Joanne Garside Dr Barbara Wood

1. The nurses role in practice based education: Innovation in academic assessment and the influence on practice development Joanne Garside Dr Barbara Wood

2. Aims Overview of the implementation of contemporary practice based, academic assessments Understand choice of assessment methods Insight into post registration students opinions and impact of a variety of assessment methods on their academic development Student and their managers view of assessment and there influence on practice development

3. Your assessment Debate the influences that inform a current health care policy, provision and practice. What assessment method would you choose to answer the question?

4. Academic assessment Essay? Presentation? Exam? Simulated exam? Why Choose??

5. Assessment • ‘..the facilitation of collection, review, monitoring and ultimately judgement of student learning.’ (Lambert and Lines, 2000) • A measure of the quality of education received and in nurse education signal that the student has acquired the necessary skills and knowledge for registration and professional practice. (Wellard et al, 2007) • No single assessment can hope to assess a students learning or practice development needs fully

6. Background to the project • New curriculum • Innovative approach to assessment • Module Evaluations • Over dependence essay/exam • High volume of assessment • Cowan (2006) & Race et al (2005) • Suggests choice improves overall standard of assessment • No published evidence found demonstrating efficacy of choice Learning styles and assessment preference

7. Implementation 2007/8 Pre registration • 2007/8 - Second year adult branch cohort – Nursing care of the person with a physiological disturbance (2007/08 – 289 intermediate level students ) CPD modules • 2007/8 Acute Illness course (62 Honours level students) • 2008/9 Cardiology – (24 Masters students) The student achieve the learning outcomes of this module in negotiation with the module leader. The outcome of these negotiations will be documented in the form of a learning contract.

8. Pre Registration • A&P, disease and nursing care • Part 1 – OSCE – 50% • Part 2 – Exam, Presentation or Essay – 50% Knowledge and Understanding Outcomes • 1. Distinguish between normal physiology and pathological processes • 2. Describe the relevant, evidence based, nursing and therapeutic interventions, required by the person with a physiological disturbance in medical, surgical, intermediate and primary care settings • 3. Identify how pathological processes affect the psychosocial wellbeing of the person, family and significant others Ability Outcomes • 4. Make sound judgements about the appropriateness of nursing care to a person with a given physiological disturbance

9. CPD students • Acute Illness professional cert/BSc route – Honours level • Cardiology MSc level • 4000 word equivalent – their choice Professional Principles underpinning Acute Clinical Practice Knowledge and Understanding Outcomes • 1. Debate the influences that inform current health care policy, provision and practice. • 2. Critically appraise the role of the practitioner within integrated service provision in the context of multi-agency and disciplinary working practices. • 3. Critically analyse care provision demonstrating an awareness of current political and moral philosophy, agendas, financial implications and constraints and social expectations. Ability Outcomes • 4. Critically apply professional principles and legal and ethical theories within acute clinical practice.

10. Methods chosen – Pre registration

11. Negotiated assessment method (N=62) • 4000 word Essay - 23% • 15 minute Presentation and 2000 word supporting essay - 32% • Poster and 2000 word supporting paper - 2% • Teaching Pack – 43%

12. The evaluation • After module completed/before assessment submitted & results • Questionnaire • Biographical details • Open ended questions • Interviews • CPD students • Ethical approval • Consent • Data Analysis • Thematic technique

13. Overall comments I was surprised when I was first made aware……but I was relieved and happy that I could choose the assessment I felt most comfortable with ‘…people are comfortable with different types of assessment’ ‘It helped us decide which method was appropriate to ourselves rather than being told what to do’ ‘It is good that you can choose to be in your comfort zone’ ‘…it made me think through what each process involved and I don’t think that any are easier than the other it is just what people feel more comfortable with.’ ‘I though this was a brilliant idea…’

14. Thoughts ‘I thought it was great to have a choice…..’ ‘I was very happy that we had a choice because it is the first course I have done where this was possible.’ Mmmm at first it was like oh God what do I do! It did take a bit of thinking about, ….which in itself is good, as it makes you think why am I here and what do I want to achieve, …well we’ve never been asked before’

15. Achievement ‘My grades were quite good for assignments’ ‘ I thought it was a good idea and would help me to be assessed on a personally stronger method of assessment.’ ‘It was a good idea as not everyone is good at exams or essays. Students can now try to get better marks by choosing what is best for them as individuals’ ‘…Different people shine at different things being given a choice rather than feeling forced to do either AB or C should produce some good results as we have all chosen what we think we are good at’. ‘Gave us an opportunity to chose an area in which we perform best. A very good idea.’

16. Exam/Presentation pressure ‘I don’t enjoy exams as I get really anxious and then my mind goes blank’ ‘Fantastic that I don’t have to do an exam’ ‘It was a relief I do not like presentations or exams’ ‘Relieved! I do not find presentations beneficial to my learning and find I can examine subjects in more depth in essay format.’ ‘I am not a confident public speaker therefore appreciate the option to express my ideas in essay format.’

17. Recruitment ‘……If I wasn’t given the choice.. that had a bearing as to whether I would have done the course or not. That’s how much I hate doing presentations ….. I never got used to it and it got to the point of being too stressed, I just can’t…, I look at doing courses and if that is the main assessment method, I wouldn’t do the course.’

18. Decision making ‘I don’t like choice; I can’t make a decision to save my life. I want the simplest method so then I am not…because I tie myself up in knots and make it more complicated.’ ‘At first I thought I would have liked to have been offered a choice but then felt a little overwhelmed by having to make a decision, I would have preferred it to have been made for me’ ‘Which do I choose?’

19. CPD – practice based ‘It was nice to be given the opportunity to choose an assessment method as an adult learner. I felt it made the course more applicable to my practice and I believe I have achieved something useful that will not just be filed in a drawer.’

20. ‘I thought this was a fantastic opportunity to relate my coursework to my current practice area and to share the knowledge I acquired with my colleagues’ I enjoyed having that choice and its good to have to do something different like the teaching and learning pack rather than having to do a 4000 word assignment.

21. I am glad that the ward got something out of it, like when I did the poster and that got taken back to the ward…I thought that was really useful The actual presentation that I did is actually going to be used….that’s quite useful and off the back of it we’ve got an unit study day where we have got about 5 presentations being delivered in a day for our newly qualified staff so its come up trumps really’

22. ‘I did a teaching package on carotid endarterectomy patients because those were the ones who were extending their stay, traditionally we had them for half an hour and then they were back to the ward so then we were like oh what do we do after half an hour, so that was really good now most of the recovery staff are doing what we should be doing with these people so we are improving care – which is fab.’

23. Summary/Discussion • Well received • Avoidance of high stress assessment methods • Comfort zones • Learning disabilities • Professional role

24. References & Acknowledgements • Cowan J. (2006) On becoming an innovative university teacher: reflection in action: Open University Press, Maidenhead. • Garside J., Nhemachena JZZ., Williams J. and Topping A. (2009) Repositioning assessment: Giving students the ‘choice’ of assessment methods. Nurse Education in Practice; 9, 141-148 • Lambert D. and Lines D. (2000). Understanding assessment. London: Routledge-Falmer • Race P., Brown S., Smith B. (2005) {500 Tips} on Assessment 2nd Ed: Routledge Falmer, London. • Welland S.J. Bethune E. and Heggen K. (2007) Assessment of learning in contemporary nurse education: Do we need standardised examination for nurse registration. Nurse Education Today: 27; 68-72. Thanks to • Julie Williams • Dr Jean Nhemachena • Dr Janet Hargreaves • Dr Annie Topping

25. Any Questions? • Thank you for listening!