ASSESSMENT IN PRACTICE
MIDWIFERY
Sign-Off Mentor Information
Mentor Handbook
2
Where to get help
Midwifery Lecturers
Name / Link Area / ContactTel No. / E-Mail Address
Nicky Clark / Labour ward
Women and Children’s Hospital, Hull / 01482
464621 /
Mary Beadle / Community Teams
Hull and East Riding
Jubilee Birth Centre / 01482
464626 /
Catriona Jones / Grimsby / 01482
464624 /
Julie Green / Labour ward
Women and Children Hospital, Hull / 01482
463095 /
Ola Ogbuehi / Rowan and Maple Ward
Women and Children’s Hospital, Hull / 01482
464620 /
Louise Lewis / Scunthorpe / 01482
464534 /
Cassandra Lynch / Scunthorpe / 01482
463354 /
Liz Smith / Grimsby / 01482
464696 /
Katie Cook
Nursing Directorate Office - Alderson House
Hull Royal Infirmary
Anlaby Road
HULL HU3 2JZ
Telephone : 01482 674063
E-Mail :
( Hull and East Yorkshire Hospital NHS Trust ) / Julie Dimaline
Nursing Directorate Office - Alderson House
Hull Royal Infirmary
Anlaby Road
HULL HU3 2JZ
Telephone : 01482 674063
E-Mail :
( Hull and East Yorkshire Hospital NHS Trust )
Janet Barrett
Diana Princess of Wales Hospital
Modular Building
Scartho Road
GRIMSBY North East Lincolnshire DN33 2BA
Telephone : 01472 874111 ext 1078
E-Mail :
( North Lincolnshire and Goole ( Grimsby ) Hospital NHS Trust ) / DEREK CONLON
Directorate of Nursing
Administrative Block
Scunthorpe General Hospital
Cliff Gardens, SCUNTHORPE. DN15 7BH
Telephone: 01724 282282 ext 5639
Email:
(North Lincolnshire & Goole (Grimsby) Hospital Trust)
Heather Groves
Diana Princess of Wales Hospital
Modular Building
Scartho Road
GRIMSBY North East Lincolnshire DN33 2BA
Telephone : 01472 874111 ext 1078
E-Mail :
( North Lincolnshire and Goole ( Grimsby ) Hospital NHS Trust ) / JEAN DONALD
Brumby Resource Centre
Horkstow House - Room G41
East Common Lane
SCUNTHORPE North Lincolnshire DN16 1QQ
Telephone : 01724 298298
E-Mail :
( North Lincolnshire Primary Care Trust )
Judith Green (nee Pepper)
Athena Building
1 Prince Albert Gardens
GRIMSBY
North East Lincolnshire
DN31 3HT
Telephone : 01472 625620
E-Mail :
( North East Lincolnshire Care Trust Plus ) / MARTIN JONES
Lancaster Resource Unit
Carer Unit
Scunthorpe General Hospital
Cliff Gardens, SCUNTHORPE. DN15 7BH
Telephone : 01724 282282 ext 2115
E-Mail :
(Rotherham Doncaster and South Humber NHS Foundation Trust (Rdash) and North East Lincolnshire NHS Care Trust Plus)
Sarah Kelly
Aire Building - room 218
The University of Hull
Cottingham Road
HULL HU6 7RX
Telephone : 01482 464623
E-Mail :
(Humber Mental Health Teaching NHS Trust) / Karen Simpkin
Aire Building - room 218
The University of Hull
Cottingham Road
HULL HU6 7RX
Telephone : 01482 464622
E-Mail :
(Humber Mental Health Teaching NHS Trust)
JOANNE DEIGHTON
Aire Building - room 209
The University of Hull
Cottingham Road
HULL HU6 7RX
Telephone : 01482 463692
E-Mail :
(North Bank PCT’s) / EMMA STEVENS (part-time)
Aire Building - room 209
The University of Hull
Cottingham Road
HULL HU6 7RX
Telephone : 01482 463692
E-Mail :
(North Bank PCT’s)
Introduction
Practice placement areas in Yorkshire and the Humber provide students with a diverse and varied experience of midwifery practice. Six universities providing pre-registration midwifery programmes within the region are working in partnership to provide the best practice experience and to utilise all practice placement areas. To fully utilise the practice areas students could be allocated to practice placements throughout the region. This will mean that a sign-off mentor could be supporting the learning and assessment of students from any of the six universities. To support and assist students and sign-off mentors with the assessment process the Strategic Health Authority funded the development of a common practice assessment document.
