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Supporting Learning and Assessment in Practice. achieving the NMC stage 2 standards for mentors. Information. fire alarm and fire escapes toilets coffee and tea group work respect and confidentiality. Underpinning Principles. same part / sub part of the register

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Supporting learning and assessment in practice l.jpg

Supporting Learning and Assessment in Practice

achieving the NMC

stage 2 standards

for mentors


Information l.jpg

Information

  • fire alarm and fire escapes

  • toilets

  • coffee and tea

  • group work

  • respect and confidentiality


Underpinning principles l.jpg

Underpinning Principles

  • same part / sub part of the register

  • knowledge, skills and competence

  • professional qualifications

  • preparation programmes


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Group Discussion

A

B

the best thing about having students is…

the worst thing about having students is…

C

D

the best thing about being a student is…

the worst thing about being a student is…


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10 Day Programme

2 days theory

mandatory

+

APEL: previous mentorship training & experience

3 days distance learning

or

+

5 days supervised practise

APEL: evaluation of learning

or


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10 Credit Module

(Bsc pathway)

10 day programme

reflective assignment

+


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Day 1 Objectives

  • understand the student experience

  • describe the effective mentor

  • structure a student placement

  • complete clinical practice assessment documents


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Day 2 Objectives

  • ‘sign off’ clinical competence

  • provide constructive feedback

  • address the failing student

  • create an environment for learning

  • teach a clinical skill


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Mentor Portfolio

  • useful information

  • learning in practice

  • peer review

  • mentor assessment

  • professional portfolio


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A Brief History of Nurse Training & Education


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‘Traditional’ Training

  • apprenticeship model

  • direct observation and practice in clinical settings

  • competence assessed through ward based examinations, written papers and a national exam

RCN 2007


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1970s

  • devolution of training

  • assessment in each country overseen by their board of nursing

RCN 2007


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Project 2000 (1992)

  • transferred nurse training to HEIs

  • diploma level

  • critical research based profession

  • students supernumerary

  • health rather than illness model

  • CFP and branch programmes 

  • primarily academic assessment

RCN 2007


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Fitness for Practice(2002)

education in partnership

all-graduate preparation

clinical skills (rebuilt skills lab)

50% theory / 50% practice…

…reflected in assessment schedule

practice education facilitators

CFP reduced to 12 months

UKCC 1999


The future l.jpg

The Future…

Develop a competent and flexible workforce

  • reconciling demand and need with safety and quality

  • enable nurses to lead and coordinate care

DoH 2006


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The Future…

Update career pathways and career choices

  • standardise advanced and specialist roles

  • develop a fast track scheme for nurse leaders

  • develop a careers framework with post graduate career pathways

  • continuity of care within and between clinical settings

DoH 2006


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NHS Modernisation

growing trend of chronic and complex illness

an aging population

focus on prevention and health promotion

managing disease in primary care settings

tackling determinants of health status such as poverty andsocial exclusion

holistic practice that links health and social care

DoH 2006


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Modernising Nursing Careers

increased public expectations and demands

review the level and content of pre- registration education

engaging the public and greater public responsibility

DoH 2006


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Fitness for Practice


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Year 1 (CFP)

42 weeks + 10 weeks holiday (3 terms)


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Year 1 (CFP)


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Health, Individuals and Society


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CARDIFF UNIVERSITY

School of Nursing and Midwifery Studies

Health, Individuals & Society Module

Student Placement Planner


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‘specific learning outcomes for the visit (minimum 3)’

practitioner

‘student reflective account of learning experience’

mentor


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Assessments CFP

Module 1

Module 2

Module 3

Communication Applied to

Nursing - Reflective Assignment

Week 14

&

Nursing Theory applied to

Practice

Week 28

3000 word essay

‘Social Policy &

Multi-professional

Approach’

Week 30

4 ECDL Modules

Hr Numeracy Exam (70% pass)

Hr Clinical Science MCQ

1.5 Hr unseen exam on

Nursing Practice

Week 35


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Year 2 (Branch)

42 weeks + 10 weeks holiday (3 terms)


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Year 2 (Branch)


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Assessments Year 2

Adult

Child

Mental Health


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Year 3 (Branch)

42 weeks + 10 weeks holiday (3 terms)


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Year 3 (Branch)


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Assessments Year 3

Adult

Child

Mental Health


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Principles of Effective Mentor Practice


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What is a Mentor?

