behaviour and conduct during the placement. The sign-off mentor will assess and sign-off the professional behaviour and conduct standards within the EOAR alongside the MC and ESC. Any concerns related to a student s professional behaviour and conduct or clinical progress should be documented in the EOAR and highlighted to the Link Lecturer as soon as possible. Practice Skills Record The aim of the practice skills record is to direct and record a student s learning in relation to the development of clinical skills, which are an essential part of midwifery practice. The student should have completed all the skills by the end of the programme. The practice skills record will be recorded in the A5 paper Ongoing Achievement Record Part Two. Record of Experience and Feedback If the student has the opportunity to work with other members of the multi-professional team the student is encouraged to ask the member of staff to complete a record of experience and feedback sheet as a testimony to inform the assessment learning process. If the student is working with a health professional who is not a midwifery sign-off mentor the student will this document for the health professional to complete. 22

23 Contract Interviews Preliminary interview During the initial negotiation of the student s learning contract with their sign-off mentor, they will have identified those midwifery competencies which they should work towards within this practice module. For module Midwifery Practice 1, 3 & 5 key generic performance and skills outcomes (PSOs) have been identified which must be achieved by the final interview. For additional midwifery focused PSOs the student must demonstrate progress. For module Midwifery Practice 2, 4 & 6 all PSOs for the stage must be achieved. Once the initial contract has been agreed between the mentor and student, the Link Lecturer will review the contract within the dates published in the relevant practice module for all stage one students. During any stage of the programme if the student or sign-off mentor expresses any concerns or uncertainty about the learning contract the student should contact their Link Lecturer as soon as possible. Intermediate Interview At the intermediate interview the sign-off mentor and student should consider whether satisfactory progress is being made towards the midwifery competencies identified within the development plan of the learning contract. On the intermediate interview page the student should document the progress they have made and the sign-off mentor should indicate whether they are in agreement with the student s statement. The Link Lecturer oversees the review process and will document any discussion and comments as appropriate. The student and mentor must complete the formative assessment marking grid individually and discuss what level the student is currently performing at. This exercise will assist the student and mentor to identify further learning needs. Following the interview the student should consider what aspects of clinical practice they would like to develop and, if appropriate, negotiate a revised action plan with their sign-off mentor to facilitate their learning. The Link Lecturer will offer support or guidance on this process as appropriate. If there are any concerns raised prior or during the intermediate review the Link Lecturer should be contacted to offer support or guidance on this process as appropriate and if required should attend the intermediate review. It is recommended that the student and mentor document achievement of competence on an ongoing basis with the student recording evidence of achievement, for triangulation purposes. 23

24 Final Interview At the end of each module an assessment of clinical practice is performed, this is termed the final interview. The final interview is a tripartite meeting attended by the student, the sign-off mentor and Link Lecturer. All relevant documentation for your final review must be completed prior to your review taking place. Prior to the meeting the sign-off mentor should consult with other midwives that the student has worked with in order to have a triangulated understanding of how the student is performing. The sign-off mentor should read the record of experience and feedback forms presented in the student s EOAR. Also prior to the meeting, the student and the mentor should review achievement of competence and the mentor should ensure that appropriate Performance and skills outcomes have been verified. The student should evaluate and document their progress and the sign-off mentor should indicate whether they are in agreement with the statement. If appropriate competence has not been achieved, the student has failed the module. The meeting will continue so that the student receives detailed feedback regarding their progress. During the meeting, the sign-off mentor, Link Lecturer and student will also discuss progress in relation to the student s evidence of achievement in their learning contract, EU numbers and performance in the identified midwifery competency. This discussion may include questioning on a specific area of clinical practice or elements of theoretical knowledge to further support the student s evidence of clinical performance. The student is encouraged to draw on the full range of clinical experience to support progress in clinical practice. Grading practice, the student will leave the room and undertake a self-assessment of their performance using the student summative assessment marking grid in their EOAR. Meanwhile the sign-off mentor will grade the student s performance using summative mentor assessment marking grid. The Link Lecturer will support this process by discussing with the mentor their justification for the marks given. If the student had not achieved competence as required for this point in their programme, their overall performance will still be graded to enable an indicative mark to be awarded to the student. Ending the meeting, the student will return to the room and the mentor will provide feedback to the student in relation to their assessment of performance. The student will leave the meeting knowing their indicative grade awarded for clinical practice. In the event of the student failing the module, the reason should be made explicit (e.g. area of unsafe practice) and clearly documented in EOAR. Recording a Student s Progress Throughout a student s clinical placement, mentors will be asked to record a student s progress. The sign off mentor s comments are included in the student s EOAR document which is useful for a student to identify their strengths and areas for future development. A summary of a student s performance may include, for example, opportunities the student has had during the placement, competence, professionalism, inter-personal skills and application of theory to practice. The five sections identified in the grading of practice may be a useful guide for you as a mentor to provide meaningful and structured comments for the student. 24

