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School of Health Sciences

BSc (Hons) Midwifery Practice Assessment Document

Module 3

Student name: .....................

Cohort: .....................

September 2015 Cohort

© Copyright University of East Angl ia, June 2016

This materia l may not be reproduced in whole or in part without the written permission of the Head of the School of

Health Sc iences of the Universi ty of East Angl ia

School of Health Sciences

BSc (Hons) Midwifery (Long & Short Programmes)

Name of Student:_____________________________________________

Module Assessment___________________________________________

Please be aware that in undertaking this summative assessment and completing the details below

you are confirming that you are an ‘active’ mentor and accountable for your practice as outlined in

NMC (2008) SLAiP guidance.

Name of Mentor:_______________________________________________

Signature of Mentor:____________________________________________

Date of signature:______________________________________________

NMC PIN Number:_____________________________________________

Date of last annual mentor update attendance:_______________________

Date of last Triennial Review:_____________________________________

(or Mentor Preparation Programme if under 3 years)

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Contents

Mentor declaration Page 2

Flow chart of assessment process Page 4

Framework which informs the assessment of practice Page 5

Module 3

Progress record sheets:

Formative planning discussion

Formative review discussion

Supplementary page

Summative interview

Page 7 Page 9 Page 11 Page 13

List of module 3 themes Page 15

Learning outcomes:

D. Midwifery practice of postnatal care

E. Midwifery practice of newborn care

F. Population health- creating healthy communities

H. Providing care for families which reflects the changing dynamics encountered in modern society

K. Safe medicine management in midwifery practice (module 3)

N. Inter-professional/interagency practice within maternity services

O. Baby Friendly Initiative

Page 16 Page 17 Page 18 Page 19

Page 20 Page 22 Page 23

Interpersonal Attributes Page 25

Grading for practice Page 27

Appendix 1: Skills cluster mapping for practice outcomes- Years 2 and 3 Page 29

Spoke placement: Summative Learning Record Page 52

Mentor evaluation Page 54

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Flow chart of assessment process

Please refer to the ‘Assessment of Theory and Practice for Mentors and Students’ document for the complete guidance on this process.

Practice orientation: information relevant to the practice area e.g. fire alarms/extinguishers, emergency numbers, health and safety, medical device alerts, coffee facilities etc. This must be completed on the first shift. Welcome Pack and learning opportunities provided to the student. Formative planning discussion between student and Mentor in first week of module practice allocation to: Identify and discuss the learning outcomes to be achieved in the module and how reflective study time will be accommodated and reviewed. Explore the available learning opportunities in relation to learning and assessment requirements and formulate an action plan to meet the learning outcomes. Set a date for the formative review discussion and summative interview (student to discuss date options with Link Lecturer).

Formative review discussion (mid way through the practice allocation) between student, Mentor and Link Lecturer: Review learning outcomes and documented evidence to date to inform discussion of grading. Discuss students self evaluation of progress and learning priorities and Mentor’s evaluation. Establish learning priorities for the remainder of the practice allocation. Formally record the outcome of the evaluation of progress against the learning outcomes, and other identified planned activities including the Interpersonal Attributes assessment. Record the discussion with a clear revised learning plan for the rest of the practice allocation.

Summative interview between student and Mentor (and Link Lecturer if required): Determine evidence of learning and achievement (confirm if learning outcomes are passed or failed, establish any areas outstanding). Establish any outstanding areas/activities regarding practice learning. Record the discussion on the summative interview page. Complete the grading of practice.

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Framework which informs the assessment of practice- Years 1, 2 and 3

Levels of performance in skill development adapted from Hilton (2004).

Observer Participant observer Supervised participant Modules 1 and 2 - In Year 1 the learning outcomes are constructed to reflect the students’ assessment at level of supervised participant at the end of the module. This recognises the initial progression from observer to participant observer in the earlier part of the module. Participant observer level is defined as: the student being closely guided by the Mentor who will ensure the student is able to firstly observe care delivery before beginning to participate. Supervised participant level is defined as: the student being able to actively participate in the delivery of normal midwifery care under direct supervision with evidence of their knowledge being relevantly applied. May revert to earlier role behaviour in new situations. Levels of performance in skill development The student has received instruction underpinning the skill, observed the procedure in the practice setting and has participated in the skill under direct supervision.

care delivery supervised by the Mentor

Supervised participant Supervised practitioner

Modules 3 and 4 - In Year 2 the learning outcomes are constructed to reflect the level of supervised practitioner. This recognises that students will be building upon midwifery skills and knowledge acquired in Year 1 while accommodating new skills and knowledge in the provision of more complex aspects of midwifery care.

Supervised practitioner level is defined as: the student is able to demonstrate active participation in complex care and able to begin to initiate appropriate midwifery care following clinical assessment. May revert to earlier role behaviour in new situations. Levels of performance in skill development The student has performed the skill on a number of occasions and requires minimal supervision.

Supervised practitioner Competent practitioner

Modules 5 and 6 - In Year 3 the learning outcomes are constructed to reflect the level of competent practice. This recognises that students will be developing and consolidating practice of holistic midwifery care during pregnancy, labour and the early postnatal weeks, providing the full range of skills and knowledge for normal midwifery practice in order to meet the needs of women and their families. They will also be able to provide care for childbearing women with more complex and health and social needs within a multidisciplinary team. Over the course of this year students will attain proficiency in the full range of NMC (2009) Pre-registration education standards, becoming competent practitioners capable of developing an autonomous role. Competent practice level is defined as: the student is able to actively undertake and initiate appropriate midwifery care and support others in the delivery of care while being able to clearly demonstrate that there is consistent evidence to practice safely and effectively without the need for direct supervision (NMC 2009). May revert to earlier role behaviour in new situations. Levels of performance in skill development The student can perform the skill safely and competently giving the rationale for actions and can identify and manage the impact of this.

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Module 3 Health and Social

Complexities

D. Midwifery practice of postnatal care E. Midwifery practice of newborn care F. Population health- creating healthy communities H. Providing care for families which reflects the changing dynamics encountered in modern society K. Safe medicine management in midwifery practice N. Inter-professional/interagency practice within maternity services O. Baby Friendly Initiative

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Practice area: ................................... Registration number: ................................... Student name: ...................................... Cohort: ................................... On the first shift orientate the student to the area e.g. fire, health and safety, policy documents, medical alerts. This discussion will be conducted by the student’s Mentor (or an identified Co-Mentor) and will normally take place in the first week of the practice allocation. Issues to be discussed include:

1. The learning opportunities profiles available within the practice area and how these may be accessed.

2. Student has access to the Placement Welcome Pack. 3. Any learning support needs that the student may have, such as dyslexia support in practice. 4. Review previous Mentor’s evaluation of student progress, noting strengths and areas for

development. 5. Identification of the learning outcomes to be achieved in this practice allocation. 6. The requirement for the student to collect and record supporting evidence of learning and

achievement and discuss how practice reflective time will be arranged. 7. Requirements and arrangements for support and supervision.

