update for nursing and midwifery practice assessor/mentors

Update for Nursing and Midwifery Practice Assessor/Mentors 2018 - 19

Lecturer guidance

This pack should have everything you need to facilitate a Practice

Assessor/Mentor update and provides a range of material for you to select

and use as appropriate:

Part one:

What is new – points for discussion

Basic overview of what Practice Assessor/Mentors need to know

What support is available for Practice Assessor/Mentors in Leeds

What to do if……………….

Part two:

New NMC standards hand out – for printing off

Part three:

Sign off Practice Assessor/Mentor guidance

Part four:

Scenarios – these can be used either to facilitate general discussion and learning , OR can

be used as sign off Mentor events. YOU CAN ONLY FACILITATE A SIGN OFF MENTOR EVENT

IF YOU HAVE A SIGN OFF MENTOR IN THE SESSION WHO IS WILLING TO SIGN OFF THE

MENTORS WHO WORK THROUGH THE CASE STUDIES

The scenarios can be printed off and taken with you for use during the session.

Part five:

Reflective accounts form – based on NMC Revalidation form to encourage Practice

Assessor/Mentors to use their learning from Practice Assessing / Supervising /Mentoring

students or attending Practice Assessor/Mentor updates as an opportunity to reflect

These forms can be printed off and taken with you for use during the session

Part six:

Practice Assessor/Mentor Update register – blank – Practice learning facilitators

(PLFs) may bring them if they are attending . Please email it to the PLF for the

relevant Trust or Private, voluntary, independent organisations (PIVO)

Statement of attendance -optional

The registers and statement of attendance can be printed off and taken with you for use

during the session

n.b. A PowerPoint presentation is available on the Practice Placement website

http://medhealth.leeds.ac.uk/info/2950/practice_placements click on Practice

Assessor/Mentors then find a Practice Assessor/Mentor update – link lecturer resources -

should it be needed –but not all Practice Assessor/Mentor update venues have accessible IT

facilities!

http://medhealth.leeds.ac.uk/info/2950/practice_placements

Part one:

What is new? Issues with the potential to impact on placements and Practice

Assessor/Mentors:

NATIONALLY:

Loss of student fees and bursaries to student loan model from September

2017 (? impact on recruitment , age profile of students, retention of students

and attitudes /expectations of practice placement if “paying” for practice

learning )

New types of learners – 3 routes into nursing;

1. Traditional 3 year full time university nursing student exiting with degree

2. Nursing apprenticeships exiting with degree

3. Nursing associates exiting with foundation degree , nationally regulated

by NMC

KEY CHANGES:

No NMC approved Practice Assessor/Mentor preparation course (such as

SLIP) but a Practice Assessor Preparation course - approved as part of NMC

monitoring and course approval

New terminology –Mentor term removed – new terms:

1. Practice supervisor

2. Practice assessor

3. Academic assessor

IE. Split between assessing and supervisor roles

No practice teacher requirement for community specialist practitioner/

specialist community public health nurses e.g. HV and DNs

No sign off Mentors

No 40% working with students on placement requirement

Increase in MDT involvement in supervision

Local operationalisation of roles to be agreed in Leeds over next few

months as preparation for NMC approval of pre- registration nursing

programmes gets underway

WHAT IS THE SAME:

2300 practice learning hours BUT Increase in amount of simulation hour

counting as practice (up to 50% of practice hours)

Students supernumerary (“Supernumerary means that students undertaking

practice experiences as part of their programme of study will not be

contracted by any person or body to provide nursing care”(NMC, 2017)

Need for a supervisory framework and monitoring/quality assurance of

practice learning (but locally rather than NMC determined.)

LOCALLY:

Pebble pad electronic practice assessment documentation being introduced :

Leeds Beckett students September 2017 year 1 , Leeds University students March 2019 year

1

THE BASICS:

Obligations including documentation of the Practice Supervisor/ Assessor/Mentor :

1. Prior to student arriving for placement

2. First day

3. First week

4. Half way through (Professional behaviours checklist)

5. End of placement

6. Making fair judgements about NMC Practice Standards AND Clinical Skills

7. Dealing with a potentially failing student – including concerns professional suitability

Local guidance on who is responsible for what is being developed

Support for Practice Assessor/Mentors in Leeds:

Leeds University Placement Unit


0113 343 1375

Contains resources for Practice Assessor/Mentors and students including copies of student

documentation, local Practice Assessor/Mentor update programmes, SLIP/Practice Assessor

programmes, contact details for the Universities if student issues. They do the allocations of

students for Leeds uni and Leeds Beckett

Health care placements website www.healthcareplacements.co.uk

Pan Yorkshire website for supporting learning:

• Profile of all practice placements in Yorkshire –check your is up to date (pass words

from PLF or your educational leads) / Practice Assessor/Mentor register / Student online

evaluation facility / Educational audits/ Details of local Practice Learning Facilitators

(PLFs)

Link lecturer


http://www.healthcareplacements.co.uk/

Practice learning facilitators – based in Trust or for private, voluntary and independent

sector, based at University - support quality assurance of the practice placement units for

students of all health professions

What if……………..