25 EOAR Submission The student is required to complete their EOAR by the date shown on the Assessment Schedule for the relevant practice module to enable their progress and experience to be collated and their grade processed. Ongoing Achievement Record Part 2 & 3 (OAR 2&3) Submission (A5 folder) The student is required to submit their OAR2&3 via the Student and Academic Services Team by the date shown on the Assessment Schedule for the relevant practice module. Quality Assurance The process of quality control is undertaken by the External Examiner. This experienced midwife and educationalist will be able to provide objective insights into how the process compares with those in other universities. They will be invited to attend a sample of final interviews to provide feedback to mentors and lecturers. They will also meet the students on a regular basis and seek their views regarding their experiences on the programme. Failure of Practice Module If the student has not achieved competence in the required performance and skills outcomes, during the practice module, this results in a fail. The student will usually be offered the opportunity to redeem the fail by the end of the fourth week of the next practice placement. An action plan will be agreed by the sign-off mentor, Link Lecturer and student at the start of the next practice module ensuring appropriate exposure to the necessary clinical activities. Failure to achieve a pass at this point will normally result in recommendation for discontinuation from the programme. Practical and Clinical Training Requirements Students are required to provide evidence that they have gained the minimum experience required for practice within the European Union. Entries are required in all sections. Entries may be made at any time during the programme and students must have achieved the specified amount of experience in order to complete the programme. In each section students will be required to give the mother s/baby s unit number which should be verified by the relevant midwife. Where a specific number of examinations etc. is specified, it is essential that this amount of experience is recorded. Impact of Grading Practice on Degree Classification A simple and easy to use calculator has been developed to enable the student to consider how achieving excellence in clinical practice might be reflected in their degree classification. It is available on their cohort Virtual Learning Environment (VLE). Only Stage Two and Three modules grades currently contribute to the final award. 25

26 Record of Experience & Feedback Students are encouraged to document their additional activities, experiences achievements and reflections and submit these to their EOAR for review. This will help to document the students learning and progress. There is a page within each module area of the EOAR called supplementary work. This is where the student can submit additional documentation related to their practice experience. The students have the option to submit additional documents to their record or they may prefer to keep them private. If the student has opportunity to work with other members of the multi-professional team they are encouraged to ask them to complete a record of experience and feedback document as a testimony to inform the assessment learning process. This can be completed via or on a paper document that the student will then upload to their EOAR. There is no required number of feedback records for the student to complete, but they should reflect on the individual experience in practice. Multiple records of experience may be submitted within the students EOAR. The student will highlight where the experience took place in the title of the document. How to Find the Record of Experience & Feedback Workbooks 1. To find the students record of experience you will need to open the EOAR for the student s current stage. 2. At the end of the modules content menu you will see a to a page link named records of experiences & feedback. Left click on the link to open this: The system will inform you if there is content to display. If there is no content displayed this means that the student has yet to submit this document. 26