‘A nurse, midwife or specialist community public health nurse who facilitates learning and supervises and assesses students in a practice setting’

NMC 2005

facilitates

supervises

assesses


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Mentor Responsibilities

  • organising practice learning

  • supervision and feedback

  • working with learning objectives

  • assessing performance

  • providing evidence of achievement

  • liaison with others

  • sign off mentoring

NMC 2008


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Why Become a Mentor?

‘You must facilitate students and others to develop their competence’

‘You must be willing to share your skills and experience for the benefit of your colleagues’

NMC Code 2008


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Benefits of Mentorship

Neary 2000


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What Makes a Good Mentor?

Quinn & Hughes 2007


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What Makes a Poor Mentor?

Quinn & Hughes 2007


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Principles of Assessment


Assessment l.jpg

Assessment

‘Mentors must ensure that assessment of clinical skills does occur as required. Passing students who should have failed in the hope that they will improve puts patients at risk’

Duffy 2004


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Group Questions

A

B

what is the purpose of assessment?

what should we be assessing?

C

D

what are the features of good assessments?

what are the methods of assessment?


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Holistic Assessment of Competence

Stuart 2007


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Purpose of Assessment

  • to monitor the student’s progress

  • to motivate the student

  • to measure the effectiveness of teaching

  • to assess competence

  • to ensure patient safety


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Validity

ensures that a test measures what it was designed to measure

  • appropriate methods need to be used depending on what is being assessed

Stuart 2002


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Reliability

assessment should give similar results when used on separate occasions & with different assessors

consistency of student performance

consistency of interpretation

consistency between assessors

Stuart 2002


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Discriminatory

assessment must be able to discriminate between those who perform well and those who do not

  • language must be fair to all students

  • assessments should be unbiased


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Methods of Assessment

simulation

patient documentation

self assessment

assignments

examinations

  • observation

  • questioning

  • discussion

  • reflection

  • testimony of others


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Recording Assessments of Clinical Practice


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Self Assessment

  • what makes you a good mentor?

  • how could you develop your mentorship practice?

  • what opportunities does the role offer you?

  • what could be threatening about being a mentor?

Action Plan


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Clinical Learning Contract

first week

middle weeks

final week


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Sally is a second year student. She is keen to learn about risk assessment and drug administration. She is quiet and doesn’t generally ask many questions or approach other healthcare professionals. However, she is generally interested and always offers to help


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Write down a learning objective:

  • based on Sally's SWOT

  • based on an opportunity offered within you clinical area


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Portfolio Assessments

  • Professional Attitude Rating Scale

  • Practical Skills Sheet

  • Reflective Accounts


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Practice Assessment

  • Professional & Ethical Practice

  • Care Delivery

  • Care Management

  • Personal & Professional Development

NMC 2002


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Clinical Practice Assessment Document


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A.Mentor

A.Mentor

Student

A.Mentor

‘Signing Off’ Practice Outcomes


Slide57 l.jpg

A.Mentor

Gordon has reviewed care well when we have worked together, but needs more experience of working with the rest of the multi-disciplinary team

A.Mentor

21/1/08

Recording Progress Towards Competence


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Assessing Practice

  • Who signs the overall clinical record? P.19-21

  • What is the difference between the level required of a first year and that of a second year?P.23 & 48

  • What more would you expect from a second year student taking a BP than you would from a first year?


Slide59 l.jpg

  • A student successfully completes several blood pressures under your supervision. In order to complete the practice outcomes on p.49-50what else do they need to do?

  • Look at p.95-96. What would you expect from a third year student to sign them off as competent?


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  • What elements of a student’s portfolio would need to be completed to achieve the outcomes on p.115 ?

  • Students must reflect on their visits for the health, individuals & society module. Which outcomes could then be assessed as completed? P.45

  • A number of outcomes relate to risk assessments. Think of two types of risk assessments which may be undertaken in your clinical area


