Part C: Clinical Education Objectives and ANMC Domain Booklet

Transcription

1 HCNUR 1141 Clinical Practice in Australia Clinical Practice Documentation Part C: Clinical Education Objectives and ANMC Domain Booklet RETURN TO PRACTICE/RE-ENTRY PROGRAM FOR DIVISION 1 REGISTERED NURSES (RTP/RPRN) and INITIAL REGISTRATION FOR OVERSEAS NURSES/PRE- REGISTRATION PROGRAM FOR OVERSEAS QUALIFIED NURSES (IRON/PPOQN) 1 (Non Award Program) ACCREDITED UNIVERSITY FOR DELIVERY School of Nursing University of Ballarat University Drive Mt Helen Vic August 2010 CRICOS CODE: F/069548E/071353J 1 These Programs may be identified by the NBV as Return to Practice & Initial Registration for Overseas Nurses

2 Students please note: This Clinical Education Objectives and ANMC Domain Booklet (Booklet) is to be read in conjunction with other documents relating to HCNUR 1141 Clinical Practice in Australia: Part A: Course Descriptor Part B: Student Information and Guidelines Governing Clinical Education At the end of this Course, the completed Clinical Education Objectives and ANMC Domain Booklet is to be photocopied. Both the original and photocopy submitted to the Course Coordinator, as directed or no later than 0900 on the last day of the Program. The original Clinical Education Objectives and ANMC Domain Booklet will be returned to the student, for use in their Curriculum Vitae when applying for employment. It is the responsibility of the student to safely maintain the Clinical Education Objectives and ANMC Domain Booklet both during the clinical placement, and when completed. Copies of Booklets (including the Appraisals) from the Partner Provider/University records will not be released to students. ii

3 TABLE OF CONTENTS 1. Introduction and Overview of Assessment and Evaluation Methods Introduction Assessing Clinical Competence ANMC Competencies Bondy Rating Scale Example of application of the Bondy Rating Scale (elements and ratings) Minimum Competency Rating Tools used to assist achievement of competency Personal Professional Reflective Journal (PPRJ) Development of Teaching and Learning Objectives Record of Clinical Educator / Preceptor / Division 1 Nurse who has supervised the student on clinical placement Guidelines for Facilitators/Preceptors/Clinical Educators in Health Care Agencies 8 2. Overview of Monitoring Student Progress, Assessment Procedures 9 and associated information. 2.1 Brief Overview Detailed Overview Confidentiality Agreement Specific Clinical Placement Learning Objectives Teaching and Learning Plan Psychomotor Psychosocial Skills/Interventions Clinical Feedback Summary Weekly Clinical Feedback summary Process if US (Unsatisfactory) rating is achieved Weekly Clinical Feedback Guidelines Clinical At Risk Report At Risk due to deficit in clinical skills/provision of care At Risk due to unprofessional conduct Teaching Assistance Request Clinical Appraisal Tools (Midway and Completion) Midway Clinical Appraisal Final/Completion Clinical Appraisal Anecdotal Notes Reflection/Evaluation of Clinical Experience Summary of the Process of Monitoring Student Progress. 17 iii

4 3. Clinical Placement Documentation Summary (Flowchart) of 19 monitoring student Progress Weekly, Midway and Completion Weekly Clinical Feedback Summary Guidelines ANMC Competency Domains Minimum Competency Rating for University of Ballarat Programs leading to NBV Division 1 Nurse in Victoria Example of application of the Bondy Rating Scale Clinical Placement Documentation Confidentiality Agreement Clinical Placement Overview Aim Specific Objectives Part A: Psychomotor and Psychosocial Knowledge/Skills/ 43 Interventions Outcome Objective Frequent specific Knowledge/Skills/Interventions 44 Part B: Psychomotor and Psychosocial Knowledge/Skills 48 Interventions.. Week 1-4 Documentation and Assessment Tools Teaching and Learning Plan Clinical Feedback Summaries Clinical Appraisal Tool: Midway Assessment Week 5-8 Documentation and Assessment Tools Teaching and Learning Plan 52 - Clinical Feedback Summaries Clinical Appraisal Tool: Final/Completion Assessment Record of the Registered Nurse Division Reflection/Evaluation of Clinical Experience Additional documentation 57 Anecdotal Note.. 58 Clinical At Risk Report Teaching Assistance Request. 62 Figures 1 Summary Flowchart of Monitoring of Student Progress 11 2 Process and Outcomes for Midway Assessment and Completion of Assessment 12 Tables 1 ANMC Competency Domains 4 2 Adapted Bondy Rating Scale 4 3 Example of application of the Bondy Rating Scale 5 4 Minimum competency Rating for University of Ballarat Programs leading to NBV Division nurse in Victoria 6 5 Overview of location of documentation relating to monitoring of student progress 10 6 Clinical Feedback Summary Guidelines 21 7 Example of the Bondy Rating Scale 26 iv

