Update for Nursing Mentors/Practice Assessors 2018 Supporting Undergraduate Pre-registration Nursing Students in practice

Over to you……….. What do you want to get out of this mentor update? Any issues or questions you want to cover today: e.g. Issues with students you have mentored; queries re pre – registration nursing programme; any other practice placement or mentorship issues?

What’s new? Issues potentially impacting on placements and mentors: Loss of student fees and bursaries to student loan model since 2017 – impact on profile of students (younger) and expectations as “consumers” Potential increased learner numbers on placements as no capped on commissioned pre reg numbers – but limited by placement circuit capacity And new types of learners………………

Nursing Associate programme expanding and NMC standards and updated NMC Code published 2018 Apprenticeships in pre- registration nursing now started in Leeds (same outcomes, 4 year programme) Associate/Assistant practitioners - “in house” roles –with local competency frameworks & different educational prepration

Differences between Registered Nurse & Nursing Associates Honours or Ordinary Degree: Be an accountable professional Promoting Health and preventing ill health Assessing needs and planning care Providing and evaluating care Leading and Managing nurse care and work in teams Improving safety and quality of care Co-ordinating care (NMC 2018 Outcome statements for platforms) Foundation degree: Be an accountable professional Promoting Health and preventing ill health Providing and monitoring care Work in teams. Improving safety and quality of care Contributing to Integrated Care. The outcome statements for each platform have been designed to apply across all four fields of nursing practice (adult, children, learning disabilities, mental health) and all care settings. This is because registered nurses must be able to meet the person centred, holistic care needs of the people they encounter in their practice who may be at any stage of life and who may have a range of mental, physical, cognitive or behavioural health challenges. They must also be able to demonstrate a greater depth of knowledge and the additional more advanced skills required to meet the specific care needs of people in their chosen fields of nursing practice. The annexes to these standards of proficiency are presented in two sections. The annexes provide a description of what registered nurses should be able to demonstrate they can do at the point of registration in order to provide safe nursing care. Annexe A specifies the communication and relationship management skills required, and Annexe B specifies the nursing procedures that registered nurses must demonstrate that they are able to perform safely. As with the knowledge proficiencies, the annexes also identify where more advanced skills are required by registered nurses, working in a particular field of nursing practice.

Introduction of Electronic practice assessment documents of pre registration nursing students via Pebblepad – Leeds Beckett year 1 started September 2017, Leeds Uni March 2019 (see slides at end) Also move to pan England Practice Assessment Documentation for student nurses……….. New NMC standards for pre reg nursing and for supporting learning & assessment in practice– RADICAL NEW MODELS FOR SUPPPORTING LEARING AND ASESSMENT IN PRACTICE coming in - will be in place England wise by September 2020 ( see Hand out for discussion)

What if………. • Student doesn’t turn up • Student is off sick • Student wants to make up hours • Student wants to work as an agency or bank HCA in your area • Student says he/she cannot arrive at start time and cannot do certain shifts OR: You have concerns about their behaviour or they have concerns about any aspect of the placement…..

Or student wants help with academic work…….. Your role as mentor may include: Discussion of an appropriate topic for case studies or specific assignments Provide a clinical experience to help them with meeting some assignment requirements Whilst mentor help and advice is appreciated, caution is needed if you share your own previous academic work with students, as there may be risks associated with this. For the Student - may result in the student inadvertently using your work resulting in an investigation of plagiarism – penalties can range from repeating the work for a lower mark to exclusion from the programme For the Mentor - Referral to NMC as a breach of The Code (2018)

What if……… a student from outside the area requests a placement allocation in Leeds and contacts the clinical area directly All placement requests of any sort MUST GO THROUGH YOUR PRACTICE LEARNING FACILITATOR AND THE UNIVERISTY PRACTICE PLACEMENT UNITS - To enable a series of checks to be in place to verify identity and status and ensure that the capacity to provide placements for local students is not compromised