27 Stage One Process for Grading and Assessing Practice 27

28 Stage Two Process for Grading and Assessing Practice 28

29 Stage Three Process for Grading and Assessing Practice 29

30 Changes to Midwifery Supervision The supervision of midwives was a statutory mechanism that has been in place since 1902 as a means to protect the women and babies we care for, by improving the standards of midwifery practice. On March 31 st 2017 the way in which the Nursing and Midwifery Council (NMC) regulates midwifery changed. The main effect of the changes was the removal of supervision from regulatory legislation (NMC, 2017a). This change occurred after a number of critical incidents and independent reports confirmed the previous arrangements were not appropriate for public protection. The changes will ensure that the NMC is solely responsible for all aspects of the regulation of midwives. All midwifery referrals will now be made directly to the NMC by employers, colleagues and the public, as is already the case for other healthcare professionals. These changes do not alter the status of midwifery as a distinct profession with its own standards of proficiency and separate part of the register. There will be no change to the protected title of midwife, and delivering a baby remains a protected function for a midwife or a medical practitioner. There are also no changes to the scope of midwifery practice, which is reflected in the and Code (NMC, 2015). Although these changes mean that supervision will no longer be linked to regulation, this does not mean that the positive aspects of supervision will be lost. Each of the four countries of the UK is taking forward their own plans for new models of supervision that will be led by employers. These models will focus on supporting and developing effective midwifery practice. New Models of Supervision Across the country, there are a number of new models of supervision developing. One model called the A-EQUIP (Advocating & Educating for Quality Improvement) is going to be adopted in the local areas where you will be placed for your practice experiences. The A-EQUIP model is made up of three distinct functions: restorative, personal action for quality improvement and education and development (NHS England, 2017). The new model of clinical supervision is employer led and not statutory. It does not involve regulatory matters: investigating concerns; imposing interim orders; specifying and monitoring local programmes or making referrals to the NMC. The Professional Midwifery Advocate (PMA) A new role, known as the Professional Midwifery Advocate (PMA) will replace the Supervisor of Midwives (SoM) for the future. A midwife must successfully complete a PMA preparation programme provided by a higher education institution (HEI). This programme will be designed to prepare both midwives who have completed the previous Preparation of Supervisor of Midwives Programme (PoSoM) and who have never completed the PoSoM or associated programme. Further information is available in Practicing as a midwife in the UK (NMC, 2017b). This gives an overview of midwifery regulation for midwives and other interested parties. It sets out the how midwives are regulated following changes to the legislation effective from 31 March

31 References: NHS England (2017) Five Year Forward View: The Professional Midwifery Advocate (PMA) Deploying a new model of midwifery supervision for England called A-EQUIP (Advocating & Educating for Quality Improvement). Available at: [Accessed on: 27/07/17]. Nursing and Midwifery Council (NMC) (2015) The Code [online] Available at: [Accessed on: 27/07/17]. Nursing and Midwifery Council (NMC) (2017a) [online] Changes to Midwifery Supervision Available at: [Accessed on: 27/07/17]. Nursing and Midwifery Council (NMC) (2017b) Practicing as a midwife in the UK. Available at: [Accessed on: 27/07/17]. 31

