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The Department of Health Sciences
Undergraduate Integrated Masters in Nursing
Professional Internship Handbook
For Interns, Providers and Teaching Staff
August 2016
Improving and Transforming Nursing
Care
Patient Experience
Strategic Imperatives
Policy Drivers
Interprofessional Learning
Integated Care Services
Clinical Skills
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Contents Page
1. The Professional Internship
2. People involved in supporting a Professional Internship
Intern
Professional Internship Co-ordinator
Mentor
Sign-off mentor
Spoke supervisor
3. What meetings should take place during the Professional Internship?
with Professional Internship Co-ordinators
with mentors
4. Learning Contract Meetings
5. Professional Internship One
6. Professional Internship Two
7. Base and spoke model adapted for the MNursing Professional Internship
8. Service Improvement Project
9. References
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The Professional Internship
This handbook has been developed following collaboration between academic staff, practice partners, mentors and interns. This guidance is of relevance to:
Academic staff (personal supervisors and link lecturers)
Clinical staff
Professional Internship co-ordinators
Mentors & sign off mentors
Interns
Spoke supervisors
Learning Environment Managers
Practice Learning Facilitators
Practice Placement Facilitators
Placement Administrators
The Professional Internship (PI) is the common thread running through the Integrated Masters in
Nursing programme. The aim of the Professional Internship is to enable interns to develop a
heightened awareness of the wider context of care. It draws together all of the elements of the
programme and enables students to learn about the organisation within which they are embedded
and how healthcare is delivered within that organisation in its broadest sense.
The Professional Internship has three main purposes:
1. To enable students to achieve competence in the NMC competencies and Essential Skills
Cluster for entry to the professional register.
2. To enable students to gain the widest experience of health care delivery from both a clinical
and strategic perspective.
3. To enable students to plan, undertake and evaluate a small scale service improvement
project.
For students in the adult field of practice interns must also ensure that they meet the requirements
specified within the NMC regulations and the European Union (EU) Directives (EU Directive
2005/36/EC) regarding people falling into the following categories: general and specialist medicine
general and specialist surgery, child care and paediatrics, maternity care, mental health and
psychiatry, care of the older person and home nursing.
The student is required to provide evidence of time spent addressing the categories outlined above
and this should be completed within their PebblePad workbook. This should be reviewed by the
sign-off mentor as part of the sign-off process at the end of Professional Internship Two.
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The Professional Internship lasts for eighteen months and comprises two modules; Professional
Internship One and Professional Internship Two, both of which are practice based. Normally an
intern will spend three days (22.5 hours) a week in practice, with one campus based study day and
one private study day per week. Both Internship Modules also have an academic credit bearing
component attached.
The Professional Internship has been developed in consultation with our practice partners who will
identify the individual nursing teams within which interns will be placed. From there interns will
identify and be guided toward learning opportunities, using the base and spoke model of practice
experience. Throughout their Professional Internship each intern will be supported by academic and
clinical staff. In practice, interns will be allocated to a Professional Internship Coordinator (PIC), who
will guide them and provide a sense of strategic imperatives. This individual will be a senior nurse or
senior healthcare professional based within the organisation hosting the Internship. In addition,
interns will have mentors based in their internship base to ensure they are achieving the NMC
outcomes and during the final 12 weeks of Professional Internship Two they will be allocated an
NMC registered ‘sign off’ mentor, who will act as the guardian to the professional register.
It is anticipated that the internship will have an overarching theme which will provide a focus and
direction for the conversations between the intern, their PIC and mentor. This may be a topic that is
of strategic interest to the partner organisation and may assist in providing direction for the Service
Improvement Project interns will be undertaking during Professional Internship Two. The diagram
below illustrates a model for an internship with the theme of ‘improving the care of people with
dementia in the acute setting’.
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The people involved in supporting a Professional Internship
Intern
This is a student registered on the Integrated Masters in Nursing programme at the University of
York. They will spend eighteen months embedded within a partner organisation to study the
delivery of healthcare in its broadest context.
