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

Preceptorship session 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 session

Preceptorship session Key personnel Clinical supervisor Mentor Educational supervisor Teachers / supervisors This latter group will comprise members of the multi disciplinary team and will include anaesthetists / qualified nurses / ODPs & surgeons in training The educational supervisor is the course leader, with input from leaders of other modules that comprise the course Every student will have their own learning style – research has shown that adult learners benefit from experiential learning and as discussed earlier, the RCS supports this by encouraging active involvement of students. Preceptorship session

The clinical supervisor Preceptorship session

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 session

Preceptorship session 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 It is important for the clinical supervisor to be familiar with the practice document and subsequent speciality paperwork. There must be a clear understanding on the part of the student for reflection on learning & practice to be embedded in their portfolio of evidence. This supports the RCS expectations and also those of the practitioner’s regulatory authority Preceptorship session

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 Learning must be in and from practice and should follow a logical, planned progression Teaching should be appropriate to the student’s stage of progression within the clinical programme – some of the current cohort of trainees come from a non perioperative background – this will, inevitably mean that they hit some of their milestones later. Preceptorship session

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 Ensure that the trainee has sufficient opportunity, in a safe environment to be taught & learn the required skills Take the lead and make the final decision in the assessment of the trainee SCP including the completion of documentation Provide advice and support, address specific needs - eg difficulties in progression Preceptorship session

Preceptorship session The mentor Preceptorship session

Preceptorship session The mentor portal www.anglia.ac.uk/mentors This is a newly developed resource to support you and to enable a better understanding of the expectations placed on students. At present the SCP site is under development, however it does contain documents that you may find useful Preceptorship session

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 The Royal College of Surgeons has stated that mentors should hold a recognised mentoring qualification That they should have an understanding of the assessment documents and the portfolio of evidence Preceptorship session

Preceptorship session 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 There is also the requirement to be familiar with the assessment documents To Liaise with the clinical supervisor with regard to practice related experiences and to confirm competence as required To have an understanding of the trainee’s course of study To be willing to share aspects of patient care (experience) Preceptorship session

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 It has been argued that a humanist approach to teaching is more appropriate for adult learnings and that a good teacher develops a feeling for students’ emotional needs, cognitive development and social background. This interest in the welfare of students has a positive influence on learning To encourage the student to use enquiry based learning and problem solving To encourage the student to work in partnership with the interprofessional team Preceptorship session

Preceptorship session Assessment system Competence: the principle that enables the SCP trainee to practice safely. Performance: the repeated and consistent demonstration of competence. The assessment of SCP trainees uses the domains established by the ISCP COMPETENCE: Grows from the flexible application of knowledge and skills Performance: Is necessary for progression through identified points in the training programme Preceptorship session

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 Assesses the trainees knowledge, judgement and surgical technique Preceptorship SD introduction

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 This exercise assesses the trainees knowledge / judgement / technique and professional performance Preceptorship SD introduction

Other clinical assessment tools Assessed ISCP domains Frequency Case Based Discussion Knowledge and judgement 1 per two months Mini Peer Assessment Tool (Mini-PAT) Knowledge, judgement, technique & professional Annually Multisource feedback Annual progress review This assesses the trainee’s knowledge and judgement A case based discussion could be fitted in at the end of an M & M meeting or after a journal club session An acute care assessment may be undertaken during a ward round. This WPBA appears to have been replaced in the ISCP scheme of assessments, however, the RCS have retained it within the Curriculum framework. This could be managed by the a CBD with the focus on the acute management of a patient Preceptorship session

Preceptorship session 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 The supervising surgeon does not have to be the student’s clinical supervisor. It may be a trainee or staff grade surgeon who has the necessary skills and knowledge to act in this capacity and who has been delegated to undertake this role by the clinical supervisor From personal experience as a tenured SCP when I unfortunately worked for a surgeon who on occasion felt it appropriate to leave the building whilst I was still working on the last patient I can assure you, this is NOT level 2 supervision!!!!! Preceptorship session

Preceptorship SD introduction 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 We have covered a tremendous amount of ground this morning, However, I feel that the take home message is: If can be difficult for departments who have not employed SCPs before to find a balance between service provision and the needs of the student. For me, the thing that stands out most is the need for TIME For the trainee For the clinical supervisor & mentor For the manager. Master’s education is what is required to support the decision making that is expected of this group of practitioners – for this they need this very valuable commodity. Preceptorship SD introduction

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