The common practice assessment document provides information related to sign-off mentors supporting learning and assessment of students in practice. Within the document are sections for the whole of the students practice experience, learning and assessment to be comprehensively documented, to ensure an ongoing achievement record and an auditable trail.
Standards for Supporting Learning and Assessment in Practice (NMC 2008)
Students on a Nursing and Midwifery Council (NMC) approved midwifery education programme leading to registration on the midwives part of the register are required to spend 50% of the programme time learning in a practice-based environment and this requires 100% attendance. Whilst students are in a practice-based environment they must be supported and assessed by sign-off mentors. The purpose is to assure that those who make judgements certify that students achieve the relevant standards and are confirming to the NMC that the student has met the defined NMC Standards of Proficiency and Essential Skills Clusters for their profession and are capable of safe and effective practice. Mentors who sign-off all or part of a programme leading to a registration are accountable to the NMC for their decisions that students are fit for practice and that they have the knowledge, skills and competence to undertake the role as a registered midwife.
The NMC set standards for education programmes, for pre-registration midwifery. These are set out within the Standard for pre-registration Midwifery Education (NMC 2009) and Essential Skills Clusters (NMC 2007). This document contains 4 key elements in assessing a student’s eligibility for registration within practice.
Competencies required to meet the NMC standards
Students need to be proficient in all the standards by the end of their training in order to practice safely and effectively as a midwife without the need for direct supervision. The standards relate to professional competence and fitness for practice to ensure that on registration a student can assume responsibility and accountability for their practice as a midwife.
Essential Skills Clusters (ESC)
The ESC was 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.
Record of Competence
The aim of the practice skills record is to direct a student’s learning in relation to the development of clinical skills, which are an essential part of midwifery practice. To meet NMC standards of supporting learning and assessment in practice (2008) all clinical skills will be accurately recorded, observe, taught, assessed as competent by the mentor.
Professional Behaviour and Conduct
The Nursing and Midwifery Council (NMC) require that midwives ensure the highest standards of professional behaviour and conduct (The Code: Standards of Conduct Performance and Ethics for Nurses and Midwives NMC 2008). 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 CAT alongside the competencies and ESC. Any concerns related to a student’s professional behaviour and conduct should be highlighted to the liaison/link lecturer as soon as possible. The standards are: -
o Make care of people your first concern, treating them as individuals and respecting their dignity
o Treat people as individuals
o Respect people’s confidentiality
o Collaborate with those in your care
o Ensure you gain consent
o Maintain clear professional boundaries
o Work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community
o Share information with your colleagues
o Work effectively as part of a team
o Delegate effectively
o Manage risk
o Provide a high standard of practice and care at all times
o Use best available evidence
o Keep your skills and knowledge up to date
o Keep clear and accurate records
o Be open and honest, act with integrity and uphold the reputation of your profession
o Act with integrity
o Deal with problems
o Be impartial
o Uphold the reputation of your profession
The professional behaviour in the practice setting form must be completed in all placements.
Support and Supervision of Students
Within pre-registration programmes there are levels of performance to be achieved. Occasionally sign-off mentors have expressed difficulty ensuring that students are supported, supervised and assessed at the appropriate level. To assist with this, the level of practice support and supervision that could be expected from a student is specified below.
Long Programme
Student Year One (Long programme) - Requires direct to close supervision/support and is expected to observe, participate and assist in care (level 4).
