MENTOR GUIDE. to Practice Assessment. Year Three

Transcription

1 MENTOR GUIDE to Practice Assessment Year Three 1

2 Why has the approach to Practice Assessment changed? We have made a number of changes to practice assessment in the Tomorrow s Workforce curriculum. These changes have been made in response to feedback from mentors, students and other colleagues. We have made a commitment to move towards a more valid and reliable system of assessment across the curriculum and the changes to practice assessment represent a key element of this commitment. In making the changes we have sought to: Make the competencies (previously referred to as proficiencies) simpler to understand Reduce the workload on mentors by making the documentation simpler and easier to navigate Assess competencies in the same way as practitioners practice e.g. in an integrated and holistic way Assess the student s ability to perform a range of skills Standardise the approach to gathering evidence Structure the assessment of practice so it is not solely based on the judgement of one person As with any change you may be initially unsure of what is expected. This guide is intended to answer common questions and provide advice. If you have any other queries please do not hesitate to contact the student s Guidance Tutor or the Programme Team. How should the initial meeting be structured? Students should have an initial meeting with their mentor within the first week of starting, or returning to, hub and spoke clinical settings. A further meeting should be conducted on return to the hub. At this initial meeting the mentor and student should identify which competencies they intend to target and plan learning opportunities During the initial meeting the mentor should advise the student about who may be available to assist with individual assessments such as Total Client Care [TCC] and Leading and Managing Care [LMC]. What am I assessing? In the final year, students are assessed against the remaining competencies for registration and in addition, any carried forward from year two that were not achieved (competencies must be rated as skilled or above to indicate achievement). The competencies which must be achieved in the third year are set out in the student s Practice Assessment Document (PAD). At the end of the final practice learning experience the sign off mentor will need to ensure that the student has demonstrated a sufficient level of practice in all relevant competencies prior to completing the sign off declaration. 2

3 Before arriving at a judgement about the student s performance you should consider a range of evidence. A number of tools have been developed to collect data on the student s performance. These include team feedback (TAPP Team Assessment of Performance in Practice), patient feedback (PAQ Patient Assessment Questionnaires), practical performance and assessments of care delivery (TCC Total Client Care) and Leading and Managing Care (LMC). Evidence from these tools should be triangulated with your observations of the student s performance to arrive at a judgement about the student s level of performance against each of competencies. What is triangulation? Triangulation is a term borrowed from geography and navigation. However, in social sciences triangulation involves using multiple data sources in an investigation to produce understanding. In the context of practice assessment triangulation involves the collection of evidence about a student s performance from different sources, comparing this evidence and arriving at a judgement about the achievement or non achievement of the progression criteria. How does the student collect evidence? It is the student s responsibility to ensure that they collate, file and make available evidence to each mentor. Where a student fails to gather or make available evidence they could fail their placement. Team Feedback [TAPP assessments] At various points in the year the student will be asked to collect data by distributing feedback forms to team member. These forms will be collated and returned to the University so that a feedback report can be generated. The report will be returned to the student so you, as their mentor, can review the student s performance. Following the review the student should reflect on their performance and the feedback provided to identify areas for future development. This reflective work and any action plan should be stored in the student s Personal and Professional Development File (PPDF). Total Client Care Assessment [TCC] Total Client Care is an assessment tool which assesses the student s ability to provide holistic care to a patient. Any registered nurse who has received instruction in the use of the TCC tool can assess a student. A further two TCC assessments should be completed during the third year. As a rule two TCC assessments should be undertaken 3

