Ceppl Seminar 1/7/09 Becoming a Professional – the contribution of Practice Assessment Margaret Fisher Senior Lecturer in Midwifery/ Academic Lead Placement Development Team Tracey Proctor-Childs Deputy Head of School of Nursing and Community Studies

Structure of Seminar Background Key findings to date The contribution of practice assessment to professional development Practical application – discussion Questions and summary

Assessment of practice is crucial in determining whether or not a student meets the criteria required of their profession, thus ensuring safety of the public Watkins 2000, Cowburn et al 2000

Aim To establish an evidence-based set of key principles and resources to guide Assessment of Practice, relevant across professional boundaries.

Research Questions 1. What are perceptions of validity and reliability of the practice assessment methods used? 2. What are perceptions of the impact of the practice assessment process on the student learning experience?

Definitions Practice The application and development of the appropriate skills and knowledge to the professional role in the environment where that professional activity takes place Practice learning Distinguished by the framework of support, teaching and assessment for students on professional programmes, working alongside others to deliver a service to the public as part of their course.

For the purposes of this research, practice assessment: May not necessarily take place in the clinical/ practice environment, but must incorporate practice Involves both formative and summative elements Includes all the evidence contributing to the judgement about whether the student can progress or not in practice

Methodology 14 participants from Midwifery, Social Work and Emergency Care degree programmes (nurses and paramedics) Semi-structured interviews at the end of each year Longitudinal case study approach Single-case and cross-case analysis and synthesis of findings – “Framework technique” Ritchie and Spencer 1984

In addition… Staff focus groups Ongoing literature search Trawl of websites Conference networking

Key features of the study Multi-professional/ -role research group Multi-professional participants Multi-role participants Longitudinal rather than ‘snapshot’ Investigating methods, tools and processes across a number of programmes Exploring latent aspects of learning and its impact on professionalism

Key themes

The importance of PREPARATION Clear guidance needed throughout Adequate preparation of assessors Process of discovery – the journey is the most important thing Need to emphasise development of professional identity within the assessment process

Understanding of the PROCESS Emerging clarity Methods used were key to the student experience Ongoing preparation/ guidance was vital Impact of the people involved and the placement grew increasingly important

Efforts to ‘measure’ competence and professional abilities have resulted in a wide variety of methods of assessment Baume and Yorke 2002, McMullan et al 2003

Which tools enabled development of the professional? Portfolios The process of reflection OSCE or the equivalent practical (eg: Social Work ‘conversations’) Observation of practice

The contribution of Portfolios Competences and how to achieve these Provide focus and motivate learning Professional accountability clear Evidence of capability/ achievement Encourage students as they see their progress Promote autonomous practice

How can Portfolios inhibit development? xBe restrictive/ prescriptive - “tick boxes” and/ or not enable the student to demonstrate the length and breadth of work undertaken xPotential to “cheat the system” xBulk and workload

The contribution of Reflection Develops self awareness Critical awareness of their own practice Reflexivity rather than just reflection by year three The development of “insightful practice” (S5) Autonomous and ethical practice

How can Reflection inhibit development? xDoes not always reflect the reality of practice xPotential to “blur the edges”

The contribution of OSCE’s/ ‘Conversations’ Preparation for real life The need to be tested against professional standards and expectations Demonstrating clinical competence Demonstrating safety The use of a range and repertoire of skills including communication Huge impact on learning

How can OSCE’s/ ‘Conversations’ inhibit development? xMay not be able to demonstrate normal practice due to stress levels xNot holistic xFalse environment

The contribution of Observation Benefit from feedback from different people Provides good insight into the student’s practice Develops the student’s learning If continuous assessment, the student is seen in a variety of real situations

How can Observations inhibit development? x May be artificial (if snapshot) - creating fake practice and not necessarily resulting in relevant feedback x Very dependent on experience of the assessor x Assessors may be inconsistent

The importance of the PEOPLE Mentors/practice assessors /supervisors key Role models Relationship Huge impact on the development of the students’ learning in practice Assessment of overt skills and the latent and more subtle attributes such as aptitude and suitability for the chosen profession Support from academics when in placement also crucial

What do students value in practice assessors? Honesty, integrity and ethical practice Constructive and supportive feedback in a timely fashion. Accountability for decisions made about the student A range of assessors to give a 360 degree view of the student’s performance in different situations and contexts

How might practice assessors disempower students? Inconsistency in professional judgement Lack of honesty Failure to give constructive feedback and allow the student time to retrieve the situation Poor relationship/ communication

The impact of the PLACEMENT Placement directs the learning Politics of the placement setting “Difficulties on placement can help develop you as a professional” (S5)

What aspects of Placements might impede learning? Mis-match with timing of relevant assessments Unsuitable/ vetting needed Disorganisation Distance/ time of travel to placement Inadequate support

Understanding the PURPOSE Growing recognition of the importance of achieving and demonstrating practice/professional competence The need to go through the process even if at times this seems like “jumping through hoops” and “ticking boxes” Being able to receive constructive feedback and act on this to improve performance and competence

Development of transferable skills Development of the “Art” of the professional Confirmed suitability for the profession

Discussion The practical application in your programmes……

Summary