FORMATIVE PLANNING DISCUSSION IN PRACTICE AREA

DATE OF DISCUSSION: .................

Student to identify areas for discussion such as; specific areas of learning linked to learning outcomes, EU requirements, personal skill profile and other activities. Key strengths and areas for development in order to identify learning priorities. To be completed prior to the discussion and recorded below:

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Formative planning discussion (continued)

Learning plan agreed between Mentor and student to manage the learning outcomes and learning activities for this practice allocation. Recorded by Mentor.

Student name: ............................................ Signature: ........................................... Mentor name: ............................................. Signature: ...........................................

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Practice area: ................................... Registration number: ................................... Student name: ...................................... Cohort: ................................... This discussion will be conducted by the student’s Mentor (or, where not available, the named Co-Mentor) and the Link Lecturer. The discussion will take place mid practice allocation. Issues to be discussed include:

A review of the student’s progress to date.

Discussion surrounding the identified learning outcomes.

A review of mutual expectations and arrangements for support and supervision.

Use of the portfolio to support the achievements to date.

Review of the Learning Plan.

FORMATIVE REVIEW DISCUSSION HELD MIDPOINT IN PRACTICE ALLOCATION

DATE OF DISCUSSION : .................

Student’s self evaluation of progress and identification of emerging strengths, areas for development and learning priorities for discussion with the Mentor. Must be completed prior to the discussion and recorded below.

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Formative review discussion (continued)

Mentor’s evaluation of progress, identification of emerging strengths, areas for development and learning priorities for discussion with the student.

Student signature: ....................................... Mentor signature: ................................ Link Lecturer signature: ............................. Date: .....................................................

Link Lecturer’s comments

Mentor’s indicative grade at formative assessment point %

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SUPPLEMENTARY PAGE: This page is for feedback to the student on their performance relating to specific learning outcomes. Any member of staff including MCAs may write comments here. Please sign, print your name and add your designation. Additional pages available on Blackboard

Date Signature Comments

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Further Review of Learning plan where required

Student Self-Evaluation

Mentor Evaluation

Student signature: ....................................... Mentor signature: ................................ Link Lecturer signature: ............................. Date: .....................................................

Revised learning plan for remainder of practice allocation

Link Lecturer’s comments

Further pages may be added by the Link Lecturer

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Practice area: ................................... Registration number: ................................... Student name: ...................................... Cohort: ................................... This interview will be conducted by the student’s Mentor (or Co-Mentor in certain circumstances). The purpose of the interview is for the Mentor to confirm achievement of the learning outcomes and award a grade reflecting the student’s ability.

SUMMATIVE INTERVIEW DATE OF INTERVIEW: .................

Student’s evaluation of the achievement of the learning outcomes and skills and identified areas for discussion regarding overall progression.

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Summative interview (continued)

Mentor’s evaluation of the student’s achievements in respect of learning outcomes, essential skills and discussion based upon reflections.

Student signature: ....................................... Mentor signature: ................................ Link Lecturer signature if present: ............. Date: ......................................................

Identification by the Mentor of the student’s key strengths and areas for further development in the next practice allocation.

Where student has a second named mentor, this mentor’s evaluation to be included

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Module 3 themes – Supervised Practitioner level

D. Midwifery practice of postnatal care E. Midwifery practice of neonatal care F. Population health- creating healthy communities H. Providing care for families which reflects the changing dynamics encountered in modern society K. Safe medicine management in midwifery practice N. Inter-professional/interagency practice within maternity services O. Baby Friendly Initiative All aspects of the learning outcome for each of the above themes are to be assessed at the level of Supervised Practitioner.

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Theme D: Supervised Practitioner level - Midwifery practice of postnatal care Outcome: the student is able to, under supervision, recognise and manage changes in the health and wellbeing of the woman in the postnatal phase. Knowledge

Utilise applied anatomy and physiology when recognising deviation in maternal wellbeing.

Consider ways to assess maternal wellbeing when health deviates, including planning care and knowing when to refer and why.

Identify support groups and how they assist women and their families to achieve best health outcomes following childbearing.

Practice and Skills

Assess, plan, implement and evaluate care to improve the wellbeing of women when health deviates.

Identify women who physically and/or emotionally are not engaging with their baby, suggesting ways to improve emotional attachment.

Applies information that is evidenced-based to help promote healthy living when planning care for women and their families.

Identify common complications of breastfeeding, how these arise and how women may be helped to overcome them (BFI 15).

Associated Skills

The student must undertake the following skills in the provision of holistic care and support for the practice above.

Postnatal assessment of maternal well-being

Use of modified obstetric early warning scoring

Frequency of taking vital signs in the context of ill-health

Post-operative care

Administration of oxygen therapy, nasal, face mask, pulse oximetry

Monitoring of intravenous fluid therapy

Assessment of pain in the mother

Use of patient controlled analgesia pumps

Wound care

assessment of abdominal/perineal wound

aseptic dressing technique and wound management

taking a wound swab and sending to laboratory

Care of indwelling urinary catheter

Monitoring nutritional requirements of the mother including hydration

Assisting mothers to breastfeed

Observation of intravenous cannulation/removal cannula

Monitoring blood sugar levels

Use of electronic devices to monitor blood sugar levels

Fluid balance interpretation and management

Presentation of skin integrity

All elements of the practice learning outcome passed YES/NO

Signature of Mentor:................................................. Date:.....................

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Theme E: Supervised Practitioner level - Midwifery practice of newborn care

Outcome: the student is able to, under supervision, provide transitional care and support parents when the newborn is sick.

Knowledge

Understand normal physiology of the newborn and recognise signs of altered physiology when health deteriorates.

Provide parents with information that is current and evidence-based to help parents make informed choices about the care of their baby.

Identify and evaluate the signs that a baby may be physically and/or socially vulnerable.

Describe the alternative feeding methods available when babies are unable to breastfeed, noting the benefits and risks (BFI 13,14).

Practice and Skills

Examine, assess and monitor care of the newborn when well-being is altered.

Share information with parents relating to the care and well-being of their baby.

Provide the basic needs of the newborn and show awareness of alterations in care.

Assist parents to care for their sick baby.

Identify the ‘at risk’ baby and, with supervision, refer to other health/social professionals.

