Midwifery Sign-off mentor update June 2014

Thank you for completing the Mentor Evaluation Form.

On line information To support this presentation please access the link below for the information and guidance included in this presentation www.anglia.ac.uk/mentors

Embracing the “NHS Values” within mentoring Positive role modelling The NHS Constitution Values The 6 “C’s” The Essential Skills Clusters.

Mentorship of Student Midwives Student midwives must have a named sign-off mentor to support them through each of their midwifery placements. Students must work with their sign-off mentor for 40% of their placement – minimum of 2 shifts a week or 15 hours. All midwifery mentors have to be a sign-off mentor or working towards becoming a sign-off mentor. Midwifery mentors working towards becoming a sign-off mentor must be supervised by a sign-off mentor when mentoring students.

Entering and Remaining “Live” on the mentor register NMC approved mentor preparation programme. Been supervised mentoring students on 3 occasions ( or done 2 simulations and 1 supervised sign-off). Have completed the Midwifery Sign-off Verification Document to enter the register. Annual mentor update (within 12 months of last update) Triennial review (within 3 years of last triennial review.) Supported and summatively assessed two students within the three year cycle.

Triennial Review Three yearly cycle of reflection of mentor practice against NMC standards. The process is a self assessment of your skills as a mentor. Complete “Triennial Review for Mentors” document available on the Mentor Portal or Trust equivalent This provides evidence of your on-going updating of your mentoring skills Meet with your line manager or appropriate other to review your evidence. The Mentor Register is then updated.

Quality assurance The HEI and Placement Providers work together to assure the quality of the student practice learning experience through the process of: Audits Practice Education Committees Student/Mentor Evaluations Moderation of Practice Assessment External reviews from CQC, Monitor, PQAF, Professional Body, NHSLA

New Curriculum Sept 2014 The September 2014 cohort will commence a new curriculum. New curriculum will have a new Practice Assessment Document. New curriculum has a new Grading in Practice Tool. September 2012 and 2013 cohorts will remain on the old curriculum, but will use the new curriculum’s Grading of Practice Tool.

Content of New Curriculum   Year One (Level 4) PROGRESSION POINT (NMC) Year Two (Level 5) PROGRESSION POINT Year Three (Level 6) Trimester One Fundamentals of Midwifery Practice 1 (30 credits, Standard Module) Small Group Presentation(Fine graded) & 1800 word reflective account(pass/fail) Knowledge, research and evidence in midwifery practice 4800 word critique of research paper (Fine graded) Midwifery Care for the woman and infant with complex needs 2 hr Multiple choice exam (pass/fail) & 3 hr written exam (Fine graded) Promoting Health & Wellbeing in Midwifery Care 5000 word essay(Fine graded) Undergraduate Major Project (30 credits, Project Module) 10,000 word major project (Fine graded) Newborn Infant Physical Examination (30 credits, Theory/Practice Module) NIPE practice document Pass/fail OSCE (Fine graded) Trimester Two Fundamentals of Midwifery Practice 2 Breastfeeding OSCE(Fine graded) MCQ paper (including A&P/ Breastfeeding; Fine graded) Fundamental Midwifery Skills (30 credits, Placement Module) Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded) Safe Medicate 80% pass  Start case-load Emergency Midwifery Skills (30 credits, Standard Module) OSCE NLS Pass/fail Random OSCE (Fine graded) Developing professional midwifery skills (30 credits, Placement Module) Collaborative professional working (30 credits, Standard module) Annotated PowerPoint (Fine graded) Advancing Midwifery Practice (30 credits, (Placement Module) Safe Medicate 100% pass Trimester Three

Placements Curriculum is 50% theory and 50% practice. During placements students will work 30 hours a week clinically. 7.5 hours will be for guided reflection, skills or theory sessions. Students will have the following placements through the course. YEAR WEEKS OF PLACEMENT   PLACEMENT AREAS ONE 21 weeks Midwifery placements TWO 30 weeks 2 weeks Gynae/acute care placement 2 weeks neonatal unit placement 2 weeks non- midwifery placements 3 weeks elective placement. THREE 24 weeks Midwifery placements.

Practice Assessment Document Students will have a separate Practice Assessment Document for each year of their course. They are designed to enable the student to demonstrate achievement of the Standards for Pre-Registration Midwifery Education (NMC 2007) and the Essential Skills Clusters (NMC 2009) which will allow them entry onto the midwifery part of the NMC register. The Practice Assessment Document will be bound and should remain with the student at all times.

Progression Points The NMC requires that there are progression points within midwifery course, where students have to pass all academic and practice assessments up to that point before they can proceed onto the next part of the course, or qualify as a midwife. The NMC state that the proficiency in practice needed to pass a progression point must to be assessed by a sign-off mentor in practice.

Progression Point 1 & 2 The sign-off mentor on the student’s last midwifery placement in the first year and second year needs to make a judgement of whether the student has achieved the level of proficiency for that year. They will do this through reviewing the student’s Practice Assessment Document and through their own observations of the student. The sign-off mentor will need to sign the Progression Point completion form to verify successful completion of the practice element of the progression point.