5 SECTION 1 INTRODUCTION AND OVERVIEW OF ASSESSMENT AND EVALUATION METHODS

6 1.1 Introduction Central themes This final course provides concentrated clinical practice learning experiences that prepare for entry level practice in the role of Division 1 registered nurse. The course contributes to the integration of theoretical and clinical concepts and their application in a health care environment. Students are required to demonstrate competency as per the ANMC (2006) National Competency Standards for the Registered Nurse: Professional and Ethical Practice; Critical Thinking and Analysis; Provision and Coordination of Care; and Collaborative and Therapeutic Practices. A particular focus of this course is for students to focus on their role as a safe and competent beginning practitioner. Objectives Following completion of this course the student will be expected to: Knowledge 1. Describe the scope of practice for a graduate/entry level practitioner as a Division 1 Nurse in Australia; 2. Synthesise information accessed from a range of sources; and 3. Describe the care and management of clients/patients with a range of conditions in a variety of settings. Skills 4. Demonstrate overall competency as per ANMC (2006) National Competency Standards for the Registered Nurse: Professional and Ethical Practice; Critical Thinking and Analysis; Provision and Coordination of Care; and Collaborative and Therapeutic Practices. Specifically: 5. Practice safety in the selected clinical agency; 6. Practice within a culturally competent, legal and ethical framework; 7. Develop a nursing care plan for a clients for whom they are allocated to provide care; 8. Demonstrate the ability to professionally document care appropriate both client and context; 9. Provide competent, holistic nursing care, appropriate to their level of preparation to clients in the selected clinical agency; 10. Demonstrate appropriate assessment of clients in their care; 11. Apply a problem solving approach to the care of the clients; 12. Apply pathophysiological, psychosocial and nursing skills/nursing practice knowledge in their nursing practice at the level of their preparation; 13. Demonstrate a complete and accurate handover of clients condition and care to oncoming staff; 14. Practice and use effective and professional communication skills with clients, their families, colleagues and other health professionals; 15. Demonstrate integration of knowledge, skills and attitudes through appropriate professional behaviour; 16. Identify situations that are beyond the limit of their level of preparation and experience and seek appropriate assistance; 17. Evaluate their own learning needs and identify their strengths and weaknesses; Course Graduate Outcomes 2 Continuous learning - they will be equipped with the skills, motivation and confidence to engage in continuous learning to meet the personal, professional and vocational challenges of an ever changing world; Self-reliance - they will possess the confidence, capability, assurance, independence and enterprise to enable them to fulfill their personal and career aspirations; Engaged citizenship - they will add to the productive capacity of the economy and be in demand and will be attuned to, and engage with, contemporary social and cultural issues and aspire to make meaningful and helpful contributions to local, national and global communities; Social responsibility - they will be aware of generally accepted norms of ethical 2 1

7 18. Demonstrate effective time management skills, flexibility, accountability, team work and ability to prioritise care; and 19. Demonstrates critical thinking and reflective practice skills Values 20. Reflect on the professional characteristics and attributes required by students completing a course leading to a Division 1 professional nurse behaviour and be encouraged to act in a socially responsible manner both in the work place and other settings. Content Relates to knowledge skills and values required of a beginning practitioner and enabling the meeting of the ANMC (2006) National Competency Standards for the Registered Nurse: Professional and Ethical Practice; Critical Thinking and Analysis; Provision and Coordination of Care; and Collaborative and Therapeutic Practices. o o 256 hours (32 hours per week x 8 weeks) of clinical placement, of which 75-80% is undertaken in an acute care setting (acute medical care and acute surgical setting) % may be undertaken in a range of other practice areas that will meet ANMC (2006) National Standards Competency for the Registered Nurses and have NBV recognition; and A minimum of 240 hour practicum (re entry program) and 280 hour practicum (initial registration program) focused on meeting ANMC competencies and standards to an independent level and enable registration as a Division 1 Registered Nurse in selected clinical agency(s). Direct contribution to ANMC (2006) competence development 3 Professional Practice 1. Practises in accordance with legislation affecting nursing practice and healthcare (Clinical Learning Objectives: 1,4,5,6). 2. Practices within a professional and ethical nursing framework (Clinical Learning Objectives: 14,15,19, 20). Critical Thinking and Analysis 1. Practices within an evidence-based framework. (Clinical Learning Objectives: 1,12). 2. Participates in ongoing professional development of self and others (Clinical Learning Objectives: 16, 17, 19, 20). Provision and Coordination of Care 1. Conducts a comprehensive and systematic nursing assessment (Clinical Learning Objectives: 7, 8,10). 2. Plans nursing care in consultation with individuals/groups, significant others and the interdisciplinary health care team (Clinical Learning Objectives: 7, 18). 3. Provides comprehensive, safe and effective evidence-based nursing care to achieve identified individual/group health outcomes (Clinical Learning Objectives: 2, 3). 4. Evaluates progress towards expected individual/group health outcomes in consultation with individuals/groups, significant others and the interdisciplinary health care team (Clinical Learning Objectives: 11,12,19,20). Collaborative and Therapeutic Practice 1. Establishes, maintains and appropriately concludes therapeutic relationships (Clinical Learning Objective: 14). 2. Collaborates with the interdisciplinary health care team to provide comprehensive nursing Care (Clinical Learning Objectives: 13,14,18)

