School of Nursing and Midwifery...the Nursing and Midwifery Board of Ireland (NMBI) and upon...

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Catherine McAuley School of Nursing and Midwifery University College Cork

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Bon Secours Hospital Cork University Hospital

Mercy University Hospital South Infirmary Victoria University Hospital

BSc (Hons) Nursing (General)

CLINICAL LEARNING OUTCOMES BOOKLET

NU1049 General Nursing Practice NU2063 General Nursing Practice

2017 INTAKE(YEARS ONE AND TWO)

Note: The Student is responsible for returning this document in its original form either in person or by registered post to the School of Nursing and Midwifery, UCC, on the dates specified by the School. Failure to do so may result in failing the Practice Placement Module. Please ensure that you sign for the submission of the document if you return it in person. Students submitting the document by registered post should, in their own interest, make a photocopy of the document before posting. Except in the case of a document lost in the post, photocopied documents will not be accepted.

Student’s Name: _____________________________________________________

Student ID: _________________________________________________________

Health Service Provider: _______________________________________________

This booklet remains the property of the UCC School of Nursing and Midwifery at all times. If found, please return this document to the School of Nursing and Midwifery, University College Cork.

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BSc (Hons) Nursing (General) 2017 Intake CLO Booklet valid for 2017/2018 and 2018/2019

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TABLE OF CONTENTS Pages Practice Placement Agreement ii Clinical Placement Details 1 Student Declaration & Self-Assessment Form Year 1 5 Student Declaration & Self-Assessment Form Year 2 6 Professional Behaviour and Standards 7 Assessment of Practice Guidelines 9 Pass and Progression Requirements Years 1 and 2 16 Cues for Steinaker & Bells Taxonomy of Learning 17 Clinical Learning Outcomes 18 Clinical Skills in General Nursing 22 Student Reflective Notes: Guidelines 35 Gibbs Reflective Cycle 36 Student Reflective Notes 37 Assessment of Practice Interviews 71 Assessment of Practice Interview Forms 72 Supportive Mechanisms for Student Learning 109 Additional Supportive Interview 109 Support Learning Plan: Guidelines 110 Reflection Time Record Sheets 128 Year One Review 132 Year Two Review 133 What I have to do with my CLO Booklet at the end of Every Clinical Placement 134 Appendices Appendix 1: Practice Module Descriptions and Programme Regulations 135 Appendix 2: Required Reading prior to, and during, all Clinical Placements 136 This Booklet has been developed by the BSc Nursing Clinical Practice Committee comprising representatives of the participating Health Service Providers and the School of Nursing and Midwifery, UCC.

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SCHOOL OF NURSING AND MIDWIFERY, UCC AND PARTICIPATING HEALTH SERVICE PROVIDERS

SAMPLE-DO NOT COMPLETE PRACTICE PLACEMENT AGREEMENT 2017

INTRODUCTION As a Nursing student you are studying to obtain a University Degree that will allow you to register with the Nursing and Midwifery Board of Ireland (NMBI) and upon registration, to work as a Registered Nurse. During your study you will gain practice experiences in various health care settings, interacting with individuals1, members of staff2, and other health care professionals. It is therefore essential that you agree with the conditions set out below to ensure that you can learn effectively and become a competent nurse. These conditions are based upon NMBI’s Requirements and Standards for Nurse Registration Education Programmes (2005) http://www.nursingboard.ie/en/education.aspx, and Code of Professional Conduct and Ethics for Registered Nurses and Midwives (2014) http://www.nursingboard.ie/en/code/new-code.aspx, University College Cork’s (UCC) Student Policies http://www.ucc.ie/en/study/undergrad/orientation/policies/, and the School of Nursing and Midwifery’s Student Policies http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/. Failure to comply with the conditions set out in this agreement, which you will be asked to sign, may result in you not being allowed to continue in your BSc Nursing programme. School of Nursing and Midwifery/

Participating Health Service Providers Student Name: __________________________ Student ID Number: ___________________ I AGREE THAT:

1. I will listen to individuals and respect their views, treat individuals politely and considerately, and respect their privacy, dignity, and their right to refuse to take part in teaching.

2. I will act according to NMBI’s Code of Professional Conduct and Ethics for Registered Nurses

and Midwives (2014).

3. My views about a person’s lifestyle, culture, beliefs, race, colour, gender, sexuality, age, social status, or perceived economic worth will not prejudice my interaction with individuals, members of staff, or fellow students.

4. I will respect and uphold an individual’s trust in me.

5. I will always make clear to individuals that I am a nursing student and not a registered nurse.

6. I will maintain appropriate standards of dress, cleanliness and appearance.

7. I will wear a health service provider identity badge with my name clearly identified.

8. I will familiarise myself and comply with the Health Service Provider’s values, policies and

procedures.

9. I have read and understood the guidelines as set out in the current Practice Placement Guidelines Booklet http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/.

10. I understand and accept to be bound by the principle of confidentiality of individuals’ records and data. I will therefore take all necessary precautions to ensure that any personal data

1 ‘Individual’ also refers to patient, client, resident, significant other, colleague, other health care professional 2 ‘Member of staff’ refers to both academic and health service personnel.

http://www.nursingboard.ie/en/education.aspx

http://www.nursingboard.ie/en/code/new-code.aspx

http://www.ucc.ie/en/study/undergrad/orientation/policies/

http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/


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concerning individuals, which I have learned by virtue of my position as a nursing student, will be kept confidential. I confirm that I will not discuss individuals with any other party outside the clinical setting, except anonymously. When recording data or discussing care outside the clinical setting, I will ensure that individuals cannot be identified by others. I will respect all Health Service Providers’ and individuals’ records.

11. I have read and understand the BSc Programme’s Grievance and Disciplinary Procedures

http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/. 12. I understand that, if I have (or if I develop) an impairment or condition that may impact in any

way on my ability to learn, perform safely in the clinical environment or affect the welfare of myself or others, it is my responsibility to share this with an appropriate person in the clinical setting (e.g. Allocations Liaison Officer, Clinical Placement Coordinator, Staff Nurse, Staff Midwife) and to declare on the relevant Fitness to Practice disclosure form http://www.ucc.ie/en/study/undergrad/orientation/policies/. I accept that only through disclosure of this impairment/condition can an appropriate plan of support to reach the required clinical learning outcomes/competencies be explored.

13. I understand that if I have any criminal conviction(s) during the programme that I will declare same on the relevant Fitness to Practice disclosure form http://www.ucc.ie/en/study/undergrad/orientation/policies/.

14. If I am returning from a period of illness/hospitalisation/surgery, it is expected that I report this

to the Allocation Liaison Officer (attached to my Health Service Provider), as I may be required to attend the occupational health department prior to accessing my clinical placement.

15. I understand and accept that any dispute between parties in relation to this Agreement, outside

of UCC’s and NMBI’s relevant regulations, may be referred to the BSc Nursing Joint Disciplinary Committee for a decision.

16. I confirm that I shall endeavour to recognise my own limitations and shall seek help/support when my level of experience is inadequate to handle a situation (whether on my own or with others), or when I or other individuals perceive that my level of experience may be inadequate to handle a situation.

17. I shall conduct myself in a professional and responsible manner in all my actions and communications (verbal, written and electronic including text, e-mail or social communication media).

18. I will attend all scheduled teaching sessions and all scheduled clinical placements, as I understand these are requirements for satisfactory programme completion. If I am unable to attend any theoretical or Mandatory/Essential Skills element (including online requirement) of the programme, I will notify the Attendance Monitoring Executive Assistant in G.03 (prior to scheduled date) and provide a written explanation for the Module Leader as soon as possible and in accordance with the current Mandatory and Essential Skills Policy (http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/). I will also inform the relevant HSP Allocation Liaison Officer prior to the commencement date of my clinical placement. If I am then unable to attend my scheduled clinical placement due to the above reasons, I will act according to Local Health Service Provider Guidelines and the Practice Placement Agreement, and will inform the relevant personnel in a timely manner e.g. Clinical Placement Coordinator, Clinical Nurse Manager, as soon as possible.

By my signature hereunder I confirm that I have read and understood all the above conditions and that I agree to comply with ALL of these for the duration of the BSc Programme.





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Student Signature: _________________________________Date:_______/________/_______ Signed on behalf of the Health Service Provider: Health Service Provider: ________________________________________________________ Please print name Director of Nursing/Nominee/Title: _______________________________________________ Please print name Signature: ________________________________________Date:_______/________/_______ Signed on behalf of University College Cork: Head, School of Nursing and Midwifery/Nominee/Title: _______________________________ Please print name Signature: _________________________________Date:_______/________/_______

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1 BSc (Hons) Nursing (General) 2017 Intake CLO Booklet valid for 2017/2018 and 2018/2019

CLINICAL PLACEMENT DETAILS

STUDENT NAME: ___________________________________________________________________________ ID NUMBER: __________________ YEAR OF ENTRY TO BSc: ___________________

Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature

PRACTICE PLACEMENT AREA: (e.g. medical / surgical/community /Public Health Nursing etc.)




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Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _____________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: ___________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature





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Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature ________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature





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Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Allocation Dates: From: ________________ To____________ No. of Weeks Allocated: ___________ No. of Weeks Completed: _____________ Clinical Assessor / Preceptor: __________________________ _______________________ Print Name Signature Total number of weeks completed in Practice Placement in Year One: Total number of weeks completed in Practice Placement in Year Two:





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STUDENT DECLARATION - YEAR ONE I declare that I have achieved and completed all the signed CLOs, clinical skills and reflective notes through my own efforts, and that all signatures are the authentic signatures of the relevant named personnel. Student Name (please print name): _____________________ Student Signature: ___________________________________ Date: _____________________________________________

NU1049: STUDENT SELF-ASSESSMENT FORM – END OF YEAR 1 The following is a summary of my self-assessment for NU1049 General Nursing Practice. I confirm that all the required elements of my Clinical Practice Placements have been met and signed off as being complete as follows: Name and Student ID on front cover of Booklet Yes ___ No ___ Clinical placements details completed Yes ___ No ___ Preceptor/Assessor Signatures completed Yes ___ No ___ Student declaration (above) signed Yes ___ No ___ Student & Preceptor/Assessor signatures/dates for all CLOs achieved Yes ___ No ___ Student & Preceptor/Assessor signatures/dates for all Skills achieved Yes ___ No ___ Assessment of Practice Interviews completed & ALL signed with dates by student and Preceptors. Yes ___ No ___ Reflective Notes written up with dates and Preceptor/Assessor signatures Yes ___ No ___ Reflection Time Record Sheet completed & signed Yes ___ No ___

• Number of Clinical Learning Outcomes achieved: At Exposure level: ___________ At Participation level: ___________

• Number of Skills achieved (excluding opportunistic & miscellaneous)

At Exposure level: ___________

At Participation level: ___________

• Number of Reflection Log Hours Year 1: ____________

_______________________ ________________ Signed Date

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STUDENT DECLARATION - YEAR TWO

I declare that I have achieved and completed all the signed CLOs, skills and reflective notes through my own efforts, and that all signatures are the authentic signatures of the relevant named personnel.