32 Guidance for Student Midwives when Caring for a Friend, Relative or Colleague Occasionally student midwives may wish to, or be requested to, provide midwifery care to a friend, relative or colleague. Often the most frequent request is to participate in caring for a friend or relative in labour. Caring for a friend or relative in labour is a request that the midwifery education team would not usually encourage. Student midwives, similarly to midwives, may find the emotional involvement and increased stress in caring for a family member or close friend can lead to a lack of objectivity in clinical decision-making. As a student midwife it is paramount that they consider both the professional and emotional aspects of caring for a friend, relative or colleague whilst a student midwife. This situation can potentially put a student and their mentor in a compromising and vulnerable position and can increase stress for all parties involved when providing the care. Discussion between the student, mentor and Link Lecturer may be helpful to identify the potential risks or benefits in this situation. The student may also find it useful to explore caring for a friend or relative with a senior midwife or professional midwifery advocate. The midwifery education team recommends that students seek early advice and support from their Link Lecturer to discuss the complexities in more detail. In addition to seeking support and guidance from their personal supervisor they may also wish to consider visiting the Student Support Hub at the following link: Here the student can make enquiries and appointments to see a range of advisors and practitioners. The code (NMC, 2015) should be referred to for guidance on professional standards in order to ensure the safety of the public. It is paramount that student midwives are familiar with and adhere to the NMC Code (NMC, 2015) The standards and values set out in the Code (NMC, 2015) are also used by educators to help students understand what it means to be a registered professional. In addition, The General Medical Council (GMC) stance is clear on this issue and recommends that it is good practice to avoid providing medical care to anyone with whom they have a close personal relationship (GMC, 2017) The midwifery education team consider that if a student comes into contact professionally with someone they know personally then it is best practice if they share this information with their mentor (or midwife that is supervising them). This guidance is not intended to limit the student midwife s clinical experiences or be an obstacle to the provision of care to a relative, friend or colleague. The aim is to ensure that the student midwife understands and acknowledges the potential conflicts that can occur in such situations, and to determine whether any involvement of care with a friend, relative or colleague is appropriate safe and/or necessary. 32

33 Local Register of Sign-off Mentors Placement provider organisations are required to hold a local register of mentors which includes information about mentors initial qualifications, mentor qualification, date of mentor updates and sign-off mentor status (NMC, 2008). Triennial Review Once every three years, employers will be expected to undertake a review of an individual s performance as a mentor. This is called the triennial review. The nature of the triennial review of mentors is for the placement provider to determine but may form part of an employer-led development appraisal. In order to remain on the local register, at the triennial review the individual mentor must produce evidence of having: 1. Mentored at least two students in the three year period 2. Participated in annual updating (see below) 3. Explored as a group activity the validity and reliability of judgements made when assessing practice in challenging circumstances 4. Mapped ongoing development in their role against the current NMC mentor standard. Annual Updating and Mentor Updates Mentors must participate in annual updating this is one of the requirements which they must meet in order to remain on the local register. The annual updating process must include the opportunity to meet and explore assessment and supervision issues with other mentors (face to face) and explore as a group the validity and reliability of judgements made when assessing practice in challenging circumstances (NMC 2009). Such updating will continue to mean attendance at a scheduled mentor meeting facilitated by academic staff. The facilitator will notify the mentor register administrator, but the individual should keep a record of the date of the face-to face activity. In addition, mentors may access a number of different forms of updating activity throughout the year, and these could include: 1. Involvement in a work-based session delivered by Link Lecturer and/or practice education facilitator (ELP); 2. Completion of the Department of Health Sciences Mentor Workbook 3. Other activities for which the mentor can produce evidence of: o updating knowledge of existing NMC approved programmes, o o consideration of changes to NMC requirements and their implications discussing issues related to mentoring, assessment of competence and fitness for safe and effective practice 33

