School of Nursing, Midwifery and Social Care

School of Nursing, Midwifery and Social Care

Bachelor of Midwifery Programme

Master of Midwifery Programme

COMPETENCY ASSESSMENT BOOK

MODULE MID07109 MIDWIFERY PRACTICE 1

STUDENT MIDWIFE ……………..……………….

SUMMARY OF RECORD OF ABSENCE/SICKNESS FROM PRACTICE DURING PLACEMENT/S

INTRODUCTION TO COMPETENCY ASSESSMENT BOOK

The Nursing and Midwifery Council (NMC) has set standards for education programmes, for pre-registration midwifery these are set out within the Standards for Pre-Registration Midwifery Education (NMC 2009). This document includes the competencies required to prepare students to practise effectively and safely and is based upon the Essential Skills Clusters (ESCs).

The four domains are divided into categories:

1.  Effective midwifery practice

2.  Professional and ethical practice

3.  Developing the individual and others

4.  Achieving quality through evaluation and research

The Midwifery ESCs are categorised in the following general headings that are fundamental to best practice:

§  Communication

§  Initial consultation between the woman and the midwife

§  Normal labour and birth

§  Initiation and continuance of breastfeeding

§  Medicine management

The above general headings reflect women’s expectations of newly registered midwives and fulfil the NMC requirements. Students must demonstrate competence in the ESCs and will be subject to ongoing monitoring and review.

THE PROCESS OF MARKING PRACTICE

Students must pass ALL the competencies as set out in the Competency Assessment Book for each placement. A practice module is made up of either one, two or three placements. The competencies assessed in each placement are grouped into four elements based on the midwifery domains and all competencies in each individual element must be achieved. The elements’ criteria statements match the Scottish Credit Qualification Framework (SCQF) of levels 7, 8 and 9 and relate to the student’s stage of study in the programme.

At the end of each placement: The sign-off mentor uses the Practice Marking Tool to assess the student’s overall performance in achieving the competencies within each element. The mentor decides on a mark from the range of marks available (100-65, 64-40 and 39-0) that reflects the overall performance of the student using the competency marking criteria.

The pass mark for each placement must be 40 or more. When a student fails any competencies, this failure will be reflected as 39 marks or less in the criteria elements and although 40 or more may be the overall score the placement outcome will be a fail.

At the end of the module: The module leader adds the marks from the placements and the average derived is the final mark for the module. Where the practice module has more than one placement the final module mark will be the average of the overall marks achieved in each placement. All competencies must be passed and the module pass mark is 40 or more. When a student fails a placement but has gained more than 40 as an average, the student will be awarded a fail for the module. A student who has a score of 65 or above will be awarded a MERIT for the module.

Students should be marked using the full grading range of 0 -100 as they are being assessed on competencies expected for their level of study.

If a student fails the practice module she/he is entitled to one re-assessment opportunity. The Board of Examiners will decide on the duration necessary for the failed element and when the component re-assessment is to be taken.

STUDENT MIDWIFE’S RESPONSIBILITIES

The NMC Code (2015) states the professional standards that nurses and midwives must uphold in order to be registered to practise in the United Kingdom.

The Code contains a series of statements that taken together signify what good nursing and midwifery practice looks like. It puts the interests of patients and service users first, promotes safety and effectiveness and promotes trust through professionalism.

Statements:

·  Prioritise people - you put the interests of people using or needing nursing or midwifery services first. You make their care and safety your main concern and make sure that their dignity is preserved and their needs are recognised, assessed and responded to. You will ensure that those receiving care are treated with respect, that their rights are upheld and that any discriminatory attitudes and behaviours towards those receiving care are challenged.

·  Practice effectively - you will assess need and deliver or advise on treatment, or give help (including preventative or rehabilitative care) without too much delay and to the best of your abilities, on the basis of the best evidence available and best practice. You communicate effectively, keeping clear and accurate records and sharing skills, knowledge and experience where appropriate. You reflect and act on any feedback you receive to improve your practice

·  Preserve safety - you make sure that patient and public safety is protected. You work within the limits of your competence, exercising your professional ‘duty of candour’ and raising concerns immediately whenever you come across situations that put patients or public safety at risk. You take necessary action to deal with any concerns where appropriate.

·  Promote professionalism and trust - you uphold the reputation of your profession at all times. You should display a personal commitment to the standards of practice and behaviour set out in the Code. You should be a model of integrity and leadership for others to aspire to. This should lead to trust and confidence in the profession from patients, people receiving care, other healthcare professionals and the public.

You should familiarise yourself with the NMC documents: The Code (2015), Midwives Rules and Standards (2012) and the Standards for Medicines Management (2010).

Practice concerns

There may be times where you see practice that concerns you. If this happens, you have a professional duty, as an aspiring midwife, to protect the women and babies you care for. You should seek advice as soon as possible and follow the whistleblowing flow chart which is found on the Practice 1 Moodle site.

If you are involved in a practice investigation

If you are involved in a practice event that requires either investigation, you are advised to contact your Practice Development Tutor (PDT) or a Supervisor of Midwives (SOM) for advice and support. If you are asked to write a factual account of your involvement in events, then always seek an appointment with your PDT and/or SOM.