Student Name (please print name): __________________ Student Signature: ________________________________ Date: ___________________________________________ NU2063: STUDENT SELF-ASSESSMENT FORM – END OF YEAR 2 The following is a summary of my self-assessment for NU2063 General Nursing Practice. I confirm that all the required elements of my Clinical Practice Placements have been met and signed off as being complete as follows: Name and Student ID on front cover of Booklet Yes ___ No ___ Clinical placements details completed Yes ___ No ___ Preceptor/Assessor Signatures completed Yes ___ No ___ Student declaration (above) signed Yes ___ No ___ Student & Preceptor/Assessor signatures/dates for all CLOs achieved Yes ___ No ___ Student & Preceptor/Assessor signatures/dates for all Skills achieved Yes ___ No ___ Assessment of Practice Interviews completed & ALL signed with dates by student and Preceptors. Yes ___ No ___ Reflective Notes written up with dates and Preceptor/Assessor signatures Yes ___ No ___ Reflection Time Record Sheet completed & signed Yes ___ No ___

• Total Number of Clinical Learning Outcomes achieved: At Exposure level: ___________ At Participation level: ___________

• Total Number of Skills achieved (excluding opportunistic & miscellaneous)

(cumulative total year 1 and 2) At Exposure level: ___________

At Participation level: ___________

• Number of Reflection Log Hours Year 2: ___________

_________________________ ________________ Signed Date

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Professional Behaviour and Standards Nursing and Midwifery undergraduate programmes prepare students for entry onto a professional Register with the Nursing and Midwifery Board of Ireland (NMBI). The Code of Professional Conduct and Ethics for Registered Nurses and Registered Midwives (2014, pg. 8) states that “every nurse and midwife has a responsibility to uphold the values of the professions to ensure their practice reflects high standards of professional practice and protects the public”. Thus any suspected forgery of a signature or other unprofessional tampering with Clinical Learning Outcome Booklet entries is deemed to be a very serious issue and will necessitate the invoking of the “Joint Health Service Provider and School of Nursing and Midwifery Disciplinary Procedures for Pre-registration BSc Nursing and BSc Midwifery students”. Under this procedure, if a student is found to have signed/forged another person’s signature, the disciplinary committee will recommend appropriate actions under the auspices of the joint disciplinary procedures. A minimum penalty as follows will apply: A fail judgement for the clinical practice module will automatically be recorded for anybody who is found to have forged another person’s signature either while on placement in clinical practice or within their clinical learning assessment documentation. If a situation exists where a student finds it difficult to access a preceptor or associate preceptor to sign their booklet while on a placement area or within a short time frame of leaving a placement area (three weeks maximum) the student is advised to discuss this in the first instance with their Clinical Placement Co-ordinator or Clinical Nurse/Midwife/ Manager or Associate Preceptor or Link Lecturer. If a difficulty continues to arise the student should make contact with the Practice Module Leader to discuss the matter. Note: Please refer to School of Nursing and Midwifery website where further information relating to the BSc Programme can be accessed. Specific guidelines relating to professional and clinical matters are available for your information on this website. It is important that each student takes the time to familiarise themselves with these matters at the commencement of each academic year. Students must read and be familiar with the Practice Placement Guidelines booklet. http://www.ucc.ie/en/nursingmidwifery/ Submission of NU1049/NU2063 Clinical Learning Outcomes (CLO) Booklet Students must submit their CLO booklets at the agreed submission date(s) (as per grid on the school of nursing and midwifery website). For students who are unable to submit their booklet by the agreed submission date, an Extension Request Form must be submitted in advance of the submission date to G.03, School of Nursing and Midwifery. The Extension Request Form must detail the reason for which an extension is required. Failure to complete the above will result in your CLO booklet not being processed in time for the relevant examination board. In addition to completing the Extension Request Form, if making up time/ paying back time or doing additional time, students must consult with the Practice Module Leader to confirm whether or not they must also submit their booklet for review on the specified submission date. Students must collect their CLO booklets from UCC in a timely manner so as to enable their availability on clinical placement. Should the relevant sections of your CLO booklet be incomplete, this will impact on your pass and progression. Please ensure these elements of

http://www.ucc.ie/en/nursingmidwifery/

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your CLO booklet are fully completed and if not you will have only one opportunity to complete same for the Final Exam Board.

The clinical modules NU1049 & NU2063 (Part B of BSc programme) are assessed when the CLO Booklets are examined and when evidence of completion of scheduled time is received by the Allocations Office, School of Nursing and Midwifery, UCC. Students must submit their time-sheets to the allocations office on or before the specific date indicated on the time-sheet. In relation to the CLO Booklet and similar to the Practice Placement Guidelines "Entries made in error should be bracketed and have a single line drawn through them so that the original entry is still legible. Errors should be signed and dated. No attempt should be made to alter or erase the entry made in error. Erasure fluid should never be used. If an enquiry or litigation is initiated, then the record must not be altered in any way either by the addition of further entries or by altering an entry made in error". (Recording Clinical Practice Professional Guidance (NMBI, November 2015, pg. 13). http://www.nmbi.ie/Standards-Guidance/More-Standards-Guidance/Recording-Clinical-Practice These extracts are taken directly from Recording Clinical Practice Professional Guidance (NMBI, November 2015). Loss of CLO Booklet: student responsibilities The CLO Booklet remains the responsibility of the student during the completion of the clinical elements of the programme. Once the clinical module results have been successfully completed and ratified at an examination board in year 2, the Booklet is maintained on file in the School of Nursing and Midwifery, UCC thereafter as a permanent record of student attainment of the clinical elements of the programme. The CLO Booklet contains most of the evidence of attainment of the requirements for passing the clinical module in each of the years of the BSc programme. It is each student’s individual responsibility to ensure that they photocopy the relevant sections of their booklet after completion of each placement and retain such photocopies in a safe manner. Thus, in the rare event of a booklet being stolen or lost etc. * the student has some evidence of what had been attained up to the time of the loss of the booklet. In the event of a booklet being misplaced it is the students’ responsibility to compile the evidence of having completed all the relevant learning outcomes/ and skills etc and present such evidence to the Practice Module Leader by the dates specified in the assignment submission grid. Evidence of having completed all the clinical module requirements verified by preceptor/associate preceptor signatures is required for students to PASS the clinical module. * If your CLO booklet is lost or stolen please make contact with your Practice Module Leader and Clinical Placement Co-ordinator. Extra Clinical Time for Extended Leave If a student has been absent from clinical placement for one calendar year or more they are recommended to undertake one week medical/surgical clinical placement which is extra to NMBI requirements. This placement is to facilitate re-visiting of clinical skills and clinical learning outcomes. Please refer to NU1049 and NU2063 module descriptors for further requirements for completion of the module.

http://www.nmbi.ie/Standards-Guidance/More-Standards-Guidance/Recording-Clinical-Practice

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ASSESSMENT OF PRACTICE GUIDELINES

Introduction The emphasis during practice placement experiences is on providing BSc Nursing (General) students with opportunities to engage in reflective nursing practice within a supportive learning environment, thereby enabling them to develop the attitudes, knowledge, and skills necessary for thoughtful, efficient and effective nursing practice. The assessment of a student’s practice is organised around the following six domains: Five domains as developed by An Bord Altranais (2005), and a sixth domain, domain F, which has been developed within the School of Nursing and Midwifery. The sixth domain consists of clinical skills.

A. Professional and ethical practice B. Holistic approaches to care and the integration of knowledge C. Interpersonal relationships D. Organisation and management of care E. Personal and professional development F. Clinical Skills in General Nursing

Each domain has a number of CLOs and each CLO has a number of indicators. The student, during her/his 4 year programme, will be assessed against criteria based on Steinaker and Bell’s (1979) experiential learning taxonomy. This taxonomy has 5 levels of learning: exposure, participation, identification, internalisation, and dissemination. This Booklet refers to Exposure and Participation levels only, and is designed to assist and assess the student’s learning during Practice Placement experiences in Year 1 and Year 2. Students will have a similar Booklet covering Year 3 and Year 4, but the emphasis there will be on the achievement of competencies, assessed against Steinaker and Bell’s levels of identification and internalisation. Exposure: Steinaker and Bell (1979) define this level in the following terms: “Exposure is the process of becoming conscious of an experience. The invitation to

an experience where extrinsic forms of motivation are used to gain and focus attention; reduce anxiety and establish in the student a willingness to participate further.”

An Bord Altranais (2000)3 interpreted Steinaker & Bell’s (1979) taxonomy4 in the following manner as regards Exposure in a nursing and healthcare context.

‘The student observes a competent practitioner carrying out aspects of nursing care and shows a willingness and ability to relate the observed practice and its underlying theory to her/his own previous experience. The student is able to discuss with the practitioner how certain aspects of care are carried out, and identifies sources and types of information required to enhance further application of knowledge to the observed practice.’

3 An Bord Altranais (2000) (2nd Edition) Requirements and Standards for Nurse Registration Education Programmes Stationery Office, Dublin 4 Steinaker N. & Bell R. (1979) The Experiential Taxonomy: A New Approach to Teaching and Learning Academic Press, New York

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Participation: Steinaker and Bell (1979) define this level in the following terms: “Participation level is the level at which the student decides to become physically a

part of the experience or becomes an active participant (to replicate in some way to which the student has been exposed)”

An Bord Altranais (2000)5 interpreted Steinaker & Bell’s (1979) taxonomy6 in the following manner as regards Participation in a nursing and healthcare context.

‘The student participates with the supervision of a competent practitioner in carrying out aspects of care, having demonstrated knowledge through discussion. The student discusses with the practitioner aspects of care and its rationale, decision-making, practical skills, and means of acquiring further information and opportunities for practice. The student is able to engage in psychomotor and interpersonal skills, and is able to use communication and problem solving skills with guidance.’

5 An Bord Altranais (2000) (2nd Edition) Requirements and Standards for Nurse Registration Education Programmes Stationery Office, Dublin 6 Steinaker N. & Bell R. (1979) The Experiential Taxonomy: A New Approach to Teaching and Learning Academic Press, New York

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ADAPTED STEINAKER AND BELL’S (1979) EXPERIENTIAL TAXONOMY

Steinaker and Bell’s (1979) first four levels (exposure, participation, identification and internalisation) of their experiential taxonomy have been adopted to guide and assist both the students and preceptors in the assessment of the students’ learning outcomes (Years One and Two) and competencies (Year Three and Four). The framework presented below is based on an in-depth examination of Steinaker and Bell’s 1979 text ‘The Experiential Taxonomy: A New Approach to Teaching and Learning’. The guiding principle in developing the framework has been to retain as far as possible the language used by Steinaker and Bell. Please note that the dissemination level is included for information purposes only. It is suggested that this level may be adopted when assessing the practice of students (Registered Nurses) who undertake Higher Diploma programmes. Taxonomy = A classification of organisms into groups based on similarities of structure or origin (Collins English Dictionary 1999) Experience = “A hierarchy of stimuli, interaction, activity and response within a scope of sequentially related events beginning with exposure and culminating in dissemination” (Steinaker and Bell, 1979:9). “Experience is cyclic as is life” (Steinaker and Bell, 1979:33).

EXPOSURE Level Sub categories of Exposure Level

Examples of Activities at Exposure Level

Implications for Students Implications for Preceptors Guidance for Assessment of Practice

The process of becoming conscious of an experience. The invitation to an experience where extrinsic forms of motivation are used to:

• gain and focus attention

• reduce anxiety and • establish in the

student a willingness to participate further

Sensory The student is exposed to an experience

Leading to a

Response The student interacts with the experience

Leading to

Readiness The student accepts the experience and anticipates participation in it.

