1. Action planning

2. Objectives
To explore reasons why learners may need additional support to progress
To explore the challenges for supervisors and assessors
To develop a plan of action to support learning and development

3. Identifying the issues
For registered professionals, supporting students in practice has many benefits such as building new relationships and maintaining own knowledge (Morley 2016)
Wenger (1998) suggested that a community can benefit from the contribution of ‘novices’ leading to collaborative professional development
Yet evidence suggests it also comes with challenges including negative emotions when dealing with an underperforming student, and a worry about the students response to negative feedback (Hunt et al 2016)
This can be exacerbated by a sense that issues related to under performance should have been dealt with sooner (Hutchison & Cochrane 2014)

4. Effective Practice Learning
All students require safe, effective and inclusive learning experiences (NMC, 2018)
And students are expected to be proactive in their own education and development
Supervisors and assessors recognise that learning experiences should be tailored to the students stage of learning
Therefore a discussion must take place at the start of the practice experience to determine any specific learning needs for your student
This will help you to understand past experiences and focus on the current needs of your student. It is also an opportunity to review progress to date and review feedback from other practice experiences
This may be your first indication that the student has developmental concerns
This initial discussion can be undertaken by the practice supervisor and shared with the practice assessor

5. Ongoing performance
If you have concerns about the level of your students ability it is important to communicate this in a timely manner with the student.
This is important because students need the opportunity to correct the behaviour you are concerned about or improve their clinical performance
You may want to ask other supervisors for their feedback
Communication should be both verbal and written and evidenced in the students practice documentation
Depersonalise the process by concentrating on the behaviour or competency

6. Firstly identify the issue Is it….
Clinical for example:
Poor skills development
Poor communication both written and verbal
Unable to escalate concerns about a patient
Unsatisfactory underpinning knowledge
Professional for example: Time keeping Enthusiasm/motivation Uniform Mobile phone usage on placement Professional boundaries

7. Reactions
Be aware that this may the first time your student has had feedback suggesting there are developmental needs so they may be shocked
There is certainly evidence to suggest a wide range of reactions including
a) acknowledgement of the need to improve
b) the student may become emotional
c) may seek to blame external forces
d) may reject the feedback (Hunt et al 2016)
You may want to have someone with you such as the academic assessor, this can help the student to see we work together and move forward together (Cassidy et al 2017)

8. Develop an action plan
Below is an example of an action plan, you will use the template on Pare
Competency
Date initiated
Proposed actions
Review date
Comments and signature
Medication management
Student to identify 3 commonly used medicines on current placement
Complete formulary sheet to demonstrate underpinning knowledge of this medication
Supervisor to facilitate daily access to medication administration in preparation for summative medication assessment
Student requires weekly feedback on performance
Practice Assessor to communicate with Academic Assessor about ongoing performance
Weekly

9. Ongoing and final assessment
Once an action plan is in place your student will need regular feedback for some indication of improvement or not
Decisions to fail a student should not come as a surprise
The academic assessor and practice assessor should agree a timeline of communication so both the assessor and student can be supported
Don’t forget there is a discussion tab on the
on line PARE system that may help with this
Set the date for final assessment so you can prepare
If your student has done well be specific about what exactly has improved so they know what to maintain
Although your student may have made improvements this may not be sufficient to meet the required proficiencies. It is important to communicate progress to the student that will support the second attempt at this assessment.
Document your decision clearly in the student practice document

10. References
Cassidy S, Coffey M, Murphy F (2017) ‘Seeking authorization’: a grounded theory exploration of mentors’ experiences of assessing nursing students on the borderline of achievement of competence in clinical practice Journal of Advanced Nursing 73 (9) p
Hunt LA, McGee P, Gutteridge R, Hughes M (2016) Failing securely: The processes and support which underpin English nurse mentors’ assessment decisions regarding under-performing students Nurse Education Today 39 p79-86
Hunt LA, McGee P, Gutteridge R, Hughes M (2016) Manipulating mentors’ assessment decisions: Do underperforming student nurses use coercive strategies to influence mentors’ practical assessment decisions? Nurse Education in Practice 20 p
Hutchison T & Cochrane J (2014) A phenomenological study into the impact of the sign-off mentor in the acute hospital setting Nurse Education Today 34 p
Morley D (2016) Applying Wenger’s communities of practice theory to placement learning Nurse Education Today 39 p
NMC (2018) Part 2: Standards for student supervision and assessment
Wenger E (1998) cited in Morley D (2016) Applying Wenger’s communities of practice theory to placement learning Nurse Education Today 39 p