NMC (2008) “Mentors are responsible and accountable for. providing NMC (2008) “Mentors are responsible and accountable for ..providing..constructive feedback” We know that students: Value feedback Want specific not generic feedback Want negative as well as positive feedback Need formative as well as summative feedback Can find feedback :motivating, increases their confidence, promotes personal development, improves self esteem, reduces stress, develops competence We know that mentors: Find giving feedback stressful at times Difficult to give to weaker students (Source: Duffy K. 2013 Providing constructive feedback to students during mentoring Nursing Standard 27 31 50 – 56)

Activity: Reflect on students who you have recently supported and come up with some general principles of giving constructive feedback

Principles: Set realistic goals Gauge students expectations of feedback by self assessment Ensure it is informed by evidence (prepare) Be timely -give as close as possible to events Be specific and balanced Document feedback discussions Invite student to contribute Involve university if risk of failing or mentor needs support (Adapted from Walsh D. 2010 The Nurse mentor handbook OUP Maidenhead)

Scenarios: 1. You are supervising a first year student in your practice learning environment. Another student discloses that they have seen a discussion on a social networking site posted by the student you are mentoring stating that the student does not feel supported by you, as the mentor. 2. Mark is a 2nd year pre-registration student. He is 4 weeks into his placement. When he sees his personal tutor in University, he complains that his preliminary interview did not occur until 2 weeks into the placement, that Jane, his mentor, ….. has not updated herself recently…..” and she is frequently working different shifts to him. What should his personal tutor do?

3. You are supervising a second year student who is in week 3 of an 8 week practice learning experience. Based on your observations and questioning, you notice that the student’s underpinning knowledge is poor when undertaking a particular intervention. As part of your support strategy you give the student a workbook previously developed which you ask to be completed within a week. You then receive a telephone call from a lecturer in the University who states that the student feels that you ( the mentor/practice assessor) have unrealistic expectations of them. 4. During your introductory meeting with a pre-registration student who you supervising, they disclose to you that they are dyslexic and so may struggle with written work

Why we moved from paper to PebblePad Better, easier support of student learning: Mentors and academics can securely view, comment on, and assess student work at any time. Easy reporting on what students have (or haven’t) done, and who might need help. Develop students’ digital literacy (and ours!) to be prepared for the modern workplace. Work can’t be left on a train or out in the rain. Save ££thousands on printing costs. Students able to upload additional pieces of evidence to aid your judgement of competence. Students can work offline and information uploaded when internet access available

Logging in to PebblePad To login, you need two things: Your username This is your full work email, e.g. florence.nightingale@nhs.net Your password A randomly generated password will be sent to your work email from noreply@pebblepad.co.uk You should change it to something memorable when you first login

Assessing student work You can give feedback/ assessment wherever you see this label: Usually this will be clicking to say you verify some element in the portfolio, or have done an interview etc. We’ll look at this in detail next. Your student will let you know which page(s) they need you to give feedback/ assessment on.

What’s where in the ePAD The ePAD is divided into 10 sections that show across the top of every page: (these won’t be in two pieces when you look on your screen…) Click here to see full table of contents and quickly navigate to different pages

Let’s start to look at each of the pages. The introduction page will have some basic guidance as to process and explanation of terms, although the process of assessment is the same: initial, mid and final interview. Practice Standards, skills logs and grading are intertwined as now.

The ‘About me’ page will have been populated by the student prior to 1st placement. We will be asking them to add in a professional photo of themselves and a bit of text describing ‘where they are at’ now. ‘Where they are at’ – give e.g. – 18 yr old, minimal caring experience, looking forward to first placement, or 25 year old, married couple of kids, HCA for 7 years….

PAD forms: these are the interview pages, incorporating the professional behaviour and grading elements in the intermediate and final interview pages. The pages will be released per placement, so for the 1st placement, you and the student will only see Placement 1 pages – the others will be released for the next placements.

PAD forms assessment – Here are the first bits where you can fill things in. Only you can complete these ‘completed by assessor’ areas and the students cannot change anything in them once completed. Maybe worth thinking about the new NMC Standards in consultation because these remove the term Mentor and introduce the concept of assessor and supervisors.

