2. Clinical Needs Assessment
Sarah Traylor
Keele University
School of Nursing & Midwifery

3. Background Information
Diagnosed disabled students in our School on 08/03/11 = 56
This is 7.1% of total students

4. Breakdown of Disabilities

5. Breakdown of Specific Learning Difficulties

6. Support Needs
All disabled students have their support needs identified by their Needs Assessment. However this is focussed mainly on needs associated with academic study.

7. Support in Practice - The real danger is doing nothing?
100% of our current students with dyspraxia are experiencing difficulties in practice
85.7% of current students with dyslexia are reported as performing well in practice with no additional support
Given the difficulties in the diagnosis of dyslexia (Kerr 2001), doing nothing may be an appropriate response in some cases.

8. Support in Practice – When and How?
A decision needs to be made with the student regarding:
Anticipatory support – organised before the student starts their practice placement
Reactive support – support is only put in place once difficulties in practice have been identified

9. Anticipatory Support For Against
Mentors are prepared and can anticipate difficulties
Support in place early
Shared responsibility and collaboration established early
Reduced risk of student failure due to lack of appropriate support.
Against
Presumption that student will have difficulty in practice
Stigma affecting performance
All problems automatically associated with disability
Students fear of discrimination

10. Reactive Support
For
Student goes into placement with no preconceived expectations from the mentor.
The risk of stigma is reduced
If no difficulties arise no support is needed which can enhance the students confidence and self esteem.
Support is tailored to specific identified difficulties.
Against
Before support is called for the student will experience difficulties which may damage their confidence and self esteem.
The relationship between the student and mentor may be damaged by the mentors identification of difficulties.
Collaboration between clinical and university staff is delayed.

11. Anticipatory v Reactive Support
Anticipatory support is usually well accepted by students in theoretical assessment and helps them to achieve success and hopefully avoid the experience of failure.
Reactive support is much more common in practice but if focussed action is taken as early as possible it can be very effective.

12. Support in Practice
5 of the 35 students with dyslexia and both of the students with dyspraxia are currently identified as needing some support in practice and have had a clinical needs assessment.
This support has been reactive as all of the students preferred to ‘wait and see’ if support would be needed.

13. What is a Clinical Needs Assessment ?
It’s a process by which:
a students specific support needs in relation to their clinical practice performance are identified
strategies to support the student and/or reasonable adjustments to the environment or to the way in which the student performs a practice element are discussed
An appropriate course of action is agreed

14. Who is involved in the process?
The Student and their Clinical Mentor are the main participants. The Link Lecturer and /or the Personal Tutor and Student Support Lecturer can also offer useful advice and support.

15. How is the process initiated?
This can happen in a number of ways for example:
The student may find a particular element of clinical practice challenging and may raise this with their mentor or a member of University staff
The mentor may have concerns about the students performance in practice and may raise this with the student and a member of University staff
The student may have had a Clinical Needs Assessment in a previous placement and the Personal Tutor / Student Support Lecturer may recommend that a new assessment is carried out at the start of subsequent placements.

16. Can this process be used by any student/mentor?
Yes, though some groups of students may be more vulnerable in clinical practice for example:
Students with a disability that makes some elements of practice more challenging.
Students for whom English is not a first language and who may be less familiar with British culture.

17. How to complete the Clinical Needs Assessment form
Discussion should take place between the mentor, student and lecturer and:
The element of practice that the student needs to perform competently should be clearly defined and recorded as the clinical need.
e.g. Completion of accurate and timely care plans for the patients in her care.

18. Clinical Need Clinical need
Completion of accurate and timely care plans for the patients in her care.

19. Support Strategies
Ways in which the student can be supported to achieve competence should be clearly defined and recorded as support strategies/reasonable adjustments.

20. Support Strategies/Reasonable Adjustments
Clinical need
Completion of accurate and timely care plans for the patients in her care.
Support Strategy/Reasonable Adjustment
Keep a list of most used words / phrases in a notebook and use this in practice.
Use handheld spell checker in practice
Allow extra time for the completion of care plans
Use green overlay to aid reading in practice
Mentor to help with proof reading documentation
Work with specialist tutor to develop spelling and proof reading strategies

21. Who is responsible for actions?
Details of who is responsible for actions to ensure that the support/ reasonable adjustments are put in place should be identified and recorded

22. Support Strategy/Reasonable Adjustment
Actions
Support Strategy/Reasonable Adjustment
Keep a list of most used words/phrases in a notebook and use this in practice.
Use handheld spell checker in practice
Extra time for care planning
Use green overlay to aid reading in practice
Mentor to help with proof reading documentation
Work with specialist tutor to develop spelling and proof reading strategies
Actions
Student
Student/CLASS
Student/Mentor
Mentor

25. Advantages of using the Clinical Needs Assessment
It is student focussed and enables student participation in the process of designing support.
It enables individualisation of support based on the growing amount of guidance available.
It provides a written record of the support agreed, evaluation of the support and details of the individuals responsible for taking action

26. Pilot Study
Between 31st January and 31st May 2011 we are piloting the Clinical Needs Assessment with 7 disabled students.
1 Student is in the 3rd year and 6 in the 1st year.
None of the 7 students agreed to an anticipatory approach to support so the support is in reaction to identified difficulties.
5 of the 7 have however agreed to a clinical needs assessment at the start of their next placement.

27. Any Questions?