8 Teaching Methods Specific clinical practice objectives, reflective practice, critical analysis of practice, demonstration of competency as per ANMC (2006) National Competency Standards for the Registered Nurse, use of evidenced based practice, clinical guidelines and policies and clinical teacher 1:8 and preceptor 1:1. Learning tasks and assessment Learning Tasks 1 Demonstrate appropriate assessment, planning, implementation and evaluation of safe nursing practice to a proficient level 2 Demonstrate appropriate assessment, planning, implementation and evaluation of safe nursing practice to the level prescribed Key: * Assessment tasks Clinical assessment Pass/fail Minimum ANMC competency* standards rating: Proficient **in all ANMC Competency Domains Clinical assessment Pass/fail Minimum ANMC competency* standards rating: Independent ** for ANMC Professional Practice; and Proficient ** for all other ANMC Competency Domains Course objective(s) addressed by this assessment task (AT) Addresses all course objectives (1 20) Addresses all course objectives (1-20) Weighting % 100% Competence (competency) is defined by the ANMC (2006) National Competency Standards for the Registered Nurse as the combination of skills, knowledge attitudes, values and abilities that underpin effective and/or superior performance in a professional/occupational area 4 ** Bondy Rating Scale 5 : contributes to objectivity of clinical competence and encompasses the (i)professional standards and procedures for the behaviour, (ii)qualitative aspects of the performance, and (iii) the assistance needed to perform the behaviour. 4 NBV, EXE POL021 AX 001 Standards for Course Accreditation 15 March, 2009, p.20 5 Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

9 1.2 Assessing Clinical Competence The importance of objectively assessed clinical competence is paramount to the success of the student. The assessment tool used in this course is based on two separate mechanisms competencies, and a rating scale ANMC Competencies 6 The overall assessment tool used is the ANMC National Competency Standards for the Registered Nurse (2006). These Standards comprise four (4) core areas or domains of practice upon which each student is assess to obtain and retain registration, and provides the framework within which each nurse is expected to practice. Table 1: ANMC Competency Domains Number ANMC Competency Domains 1 Professional Practice 2 Critical Thinking and Analysis 3 Provision and Coordination of Care 4 Collaborative and Therapeutic Practice Source: Bondy Rating Scale 7 The second tool utilises the Bondy Rating Scale, a structured assessment tool for clinical practice. This tool outlines Five (5) levels of competence: independent, proficient, advanced beginner, beginner unsatisfactory; and Three (3) specific areas assessed for each level of competence: professional standards,quality of performance and assistance required. Further, the scales encompasses the following elements (i) Professional standards and procedures for the behaviour (ii) Qualitative aspects of the performance, and (iii) Assistance needed to perform the behaviour. Competency Rating Table 2: Adapted Bondy Rating Scale Overview of Bondy Elements: Note: Each level is assessed considering 3 areas*: Professional Standards (ii) Quality of Performance (iii) Assistance required 5 Independent Practices in a safe, accurate, co-ordinated and effective manner with little need for guiding cues 4 Proficient Practices in a safe, accurate, co-ordinated and effective manner with some need for guiding cues 3 Advanced Beginner Practices in a safe, accurate, co-ordinated manner most of the time with frequent cues required 2 Beginner Practices in a safe manner when continuous guiding cues are given 1 Unsatisfactory Unable to demonstrate safe practice, adequate knowledge base and/or professional behaviour X Not Applicable Not observed or not applicable Source: Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9), Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

