Portfolio of Learning Outcomes through Self Assessment

Published Date: 23 Mar 2015

This portfolio provides evidence of achieving learning outcomes. To provide this evidence I attended tutorials envisaging interactive methods and student cantered teaching strategies (Hinchcliff 2004), self-directed learning, group work and discussion. I also did further reading, utilizing library facilities, the cinnahl, Athens and other web sites available. To make this learning achievement possible I engaged in mentee / student relationship with the support and guidance of an approved mentor (NMC 2000).

I chose this module due my interest in teaching. Since qualification, I have worked in specialist areas and have been actively involved in associate mentorship. I feel this module will be beneficial in my professional development and within the clinical areas, I choose to work.

I have written this portfolio in first person (Webb 1992), as it is a reflective account, of experiences, thoughts and feelings, learning through critical analysis and evaluation. This kind of reflection enables us to take account of what has happened and to make sense of the outcome (Boud and Miller 1996).

Many models of reflection may be used, Ghaye and Lilyman (2000) refer to structured models leading learners' through stages and questions useful as a guide and others are flexible taking into account the reflective process and can start at different points then there is the focused model giving meaning to events improving practice. I have used an adaptation of the Reflective Cycle Model (Gibbs 1988) as it is simple and easy to interpret.

Learning Outcomes

1. Assist students to identify current learning needs.

___

Self-assessment of current practice and identification of learning need(s) in relation to this outcome.

Current practice:

• Knowledgeable of student nurse curriculum.

• Have a willingness and commitment to teach.

My learning needs:

• Gain an understanding of the FDA programme.

• Review and critically analyze literature.

• Critical reflection.

Learning Outcome 1. Assist students to identify current learning needs.

_____

Examples of evidence that could be provided by the end of the module to show how this outcome has been achieved.

Produce evidence of placement learning opportunities suitable to meet the needs of specific students.

Give at least one example of how you have helped the student to identify his/her learning needs, set goals and develop action plan for learning.

___________

Summary of Evidence for summative assessment of what you have achieved during the module.

Cross- reference as appropriate.

• I obtained copies of Sandra's job description and FDA Mentor Pack.

• Reviewed literature.

• Critical reflection.

Description

The vascular surgical ward I work encounters many Nursing, Medical, Foundation Degree Studies, National Vocational Qualification students and newly qualified nurses all needing support. I have been asked by Sandra a 2nd year FDA student to be her mentor to take on this role effectively I attended a meeting with Sandra and her Practice trainer. Through discussion, we were able to complete a negotiated learning contract documenting the learning and achievements Sandra had gained, outlining what her current learning needs were to devise an agreed action plan.

Feelings

I take my role seriously, committing myself in assisting and supporting junior colleagues and students. I am genuinely interested in their stage and level of learning and enjoy having an active role in their learning experience.

Analysis

I agree with Hincliffe (2004) that learning is seen as a change in behaviour that is brought about to enable enhanced care for patients/clients, an event from experience and practice causing relative permanent change in students' behaviour. Curzon (1990) enhances this view considering learning as modification of behaviour through activities and experiences so that knowledge, skills, attitudes and process of adjustment to the learners environment is changed. Quinn (1995), Welsh and Swann (2004), and Nicklin and Kenworthey (1995) all have similar descriptions.

A successful teacher has knowledge of different learning theories and learning processes using them as framework to base teaching maximizing opportunities of learning (McKenna 1995, Nicklin and Kenworthey 1995). Raynor and Riding (1997) and Snelgrove (2004) refer growing need for teachers to understand the learning process to facilitate individualized learning reducing academic failure.

There are many different theories of learning mentioned within the literature (Hincliffe 2004, McKenna 1995 a/b/c, Nicklin and Kenworthey 1995, Welsh and Swann 2004), no single theory has all the answers, some theories view humans as extensions of the animal species, whereas others see humans as separate, distinct, with intellectual characteristics of their own (Nicklin and Kenworthey 1995).

Early theories of behaviourism such as Pavlov, Watson, Thorndike and Skinner used animals whose behaviour resulted from a stimulus. Much of the literature suggests that such learning is limited and has no real place in nursing education (Hincliffe 2004, McKenna 1995(c), Nicklin and Kenworthey 1995, Quinn 1995) yet I believe there are still situations where these theories are relevant but learning is limited.