Uses audio or visual materials Observes examples to illustrate a principle, concept or skill Locates resources Listens to facts or principles being presented Views situations, objects, roles Asks fundamental / naïve questions Recognises changing relationships between previously used words, images, activities

The student uses all 5 senses: • Seeing • Hearing • Smelling • Touching • Tasting

The student reacts, recognises and notices with a degree of controlled thought

The preceptor: • Motivates the student • Focuses attention

on the experience • Keeps the student’s

anxiety within bounds

• Maintains the student’s confidence

Observe and sense the positive and/or negative reactions of the student Determine initial understanding and willingness to proceed

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PARTICIPATION Level Sub categories of the Participation Level

Examples of Activities at

Participation Level

Implications for Students Implications for Preceptors Guidance for Assessment of

Practice The level at which the student decides to become physically a part of the experience

or becomes an active participant (to replicate in some way to which the student has been exposed)

Representation (characterised by a feeling of discovery) Reproducing, mentally and/or physically, an experience either:

• covertly - a private rehearsal or

• overtly - in a small/large group interaction.

Leading to Modification (characterised by cognitive confirmation) With the input of past personal activities the experience develops and grows (the student defines a beginning frame of reference) The student becomes an active participant

Participates in structured data gathering activities Discusses and reviews data presented Avails of opportunities to practice an observed event Participates in hands-on activities Reacts to new, difficult or unusual occurrence

The student engages in mental and/or physical activities: Mental Activities

• Visualising • Modelling • Recalling • Role playing

(‘walking through’) of experiences

Physical Activities

• Exploring • Manipulating • Collecting,

discussing and inferring from available data relevant to the experience

The preceptor:

• acts as a catalyst for the student’s progress

• provides initial guidance and supportive feedback

• bridges gap between what the student already knows and what the student needs to know

• encourages the student to think critically about the experience

Examine and judge the designed and implemented learning activities Ask questions that demonstrate understanding and ability to succeed Determine whether the student’s knowledge and skills need further advancement

or need to revise learning activities

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The Focus in Years One and Two: The focus in Year One is on assisting students to familiarise themselves with the world of nursing. Clinical skills, procedures and techniques are learned and practised in defined parts through guidance from, and with the supervision of, experienced practitioners, until confidence in each element is acquired. The learning that takes place is context-free, which means that students learn in any given setting, without needing to have a clear understanding of the specific nursing situation in which the learning takes place. The learning focuses mainly on the development of skills, attitudes and knowledge. The focus in Year Two is on assisting the student to begin to link and integrate different sources of knowledge and skills, in the context of specific nursing situations. The student will begin to identify and appreciate the relationships between different areas of knowledge, and will begin to adopt techniques, procedures, and strategies based on principles. However, students will still need guidance and support in prioritising and identifying salient aspects of specific nursing situations. The context of learning in Year One and Two are relative to the opportunities available in the clinical placement areas. It is important to recognise that practice placement experiences differ from student to student. There are differences in the order and sequence, but also differences in the length of the various experiences. Guidance in using the Booklet The following guidelines are intended to facilitate the assessment of practice procedures. These guidelines have been divided into content and process elements of the assessment. In addition, there are a number of important guidelines for the student. The Content: Domains, Clinical Learning Outcomes (CLOs), Indicators and Clinical Skills

1. The assessment of practice is organised around Domains. Each domain has a number of CLOs and each CLO has a number of indicators.

2. The CLOs are assessed against the Exposure and Participation level, based on Steinaker and Bell’s (1979) experiential learning taxonomy.

3. There is a total of 10 CLOs to be achieved at 2 levels, Exposure level and Participation level in years one and two. This is equivalent to 20 elements (10 elements at Exposure level and 10 elements at Participation level).

4. YEAR ONE: The student must achieve a minimum of 5 Clinical Learning Outcomes (CLOs) at Exposure level or at a combination of Exposure and Participation levels. For example, 5 CLOs at Exposure level only or 3 CLOs at Exposure level only and 1 additional CLO at both Exposure level and Participation level, at the end of Year 1. Students must also achieve a minimum of 14 clinical skills (excluding opportunistic and/or miscellaneous skills), complete the required number of reflective notes/interviews, clinical placement details, ‘End of Year Declaration, self-assessment page in CLO book and scheduled time by end of year one in order to pass NU1049 (all practice placement experiences are contained within this module).

5. YEAR TWO: The student must have achieved all 10 CLOs (all elements, 10 at Exposure level AND 10 at Participation level) and all clinical skills (excluding opportunistic and/or miscellaneous skills) at Exposure and Participation level. Students must also complete the required number of reflective notes/interviews, clinical placement details, ‘End of Year Declaration’, self-assessment page in CLO book and scheduled time by the end of Year 2 in order to pass NU2063.

6. Each CLO achieved is required to be signed and dated by both the student and the preceptor7. A CLO can only be achieved if all the indicators, (which represent the CLO), have been assessed.

7. In the case of a student who has not met all the indicators in relation to a CLO during a placement, the preceptor should initial and date the indicator(s) met to enable the student to follow up the outstanding indicators in subsequent placements. The preceptor in these subsequent placements will then be aware which indicators the student has ‘worked’ on so far.

8. Where CLOs and clinical skills have been achieved, it is important that the student continues to demonstrate these within subsequent placements.

9. Students should have ample opportunities to achieve the CLOs/clinical skills. The Process of Assessment

1. The student and the preceptor agree at the 1st meeting (beginning of the placement) the specific CLOs the student can best work on and achieve. These should be identified and listed in the Commencement of placement interview form. The preceptor decides whether a CLO can be assessed within the time frame in which the student has had appropriate learning opportunities to avail her/himself of. The CPC may be a useful resource in this regard.

2. The student and the preceptor may wish to consider the placement specific learning opportunities available, the student’s prior health care experience and the student’s course booklet for the academic input to assist in the identification of learning needs and the achievement of CLOs.

7 In the absence of a preceptor, a designated assessor undertakes this function.

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3. The agreed number of CLOs should be determined by the nature and length of the practice placement experience.

4. The student & preceptor should schedule the next Mid-placement OR End of Placement Interview at first meeting.

5. The student and the preceptor meet for mid placement interview for assessment and review of learning. A Mid-placement interview is not required for placements of up to and including 3 weeks duration. However, if a student is viewed by the preceptor as not progressing towards agreed CLOs, the student must be advised of this in writing at the earliest opportunity during the placement.

6. Preceptors can adopt a variety of methods to assess the CLOs. This may be through direct observation, feedback from staff, interview, discussion, assessment of documentation, or any other evidence that is considered to be relevant.

7. The student is encouraged when not working with their Preceptor/Assessor to ensure that other registered nurses comment on their clinical performance in notes page for Preceptors/Associate Preceptors/Staff Nurses/CPC/CNMs.

8. The student is expected to continuously self-assess their knowledge and skills with their preceptor/assessor as an integral part of the assessment process.

9. Students may be encouraged to revisit clinical skills and CLOs where indicated. 10. The student is required to write Reflective notes (using the Gibbs’ Cycle), and provide other sources of

evidence, including references and local policies where relevant, to assist in the assessment process. Evidence can be in the form of care-plans, specific assessments undertaken, feedback from patients/clients, and/or appraisal of own skill development

11. The student is encouraged to keep a Personal diary of his/her learning experiences, which she/he may wish to draw on in meetings with preceptors, Clinical Placement Co-ordinators8 (CPC) and Link lecturers. Keeping a Personal diary may help to refine reflective writing skills and help students to select situations that can be used when writing reflective notes. Reflective Notes must be completed and shown to Preceptor on or before final interview. Each reflective note must be dated, and signed by the Preceptor.

12. The student and the Preceptor/Assessor must meet for end of placement interview for assessment review of learning and sign off on student’s CLOs and Skills achieved and/or CLOs and skills revisited during making up time.

13. The student must make some concluding comments in writing at the end of placement interview form and must sign and date the interview page at time of interview.

14. The preceptor is required to make some concluding comments in writing at the end of placement interview that evaluate the student’s overall learning.

Additional Support

1. Additional support may be required if a Preceptor/Associate preceptor/CPC/other member of staff has a concern about a student’s lack of achievement of agreed clinical learning requirements with respect to the BSc programme and reasonable for that clinical area, explicit loss of a student’s earlier level of achievement, or where a student could benefit from support in relation to professional behaviour and/or to practice within their agreed/signed Practice Placement Agreement (PPA).

2. This concern must be highlighted and communicated to the student by the Preceptor/Associate preceptor/CPC/other member of staff at the earliest opportunity and documented in the Notes Page of the student’s Clinical booklet in the Student Interviews section This can be done at any time e.g. before, during, or after the mid interview or at any time in a practice placement.

3. The Preceptor/Associate preceptor and/or other relevant personnel request a meeting with the student as soon as possible to address this concern. Depending on the nature of the concern the Link Lecturer (LL) may also attend. The purpose of this meeting is to: I. Ascertain the student’s view of their practice and progress

II. Highlight to the student by giving specific examples of the concerns which the Preceptor/CPC and/or relevant personnel have in relation to their CLOs, skills, professional nursing practice/other. III. Give constructive feedback and direction by giving 2 or 3 specific guidelines to the student on what they need to do or work on to address the identified issue(s) or concern(s). IV. Specify a date to review the learning/practice/concern with the student/Preceptor/other

4. The nature of the concern, feedback and direction given with review date of next meeting or other outcome of meeting must be documented in the Mid interview or Additional Supportive Interview Section.

5. The student needs to be given a reasonable amount of time (for example a minimum of one week) to address the concerns highlighted, where possible. If after this time the original concern(s) remain, a Supportive Learning Plan (SLP) or other mechanism 9may be introduced in advance of their final interview. [In exceptional circumstances however, an SLP/other mechanism may need to be introduced immediately e.g. student performing outside their scope of practice and/or patient safety concerns].

8In placement areas where a CPC/CDC is not attached, the preceptor makes contact with the relevant link Lecturer. 9 Other mechanism for example may include disciplinary procedures, fitness to practice, occupational health etc.

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6. At this meeting, however, depending on the nature of the concern and following some discussion, there is a possibility that the need for a SLP or other mechanism may be suggested to the student to assist with their practice/learning issues or to address professional matters. The LL, if not present at the Additional Supportive interview may be informed by the CPC that an Additional Supportive interview has occurred. If an SLP/other mechanism is suggested then the L.L. and Practice Module Leader are informed of the need to arrange a meeting as appropriate.

7. Where a final interview has been completed and a concern is raised after this interview an Additional Supportive interview must be conducted with the student, preceptor/associate preceptor/ CPC/ LL. The student must be given constructive feedback and direction by giving 2 or 3 specific guidelines on what they need to do or work on to address the identified concern(s). This must be documented and signed by all present. This is carried forward into the next placement and the student, on commencing their next placement, must inform his/her preceptor if an issue raised in the Additional Supportive interview is still ongoing.

Please refer to section on Supportive Mechanisms for Student Learning (page 109 for more detail)

Other Student-specific Guidance

1. The student must ensures that the CLO Booklet is at hand/available at each day of the placement - including during making up time.

2. The student maintains the Booklet in a neat and workable order during the two years of its use. It is recommended to store it in a folder.

3. The student is responsible for ensuring that the achieved CLOs at exposure or participation level, clinical skills, reflective notes, interviews and practice placement details are signed prior to completion of the practice placement. Where this is not possible the student must negotiate an agreed date with the preceptor/associate preceptor/CNM and this must be completed within a three week time-frame of finishing the clinical placement.

4. The student returns the Booklet to the School of Nursing and Midwifery, UCC at scheduled dates as outlined by the School of Nursing and Midwifery.

5. It is recommended that students take intermittent photocopies of their booklet for consideration the event of loss of the booklet. Each page must be authenticated with student’s name, signature and student number.