34 Mentor Updates, Mentor Preparation and E-Portfolio sessions Mentor Updates Mentor updates are usually for a one hour session. They are an opportunity to discuss with the mentors specific changes to the BA (Hons) Midwifery Practice Programme that may affect the student midwife and/or the mentor in practice. Where possible these updates will be part of the Trusts mandatory update sessions. These updates will include any new developments with the programme and opportunities for mentor involvement at the University. A register of attendance will be collected and stored at the University however it is the responsibility of the local Trust to maintain and store the up-to-date mentor register. The update will be facilitated by academic staff/link Lecturers. Information regarding the triennial review will be highlighted and the significance of maintaining mentorship status discussed. A mentor certificate for an update session will be given to the midwives attending. This update will meet the NMC (2009) standards. It is a requirement of a mentor to attend such sessions on an annual basis. Mentor Preparation The mentor preparation sessions are offered in addition to the above mentor updates. They will usually be for two hours if required, depending on how many mentors attend. They will be available in each Trust area when requested by mentors, prior to the commencement of the students placements. They are an opportunity for mentors to explore in more detail their concerns and issues of mentoring students. It can be a protected time for mentors to share the sometimes challenging circumstances that mentoring a student entails. Through group discussion, facilitated by a Link Lecturer, mentors can explore the validity and reliability of the judgements made during assessment. The mentor preparation session will be particularly useful to newly qualified mentors and those that may not have mentored a student for a while, due to sickness or maternity leave for example. It will be a time where the documentation specific to the University of York midwifery students can be clarified. The mentor preparation sessions are useful to discuss the grading of clinical practice in more detail. It is essential for those mentors that have never graded a student midwife from the University of York to attend these sessions. A register of attendance will be collected and the mentor preparation will be facilitated by academic staff/link Lecturers. A mentor certificate for a mentor preparation session will be given to the midwife attending. It is not essential to attend a mentor preparation session if you are familiar with the process of mentoring a midwifery student from the University of York. E-Portfolio (PebblePad) In addition to mentor updates and preparation sessions, E-Portfolio (PebblePad) training is available and essential for all sign-off mentors by the University of York E-Portfolio team. Please contact the E-Portfolio Learning and Support Team on or dohs-practiceeducationsupport@york.ac.uk. Maintaining Mentorship Status: If a midwife has a mentorship qualification and has not mentored a student for over three years then the midwife will need to: Contact the Link Lecturer for the placement area or contact the PEF 34

35 References Campbell A (1984) Moderated love. A theory of professional care. London, SPCK. Carper, B. A. (1978) Fundamental patterns of knowing in nursing. Advances in Nursing Sciences 1 (1) Department of Health (2004) National Service Framework for Children, Young People and Maternity Services. Standard 11. Maternity Services. Department of Health (2010) Midwifery 2020: Delivering the expectations. London. Department of Health General Medical Practice (GMC) (2013) Good Medical Practice. [online]. Available at: [Accessed 8/11/2017]. Marmot, M. (2010) Fair Society, Healthy Lives: Strategic Review of Health Inequalities in England post Marmot Review Nursing and Midwifery Council (NMC) (2015) The Code: Professional standards of practice and behaviour for nurses and midwives [online]. Available at: [Accessed 13/08/2015]. Nursing and Midwifery Council (2009) Standards for pre-registration midwifery education. London, NMC. Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice. London, NMC. UNICEF UK Baby Friendly Initiative (2014) Learning outcomes for higher education. Available at: [Accessed 8/11/2017]. 35

36 Appendix 1 Summary of Key Focus of the Midwifery Competency Domain Effective midwifery practice 1. Communication: Communicates effectively with women and their families throughout the preconception, antenatal, intrapartum and postnatal periods. 2. Diagnosis, monitoring and assessment: Diagnose pregnancy, assess and monitor women holistically throughout the pre-conception, antenatal, intrapartum and postnatal period through the use of a range of assessment methods and reach valid, reliable and comprehensive conclusions. 3. Programmes of care and evaluation of care: Determine and provide programmes of care and support for women. 4. Provision of antenatal care and accountable record keeping: Provide seamless care and where appropriate interventions in partnership with women and other care providers during the antenatal period Work collaboratively with other practitioners and agencies Complete, store and retain records of practice. 5. Referral to access information, skills, advice, assistance, support and treatment: Refer women who would benefit from the skills and knowledge of other individuals. 6. Intrapartum care and management of the neonate at birth: Care for, monitor and support, women during labour and monitor the condition of the fetus and conduct spontaneous births. Examine and care for babies immediately following birth 7. Emergency procedures: Undertake appropriate emergency procedures to meet the health needs of women and babies. 8. Postnatal care: Work in partnership with women and other care providers during the postnatal period to provide seamless care and interventions 9. Neonates with special needs: Examine and care for babies with specific health or social needs and refer to other professionals or agencies as appropriate 10. Postnatal health and transition to motherhood: Care for and monitor women during the puerperium, offering the necessary evidence-based advice and support regarding the baby and self-care 11. Safe and accountable drug administration: Select, acquire and administer safely, a range of permitted drugs consistent with legislation, applying knowledge and skills to the situation which pertains at the time 12. Public health: Contribute to enhancing the health and social wellbeing of individuals and their communities. 36