Curzon (1997) believes human behaviour is very different from that of animals questioning validity of behaviourism theories. Supporters acknowledge refinement of these works could shape intellectual development cognitivity being how we acquire information and what we need to know emotional responses learned in part by classical conditioning (Woolfork and Nicolick 1980). Lovell (1987) refers to emotional responses being positive or negative relating to Pavlovs theory. Repetition is useful in practice which relates to Thorndike's theory of trial and error (McKenna 1995a), but knowledge of the skill learnt is crucial. As teachers, we constantly use Skinners theory of positive and negative reinforcement, through praise and by giving information and cues prior to the task performed and by practising a skill repeatedly over till competent in practice (McKenna 1995a).

Cognitive theories refer to meaningful approaches of learning, recognizing students' knowledge, experience and stages of development. I believe that as a mentor it is my responsibility to establish these factors early in the student relationship (Andrew and Wallis 1999, Forrest 2004, Phillips et al 1994). I agree learning is a purposive process concerning perception, organization and insight. The learner actively seeks new information and uses past experience to gain understanding (Child 1986, Quinn 1995). Insightful learning occurs from modified experience or knowledge gaining new insight (Child 1986), the student relating to previous knowledge and experience to solve new problems.

Experimental learning leads on from cognivitism; Allan and Jolley (1987) refer to learners becoming independent of their teachers eventually setting their own objectives initiating their learning using available resources and self-assessment. Burnard (1987) describes this as involving personal experience and reflection making sense of events transforming knowledge and meaning from them. I think Allan and Jolley (1987) are correct in saying that this type of learning is effective in demonstration and practice. Allan and Jolley (1987) also state that increased activity and involvement leads to increased learning.

The Humanistic view is related to feelings and experience, including Maslow (1971) humanist approach cited in Wickliffe (2004), McKenna (1995c), Nicklin and Kenworthey (1995), Quinn (1995) and many more. The aim is to assist self-actualisation fulfilling maximum potential, this links closely to Knowles (1978) and Rogers (1983) works frequently cited within the literature (Burnard 1987, Mckenna 1995(c), Nicklin and Kenworthey 1995, Welsh and Swann 2000). I believe student centred approaches allow students to take active involvement in their learning enabling them to take ownership for it (Allan and Jolley 1987).

Kauffman (2003) sees Knowles (1978) theory of andrology as a useful tool rather than a theory. Knowles acknowledges adult learners having vast ranges of experience, which they use as a basis for new learning, learning occurring through efforts made by the individual. Student and teachers need to treat each other as equals to allow student centred learning students taking responsibility and ownership of it (Bennett 2002, Hutchinson 2003 and Mckenna 1995(c). I agree that a partnership based on cooperation and interaction brings about mutual learning due to openness and trust (Atkins and Murphy 1995). I also agree with Ewan and White (1996) that it is important to know the students individual characteristics and needs being aware of the students' current knowledge, competence and stage of training (Wickliffe 2004).

A learning contract is a valuable tool (Calhoun et al 2000), utilizing optimum learning. It is a formal written agreement between the student and mentor specifying what needs to be done to achieve the students learning outcomes. Regular formative discussion enables skills and us to get to know each other allowing me to establish the student's stage of training, previous experience. Regular discussions are necessary as part of the learning process (Cahill 1996) as through discussion we can identify strengths, weaknesses and any problems encountered by the student, measuring the level of competence revising our initial plan to achieve the rest of the student's outcomes which utilises the student centred approach.

Action Plan

I need to hold frequent discussions with Sandra to monitoring her progress effectively promoting active involvement and ownership. I am aware that an effective mentor/student relationship enhances the level of learning accomplished to make this possible we need to have significant contact involving us to arrange our off-duty to make sure we frequently work together.

Learning Outcomes

2. Develop self-awareness in order to be a role model.

__________

Self-assessment of current practice and identifications of learning need(s) in relation to this outcome.

• Acknowledge that self-awareness is important.

I am knowledgeable.

• It is my professional responsibility to provide best care.

• It is my responsibility to be good role model.

My Learning Needs

• Gain greater awareness of how others view me.

• Further reading.

• Become self aware through reflection.

Learning Outcome 2. Develop self-awareness in order to be a role model.

_____________

Example of Evidence

Recognize the impact of own professional behaviour and actions on students learning.

_____________

Summary of Evidence summative assessment of what you have achieved during the module

Cross-reference as appropriate.

• Understand others views gaining insight of how I'm seen.

• Now familiar with the terms self-awareness and role model.

• Critically reflected, becoming increasingly self aware of my actions.