4 on the first visit to the hub at the beginning of the third year. The assessments should be completed relatively closely together and by the same registered nurse on each occasion. The student should try to ensure that they are assessed when providing care to complex patients. As TCC assesses the student against the standards for registration, expectations are that they achieve a score of skilled or accomplished in the third year. Leading and Managing Care [LMC] LMC is similar to the TCC tool in that it seeks to assess competencies in an integrated way. Depending upon the clinical environment, students will either be assessed as a team leader (or in some very high dependency areas caring for an individual patient) or a shift leader. Any registered nurse who has received instruction in the use of the LMC assessment tool can assess the student. The student should be assessed, as a minimum, on two occasions and they should receive independent ratings from two qualified nurses who have observed their performance. As LMC assesses the student against the standards for registration they should expect a score of skilled or accomplished by the end of their final placement in the third year. *There is a specific user guide for TCC and LMC What are DOPS and when do I need to complete them? DOPS stands for Direct Observation of Procedural Skills. There are three DOPS which the student needs to be assessed as competent in before the end of the programme. These relate to infection control, nutrition and drug administration and apply to all fields of nursing. Specific checklists exist for each of the DOPS to be assessed. The student needs to decide when they should be assessed. Any registered nurse can assess a student. Students can be assessed against the DOPS criteria on multiple occasions. They must achieve all of the criteria before the end of the course. *There is a specific user guide for DOPS Skills Passport The student should maintain her / his skills passport by completing the relevant sections following session attendance at University or when on placement in the Trust. The skills passport should be stored in the student s PPDF. Safe-Medicate Throughout the programme the student will have had an opportunity use the online medicines calculation package called 4

5 Safe-Medicate. The student will have been afforded opportunities to develop their knowledge and ability to calculate doses and safely administer medicines. The student will undertake a final summative assessment of competence in this area in the third year. The print out of this summative assessment will be placed in the student s PPDF and made available to you to assist you to assess the student against the relevant competencies. Leading and Improving module assessment As part of the third year Leading and Improving module, the student, will be asked to consider an aspect of care or service delivery, where improvements could contribute to savings or more effective care for patients. At the end of the module the student will undertake an assessment to explore their understanding and ability to apply concepts related to service improvement. The student will receive a mark for this assessment as well as detailed feedback. This should be stored in their PPDF. Evidence Based Practice / Research assignment The student will undertake an assessment of their knowledge and skills related to the identification of critical appraisal of evidence to support clinical practice. The student will receive a mark and written feedback on this assignment. This should be placed in their PPDF to assist you to form a judgement on whether or not the student has achieved the competencies related to evidence based practice. Discussions with mentor The student s PPDF contains pro forma documents to enable them to record any discussions they have with you which are relevant to the achievement of specific competencies. This will usually involve discussions about ethics, policies, procedures or protocols such as those related to safeguarding etc. Is this the only evidence the student should collect? No, the student s PPDF contains sections where they can reflect on specific incidents or learning opportunities. They can also obtain witness testimony and other forms of evidence. Students are encouraged to collate as much evidence as possible to support achievement of the progression criteria. *Guidance suggesting appropriate evidence for each individual competency is provided in the PAD. How do I assess the achievement of the competencies? Mentor s should provide the student with feedback on their performance related to the competencies using a modified Bondy rating scale. The original Bondy scale was developed in the 1980 s and since that time it has been used widely across the world and in the UK to assess the competency of nurses. We 5

6 have modified the Bondy scale to reflect the fact that students remain under supervision until they qualify as nurses. Therefore, the notion of being skilled or accomplished relates to demonstrating the capability for independent practice. The modified Bondy scale is show over the page You should assess the targeted competencies at the end of the first clinical visit to the hub experience. All competencies must have been assessed at least once by the end of the final visit to the hub. At this stage students should expect a rating of skilled or accomplished. Modified Bondy Scale [adapted from Bondy, 1983] MEETS EXPECTATIONS FOR REGISTRATION Accomplished Skilled Demonstrates capability for independent practice and often exceeds expectations Demonstrates capability for independent practice At the end of the programme the student will need to have achieved all of the competencies to a level of skilled or accomplished. BORDERLINE FOR REGISTRATION Supported Needs occasional direct supervision or support What else am I expected to complete? At the end of each hub experience the mentor should complete, the summative assessment form, indicate strengths, areas for development and complete the development plan. In addition they need to identify if the practice learning experience has been passed or failed. At the end of each learning opportunity (hub & spoke) the record of attendance should be completed. NEEDS DEVELOPMENT FOR REGISTRATION Assisted Dependent Needs regular direct supervision or support Needs constant direct supervision or support 6