Commencement of Placement Interview The student and preceptor meet to explore CLOs and learning opportunities, so that specified CLOs can be identified, practised and achieved. These should be identified and listed in the commencement of placement interview form as (a) a guide to structuring the practice experience, and (b) as a guide for discussion at the Mid Placement and/or Final Interviews. Mid Placement Interview (A mid-placement interview is not required for placements of up to and including 3 weeks’ duration.. However, if a student is viewed by the preceptor as not progressing towards agreed CLOs, the student must be advised of this at the earliest opportunity during placement.) Where a mid-placement interview is required, the student and preceptor meet to review relevant aspects of the learning experiences and opportunities to date, and to assess progress. The student and the preceptor discuss and reflect upon the student’s learning needs, with particular emphasis on those areas that require particular attention. It is important that students should not learn of identified concerns at the end of the placement without having had the opportunity to reflect on those aspects of their learning, which require particular attention. On this basis, further opportunities are identified to meet specific CLOs. These are documented, and form the basis of discussion at the end of placement assessment and interview. The achievement of specific CLOs is recorded. End of Placement Interview The student and preceptor/associate preceptor must meet for an End of Placement Interview to assess and discuss the student’s learning, their overall placement experience and to identify future learning needs. Students should request feedback from their Preceptor/Associate preceptor about their performance in order to gain insight on their achievements/ability and with identifying areas for future learning. Both student and preceptor/Associate preceptor must document some concluding comments in the End of placement interview. Please refer to section on Assessment of Practice Interviews (page 71 for more details) References Nursing and Midwifery Board of Ireland (NMBI), (2016) Nurse Registration Programmes Standards and Recommitments (Fourth Edition), NMBI. http://www.nmbi.ie/nmbi/media/NMBI/Publications/nurse-registration-education-programme.pdf?ext=.pdf Steinaker N. & Bell R., (1979) The Experiential Taxonomy: A New Approach to Teaching and Learning Academic Press, New York

http://www.nmbi.ie/nmbi/media/NMBI/Publications/nurse-registration-education-programme.pdf?ext=.pdf

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PASS AND PROGRESSION REQUIREMENTS YEARS 1 AND 2

Please read above in conjunction with relevant Module Descriptor and the BSc Programme Marks and Standards both of which are available on the UCC examinations webpage.

NU1049 Pass and progression requirements are as follows:

(Year 1)

NU2063 Pass and progression requirements are as follows:

(Year 2) BSc General Nursing students

• Continuous Assessment – Clinical Learning Outcomes Booklet (Pass/Fail).

• Completion of scheduled clinical hours prior to Summer and/or Autumn Examination Board, NU1049 clinical placement duration is 7 supernumerary weeks.

• Achievement of 5 Clinical Learning Outcomes (CLOs) at Exposure level or a combination of Exposure and Participation levels. For example, 5 CLOs at Exposure level only or 3 CLOs at Exposure level only and 1 additional CLO at both Exposure level and Participation level. The rate of achievement is restricted to a maximum of one CLO at one level only (exposure or participation) per week of clinical placement.

• Achievement of 14 Clinical Skills (excluding opportunistic and miscellaneous skills) at Exposure level or a combination of Exposure and Participation levels. For example, 10 clinical skills at Exposure level only and 2 additional clinical skills at both Exposure level and Participation level. Students are required to achieve a minimum of 2 clinical skills at one level per week (excluding opportunistic and miscellaneous skills) regardless of the clinical placement area. The rate of achievement is restricted to a maximum of 5 clinical skills at one level (exposure or participation) per week of placement.

• All relevant CLOs, clinical Skills, Reflective notes, Interviews and Clinical Placement Details must be completed, signed and dated by both student and preceptor in order to PASS and progress. Students must also complete the student declaration form and the Student self-assessment form on page 5.

• Students are expected to complete all of NU1049 as outlined in the Module Descriptor, online UCC Book of Modules.

• Continuous Assessment – Clinical Learning Outcomes Booklet (Pass/Fail)

• Completion of scheduled clinical hours prior to Autumn Examination Board, NU2063 clinical placement duration is 21 supernumerary weeks.

• Achievement of all 10 Clinical CLOs at both Exposure level and Participation level. The rate of achievement is restricted to a maximum of one CLO at one level only (exposure or participation) per week of clinical placement.

• Achievement of all clinical skills (excluding opportunistic and miscellaneous skills) at both Exposure level and Participation level. Students are required to achieve a minimum of 2 clinical skills at one level per week (excluding opportunistic and miscellaneous skills) regardless of the clinical placement area.

• All relevant sections of the CLOs booklet (interview pages, reflective notes, student declaration, student self-assessment etc.) including student and preceptor signatures must be complete.

• Students are required to complete all of NU2063 as outlined in the Module Descriptor for the current year (See online UCC Book of Modules).

All Clinical Skills required for Pass and Progression are shaded in the CLO book (excluding opportunistic and miscellaneous skills).

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CUES FOR STEINAKER AND BELLS TAXONOMY OF LEARNING Year 1 & 2- Exposure/Participation Levels Exposure Level The student observes and may participate in aspects of care to a patient with the support and guidance of a competent registered nurse and can relay the care observed e.g. checking vital signs with the understanding of normal parameters, admitting a patient, bed bathing and documenting care. The cues are:

• The student observes a competent practitioner carrying out aspects of nursing care • The student becomes conscious /familiar of an experience or interaction • The student responds to an invitation to participate in an experience • The student interacts with the experience and anticipates participation in it

Participation Level The student participates in caring for patients with the support and guidance of a competent registered nurse e.g. admitting a patient, bed bathing a patient and documenting care. The student understands variable rationale for nursing care e.g. rationale for checking vital signs on admission, checking vital signs post-surgery and checking vital signs during a blood transfusion etc. The cues are:

• Physical and mental inclusion and involvement in an experience / learning opportunity • Replication of a previously exposed experience at active participation level • Demonstrating an aspiration to deliver care with knowledge and understanding by asking

Preceptor/staff to explain rationale for care without being prompted

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CLINICAL LEARNING OUTCOMES YEARS ONE AND TWO

LEVEL STAGE OF ACHIEVEMENT

Exposure The student observes and reflects on the activity being carried out and provides accurate feedback. The student establishes a willingness to participate further.

Participation The student participates, with the supervision of a competent practitioner, in carrying out aspects of care, having demonstrated knowledge through discussion.

DOMAIN A: PROFESSIONAL AND ETHICAL PRACTICE

Learning Outcome 1 Student demonstrates an awareness of relevant national legislation and

professional guidelines for practice Indicators:

1. Demonstrate professional behaviours of accountability, implement appropriate patient care, and effectively communicate with patients/clients, family members and members of the interdisciplinary healthcare team within the context of this learning outcome

2. Code of professional Conduct and Ethics for Registered Nurses and Registered Midwives (NMBI 2014) 3. Scope of Nursing and Midwifery Practice Framework (NMBI 2015) 4. Guidance to Nurses and Midwives on Medication Management (An Bord Altranais 2007) 5. Recording Clinical Practice: Professional Guidance (NMBI 2015)

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

Learning Outcome 2 Student has a working knowledge of local Health Service Provider’s policies and

protocols, which inform nursing practice Indicators:


2. Familiarizes her/himself with Health Service Provider’s Policy Guidelines 3. Seeks clarification from preceptor/registered nurse in relation to implementation of local policies 4. Works within the criteria as agreed in the Practice Placement Agreement (pages ii-iii)

Level Student Signature Preceptor/Assessor

Name Preceptor/Assessor Signature Date

Exposure Participation Revisit if applicable

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Learning Outcome 3 Student ensures confidentiality in respect to client documents and interactions with patients/clients, significant others, and members of the health care team

Indicators: 1. Demonstrate professional behaviours of accountability, implement appropriate patient care, and effectively

communicate with patients/clients, family members and members of the interdisciplinary healthcare team within the context of this learning outcome

2. Respects and ensures confidentiality and security of written, verbal and electronic information acquired in a professional capacity

3. Seeks clarification when instructions are unclear

Level Student Signature Preceptor/Assessor Name

Preceptor/Assessor Signature Date


DOMAIN B: HOLISTIC APPROACHES TO CARE AND THE INTEGRATION OF KNOWLEDGE

A. ASSESSMENT

Learning Outcome 4 Student assesses and identifies needs and problems in partnership with patients/clients, significant others and members of the health care team

Indicators:


2. Discusses, demonstrates and understands the need for a structured approach to assessment 3. Uses a variety of informal and formal assessment strategies, methods and tools to assess the patient’s / client’s needs for

nursing care 4. Collects relevant information about the patient/client and significant others from a variety of sources, adopting a

structured approach 5. Accurately structures and documents relevant information, with consideration for its legal and ethical implications 6. Recognises own influence in and on the assessment process 7. Differentiates between objective and subjective data 8 and how they inform care planning 8. Identifies needs and problems in partnership with the patient/client and significant others 9. Recognises and reports abnormal observations and findings to a registered nurse

Level Student Signature Preceptor/Assessor

Name Preceptor/Assessor Signature Date


8Objective Data: Information that can be directly measured by the nurse e.g. temperature, weight, pulse, blood pressure. Subject of Data: Information that the patient gives to the nurse or the nurse interprets from observation and non-verbal cues. B. PLANNING Learning Outcome 5 Student identifies, formulates and agrees measurable outcomes in partnership with

the patient/client, significant others, and members of the health care team, based on the assessment data



2. Considers the planning of nursing care in the context of actual and potential needs 3. Recognises the uniqueness of the individual patient/client, and reflects this in mutual care planning 4. Takes account of the influence of social, political, spiritual, cultural factors in determining priorities

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5. Determines priorities in planning care and identifies outcomes according to immediate, intermediate and long-term needs

6. Recognises and incorporates opportunities for health education and promotion 7. Formulates and documents outcomes with the patient/client that are achievable and measurable. 8. Effectively communicates the agreed outcomes and interventions with the patient/client, significant others, and

members of the health care team 9. Recognizes the importance of and participates in discharge planning


C. IMPLEMENTATION Learning Outcome 6 Student contributes to the implementation of individual care in partnership with the

patient/client, significant others and members of the health care team Indicators:


2. Demonstrates respect and sensitivity to the uniqueness of the individual patient/client and significant others. 3. Gives a rationale for nursing interventions drawing on relevant literature and research 4. Adopts appropriate strategies in responding to actual and potential acute patient/client needs 5. Recognizes the significance of and responds to changes in the needs of patients/clients 6. Considers the use of subjective and objective data in implementing care with patients/clients. 7. Reports and/or documents relevant information in a structured manner taking account of legal and ethical considerations. 8. Participates in various individual patient/client and/or group therapeutic activities, selected to promote and enhance the

patient’s/client’s well being


D. EVALUATION Learning Outcome 7 Student adopts appropriate methods to review and measure the effectiveness of

the implementation of care in partnership with the patient/client, significant others, and members of the health care team



2. Identifies and reflects upon factors that influence the effectiveness and quality of care 3. Seeks and documents the patient’s/client’s and/or significant others’ perceptions and views 4. Considers the use of subjective and objective data in evaluating care with patients/clients, significant others and

members of the health care team 5. Gives a rationale for a structured approach to evaluating care, drawing on relevant literature and research 6. Accurately reports and/or documents relevant evaluative information, in a structured manner taking account of legal and

ethical considerations


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DOMAIN C: INTERPERSONAL RELATIONSHIPS Learning Outcome 8 Student establishes, maintains and enhances an effective therapeutic relationship

with patients/clients, significant others and members of the health care team in a sensitive, professional and tactful manner