Student doesn’t turn up – contact Uni

Student is off sick – ensure they have let Uni know ( for Leeds Beckett , student

must give name of person they phoned in sick too on placement and student

must email course administrator)

Student wants to make up hours – only with agreement of university and

placement area

Student wants to work as an agency or bank HCA in your area – not appropriate

Student says he/she cannot arrive at start time and cannot do certain shifts –

students sign contract to agree available for shift work and unless emergency

(carer/parental issues) should work shifts appropriate to maximise learning –

which usually means working with their Practice Assessor/Mentor

Part two: NMC changes for mentors and practice learning – summary handout

Following a consultation during 2017, the Nursing and Midwifery Council (NMC) has produced

new education standards that will significantly affect all aspects of practice learning, and the roles

of nursing and midwifery mentors. All universities will be required to have had all their

programmes revalidated with NMC against the new standards by September 2020. New

midwifery standards are planned for 2020.

Some of the new standards impacting on mentors are summarised below:

1. The Future Nurse: standards of proficiency for registered nurses

(These standards inform the curriculum of pre –registration nursing programmes – apprentice or

traditional route)

Key changes:

• Increased emphasis on shared skills and knowledge across the 4 fields. No field specific

outcomes or field specific nursing procedures - but “…level of expertise and knowledge required

will vary depending on the chosen fields of practice”

• Includes skills such as venepuncture, cannulation, ECG, chest auscultation, whole body

assessments, insertion of NG tubes, IV medicine administration; more on prescribing theory;

effective supervision and teaching of others

2. Programme standards - Standards for pre-registration nursing programmes

Continuing 50: 50 theory practice split; continuing limits of 50% for recognition of prior leaning;

Key changes:

• Cap on simulated learning hours removed (currently NMC allow a maximum of 300 hours)

• Supernumerary status redefined:

“Students in practice or work based learning must be supported to learn without being counted as

part of the staffing required for safe and effective care in that setting….The decision on the level of

supervision provided for students should be based on the needs of the individual student. The level

of supervision decreases with the student’s increasing proficiency and confidence.”

3. Standards for student supervision and practice (of most significance for mentors and those

who supervise and assess students in practice)

These replace the existing NMC (2008) Support for Learning and Assessment in Practice (SLIP)

standards. They are radically different to enable “..more flexibility, creation and innovation.” In

summary, there is removal of the current requirements for:

• Roles of mentor, practice teacher and sign off mentors

• 40% mentor -student working

• Mentor register

• Approved mentor preparation programmes

• Annual updates and triennial review

• Educational audit

• NMC approved mentor preparation programmes (SLIP)

All disappear as NMC requirements – however, there will still be a requirement for placement

providers and universities to have an infrastructure in place to support quality of placement

learning, so it is likely we will keep many of the elements that work well currently – and the NMC

will monitor this annually as part of their quality assurance processes

Removal of Mentor and Practice Teacher (community) roles and introduces 3 new roles:

1. Practice supervisors (PS) Students will require to be supervised on a day-by-day basis in

practice as happens currently - “All NMC registered nurses and midwives are capable of

supervising students, serving as role models… students may be supervised by other registered

health and social care professionals… in line with their competence.”

PSs must “contribute to the student’s record of achievement …”and “..to students assessments to

inform decisions for progression..” and “..engage with practice assessors and academic assessors

to share relevant observations ..on the students they are supervising.”

2. Practice Assessor (PA) must be assigned for each practice placement or series of practice

placements . They :

“..conduct assessments to confirm student achievement of proficiencies and programme outcomes

for practice learning ……..work in partnership with practice assessor to evaluate and recommend

student for progressions………. Periodically observe student across environments…coordinate

feedback from practice supervisors… Are not simultaneously the practice supervisor and academic

assessor for the same student..”

They are required to undergo “preparation or training” but specific training is not mandated but

“must demonstrate the following minimum outcomes:

• interpersonal communication skills, relevant to student learning and assessment

• conducting objective, evidence based assessments of students

• providing constructive feedback to facilitate professional development in others,

• knowledge of the assessment process and their role within it

• receive ongoing support and training to reflect and develop in their role

• continue to proactively develop their professional practice and knowledge in order to fulfil

their role,

• have an understanding of the proficiencies and programme outcomes that the student

they assess is aiming to achieve “

We will need to develop a new preparation programme for registered nurses and midwives who

take on Practice Assessor role to replace current SLIP programme. It is likely that our current

mentors will be automatically migrated to become first wave of Practice Assessors. Subsequently

new PAs will need to undertake the new preparation programme.

