The author will discuss issues relating to assessment in the clinical area including areas for development and improvement. The assessment under consideration is ‘A Safeguarding Children Induction Handbook’ (Nottinghamshire Community Health 2009). This is a competency based induction framework and is designed to be undertaken by all new staff who will have regular contact with children and families (appendix 3). It is the responsibility of managers to ensure that staff will have the opportunity to achieve and maintain the competencies. The Primary Care Trust (PCT ) intends that use of this framework will meet statutory requirements to safeguard children (Nottinghamshire Community Health 2009). . Practice teachers were directed to facilitate this programme for Specialist community public health nursing (SCPHN) students.
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Assessment is the means by which learners are graded, failed or passed fit for practice (Quinn and Hughes 2007). Assessment in practice provides the grounding to ascertain if a learner is ready to move on or can demonstrate competence. This is needed in order to protect the public. Nursing and Midwifery Council (NMC) directs that SCPHN courses are balanced with 50% of learning in practice. Practice teachers are responsible for assessing students in public health practice. The portfolio is used to show evidence of achievement in practice. NMC (2008) advises portfolios are a method of evaluation suitable to collect information about a student’s competence to practice. Portfolios can demonstrate learning, by experience, reflection, personal and professional development and the students must cross reference all work to demonstrate achievement of NMC Standards of proficiency for SCPH nurses. Portfolio marking can be subjective and experience suggests students are not always clear what is needed to compile them. Calman et al (2002) suggested clinical assessment has relied on one practitioner observing and reporting on another which runs the risk of bias. As a student practice teacher the author has found this trying. There have been difficulties in achieving supervision due to a demanding caseload. A practice teacher mentor located at some distance has added to the challenge. The student and student practice teacher have benefited from time with university tutorial staff. In order to maintain good assessment processes careful allocation of mentors would be beneficial in future. Price (2007) and Gopee et al (2004) suggest that heavy workload of mentors and practice teachers may hinder learning; however teaching frameworks such as this one can help. Price (2007) suggests that knowing and being able to demonstrate knowledge are not enough to define fitness for practice. Practitioners should be assessed on consistency of accomplishments. Thus placements which take place over a long period are well set to meet those needs .The SCPHN student takes place over one academic year with a one to one practice teacher and student relationship. The author as a new practice teacher has found this very rewarding but also a fine balance between meeting the demands of student, clients and her own studies. Duffy (2004) in a report concerning mentors failing to fail students made recommendations. In order to identify any weaknesses in clinical practice mentors should work closely and habitually with students in order to make precise and honest assessments. As a trainee practice teacher the author has felt poorly prepared for assessment of students and though previous mentorship experience has proved useful it was very different. Closer work with a practice teacher mentor would be beneficial and the author has taken steps to address this. Peer support has proved invaluable and shared experience has been a reassuring factor.
It is envisaged that the safeguarding induction programme will be part of portfolio evidence for student and practice teacher (appendix 3). It is the responsibility of the managers to evaluate which level of competency should be achieved. A problem based learning approach was considered to provide formative assessment. The NMC (2006) acknowledges that while the practice teacher will make summative assessments there is value in other mentors being involved in formative assessment. In practice other mentors have not been available due to staff sickness. Ousey (2003) found that problem based methods may promote learning as students felt involved and learn knowledge in context. Unfortunately the group identified to take part in this were not able to commit to regular meetings .Student anxiety about working with an unknown group was also a factor. The practice teacher was able to reassure the student that formative assessment was to provide the student with information about progress and tailor teaching to her needs (Quinn and Hughes 2007). Issues of equity and diversity were addressed as the course was tailored to meet an individual’s needs. It seemed realistic to assume that the SCPHN student should achieve level 4 competencies, (can teach others) by the end of her course. When participating in an information evening and later first level interviews for potential CCPHN students the clear message was that the PCT intends that nurses with this level of qualification will be team leaders (Nottinghamshire Community Health 2008). Problem based learning can be a very supportive process and has the value of shared expertise (Price 1999). With future students and new starters better preparation should make this possible
The safeguarding handbook does not make clear if there is a time limit set to achieve outcomes however they are based on recommendations from a national intercollegiate report (Royal College of Paediatrics and Child Health 2006).
Competency based assessment such as these rely on the assessor having the skills and knowledge to effectively monitor learning. The competency framework in question was delegated to new practice teachers with little preparatory training and this has resulted in needing to seek guidance form safeguarding nurses. This could have been avoided with better preparation.
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Use of the safeguarding induction handbook has proved useful tool to direct specific learning. This however was fixed by the needs of the PCT in order to meet national safeguarding directives. Its content is clearly and carefully designed but like all competency based assessment it relies on the assessor’s objectivity. It is described as an induction framework which implies it is for new starters only. This is confused by guidance notes which imply it is to be used to maintain staff competence. There are no clear timescales for achievement, that and the level to be achieved relies on individual managers. This may cause problems with equity of competence. Evaluation suggests this is a work in progress .The author recommends that new practice teachers and managers should have further training and feed back should be given to the development group for the annual review.
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