7 Why might the student fail or be referred? The student may be referred if they have not completed sufficient time in placement in order to be assessed. Reasons for not completing sufficient time may relate to sickness or delays in Occupational Health or CRB clearance. The student may fail, if they do not achieve target competencies (i.e. reaching the level of skilled or above) by the end of the placement/year. All competencies contained in the PAD must have been assessed by the end of the year. Students would fail if they are marked as unsafe or unprofessional in any area or if they do not provide appropriate evidence. If the student is deemed unsafe in practice they may be prevented from re-sitting and the Programme Team may commence a professional suitability investigation. Remember that if you have concerns about your student s ability, professional approach or safety in practice, contact the student s Guidance Tutor or your Practice Placement Facilitator immediately. What if the evidence suggests non-achievement but I believe the student should be marked as having achieved the criteria? You can proceed to pass the student but you should provide a rationale for your decision on the variance sheet. This may occur if the student fails an element such as a module assessment in the course but has then made progress and can now demonstrated sufficient knowledge, skill and understanding to be marked as achieving the relevant competency. My student is doing a re-sit following referral what do I do with the documentation? The student should have additional pages for the re-assessment. If not the student should ask their Guidance Tutor for this documentation immediately. If this is a re-sit following a second year failure (within 12 weeks of entering the third year) then you should re-assess the student against any competency not previously completed to the level of supported and on their ability to practice safely and professionally. If this is a re-sit following a third year failure any re-assessed competency must be assessed as achieved (i.e. skilled or above) for the student to pass. 7

8 Where does the student store their Practice Assessment Document (PAD) and the evidence? The student s PAD is supplied with a temporary spine binder to allow them to transport it easily. The document is also hole punched so that it can be placed in the student s PPDF prior to submission. All of the evidence used to support the student s practice assessment should be placed in their PPDF. The student s PPDF will become their continuous record of achievement and will be used by the sign off mentor in their final placement to assess them for registration as a nurse. What is the sign off declaration? A declaration in practice must be signed indicating that the student has met the requirements for entry to the register. This assessment is completed by the sign-off mentor who may be different to the students practice mentor. The sign off mentor should be based in the hub environment and be from the same nursing field as the student. As part of the final assessment the sign off mentor should review year two and three practice assessment documentation and the evidence gathered by the student to illustrate achievement of competence. Only when they are satisfied that the student has achieved all the required competencies, should they sign the declaration. The University will inform the NMC when the student has been signed off in practice. There is no requirement for the mentor to do this. Preparation for working life module assessment The assessment for this module will require students to undertake a clinically based viva presentation (this is an oral type of assessment) at the end of the final clinical learning experience. This assessment will take place during a tripartite meeting between Guidance Tutor, student and mentor. The student must present evidence of competency and learning in practice drawn from their PPDF and be able to convey their knowledge and understanding during any subsequent discussion. In addition they will need to present a successful summative safe medicate report to complete the assessment. The Guidance Tutor will arrange this meeting and it will take place somewhere appropriate in the clinical setting. Sources of help and advice As the student mentor you can contact the Guidance Tutor, Practice Placement Facilitator or other member of the practice learning team at any time for advice and support or to request a meeting in the clinical area. Advice is also available via the Practice Placements website. References Bondy K. (1983) Criterion referenced definitions for rating scales in clinical evaluation. Journal of Nurse Education 22 (9): Nursing & Midwifery Council (2008) Code of Conduct, Performance and Ethics. NMC: London 8