10 1.2.3 Example of application of the Bondy 8 Rating Scale (elements and ratings) Five (5) levels of competence: independent, proficient, advanced beginner, beginner unsatisfactory; and Three (3) specific areas assessed for each level of competence: professional standards, quality of performance and assistance required. Table 3: Example of the Bondy Rating Scale 1. Professional Standards Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 Safe client, nurse & others Safe Safe Not always safe Unsafe Accurate Accurate Accurate Not always accurate Inaccurate - knowledge base - professional vocabulary - communication, (verbal, non-verbal and written) - approach to various situations - psychomotor skills Appropriate effect* Appropriate effect* Effect &/or affect Effect &/or affect Effect &/or affect Appropriate affect* Appropriate affect* Difficulties at times Difficulties at times Poor *The students effect = achievement of intended purpose *The students affect = manner in which the behaviour is performed / demeanour 2. Quality of Performance Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 - Exceptional coordination - Efficient & coordinated - Lacking efficiency and/or uncoordinated - Comprehension of - Comprehension of - Comprehension of knowledge evident knowledge beginning knowledge insufficient - Confident and relaxed - Confident - Anxious, appears confident - Time taken (proficient) - Time taken (acceptable) - Client Focused (always) - Client Focused (not on skill or task) (mostly) (can be distracted) 3. Assistance Required (Cues*) - Inefficient/ uncoordinated - Inefficient/ uncoordinated - Comprehension of - Comprehension of knowledge poor knowledge NIL - Not confident - Not confident - Time taken (slow) - Time taken (poor) - Time taken (unable to complete) - Focus more on the behaviour/self than client - Not client focused at all - No client focus Independent = 5 Proficient = 4 Advanced beginner = 3 Beginner = 2 Unsatisfactory = 1 - NO Cues required - Occasional supportive cues /an infrequent directive cue - Continuous directive cues are required Key: - Frequent directive cues are required in addition to supportive cues - Cues are so directive/continuous that the staff is now performing the task/skill CUES* Directive Cues refer to assistance/cues that give direction or correct the students performance / expression of knowledge. Directive cues can be verbal or physical. Supportive Cues - refer to cues that only reinforce or encourage a student s performance / expression of knowledge, but do not change or direct the performance. The LOWEST level of achievement in any of the three areas is the final score/rating. Accurately, confidently, with sound comprehension of knowledge (independent) but required one directive cue (proficient). Then the final score = Proficient 8 Bondy, K.N. (1983). Criterion-Referenced Definitions for Rating Scales in Clinical Evaluation Journal of Nursing Education, 22(9),

11 1.3 Minimum Competency Rating This interrelationship of ANMC Domains and Bondy Rating Scale is outlined in the following table and provides the minimum competency rating for this Program, which is the same required for final year students enrolled in the Bachelor of Nursing program, University of Ballarat. These minimum competency ratings enable consistency and quality between outcomes of Programs that lead to registration as a Division 1 Nurse in Victoria. ANMC (2006) DOMAINS* 1. Professional Practice 2. Critical Thinking & Analysis 3. Provision and Coordination of Care 4. Collaborative and Therapeutic Practice Table 4: Minimum Competency Rating for University of Ballarat Programs leading to NBV Division nurse in Victoria RPRN/POQN Bondy Rating Scale midway assessment (by end of week 4) RPRN/PPOQN final assessment (by end of week 8) BN** Yr 1 BN Y 2 BN Y 3 Semester 1 BN Y 3 Semester 2 Advanced Proficient Proficient Independent Beginner Beginner Advanced Beginner Proficient Proficient Beginner Advanced Beginner Proficient Proficient Beginner Advanced Beginner Proficient Proficient Key: * ANMC = Australian Nursing and Midwifery Council National Competency Standards for the Registered Nurse (2005) ** BN= Bachelor of Nursing RPRN/PPOQN midway and final assessment times and outcome to be achieved - Standard is equivalent to that of the Bachelor of Nursing (BN) for Year 3 Semester 1 and Semester Tools used to assist achievement of competency Personal Professional Reflective Journal (PPRJ) The PPRJ is a personal record maintained by the student and will not be viewed, or corrected, however feedback regarding thematic direction will be provided by the Preceptor/Clinical Educator/Course Coordinator. Maintaining a PPRJ enables the participant to Reflect on the experiences of the clinical placement; Critically analyse the experience; Develop teaching and learning plans to meet competencies; and Develop professionally, by considering how aspects/situations encountered may be managed differently in the future. Instructions: Continue using the Notebook commenced in HCNUR 1131 Contextual Nursing Practice in Australia each week of clinical practice to enable integration of theory and practice; Commence writing on the right page only; Leave the left page free for comments, based on ongoing reflection; Write responses to the following critical reflection and discussion topics and discuss responses with your Preceptor/Clinical Educator; With the support of the Preceptor/Clinical Educator, develop objectives and strategies for areas identified requiring further development; and Submit your Teaching and Learning Plan for the next week, to the Course Coordinator (each Friday in class). Critical reflection and discussion topics 6

