MENTOR GUIDE to Practice Assessment Year Two 1
Why has the approach to Practice Assessment changed? We have made a number of changes to practice assessment in this 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 repetition of assessment and increase the guidance thus making it 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 commencing each of their placements. At this initial meeting the mentor and student should identify which competencies they intend to target and plan learning opportunities. The student should select approximately 1/3 rd of the competencies to focus upon in each placement. 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]. What am I assessing? During the three placements in year two, students are assessed against a range of the competencies for registration. The competencies which must be assessed are in the second year Practice Assessment Document (PAD). In addition to the competencies the student will also be assessed on their ability to practice safely and professionally in each placement. 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 2
Assessment Questionnaires), practical performance and assessments of care delivery (TCC Total Client Care). 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 relevant competencies. 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. Six TCC assessments should be completed during the second year. As a rule two TCC assessments should be undertaken on each placement. The assessments should be completed relatively close together and by the same registered nurse on each occasion. During the year the student should ensure that they are assessed when providing care to increasingly complex patients. As TCC assesses the student against the standards for registration they should expect to reach the level of supported or skilled by the end of the second year. 3
*There is a specific user guide for TCC What are DOPS and when do I need to complete them? DOPS stands for Direct Observation of Procedural Skills. Across all fields of nursing there are three specific DOPS which need to be assessed before the end of the programme. These relate to infection control, nutrition and drug administration. 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 the student and the assessment can be conducted as many times as necessary until all of the criteria have been met. *There is a specific user guide to 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. Public Health module presentation and oral examination As part of the second year module on public health the student will be asked to contribute to a student health event. Following the event the student presents a poster and is subject to an oral examination to explore their understanding and ability to apply concepts related to public health. The student receives a mark for the final presentation / oral examination and detailed feedback. This should be stored in their PPDF alongside the abstract of their presentation / poster. Discussions with mentor The student s PPDF contains pro forma documents to enable them to record any discussions they have 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. Safe-Medicate During the first year the student will be introduced to an online medicines calculation package called Safe-Medicate. The student will be afforded opportunities to develop their knowledge and ability to calculate doses and safely administer medicines. As in the first year, the student will undertake a formative assessment of their progress. The print out of this formative assessment will be placed in the student s PPDF and made available to you to assist with the assessment of the progression criteria. 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 4
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 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 shown over the page Modified Bondy Scale [adapted from Bondy, 1983] You should rate each of the targeted competencies at the end of the placement. Ideally, students should work towards achieving skilled in each of the competencies. However, provided they achieve a rating of supported or above they will still pass the placement and the second year of the course. 5
MEETS EXPECTATIONS FOR REGISTRATION Accomplished Skilled Demonstrates capability for independent practice and often exceeds expectations Demonstrates capability for independent practice At the final interview the mentor should complete the summative assessment form and indicate strengths and areas for development. They should also complete the development plan and indicate if the placement has been passed or failed. The mentor should also sign the off duty record sheet to indicate the hours completed by the student on placement. Unless the student has failed then all of the elements of practice assessment document are completed. BORDERLINE FOR REGISTRATION NEEDS DEVELOPMENT FOR REGISTRATION Supported Assisted Dependent Needs occasional direct supervision or support Needs regular direct supervision or support Needs constant direct supervision or support 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 make the required progress towards target competencies (i.e. reaching the level of supported) by the end of the placement/year. All competencies contained in the PAD must have been assessed by the end of the year. What else am I expected to complete? Students will fail if they are marked as unsafe or unprofessional in any area or if they do not provide appropriate evidence. 6
If the student fails they would normally be afforded a further opportunity to be assessed on their next placement. The student must retrieve any fail within 12 weeks of beginning the following year in order to continue on the programme. 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 the public health module oral examination during the programme but has then made progress in practice so that they can now demonstrate 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 the re-sit occurs during year two you should re-assess the student against any competency not completed to the level of supported and on their ability to practice safely and professionally. Then complete the other associated documentation. 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 this 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. This will be used in their final placement to assess them for registration as a nurse. 7
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 at http://www.northumbria.ac.uk/hces/placements/pan References Bondy K. (1983) Criterion referenced definitions for rating scales in clinical evaluation. Journal of Nurse Education 22 (9): 376-382 Nursing & Midwifery Council (2008) Code of Conduct, Performance and Ethics. NMC: London 8