Using the newNursing PracticeAssessment Document

Introducing the Nursing PracticeAssessment Documentation andOngoing Achievement RecordThe new Practice Assessment Documentation (PAD) andOngoing Achievement Record (OAR) has been designedfollowing consultation with academics, external advisors, stafffrom practice in partner organisations, students, mentors andservice users/patients.The documents were validated by the NMC in May to beused as part of the new curriculum for undergraduate nursingprogrammes delivered by the University of Lincoln beginning inSeptember .

What’s New? One PAD per placement which contains all the paperwork needed for thatplacement Competencies and essential skills are listed under 5 headings relating tothe 4 P’s of The Code: Professional standards of practice and behaviourfor nurses and midwives (NMC) and Medicines Management The Episode of Care - A graded assessment of nursing skills andcompetencies, delivered during an ‘Episode of Care’ with a patient andassessed by the mentor. This means students get credit for practice There are no bondy levels. Instead a 1-6 grading scale based on what isexpected of students in that year There is no requirement to generate a portfolio of evidence Service user feedback on student’s care delivery An OAR will capture three years of information relating to progression.The student will make this available to all mentors on request.

How to use the PADOn pages 2-4, 9 & 21 of each PAD there are guidelines on thecontents of the document and requirements of the mentor andstudent.There is a guidance document which mentors can access from or request from their PSTlink.There is a brief page by page guide to explain what you need to do tocomplete the document.

Guidance for CompletionThe student will take ownership of their PAD and OAR and work withtheir mentor to ensure its completion.The mentor will ensure they see these two documents at the start ofthe placement, complete the orientation using the checklist, completethe preliminary, intermediate and final interviews, grade the studentagainst all competencies under the 5 headings, and complete anEpisode of Care summative assessment.Mentors can contact their link lecturer or the University if they feelthey need support.Students will also be working towards their EU requirements andthese are documented in their PAD and recorded in the OAR. Theymust also complete summative assessments with mentors on thespecific ESCs in the PAD (discussed later) with advice to completeearly on in the year.

Who is able to undertake student assessments?The NMC standards for pre-registration nurse education state that allsummative judgments regarding student competence must be made by a suitablyqualified mentorA mentor is a qualified nurse or allied health professional who has successfullyundertaken an NMC approved mentorship course Year one – can be any qualified mentor/AHP (must be a registered nurse from anyfield at progression point) Year 2 – any qualified nurse mentor (a nurse from the same field at progressionpoint) Year 3 – any qualified same field nurse mentor (sign-off for final placement).Other members of the MDT can inform the mentor of their observations to aidassessmentThe mentor or associate mentor complete the documentationA sign-off mentor must be allocated to third year students in their final placement toassess competency, fitness to practice and progression to enter the register

Front PageStudents willpopulate the frontpage of each PADinputting theirdetails and that oftheir placement.This page will thenbe completed bythe academic tutorat the end of theplacement.Mentors must signthe front page.

OrientationIt is important thatstudents are orientated toeach clinical area prior toundertaking any clinicalactivity.Some orientation activitymust take place on thefirst day of a placement,other activities may becompleted within the firstweek.The nurse whoundertakes the orientationactivity must sign anddate the appropriate box.

Preliminary InterviewMentors will meet withtheir student in the firstweek of placement tocomplete theirpreliminary interviewincluding how thestudent aims to meetthe competenciesunder the 5 headings.A date to practice theEpisode of Care shouldbe discussed.

Intermediate InterviewThe student will completetheir review of thecompetencies prior to thisinterview and discuss thiswith their mentor who willcomplete theirassessment.A date for the summativeattempt at the Episode ofCare will be agreed.Any concerns thatcompetencies won’t bemet at a 3 or above, will bediscussed with student, anaction plan should beinitiated and link lecturerinformed who will monitorthis with the mentor.

Final InterviewThe University willhave been informed ifthe student is notgoing to pass thisassessment, and iftheir attendance isrequired at thismeeting.The student will againreview theircompetencies anddiscuss with theirmentor. The mentorwill highlight areas ofdevelopment andachievement and signoff the competencies.

How are Students Assessed?Below expectationsRefer/FailRequires developmentRefer/Fail21SatisfactoryMeets all of the criteriaand is safe in practice3GoodMeets all of the criteriato a standard higherthan expected4Very goodMeets all of the criteriato a high standard5ExcellentMeets all of the criteriato an exceptionally highstandard6Students are assessed for competence and the episode of care on a scale of 1-6.1 & 2 are a fail which would result in an action plan to improve with the Universitybeing informed. 3 is satisfactory, competent and safe to progress.Each assessment is relevant to year of study the student is in. They are able toachieve grades across the scale.The new scale supports students who perform very good, or excellent, for theiryear of study to be acknowledged and rewarded.

Assessment Rubrics If the mentor considers that any aspect of the student’s performancefalls within the ‘unsatisfactory’ band then they must award the‘unsatisfactory’ descriptor overall on that competency. At the intermediate interview, this will enable the student to reflect ontheir performance and help them to identify areas for developmentbefore the final interview. The Link Lecturer should be contacted and an action plan completedto enable the student to focus on specific development requirements. This will be monitored to support achievement either on placement orinsight visits prior to final interview.

Year 1 – Assimilating. High levels ofdirections and supervisionYear 2 – Engaging. Reducing levels ofdirection and supervisionYear 3 – Impacting. Minimaldirection and supervisionExcellent6This escalator showshow students areassessed on the scaleand that they canscore across the scalein each year due tothe expectationschanging as theyprogress.Very Good54321Year 1SatisfactoryRequires DevelopmentYear 3Year 2GoodNot Competent

CompetenciesThe competencies are alignedto the NMC essential skillsclusters and domains.The student should self assessprior to intermediate and finalinterviews. The mentor shouldcomplete their assessment ateach interview.If any competency is assessedas below a 3, an action planmust be completed and theUniversity contacted.The student may grade acrossthe scale and a discussionshould be held if student andmentor assessments differ.