Day 1 objectives61 l.jpg

Day 1 Objectives

  • understand the student experience

  • describe the effective mentor

  • structure a student placement

  • complete clinical practice assessment documents


Day 2 objectives62 l.jpg

Day 2 Objectives

  • ‘sign off’ clinical competence

  • provide constructive feedback

  • address the failing student

  • create an environment for learning

  • teach a clinical skill


Supporting learning and assessment in practice63 l.jpg

Supporting Learning and Assessment in Practice

achieving NMC stage 2 standards for mentors


Information64 l.jpg

Information

  • fire alarm and fire escapes

  • toilets

  • coffee and tea

  • group work

  • respect and confidentiality


Day 1 objectives65 l.jpg

Day 1 Objectives

  • understand the student experience

  • describe the effective mentor

  • structure a student placement

  • complete clinical practice assessment documents


Day 2 objectives66 l.jpg

Day 2 Objectives

  • ‘sign off’ clinical competence

  • provide constructive feedback

  • address the failing student

  • create an environment for learning

  • teach a clinical skill


Using the clinical practice assessment document l.jpg

Using the Clinical Practice Assessment Document


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Practice Assessment

  • Professional & Ethical Practice

  • Care Delivery

  • Care Management

  • Personal & Professional Development

NMC 2002


Slide69 l.jpg

Clinical Practice Assessment Document


Slide70 l.jpg

A.Mentor

A.Mentor

Student

A.Mentor

‘Signing Off’ Practice Outcomes


Slide71 l.jpg

A.Mentor

Gordon has reviewed care well when we have worked together, but needs more experience of working with the rest of the multi-disciplinary team

A.Mentor

21/1/08

Recording Progress Towards Competence


The final assessment of practice l.jpg

The Final Assessmentof Practice


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Group Questions

A

B

manage care

appropriate attitudes

manage team

ethical dilemmas

C

D

drug administration

peer support

communication

supervision and teaching


Sign off mentors l.jpg

Sign-Off Mentors

a mentor who:

  • meets NMC registration requirements

  • has been supervised on 3 occasions

    has an in-depth understanding of their accountability when making the final assessment of proficiency


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Sign-Off Mentors

The Trust Position:

  • APEL of all practicing mentors

  • ‘exceptional circumstances’

  • status monitored through annual IPR


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Provision of Effective Feedback


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Effective Feedback

  • as soon as possible

  • prepare for the session

  • oral, written or both

  • ensure privacy

  • give full attention


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Feedback Process

don’t tackle too many things at once – try to foster a sense of progress

always try to make the session a learning situation for the student


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Learning from Feedback

  • listen to the student

  • student self assessment

  • do not be confrontational

  • focus on behaviour & facts and not on opinions, personalities & generalities

  • negative feedback must not be avoided

  • use open-ended questions

  • give rationale for questions and comments

  • encourage frankness and share worries & uncertainties


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Feedback Outcomes

  • ask the student how performance can be improved

  • show how performance can be improved

  • be specific: offer alternatives

  • ensure that the student knows what is expected

  • make a written agreement with the student in the form of an action plan

  • try to end the session on a positive note


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Management of the Failing Student


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Group Activity

think of a student or a member of staff who you felt was unsuitable for clinical practice (no names!)

discuss in your groups your rationale and experiences


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Common Indicators Of Student Underachievement

  • unsafe practice

  • inconsistent clinical performance

  • lack of insight into weaknesses

  • unable to respond to feedback


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Common Indicators Of Student Underachievement

  • lack of interest or motivation

  • limited interpersonal skills

  • absence of professional boundaries

  • unreliable or poor attitude

  • lack of theoretical knowledge


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Failing Students

‘As a professional, you are personally accountable for actions and omissions in your practice and must be able to justify your decisions’

NMC 2008


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Failing Students

failing students is essential in order to safeguard the public and uphold the profession

Ask Yourself:

would I be happy for this person to care for me or one of my relatives?

Duffy 2004


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Supporting Mentors in Practice

  • clinical teachers

  • link lecturer

  • personal tutor


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Scenario

you are mentoring a module 9 student who still has many learning outcomes to achieve

it quickly becomes apparent that the student is not of the standard expected of a 3rd year and requires close supervision

the student feels the placement is going well

discuss the management of this student in practice


Clinical learning environments l.jpg

Clinical Learning Environments


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Student Welcome Pack

What should be included?

  • welcome letter

  • ward philosophy

  • general introduction to the area

  • information on relevant clinical conditions

  • glossary of terms used/abbreviations

  • clinical area layout

  • ward team


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Student Welcome Pack

What should be included?

