Both Government and Department of Health guidance have clearly promoted the notion of the ‘expert’ patient in shaping and informing ongoing service improvement. (Glynn et al 2008, and Glasby and Beresford 2006). Similarly, higher education providers of health and social care programmes have increasingly included service user and carer perspectives in design and delivery of courses.
The nursing course at Coventry University embraces the underpinning principle that service users and carers clearly have unique experiences, skills and abilities that enable them to provide ‘expert advice’ in the field of health and social care. Health and social care services are likely to be more effective if those who are being educated and trained to deliver care in these environments understand the needs of the people who use them by the people who use them.
Therefore, in order to fully embrace both guidance and legislation, service users and carers are actively welcomed to participate and collaborate in a range of activities that enhance the nursing programme at Coventry University.
Service users and carers are engaged from the very start of the student journey; student selection, teaching, assessment and support for quality monitoring processes are all enhanced by our service user colleagues.
As such, in nursing, service users and carers are considered an invaluable resource to enhance the student experience and learning.
2.4 Teaching and Learning Methods
The course is designed to expose students to a wide range of teaching and learning methods, not only to accommodate individual learning styles but also to enhance their professional practice. The need to provide sufficient direction, particularly in the early stages of a module or course is accepted but increasingly the approach will adopt a student directed approach via teaching and learning methods employed and also in the provision of flexibility within many module assessments.
The course will encourage reflection on experience and to enable students to apply and evaluate theoretical principles to relevant professional practice contexts within academic sessions. The
reflective process promotes the acquisition of the higher order cognitive skills and encourages not only the consolidation of knowledge but the opportunities for the emergence of new knowledge. It is a process through which attitudes can be explored to facilitate the personal and inter-professional development of students.
i) Lectures – A lecturer-directed session with emphasis on the introduction and development of study topics. Lecture programmes will be supplemented with appropriate reference material required reading assignments and a limited number of written assignments in which students will be expected to show evidence of independent study. Many lecture sessions will be complemented by various interactive strategies.
ii) Seminars – Seminars will normally be topic orientated to each field and will offer students opportunity to direct learning either individually or in small groups. This process will be facilitated by a member of the module team.
iii) Tutorials – A discussion session which is chaired by a member of staff and consists of any number of students from one to approximately twenty. The tutorial will be used:
for the discussion of new concepts being introduced in the lecture course; to discuss issues that emerge solely from the students own agenda.
iv) Workshops – Within the workshop format a variety of methods will be employed, including group exercises, presentation, role playing and videos.
Students entering the course with a wide range of experiences can be of great educational value to their peers. Small group work in the workshop format encourages sharing of ideas and knowledge and promotes the inter-professional agenda.
v) Reflective Practice – provides opportunity to think deliberately about interpreting experience in order to learn from it. The deliberate process of reflection can provide experiences and understanding of care and the application of theory to practice. The reflective process assists students in the acquisition of the higher order cognitive skills and encourages not only the consolidation of knowledge but the opportunities for the emergence of new knowledge. It is a process through which attitudes can be explored or challenged to facilitate the personal and professional development of students. This can be recorded in the student’s portfolio.
vi) Clinical Practice – The nursing practice has been underpinned by key themes and values which have been identified by service users and key stakeholders and include compassion, caring, communication, competence, collaboration, accountability and safeguarding the public. As protecting the public through professional standards is seen as an integral aspect of the role of the nurse further learning opportunities have been designed as part of the curriculum to provide the student with the capabilities that they will need to perform this function. Part of this approach includes the development of a collaborative capability framework, which comprises of 9 capabilities divided between three domains:
Personal and professional Organisational
Ethical
The student will be expected to develop these capabilities throughout the course which will be assessed through a portfolio of evidence. Some of the evidence can be accrued from
placement experiences.
In total there are 6 practice modules which account for 50% of the course. These have been developed and planned to reflect the overall developmental stages identified within the nursing course which are:
Foundations of practice Managing own caseload
Managing own caseload, supervising and supporting others in the practice setting The practice modules are those which are primarily undertaken within practice placements although a small proportion (up to 300 hours) may be undertaken through simulation. Simulation allows the student to learn or practice skills in a safe situation that imitates reality. Simulation has been planned into the course and will be used to build upon the student’s nursing skills over the three year period. This is aimed at developing their critical reflection whilst enhancing the skills of working both analytically and holistically in evaluating care delivery in partnership with other professionals, patients, service users, families, carers and other health and social care providers. Simulation will also provide opportunities to practice essential skills. This will be achieved via a series of objectives linked to prescribed workshop scenarios and exercises planned as part of the student’s placement experience.
