Clinical Placement Review Royal Cornwall Hospitals Trust Benchmarking Exercise May 2002 Adele Kane

Why Review Clinical Placements?  Forthcoming QAA academic review of practice placements.  DOH Guidance for education in practice. (Placements in focus DOH/ENB 201)  Single Intake project in Cornwall.  Elective placements (work-base learning / impact on recruitment.  PLU.  Practice Educator’s role.  Roles / responsibilities of Trusts and Universities.

The Review Team §Trust Link for Pre-registration Students §Clinical Practice Educators - Adult Branch §Lecturer Practitioner for Midwifery

Methodology 57 Clinical Areas surveyed across the 3 RCHT sites for Adult, Child Health and Midwifery  Suitability of learning environments.  Student and Staff Support.  Assessment of Learning outcomes Based on: QAA review Categories (QAA 2001) Placements in Focus (DOH/ENB 2001)

Methodology  Week 1: Questionnaires given out interview date arranged.  Week 2/4: Follow up with informal interviews with Clinical Manages. Evaluating, comparing the quality of their clinical area against the benchmark. Drawing up action plans.  Week 5/6: Correlation of information. Formalisation of action plans.

1. Suitability of Learning environment Selection and monitoring of practice experience and placements: Benchmark: “ There should be a jointly developed strategy for the selection and monitoring of practice experience and placements”(3.1.1 DOH/ENB)  There was no formal joint strategy.  Decisions based on university led educational audits, ENB validations and individual links with tutors.  Prospective placement areas:- no formal pathway.  Review of capacity:- no formal pathway.

Action Plan  Meeting with I.H.S Academic Co-ordinator Placement CO-ordinaor, PLU / to review processes.  Template for placement numbers: 2-1 mentor ratio.  Annual joint review re numbers of students  System / process for prospective new placement areas.

Educational Audit Benchmarks §“Placement areas should be audited in line with the requirements of the statutory / professional body.. They should be monitored jointly(3.1.12) §Student feedback should be actively sought and should contribute to the ongoing evaluation of the learning environment”. (3.2.13) (DHO/ENB 2001)

Outcomes  When was your last educational Audit?  Are the results of the audit available to all staff?  Have you evidence of actions taken as a result of the audit? Evidence of audit within the last 2 yrs 28% Evidence of audit unavailable/ more than 2yr Evidence of audit feedback Evidence of audit within the last year Evidence of accessibility for all staff Evidence of action plans being implemented 50% 26% 29% 5% 22%

Educational Audit Action Plan  Practice Educators to be involved in reviewing the Educational audit results with clinical areas.  Clinical Managers to ensure up-to-date audit feedback is accessible to staff.  Clinical Managers to ensuring action plans implemented.  That the I.H.S ensures all understand the audit cycle.  That all clinical areas receive prompt feedback of the audit, to include student feedback.

Suitability of Learning Environment Benchmarks §“Placement providers should have a profile which identifies: the learning opportunities available, The learning outcomes expected (3.1.2) (3.3.5) §The students should gain where possible experience as part of a multiprofessional team(3.2.10) §A learning resources area whith releveant materials should be available in the placement environment (3.2.13)” (DOH/ENB 2001)

Outcomes  What learning resources are there available?  Do you have an up to date placement profile?  Do you have specific objectives for your area? Evidence of up to date placement profile 68% Evidence of a placement profile / student pack Evidence of placement specific objectives Evidence of accessibility to a wide variety of placement specific learning resources 30% 39% 12%

Outcomes  Have you included placement mapping/ pathway for your area  Have you included a staff profile?  Can students experience MDT working and learning? Evidence of placement mapping in process 17% Evidence of staff profile Evidence of multi-professional learning opportunities Evidence of placement mapping in profile 4% 11% 52%

Action Plan §All placement profiles to be updated to meet DOH requirements. §A standard format/ framework for placement profiles and learning pathways should be introduced across the Trust.

2. Student and Staff Support prior to and during Placement Benchmark §“Lectures should contribute to the support of students’ learning in the placement area” (3.313) (DOH/ENB 2001)

Outcomes  What pre-placement support does your area receive?  What support do you get whilst students are in your area? Evidence of active relationship with PE 36% Evidence of relationship with LT Evidence of relationship with PE Evidence of active relationships with with LT Evidence of pre-placement allocation information Evidence of pre-placement support from PE 31% 32% 85% 42% 45% Evidence of support during placement from PE52%

Action Plan  Practice Educators to continue to raise their profile, clear timetabling for mentor/assessor support vacancy to be appointed.  Clinical Managers to ensure allocation information available for all staff.  All students should visit contact the placement area before starting to meet the team/mentor, explore the placement profile/ objectives etc. at least 3 weeks prior to commencement.

3. Assessment of Learning Outcomes Benchmarks §“There should be a named assessor/mentor with appropriate qualifications and experience to support and assess the student.. (3.37, 3.42) §Service providers and HEI’s should support dedicated time.. For practice staff to ensure they are competent and confident in teaching/mentoring and assessing roles” (3.311) (DOH/ ENB 2001)

Outcomes  How do you select assessors for your clinical area?  How many are up to date?  Do all your staff understand the assessment process? Evidence of adequate preparation for the role (course /update) 64% Evidence that all mentors/assessors have yearly update All staff understood the assessment process (CM) Evidence of suitable method of mentor/assessor selection 52% 37% 61%

Outcomes  How do you assess the competency of your assessors? An assessors annual update ensures competency 17% Confirmation of assessment of competency by other methods Assessment of competency not previously considered Evidence of mentor’s competency assessed at IPR 22% 54% 15%

Action Plan  Clinical managers to keep records of assessors updates attended.  Clinical Managers and Practice Educators to ensure all staff remain familiar and updated with assessment processes.  Clinical Managers to consider assessing competency of staff at IPR.

Conclusion  Provided information about the quality of learning placements across the Trust.  Raised awareness that recorded evidence to quantify the quality of the placement is required to meet the DOH standards and Clinical Governance requirements.  Many of the action plans set to improve the quality of placements and joint working between the Trust and University are being implemented and are linked to the work of the PLU.

The interest and co-operation of all those involved in the exercise reflects the enthusiasm of all parties to provide a quality learning experience for students at RCHT.