Description

As an E grade, I have a responsibility for junior colleagues and student nurses and am involved in their learning and teaching. I am competent and skilled trying to act in a professional manner at all times. Feedback from my colleagues and students shows I'm respected and liked but at times of stress, I can come across as harsh and abrupt not tolerating fools gladly.

Feelings

I am proud of my achievements and think I am a good role model but am aware that I can be abrupt on occasions. .

Analysis

The former U.K.C.C (2000) standards for preparation of teachers of nursing and midwifery state clearly that as nurse I must be a good role model enabling me to build effective relationships with patients and clients and contributing to an environment in which effective practice is maintained ensuring safe and effective care through assessment and management.

Nursing relies on clinical staff to support and teach rationale being the student learns from an expert in a safe, supportive and educationally adjusted environment (Andrews and Wallis 1999). As a senior nurse students' and junior colleagues see me as a role model. Students see a good mentor as someone who teachers, guides and assesses having a genuine interest in student learning (Andrews and Chilton 2000, Gray and Smith 2000, Neary 2000). Good role models are knowledgeable and skilful professionals who are respected and trusted. Taylor (1997) suggests novices copy or imitate professionals modelling themselves on nurses with varying standards of practice, observation being an important part of their learning.

Spouse (2001) small longitudinal study utilised various data collection methods that found evidence of students observing and relating to actions and behaviours they believed as good. My actions evidenced by tone of voice, comments made and enthusiasm and interest shown have an impact on learning, inappropriate behaviour is noticed and at worst copied because the learner see it as acceptable to do so. Findings of this study would be more valid and a claim made stronger if repeated on a grander scale literature supports these findings.

Bandura's (1977) theory of social learning and vicarious conditioning (cited by Mckenna 1995) involves this observation of behaviours and consequences of this to the learner this theory differs from others, as learning is instant therefore role modelling can be highly effective and positive or destructive.

Self-awareness is being aware of what is taking place in oneself learning experience and self-concept changing over time as we see ourselves in many different roles influenced by others and the media (Quinn 1995).

Reflection of events and actions increases self-awareness giving insight of behaviour and response enabling us to examine relationships with others in the practical and social setting. Haddock and Bassett (1997) suggest that use this in self-management and improvement. To be a self-aware practitioners' we need to reflect on the way we come across to others implementing required changes (Stuart 2003). Self is as all thoughts, feelings and experiences of an individual, arising from biological and environmental influence. It is the way individuals see and feel about themselves (Quinn 1995).

" The major resource that a helper brings to the relationship is himself, the more complete his understanding of himself, the greater his capacity for self awareness and more effective he will be as a counsellor" Nicklin and Kenworthey pg 120.

Self-awareness also implies to individuals being aware of their limits of knowledge and ability reflected by the individual partaking in further training or seeking help from experienced colleagues.

Quinn (1995) and Burnard (1990) refer to two main ways we can be self aware, introspection and feedback from others. Introspection is looking within oneself and attempts to recognize own feelings and reactions, this is not easy and can cause feelings of discomfort and fright but allows identification of our emotions good and bad assessing their impact. Palmer (2001) states a highly developed sense of self worth comes about within a person who can identify his/her emotions, learning to manage and contain them when inappropriate. Being self-aware give insight of what we can change. Feedback is a way of seeing how others see us, ability to give and receive constructive feedback is a skill; being told how you are perceived is hard but thought provoking.

Crewe (2004) relates to research of the Duval and Auckland theory (1972), based on two distinct forms of conscious attention, attention focusing outwards towards the environment or inward towards oneself. The person receives and perceives feedback from the environment regarding their behaviours and attitudes. Perception of approval from others can increase confidence and self-esteem while perception of disdain or negative evaluation can have the opposite effect. Objective self-awareness is an individual being aware of the personal characteristics that distinguish them from the majority; the focus is exclusively on the self.

Conclusion/ Action Plan

I was not fully aware of my impact on others. It is critical for me to be conscious of my level of patience taking great care not to react negatively in times of stress, or when students' or colleague fail to progress (Borgess and Smith 2004) as this can cause great harm to the learner.

Learning Outcomes

3/6/7 Develop, maintain, and evaluate an environment for learning in your area of practice.

Self-assessment of current practice and identification of learning need(s) in relation to this outcome.

Current Practice

• Have interest and commitment in teaching.

• I'm friendly and approachable supporting students in their learning.

• Orientate students to environment.

• Participate in assessment with formative feedback.

My Needs

• Increase awareness of what contributes to a good and bad learning environment.

• Be involved in educational placement audit.

Learning Outcome 3/6/7. Develop, maintain and evaluate an environment for learning in your area of practice.