Indicators: 1. Adopts appropriate verbal and non-verbal responses in interactions with patients/clients, significant others, and

members of the health care team 2. Adopts appropriate ways of maintaining and enhancing therapeutic relationships and a therapeutic environment with

patients/clients, significant others and members of the health care team. 3. Establishes and maintains an effective working relationship with all members of the health care team 4. Recognises potential barriers to maintaining and enhancing relationships with patients/clients, significant others, and

members of the health care team, and responds to these in a sensitive, professional and thoughtful manner. Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

DOMAIN D: ORGANISATION AND MANAGEMENT OF CARE Learning Outcome 9 Student effectively plans and manages own time within the context of the

overall organisation and management of care Indicators:


2. Effectively plans and manages their time in prioritising their day-to-day nursing activities. 3. Works as a member of the health care team 4. Utilises resources effectively and efficiently 5. Acts to minimise risk to patients/clients, significant others, and members of the health care team 6. Contributes to the overall goal/mission of the placement area and Health Service Provider

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor

Signature Date


DOMAIN E: PERSONAL AND PROFESSIONAL DEVELOPMENT Learning Outcome 10 Student demonstrates a commitment to the personal and professional

development of own learning Indicators:


2. Reflects upon own strengths and weaknesses in the learning process, and identifies ways of addressing the latter 3. Demonstrates initiative in seeking out learning opportunities 4. Demonstrates an ability to negotiate learning processes with preceptor and others 5. Demonstrates self-awareness in relation to the overall practice placement experience

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor

Signature Date


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SECTION F: CLINICAL SKILLS IN GENERAL NURSING To develop your clinical learning it is advisable that you achieve exposure level in all of the following clinical skills. However, some clinical skills are designated “opportunistic” as the learning opportunity may not arise in particular clinical areas

CLINICAL SKILL 1: OBSERVATIONS AND RECORDINGS Student discusses the rationale for, participates in and interprets the measurement and documenting of clients’/patients’: SKILL: Blood Pressure (Manual)

Level Student Signature Exposure Participation Revisit if applicable

SKILL: Blood Pressure (Automated)


SKILL: Pulse Manual


SKILL: Respirations


SKILL: Temperature

Level Student Signature Exposure Participation Revisit if applicable

SKILL: Blood Glucose Monitoring

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation(2nd year)

Revisit if applicable

SKILL: Oxygen Saturation


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SKILL: Assessment of Pain with Pain Assessment Tool




SKILL: Use of National Early Warning Score (NEWS)




CLINICAL SKILL 2: AIRWAY MANAGEMENT

SKILL: Assessment and observation of general airway care Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Positioning of patient to maintain airway patency


CLINICAL SKILL 3: CARDIOPULMONARY RESUSCITATION

SKILL: Responds appropriately to a cardiac/respiratory arrest situation (OPPORTUNISTIC) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Assist with the checking of the Cardiopulmonary resuscitation trolley (OPPORTUNISTIC)


CLINICAL SKILL 4: PERSONAL CLEANSING AND DRESSING

SKILL: Assessment and Management of Personal Hygiene Needs Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

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SKILL: Oral Health Assessment/ Management (using tool where available) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Assist with Eye Care - (OPPORTUNISTIC)


SKILL: Promoting and Maintaining the Patient’s Skin Integrity


SKILL: Use of Pressure Ulcer Risk Assessment/Grading Tools


CLINICAL SKILL 5: MAINTAINING PATIENT SAFETY

SKILL: Bed preparation and maintenance Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Application of Principles of Manual Handling & People Load Moving and Handling


SKILL: Care and Maintenance of Equipment e.g. Thermometers, Blood Pressure Apparatus, Suction Machine etc.


CLINICAL SKILL 6: INFECTION CONTROL

SKILL: Hand Hygiene


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SKILL: Waste Management Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Applying principles of standard precautions


SKILL: Application of the Principles of Aseptic Technique


SKILL: Assessment and Maintenance of a Clean Clinical Environment


SKILL: Isolation Nursing


CLINICAL SKILL 7: WOUND CARE

SKILL: Assessment of wounds Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Promotion of wound healing


SKILL: Perform wound dressing


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SKILL: Suture /clip removal (OPPORTUNISTIC) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Care and management of wound drain (OPPORTUNISTIC)


SKILL: Wound drain removal (OPPORTUNISTIC)


CLINICAL SKILL 8: HYDRATION AND NUTRITION

Student promotes and maintains the patient’s nutritional and hydration status SKILL: Assisting with Hydration and Nutrition


SKILL: Managing Fluid Balance (Recording intake and output)


SKILL: Assessment of Nutrition (using tool where appropriate)


SKILL: Documenting of Dietary intake (including Special Dietary Intake) – (OPPORTUNISTIC)


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SKILL: Clinically Assisted Nutrition and Hydration (CANH) i.e. Nasogastric Feeding, Percutaneous Endoscopic Gastrostomy (PEG) Feeding, Total Parental Nutrition (TPN) – (OPPORTUNISTIC)


SKILL: Care of Nasogastric Tube – (OPPORTUNISTIC)


SKILL: Insertion of Nasogastric tube – (OPPORTUNISTIC)


SKILL: Care of Percutaneous Endoscopic Gastrostomy Tubes – (OPPORTUNISTIC)


SKILL: Observing Intravenous Fluids


SKILL: Observation of Intravenous Cannula


SKILL: Removal of Intravenous Cannula


CLINICAL SKILL 9: COLLECTION OF SPECIMENS

SKILL: Mid-Stream Specimen of Urine (Safe handling, management and labelling) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

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SKILL: Catheter Specimen of Urine - (OPPORTUNISTIC) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Faeces - (OPPORTUNISTIC)


SKILL: Sputum


SKILL: Swabs


CLINICAL SKILL 10: ELIMINATION

SKILL: Assessment and Documenting of Patients’ Elimination Pattern Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Recognising and Documenting Deviation from usual Elimination Habits


SKILL: Urinalysis


SKILL: Catheter care - (OPPORTUNISTIC)


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SKILL: Removal of Catheter - (OPPORTUNISTIC) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Catheterisation – (OPPORTUNISTIC)


SKILL: Stoma care – (OPPORTUNISTIC)


CLINICAL SKILL 11: MEDICATION MANAGEMENT *Note: The learning outcomes for this skill must be in accordance with ‘Guidance to Nurses and Midwives on Medication Management (An Bord Altranais 2007) and local policies and protocols of Health Service Provider. While Exposure may be achieved in Year 1, for this skill, participation level is necessary as part of the requirement for passing NU2063. SKILL: Safe practices in relation to storage of prescribed medication (Relative to Scope of Practice)


SKILL: Safe practice in relation to storage, administration and checking of controlled drugs (OPPORTUNISTIC)


SKILL: Safe practices in relation to the administration of oral medications


SKILL: Safe practices in relation to calculation of oral medication dosages

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Revisit if applicable

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SKILL: Safe practices in relation to rectal preparations – (OPPORTUNISTIC) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Safe practices in relation to topical preparations - (OPPORTUNISTIC)


Injections SKILL: Demonstration of safe practices in relation to Intramuscular Injections – (OPPORTUNISTIC)


SKILL: Demonstration of safe practices in relation to the administration of Subcutaneous Injections


SKILL: Demonstration of Safe Practices in relation to Instillation Preparations (eye/ear drops) (OPPORTUNISTIC)


Inhalation preparations SKILL: Demonstration of Safe Practices in relation to management of Oxygen Therapy


SKILL: Demonstration of Safe Practices in relation to Nebuliser Therapy - (OPPORTUNISTIC)


SKILL: Demonstration of an Understanding of Safe Practice in relation to Blood and Blood Product Transfusions - (OPPORTUNISTIC)


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SKILL: Demonstration of safe practices in relation to calculation of intravenous flow rate/ hourly rate (OPPORTUNISTIC)

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Revisit if applicable

CLINICAL SKILL 12: COMMUNICATION

SKILL: Observe and Give verbal patient hand-over at report time Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

SKILL: Assist with documenting patient reports for handover


SKILL: Apply ISBAR in professional communication (OPPORTUNISTIC)


CLINICAL SKILL 13: INTRAVENOUS FLUID MANANGEMENT SKILLS

SKILL: Observe a Registered Nurse/Midwife prime a peripheral intravenous infusion line.

Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure (1st Year)

Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife insert a primed peripheral intravenous infusion administration set correctly into intravenous fusion pump.


Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife calculate and set the intravenous flow rate of a peripheral intravenous infusion using the roller clamp of an intravenous infusion administration set.


Exposure (2nd Year)


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SKILL: Observe a Registered Nurse/Midwife calculate and set the intravenous flow rate of a peripheral intravenous infusion using an intravenous infusion pump.


Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife connect a primed intravenous infusion administration set to a peripheral venous cannula and commence a peripheral intravenous infusion as prescribed.


Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife attend to and manage peripheral intravenous infusion pump alerts and alarms


Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife replace a completed peripheral intravenous infusion with prescribed follow-on infusion fluids.


Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife pause or stop a peripheral intravenous infusion using the pause/stop function of an intravenous infusion pump or the roller clamp of an intravenous administration set when attending to patient hygiene, clothes change or elimination needs.


Exposure (2nd Year)


SKILL: Observe a Registered Nurse/Midwife stop a peripheral intravenous infusion, disconnect the intravenous administration set from a patient’s peripheral intravenous cannula and dispose appropriately.


Exposure (2nd Year)


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CLINICAL SKILL 14: END-OF-LIFE CARE – (OPPORTUNISTIC) SKILL: Assist in the care of patient/family members at end-of-life (OPPORTUNISTIC)


SKILL: Assist in the care of a deceased individual (OPPORTUNISTIC)


This list is not exhaustive and other learning opportunities may present themselves during clinical placement – please specify below

MISCELLANEOUS Other (specify):


Other (specify):


Other (specify)


Other (specify)


Other (specify)


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Other (specify) Level Student Signature Preceptor/Assessor Name Preceptor/Assessor Signature Date Exposure Participation Revisit if applicable

Other (specify)


Other (specify)


Other (specify)


Other (specify)


Other (specify)


Other (specify)


Other (specify)


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STUDENT REFLECTIVE NOTES: GUIDELINES Frequently Asked Questions

1. What is reflective learning?

Reflective learning is another way of learning. It is a process that enables you to learn from what you see and what you do during your clinical placements. The aim of reflection is to encourage you to examine and explore your behaviors, thoughts, feelings and attitudes about your clinical experiences. You must write at least one Reflective note in each Clinical placement area irrespective of duration for example: 1 week in any one placement area = ONE reflective note

1-3 weeks in any one placement area = ONE reflective note 4-6weeks in any one placement area = TWO reflective notes 7-9weeks in any one placement area = THREE reflective notes etc.

2. Why do I need to reflect on my practice? There are many reasons why you need to reflect on your practice. For example, it helps you to acknowledge your thoughts and feelings, thereby enabling you to scrutinise your practice. Following on from this it may prompt you to embrace new ideas and better ways of delivering nursing care. This helps to improve your nursing skills and make clearer links between theory and practice. Reflection assists you to identify your own learning needs and develop your practice further. Reflecting on practice will identify for you your own core decision making skills, help you to problem solve and assist you in developing your critical thinking skills. 3. What should I reflect on? You can reflect on anything that occurs during clinical placement. It may be an experience that went well, an experience that was particularly demanding, a very ordinary, everyday experience or an experience in which things did not go as planned. You can link your reflective notes back to any one of the Clinical learning outcomes or Domains (including clinical skills) that you have achieved.

