Image with kind permission of Christopher G. Marshall . 06.06.07

1. Stimulus • Practice Assessors of NHS Trusts locally involved in the delivery of the Dip HE Operating Department Practice (ODP) programme, expressed on-going difficulty in establishing the suitability, depth and academic level of evidence, as required for the assessment in practice of student ODPs at level C and level I. • Set requirements for the assessment and mentorship of students are published at both local (programme)1 and national (governing body)2 level, with support given from the academic institution 3, yet approach and understanding remained inconsistent. • A Literature Review was undertaken, with a view to highlighting key factors that detract from effective practice assessment, and to identify areas for improvement and consideration. • Emergent issues were as follows (limited sample) and centred upon 3 specific themes: • Communication and Comprehension • The Assessment Process • Partnership Working • Outcome • Notably, there was significant coverage of factors that detract from an effective learning process, with little suggestion that a substitution of current learning and assessment methods with newer innovations would prove beneficial. • Clear communication and exploration of conceptive objectives, may have greater benefit that a more specific didactic / instructional model of learning . This may further enable independent learning and development across a broader range, and release the academic and professional potential of those involved. Comfortable With Academic Challenge ? Releasing Potential In Practice-Based Learning & Higher Education[Literature Review] Nick Rowe - Institute of Health & Community Studies, Bournemouth University – U.K. The ‘Knowledge-Paradox’ & Academia ‘Knowledge’ is increasingly highly valued, however regard for the credibility of Universities and Higher Education, is in question 11. Previous experience of many established clinical staff, centred upon ‘didactic’ or instructional learning. Higher Education (and Continued Professional Development) require a more conceptualised approach, where learners follow predominantly self-directed / guided study, that builds upon established principles 12. Within Higher Education, there is a perceived ‘prestige’ of Research, over the learning & teaching process. Inherent to current day healthcare however, is a requirement for Evidence-Based Practice7,8,9,13. It is this shared requirement for evidence that provides common ground for clinical & educational partnership working. ‘I don’t understand – perhaps I might, if the basic principles were explained to me …’ bromine.servlet.net/.../ninarios/STEPPING.jpg The Dual Role of Practice Educators Deficits in learning organisation & structure are often permeated by a perceived incomprehension between staff & student14. The majority of professions have adapted their learning process from a system of ‘apprenticeship’ to more academic models, yet the change is incomplete, with varied appreciation of shared values15. Teaching & Nursing have been compared in regard to scale, gender balance & social status15. The requirements for Evidence-Based Practice, research appreciation and professional conduct, also provide mutual areas within which to develop7,8,9,13. Practice Educators combine the teaching and assessment of ‘broad-range’ concepts, together with skill specific knowledge-based approaches. Recognition & differentiation of this role can improve performance & reduce student stress16. The Role of Institutions Universities often hold a ‘bridging’ role in their communities, with emphasis being placed upon common approach and inter-organisational linkage. A team-based approach may improve organisational performance4. Instructional and scholarly aims may have increased effectiveness if teaching and research are flexible in structure, with the clear establishment of mutual obligations, in regard to the institution and its employees5. Universities are not always good at recognising partnership working, with debate regarding the suitability of their ‘product’, to the comparative needs of the ‘customer’ 5. Conclusions Many problems in Work-Based Learning and Higher Education have roots in the areas of understanding and communication. This involves all of the ‘stakeholders’; those being the partnership institutions and individual students & staff. Objective focus is often separated between staff & student, yet there is suggestion that a shared learning approach, may be of engaging and mutual benefit. Clear definition of roles & objectives, helps to establish a common purpose. The role of teacher and lecturer is a combined requirement of practice assessors, with clear employment of didactic and conceptual learning. Relation of these concepts to clinical professional markers, may help to direct students to learning and competency at the required level, and also enhance the development and currency of education staff, by means of a shared / mutual learning approach. Demonstrable commonality between Higher Education and professional practice may indicate that the core principles of self-directed learning and development, are indeed already