Demonstrates alternative ways to feed a baby when breastfeeding cannot be achieved (BFI 13,14 ).

Associated Skills The student must undertake the following skills in the provision of holistic care and support for the practice above.

Assessment of appropriate growth and development of the neonate growth centiles

Assessment of neonatal well-being to include temperature, respiratory, heart rate and maintenance of thermoregulation Pulse oximetry Neonatal feeding - insertion of naso-gastric tube, naso-gastric feeding, removal of naso-gastric tube Calculation of feeding requirements for term / preterm infants Obtaining specimens and swabs from the neonate

Care of babies

congenital abnormality

preterm

small for gestational age and intrauterine growth restriction Neonatal capillary blood sampling and bilirubin estimation/monitoring Assessment of pain in the neonate Care of babies with jaundice/phototherapy, infection, and babies of diabetic mothers Skin integrity and positioning



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Theme F: Supervised Practitioner level - Population health- creating healthy communities Outcome: the student is able to initiate activities within the midwife’s role which will increase the opportunities to improve health for women, the newborn and families.

Knowledge

Describe how healthy living/public health programmes alter women’s health lifestyles, considering how these may be influenced by their social, religious and cultural background.

Discuss current health policy.

Practice and Skills

With supervision, assess women’s health lifestyles and offer choice and advice.

Implement and evaluate care that is evidence-based with the aim to improve wellbeing for women /baby.

Illustrate how to refer women to health promotion specialists.




Discharge planning which involves relevant agencies, organisations and professionals Discuss sensitively a wide range of services with women and their partners which will improve health outcomes for the mother, fetus & neonatefor example:

Substance misuse/addiction services/support

Dieticians

Medical specialists- asthma, diabetes, epilepsy

Bereavement support

Physiotherapists

Social workers

Health Visitors

Mental health team

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Theme H: Supervised Practitioner level – Providing care for families which reflects the changing dynamics encountered in modern society

Outcome: engages with women and their partners in providing the full cycle of care which is sensitive to family circumstances. Knowledge

Formulate and plan midwifery care which meets and respects religious and cultural views.

Recognise why care may be different for some cultural/social groups and the rationale for these differences. Practice and Skills

Respect and negotiate midwifery and newborn care with respect to family religious & cultural beliefs.

Participate and communicate with families and women and other health professionals when women’s health and wellbeing is altered.

Begin to plan appropriate care based on best practice, respecting religious & cultural variations. Associated Skills The student must undertake the following skills in the provision of holistic care and support for the practice above.



Contributes to safeguarding planning in a hospital context Engages appropriate planning and management approaches when working with parents with learning/mental health difficulties Practice in conjunction with specialist midwives and nurses who hold lead roles for vulnerable groups Participate in the care of women with complications in early pregnancy, including pregnancy loss

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Theme K: Supervised Practitioner level - Safe medicine management in midwifery practice

Outcome 1: under direct supervision of your Mentor, safely select, obtain and administer medicines relevant to women in your care in accordance with legislation and trust policy.

Knowledge

Identify permitted drugs and rationale for selection.

Can recall the known side effects and contraindications of drugs before their administration.

Show understanding of professional obligations to legislation including reference to NMC Standards for medicines management.

Recognise why medicines are administered via different routes.

Practice and Skills

Under direct supervision select, prepare, calculate and administer a number of permitted drugs correctly.

Observe and monitor maternal wellbeing following administration of medicines.

Demonstrate the ability to use and refer to British National Formulary for medicine and product information.

Refers to national and local policies for medicine management guidance.


Reading and understanding information on maternal drug charts Observation and/or participation in the administration of medicines in the context of maternal health. Pharmacological preparations for women, for example

mental health

diabetes

asthma

hypertension

epilepsy

Substance misuse

antenatal corticosteroids therapy

antibiotic therapy



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Theme K: Supervised Practitioner level - Safe medicine management in midwifery practice Outcome 2: under direct supervision of your Mentor, safely select, obtain and administer medicines relevant to the neonate in your care in accordance with legislation and trust policy.

Knowledge

Identify permitted drugs and rationale for selection.

Can recall the known side effects and contraindications of drugs before their administration.

Show understanding of professional obligations to legislation including reference to NMC Standards for medicines management.

Recognise why medicines are administered via different routes.

Practice and Skills

Under direct supervision select, prepare, calculate and administer a number of permitted drugs correctly.

Observe and monitor neonatal wellbeing following administration of medicines.

Demonstrate the ability to use and refer to British National Formulary for medicine and product information.

Refers to national and local policies for medicine management guidance.


Reading and understanding information on neonatal drug charts. Observation and/or participation in the administration of medicines in a neonatal context, for example:

oral administration / via naso-gastric tube

intramuscular injection

subcutaneous injection

oxygen therapy Preparation of intravenous infusion giving set Administration of topical preparations

Calculate dosages of common neonatal medications within a neonatal setting.



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Theme N: Supervised Practitioner level - Inter-professional/interagency practice within maternity services

Outcome: begins to play a key role with the multidisciplinary team in providing midwifery care. Knowledge

Recognise situations when midwives need to refer childbearing women and families to relevant professionals in order to optimise maternal/fetal/newborn wellbeing.

With guidance, demonstrate verbal and written skills when communicating with the multidisciplinary team. Practice and Skills

Engage with health professionals to understand their roles and responsibilities in order to deliver appropriate care to women/babies.

Attend audit meetings which are multi-professional, where care and management of obstetric cases are reviewed. Associated Skills The student must undertake the following skills in the provision of holistic care and support for the practice above.



Collaborates with other practitioners as required Refers women to other specialists to improve women’s health/social outcomes Engages with planned care pathway

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Theme O: Supervised Practitioner level - Baby Friendly Initiative Outcome 1: the student is equipped to provide parents with accurate evidence-based information about activities that may have an impact on breastfeeding.

Knowledge

Discuss the nature and basis of different attitudes to breasts and breastfeeding and how these may be influenced.

Articulate the potential impact of mother-infant separation, restricted feeding practices, supplementation and the use of teats and dummies on breastfeeding and infant health.

Identify and define the importance of informed choice.

Practice and Skills

Demonstrate effective communication skills, including the importance of giving full, unbiased information in a non-judgmental way.


Importance of skin to skin care/Kangaroo care Assist with breastfeeding

positioning of mother

positioning of baby

correct attachment

recognition of suckling and milk transfer Hand expression of breast milk Milk expression using breast pump Safe collection and storage of breast milk Feeding expressed breast milk via a cup Feeding expressed breast milk via a syringe Preparation and storage of infant formulae

Preparation of formula feed Feeding a baby safely with formula Sterilisation of feeding equipment



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Theme O: Supervised Practitioner level - Baby Friendly Initiative

Outcome 2: the student is able to support mothers who are separated from their babies (for example, on admission to Neonatal Unit or when returning to work), to initiate and/or maintain their lactation and to feed their babies optimally.