Intern responsibilities:
Prior to the beginning of Internship One:
Meet with your personal supervisor prior to a practice experience to discuss areas for
development.
Contact your base area to obtain details of start dates and shifts and the name(s) of
your Professional Internship co-ordinator and mentor(s)
During Internships One and Two:
Uphold the reputation of your chosen profession and the HEI by adhering to the
Nursing and Midwifery Council (NMC 2009, NMC 2010a) requirements and guidance
for professional conduct. Additional information is available in the course handbook.
Negotiate your initial, mid-point and final interview dates and any other meetings
with your Professional Internship co-ordinator and primary mentor in advance.
Contact the MNursing programme leader to arrange a date and time for your
learning contract meeting within the first four weeks of both internships.
Make appropriate contact with intended spoke areas and negotiate a mutually
convenient date and time to attend.
Negotiate specific learning outcomes in partnership with your mentor and spoke
supervisor(s) at the initial interview or prior to a spoke experience respectively.
Manage and document learning in relation to the main and subsidiary learning
outcomes during practice experiences.
Alert the placement provider and/or DoHS of any concerns about practice
experiences which affect progress and/or satisfactory completion of the learning
outcomes or adversely affect the safety and welfare of clients. (NMC 2010b)
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Professional Internship Co-ordinator (PIC)
This individual will be a senior nurse or senior healthcare professional based within the organisation
hosting the Internship. They do not need to be a registered mentor as they will not be making
pass/fail decisions relating to the intern, although they will be included in discussions about an
interns progress. They will meet with the intern and their mentor as appropriate to provide a
strategic overview of the organisation hosting the internship and identify potential learning
opportunities for interns to shadow or experience broader aspects of the organisation. This will
develop their knowledge and understanding of the wider context of healthcare and the strategic
decisions that underpin it.
Responsibilities of the Professional Internship Co-ordinator
To meet with your intern, their mentor and programme link lecturer to develop a learning contract for the duration of their Internship, taking into account the need for interns to explore the broadest context of care.
To identify appropriate learning opportunities and /or individuals who can provide insight into and experience of the wider strategic context of care.
To meet with your intern every four to six weeks and to support and guide as necessary.
Mentor To become safe, effective and autonomous practitioners students must be actively involved in care
delivery under supervision of a ‘suitably prepared’ mentor who has a responsibility to ‘facilitate
interns and others to develop their competence’ (NMC 2010a:64, NMC 2008:5). The mentor must
be ‘available’ to the intern for at least 40% of the time in practice (NMC 2010a). This individual will
be a registered mentor in the base area hosting the internship. They will be responsible for
assessing the intern against the relevant NMC competencies and Essential Skills Clusters and making
a pass/fail decision at the end of both Professional Internships One and Two. They will be also be
involved in discussing relevant spoke visits to support the knowledge and understanding of the
intern in relation to the development of their nursing practice and the wider context of care
delivery within the host organisation.
Mentor responsibilities
Ensure that your intern is settled and embedded within the base team before they begin to attend spokes.
If an intern has not arranged their learning contract meeting then contact the relevant PLF or link lecturer.
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Ensure your intern has identified and that you have agreed specific learning outcomes prior to a spoke experience.
Confirm that there is an appropriate spoke supervisor for each spoke an intern intends to visit.
Check that the spoke supervisors contact details are available.
If you have concerns about the intern’s safety or the relevance of the intended spoke then as an accountable registrant you cannot agree to it.
Sign-off mentor
A registered nurse, on the same part of the register and in the same field of practice, and who has
met additional criteria identified by the NMC (2008:2.1.3). They confirm that an intern has met the
standards leading to registration and a qualification that is recordable on the NMC register. A sign
off mentor is required for the final 12 weeks of Professional Internship Two.
Sign-off mentor responsibilities
To meet with your intern for at least an hour a week for the final twelve weeks of Professional Internship Two.