3. Academic assessor - Must have a “.. different nominated Academic Assessor for each part

of the education programme” (ie. minimum of 3 per programme) who “…….collate and confirm

student achievement…….work in partnership with nominated practice assessor to ..make

recommendations for progression… communicate with PAs at scheduled points in programme.”

i.e. need for real or virtual tripartite meeting or communication at the progression points.

Academic and Practice Assessors must be RNs for nurses or MWs for midwives. They don’t have

to be from the on same field of practice if they have “.. suitable equivalent experience.” Similarly,

for SCPHN programmes, the PA or AA doesn’t have to be the same field if they have “..

appropriate experience for programmes outcomes”

See the NMC website for more detailed information https://www.nmc.org.uk/education/

(This summary prepared by Debbie Casey, Leeds Beckett, updated September 2018)

https://www.nmc.org.uk/education/

Part three: Sign off Mentor (SOM) guidance n.b the requirement for this role will go once

the new standards are introduced – by September 2020 –current final placement 3 year

students still need a SOM though!!

Sign off Mentors: NMC require sign- off Mentors who make the final assessment of practice (i.e. for

final placement students) to meet additional criteria to reflect the level of responsibility:

Working in the same field of practice……. Registered on the same part of the register Have clinical currency and capability…….. Demonstrate a working knowledge of current programme requirements, practice assessment

strategies and relevant changes in education and practice for the student they are assessing.. Have an in-depth understanding of their accountability to the NMC for the decision they make

to pass or fail a student when assessing proficiency requirement at the end of a programme.” (

Been supervised on at least 3 occasions for signing off proficiency at the end of a final placement…….by an existing sign off Practice Assessor/Mentor or practice teacher

NMC, 2008 p. 21)

However up to 2 occasions may be simulated – but must still be signed off by a sign off Mentor . Sign

off Mentor sessions give existing Practice Assessor/Mentors the opportunity to:

Undertake two case study simulations

The /Mentor must engage in discussion and document these discussions which will be

facilitated by a sign off Mentor and link/ liaison lecturer

They should keep the record of the two simulations

The Mentor must then mentor a real live final placement student under the supervision

of a sign off mentor in your placement area. The Sign off Mentor should review the

evidence from the two sign off simulations and if they are happy that the Mentor is ready to

be a SOM, sign the Mentor’s Triennial Review/ Mentor update documentation . The

Mentor should then then let whoever manages the processes for updating your local

Practice Assessor/Mentor register – usually a Practice learning Facilitator –that they are

now ready to be a SOM and annotated as such on the Practice Assessor/Mentor register.

Part Four:

Scenarios – these can be used either to facilitate discussion OR can be used as sign off

Practice Assessor/Mentor events. If used for sign off events, they should be signed and

dated by the sign off Practice Assessor/Mentor who has been present for the session.

Scenario One

If you are using this Practice Assessor / /Mentor update as a one of your

simulation events, you must document some bullet points for each question.

This will form part of the evidence of achieving the Sign-off Practice

Assessor/Mentor criteria.

You are the Sign Off Practice Assessor/Mentor to a final placement student. The

student you have been Practice Assessor/Mentoring has been meeting all

competencies required to date and has very good communication skills. Other staff

have also given very positive feedback to you about the student’s abilities. The clinical

unit you work in has recently been treating a well-known ‘B’ list celebrity for a condition

that your unit specializes in. This ‘celebrity’ has now been discharged but was an

inpatient for a number of days and you are aware that they are an active user of social

media as you have been following their Twitter account.

This morning a first year student, also on placement within your unit, asks you to look

at an image she has received on her phone from your mentee via the Snapchat social

media application. This image appears to show a ‘selfie’, of your mentee together with

the ‘celebrity’ smiling into the camera whilst at the same time giving a big hug to the

student nurse. In the background you can see another patient lying in a hospital bed

but they are out of focus and you cannot make out who this other person might be.

Focused activities:

1. Contextualise the scenario to your own setting/specialist area

2. Discuss how you could address this

3. Describe how you would give feedback to the student in a constructive and

supportive way

4. Discuss the professional implications of this scenario

This activity was used as a sign off scenario and …………………….demonstrated

appropriate knowledge and understanding of the Practice Assessor/Mentor role

Signature of sign off Practice

Assessor/Mentor………………………………………..date

…………………………………….

