Tomorrow’s WorkforceCompassion Education Transformation

Mentor Guide to Practice Assessment Year One2012

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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 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.

Mentor Guide to Practice AssessmentHow 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. This initial meeting should review progress towards achievement of progression criteria, plan clinical learning opportunities and experiences and identify ways to collect evidence of achievement.  What am I assessing?

In the first year mentors will formally assess students against the achievement of 18 progression criteria. These progression criteria have been set out by the Nursing & Midwifery Council and all students must achieve them in order to proceed to the second year of the course. The student will also be assessed on their ability to practice safely and professionally. In addition, to assessing students against the progression criteria you are also asked to give the student feedback on their performance related to some of the competencies they are expected to achieve later in the programme. This feedback is designed to assist the student to plan their future learning as well as to monitor their progress. 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.

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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).

Evidence from these tools should be triangulated with your observations of the student’s performance to arrive at a judgement about the achievement or non achievement of the progression criteria.

At the end of the first part of the student’s hub experience (either at four or six weeks) the student’s progress should be formatively assessed and the appropriate documentation in the practice assessment document completed. If necessary an additional action plan should be developed and agreed with the student and the practice learning team (Guidance Tutor, Practice Placement Facilitator). At the end of the second visit to the hub experience the student should be formally assessed by his/her mentor.

Spoke based mentors/educators should complete the appropriate record of formative assessment and encourage the student to collect evidence.

Students can be assessed against any of the progression criteria at any time during the year whether on the ward or when undertaking another component of practice learning.

Mentor Guide to Practice AssessmentStudents must avoid leaving all of the progression criteria until the final few weeks of their second hub visit, at the end of the year. 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.  Patient and Team Feedback [PAQ and TAPP assessments]At various points in the year the student will be asked to collect data by distributing feedback forms to team members and patients. These forms will be collated and returned to the University so that feedback reports can be generated. These reports 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).

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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.

 

Objective Structured Clinical Examination [OSCE]

During the first year the student will be formally assessed in University as part of the core skills module via an OSCE. An OSCE is a structured practical examination and in this case it will consist of three stations (sections) all relating to the recognition of physical and / or psychological deterioration in patients. The assessment is based on the skills related to assessing and recognising deterioration (Station 1), record keeping (Station 2) and reporting via a handover (Station 3). At the end of the OSCE the student will be given a carbon copy of their score sheet and feedback. This should be stored in the student’s PPDF and made available to you for the purpose of assessing the progression criteria.

 

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.

Mentor Guide to Practice AssessmentTwo TCC assessments should be completed during the first year. The assessments should be completed relatively close together and by the same registered nurse on each occasion. It is likely that students will be assessed at this stage when providing care to a low complexity patient.  As TCC assesses a student against the standards for registration the students should NOT expect a score of skilled or accomplished in all elements.  * There is a specific user guide for TCC Safe-MedicateDuring 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. Towards the end of 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 document discussions they have with you which are relevant to the achievement of specific progression criteria. 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.

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How do I assess the progression criteria?

There are 18 progression criteria which must be achieved by the end of the first year. The progression criteria are assessed as either achieved or not achieved.

How do I provide feedback on progress towards the achievement of the competencies?

In addition, to the progression criteria a small number of related competencies have been identified which the student should be working towards. These competencies do not need to be achieved by the end of the first year but rather will be formally assessed in the second year of the programme.

In the first year mentors 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

You should rate each of the competencies at the end of the first year. At this stage students should NOT expect to meet the expectations for registration.

Mentor Guide to Practice Assessment

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Mentor Guide to Practice Assessment

   MEETS EXPECTATIONS FOR REGISTRATION

  Accomplished

Demonstrates capability for independent practice and often exceeds expectations

  Skilled

 Demonstrates capability for independent practice

 BORDERLINE FOR REGISTRATION

  Supported

 Needs occasional direct supervision or support

   NEEDS DEVELOPMENT FOR REGISTRATION

  Assisted

 Needs regular direct supervision or support

  Dependent

 Needs constant direct supervision or support

Modified Bondy Scale [adapted from Bondy, 1983]

What else am I expected to complete?At the final interview the mentor should complete the summative assessment form and indicate strengths, areas for development, complete the development plan and indicate if the student has 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, all of the elements of practice assessment are then completed for the first year. 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 would fail if they do not achieve all of the progression criteria. Students may also fail if they are marked as unsafe or unprofessional in any area or if they do not provide appropriate evidence.

If the student fails they would normally be afforded a further opportunity to be re-assessed on their subsequent placement. At the end of year one any student who fails or does not achieve all the identified progression criteria must be re-assessed within 12 weeks of entering the second year.

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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 to meet the progression criteria or about their ability to practice safely and professionally you should 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 OSCE early in the course but has then made progress and can now demonstrate sufficient knowledge, skill and understanding to be marked as having achieved the relevant progression criteria.

 

My student is doing a re-sit following referral (unlikely in the first year) 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.

 

You should assess the student against the previously unachieved progression criteria and their ability to practice safely and professionally. Then complete the other associated documentation.

Mentor Guide to Practice AssessmentWhere 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.   Sources of help and adviceAs 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/sd/academic/sches/placements/?view=Standard  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