4. How can I reflect? • Use Gibbs Cycle (1988) framework and use all stages of that framework • You may also find it helpful to refer to lecture/practice notes on reflection from NU1026 • You might find it useful to use the headings within Gibbs’ cycle to structure your reflective notes • Keeping a personal diary may help to hone reflective writing skills and help you select situations that you

can use when writing reflective notes. Use experiences that you feel comfortable with for your reflective notes

• Start writing as early as possible, in your own words. You may find it helpful to refer to the literature for examples of how to write reflectively e.g. Burns & Bulman (2000). While there is no right or wrong style of writing up your reflections, these guidelines may make it easier for you.

• You should make reference to local policies, procedures and literature that have relevance to your reflective notes, particularly in the analysis section.

• You need to make time to write up your reflections • It may be helpful to write something, leave it, return to it later and then try to question different aspects of

this experience. • Remember to maintain confidentiality and anonymity of the individual, staff and placement area. • Your CPCs, preceptors, link lecturer, and other students may advise you on structuring your reflective

notes. It may help you to get started by talking through an experience with somebody. • Remember reflection is a skill that you can develop, so the more you practice the better you will become.

Also you may find that you will write less as your skills of reflection develop. 5. Do I need to reflect when I am repeating time or making up time? • Yes. It is important that you reflect on all clinical experiences. You must write reflective notes when

repeating AND/OR making up time in clinical practice of 30 hours or more. Note: All Reflective Notes are part of your assessment criteria and must be read and signed by the preceptor

with dates prior to/or at the Final Interview. Typed reflective notes stapled to the CLO booklet must have all the signatures and dates as on CLO booklet References

Bulman C. & Schultz S. (2004) Reflective practice in nursing 3rd Ed. Blackwell, Oxford. Burns S. & Bulman C. (eds) (2000) Reflective Practice in Nursing~ the Growth of the Professional Practitioner 2nd Ed . Blackwell Science, London. Gibbs G. (l988) Learning by Doing A guide to Teaching and Learning’ Methods. Further Education Unit, Oxford.

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GIBBS REFLECTIVE CYCLE. 1988 1. Description

What Happened?

6. Action Plan 2. Thoughts & Feelings 5. Conclusion 3. Evaluation 4. Analysis What sense can you make of the situation?

(Gibbs, 1988)

If it arose again, what would you do?

What else could you have done? What was positive and/or negative about the experience?

What were you thinking and feeling?

Stage 1: Description of the event/experience Describe an event/experience that you feel you would benefit from reflecting on. Include e.g. where you were; who else was there; what were you doing; what was the context of the event; what happened; what was your part in this; what was the result. Stage 2: Thoughts / Feelings At this stage, try to recall and explore the things that were going on inside your head i.e. why does this event/experience stick in your mind. Include e.g. how you were feeling when the event started; what you were thinking about at the time; how did it make you feel; how did other people make you feel and how did you feel about the outcome of the event. Stage 3: Evaluation Try to evaluate or make a judgement about what has happened. Consider what was good/ positive about the experience and what was bad/ negative about the experience or what didn’t go so well. Stage 4: Analysis Break the event/experience down into its component parts and ask more detailed questions relating to the last stage (evaluation). Explore for example; what went well; what did you do well; what did others do well; what went wrong or did not turn out how it should have done; in what way did you or others contribute to this. Here you also need to draw on your own knowledge; past experience; policies, literature, or research. Your depth of analysis should reflect your level of learning Stage 5: Conclusion This differs from the evaluation stage in that now you have explored the issue from different angles and have a lot of information on which to base your judgement. It is here that you are likely to develop insight into your own and other people’s behaviour in terms of how they contributed to the outcome of the event. Remember the purpose of reflection is to learn from an experience. Without detailed analysis and honest exploration that occurs during all the previous stages, it is unlikely that all aspects of the event/experience will be taken into account. Stage 6: Action Plan During this stage you should think about the possibility of encountering this event again and try to plan what you would do – would you act differently or would you be likely to do the same? Here the cycle is tentatively completed and suggests that should the event occur again it will be the focus of another reflective cycle. Reflections on writing this incident/activity/experience What has been your most valuable learning from this incident/experience during this placement? When writing your reflective account, ensure individual confidentiality & anonymity. Description of the reflective account adapted from Jasper M. (2003) Beginning Reflective Practice – Foundations in Nursing and Health Care Nelson Thornes. Cheltenham. P.77-82 (chapter 3) Note: Use of references may support your reflection.

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ALL REFLECTIVE NOTES MUST BE DATED AND SIGNED BY PRECEPTOR STUDENT REFLECTIVE NOTES

PLACEMENT AREA: _______________________________________

(E.G. ACUTE, DAY-CARE, RESIDENTIAL, MEDICAL, SURGICAL)

To ensure anonymity throughout, please do not make any reference to named individual patients/clients /relatives/professionals. Please use black or blue pen only. All reflective notes (including each page of typed notes inserted by student) must be dated, and signed by the preceptor to verify that note(s) has/have been written prior to the final interviews.

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Date Note Written: _ _/ _ _/ _ _ Student signature: Read by: (Preceptor Name): Read by: (Preceptor Signature):

Date: _ _/ _ _/ _ _

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STUDENT REFLECTIVE NOTES

PLACEMENT AREA: _______________________________________ (E.G. ACUTE, DAY-CARE, RESIDENTIAL, MEDICAL, SURGICAL)


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ASSESSMENT OF PRACTICE INTERVIEW(S)

Assessment of Practice Interview Forms are set out in the following pages. Commencement of Placement Interview At the Commencement of Placement Interview, the student and preceptor meet to explore learning needs and opportunities, so that specified CLOs can be identified, practised and achieved. These are then listed in the commencement of placement interview form as (a) a guide to structuring the experience, and (b) as a guide for discussion at the Mid Placement Interview and/or End of placement interview as relevant. The preceptor is required to review the previous placement entries in the student’s clinical book (to afford continuity & be fully informed). Mid Placement Interview (Mid Placement Interviews are applicable only for placements of more than three weeks.) At the Mid Placement Interview, the student and preceptor meet to review relevant aspects of the learning experiences and opportunities to date, and to assess progress. The student and the preceptor discuss and reflect upon the students’ learning needs, with particular emphasis on those areas that require particular attention. The Preceptor is required to give the student feedback on their progress. It is important that students should not learn of identified concerns at the end of the placement without having had the opportunity to reflect on those aspects of their learning, which require particular attention. On this basis, further opportunities are identified to meet specific CLOs. These are documented, and form the basis of discussion at the end of placement assessment and interview. The achievement of specific clinical learning outcomes is recorded. End of Placement Interview At the End of Placement Interview, the student and Preceptor meet to assess and discuss the student’s learning, overall placement experience, and to identify areas for future learning. The achievement of specific CLOs is recorded. Reflective notes (including each page of typed notes inserted by student) are signed and dated by preceptor and student (to verify that they have been completed prior to the final interview). Additional interview section This section can be used to highlight areas of concern by either the preceptor or CNM or CPC, before, during or after mid-interview or at any time in practice placement. Please refer to section on Supportive Mechanisms for Student Learning (page check page 109 for more detail) Notes Pages for Preceptor/Associate Preceptor/Staff Nurse This section can be used by the above personnel to communicate with each other by documenting a student’s progress and areas of concern. * Please note if you require further Practice Interview Forms, Notes Pages for Preceptors and

Miscellaneous Skills pages – they can be downloaded from the UCC School of Nursing and Midwifery website.

Please refer to section on Interviews (check page 15 for more information)

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Assessment of Practice Interview(s) Form Preceptor Name: Practice Placement Area:

Placement Dates: From To

COMMENCEMENT OF PLACEMENT INTERVIEW Student has been orientated to the ward Student introduced themselves to CNM/Staff Student Comments Please identify and list the agreed learning outcomes Preceptor/Assessor Feedback Preceptor advised to review the previous placement entries in the student’s clinical book (to afford continuity & be fully informed). Student Signature: Date: Preceptor/Assessor Signature: Date: Time: MID PLACEMENT INTERVIEW Student Comments Preceptor/Assessor Feedback Student Signature: Date: Preceptor/Assessor Signature: Date: Time: END OF PLACEMENT INTERVIEW List CLOs achieved Student Comments Preceptor/Assessor Feedback Student Signature: Date: Preceptor/ CNM/ Assessor Signature: Date: Time:

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Additional Supportive Interview Student’s view of his/her progress

Preceptor’s concern about student’s progress

Decisions reached Student signature: Date: Preceptor/CPC signature: Date: Time:

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NOTES PAGE FOR PRECEPTORS/ASSOCIATE PRECEPTORS/STAFF NURSES/CPCs/CNMs

Please date, time and sign ALL entries

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ASSESSMENT OF PRACTICE INTERVIEW(S) FORM Preceptor Name: Practice Placement Area:


COMMENCEMENT OF PLACEMENT INTERVIEW Student has been orientated to the ward Student introduced themselves to CNM/Staff Student Comments Please identify and list the agreed learning outcomes Preceptor/Assessor Feedback Preceptor advised to review the previous placement entries in the student’s clinical book (to afford continuity & be fully informed). Student Signature: Date: Preceptor/Assessor Signature: Date: Time: MID PLACEMENT INTERVIEW List CLOs achieved Student Comments Preceptor/Assessor Feedback Student Signature: Date: Preceptor/Assessor Signature: Date: Time: END OF PLACEMENT INTERVIEW Student Comments Preceptor/Assessor Feedback Student Signature: Date: Preceptor/ CNM/ Assessor Signature: Date: Time:

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Additional Supportive Interview

Student’s view of his/her progress



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Student’s view of his/her progress



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BSc (Hons) Nursing (General) 2017 Intake CLO Booklet valid for 2017/2018 and 2018/2019 95



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NOTES PAGE FOR PRECEPTORS/ASSOCIATE

PRECEPTORS/STAFF NURSES/CPCs/CNMs Please date, time and sign ALL entries

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Clinical Supportive Mechanisms for Student Learning

Additional Support


Supportive Learning Plan

BSc Nursing and BSc Midwifery

Agreed by: Steering Group – July 2015 Revised by: Clinical Practice Committee – February 2016 Review Date: May 2017

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Supportive Mechanisms for Student Learning 1. ADDITIONAL SUPPORT Every effort is made to support and guide a student in achieving their Clinical learning outcomes (CLOs), Competencies and Clinical skills however, some students may require additional support. The need for additional support does not mean that a student will not achieve or is more likely not to achieve their clinical requirements but quite the contrary, in that, the earlier a preceptor/associate preceptor or indeed the student themselves may see that more support is needed in a specific area then the more likely they are to achieve their clinical requirements. Furthermore, the earlier this is addressed by either party also the more time there is to set out specific objectives to support a student with achieving their identified requirements. Additional support is provided by way of an Additional Supportive Interview or a Supportive Learning Plan. 2. ADDITIONAL SUPPORTIVE INTERVIEW The Additional Supportive Interview section should (where possible), be implemented prior to the initiation of a Supportive Learning Plan (SLP). This can be done at any time e.g. before, during, or after the mid interview or at any time in a practice placement. The Additional Supportive Interview page is located in the student’s Clinical Booklet in the Student Interviews section. See page for specific requirements to complete. Process for conducting an Additional Supportive Interview The Preceptor/Associate preceptor/CPC and/or other relevant personnel request a meeting with the student as soon as possible to address this concern. Depending on the nature of the concern the Link Lecturer (LL) may also attend. The purpose of this meeting is to:

• Ascertain the student’s view of their practice and progress • Highlight to the student by giving specific examples of the concerns which the

Preceptor/CPC and/or relevant personnel have in relation to their CLOs, Competencies, skills, professional nursing practice/other.