Examples of Evidence

• Produces evidence of placement learning opportunities/resources suitable for meeting needs of specific students.

• Give examples of how you create and sustain an environment for learning.

Summary of Evidence for summative assessment of what you have achieved during the module.

Cross-reference as appropriate.

• Greater awareness of what contributes to a good learning environment.

• I try to maintain adequate supervision and liaise with colleagues regarding my student's progress.

• Attend courses and study days for my personal development.

• Students always have a designated Mentor.

• There is a ward philosophy of care.

• Students have access to the internet, journals, pt notes and policies/procedures.

• Students attend spokes placements attached to the ward area, and have opportunities to spend time in theatre watching relevant procedures.

Description

Patients are admitted onto my ward from electoral and urgency lists or via A+E for vascular assessment, procedures or surgery. Wound care and management is a large part of our role as well as patient education and discharge planning.

Feelings

I feel this ward environment offers a lot of learning opportunities to students and new staff but has high patient demands, reduced staffing and skill mix due to high levels of sickness effecting team spirit and morale, which has a huge impact on our ability to teach, directly affecting the learning of students and junior colleagues.

Analysis

Finding a description of a clinical learning environment is not easy due to a complexity of numerous factors involved. Quinn (1995) uses holistic description, a broad definition referring to all factors influencing quality and effectiveness of a learning environment, Chan (2001) description is similar relating to the learning environment as a multidimensional entity with interactive networks of forces that can affect the learners learning outcomes.

Literature cites numerous studies concerning social support for students and nursing staff. These studies include Fretwell (1982) and (1985), Lewin and Leach (1982), Ogier (1982) and Orton (1981) conclusively identify quality relationships between trained staff and students and support being crucial in creating a positive learning environment (Cahill 1996, Chan 2001, Saarikoski and Leino-Kilpi 2002). All studies conclude that an important determinant of an effective learning environment is the managers organisational and leadership style. Highly structured wards with rigid task allocation and hierarchical systems unlikely to meet the learning needs of students and staff (Chan 2001). It identified throughout the studies that team spirit, humanistic approach to students learning and teaching and learning support are influential factors of an effective ward setting. The frequent references to these studies show that their findings are seen as valid even though all were small sized.

I believe team spirit comes from working as a team, best achieved through encouragement of the ward manager (Welsh and Swann 2002) giving a sense of group pride and self-esteem for all staff. We need to make students feel part of this team so that they feel accepted having a sense of belonging (Chan 2001, Quinn 1995 and Spencer 2003).

"A team approach with an appropriate leadership style on the part of the manager creates fertile ground for the development of an appropriate learning climate." (Welsh and Swann 2002 pg 117)

Studies carried out post Project 2000 explored more in depth themes and perceptive related to the clinical learning environment and clinical supervision (Wilson and Barnett et al 1995) the meaning of nursing care and the teaching activities of nurses' explored also. Saarikowski and Leino-Kilpi (2002) felt these studies demonstrated transition of individualised supervision and the role of the mentor. I agree with Lambert and Glacken (2004) that ward managers are no longer able to dedicate time to teaching due to managerial demands, therefore nurses now have this overall responsibility for teaching.

Mentorship is favoured in facilitating learning (Chow and Suen 2001). Watson (2000) acknowledges that mentors need education and training to function effectively in this demanding role with preparation mentors are able to create opportunities for students identifying experiences that meet individual learning needs.

Studies by Cahill (1996), Darling (1984), Earnshaw (1995), Hart and Rotem (1994) (cited by Chan 2001) and Spouse (2001) are again small sized but all use similar methods of valid and reliable data collection. The common theme throughout these studies is personal characteristics of the mentor, which include approachability, interpersonal skills, interest learning and teaching and supervision and support. These studies relate to students perspectives of the learning environment and mentorship, most of the findings viewing mentorship in a positive light and find it beneficial in reducing the theory practice gap for students. Staff attitudes and behaviour, the need of the student to belong and level of mentor contact highlighted throughout. Mentors need to make time for the student so that they can practice, develop and learn to be a nurse (Spouse 2002).

Phillips et al study (1994) was of a larger scale, carried out throughout Wales commissioned by the D.O.H., a two-year research project concerned with the implications and impact of mentorship. This had qualitative and quantitative methodology information gathered through questionnaires, diary accounts, interviews and observation again the key elements of mentorship surrounded mentor/student relationships. Evidence of teaching, organisation of experiences consolidated with feedback and discussion that aided and enhanced the students' experience.