What this means in practice
Initially, a student will be observing how clinical activities are undertaken and performed. Once the student and sign-off mentor are in agreement that the student is appropriately prepared, participation should be encouraged. As the student’s ability and confidence develops, they could assist but not practice activities. The student will remain under direct to close supervision. However, by the end of year one, the student should be demonstrating the ability to carry out some practised activities with confidence. Once the sign-off mentor is sure of the student’s ability through direct observation and careful questioning they may be able to plan and lead certain basic practised activities with few prompts and close to minimal supervision. The sign-off mentor should utilize practice learning outcomes, competencies, ESC, professional behaviours/conduct and student’s learning needs to guide them.
Student Year Two (Long Programme) - The student requires close to minimal supervision/support and is expected to participate actively as well as to be able to plan most complex but predictable activities and to lead some of them (level 5).
What this means in practice
The level of supervision/support provided follows on from that which is required at the end of year one. As the student gains confidence, they should be able to carry out a wider range of care activities under minimal supervision. However, decisions concerning the degree of supervision should be based on a reasonable amount of prior direct observation and questioning of the student’s knowledge and understanding of practice. It is vital that the student knows the relevance of evidence based practice (i.e. knows how to undertake care as well as know why that care is necessary), begins to recognise deviation from the norm and knows when to seek assistance.
Student Year Three (Long Programme) - The student requires minimal to indirect supervision/support and is expected to participate actively as well as to be able to plan all activities and to lead most of them (level 6).
What this means in practice
The level of supervision provided follows on from that which is required at the end of year two. Increasingly, the student should be able to use their initiative to recognise and meet the needs of women and their families. Supervision is indirect which means the sign-off mentor should be discreetly observing the student undertake agreed practice activities. If the sign-off mentor is not directly observing the student, they will be aware of the student’s activities. At this stage, the sign-off mentor should use questioning not only to test the student’s knowledge and understanding of midwifery care activities, but also to ascertain how they would recognise deviation from the norm and change midwifery care to meet the needs of the women. Also, the sign-off mentor should ask the student how they would plan, prioritise and manage women’s care, providing a rationale for their decisions. By the end of the programme, the student should be able to demonstrate all the competencies to the standard of a newly qualified practitioner (Stuart 2007).
85 Week Programmes—BSc and Postgraduate Diploma (PG Dip)
Students on these programmes will have transferable clinical skills, which they have acquired from nursing education and practice. They will therefore have experience to apply to the new midwifery context. Students will therefore need a different level of supervision depending on what kind of practice they are undertaking. It is the responsibility of the mentor to determine the level of supervision required, whilst providing suitable learning opportunities for students to be able to meet the required level in order to demonstrate achievement of their learning outcomes.
Year One (Short Programmes)—January February—September/ October
What this means in practice
Students on the 85 week BSc programme, commence at level 5, which parallels students in year 2 of the BSc Long Programme. Students (see above)
Students on the 85 week PG Dip programme, commence at level 6, which parallels students on year 3 of the BSc Long Programme (see above).
However, all students will commence requiring direct supervision and support in acquiring new midwifery skills initially, before progressing to indirect supervision. However, these students are expected to be able to participate and perform new skills with more immediacy than students with no background in clinical nursing. It is important that mentors’ expectations are closely correlated with the students’ learning needs as identified in their assessment of practice documents.
Year 2 (Short Programmes)
What this means in practice
At the end of their first academic year (September/October) all short programme midwifery students progress to the next academic level.
Students on the 85 week BSc programme, progress to Level 6
Students on the 85 week PG Dip programme progress to level 7
See guidance on the use of the assessment tool for level descriptors in the assessment of practice grading grids.
Assessment of Practice
Assessment in practice by sign-off mentors is a central part of midwifery education to ensure those who become registered midwives are safe and competent practitioners. The purpose of assessment is not just about giving a student a mark or grade but undertaking an appraisal and evaluation of performances, identifying strengths/weaknesses and making a judgement (Rust 2002). All assessment of students’ performance should be fair, balanced, reliable, valid and must balance rigour (validity, reliability and discriminating power) against feasibility. However, the principle of practice assessment is to ensure that professional standards are maintained and only those students who meet the standards can be admitted to the Register i.e. fit for practice, fit for purpose and fit for award (NMC 2008).