Knowledge When separation occurs from birth:

Understand the importance of breast milk for all babies, including those who are preterm, ill or compromised.

Demonstrate the importance of early breast milk expression in initiating and establishing lactation.

Describe the value of skin contact/kangaroo mother care for the baby’s wellbeing and for stimulating lactation and mothering.

Justify the benefits of hand expression in the first few days.

Practice and Skills

Demonstrate ways to optimise lactation through frequent expression, breast ‘switching’, dual expression when separation of baby occurs at birth.

Evaluate the importance of frequent, effective breast milk expression in maintaining breast milk production.

Suggest methods of stimulating/assisting the oxytocin reflex.

Evaluate the ongoing value of hand expression and the appropriate use of breast pumps.

Suggest ways to help mothers’ re-establish/induce lactation, including skin to skin contact.


Initiate the value of skin contact whenever mother and baby are together Advise women how to store breast milk, both for home use and for baby in Neonatal Unit Safely tube/cup/spoonfeed



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Interpersonal Attributes

Supervised practitioner level of practice

The column “Fixed Standard” cannot be altered and sets the standard for the year. The Mentor will select five attributes that best reflect the student demeanour. All five must be in the ‘Pass’ category for the student to be eligible to pass the practice component of the module. Reference: Adapted from Knight J (1998) A Fieldwork award: rewarding Excellence in Practice. British Journal of Occupational Therapy 61(7): 316-320.

Fixed

Standard Pass/Fail

Interpersonal Attributes Signature

1 P Has become a valued and respected team member.

2 P Considerate, demonstrates awareness of the needs of others.

3 P Demonstrates an empathetic approach to midwifery care.

4 P Demonstrates self awareness.

5 P Displays a non-judgmental approach towards others.

6 P Able to accept and use constructive feedback to improve performance.

7 P Demonstrates a professional approach to midwifery practice.

8 P Motivated and adaptable and able to use initiative.

9 P Has a pleasant and approachable manner and displays a mature attitude.

10 P Has developed in confidence during this placement.

11 P Willing to try.

12 P Needs to be more assertive.

13 F Appears to be overconfident for stage of training.

14 F Lacks empathy.

15 F Lacks self awareness and the effect of behaviour on others/lacks maturity.

16 F Lack of confidence adversely inhibits performance.

17 F Reacts adversely to constructive feedback.

18 F Blames circumstances for difficulties encountered.

19 F Displays a negative attitude/lacks motivation/ disengaged.

20 F Behaves in an unprofessional manner i.e. dress code, time keeping, use of negative body language.

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Grading for practice – based on 40% pass mark

Supervised practitioner level of practice

Skills and Knowledge Supervised practitioner

Exceptional 80-100%

Grade awarded

Communication with other professionals and client group is consistently informative and applied relevantly to women’s health and choices. Consistently uses current evidence, audit, theory and policy in professional/clinical discussions to accurately inform practice decisions. Is consistently adaptable in the practice setting with women, families, professionals and prioritises practice activities effectively. Contribution to team working is consistently reliable and effective, demonstrating sound communication and activities. Consistently demonstrates accurate knowledge and ability in the conduct of midwifery practice which reflects women centred care. Excels in the execution of practice skills, consistently conducts skills in a safe and sensitive manner respecting the privacy and dignity of the individual.

Mentor signature


Excellent 70-79%

Grade awarded

With occasional guidance communication with other professionals and client group is always informative and applied relevantly to women’s health and choices. Utilises current evidence, audit, theory and policy in professional/clinical discussions and with occasional guidance accurately inform practice decisions. Is adaptable in the practice setting with women, families, professionals but requires occasional guidance to prioritise practice activities effectively. Most team working activity is reliable and effective. With occasional guidance demonstrates knowledge and ability in the conduct of midwifery practice which reflects women centred care. Practice is always safe practice and conducts practice skills in a safe and sensitive manner respecting the privacy and dignity of the individual.

Mentor signature

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Good 60-69%

Grade awarded

Communication with other professionals and client group is informative and usually applied relevantly to women’s health and choices but requires prompting. When using current evidence, audit, theory and policy in clinical and professional discussions to accurately inform practice decisions, requires prompting. Usually adaptable in the practice setting with women, families, professionals and can prioritise practice activities effectively. Requires occasional prompting to integrate with team working to contribute more to the team. Demonstrates knowledge and ability in the conduct of midwifery practice which reflects women centred care but requires prompting. Practice is always safe and care is usually conducted in a safe and sensitive manner respecting the privacy and dignity of the individual.

Mentor signature


Pass 50-59%

Grade awarded

Communication with other professionals and client group is informative but sometimes requires assistance to apply relevantly to women’s health and choices. Engages in discussion using current evidence, audit, theory and policy but requires more depth and breadth of knowledge in its application. Sometimes requires support to adapt in the practice setting with women, families, professionals and generally can prioritise practice activities sufficiently. Generally integrates with team working but requires encouragement to contribute and be proactive. Generally demonstrates knowledge and ability in the conduct of midwifery practice which reflects women centred care and sometimes lacks depth and breadth of the subject. Practice is always safe and care is generally conducted in a safe and sensitive manner respecting the privacy and dignity of the individual.

Mentor signature

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Borderline pass 40-49%

Grade awarded

Inconsistent with communication which can be irrelevant or not appropriate when engaging with other professionals and client group. Inconsistent in discussion when using current evidence, audit, theory and policy and requires significant prompting to apply knowledge to midwifery management and care. Frequently requires guidance to adapt in the practice setting with women, families, professionals and requires assistance to prioritise practice activities. Generally integrates with team working but lacks confidence in own abilities. Demonstrates minimal knowledge and ability to conduct midwifery practice which reflects women centred care. Practice is always safe and is conducted in a sensitive manner respecting the privacy and dignity of the individual with prompting.

Mentor signature


Fail 0-39%

Grade awarded

Unable to communicate with other professionals and client group, is insensitive to the situation. Fails to use current evidence, audit, theory and policy with any relevance when in discussion with women, families and other professionals. Fails to apply relevant knowledge and valid evidence in the assessment, planning, delivery and evaluation of midwifery care. Cannot adapt in the practice setting with women, families, professionals, and unaware of their needs. Has difficulty interacting with others including team working. Lacks insight into their own influence upon the outcome of care activities. Acts without due regard to present level of ability and fails to take up learning opportunities. Inability to complete or achieve a pass in all practice outcomes. Written reflective evidence to support designated practice theme is not completed. Practice is unsafe.