Significant mentor contact seen to directly affect activities students' are involved in, this contact essential for building rapport needed in a good working relationship. Mentor presence provides emotional support to students' allowing gentle introduction into the different and a difficult experience that exist and is crucial to students well being and learning potential, reducing anxiety (Jowett et al 1992). Feeling useful and part of a team are other important aspects. Chan (2001) and Welsh and Swann (2002) relate to this but feel that the students' role needs to be understood acknowledged and clarified to prevent them being used as a "pair of hands".

Studies that concern nurses' perspective of the learning environment and mentorship (Andrews 1993, Atkins and Williams 1995 and Rogers and Lawton 1995) highlight barriers of effective mentorship due to lack of time, inadequate planning and role conflict. Lambert and Glacken (2004) also view inadequate staffing, poor skill mix, lack of support and training of staff and poor management structure as barriers that reduce learning potential.

Phillips et al study (1994) reflects the findings of Jowett et al (1992) which I agree that in clinical area where demands for care are high and resources stretched it is difficult to give adequate support and supervision to the junior student. When I am in charge of the ward, I am less involved in direct care of patients and have difficulty working closely with the student.

Action Plan

I need to liaise with my colleagues closely to make them aware of my students learning needs so that constant supervision and constructive support and feedback is ongoing when I am not available or am engaged in ward coordination. This will enable my student to be increasingly involved in the nursing team learning skills appropriate to their training preventing them feeling neglected, used or ignored.

________________

Learning Outcomes

4. Create and develop opportunities for students to learn, utilising

evidence-based practice.

_________________

Self-assessment of current practice and identification of learning need(s) in

relation to this outcome.

Current Practice.

• Awareness of constant changes within nursing and medicine that initiates change.

• I am familiar of protocols, standards and procedures regarding nursing intervention based on evidence-based practice.

• I back up my teaching with evidence based on experience or acknowledged research.

• Attend attending Pain Nurse Link meetings and wound care sessions providing me with current evidence for practice.

Needs.

• To develop skills of critical analyse, systematic review and evaluation of research.

• Review literature increasing my awareness of this topic.

Learning Outcomes 4. Create and develop opportunities for students learning of

utilising evidence-based practice.

_____________

Examples of Evidence

• Produce evidence of the ability to meet own learning needs in relation to the

facilitation of learning.

• Give Examples of how you have identified and facilitated individuals or groups to

learn.

_____________

• Reviewed and critically analysed the literature.

• I am increasingly aware of the importance of evidence-based practice.

Description

I have gained a great deal of experience throughout my career, which I use within my clinical practice and teaching. My knowledge has developed through practice, study sessions relevant to my area, advice of specialist nurses, reading journals and following clinical guidelines, standards and protocols that I encourage students to read. Students invited to attend relevant wound care updates and to spend time with many of our specialist nurses.

Feelings

I already base most of my practice on evidence but need to participate in literature reviews and develop skills to analyse and scrutinise research findings.

Analysis

I believe evidence-based nursing is a process in which nurses' base clinical decisions using the best available evidence (The University of Minnesota 2005). The Editorial (1997) defines evidence-based practice as giving quantitative and qualitative meaning to a cause, course, diagnosis, treatment and economics of health problems managed by us nurses including quality assurance and continuing professional development which maintains and enhancing knowledge, expertise and competence to give best care (cited by Hincliffe 2002 pg 11). Curzio (1997) views it as the bridge between theory and practice agreed by White (1997) agrees with this suggesting it links personal intuition research and practice providing nurses with greater knowledge to base their care, our clinical decision-making and teaching must be based on evidence, expertise and highly importantly patients' preference as referred to by Hincliffe (2002).

The aims of evidence-based practice/nursing ensuring patients receive up to date care based on up to date knowledge. As we develop skill inquiry, we become more knowledgeable in our profession that improves standards of care (Hincliffe 2002). I agree with Welsh and Swann (2002) that there is a need for well-informed nurses using initiative, effective communication and clinical reasoning skills so that informed decisions are made through critical analysis of evidence available especially due to the constant changes within the NHS.

The government introduced a framework of clinical governance in an attempt to achieve national clinical effectiveness within the NHS to guarantee quality services for patients and clients a key component being evidence-based practice. Behi (2000) states clinical governance requires every professional to use evidence-based practice. The New NHS: Modern, Dependable (D.O.H 1997), The Drive for Clinical Effectiveness (D.O.H 1996) and A First Class Service: Quality in the NHS (D.O.H 1998) shows quality improvements at the forefront of the NHS agenda. The NHS National Service Knowledge and Skills Framework (Hincliffe 2002 McSherry and Haddock 1999 and Welsh and Swann 2002) development tool promoting effectiveness through quality, staff and service development linking current and future research activity.