There is a recognition that the practice placements are fluid and dynamic and the programme team will ensure that the students will be exposed to comtemporaneous placement
experiences which reflect the changing health and social care landscape. All students will be exposed to a variety of placements across community, acute and independent sectors. The placement organisation will use a hub and spoke approach where the hub is the main
allocated placement, supervised and summatively assessed by the mentor, and the spokes are a range of practice experiences that the student can access whilst in their hub placement to provide additional learning opportunities. Students will be assessed in all practice modules.
Progression points
Part 1 of the programme (end of year 1) Part 2 of the programme (end of year 2)
Part 3 of the programme leading to the NMC registration (end of year 3 and final progression point)
Practice competence
At the end of year three, the final progression point, the student is deemed to be competent in practice when they have successfully achieve the NMC (2010) practice competencies which have been signed off by a Sign off Mentor. A Sign off Mentor is an experienced Mentor who has met the
additional criteria who is registered in the field of practice that the student intends to enter and makes a final judgement of competence. The evidence must show that the student is safe and effective in practice at the end of the programme.
Stages of Practice
The assessment of practice is aligned to the developmental stages identified within the curriculum; Year 1 – Foundations of practice
Year 2 – Managing own caseload
Year 3 – Managing own and relevant others caseload
The stages contain levels of outcome and competence criteria that have been developed to judge your achievement of practice;
Level 1 – Understand, participate and initiate Level 2 – Initiate and manage
Level 3 – Lead, manage and delegate
Level 1 – Understand, participate and initiate (Understand the foundations of basic care needs. Participate in the delivery of service user care. Develop an understanding of the role of the nurse. Initiate care under the supervision of the student’s Mentor)
Under direct supervision participates in care delivery
Understands and follows instructions when participating in care
Demonstrate knowledge and understanding of the physiological and psychological needs of the service user
Never undertakes anything beyond own stage of proficiency without guidance from or referring to a supervising practitioner
Identifies through assessment the needs of the service user and initiates care delivery Recognises the need to prioritise and to seek help when necessary
Always ensures the safety and well being of the service user and acts in a professional manner Level 2 – Initiate and manage (Can initiate and deliver care to the service user/family carer and manage own work load)
Demonstrates the ability to undertake assessment of service user needs, interprets the data and initiate care delivery
Applies knowledge and understanding of the physiological and psychological needs of the service user within practice
Capable of informed decision making and can take responsibility for and can justify actions Never undertakes anything beyond own stage of proficiency without guidance from or referring to
a supervising practitioner
Manages and prioritises personal workloads effectively
Always ensures the safety and well being of the service user and others and acts in a professional manner
Performs care activities with some guidance and supervision and can be trusted to practice safely in similar situations and evaluates the care delivered
Seeks guidance and support to perform care in unfamiliar or complex situations
Level 3 – Lead, manage and delegate (Can lead, manage and delegate care within care teams working collaboratively within health and social care. Can use initiative to manage own and relevant others case loads.
Practices in accordance with the NMC’s ethical and legal frameworks Practices safely and effectively without the need of direct supervision
Manages care to always ensure the safety and well being of the service user and others and acts in a professional manner
Can plan, deliver, delegate and evaluate person centred care to service users/families and carers Articulates, qualifies and revises decisions and demonstrates the ability to change care to meet
identified needs
Takes responsibility to lead the care team delegating duties safely and appropriately to those concerned with person centred care
Critically evaluates their own performance and plans for their own personal and professional development
Supports the learning of others
Contributes and takes initiative to inform decisions about service user care within the multi- disciplinary team and multi-agency services
Appraises, critiques, interprets evidence based materials to inform decision making in practice. (Levels adapted from Southampton University assessment of practice nursing)
vii) Portfolio – The portfolio enables the student to maintain an up-to-date record of progress through the programme and provides a tool for integrating theory and practice. It enables the student to take responsibility for individual learning and appreciate the growth and development which occurs in professional and academic life. The use of reflective writing will be an intrinsic part of their portfolio. It will also contribute to their personal development plan activities.
viii) Moodle – It is an online learning environment which is used to support teaching and learning. Students are able to access Moodle to communicate with peers and the module leader, to gain information related to the module as well as to conduct on-line debates and discussions.
ix) Independent Learning – will be encouraged from commencement of the course through a series of mechanisms. Initially the students will study modules which draw upon the more traditional forms of teaching and learning with guided study to support the programme and provide a sense of direction for the students. As the programme progresses so the degree of independence, with supervision and guidance, will increase and the expectations will be upon the student initiating contact for further guidance, remedial work, through the individual tutorial/small group tutorial provision or Moodle.