• Give constructive feedback and direction by giving 2 - 3 specific guidelines to the student on what they need to do or work on to address the identified issue(s) or concern(s).

• Specify a date to review the learning/practice/concern with the student/Preceptor/other

• The nature of the concern, feedback and direction given with review date of next meeting or other outcome of meeting must be documented in the Additional Supportive Interview Section.

It is essential that the Preceptor/Associate preceptor/CPC or other member of staff document any concerns in the student’s clinical booklet in an objective and factual manner, providing examples from student’s practice.

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The student should be provided with a reasonable timeframe (pending length of placement) to address performance/learning issues identified (two days to one week where possible). This record, including “decisions reached” must be signed and dated by both the student and preceptor. If after this time the original concern(s) remain, a Supportive Learning Plan (SLP) or other mechanism10 may be introduced in advance of their final interview. If an Additional Supportive Interview remains open at the end of a clinical placement then this (Additional Supportive Interview) is carried forward to the student’s next clinical placement area. The student, on commencing their next placement must inform his/her Preceptor/CPC/CNM/CMM, if an issue raised in the Additional Supportive Interview is still ongoing. The student must then be assessed and evaluated during the 1st week of placement in relation to issues/actions identified in the Additional Supportive Interview. A decision is then made to either close the Additional Supportive Interview or to progress to opening a Supportive Learning Plan (SLP). At this meeting (Additional Supportive Interview) however, depending on the nature of the concern and following some discussion, there is a possibility that the need for an SLP or other mechanism may be suggested to the student to assist with their practice/learning issues or to address professional matters. The LL, if not present at the Additional Supportive interview must be informed by the CPC that an Additional Supportive interview has occurred. If an SLP/other mechanism is suggested, then the L.L. and Practice Module Leader/Programme Leader are informed of the need to arrange a meeting as appropriate. N/B: [In exceptional circumstances however, and pending nature of event, an SLP/other mechanism may need to be introduced immediately without an Additional Supportive Interview e.g. student performing outside their scope of practice and/or patient safety concerns]. The Clinical Placement Co-ordinator (CPC) / Link Lecturer (LL) will inform CPC/LL for next placement as appropriate. 3. SUPPORTIVE LEARNING PLAN NB – See section on “Additional Support” and “Additional Supportive Interview” above prior to initiating a Supportive Learning Plan. Definition A Supportive Learning Plan (SLP) is a structured process to provide additional support to a student in the achievement of agreed clinical learning requirements during a practice placement. The process is a supportive mechanism undertaken by UCC and respective HSP personnel. All personnel involved will demonstrate respect for the dignity of the student and their colleagues, and will maintain confidentiality at all times during the process. Indicators for a Supporting Learning Plan The need for a SLP may reflect:

• When a student has not achieved requirements using the Additional Supportive Interview section

10 Other mechanism for example may include disciplinary procedures, fitness to practice, occupational health etc.

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• A requirement for additional support for a student in order to achieve agreed clinical learning requirements at the required rate with respect to the BSc programme and reasonable for that clinical area.

• Explicit loss of a student’s earlier level of achievement • The student’s own wishes for additional support because they are not achieving clinical

learning requirements relative to their identified learning needs • Where a student could benefit from support in relation to professional behaviour (for

example, interpersonal relationships) • Support for a student to practice within their agreed/signed Practice Placement

Agreement.

Please note: Placement duration should have no bearing on the need to initiate an SLP. Timing of Opening an SLP In the absence of exceptional circumstances, an SLP must not be initiated on last day of placement. A Supportive Learning Plan (SLP) can only be initiated during allocated clinical placement time and SLP meetings can only take place during allocated clinical placement time. A student must not be called out of theory (study leave or any other leave) for an SLP meeting. Setting up a Supportive Learning Plan Meeting The Preceptor must liaise with the Clinical Placement Co-ordinator (CPC)11 who will contact the area specific Link Lecturer (LL) regarding the need to initiate an SLP. The CPC12 must liaise with the LL to arrange a meeting of the relevant personnel, consisting of a minimum of four and a maximum of five people. This must include the student, preceptor, LL, CPC and/or the CNM/CMM. The CPC/LL, in advance of the meeting will provide the student and other personnel with the details of the meeting (the process, purpose, date, time, venue and persons to be present). In the event of the unavailability of a LL for a specific clinical area (ideally the LL should arrange their own cover for SLP meetings), and to avoid an unnecessary delay in the scheduling of an SLP meeting, the CPC or LL are required to inform the Practice Module Leader, Programme Leader if LL (or cover) is unavailable. The Practice Module Leader/Programme Leader will then take responsibility for allocating a replacement LL to attend SLP meeting.

The Process of Conducting and Documenting the SLP Plan Meeting INITIAL MEETING The CPC/LL or CNM/CMM will chair the meeting and the LL or CPC will record the process that includes the student’s specific learning requirements. All parties, or their representatives, must be present at all meetings relating to the SLP. First, the student is invited to give a view of his/her progress. Secondly, the preceptor is asked to comment on the following: (using specific examples/incidents)

11Where CPCs are not in place, the preceptor must liaise with the Clinical Development Coordinator or LL. 12 If no CPC linked to a clinical area the LL arranges the SLP meeting of the relevant personnel, consisting of a minimum of three and a maximum of five persons and must include student, preceptor, LL and a CNM/CMM where possible.

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• why he/she considers it necessary to implement an SLP • identify the student’s clinical learning requirements needing attention (See indicators

for SLP above). The student is given the opportunity to respond to the preceptor’s comments/concerns.

Thirdly, any other evidence that supports the preceptor’s concerns in relation to the student can then be presented e.g. from a CPC/CNM/CMM or LL where relevant. The student is given the opportunity again to respond. Fourthly, the steps the student needs to take towards achieving their learning requirements must be clearly identified and documented as Agreed Goals. The Agreed Goals must reflect the associated Domains, and outcomes specified in the Clinical Learning Booklet13. The SLP should also identify methods of achieving the Agreed Goals. For example, provide a maximum of three measurable outcomes (measured by observation, problem-solving exercises, regular communication or other evaluation methods), using active verb statements (e.g. report, plan, document, demonstrate, communicate etc.) to give the student specific direction of how to achieve their clinical learning. Finally, a reasonable review date must be agreed and set to provide the student with an opportunity to discuss/demonstrate progress by that date or for further supports to be put in place. The SLP must be signed and dated by both the Preceptor, student and all others present at the meeting. The Link lecturer informs the Practice Placement Module Leader, Programme Leader and Director of Practice Education of the implementation of an SLP. The Link lecturer must place a copy of the SLP in the student’s file in G03, School of Nursing & Midwifery, UCC. The original copy must remain in the student’s Clinical Booklet. REVIEW MEETING At the review meeting, the CPC/CNM/CMM or LL will either chair the meeting or record the process. Similar to the Initial meeting (as outlined above) the student is asked to comment on his/her progress. Then the preceptor responds to the student’s comments. Others present at meeting may comment on the student’s progress where relevant. A judgment will be made by the preceptor following discussion (at the meeting) with all parties present whether to continue or close the SLP on the basis of progress made by the student. The section “Review of student’s progress and further recommendations” in the Clinical Booklet is intended for use at the review meeting. The SLP review meeting record must be signed and dated by the preceptor, student and all others present at the meeting. The LL informs the Practice Placement Module Leader, Programme Leader and Director of Practice Education of the outcome of the SLP review meeting. The LL must place a copy of the SLP review meeting in the student’s file in G03, SONM, UCC. The original copy must remain in the student’s Clinical Booklet.

13 Students can also work to achieve clinical learning outside of identified learning within the SLP during their Clinical Placement if deemed appropriate

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The Process of Notification Student Responsibilities. The student must:

• On commencing their next placement, inform his/her preceptor/CPC14 either verbally or via e-mail that they are carrying an OPEN SLP forward from a previous placement or previous academic year.

The Clinical Placement Coordinator (CPC) Responsibilities. The CPC must:

• Inform the Nurse/Midwife Practice Development Coordinator if a student has an open SLP.

• Inform the CPC/CDC for the next practice placement of the open SLP15. • Liaise with the student at the commencement of the next clinical placement.

The Link Lecturer (LL) Responsibilities. The LL must:

• Inform the Practice Module Leader, Programme Leader, Director of Practice Education and LL in the student’s next placement of a student having an open SLP.

• Liaise with the external hospital sites, in relation to a student going to or leaving a placement with an open SLP.

The Programme Leader/Practice Module Leader in consultation with the Allocations Officer (AO), Allocations Liaison Officer (ALO) may consider the suitability of the next placement in order for the student to achieve the learning requirements outlined in the SLP. This is in context of a general or specialist placement. Whilst some re-organisation may be achievable for years one, two or three of the BSc programme however, students must complete the entire 18 weeks of their specialist placements prior to internship placements in year four as stated by ABA, 2005) “All theory, supernumerary core placements and the specialist placements must be completed prior to students undertaking the final placement of 36 weeks internship which consolidates the completed theoretical learning and supports the achievement of clinical competence within the learning environment” (ABA, 2005, p.20). Therefore, SLPs may be carried over to specialist placements. Process for Carrying an Open SLP to the Next Academic Year Students are required to meet the pass and progression requirements for the respective years. However, if an SLP is initiated during an academic year and remains open at the end of that year, then on commencement of their next clinical placement for the next academic year, a meeting must be held to review the open SLP. Follow guidelines for review meeting and student responsibilities outlined above. Student Refusal to Engage with the SLP process The SLP is initiated with the agreement of the student. If a student refuses an SLP, the CPC must arrange a meeting with the student, preceptor, CPC and LL. to discuss the matter. This 14Where CPCs are not in place, the student must liaise with the Clinical Development Coordinator or LL. 15 BSc Integrated Children’s programme only: Child and Adult specific learning requirements must be achieved in the relative disciplines whereas shared can be achieved in either child or adult placements. These principals remain relevant during the SLP process.

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can be done at mid interview or as an additional interview. Here the student’s reasons for refusing an SLP must be documented as well as advice given and signed by all present. The student is made aware of the implications of this i.e. they may not achieve Pass and Progression requirements for their clinical module. If a student refuses to engage with the SLP processes and/or refuses to sign the SLP, in the interest of patient/client safety the student will be notified by the CPC/LL that this refusal to engage with the SLP process may be in breach of the Practice Placement Agreement for example

“I confirm that I shall endeavour to recognise my own limitations and shall seek help/support when my level of experience is inadequate to handle a situation (whether on my own or with others), or when I or others perceive that my level of experience may be inadequate to handle a situation”. “I shall conduct myself in a professional and responsible manner in all my actions and communications (verbal, written and electronic including text, email or social communication media).

The student is advised that this may have implications for their pass and progression to the next academic year. The student will also be notified by the CPC/LL that they may be removed from placement as deemed appropriate16. In the event of a student refusing to engage with the SLP processes and / or refusing to sign the SLP, the LL/CPC (if applicable) must organise a meeting to review this situation within a maximum timeframe of 2 weeks with the relevant personnel in the Health Service Provider & School of Nursing & Midwifery, UCC. This meeting must include the student, CPC, Nurse/Midwife Practice Development Co-ordinator (N/MPDC), Programme Leader and Director of Undergraduate Practice Education. Student with Continuous or high volume of SLP’s If a student has continuous open SLP’s or has a high number of SLPs within an academic year the LL/CPC (if applicable) must organise a meeting to review this situation prior to completion of the student’s clinical placement for that academic year. A review meeting with the relevant personnel in the HSP and SONM, UCC will be held. This meeting must include the student, CPC, LL, Nurse/Midwife Practice Development Co-ordinator (N/MPDC) and Programme Leader.