  • student link nurses

  • clinical teacher contact details

  • shift patterns

  • sickness policy/ phone numbers

  • learning opportunities

  • induction check list / safety checks


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Welcoming Students

  • mentor and co-mentor allocated prior to placement

  • provide student welcome pack

  • organize orientation to the placement

  • introduce to the clinical team

  • plan a meeting with the student during the first week


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Welcoming Students

  • agree a timetable for working together and assessment meetings

  • establish roles & responsibilities in terms of standards and attitudes

  • be aware of the programme & the student’s level of training

  • ensure that the student knows who will be supervising them in the absence of the mentor


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Supporting Dyslexia in Clinical Practice

‘difficulty with words’

specific learning difficulty

neurological in origin

persists across the lifespan


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Presentation

  • problems processing information

  • memory problems

  • sequencing problems

  • difficulties with motor skills

  • perceptual difficulties

  • problems concentrating

  • difficulties with orientation


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Approaches

  • respond positively

  • ask how you can help and what they may need

  • don’t share information unless they grant permission

  • be clear about your expectations

  • consider reasonable adjustments


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Reasonable adjustments

  • communicate in more than one format

  • allow the student to repeat information to check understanding

  • use a phonetic dictionary

  • regular breaks

  • develop & explain schedule / routine

  • agree priorities / order of work


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Teaching Clinical Skills


Teaching clinical skills99 l.jpg

Teaching Clinical Skills

assess


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Assessment Guidelines

knowledge

informed

consent

appropriate

assessmentcompleted

observed

confidence


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Learning Styles

Honey & Mumford 1989

hands-on; throw themselves in; ‘here and now’; willing to try

activists

practical; experimenter; meet challenges; make decisions

pragmatists

cautious; meticulous; analytical; observer

reflectors

perfectionist; rational; methodical; objective

theorists


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Adult Learning

pedagogy

andragogy

teacher-centred

dependency

dominated by curriculum

external motivation

learner-centred

self directed

problem solving orientation

internal motivation


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Teaching Clinical Skills

assess

assess

plan


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Teaching Clinical Skills

assess

plan

undertake


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Teaching Clinical Skills

assess

evaluate

plan

undertake


Teaching clinical skills106 l.jpg

Teaching Clinical Skills

A

B

what do I need to assess for?

what should be in my plan?

C

D

what should I consider to undertake this?

how will I evaluate performance?


Teaching clinical skills107 l.jpg

Teaching Clinical Skills

assess

evaluate

plan

undertake


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Professional Issues and Practice Placements


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Professional Behaviour

  • sickness & absence policy

  • uniform policy

  • time keeping

  • study time

  • bank holidays

  • shadow the mentor’s shifts for at least 40% of placement


Student timesheet l.jpg

Student Timesheet


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‘Please enter below the TOTAL number of practical outcomes that have been achieved during this placement’

mentor’s signature


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Preceptorship and the Nurse Foundation Programme


Preceptorship l.jpg

Preceptorship

‘Preceptorship is about providing support and guidance enabling new registrants to make the transition from student to accountable practitioner’

NMC 2006


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Preceptorship

  • Peach Report recommendations

  • Nurse Foundation Programme

  • NMC standards


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Trust Policy

Role Profile:

  • band 5 / 6

  • same part of register

  • 2 years’ post-reg experience

  • 1 year in clinical area

  • mentorship training and practice


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Trust Policy

Process:

  • 12 monthly meetings

  • working together

  • learning contract

  • preceptor toolkit


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Frequently Asked Questions


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FAQs

RCN 2007

Must the student ‘work’ with me the whole time?

No. Students can spend time with others, depending upon their learning needs and the opportunities available. However, in order to effectively teach and assess the student, they should work with you at least 40% of their time


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FAQs

RCN 2007

What do I do if the student doesn’t cooperate with me?

Make the student aware of your thoughts. Document the incident / issues. Contact senior staff / personal tutor / clinical teacher.


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FAQs

RCN 2007

What can I do if the student is unsafe in practice?

They should be removed from the clinical area. Inform the university and senior staff and record rationale in their documentation.


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FAQs

RCN 2007

What can I do to reward the student who is exceptional?

Overt praise and recognition are the best rewards. Be sure to record it in the students documentation.


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10 Questions


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Clinical Teaching Team

  • Tricia Brown 0797457918

  • Dawn Casey 07966 440657

  • Jane Gray 07966412664

  • Janet Keggie 07974579716

  • Alex Nute 07968697788


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Day 2 Objectives

  • ‘sign off’ clinical competence

  • provide constructive feedback

  • address the failing student

  • create an environment for learning

  • teach a clinical skill


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