To review the Intern’s CAP documentation (PebblePad workbook) and make a final decision about their suitability to enter the professional register.
To complete the appropriate documentation. Spoke Supervisor This person is responsible for the supervision of interns within spoke areas. There is no summative assessment of students within spokes and any concerns about a student must be reported back to the students mentor. Spoke supervisor responsibilities
Ensure the intern has identified specific learning outcomes prior to a spoke experience.
Confirm that you have the intern’s mentor’s contact details.
Inform the relevant mentor / link lecturer if you have any concerns about the intern’s conduct or practice.
What meetings should take place during the Professional Internship?
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Meetings with Professional Internship Co-ordinators
Interns should meet with their PIC every four to six weeks and these meetings should be
documented by the intern and PIC within the PebblePad workbook. These meetings should focus on
the wider strategic aspects of the Professional Internship as well as potential service improvement
initiatives and the opportunity to identify shadowing spokes with senior members of the
organisation to facilitate understanding of the broader aspects of delivering health care.
Meetings with mentors
As well as organising meetings to complete the initial, midpoint and final interviews, interns should
arrange to meet with their mentors to discuss their progress and to identify potential spokes.
Further information about spokes is available on page 12, however, students and mentors could use
the following process to consolidate thinking about the potential opportunities required to support
learning.
Making the most of spokes to support learning.
Learning contract meetings
The Learning Contract Meeting takes place between the intern, Professional Internship Co-
ordinator, mentor and programme link lecturer or personal supervisor. The aim of the learning
contract meeting is for the intern, Professional Internship co-ordinator, primary mentor and link
lecturer to develop agreed learning contracts for each Professional Internship. They should take
place within the first four weeks of each internship and it is the intern’s responsibility to organise a
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mutually convenient time with their Professional Internship co-ordinator, mentor and relevant link
lecturer or personal supervisor.
Objectives of the Learning contract meetings
To facilitate identification of the practice learning needs of interns relevant to the stage of the curriculum.
To discuss and select learning opportunities most relevant to identified needs and required learning outcomes and explore how those can be best met using base and spoke experiences.
To discuss the criteria against which achievement of outcomes can be measured and types of evidence interns can use to demonstrate competence.
To provide a supportive and open climate for practice-based learning in which all
contributions are valued and respected.
Professional Internship One
This module spans two University terms with interns spending 18 weeks linked to a primary or
acute care-based nursing team. It runs concurrently with Cooperative Learning Group 6 and the
Health Behaviours and Approaches the Health Promotion theoretical module enabling interns to
explore, in detail, every aspect of the role of the nurse working within their allocated internship
base.
The module will identify and review intern’s personal learning needs in relation to the NMC
Standards for Pre-registration Nursing (2010) Annex Three third progression point essential skills
cluster: organisational aspects of care 14, 15 & 16 to assess their practice development as a leader
in Health and Social Care delivery. Interns will work in partnership with clients, carers, other
professionals and other agencies with support from their mentor to achieve competence in relation
to the agreed NMC competencies and Essential Skills Clusters for entry to the register.
This module will enable the intern to identify and meet their learning needs in relation to:
1. Exploring solutions and ideas with others to enhance care.
2. Challenge the practice of self and others across the multi-professional team.
3. Working inter-professionally as a means of achieving the optimum outcomes for people and
ensuring the safety of themselves and others.
4. Taking responsibility for delegating care to others, including the preparation, support and
supervision of others to whom care has been delegated.