Scenario Two

If you are using this Practice Assessor /Mentor update as a one of your




You are Practice Assessor/Mentoring a final placement student. At the preliminary

interview, you looked through the student’s ‘Ongoing Achievement Record and Skills

log’. The student has been signed off as competent in a specific skill. During a shift

you observe the student preparing to undertake this skill in what you perceive to be an

unsafe manner.

Focused activities:


2. Identify the immediate actions you would take

3. What would you do subsequently?

4. Discuss the professional implications of you as Sign-off Practice

Assessor/Mentor failing to act on an area of concern regarding a student’s

practice




Assessor/Mentor………………………………………..date …………………………

Scenario Three

If you are using this Practice Assessor /Mentor update as a one of your




Chris tells you at your initial meeting that he has been recently diagnosed with dyslexia

and that he is developing strategies to deal with it. He makes you aware that support

mechanisms have been put in place following a Disability Assessment by the

University Disability support team.

Focused activities:


2. Identify your obligations to the student

3. What actions would you take ?

4. Discuss the actions you would take if you had concerns over Chris’s ability to

practice safely




Assessor/Mentor………………………………………..date ………………

Scenario Four

If you are using this Practice Assessor /Mentor update as a one of your simulation

events, you must document some bullet points for each question. This will form part

of the evidence of achieving the Sign-off Practice Assessor/Mentor criteria.

Francis/Frances is a student, who previously worked has a health care assistant;

he/she has 23 years’ experience. It is the first week of his/her placement, and you

have worked three shifts with him/her. He/she is very keen to learn, but you feel

exhausted and out of your depth because of the various enthusiastic questions he/she

continually poses.

Contextualise this scenarios to your own clinical situation.

a) Identify what are the issues each scenario raises that requires addressing

b) What would you do to facilitate the student’s learning?

c) What would you do in terms of assessment, documentation and further action?




Assessor/Mentor………………………………………..date ……………………………

(Modified from NMC Reflective Account Form http://revalidation.nmc.org.uk/download-resources/forms-and-templates)

http://revalidation.nmc.org.uk/download-resources/forms-and-templates

Use this form to record a written reflective account of your experiences of mentoring/ practice supervising and

assessing /or the annual update you have just attended. For revalidation the NMC requires you to provide 5

reflections on your CPD and/or practice-related feedback and/or an event or experience in your practice and how this

relates to the Code.. This form will support you in providing evidence

Reflective account:

What was the nature of the CPD activity and/or practice-related feedback and/or

event or experience in your practice? Describe the Practice Assessor/Mentor update event/

Practice Assessor/Mentor discussions or an experience with a student in practice where personal

learning took place

What did you learn from the CPD activity and/or feedback and/or event or

experience in your practice?

How did you change or improve your practice as a result?

How is this relevant to the Code?

Select one or more themes: Prioritise people – Practise effectively – Preserve safety – Promote

professionalism and trust

And consider NMC standards for Practice Assessor/Mentors ( see NMC (2008) Standards to

support learning and assessment in practice from

https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-

assessment.pdf

8 domains for Practice Assessor/Mentors:

Establish effective working relationships

Facilitation of learning

Assessment and accountability

Evaluation of Learning

Creating an environment for learning

Context of practice

Evidence-based practice

Leadership

NAME……………………………………………..DATE…………………………………………..

Part SIX:

• Practice Assessor/Mentor Update Register – blank – Practice learning facilitators

(PLFs) may bring them if they are attending. Please email it to the PLF for the relevant Trust

or Private, voluntary, independent organisations (PIVO)

https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-assessment.pdf

https://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-assessment.pdf

• Statement of attendance –optional

Practice Assessor/ /Mentor Update Attendance Sheet

Name of person who is providing the update ……………………….............................

Date : / / Type of Practice Assessor/Mentorship

Update/Location..…………………………………….

Name (please print) Ward / Department Practice Assessor/Mentorship Qualification

Sign

Please send a copy of this update to the Practice Learning Facilitators to enable them to

update the Practice Assessor/Mentors on the Healthcare placement website:

Heather Ong – [email protected] Leeds Teaching Hospitals NHS Trust Doug Bodey - [email protected] Leeds Teaching Hospital NHS Trust Jenny Shaw - [email protected] Leeds & York Partnership NHS

Foundation Trust Jude McKaig - [email protected] Leeds Community Healthcare NHS Trust Siobhan Zagajewski [email protected] Leeds Community Healthcare NHS Trust For advanced training /Primary Care Workforce Hub – GP practices in Leeds [email protected]

mailto:[email protected]






Certificate of Attendance

This is to certify that: …………………………………………………………..

From practice placement location:………………………………………

has attended a Nursing / Midwifery Practice Assessor/

/Mentor update session on: / /

Signed: …………………………………..

Date: / /

update for nursing and midwifery practice assessor/mentors

Documents