37 Domain Professional and ethical practice 13. Professional accountability: Practice in accordance with The Code: Standards of conduct, performance and ethics for nurses and midwives (NMC 2008), within the limitations of the individual s own competence, knowledge and sphere of professional practice, consistent with the legislation relating to midwifery practice. 14. Accountability to individual: Practice in a way, which respects, promotes and supports individuals rights, interests, preferences, beliefs and cultures. 15. Accountability to society: Practice in accordance with relevant legislation. 16. Confidentiality: Maintain confidentiality of information. 17. Managing self and others: Manage and prioritise competing demands. 18. Health and safety: Support the creation and maintenance of environments that promote the health, safety and wellbeing of women, babies and others Domain Developing the individual midwife and others 19. Lifelong learning: Review, develop and enhance the midwife s own knowledge, skills and fitness to practice. 20. Multi-professional working and inter-agency collaboration: Demonstrate effective working across professional boundaries and develop professional networks Work collaboratively with other practitioners and agencies 21. Evaluation of practice, evidence based practice and professional and policy awareness: Contribute to the development and evaluation of guidelines and policies and make recommendations for change in the interests of women, babies and their families Apply relevant knowledge to midwife s own practice in structured ways which are capable of evaluation Inform and develop the midwife s own practice and the practice of others through using the best available evidence and reflecting on practice. Domain Achieving quality care through evaluation and research 22. Information technology skills: Manage and develop care utilising the most appropriate information technology (IT) systems. 23. Audit: Contribute to the audit of practice to review and optimise the care of women, babies and their families. 37

38 Appendix 2 Practical and Clinical Training Requirements Definitions Prenatal examinations an examination of a pregnant woman that the student has personally conducted. Subsequent examinations may be made on the same woman at different stages of her pregnancy. Supervision and care of women in labour where the student has given a significant amount of care to a woman in labour. It is not necessary to witness the birth. Personal births where the student has personally assisted a woman in an uncomplicated birth and has managed the uncomplicated delivery of the placenta and membranes. If a woman gives birth to twins, this counts as one birth. These births should be documented on the sheet Conduct 40 Personal Deliveries. If the student cares for a woman during labour and witnesses the birth but does not personally deliver the baby or placenta, they should document this case on sheet Evidence of Active Participation in Births. (for example, a woman has a retained placenta or an assisted birth and the student continues to be involved in her care. Assistance with breech births entries should be made if the student is able to observe or assist with a vaginal breech birth. If this experience is not available then simulation of a breech birth will be facilitated. Experience of episiotomy - entries should be made whenever the student observes or performs an episiotomy. If this experience is not available then simulation of an episiotomy will be facilitated. Suturing of the perineum - entries should be made whenever the student observes or participates in suturing the perineum. If this experience is not available then simulation of suturing of the perineum will be facilitated. Supervision and care of women at risk entries should be made when the student cares for a woman whose pregnancy, birth or postnatal period has become complicated. These complications are associated with childbearing rather than pre-existing conditions. For example women who develop pregnancy-induced hypertension; women who have a twin pregnancy; women who develop mastitis postnatally. Postnatal examinations a postnatal examination of a woman that the student has personally conducted. Subsequent examinations may be made on the same woman during the postnatal period. Examination of the normal newborn infant this examination may be made following birth or at any time during the midwife s sphere of responsibility. Subsequent examinations may be made on the same baby during the postnatal period. 38

