Supporting and assessing the student Susan Hall Senior Lecturer in Surgical Care Practice

Session objective To introduce the key individuals in the education, support and assessment of Surgical Care Practitioner trainees To provide an overview of the workplace based assessments required by the Royal College of Surgeons of England’s Curriculum Framework. Preceptorship session2

Key personnel Clinical supervisor Mentor Educational supervisor Teachers / supervisors Preceptorship session3

The clinical supervisor Preceptorship session4

The clinical supervisor - professional characteristics Must be a current Fellow of a Royal College of Surgeons Should be recognised as an Assigned Educational Supervisor or Clinical Supervisor Preceptorship session5

Responsibilities Ensure opportunities for professional and personal development Ensure that the assessment documents and SCP portfolio of evidence is discussed as early in the course as possible Ensure that there is time allocated for initial and subsequent interviews Preceptorship session6

Responsibilities (ii) Identify and provide access to learning opportunities and resources Teach the trainee within the clinical environment Liaise with the mentor for the assessment of competence Collate feedback from all learning events Preceptorship session7

Responsibilities (iii) Provide an environment that permits students to plan their workplace based assessments & provide constructive feedback Co-ordinate the results of the assessments to make a final, informed judgement of professional competence Preceptorship session8

The mentor Preceptorship session9

The Mentor professional characteristics Senior hospital professional with suitable background to support the trainee The appropriate education and training to perform the role of mentor Preceptorship session10

Responsibilities Have a clear understanding of the competencies to be achieved Undertake assessments as required Complete the necessary parts of the trainee’s portfolio of evidence (practice document) Provide a learning environment that permits students to plan their workplace based assessments Preceptorship session11

Responsibilities (ii) To be approachable, supportive and aware of the student’s learning style To ensure the provision of time for reflection, feedback and monitoring of progression To ensure that the trainee receives constructive feedback & suggestions on how to make improvements Preceptorship session12

Assessment system Competence: the principle that enables the SCP trainee to practice safely. Performance: the repeated and consistent demonstration of competence. spx Preceptorship session13

Direct observation of procedural skills Known as DOPS Direct observation of a short procedural skill by a trained assessor Recommendation as for (junior) surgical trainees – 6 per year Preceptorship SD introduction14

Mini clinical evaluation exercise Known as ‘miniCEX’ Assessor observes the trainee dealing with a patient in the Outpatient, A & E, or ward environment History taking Examination Investigation Management plans communication Recommendation as for surgical trainees – 6 per year Preceptorship SD introduction15

Other clinical assessment tools ToolAssessed ISCP domainsFrequency Case Based DiscussionKnowledge and judgement1 per two months Acute Care assessment toolKnowledge, judgement and professional 1 per two months Mini Peer Assessment Tool (Mini-PAT)Knowledge, judgement, technique & professional Annually Multisource feedbackKnowledge, judgement, technique & professional Annually Annual progress review Preceptorship session16

Levels of supervision Level 1 Supervising surgeon in the immediate vicinity Level 2 Tasks undertaken as delegated by the operating surgeon who may not be in the immediate vicinity Preceptorship session17

The take home message The modern Surgical Care Practitioner must be suitably educated and qualified The standard of competence required of an SCP delegated to perform a task is that of the medical practitioner they are replacing The time required to acquire the necessary experience is enormous Preceptorship SD introduction18

References & resources Bartter, K., Ethical Issues in Advanced Nursing Practice. Oxford: Butterworth Heimann. Bolam V Friern Hospital Management Committee (1957). Department of Health, Advanced Level Nursing: A Position Statement, COI for the Department of Health. Dimond, B., Scope of Professional Practice in theatre nursing. In: Legal Aspects of Nursing. 7th ed. Harlow: Pearson Education Ltd, p Gibb, G., Medical Malpractice Lawsuit Accuses Surgeon of Leaving Procedure Early. [Online] Available at: Hall, S., Quick, J., Hall, A. & Jones, A., Surgical Assistance: who can help?. Annals of Royal College of Surgeons of England (Suppl), July, Volume 96, pp Health Care Professions Council, Professional indemnity cover and your registration. [Online] Available at: Health Care Professions Council, Aims and vision. [Online] Available at: Healthtrust Inc vs Cantrell (1997). Hughes, S. & Quinn, F., Quinn's principles and practice of nurse education. 6th ed. Andover: Cengage Learning. Kirk, R., Basic Surgical Techniques. 6 ed. Edinburgh: Churchill Livingstone Elsevier. Nursing & Midwifery Council, The Code: Professional standards of practice and behaviour for nurses and midwives. London: NMC. Nursing and Midwifery Council, Professional indemnity. [Online] Available at: Perioperative Care Collaborative, Position Statement. Surgical First Assistant (formerly the 'Advanced Scrub Practitioner'). Perioperative Care Collaborative. Rothrock, J. C., The RN First Assistant. 3rd ed. Philadelphia: Lippincott Rothrock, J. & Seifert, P., Assisting in Surgery: Patient Centred Care. Competency and Credentialing Institute. Royal College of Surgeons of England, Surgical Assistants. Position Statement. Royal College of Surgeons of England, Surgical Care Practitioner (SCP). [Online] Available at: Royal College of Surgeons of England, Good Surgical Practice. London: Royal College of Surgeons of England. Royal College of Surgeons of England, SCP curriculum. [Online] Available at: Royal College of Surgeons, Statement on Duty of Candour. London: RCS. Simpson, J. & Rowlands, B., Trainees and Trainers: rights and duties. Surgery, October, 26(10), pp Wilsher v Essex Health Authority [1988] 1 AC 1074 (1988). 19Preceptorship SD introduction