16 In the event of a student being removed from placement the AO in UCC and ALO in the HSP must be notified immediately by the CPC/LL. Any time missed from clinical practice by the student must be repaid in full as per the NMBI requirements and standards.

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SUPPORTIVE LEARNING PLAN (SLP) ALGORITHM Planning the SLP Review outcome of Additional Supportive Interview Preceptor/CNM/CMM/CPC/LL identifies that a student is not achieving their clinical

learning requirements, is not conducting themselves in a professional and responsible manner and/or not working within their agreed Practice Placement Agreement (PPA).

Preceptor/CNM/CMM liaises with CPC/CDC to discuss the ongoing concerns in relation to a student’s failure to progress following Additional supportive interview.

Student is informed by the preceptor/CNM/CMM/CPC or LL in advance of the proposed/scheduled SLP meeting and of their preceptors/CNMs concerns.

CPC/CDC/LL liaises with all relevant personnel (student, preceptor/CNM/CMM, CPC, LL) to arrange a meeting, giving details of the purpose, date, time and venue.

Initial Meeting The CPC/LL or CNM/CMM will chair the meeting and either the LL/CPC will record the process. First, the student is invited to give a view of his/her progress. Secondly, the preceptor is asked to comment on the following: (using specific examples/incidents)

• why he/she considers it necessary to implement an SLP • to identify the student’s clinical learning requirements needing attention (See

indicators for SLP above, pgs. 110/111 of this book). The student is given the opportunity to respond to the preceptor’s comments/concerns. Thirdly, any other evidence that highlights a student’s learning deficits is then presented/discussed e.g. from a CPC/CNM/CMM or LL where relevant. The student is given the opportunity again to respond. Fourthly, an appropriate plan with Agreed Goals and support mechanisms are identified to help the student to achieve the learning/practice concern(s). Finally, a time frame is agreed and review date set. SLP is signed and dated by all present. The SLP is documented in the student’s Clinical Booklet and a copy must be placed in the student’s file in the School of Nursing and Midwifery, GO3, UCC. Review Meeting The student’s progress is reviewed. Follow procedure as for Initial meeting (outlined above) Student is invited to give a view of his/her progress. Preceptor/CNM/CMM/CPC/LL gives his/her feedback. If learning/practice concern(s) has been achieved - SLP is signed off and closed If the student is not achieving the Agreed Clinical Goals, a revised plan is formulated with a

new review date within a reasonable timeframe. (Refer to ‘notification’ section above if student with open SLP moving to a new placement area)

The section “Review of student’s progress and further recommendations” in the Clinical Booklet is intended for use at the review meeting.

The SLP review meeting record must be signed and dated by all present at meeting. LL must place a copy of the SLP review meeting in the student’s file in G03, SONM, UCC.

On closure of an SLP, there is no requirement to notify future placement areas of the

prior existence of an SLP, thus upholding confidentiality.

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SUPPORTIVE LEARNING PLAN FOR PRACTICE PLACEMENT Student Name: ____________________ Intake Year: ______ I.D Number: ___________ Practice Placement Area: ______________________________________________ Practice Placement Dates: From ___________________ To __________________ Preceptor’s Name & Grade: _____________________________________________ Date_________________ Time________________ List all persons present: ______________________________________________________________________________________________________________________ Description of specific concern/s as described by Student and Preceptor. (Link specific concerns with the Domains and the Clinical learning outcomes). Agreed Goals (Suggested and recommended methods to facilitate achievement of CLOs) Continue on next page

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Student Signature ____________________ Preceptor Signature ___________________ Link Lecturer Signature ____________________ CPC/CDC Signature ____________________ Review Date Agreed ___________________________

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REVIEW MEETING Date of Review Meeting _________________ Time:________________ List all persons present: ______________________________________________________________________________________________________________________ Review of student’s progress and further recommendations:


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REVIEW MEETING Date of Review Meeting _________________ Time: _______________ List all persons present: ______________________________________________________________________________________________________________________ Review of student’s progress and further recommendations:


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SUPPORTIVE LEARNING PLAN FOR PRACTICE PLACEMENT Student Name: ____________________ Intake Year: ______ I.D Number:__________ Practice Placement Area:______________________________________________ Practice Placement Dates: From ___________________ To __________________ Preceptor’s Name & Grade:_____________________________________________ Date_________________ Time: _______________ List all persons present: ______________________________________________________________________________________________________________________ Description of specific concern/s as described by Student and Preceptor. (Link specific concerns with the Domains and the Clinical learning outcomes). Agreed Goals (Suggested and recommended methods to facilitate achievement of CLOs)

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REVIEW MEETING Date of Review Meeting _________________ Time: ________________ List all persons present: ______________________________________________________________________________________________________________________ Review of student’s progress and further recommendations:


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SUPPORTIVE LEARNING PLAN FOR PRACTICE PLACEMENT Student Name: ____________________ Intake Year: ______ I.D Number:___________ Practice Placement Area:______________________________________________ Practice Placement Dates: From ___________________ To __________________ Preceptor’s Name & Grade:_____________________________________________ Date_________________ Time: _____________________ List all persons present: ______________________________________________________________________________________________________________________ Description of specific concern/s as described by Student and Preceptor. (Link specific concerns with the Domains and the Clinical learning outcomes). Agreed Goals (Suggested and recommended methods to facilitate achievement of CLOs)

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REVIEW MEETING Date of Review Meeting _________________ Time: _________________ List all persons present: ______________________________________________________________________________________________________________________ Review of student’s progress and further recommendations:


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BSc. Nursing Students Reflection Time Record Sheet

Including an account of any of the following: Reflection/Self-Directed Study/Directed Learning/Problem Solving Activities During clinical placements each student is expected to complete 5 hours of reflective time per week, to augment their learning. This can be spent outside the practice placement area. This is a record of how the student spent this time. (7 weeks placement = 35 hours year 1; 21 weeks placement = 105 hours year 2)

Student Name________________ Student Number_____________________________

Date Activity Theme/Reflection Topic Student Signature Total Hours

Student signature __________________________________________ Date _____________________________________________________

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Date Activity Theme/Reflective Topic Student Signature Total Hours


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Date Activity Theme/Reflective Topic Student Signature Total Hours


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Date Activity Theme/Reflection Topic Student Signature Total Hours


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NU1049 General Nursing Practice: Assessment and Feedback Sheet

End of YEAR ONE Assessment of your Clinical Learning Outcomes Booklet demonstrates that all assessment requirements and documentation are: COMPLETE _______________ INCOMPLETE_______________ 1st Submission _______________________________ Date: Practice Module Leader/Link Lecturer Resubmission: _______________________________ Date: _________

Practice Module Leader/Link Lecturer If assessed as INCOMPLETE please attend to the following as outlined in the page numbers below immediately and resubmit by ________________________ Page Number(s) Clinical Placement Details __________ Details of placement area in Reflective note(s) __________ Details of placement area in Interview Form(s) __________ Interview(s) not signed/dated by preceptor __________ Interview(s) not signed/dated by student __________ Reflective notes not written up/included __________ Reflective note(s) not signed/dated by preceptor __________ Reflective note(s) not signed/dated by student __________ Clinical Skill(s) not signed/dated by preceptor __________ Clinical Skill(s) not signed/dated by student __________ Student declaration not signed __________ Reflective Log not signed/dated or activity theme filled in __________ Other (specify) __________ Comments Please take note of issue(s) ticked and comments above and ensure that all relevant corrections are made before next Booklet submission. If you have any queries please do not hesitate to contact the Practice Module Leader or Link Lecturer listed above.

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NU2063 General Nursing Practice: Assessment and Feedback Sheet

End of YEAR TWO Assessment of your Clinical Learning Outcomes Booklet demonstrates that all assessment requirements and documentation are: COMPLETE _______________ INCOMPLETE_______________ 1st Submission _______________________________ Date: Practice Module Leader/Link Lecturer Resubmission: _______________________________ Date: _________

Practice Module Leader/Link Lecturer If assessed as INCOMPLETE please attend to the following as outlined below immediately and resubmit by ________________________ Page Number(s) Clinical Placement Details __________ Details of placement area in Reflective note(s) __________ Details of placement area in Interview Form(s) __________ Interview(s) not signed/dated by preceptor __________ Interview(s) not signed/dated by student __________ Reflective notes not written up/included __________ Reflective note(s) not signed/dated by preceptor __________ Reflective note(s) not signed/dated by student __________ Clinical Skill(s) not signed/dated by preceptor __________ Clinical Skill(s) not signed/dated by student __________ Student declaration not signed __________ Reflective Log not signed/dated or activity theme filled in __________ Other (specify) __________ Comments Please take note of issue(s) ticked and comments above and ensure that all relevant corrections are made before next Booklet submission. If you have any queries please do not hesitate to contact the Practice Module Leader or Link lecturer listed above.

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What I have to do with my CLO Booklet at the end of Every Clinical Placement

(Irrespective of placement duration/repayment of time)

PERSONAL USE ONLY

(1) Clinical Placement Details completed (area, dates, preceptor name, weeks) (2) Interview page completed (preceptor name, area, placement dates) (3) Interview(s) all signed/dated by preceptor (4) Interview(s) all signed/dated by student (5) Reflective Notes page completed (area, date, preceptor details) (6) Reflective notes written up/included (7) Reflective notes signed/dated by preceptor (8) Reflective notes signed/dated by student (9) Clinical Skills signed/dated by preceptor (10) Clinical Skills signed/dated by student (11) CLOs signed/dated by preceptor (12) CLOs signed/dated by student (13) Reflection Time Record Sheet completed (activity/hours/signed by student) If you encounter any difficulty regarding the achievement of your clinical learning or completion of CLO booklet during your placement it is your, responsibility to bring this to the attention of the relevant personnel (Preceptor, CPC, Link Lecturer, and Practice Module Leader, as appropriate).

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APPENDIX 1 – PRACTICE MODULE DESCRIPTORS AND PROGRAMME REGULATIONS

NU1049 General Nursing Practice

Please refer to online University Book of Modules 2017/2018

NU2063 General Nursing Practice

Please refer to online University Book of Modules 2018/2019 Note: Please also refer to BSc programme regulations.

• Undergraduate calendar entry • BSc Nursing marks and standards these can be accessed on the UCC web

http://www.ucc.ie/en/CurrentStudents/.

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APPENDIX 2 REQUIRED READING PRIOR TO, AND DURING, ALL CLINICAL PLACEMENTS Please note students are required to refer to the most up to date version of these policy and guidance documents, available at http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/ Disciplinary Policy Grievance Policy Intravenous BSc Student Nurse Competency Policy for BSc Nursing (General & Integrated) Students Manual Handling and People Load Moving and Handling Training Policy Policy for Repeating Clinical Module Practice Placement Guidelines ‘Request for Extension’ Form Mandatory and Essential Skills for BSc Nursing & BSc Midwifery Students Clinical Supportive Mechanisms for Student Learning: Additional Support, Additional Supportive Interview, Supportive Learning Plan BSc Nursing and BSc Midwifery Appendix 2 is not an exhaustive list and is intended as a guide only, students are required to refer to the School of Nursing & Midwifery web site, current students section, for the most up to date versions of the documents listed above. http://www.ucc.ie/en/nursingmidwifery/students/bscnursemid/



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