The National Institute for Clinical Excellence (N.I.C.E) is responsible for assessment of technologies and for producing guidelines and the Commission for Health Improvement (C.H.I.M.P) monitors quality of services at a local level and ensure organisations are fulfilling their responsibility for clinical governance Health Care Organisations accountable for quality of services they provide, Chief Executives carry ultimate responsibility. The government also provides funding essential for research activity.

Spector (2004) refers to evidence-based practice as being rigorous and time-consuming involving selection of all research done in an area, analysis and synthesis developing integrative reviews termed within the literature as a systematic or meta-analysis reviews (Renfrew 1997, University of Minnesota 2005). Completed reviews are available to taking some of the pressure of us; the Cochrane database has a wide range of these. Behi (2000) and Mcsherry and Haddock (1999) relate to clinical practice standards and guidelines produced by the N.M.C, R.C.N and local Health Authorities systematic review, recommendations and policy statements based on best evidence agreed by experts. There are also systematic reviews published in research journals and by the National Clearing House.

Clinical appraisal is crucial in ensuring practice is evidenced based involving asking a clinical question related to practice and finding the research and literature to answer it, appraising evidence and deciding on its relevance and validity before applying findings to practice and evaluating effectiveness (Behi 2000 and McSherry and Haddock 1999). Castledeine (2003) refers to this as a three-stage process producing the evidence/research, making it understandable and available and using the evidence to enhance practice. Rigorous evidence provided by well-designed studies with grounded methodological positioning (RCN 2005).

A thorough literature search can be conducted by utilising library facilities and internet services research and literature needed (Muhitial and le May 2001, RCN 2005), we need to review and critically analyse this evidence to develop a systematic review. This involves questioning stages of the research process, aims and methodology, data collection and statistics, McSherry and Haddock (1999) and Renfrew (1997) believe this avoids bias and incompleteness as evidence of rigorous methods used provides reliability and validity to the review, providing confidence to ourselves and to those we share it with that literature examined was complete and unbiased.

Unbiased systematic reviews increase power and effectiveness of data showing consistency across all studies measured. The overall picture being generalised reduced by synthesis/analysis to a meaningful form presented so that others understand and can interpret. Meta-analysis is a quantitative synthesis or analysis of data translation, used to produce an overall summary that results in guidelines standards and protocols of best practice (Renfrew 1997 and Spector 2004).

Armed this evidence and recommendations it is important for us to implement it into our practice as suggested by McSherry and Haddock (1999) constantly evaluating quality, standards and effectiveness of our care and practice. The RCN (2005) highlight the importance of using evidence as basis for changing established practice and improving nursing care.

Barriers do exist due to attitudes, support of experienced staff and due to lack of skill in reading and interpreting research. Nurses need adequate training to develop skills of assessment, analysis of research, decision making and reflection. I believe in Castledeine's (2003) view training strengthens our skills of critical appraisal. Other barriers exist due to poor motivation, accessibility of research, anticipated outcomes and time restraints. It is crucial that managers' colleagues and multidisciplinary team members support this process, the organisation as a whole providing time for us to use and conduct research.

Action Plan

I need to increase my skill of critical analysis to be able to be increasingly involved in implementing evidence-based practice and change. To be able to do this I need to attend further training helping in my continuous development .I also need to spend time doing thorough literature searches and reviews based on relevant practice in my specialist area.

Learning Outcomes

5. Utilising approved assessment procedures, assess the practical ability of at least one student.

Self-assessment of current practice and identification of learning need(s) in relation to this outcome.

Current Practice

• Utilise variety of assessment methods.

• Provide constructive feedback.

• Discuss student's progress with colleagues.

• I am involved in formative and summative assessment.

My Needs

• Critically analyse and evaluate my current practice.

Learning Outcome 5. Utilising approved assessment procedures, assess the

practical ability of at least one student.

Examples of Evidence to be produced by end of module and documented

• Demonstrates knowledge and understanding of the assessment of practical

competence.

• Implements approved assessment procedures.

Summary of evidence for summative assessment of what you have achieved during

the module.

Cross-reference as appropriate.

• Increased awareness of effective, reliable and valid assessment.

• Critically analysed, reflected and self assessed my own practice.

• Gained feedback from students and colleagues regarding my teaching evaluating my practice.

