Ceppl Seminar 1/7/09

Becoming a Professional – the contribution of Practice Assessment

Margaret FisherSenior Lecturer in Midwifery/ Academic Lead Placement Development Team

Email: mfisher@plymouth.ac.uk

Tracey Proctor-ChildsDeputy Head of School of Nursing and Community Studies

Email: tproctor-childs@plymouth.ac.uk

www.placementlearning.org

Structure of Seminar

• Background

• Key findings to date

• The contribution of practice assessment to professional development

• Practical application – discussion

• Questions and summary

Assessment of practice is crucial in determining

whether or not a student meets the criteria required

of their profession, thus ensuring safety of the

public

Watkins 2000, Cowburn et al 2000

Aim

To establish an evidence-based set of key principles and

resources to guide

Assessment of Practice,

relevant across professional boundaries.

Research Questions

1. What are perceptions of validity and reliability of the practice assessment methods used?

2. What are perceptions of the impact of the practice assessment process on the student learning experience?

Definitions

• PracticeThe application and development of the appropriate

skills and knowledge to the professional role in the environment where that professional activity takes place

• Practice learningDistinguished by the framework of support, teaching

and assessment for students on professional programmes, working alongside others to deliver a service to the public as part of their course.

For the purposes of this research, practice assessment:

• May not necessarily take place in the clinical/ practice environment, but must incorporate practice

• Involves both formative and summative elements

• Includes all the evidence contributing to the judgement about whether the student can progress or not in practice

Methodology

• 14 participants from Midwifery, Social Work and Emergency Care degree programmes (nurses and paramedics)

• Semi-structured interviews at the end of each year

• Longitudinal case study approach• Single-case and cross-case analysis

and synthesis of findings – “Framework technique”

Ritchie and Spencer 1984

In addition…

• Staff focus groups

• Ongoing literature search

• Trawl of websites

• Conference networking

Key features of the study

• Multi-professional/ -role research group• Multi-professional participants• Multi-role participants• Longitudinal rather than ‘snapshot’• Investigating methods, tools and

processes across a number of programmes

• Exploring latent aspects of learning and its impact on professionalism

Key themes

People

PREPARATION

Consistency

Becoming a

professional Doing the job

PURPOSE

PROCESS

Timing Clarity Placements

Paperwork

The importance ofPREPARATION

• Clear guidance needed throughout

• Adequate preparation of assessors

• Process of discovery – the journey is the most important thing

• Need to emphasise development of professional identity within the assessment process

Understanding of the PROCESS

• Emerging clarity• Methods used were key to the student

experience• Ongoing preparation/ guidance was

vital• Impact of the people involved and the

placement grew increasingly important

Efforts to ‘measure’ competence and

professional abilities have resulted in a wide variety of methods of

assessment

Baume and Yorke 2002, McMullan et al 2003

Which tools enabled development of the professional?

• Portfolios

• The process of reflection

• OSCE or the equivalent practical (eg: Social Work ‘conversations’)

• Observation of practice

The contribution ofPortfolios

Competences and how to achieve theseProvide focus and motivate learningProfessional accountability clearEvidence of capability/ achievementEncourage students as they see their

progressPromote autonomous practice

How can Portfolios inhibit development?

x Be restrictive/ prescriptive - “tick boxes” and/ or not enable the student to demonstrate the length and breadth of work undertaken

x Potential to “cheat the system”

x Bulk and workload

The contribution ofReflection

Develops self awarenessCritical awareness of their own

practiceReflexivity rather than just reflection

by year threeThe development of “insightful

practice” (S5)Autonomous and ethical practice

How can Reflection inhibit development?

x Does not always reflect the reality of practice

x Potential to “blur the edges”

The contribution ofOSCE’s/ ‘Conversations’

Preparation for real lifeThe need to be tested against

professional standards and expectationsDemonstrating clinical competenceDemonstrating safetyThe use of a range and repertoire of skills

including communicationHuge impact on learning

How can OSCE’s/ ‘Conversations’ inhibit development?

x May not be able to demonstrate normal practice due to stress levels

x Not holistic

x False environment

The contribution ofObservation

Benefit from feedback from different people

Provides good insight into the student’s practice

Develops the student’s learningIf continuous assessment, the student

is seen in a variety of real situations

How can Observations inhibit development?

x May be artificial (if snapshot) - creating fake practice and not necessarily resulting in relevant feedback

x Very dependent on experience of the assessor

x Assessors may be inconsistent

The importance of the PEOPLE

• Mentors/practice assessors /supervisors key• Role models • Relationship• Huge impact on the development of the

students’ learning in practice • Assessment of overt skills and the latent and

more subtle attributes such as aptitude and suitability for the chosen profession

• Support from academics when in placement also crucial

What do students value in practice assessors?

• Honesty, integrity and ethical practice • Constructive and supportive feedback in

a timely fashion.• Accountability for decisions made about

the student• A range of assessors to give a 360

degree view of the student’s performance in different situations and contexts

How might practice assessors disempower students?

• Inconsistency in professional judgement

• Lack of honesty

• Failure to give constructive feedback and allow the student time to retrieve the situation

• Poor relationship/ communication

The impact of the PLACEMENT

• Placement directs the learning

• Politics of the placement setting

• “Difficulties on placement can help develop you as a professional” (S5)

What aspects of Placements might impede learning?

• Mis-match with timing of relevant assessments

• Unsuitable/ vetting needed

• Disorganisation

• Distance/ time of travel to placement

• Inadequate support

Understanding the PURPOSE

• Growing recognition of the importance of achieving and demonstrating practice/professional competence

• The need to go through the process even if at

times this seems like “jumping through hoops” and “ticking boxes”

• Being able to receive constructive feedback and act on this to improve performance and competence

• Development of transferable skills

• Development of the “Art” of the professional

• Confirmed suitability for the profession

Discussion

The practical application

in your programmes……

Summary

→

Clear understanding of

PURPOSE

Safe, competent

PROFESSIONAL PRACTITIONERS

Clear, consistent and timely

PREPARATION

Optimise the

PROCESS

People Placement Paperwork