Attendance record – The students will have been shown how to get the forms, however if you can’t see the weekly forms, please can you ask the student to check they have moved this button to ‘on’, as the forms will only be visible when they have done so.

Practice Standards page looks like this, but we can’t easily show you how the whole standard looks when completed by both you and the student, therefore the next slide has the whole process on.

Care, compassion and communication 1 As partners in the care process, people can trust a newly registered graduate nurse to provide collaborative care based on the highest standards, knowledge and competence. 1a Articulates and adopts a principled approach to care and works within the Code (NMC 2015) and adheres to the Guidance on professional conduct for Nursing and Midwifery Students Click yes when ready to be assessed Yes Working towards Student Comment Attach any evidence to the rosette certificate/offline form/reflection/document etc. ONCE THE STUDENT HAS TICKED THAT THEY ARE READY TO BE ASSESSED, AND IDEALLY HAS WRITTEN /ATTACHED SOME EVIDENCE TO SUPPORT THIS, THAT WOULD BE THE TIME WHEN WE WOULD RECOMMEND YOU MAKE A DECISION AS TO ACHIEVEMENT. There is a box for you to give feedback, which you may want to do, although this isn’t essential. There are 3 boxes you can use to state how you assessed the student. You can click one or more. COMPLETED BY ASSESSOR Observed Questioning Written/Documentation Achieved Not achieved Mentor feedback Please note, that we have removed the Core Practice Standard requirement. Also, the Practice Standards are to be completed throughout each year, so ideally, as Stage 1 has 3 placements, approx 1/3 should be achieved by the end of placement 1, 2/3 by the end of placement 2 and all by end of placement 3. This would be the same for stage 2, but as stage 3 has 2 placements, ½ and ½ each placement. Talk through that the student clicks ‘yes’ ready to be assessed – this then alerts the Mentor that the student has done this. It is good practice for the student to either/or comment on why they are ready to be assessed or attach some evidence. This might be that they have been on a complementary placement and have learnt something, or they have got a testimony, or simply done something in the placement with the team. There are options for the Mentors to click observed, questioned, seen written work or documentation. They don’t all need to be ticked, just the most appropriate one for the standard. Then tick either achieved or not achieved. There is also a area where the Mentors can add feedback also if they want.

Skills- this is a purely Mentor-only page, as it currently is in the paper PADs. You may be prompted to SAVE as you go along, and if you haven't saved for 20 mins or more, you get an alert such as this

Skills example – here the student has had stage 1 and 2 ticked as being competent in this skill as they are a stage 2 student… Please only tick the relevant stage – for the September 2017 cohort, this will be stage 1.

Pebblepocket

A note about the Practice Standards and Skills log The Practice Standards are the same as you are already familiar with, although they have been slightly reduced. We have also grouped the skills into the same domains as the Standards. This can help you to gauge how the student is achieving – if they are competent with a skill, they should be competent (for their stage of training) in some or all of that domain of the Practice Standards.

Medicines management – looks similar to the current documents Medicines management – looks similar to the current documents. You only need to check the students work and click that you have verified it. Please do check the calculations… Students as now, have to complete a variety of medications over the 3 years, with 10 per stage. This should help in placements where they don’t deal with medication directly. Hopefully the 3 placements per stage in 1 & 2 will ease this.

AFE (Alternative Field Experience) – The NMC require that all nurses should be confident to deal with people in all fields of practice. These pages are assessor only pages, as you need to judge how well the student can respond to people across the healthcare spectrum.

Testimonies – these will be evidenced by the student either printing off the current paper version, or using a form on the PebblePocket app on their phone.

Can I search for specific items in any of the pages of the portfolio? Yes, although it is slightly limited. On your keyboard, Press Ctrl + F together which will open up a small box where you can type in your search terms. See example on next slide

Depending on how your computer is set up, a small box appears somewhere on your screen. Mine appeared up here. The search box is per page only. You can’t search the whole workbook for specific items

Questions?