Description

I have been involved in the teaching of two students' assessment. I have made time for frequent discussion, feedback and evaluation of progress actively involving them in their learning and planning of achieving set/negotiated outcomes. I utilise variety of methods in their assessment such as demonstration, explanation, questioning and direct observation.

Feelings

I am able to establish good relationships with my students reducing their initial anxieties and increasing their motivation by using a student centred approach to their learning.

Analysis

Definitions of assessment within the literature are of a similar nature Nicklin, Kenworthey (1995) define it as a measurement relating to the quality and quantity of learning, concerned with student progress and attainment Hincliffe (2002) refers to it as being a collection of data on which we base evaluation. . I agree with Eble's (1979) definition that assessment intends to ensure competence and maintenance of professional standards (cited by Harding and Grieg 1994 pg 118).

The main aim of the nursing curriculum is ensuring students are prepared to practice safely and effectively for public safety and protection. The public have a fundamental right to expect competence from qualified nurses and protection against unsafe practice, therefore assessment is concerned with the control of students' entering the Nursing and Midwifery Council register (Nicklin and Kenworthey 1995, Neary 2000(a) and 2000(c), U.K.C.C 1999, Welsh and Swann 2002). As Harding and Grieg (1994) states, we are professionally accountable for standards of care and safety of our patients and clients taking precedence over our accountability of the student. Student need to show evidence of competence at nursing skills and procedures before practicing alone, ensuring patients' safety is not compromised (U.K.C.C 1999).

Girot (1993) refers to competence as with the students ability to coordinate cognitive (knowledge and intelligence), affective (feelings and attitudes constituting to caring function) and psychomotor skills (motor skills relevant to nursing practice) in carrying out nursing activities. All three elements need addressing in assessment to enable the student to perform to a professional standard practicing safely and effectively without direct supervision (Glasgow university 2004, Hincliffe 2002 U.K.C.C 1999).

The current nursing curriculum uses continuous assessment defined by Nicklin and Kenworthey (1995) as a series of ongoing intermittent assessments monitoring the student's progress throughout their course. All these individual assessments help to build the total valid and reliable picture of the student's ability and performance. Therefore, it is crucial that these are accurate and reliable assessments of the students' achievements (Hincliffe 2002, Nicklin and Kenworthey 1995, Welsh and Swann 2002).

Two main assessment models identified are within the literature of nursing. Benners' from Novice to Expert (1984) adapted from the Dreyfus and Dreyfus Model of Skill Acquisition (1981) relates to students as novices at the start of their training with no previous knowledge and experience. With experience, the student develops and progresses through five stages until viewed as an expert who is a highly skilled practitioner with an intuitive grasp of situations (Nicklin and Kenworthey 1995, Quinn 1995, Welsh and Swann 2002). The Steinaker and Bell Experimental Taxonomy (1979) refers to the new learner being exposed or introduced to an experience which leads on to participation, identification, internalisation and finally dissemination which means the student has the knowledge, skills and ability to be able to teach others (cited by Nicklin and Kenworthey 1995 and Quinn 1995).

Literature frequently refers to assessment documentation as being confusing (Duffy and Watson 2001, May et al 1997, White et al 1994). To prevent such confusion both the student and I need to familiarise with the assessment documentation and required outcomes and competencies, as indicated by Welsh and Swann (2002), U.K.C.C (1999) and within the University of Manchester Student Placement Assessment guidelines. Wilkinson (1999) believes if assessment criterion is followed mentor expectations will become more realistic helping in the mutual planning of how the student can address his/her learning needs.

The ENB (1997) standard 14 states that the assessor must spend a minimum period of two days per week working with the student to be able to directly observe support and assess them effectively. I must make time early in the student's placement for discussion as advocated by ENB (1997) Nicklin and Kenworthey (1995) and Glasgow University (2004) enabling me to establish their level of learning and to listen to my student to be able to develop a mutually agreed learning plan. Phillip et al (1994) refer to this mutual process as an andrological approach to student learning and assessment.

Frequent discussion and evaluation of progress is needed the ultimate aim of evaluation being decision-making identify what needs changing in our plan leading back to the assessment of learning needs. Hincliffe (2002) refers to evaluation as part of a continuous cycle applied to teaching like the nursing process - assessment, planning, implementation and evaluation.