39 Supervision and care of mothers and newborn infants including pre-term, post-term, underweight and ill newborn infants any baby who requires some degree of special care should be included e.g. baby requiring phototherapy; baby with cleft palate; baby of a diabetic mother. It is not necessary for these infants to be in special care facilities as the student might care for these babies on a ward or at home. Care of women with pathological, gynaecological or obstetric conditions - entries should be made when the student cares for a woman whose pregnancy, birth or postnatal period might be complicated by a pre-existing condition. For example a woman with diabetes or essential hypertension who becomes pregnant; a woman who has had previous gynaecological surgery such as cone biopsy or myomectomy; a woman who is diagnosed with uterine fibroids during ultrasound scanning. 39

40 Appendix 3 Example of EU (mandatory) and Non-EU Practical and Clinical Training Requirements EU Practical and Clinical Training Requirements 100 Prenatal Examinations 100 Examinations of Normal Newborn Infants Supervision and Care of 40 Women in Labour 100 Postnatal Examinations Conduct 40 Personal Births Evidence of Active Participation in Births Supervision & Care of Mothers and Newborn Infants including Pre-term, Post-term, Underweight & Ill Newborn Infants Care of Women with Pathological, Gynaecological or Obstetric Conditions Assistance with Breech Births (minimum 2) Experience of Episiotomy (minimum 2) Suturing of Perineum Supervision and Care of 40 Women at Risk Non-EU Practical and Clinical Training Requirements Abdominal Examinations Record of CTG Interpretations (Stages Two and Three only) Record of Vaginal Examinations Record of Speculum Use Speculum Examinations Experience of Births outside Acute Maternity Units Observation of Complete Breastfeed Supporting Women to Breastfeed Teaching Hand Expression of Breast Milk 40

41 Appendix 4 Contact Details Cathryn Britton Lead Midwife for Education / Senior Lecturer in Midwifery Link Lecturer Scarborough & Malton Room A/TB/254, Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: cathryn.britton@york.ac.uk Helen Recchia Programme Lead / Lecturer in Midwifery / Link Lecturer York Room A/TB/245, Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: helen.recchia@york.ac.uk Louise Armstrong Lecturer in Midwifery / Link Lecturer Harrogate / Joint Cohort Lead Mid 17 Room A/TB/244, Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: louise.armstrong@york.ac.uk Rachel Lavelle Deputy Programme Lead / Lecturer in Midwifery Link Lecturer Northallerton, Whitby & Bridlington / Cohort Lead Mid 15 Room A/TB/247, Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: rachel.lavelle@york.ac.uk Helen Bedford Lecturer in Midwifery / Link Lecturer York Room A/TB/246, Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: Carole Lindsey Lecturer in Midwifery / Link Lecturer York, Joint Cohort Lead Mid 17 Room A/TB/278, Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: carole.lindsey@york.ac.uk 41

42 Denise Hare Course Secretary / Midwifery Programme Administrator Area 5, 2nd Floor, Seebohm Rowntree Building, University of York, Heslington, York, YO10 5DD Direct line: Fax number: denise.hare@york.ac.uk Other Useful Contacts Student and Academic Services Team is the first point of contact in the department. They are available on The Allocations Team (Julie Platts, Sue Maude, Sarah Wooffitt) can be reached on / 1316 Electronic Portfolio Learning and Support Team For support using the PebblePad system please contact Further guidance for mentors can be found on the Health Sciences PebblePad for Mentors website. Learning Environment Managers: York: Suzanne Hadfield (Hospital) Michelle Wilson (Community) East Coast: Jenna Walker Harrogate: Hazel Hughes (Hospital) Isabel Peel (Community) Northallerton: Lisa Payne (Hospital) Julieanne Larder (Community) suzanne.hadfield@york.nhs.uk michelle.wilson@york.nhs.uk jenna.walker@york.nhs.uk hazel.hughes@hdft.nhs.uk isabel.peel@hdft.nhs.uk lisa.payne@stees.nhs.uk julieanne.larder@stees.nhs.uk Mentors in Practice Website Further support and advice is available on-line on the Department s mentors website accessed by the following link 42

43 Appendix 5 BABY FRIENDLY INITIATIVE 5 Themes 43