Mentor signature

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Skill Cluster for Communication

Skill – 1. Be attentive and share information that is clear, accurate and meaningful at a level which women, their partners and family can understand.

Component Skills

Module 3

Module 4

Module 5

Module 6

Consistently shows ability to communicate safely and effectively with women, providing guidance for juniors.

Theme A

Can articulate a clear plan of care that has been developed in partnership with the woman.

Theme A

Communicates effectively and sensitively in different settings, using a range of methods and styles in individual and group settings.

Theme A

Provides accurate and comprehensive written reports based on best available evidence.

Theme A

Familiar with accessing and recording information other than in handwritten form, such as texting, emailing, or computing and other electronic formats.

Theme A

Acts to reduce and challenge barriers to effective communication and understanding.

Theme A

Is proactive and creative in enhancing communication and understanding.

Theme A

Where appropriate uses the skills of active listening, questioning, paraphrasing, and reflection to assist in effective communication.

Theme A

Uses appropriate and relevant communication skills to deal with difficult and challenging circumstances in individual and group scenarios.

Theme M

Appendix 1: Skills cluster mapping for practice outcomes (NMC 2009) Years 2 and 3

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Skill – 2. Protect and treat as confidential all information relating to themselves and their care.

Component Skills

Module 3

Module 4

Module 5

Module 6

Acts professionally and appropriately in situations where there may be limits to confidentiality (e.g. child protection, protection from harm).

Theme E

Recognises the significance of information and who does/does not need to know.

Theme N

Distinguishes between information that is relevant to care planning and that which is not.

Theme N

Acts appropriately in sharing information to enable and enhance care (multidisciplinary team, across agency boundaries.

Theme N

Works within the legal framework for data protection (e.g. access to and storage of records).

Theme A

Demonstrates ability to act within the law when confidence has been broken.

Theme A

Skill - 3. Enable women to make choices about their care by informing women of the choices available to them and providing evidence-based information about benefits and risks of options so that women can make a fully informed decision.

Component Skills

Module 3

Module 4

Module 5

Module 6

Respect the role of women as partners in their care and contributions they can make to it.

Theme N

Uses appropriate strategies to encourage and promote choice for all women.

Theme N

Provide accurate, truthful and balanced information that is presented in such a way as to make it easily understood.

Theme H

Respect women’s autonomy when making a decision, even where a particular choice may result in harm to themselves or their unborn child, unless a court of law orders the contrary.

Theme H

Discuss with women local/national information to assist with making choices, including local and national voluntary agencies and websites.

Theme F

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Skill – 4. Ensure that consent will be sought from the woman prior to care being given and that the rights of women are respected.

Component Skills

Module 3

Module 4

Module 5

Module 6

Works within legal frameworks when seeking consent. Theme N

Seeks consent prior to sharing confidential information outside of the professional care team (subject to agreed safeguarding / protection procedures).

Theme N

Uses appropriate strategies to enable women to understand treatments and interventions in order to give informed consent.

Theme H

Demonstrates respect for client autonomy and the rights of women to withhold consent in relation to care and treatment within legal frameworks.

Theme H

Skill – 5. Treat women with dignity and respect them as individuals.

Component Skills

Module 3

Module 4

Module 5

Module 6

Acts professionally to ensure that personal judgements, prejudices, values, attitudes and beliefs do not compromise the care provided.

Theme G

Is proactive in maintaining dignity. Theme G Challenges situations/others where the dignity of the woman may be compromised.

Theme G

Confidently shares information with women who have physical, cognitive or sensory disabilities and those who do not speak or read English.

Theme A

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Skill – 6. Work in partnership with women in a manner that is diversity sensitive and is free from discrimination, harassment and exploitation.

Component Skills

Module 3

Module 4

Module 5

Module 6

Upholds the rights of the women and speaks out when these are at risk of being compromised.

Theme G

Takes into account UK legal frameworks and professional ethics when planning care.

Theme N

Is proactive in promoting care environments that are diversity sensitive and free from exploitation, discrimination and harassment.

Theme N

Manages challenging situations effectively. Theme N

Skill – 7. Provide care that is delivered in a warm, sensitive and compassionate way.

Component Skills

Module 3

Module 4

Module 5

Module 6

Anticipates how a woman might feel in a given situation and responds with kindness and empathy to provide physical and emotional comfort.

Theme N

Makes appropriate use of touch. Theme C

Listens to, watches for, and responds to verbal and non verbal cues. Theme G Delivers care that recognises need and provides both practical and emotional support.

Theme C

Has insight into own values and how these may impact on interactions with women.

Theme G

Recognises circumstances that trigger personal negative responses and takes action to prevent this compromising of care.

Theme G

Recognises and responds to emotional discomfort/distress of self and others.

Theme C

Through reflection and evaluation demonstrates commitment to personal and professional development.

Theme G

33

Skill – 8. Be confident in their own role within a multi-disciplinary/multi-agency team.

Component Skills

Module 3

Module 4

Module 5

Module 6

Works within the NMC Midwives rules and standards. Theme N Appropriately consults and explores solutions and ideas with others to enhance care.

Theme N

Appropriately challenges the practice of self and others across the multi-professional team.

Theme N

Acts as an effective role model in decision making, taking action and supporting more junior staff.

Theme N

Works inter-professionally as a means of achieving optimum outcomes for women.

Theme N

34

Skill Cluster for Initial Consultation between the Woman and the Midwife

Skill 1 – Be confident in sharing information about common antenatal screening tests.

Component Skills

Module 3

Module 4

Module 5

Module 6

Acts professionally to ensure that personal judgements, prejudices, values, attitudes and beliefs do not compromise the provision of care.

Interpersonal Attributes 2, 3, 4,

5 and 7

Facilitates informed choices regarding antenatal screening tests ensuring women fully understand the purpose of all tests before they are taken.

Theme B

Can accurately interpret data/results and share this information sensitively with women, including the ability to discuss any further action/consequences as necessary.

Theme B

Can conduct general information sharing (e.g. optimum times for testing) as appropriate through a variety of multi-media channels, such as texting.

Theme A

Can effectively share information in challenging circumstances, such as a previous bereavement, or affected/high risk screening result.

Theme B

Discuss with women local/national information to assist with making choices, including local and national voluntary agencies and websites.

Theme F

Is able to seek out required information about less common/specialised antenatal screening tests.

Theme B

35

Skill – 2. Accurately complete an initial consultation ensuring women are at the centre of care.