Constructive discussion helps to reduce the students' anxiety, increases learning satisfaction and student motivation self-assessment and reflection being encouraged (Girot 1993, Welsh and Swann 2002, Wilkinson 1999). I agree with Welsh and Swann (2002) that we should not miss any opportunities to discuss the student's progress giving constructive feedback and encouraging the student in self-assessment and reflection of experience. Nicklin and Kenworthey (1995) advocate the student being actively encouraged in evaluating their progress and performance done through verbal and written reflective accounts, the student critically evaluating their strengths and weaknesses we need to help focussing them on their positive elements of practice so that they do not dwell on negatives.

Mentors need time to observe students undertaking new skills (Hincliffe 2002). The student's initial reaction initiated by activities determines their attention, understanding of purpose and willingness to participate. Nicklin and Kenworthey (1995) suggest that by examining the students practice, we are able to assess their ability, discussion and questioning validates their level of knowledge and understanding taking into account the cognitive, affective and psychomotor domains. It is through observation that were able to identify skills the student is best at and those that need further preparation and practice (Welsh and Swann 2002, Wilkinson 1999). Feedback and viewpoints from colleagues is valuable in identifying the student's strengths and weaknesses giving the assessment a level of consistency two or more people involved in the supervision of the student coming to the same conclusions, the overall assessment being valid and reliable. The Manchester University Student Assessment document states that its' expected that other registered nurses working with the student contribute to their assessment. Feedback on student progress can also come from listening to the views of patients, other professionals and peers. This may be subjective and there is a great reliance on the skills of the mentor to decipher the relevance and importance of this information

The final discussion involves consolidation and evaluation based on all assessment evidence, the mentor making final judgements and decisions regarding the student's achievement of required competence and fitness of practice (Glasgow University 2004, Nicklin and Kenworthey 1995, Welsh and Swann 2002 U.K.C.C 1999). The literature states the importance of early identification of problems and a failing student. It is essential to discuss any problems early with the student to be able to take action promptly as recommended by Hincliffe (2002) and Wilkinson (1999). The link or personal tutor needs to be involved if there are any concerns regarding patient safety to allow for additional support and teaching, all of this needs carefully documenting. We also need to monitor the student more closely through further discussion, feedback and evaluation to establish if the problems have resolved (ENB 1997, Glasgow University 2004, Welsh and Swann 2002).

It is difficult to fail a student, but if there is earlier evidence documented indicating failure, the final decision will not surprise the student, as they are aware of the concerns (Welsh and Swann 2002). It is vital that the student, mentor, colleagues who have worked with the student and the link/personal tutor all contribute in this final decision so that it is fair and well balanced. Welsh and Swann (2002) state that well documented records are essential in supporting this decision to fail, if the student wishes to appeal these records are used.

Neary refers to two studies (2000a) and (2000b) whose aims were to establish student and nurses' perspective regarding assessment of clinical competence in practice. Both studies used a qualitative and quantitative approach utilising a wide range of data collection methods with a significant number of participants within three Colleges of Nursing.

The main findings of these studies were that students and mentors favoured continuous assessment, students appreciated constructive feedback but felt there needed to be more time spent for this activity and that team approach in assessment advocated by both students and mentors. A set criterion of assessment seen as a good thing but students felt it needed to be flexible, not dependent on preset objectives that were restrictive. To be able to cope with this difficulty students and mentors often set their own negotiated outcomes for learning and competence. The main problem identified was that assessment was sometimes dependent on the relationships the student had with their mentor and ward staff provoking a high level of anxiety.

Action Plan

To continue to be effective in my assessment of students' I need to attend regular assessment updates and to continue to utilise all of the assessment methods required being able to make informed decisions and judgements of student competence. I also need to be more thorough in my documentation regarding student feedback and evaluation of progress in case it was needed in an appeals procedure.

Conclusion

I have found this course valuable and I have learnt a great deal especially when working to produce this portfolio of evidence. I feel equipped with knowledge, skills, and ability to mentor students', junior colleagues effectively as recommended by the ENB (1997) and NMC (2004) Standards for Preparation of Teachers, Nurses Midwives and Specialist Community and Public Health Nurses. I have become more self aware, reflective and critical of my practice and consider my self as a good experienced and knowledgeable role model (Haddock and Bassett 1997, Stuart 2003, Quinn 1995).

I have found this assignment difficult to do mainly due to the fact I have not done any academic courses over the past five years and have not the experience of writing at this higher level. I also had a lot of work and personal pressures that meant I struggled to find time do attack this portfolio running short of time to meet the submission date. My main problem though was that I ended up with too much literature and had to go through a very time consuming process of finding out what was relevant.

I intend to do a degree pathway in the very near future and it's hoped that I will develop skill and abilities required for this academic level.