5. Negotiating with others to balance competing and conflicting priorities.
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Professional Internship One is assessed summatively by the successful completion of the CAP
documentation (PebblePad workbook) and by a 1500 word reflective essay. Details of this can be
found by following the link below:
https://www.york.ac.uk/healthsciences/student-intranet/timetables/assess-guide/
Professional Internship Two During this module, an intern will spend 31 weeks linked to the same primary or acute care-based
nursing team as Professional Internship One. This module spans across the whole of stage four of
the programme and runs concurrently with Cooperative Learning Groups 7 and 8, the Service
Improvement Project and the Person-centered Consultation and Physical Assessment Skills
theoretical modules. This approach will enable each intern to critically explore every aspect of the
role of the nurse working within their allocated internship base. In the final 12 weeks of Professional
Internship Two, each intern should meet with their NMC registered ‘sign off’ mentor on a weekly
basis.
Professional Internship Two will identify and review the intern’s personal learning needs in relation
to the NMC Standards for Pre-registration Nursing (2010) Annex Three, third progression point
essential skills cluster: organisational aspects of care 17, 18 & 19 to assess their practice
development as a leader in healthcare delivery. Interns will work in partnership with clients, carers,
other professionals and other agencies with support from their Professional Internship co-ordinator
and mentor to achieve competence in relation to the agreed NMC competencies and Essential Skills
Clusters.
This module will enable the intern to identify and meet their learning needs in relation to:
1. Working safely under pressure and maintaining the safety of service users at all times.
2. Assessing and implementing measures to manage, reduce or remove risk.
3. Assessing, evaluating and interpreting risk indicators and balancing risks against benefits.
4. Working within legal and ethical frameworks to promote safety and positive risk taking.
5. Selecting and applying appropriate strategies and techniques for conflict resolution and de-
escalation.
Professional Internship Two is assessed summatively by the successful completion of the CAP
documentation (PebblePad workbook) and by the production of a conference style poster looking at
risk management. Details of this can be found by following the link below:
https://www.york.ac.uk/healthsciences/student-intranet/timetables/assess-guide/
Throughout Professional Internships One and Two each intern will use an expanded version of the
Base and Spoke model of practice experience.
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Key elements of the Base and Spoke model (adapted for the Professional Internship)
Base Experience
This is the intern’s primary experience and will be no less than 50% of the entirety of the
Professional Internship. The base experience will have been identified by the partner organisation
specifically for the Professional Internship and could be in either an acute or primary health care
setting focusing on adult or mental health nursing. Base experiences must have a valid educational
audit and will provide learning opportunities appropriate to the stage of the programme to facilitate
achievement of the required NMC Standards for pre-registration nursing education (NMC 2010a).
Interns are expected to spend no less than 50% of the entire professional internship within their
base area. It is anticipated that interns will spend at least four weeks in the base placement at the
beginning of Professional Internship One to orientate themselves to the area before they begin to
attend spokes and four weeks at the end of Professional Internship One to consolidate their
learning. During the final 12 weeks of Professional Internship Two students must ensure that they
meet with their sign-off mentor on a weekly basis.
The base experience will reflect interns’ theoretical learning at the same stage of the programme
allowing them to apply theory to practice. The base and spoke model will offer the intern the
opportunity to gain knowledge and understanding of the broadest aspects of healthcare delivery
within their host organisation with clinical and strategic experiences allowing them to gain insight
into the local and national policy drivers and strategic imperatives which are shaping current
nursing practice and care delivery.
All base areas must have ‘suitably prepared’ mentors sufficient for the number of students allocated
(normally no more than three per mentor) – NMC (2010a:R4.3.2, G9.3.3). Interns may be supported
by a system of team mentorship. However, a primary mentor must be identified in the base
experience to maintain accountability for assessing the intern’s overall performance and signing the
intern’s Continuous Assessment of Practice (CAP) document (PebblePad workbook). This decision
will be influenced by both direct supervision and further evidence provided by other members of
the team as well as spoke supervisors.
Mentors in bases during Stages Three and Four of the programme must meet the requirements for
‘due regard’ i.e. be qualified in the same field of practice as the intern is studying.
When an intern is away from their base, i.e. during a spoke experience, there should be clearly
established communication systems between the primary mentor in the base area and the spoke
supervisor in the area the intern is visiting. This is to ensure intern safety and to maintain an ‘on-
going achievement record’ (NMC 2007b), based on the CAP document (PebblePad workbook) and
other authenticated evidence.