Component Skills

Module 3

Module 4

Module 5

Module 6

Consistently shows the ability to: - share information with women - assess maternal and fetal wellbeing relevant to gestation, and

acts upon the need to refer to appropriate individuals where necessary

- plan, in partnership with women, a care pathway to ensure individual needs are met.

Theme B

Effectively explores social, religious and cultural factors that inform an individualised antenatal care pathway for women that is diversity sensitive.

Theme B

Is competent in recognising and advising women who would benefit from more specialist services.

Themes N and B

Empowers women to recognise normal pregnancy development and when to seek advice.

Theme N

Skilled in providing the opportunity to women to disclose domestic abuse and is able to respond appropriately.

Theme B

Is competent in sharing information about: the pregnancy care services and options available; lifestyle considerations, including dietary information; and screening tests.

Theme N

Skill – 3. Work collaboratively with other practitioners and external agencies.

Component Skills

Module 3

Module 4

Module 5

Module 6

Is competent to refer women who would benefit from more specialist services, such as a local substance misuse support unit.

Theme N

Able to collaborate effectively with other practitioners and agencies as required.

Theme N

36

Skill – 4. Be the first point of contact when seeking advice and / or information about being pregnant.

Component Skills

Module 3

Module 4

Module 5

Module 6

Where available, to be actively involved in being accessible for women in environments other than traditional NHS settings.

Theme B

Be confident in working in a variety of models of service delivery which encourage early access to care.

Theme B

37

Skill Cluster for Normal Labour and Birth

Skill - 1. Work in partnership with women to facilitate a birth environment that supports their needs.

Component Skills

Module 3

Module 4

Module 5

Module 6

Able to support women in a variety of birth settings, other than the acute hospital environment, taking into account the health, safety and wellbeing of women.

Theme C

Ensures that women’s labour and birth is diversity sensitive meeting the individual needs and preferences.

Theme C

Can anticipate and provide for the needs of women. Theme C Inspires confidence and bases decisions on evidence and uses experience to guide decision making.

Theme C

Acknowledges the roles and relationships in families, dependent upon religious and cultural beliefs, preferences and experiences.

Theme C

Practises in accordance with relevant legislation. Theme K

Skill - 2. Be attentive to the comfort needs of women before, during and after the birth.

Component Skills Module 3

Module 4

Module 5

Module 6

Listens to, watches for, and responds to verbal and non verbal cues. Theme A Applies in-depth knowledge of the physiology of labour and birth. Theme C

Uses skills of observation and active listening in order to analyse the effectiveness of care being provided.

Theme A

38

Skill - 3. Determine the onset of labour.


Module 4

Module 5

Module 6

Identify the onset of labour and discuss the findings accurately and share this information with women, including the ability to discuss any further action / consequences as necessary.

Theme C

Skill - 4. Determine the wellbeing of a women and her unborn baby.

Component Skills

Module 3

Module 4

Module 5

Module 6

Assess maternal wellbeing and interpret the findings accurately and share this information with women, including the ability to discuss any further action/consequences as necessary.

Theme C

Identify and safely manage risk. Theme C

Refer women who would benefit from the skills and knowledge of other individuals.

Theme B

Assess and implement measures to manage, reduce or remove risk that could be detrimental to women, self and others.

Theme B

39

Skill - 5. Measure, assess and facilitate the progress of normal labour.

Component Skills

Module 3

Module 4

Module 5

Module 6

Identify and appropriately manage latent and active phase of labour. Theme C Accurately assess progress of labour and share this information with women, including the ability to discuss any further action/consequences as necessary.

Theme C

Able to discuss with women the progress of labour in relation to the birth plan/written wishes and modify in partnership with women, as need dictates.

Theme C

Critically appraise and justify the use of any intervention, such as artificial rupture of membranes, continuous electronic fetal monitoring, urinary catheterisation, in order to facilitate a spontaneous vaginal birth.

Theme C

Seek informed consent prior to undertaking any procedure. Theme C Recognise any deviation from the normal progress of labour or wellbeing of the woman or fetus.

Theme C

Timely referral of women who would benefit from the skills and knowledge of others.

Theme C

40

Skill - 6. Support women and their partners in the birth of their baby.

Component Skills

Module 3

Module 4

Module 5

Module 6

Accurately assess progress and shares this information with women, including the ability to discuss any further action / consequences as necessary.

Theme C

Prepares the environment ready for the birth. Theme C Sensitively care for women and be attentive to the ‘moment of birth’, creating an environment that is responsive to the woman’s needs.

Theme C

Safely support women in the birth of their baby. Theme C Initiate emergency measures if required, such as episiotomy. Theme C

Timely referral of women who would benefit from the skills and knowledge of others.

Theme C

Continue to provide care to women undergoing complications as part of a multidisciplinary team.

Theme C

Assess and monitor the woman’s condition throughout the third stage of labour facilitating safe delivery of the placenta and membranes by physiological or active management.

Theme C

Skill - 7. Facilitate the mother and baby to remain together.

Component Skills

Module 3

Module 4

Module 5

Module 6

Accurately assess the health and wellbeing of the newborn baby. Theme E Initiate emergency measures if required in relation to relevant guidelines.

Theme E

In a culturally sensitive manner, create an environment that is protective of the maternal infant attachment process, such as minimal handling of the baby, discovering gender, fostering maternal infant eye contact, skin-to-skin contact.

Theme D

41

Skill - 8. Identify and safely manage appropriate emergency procedures.

Component Skills

Module 3

Module 4

Module 5

Module 6

Can initiate emergency measures in both primary and secondary care settings.

Theme L

Can sustain emergency measures until help arrives. Theme L

Skill - 9. Works collaboratively with other practitioners.

Component Skills

Module 3

Module 4

Module 5

Module 6

Is an advocate for women. Theme D

Negotiates with others in relation to balancing competing/conflicting priorities.

Theme D

Can articulate professional limitations and boundaries. Theme D

Confident to call appropriate professional regardless of hierarchy, when care requires expertise beyond the midwife’s current practice, or the needs of the women or baby fall outside the scope of midwifery practice.

Theme D

Practices in accordance with the NMC Midwives rules and standards. Theme D

Skill - 10. Keep accurate records.


Module 4

Module 5

Module 6

Provides detailed reasoning in the written records for any actions or interventions taken. Practices in accordance with the NMC Midwives rules and standards.

Theme A

42

Skill Cluster for Initiation and Continuance of Breastfeeding

Skill - 1. Understand and share information that is clear, accurate and meaningful at a level which women, their partners and family can understand.

Component Skills

Module 3

Module 4

Module 5

Module 6

Listens to, watches for, and responds to verbal and non verbal cues. Theme O:1 Uses skills of being attentive, open ended questioning and paraphrasing to support information sharing with women.