CommentsThe commentsboxes allowsboth student andmentor to recordprogresstowards meetingthe criterion ateach interviewand ways toimprove.

Specific Essential SkillsThese are the ESCs thestudent must achieve acrossthe programme and before thestated progression points.Students are expected topractice the skills beforeundertaking a summativeattempt. They are to beobserved by their mentor andoutcome is recorded in thePAD.Refer to guidance andchecklist of clinical activityrequired to achieve theseskills, provided separately.

Episode of CareA pre-negotiated date toundertake thesummative assessmentof an Episode of Carewill be set.The mentor will assessthe student againstcompetencies listed andgrade their competencebased on the same 1-6scale.If any descriptor attractsbelow 3 (satisfactory),this would be an overallfail. This will necessitatereferral to the University.

Episode of Care4. Fundamentals of careincludingemotional/psychological,nutrition, infectioncontrol, painmanagement andpersonal needs:Provides adequate andappropriate personalcare, assesses, managespain or deterioration.Ensures nutrition andhydration are adequate atall times, if the patient isunable to manage thisthemselves, recognisesmobility andcommunication factors,assesses risk; maintainspatient safety;documents in records.5. Post Episode of Care discussionStudent reflects on ownpreparation, interactions andinterventions and mentor andstudent assess. Further discussionmay include:Who needs to be involved indecisions around care, whatprofessionals, agencies, services,assessments, treatment optionsand accessibility?Student acts within sphere ofcompetence and skills required,relevant to patient need.6. Patient Feedback3. Patient centred, homeand social issues, ieisolation, family, carer,information and decisionsaround condition, care andinterventions, includingknowledge of prescribedmedication, sideeffects/effect, withinsphere of knowledge andrecognizing limitations;treat patients withrespect, kindness, dignity,compassion,understanding, sensitivityand honesty.1. Episode of CarePreparation:negotiate a suitablepatient. Assess thestudent’s ability to:Respect the person asan individual: know ifcommunication needstailoring, read notes,care plans,prescriptions, knowname and reason forneed for services, howthe condition affectsthe person, and howthe person'scircumstances andexperiences affecttheir condition andtreatment2. Communication:confident approach, eyecontact, introduction,checks identity, respectsconfidentiality, explainsreasons for interaction,gains consent, listens toand addresses any healthbeliefs, concerns andpreferences that thepatient has, respect views,offer support, reassures,asks relevant questions

Service user feedback formWithin each Episode ofCare there is a page forstudents to receivefeedback directly fromsomeone they have caredfor or their relative.The mentor that works withthe student should approachthe patient/service user toseek consent and ask forfeedbackMentors may complete theform on behalf of the serviceuser and ask them to sign orinitial to verify theinformation.Mentors are also asked tosign on completion forverification purposes.

EU RequirementsThe mentor is askedto make notes onhow the student mayhave met specific EUrequirements duringplacement asevidence to informthe students OAR.Information aboutrequirements can befound on page 2.

FeedbackMentors will completethe feedback formafter the Episode ofCare to help thestudent progress,reflect and learn fromthe experience.The overall grade forthe assessment willbe interpreted by theacademic team oncethe student submitstheir PAD toUniversity by anagreed deadline.

ModerationThe University linklecturers will randomlyselect a sample ofstudents and observethese assessments formoderation purposes.If you would specificallylike the link lecturer tomoderate yourassessments, pleasemake contact withthem.

Evidence of Additional LearningThere are several forms ineach PAD that a studentwill complete as part ofattending an “insight” or“care pathway” visit.This allows the mentor tosee what learning thestudent gained from thisvisit and the student achance to record theirexperience and possibleevidence for EUrequirements.A member of staff at thisvisit must sign the formand hours completed toinform the mentor.

Action PlanIf an action plan isneeded, thetemplate for this isincluded towardsthe end of thedocument.The mentor andstudent willcomplete thistogether alongwith a link lecturerif needed.

Cause for ConcernThe early warningchecklist is includedto help mentorsidentify if there is acause for concernearly on with astudent in relation tothe 5 areas ofcompetence.These points shouldaid earlyidentification ofproblems to speedup resolution andinitiatedevelopmentalaction plans.

Authorised SignaturesAnyone who writesin the student’s PADor OAR shouldrecord theirsignature and detailsat the back of thePAD.This includesmentors, comentors, associatementors, mentors intraining, supervisorsfrom insight visits,etc.

The Ongoing Achievement Record (OAR)ContentsThe OAR contains the student’s tutorialrecords (both one to one and group),evidence towards EU requirements,summary and interview pages of previousPADs, action plans and cause for concernforms. This document covers the fullthree years of the programme.Mentors may wish to review the student’sOAR to understand prior learning, atpreliminary interviewThis is an electronic document andstudents will either show you an electronicversion or they may choose to print andpresent this in a file.

Records of Practice HoursStudents will be recording their hours on PEMS which is an electronictimesheet.Mentors will need to verify the hours recorded on these sheets by viewing themand entering a unique pin number to agree the hours (or ask the student toamend if needed and then agree).Mentors will be assigned a pin number through PEMS and they will find this ontheir dashboard when they log in.This pin will be active for your linked students only and for the period of theplacement only. Students will have university specific information regarding how thisinformation is submitted, reported and recorded.