Final progression point The student will be allocated a final sign-off mentor in the third year. The final sign-off mentor must work a placement with the student in their 3rd year and must meet with the student for at least 1 hour per week in their final placement. The final sign-off mentor is responsible and accountable for assessing the student against the NMC Final Progression Point Standards. The final sign-off mentor will need to sign the declaration to verify that the student has met the standards in order for the student to enter onto the midwifery register.

Practice skills Each year the students will have a set of practice skills in which they need to be able to demonstrate proficiency. These skills can be signed off by any midwife who the student works with and who observes their proficiency in the skill.

Essential Skills Clusters The Essential Skills clusters (ESC’s) are a set of broad, woman-focused, midwifery skill statements introduced by the NMC (2009). The ESC’s cover five areas of midwifery practice: Communication Initial antenatal assessment Normal labour and birth Breastfeeding Medicine management. ESC outcomes are assessed at 2 points; at the end of the first year and at the end of the third year. The Essential skills clusters must be signed off by the student’s sign-off mentor.

NIPE assessments 1st year Students must complete 10 formative top to toe Examinations of the Newborn, which include examination of the TESTES (part of the NIPE check). A sign off- mentor can assess these examinations. · At the end of the year students MUST also undertake a summative assessment of a top to toe Examination of the Newborn. The summative assessment must be observed by a sign-off mentor who has done at least 3 of the student’s formative assessments. Students will be completing the Newborn Infant Physical Examination module (NIPE) as part of their midwifery course. This will be taken as a module in Year 3. However, students must prepare for the module throughout their midwifery course and keep a practice document of their progress.

NIPE assessments continued 2nd year Students must complete 10 formative top to toe Examination of the Newborn examinations, which include the HEART (part of the NIPE check). These must be assessed by a practitioner with the NIPE qualification to ensure accuracy of the Heart examination. A further 10 formative top to toe Examination of the Newborn examinations are required, but could exclude the heart if assessed by a practitioner without the NIPE qualification. At the end of the year students MUST also undertake a summative assessment of a top to toe Examination of the Newborn. The summative assessment must to be observed by a sign-off mentor who is a NIPE practitioner who has done at least 3 of the student’s formative assessments. 3rd year Students must complete the NIPE module. This includes:- · 10 formative Newborn Infant Physical Examination (NIPE) assessments with a NIPE qualified practitioner. · An OSCE- summative assessment which is undertaken in the University. · Producing a practice document with evidence of all assessments.

Placement documents Mentor details Orientation to practice area Learning contract Mid-placement/interim review Grading in Practice Tool Feed forward

Grading in Practice Tool The Traffic Light System Any mark that falls in The red is unsafe practice so the student will fail the assessment with an overall mark as 0 In the amber column is satisfactory In the green column indicates good /excellent progress. Holistic assessment tool to be completed at the end of every midwifery placement of 4 weeks or more. Different grid for each year of the course. Marks contribute credits to the student’s degree. Follows a traffic light system. Pass mark for FGT is 40%

Failing the Grading in Practice Tool – what happens? Inform the student’s personal tutor/link lecturer immediately. A tripartite meeting will be set up between the student, sign-off mentor and personal tutor to develop an action plan for remedial action for further placements. The student will need to repeat and pass the placement in the first trimester of the next year.  

Feedback and feed forward Feedback is important to help the student know how they are performing. Feed forward gives specific suggestions to the student on how they could improve their performance. To be effective feedback and feed forward needs to be: Early Specific Written feedback is crucial for Sign-off mentors decision at progression points Continuity and validity of summative assessment Student reflection Verbal feedback should be honest and caring Service users feedback is important Interpersonal skills Confidentiality

The Old and the New New Curriculum Old Curriculum Learning contract Mentor details & Orientation to practice area Mid-placement/interim review Practice Skills Essential skills clusters Examination of the Newborn Skills formative & summative assessments Grading of Practice Tool & Feed forward. Interprofessional learning Management practice assessment Sign-off of 3 progression points Old Curriculum Learning contracts Preliminary practice reviews Interim practice reviews Midwifery practice skills Midwifery practice outcomes Observed practice assessments Fine grading tools Interprofessional Learning Opportunities Sign-off of 2 progression points.

Case loading It is an NMC requirement that students hold a small caseload during their course (NMC 2009). Students will carry a caseload of a minimum of 5 women over the 3 years of the course. Students can start to gather their caseload in the 3rd trimester of their 1st year. Students must gain consent from the woman and the woman can withdraw at any time. All care given must be fully supervised.

Empathy for Students Make students feel welcome. Sensitive to students’ needs Respect student as you would a colleague Understand that student has deadlines Consider them as your future colleague Ensure they feel a ‘valued’ member of the team Encourage students to discuss potential improvements to standards of care Maintain student’s confidentiality

Mentoring is Key to Student Learning Professional gatekeeper Professional role model Positive mentoring is valued by the student You may be the most inspirational figure in the student’s career

References. NMC (2008) Standards to Support Learning and Assessment in Practice London: Nursing and Midwifery Council   NMC (2009) Standards for Pre-Registration Midwifery education London: Nursing and Midwifery Council