Theme O:1

Able to lead a variety of forums where information is shared with women about the advantages and disadvantages of different infant feeding methods, without regarding breastfeeding and artificial feeding as ‘equal’ choices.

Theme O:1

Understands the importance of exclusive breastfeeding and the consequences of offering artificial milk to breastfed babies.

Theme O:1

Critically appraises the nature and strength of breastfeeding promotional and support interventions.

Theme O:1

Understands the nature of evidence and how to evaluate the strength of research evidence used to back information.

Theme O:1

Keep accurate records of the woman and her baby relating to breastfeeding, including plans of care and any problems encountered or referrals made.

Theme O:1

43

Skill - 2. Respect social and cultural factors that may influence the decision to breastfeed.

Component Skills

Module 3

Module 4

Module 5

Module 6

Demonstrate a working knowledge of the local demographic area and explore strategies to support breastfeeding initiatives within the locality.

Theme O:1

Skilfully explores attitudes to breastfeeding. Theme B Takes into account differing social, and cultural factors (traditions, beliefs and professional ethics) when communicating with women.

Theme F

44

Skill - 3. Effectively support women to breastfeed.

Component Skills

Module 2 Module 3

Module 4

Module 5

Module 6

Applies in-depth knowledge of the physiology of lactation to practical situations.

Theme O:1

Can recognise effective positioning, attachment, suckling and milk transfer.

Theme O:1

Uses skills of observation, active listening and on-going critical appraisal in order to analyse the effectiveness of breastfeeding practices.

Theme O:1

Confident at exploring with women the potential impact of delivery room practices, such as the effect of different pain relief methods and the importance of skin-to-skin contact, on the well being of their baby and themselves, and on the establishment of breastfeeding in particular.

Theme O:1

Uses appropriate skills to support women to be successful at breastfeeding for the first six months of life.

Theme O:1

Empowers women to recognise effective positioning, attachment, suckling and milk transfer for themselves.

Theme O:1

Explore with women the evidence-base underpinning information, which may have an impact on breastfeeding such as bed-sharing and the use of dummies.

Theme O:2 Theme O:1

Skilled at advising women over the telephone when contacted for advice on breastfeeding issues.

Theme O:1

45

Skill - 4. Recognise appropriate infant growth and development, including where referral for further advice / action is required.

Component Skills

Module 3

Module 4

Module 5

Module 6

Acts upon the need to refer when there is a deviation from appropriate infant growth.

Theme E

Demonstrates skills to empower women to recognise appropriate infant growth and development and to seek advice when they have concerns.

Theme E

Skill - 5. Work collaboratively with other practitioners and external agencies.

Component Skills

Module 3

Module 4

Module 5

Module 6

Practices within the limitations of their own competence, knowledge and sphere of professional practice, consistent with the legislation relating to midwifery practice.

Theme E

Works confidently, collaboratively and in partnership with women and others to ensure the needs of women are met.

Theme E

Understand the importance of community support for breastfeeding and actively refers women to community based support networks, both in supporting women to breastfeed and as a resource for health professionals.

Theme O:1

Actively work with other health professionals and external agencies to promote breastfeeding and support women in their choice to breastfeed.

Theme O:1

Is able to discuss with women the importance of exclusive breastfeeding for six months and timely introduction of complementary foods and continuing breastfeeding during the weaning period, into the second year of life and beyond.

Theme D

46

Skill - 6. Support women to breastfeed in challenging circumstances.

Component Skills

Module 3

Module 4

Module 5

Module 6

Involve appropriate help, such as a lactation consultant, where specialised skills are required, in order to support women to successfully breastfeed.

Theme O:1

Acts upon the need to refer to appropriate health professionals where deviation from appropriate infant feeding and growth patterns are apparent.

Theme O:2

Support women who are separated from their babies (on admission to NNU, women receiving high dependency care in a separate environment) to initiate and maintain their lactation and feed their babies optimally.

Theme O:2

Feed expressed breast milk to a baby, using a cup and/or syringe as appropriate.

Theme O:1

Teach women how to use mechanical breast pump where appropriate. Theme O:1

47

Skill Cluster for Medicines Management

Skill - 1. Within the parameters of normal childbirth, ensure safe and effective practice through comprehensive knowledge of medicinal products, their actions, risks and benefits including the ability to recognise and respond safely to adverse drug reactions and adverse drug events.

Component Skills

Module 3

Module 4

Module 5

Module 6

Apply an understanding of basic pharmacology, how medicinal products act and interact in the systems of the body as well as their therapeutic action in all aspects related to midwifery practice.

Theme K

Uses knowledge and understanding of commonly supplied or administered medicinal products to the woman or baby in order to act promptly in cases where side effects and adverse reactions occur.

Theme L

Safely manage drug administration and monitor its effect. Theme K

Reports adverse incidents and near misses and adverse drug reactions.

Theme M

Safely manages anaphylaxis. Theme L

Skill – 2. Correctly and safely undertake medicinal product calculations.

Component Skills

Module 3

Module 4

Module 5

Module 6

Accurate calculation of medicinal products frequently encountered within field of practice.

Theme K

48

Skill - 3. In the course of their professional midwifery practice, supply and administer medicinal products safely in a timely manner, including controlled drugs.

Component Skills

Module 3

Module 4

Module 5

Module 6

Safely and effectively select, acquire and administer medicinal products via routes and methods commonly used within normal midwifery practice and maintains accurate records.

Theme K

Uses prescription charts correctly and maintains accurate records. Theme K

Utilises and accurately interprets medicine legislation related to midwives exemptions.

Theme K

Skill - 4. Keep and maintain accurate records, which includes when working within a multi-disciplinary framework and as part of a team.

Component Skills

Module 3

Module 4

Module 5

Module 6

Demonstrate an understanding of roles and responsibilities within the multi-disciplinary team for medicinal products management, including how and in what ways information is shared.

Theme C

Effectively keep records of information sharing with women about the benefits and risks of relevant medication.

Theme K

Effectively keep records of medication supplied and/or administered and omitted, including controlled drugs.

Theme K

49

Skill - 6. Work in partnership with women to share information in assisting them to make safe and informed choices about medicinal products related to herself, her unborn child or her baby.

Component Skills

Module 3

Module 4

Module 5

Module 6

Ensures information sharing is woman-centred and provides clear and accurate information.

Theme K

Assist women to make safe and informed choices about their medicinal products.

Theme K

Assess the woman’s ability to safely self-administer their medicinal products.

Theme K

Give clear instruction and explanation and check understanding relating to use of medicinal products and treatment options.

