Practice Education Facilitators

1. Practice Education Facilitators April 2005

2. Aim of the session:- Supporting the Underachieving Student The mentor will have a clearer understanding of the assessment process, including their professional responsibility and accountability Objectives:- The mentor will recognise how each step of the assessment process is integral to providing a ‘fair and objective’ assessment. The mentor will have an understanding of the professional and personal implications regarding signing off of on their assessment of their student.

3. A little bit of reflection...Mentors are aware that most of the students that they teach in the placement will manage to achieve the expected level of competency. Motivating them, assessing and evaluating their performance is not a problem.Many mentors will have had the experience of working with a student who is underachieving and it appears that they will not achieve their competencies.If you have:Did you feel you handled the situation well?Would you/ should you have done things differently?Would more support, encouragement and the involvement of others have helped the student to reach their potential and meet their competenciesIf the student didn’t make the grade, did you bite the bullet and give your student an assessment that showed they had not reached the required level of competency ……………...ordid you give them benefit of the doubt and tick their boxes?

4. Your student can be there for a few weeks or a couple of months and like you they want to be part of the team. The first few days, even hours can make the difference as to how easily and quickly a student can settle into your area. Did You…….? NOTE - You can find a template for a learning contract and an orientation package on the CPPSU site - http://www.cppsu.dundee.ac.uk/ Welcome the student Orientate the student Allocate a mentor Discuss and agree goals Agree on a Learning Contract Carry out ongoing assessment Remember back to your time as a student…… a new area, especially a busy area can be an extremely daunting experience. How you welcome and help your student acclimatise can often set the tone for the rest of the placement. Being a mentor to a student is a two way street. Students have a responsibility to learn, ask questions and stretch both their own and their mentors skills, knowledge and professionalism. You as the mentor have a responsibility to support, encourage and push the student to achieve what they are capable of. And of course you are both responsible to provide objective and constructive feedback regarding performance…both good and poor. Competencies based on the CAP Booklet

5. Your student is not performing as well as expected… They aren’t meeting the required competencies as stated in the CAP BookletEven with all the support, encouragement and hard work on you and the teams behalf you find that your student is struggling in one or more areasThere are procedures and guidelines for mentors to follow if they feel their student is not achieving the required competencies for the placement … EARLY INTERVENTION IS VITAL • ALL the literature says to bring in help sooner rather than later. Duffy tells us to identify the problem and involve the school. (NMC study 2004) • Our own CPPSU also tells us to call early, before a situation becomes more fraught or difficult, even if only for advice.

6. Doubts over a students performance during their placement must be qualified in terms of outcomes and explanation. In general this will be based on the competencies as set out in the CAP book. By linking your assessment closely to the competencies you will be able to keep your assessment objective. Anything you do should be discussed with the student. The first thing you must do is let the student know that something is wrong Discussion with the student Discussion with personal and/or link tutors Exploration of opportunities that would enable evidence to be acquired towards the resolution of any uncertainties

7. “Assessment can aid the student rather than just a measurement of performance” Wallace (2003) • The Learning Contract is a fluid document that can be adapted from the original contract developed as part of the initial interview. • The Learning Contact offers self-direction for the learner. • Action Plans should be agreed between the mentor and the student: again these can be adjusted throughout the placement to suit the learning needs of the student. If there is a problem with the student bringing in others to assist ensures fairness and objectivity with its development. • Is the student getting sufficient learning opportunities to achieve competencies? • Always set a review date. Highlights the mentorsview of the importance of continuous and onion assessment. Also ensures feedback as to progress being made.

8. The Midway Assessment The Midway remains a formative assessment and is another opportunity for mentor to discuss progress made and develop new plans for remainder of the placement. With a good student it maybe about challenging them - provide the student with added learning opportunities tied in with the competencies in order to allow them to obtain experience compatible with their abilities. With the Underachieving student the Midway assessment is about supporting them. By involving the University and other clinical staff members before the Midway Assessment the mentor will be able to implement an Action Plan that has been universally agreed. Continue process of feedback, set date(s) You must record your plan of action, support provided, input from others, thoughts, attitude and response of the student. Evidence of the work, effort and time you are putting in is vitally important. Reflect on issues previously discussed e.g. Learning Contract & Action Plan Specific Learning Opportunities (CAP Booklet) Set Review Date Document the session

9. Literature states that ‘anecdotal notes are significant’(Smith et al 2001) • They provide day to day data about a students progress within the clinical placement • In the case of an appeal the mentors responsibility is eased when there has been careful, deliberate and objective documentation of the students clinical performance. • There have been cases where the importance of clinical anecdotal notes have been illustrated. (Davies v. Regis College 1991) • Input from others involved with working and assessing the students performance allows a more objective opinion and decreases the possibility of student crying foul re personality clash. The decision to fail is not an individual one. • Also protects the student against irresponsible decision to fail them. • Security: Locked drawer in Charge Nurses Office, or other suitable system to prevent unauthorised access. Time: “personal data held for any purpose or purposes shall not be kept longer than is necessary for that purpose or those purposes” Data Protection Principles as per Central Legal Office. Safely disposed when no longer required. Trust Policy re disposal of sensitive data. • Under the Data Protection Principle the student is entitled to be aware of reports on there progress (regular feedback). Evidence

10. “Failing a student can stir up a hornets nest.”(Lankshear 1990) • “her reaction was a combination of aggression and distress” (Duffy 2004) • “unpleasant, messy, emotionally fraught experience” (Milner & O’Bryne 1986) • Don’t forget there is always support and help available

11. The Final Assessment Student still not achieving the required competencies?You have no choice but to fail your student • “Students should understand that the formative clinical evidence is an ongoing process throughout the clinical rotation compiled to determine the final grade.” (Smith et al 2001) • The evidence you have collected allows you to make your decision regarding the students performance throughout the placement. That decision is either to PASS or to FAIL the student. • Failing a student in your placement does not necessarily mean they will be thrown off the course. • “The student must demonstrate 100% achievement of the clinical outcomes at the required level by the end of the CFP” (1st year) • “Students at the discretion of the Board of Examiners, may be allowed to carry normally no more than 10% of unmet clinical competencies from year two to year three, with stated conditions for these unmet competencies being met by a specified date in the year of that programme” • (Programme Guide for Students Jan 2004) • The final assessment should come as no surprise to any involved throughout the whole assessment process. • You are training tomorrows nurses today • You have a responsibility not only to your patients… • but to your profession …..and to yourself.

12. Section 8:- “As a registered nurse or midwife, you must act to identify and minimise the risk to patients and clients.” NMC Code of Professional Conduct • Please note Section 8.2 in particular • The NMC Code of Professional Conduct 8.2 states… • “…..you must act quickly to protect patients and clients from risk if you have good reason to believe that you or a colleague,….,may not be fit to practice for reasons of conduct, health or competence” • The Mentor & Accountability • You have a duty to facilitate students and develop their competencies • You are personally accountable for your practice, for your actions and your omissions • (Code of Professional Conduct, clauses 6.4 & 1.3)

13. “It is inevitable that some students will not be able to meet the required level of practice and it is essential that mentors do not avoid the difficult issue of having to fail these students” Duffy 2004