EJEMPLOS DE BUENAS PRÁCTICAS

This subject merits examination as the portfolio is a primary means of evidencing professional development.

The work of Endacott et al (2004) considers the role of the portfolio in assessing learning and competence across pre and post registration nursing programmes. This study had been commissioned by the ENB and involved seven researchers from separate HEIs. The study had two stages; the first stage involving a national telephone survey of HEIs which deliver nursing programmes. The second stage consisted of four in-depth case studies based on field work in HEIs. The study employed a range of research methods based on a grounded theory approach. Given the size of the research project and the reported resulting rich data , the study has generated a number of published papers (Endacott et al, 2002, 2004, Mc Mullan et al, 2003, Scholes et al, 2004), and offers an insight into the difference between pre and post registration portfolio construction. The main difference is identified (Endacott et al, 2004) as:

…the activities required for portfolios of this sort map on to the academic skills found at Honours or Master’s level in terms of demonstrating higher levels of critical analysis and evaluation, together with accurate assessment of student’s own skills, knowledge and practice acquisition.

Endacott et al, 2004, p255

This provides further credence to my project focus, as it suggests that higher levels of skill acquired by the practitioner can be articulated through portfolio development. However, the role of the practice

the role of the lecturer as a facilitator of student self-reflection is critically questioned within the study; implying that facilitation should be adopted by others.

This latter point is borne out in an earlier paper by Gerrish (1993) in a pilot study of the use of portfolios in assessment of nurse teaching practice. Although dated, this study is one of few to concentrate on post-registration nurse education and portfolio assessment, and suggests that methods of self-assessment should be developed to enable the student to largely assess their own competence in practice. Portfolios are used as the main form of assessment in this study, and although I agree with Gerrish (1993) that the requirement for the lecturer to assess the portfolio is questionable, I consider the role of the PT in guiding portfolio construction as of great importance. As previously identified, Andrews and Roberts (2003) appraise the role of the clinical guide employed by a HEI specifically to support students in practice; asserting that the mentor in practice should focus on support and should not have a lead role in student learning. Although this evaluation relates to pre-registration nursing, it does highlight the need for a named individual whose role is to guide and inform professional development throughout the programme of education undertaken by the student. The specialist practice nursing student is allocated a PT on the same principle, and the PT has the added complication of a dual role of mentor and assessor. The majority of literature found relates to the pre-registration level of nurse education (Neary, 2000b, Duffy, 2003, Carr, 2005, for example) and therefore further supports my intention to examine practice assessment at higher levels.

A study undertaken by Canham (2001) investigated the acceptability and feasibility of an assessment tool. This tool had been designed to enable PTs to classify specialist practitioner student practice at first degree level. The classification (and therefore, in terms of the

portfolio; grading) of practice has stimulated much debate amongst the post registration team of which I am a member. As previously mentioned, within the SCP programmes PTs apply a simple pass/fail result to the assessment of the portfolio of practice. I had considered including research on grading of portfolios as part of this investigation, and despite subsequently considering that the two subjects should be approached separately in a staged process to ensure that PTs do not feel overwhelmed by the extent of responsibility they are assuming within the assessor role, the subject of grading spontaneously arose within the PT interviews. Discussion regarding grading, although not the focus of the project and therefore not linked to proposals arising from it, is included in the data analysis section, as an area for further consideration outside of the project remit.

In spite of dissenting views related to quantifying practice and establishing valid, reliable assessment tools, such as Goding (1997) and Chambers (1998), Canham and her colleagues developed a tool for the assessment of specialist practice, the evaluation of which is the focus of the study (Canham, 2001).

The Canham (2001) paper would be extremely useful to academics faced with the same dilemma of applying a classification to the practice component of educational programmes. The aims of the study are clearly defined, and reasons for not carrying out a pilot study explained. I question this decision, however, as in spite of the involvement of practice mentors in devising the assessment tool, unless it is piloted, those producing the tool cannot determine effectiveness in areas within it, such as understanding of terminology and clarity and ease of completion. As suggested by Polit and Hungler (1994), a pilot study offers the opportunity to identify any revisions required and therefore should appraise feasibility and improve the project outcomes. The unpiloted format and lack of

practitioner involvement in the initial planning stage may also lead to bias. The practice assessment criteria set appear very broad and therefore open to interpretation. The practice assessment indicators provided for each of the criteria are intended to guide the assessor. Again, these are open to interpretation; for example, one indicator refers to ‘Utilising appropriate methods of teaching/ learning’ (Canham, 2001. p489), which raises the question as to how the appropriateness would be measured, and whether it could it be replicated.

The Canham (2001) paper also highlights the difficulties involved in carrying out a longitudinal study, particularly in retaining the commitment of practitioners alongside competing practice demands. Responses were requested from SP students in assessment of their practice development evidenced within the portfolio of practice, and from practice teachers in their assessment of students at two stages of portfolio development. Response rates were poor, particularly from practice educators due to work commitments and from learning disability/mental health students (cause not specified). It signals to me the importance of ensuring that the PTs involved in my study recognise the importance and relevance of the research process in strengthening and influencing the support and guidance they receive to ensure a positive outcome for the student, which recognises the level of practice achieved.

Generally, responses to classification of practice were positive (Canham, 2001): an interesting outcome in view of my research focus. The means of assessment are not clearly explained within the Canham study. The current SCP programmes utilise practice portfolios for assessment and in light of this, further appraisal of work related to portfolios as a means of supplying evidence of practice development will be explored within subsequent chapters.

In summary, the initial literature review has revealed the following themes:

The nature of knowledge acquisition, and the importance of socialisation in knowledge transfer, the articulation of knowledge and practical expertise.

The value of reflective practice in the development of expertise, and the importance of both guidance in reflection and student self- assessment of knowledge and skills acquisition.

Identification of the starting point of the student in appraising their potential in pursuit of proximal development.

The relevance of the portfolio as evidence of professional development and articulation of higher level skills.

This chapter has served as a starting point for the study: reinforcing the need to examine the development and assessment of nursing knowledge within higher level practice with a view to ensuring that practice assessors are supported appropriately and effectively. The project is intended therefore to add to the limited body of knowledge in this area related to post registration nurse education.

The following chapter will explore general and specific research methodology as a rationale for the approach employed for the project. It will also provide an overview of the development of the data to inform the direction taken and methods employed in subsequent data collection.

Chapter Three: Research Methodology

3.1 General research methodology introduction

3.1.1 Qualitative methodology – social constructions of reality

3.2 Art v science in nursing practice 3.3 Developing nursing knowledge 3.4 Grounded theory approach

3.5 Research methodology for the project

3.5.1 Defence of a modified grounded theory with data categorisation

3.5.2 Introduction to the focus of the study – context and relevance to practice

3.5.3 Data collection – the semi-structured interview 3.5.4 Sampling techniques

3.5.4.1Sample inclusion criteria and defence of approach 3.5.5 The focus group

3.5.5.1 Focus group selection

3.5.6 Ethical considerations in data collection 3.5.6.1 Involvement-Detachment

3.5.7 Sequencing of interview and focus groups 3.5.8 The practice narrative

3.6 Considering validity and rigour

3.7 Relevance of regular reviews of the literature 3.8 The interview process

3.8.1 Formulating and reviewing questions 3.8.2 Managing data sets

3.9 Inclusion of the focus group

3.9.1 Number and size of focus group