Hours of work/time keeping

In Practice 1, you are required to undertake 30 hours practice per week. The identified dates for reflection are out-with clinical hours.

In preparation for the initial meeting with your mentor, you should have reflected on your learning and identified goals and expectations for the current placement as per the Practice Learning Checklist (2014). It is your responsibility to keep your practice assessment documents safe and ensure that current documents are always readily available for your mentor to sign-off competencies following discussions on your progress. You are expected to reflect and self-assess your own progress during a placement and be prepared to discuss your learning with your mentors, your PDT and link lecturer.

It is your responsibility to ensure that the mentors sign the timesheets for practice attendances daily and any sickness/absence is recorded. You should refer to your programme handbook for more details concerning reporting sickness when in practice.

ROLE AND RESPONSIBILITIES OF A SIGN-OFF MENTOR

The sign-off mentor must have completed the essential mentor preparation and be recorded as active on the Sign-off Mentor database held by the relevant NHS provider. It is the mentor’s responsibility to orientate the student at the start of the placement and ensure that health and safety procedures are explained. The sign-off mentor is responsible for ensuring that the learning experience available for the student enables them to meet the required learning outcomes. Sign-off mentors are accountable to the NMC for ensuring that students are fit to practice and should assess the students’ level of competence by observing their practice and discussing the knowledge and skills required to practice safely.

The mentor should encourage the student to reflect, self-assess her /his own achievement of the competencies, and that they are ready to discuss on-going learning experiences. The mentor must involve the link lecturer and/or the practice education facilitator (PEF) at an early stage when there are concerns about a student’s standard of practice or behaviour. In this instance any action plan and follow-up review must be clearly documented in the Competency Assessment Book.

Initial Meeting / Orientation

At the beginning of a placement (within two days), the sign-off mentor must meet with the student to complete the orientation checklist and discuss the student’s previous learning. At this initial meeting, the sign-off mentor will discuss learning needs and prepare a development plan for learning opportunities to be facilitated during the placement. The outline of the plan must be documented and signed.

Mid-point Meeting

Both mentor and student should meet at the mid-point of the placement to discuss progress. This is a valuable time for the student and mentor to review the initial developmental plan. Students must be given objective feedback on their progress at this point; and where concerns have been raised that a student may not achieve the required level of competence, an action plan must be developed. Where appropriate the link lecturer and/or PEF will be involved at this meeting. It would be good practice to sign individual competencies throughout the placement to monitor the students’ progress.

Final Meeting

At the end of the placement, the student and mentor must meet to discuss and complete all the documentation in the Competency Assessment Book. The mentor enters a grade and completes the individual competencies that are left to sign. It is the responsibility of the sign-off mentor to document the rationale for the overall mark awarded. This should be documented as a summary during the final meeting. It would be beneficial to also include feedback from the wider team, women and their families.

What to do IF an experience/competency is not available during the placement

When there is no opportunity for the student to demonstrate a competency, such as an obstetric emergency, the student midwife must be able to discuss and demonstrate accurate understanding of the situation and the implications. Simulation can be used to assess competence.

The mentor will then verify that the competency is achieved by signing it off as “Explanation Verified” (EV). When a student is unable to explain, the competency is recorded as ‘FAIL’.

The mentor must also document the EV or Fail in the Student’s Ongoing Record of Attainment (ORA).

Apart from ‘EV’, the assessment outcome of each competency outcome must be written P for pass or write FAIL in full for clarity.

On-going Record of Achievement (ORA)

The NMC Standard 16 (NMC, 2009) states that an on-going record of achievement (ORA) is a required component of the assessment of practice.

The ORA allows information about overall student performance to be passed from one placement mentor to the next, enabling the mentors to judge student progress. All three years of practice learning are evidenced in this document providing mentors with an overview that will support mentors and students to plan the learning outcome and complete the assessment process.

LINK LECTURER AND PEF’S RESPONSIBILITIES

A midwife lecturer is identified as the link lecturer for each approved midwifery practice placement area. They discuss changes, developments and review students’ allocations and suitability of the placements by conducting practice placement audits and completing placement profiles every 18 to 24 months.

The link lecturer updates the mentors of any regulatory and programme changes such as assessment processes to ensure that the practice marking tools are used effectively. The link lecturer (and where appropriate the midwife PEF) will be involved in supporting and guiding both mentors and students when issues arise, for example, if the sign-off mentor is concerned about a student’s lack of progress or unacceptable behaviour, the link lecturer will be involved in discussions and give guidance of the marking and moderation of practice. Any decisions or action points must be documented in the Competency Assessment Book.

PEF’s support mentors in the practice learning environment and they are responsible for a range of placements.

MODULE LEADER’S RESPONSIBILITIES

The module leader is responsible for issuing the Competency Assessment Book to students and prepares the students for the learning outcomes of each practice module. The module leader must give students information about the submission date and how/where to submit the completed documents. The module leader is responsible for ensuring fairness and equity of the assessment process and will moderate and ensure due process has been applied. The module leader ensures that the external examiner is able to scrutinise completed Competency Assessment Books, discussing the marking/moderation and any issues with them. It is also the module leader’s responsibility to present the results to the Module Board of Examiners.

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