Theme K

Skill – 5. Work within the legal and ethical framework that underpins safe and effective medicinal products management, as well as in conjunction with national guidelines, and local policies.

Component Skills

Module 3

Module 4

Module 5

Module 6

Is conversant with legislation related to midwives exemptions, Pharmacy only and General Sales Lists medicinal products, Midwives Supply Orders, destruction of controlled drugs and Patient Group Directions Is aware of personal accountability in respect of supplying and administering unlicensed products.

Theme K

Demonstrates the ability to use relevant medicines legislation to support midwifery practice within the NHS in both the primary and secondary care settings, as well as during self-employed practice.

Theme K

Applies legislation in practice to safe and effective ordering, receiving, storing administering and disposal of medicinal products and drugs, including controlled drugs in both primary and secondary care settings.

Theme K

50

Skill - 7. Work in partnership with women to share information about alternative approaches to using medication, where appropriate.

Component Skills

Module 3

Module 4

Module 5

Module 6

Question, critically appraise and use evidence to support an argument in determining when medicinal products may or may not be an appropriate choice.

Theme K

Can make an appropriate referral to a registered complementary therapist.

Theme K

Shows awareness of the dangers of giving complementary therapy advice when not qualified e.g. raspberry leaf, over the counter herbal products.

Theme K

Skill - 8. Order, receive, store, transport and dispose of medicinal products safely and in accordance with relevant legislation, in any midwifery setting (including controlled drugs).

Component Skills

Module 3

Module 4

Module 5

Module 6

Order, receive, store and dispose of medicinal products safely, including controlled drugs.

Theme K

Skill – 9. Use and evaluate up-to-date information on medicinal products management and work within national and local policies and guidelines using appropriate reference.


Module 4

Module 5

Module 6

Confident in accessing commonly used evidence based sources of information relating to the safe and effective management of medicinal products.

Theme K

Work within national and local policies. Theme K

51

Skill – 10. Recognise and correctly respond to obstetric emergencies in the context of medicines management.


Module 4

Module 5

Module 6

Recognise and act accordingly when confronted with obstetric emergencies, in both primary and secondary care settings.

Theme K

Developed in partnership with NNUH

Spoke Placement: SUMMATIVE LEARNING RECORD

This document is for use by Students and Mentors in a ‘Spoke’ area. It is designed to help focus student activity upon identified learning outcomes that may be addressed away from the Hub placement.

It should be used where a student wishes to provide evidence for Summative Assessment of a learning outcome(s) whilst in a Spoke area and should be presented to the named Hub Mentor as part of the formative or summative assessment interview. This document should then be retained in the student’s portfolio alongside other written evidence of learning and achievement and the main Assessment of Practice document.

Advice for Students: Before commencing each ‘Spoke’ placement, please discuss with your named Hub placement mentor the potential learning outcome(s) you will focus upon within the Spoke placement. This should then be agreed on your arrival in the Spoke area with your supervising practitioner and ‘evidence’ collated of your achievement whilst there. You should then share this with your named mentor on your return to your main hub placement. Advice for Spoke Placement Mentor: Please discuss identified learning outcome(s) with your student on the first day of the Spoke Placement and agree the relevant activity and ‘evidence of achievement’ to be generated. On completion of the Spoke placement please review this evidence and comment upon the student’s achievements whilst placed with you. Please also identify any future learning activity that the student might benefit from in their Hub or future placement areas. PLEASE NOTE any practice concerns arising in the Spoke placement must be communicated to the named mentor. Student Name:

Intake & Module of study:

Named Hub Mentor: Hub placement area:

Spoke Mentor:

Spoke placement area:

Date(s) of Spoke Placement:

Hours worked:

PLEASE NOTE students are expected to demonstrate the same professional regard and behaviour in Spoke placement settings as in the main Hub placement as outlined below. Expectations of Students:

Please ensure you have accessed any available ‘Welcome Pack’ or ‘Information Packs’ for each ‘Spoke’ area.

Students should adhere to the NMC ‘Student Code of Conduct’ 3rd Edition

Students should comply with Trust / University policies and guidelines. For Example:

Punctual attendance

Adherence to Trust uniform policy.

Maintain a professional attitude at all times

Confidentiality, respect, privacy and sensitivity to the needs of others


Actively participate in your time with each ‘Spoke’ area, show willingness, use your initiative and display commitment.

Identified Learning Outcome(s): please identify here any learning outcome(s) from within the Assessment of Practice

document which will be addressed within the Spoke placement area

Student Signature: Date: Spoke Mentor: Date:

Student Summary of Evidence: please note here evidence of achievement relating to the learning outcome(s)

identified above

Feedback from Spoke Mentor: please comment on the sufficiency of evidence presented by the student to

demonstrate achievement of a specific learning outcome(s)

Student Signature: Date: Spoke Mentor Signature: Date:

Ongoing Placement Development: please note any learning or professional issues that might be addressed in the Hub

or future placement settings

Spoke Mentor Signature Date:

MENTOR/ ASSOCIATE MENTOR EVALUATION FORM

Please complete the attached form and leave it attached to the assessment document where it will be removed and submitted to the placement office

OR

Remove the form and fill it in separately and return it to: Support Office, School of Health Sciences, Edith Cavell Building, University of East Anglia, Norwich

Mentor Name (Optional):

Link Lecturer:

Trust / employing organisation

Name of Practice Learning area

Student cohort:

Date:

Strongly disagree

Disagree Agree Strongly agree

N/A

1. I had adequate preparation to fulfil my role as mentor

2. The students appeared prepared for the placement

3. Students are able to access a mentor at least 40% of the time

4. I was able to contact the link lecturer for support if needed

5. I understood how to complete the assessment document(s)

Please use the space below to elaborate on any of the above statements or add any further comments about your experience as a mentor in this placement

Please use the reverse of this form if you need more space


MENTOR/ ASSOCIATE MENTOR EVALUATION FORM

Please complete the attached form and leave it attached to the assessment document where it will be removed and submitted to the placement office

OR

Remove the form and fill it in separately and return it to: Support Office, School of Health Sciences, Edith Cavell Building, University of East Anglia, Norwich

Mentor Name (Optional):

Link Lecturer:

Trust / employing organisation

Name of Practice Learning area

Student cohort:

Date:

Strongly disagree

Disagree Agree Strongly agree

N/A

1. I had adequate preparation to fulfil my role as mentor

2. The students appeared prepared for the placement

3. Students are able to access a mentor at least 40% of the time

4. I was able to contact the link lecturer for support if needed

5. I understood how to complete the assessment document(s)

Please use the space below to elaborate on any of the above statements or add any further comments about your experience as a mentor in this placement

Please use the reverse of this form if you need more space

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