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Spoke areas
Spoke areas are secondary learning experiences related to patient/client care within the base. This
experience may be in acute, community, independent, voluntary or private sector settings. Spoke
areas may be in different fields of practice if it is related to the needs of patients/ clients in the base
setting. A spoke experience ‘adds value’ to the existing learning opportunities in the base to enable
an intern to achieve the required standard and learning outcomes. The purpose of spokes within
the Professional Internship is two-fold; firstly they could be linked to the patient/client journey
through the health care system (clinical spokes) and secondly they could provide an intern with
insight or experience of local and national policy drivers and strategic imperatives which are shaping
current nursing practice and care delivery for example exploring integrated services within the
partner trust or shadowing a senior member of staff (strategic or shadowing spokes).
The length of a spoke experiences will normally vary between 1hr – and 6 working days and must be
agreed between the intern, their primary mentor and spoke supervisor. The learning from spoke
experiences and time spent must be recorded in the CAP document (PebblePad workbook) and
signed by the relevant spoke supervisor. There must be consistent and appropriate supervision for
interns in the spoke area by a suitably prepared person. Within a spoke experience there is no
formal summative assessment of an intern’s performance but supervisors and interns must provide
evidence of attendance, learning outcomes achieved and level of performance related to the
negotiated learning outcomes. If an intern’s conduct/behaviour gives cause for concern then the
spoke supervisor must contact the intern’s mentor as soon as possible.
It is the intern’s responsibility to arrange their spoke experiences through negotiation with their
mentor. The intern must clearly articulate and document the learning outcomes that are to be met
by the spoke experience. Any spoke experience must be agreed by the mentor and if a mentor feels
that an intern is potentially at risk by, or misguided in, their choice of spoke then, as an accountable
registrant, they cannot agree to it.
When is a spoke not a spoke?
When it is a visit. If a proposed ‘spoke’ experience is not within the Department’s audited
placement circuit the length is limited to a maximum of two days and is referred to as a visit. Interns
visiting unaudited areas should not provide direct clinical care and should do no more than any
other visitor would. The learning outcomes in this situation would relate to knowledge gathering
and observation.
When an intern is attending a spoke experience or a visit, there should be clearly established
communication systems between the mentorship team in the base area and the spoke or visit
supervisor in the area the intern is visiting. This is to ensure intern safety and to maintain an ‘on-
going achievement record’ (NMC 2007b), based on the CAP document (PebblePad workbook) and
other authenticated evidence.
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Service Improvement Project
During Professional Internship Two each student will undertake a Service Improvement Project. This
project will be patient focused and negotiated through discussions with patients, mentors and
practice staff. This is a substantial piece of work which forms the basis of the dissertation for the
MNursing. Details of this assignment can be found at:
https://www.york.ac.uk/healthsciences/student-intranet/timetables/assess-guide/#tab-7.
Students should use Professional Internship One as an opportunity to explore ideas for their project
which should also aim to meet the strategic objectives of the organisation hosting their internship.
If you have any comments about this guide or suggestions for additional material please email [email protected]
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References
NMC (2007a) Applying due regard to learning and assessment in practice. NMC Circular 26/2007.
September 2007. NMC: London.
NMC (2007b) Ensuring continuity of practice assessment through the ongoing achievement record.
NMC 33/2007 Oct 2007. NMC: London.
NMC (2015) The Code . NMC: London
NMC (2008b) Standards to support learning and assessment in practice; NMC standards for
mentors, practice teachers and teachers. 2nd Edition July 2008 NMC, London.
NMC (2009) Guidance on professional conduct for nursing and midwifery students. NMC: London
NMC (2010a) Standards for pre-registration nursing programmes. September 2010. NMC: London
NMC (2010b) Raising and escalating concerns: Guidance for nurses and midwives. November 2010.
NMC: London