established. ‘Translation’ of these into mutually understandable terminology, may facilitate the release of individual potential, in regard to academic and professional development. Involvement of key ‘stakeholders’ is required (Institutions / Staff / Students), in order to maximise the outcomes of those concerned. A collaborative approach in support of both pre-registration and post-registration learning and assessment, can enable individuals to build upon emergent learning, with benefit to both the individual and employing institution. Further research is indicated, in order to test the suitability of this approach within the practice environment, and to provide measurement of its outcomes. Partnership Working & Accountability Placement educators (of any designation) are subject to the joint expectations of both partner institutions, and this requires a planned commitment, in order to effectively undertake the roles required6. Whilst there is a clear position of accountability within the codes of conduct of clinical professional roles7,8,9, this is not always implicit, in regard to the education and assessment of students6. Non-performance / achievement may be viewed as ‘risk’ by those concerned. In common with professional practice and Higher Education, there is a need for this to be predominantly self-managed. This ‘protectionist’ approach may serve to stimulate the development of expertise in individuals, by means of promoting self-initiated work / study10. Image with kind permission of Christopher G. Marshall . 06.06.07 Release your potential through collaborative working – see where it takes you … Methodology The search strategy accessed a variety of databases (Academic Search Premier, British Nursing Index, CINAHL with Full Text, MEDLINE, PsycARTICLES) in relation to the following Boolean linkage: Improve OR Effective Simple Clear AND Student ODP [+exp] OR Peri-Operative OR Medical AND Work-based Practice OR Practical Skills AND Assessment AND Healthcare AND Higher-Education Preliminary Research Question : Given the requests from placement partners, for clarification / development of the process and documentation involved in Dip HE ODP assessment, initial lines of enquiry sought to examine ‘What considerations are involved in effective student placement assessment ?’ Search Restrictions : Restrictions required references and abstracts to be available. Given that the intended objective was the development of practice assessment, a 10 year limitation (Jan 1997 – May 2007) was also imposed. The initial search produced 4899 results. National restriction to coverage of Great Britain reduced applicability to 382 results, with an involvement of Universities / Colleges, resulting in a final availability of 220 results. Review of abstract and initial material led to the inclusion of 15 works, as contributory findings. References: 1BOURNEMOUTH UNIVERSITY, 2006. The Essential Guide to Pre-Registration Operating Department Practice - Clinical Staff Guide. Bournemouth: BU / ODP, version 3. 2ASSOCIATION OF OPERATING DEPARTMENT PRACTITIONERS, 2006. Qualifications Framework for Mentors Supporting Learners in Practice: Standards and Guidance for Mentors and Practice Placements in Support of Pre-registration Diploma of Higher Education in Operating Department Practice Provision. London: AODP, Issue 2. 3BOURNEMOUTH UNIVERSITY, 2006. The Essential Guide to Pre-Registration Operating Department Practice - Clinical Staff Guide. Bournemouth: BU / ODP, version 3. 4 JACOBSEN, D.,2001. A New Agenda for Educational Partnerships : Stakeholder Learning Collaboratives. Change, September / October, 44-53. 5 BIAŁECKI, I., 2001. Goals and Policies of Higher Education Reform. Higher Education in Europe, XXXVI (3), 351-366. 6 WILSON, S., 2003. Realising our rhetoric: making teaching public. Journal of Curriculum Studies, 35 (2), 217-229. 7 HEALTH PROFESSIONS COUNCIL, 2004. ODP Standards of Proficiency. London: HPC.8 ASSOCIATION OF OPERATING DEPARTMENT PRACTITIONERS, 2003. Scope of practice. London: AODP, Issue 1 Revised 2004.9 NURSING & MIDWIFERY COUNCIL, 2004. The NMC code of professional conduct: standards for conduct, performance and ethics. London: NMC, Standards.07.04. 10 McWILLIAM, E., 2004. Changing the academic subject. Studies in Higher Education. 29 (2), 151-163. 11HELLSTRÖM, T., 2004. Between a rock and a hard place: Academic institutional change and the problem of collective action. Higher Education, 48, 511-528. 12 HENDRY, C., FARLEY, A., 2006. Essential skills for students who are returning to study. Nursing Standard, 21 (6), 44-48.13 NHS EXECUTIVE, 1996. Promoting Clinical Effectiveness: A framework for action in and through the NHS. London: NHSE. 14 PRITCHARD, R., 2004. Humboldtian values in a changing world: staff and students in German Universities. Oxford review of Education. 30 (4), 509-528. 15 SCOTT, P., 2004. Commentary. The contribution of universities to the development of the nursing workforce and the quality of patient care. Journal of Nursing Management, 12, 393-396. 16 HALLEY, E., NESTLE, D., DOHERTY, R., 2003. Introducing assessments to new medical students: a transition workshop. Medical Education, 37, 1025-1049.