12 1. Discuss the areas of professional practice where you think you are doing well and the areas you would like to improve (knowledge, skills and values/attitudes), with your Preceptor/Clinical Educator. 2. Critically reflect and review your practice in the clinical area and note areas for improvement, and develop appropriate objective and strategies to improve performance. 3. Critically reflect on interactions in the clinical setting and discuss how you approached/resolved any issue/s that may have occurred. 4. Summary question: If you were the Preceptor/Clinical Educator, how would you assess yourself, in relation to the four ANMC Domains this week? 1.5 Development of Teaching and Learning Objectives Concepts relating to writing objectives and strategies to ensure learning outcomes are discussed in HCNUR 1131 Contextual Nursing Practice in Australia. Objectives and relative strategies for the weekly HCNUR 1141 Clinical Practice in Australia Teaching and Learning Plan will be developed by the student, normally in consultation with the Preceptor/Clinical Teacher. The following Steps in developing the Teaching and Learning Plan are recommended. Students will work closely with the Preceptor/Clinical Educator, each step of the way. Step 1 Based on student reflections and outcome of weekly assessments, topic/areas to be improved are identified, and associated teaching, learning and resource needs; Step 2 Students specify the learning objectives they will need to achieve in order to meet the identified learning needs; Step 3 Participants will identify and outline the resources and strategies required to achieve the learning objectives; Step 4 Once steps one to three have been completed and agreed on by the student and Preceptor, evidence of accomplishment of objectives will need to be specified; Step 5 Criteria determining how evidence will be validated will need to be stated, including timelines for completion of objective(s); Step 6 The Teaching and Learning Plan is agreed to by the Preceptor and student, and subsequently signed and dated; Step 7 Implementation of the Teaching and Learning Plan; and Step 8 Evaluation of the Teaching and Learning Plan. Review and examination of supporting evidence is undertaken between the Preceptor and student. 7

13 1.6 Record of Clinical Educator/Preceptor/Division 1 Nurse who has supervised the student on clinical placement This Record of Supervision form is to be signed by the Clinical Educator, Preceptor, Division 1 Nurse who has supervised the student on any one day, throughout the clinical placement. 1.7 Guidelines for Facilitators/Preceptors/Clinical Educators in Health Care Agencies Guidance in the supervision and/or assessment of students in HCNUR 1141 can be obtained from the Course Coordinator of the Program, completion of Preceptorship Programs and health care agency Policies, Procedures and Guidelines. Clinical Educators/Preceptors should: View Part A: Course Descriptor (which contains references that may be useful) View Part B: Student Information and Guidelines Governing Clinical Education View Part C: Clinical Education Objectives and ANMC Domain Booklet; and further Access specific guidance regarding supervision and assessment of nursing students and associated professional responsibilities and accountability at the NBV website Specific documentation includes: ANMC Code of Ethics for Nurses in Australia; ( ANMC Code of Professional Conduct for Nurses in Australia; ( ANMC National Competency Standards for the Registered Nurse (2005) Guidelines: Delegation and Supervision for Registered Nurses and Midwives (2007); ( and Guidelines: Scope of Nursing and Midwifery Practice (2007); ( 8

14 SECTION 2 OVERVIEW OF: MONITORING STUDENT PROGRESS ASSESSMENT PROCEDURES AND ASSOCIATED INFORMATION 9

15 2. Overview of monitoring student progress, assessment procedures and associated information This area provides Information surrounding documentation required to commence clinical placement and monitoring of student progress, assessment procedures and associated information; Locations of associated documentation and additional copies are initially provided for quick reference; and Detail regarding each area identified. 2.1 Brief Overview Table 5: Overview of location of documentation relating to monitoring of student progress Area Location of associated Documentation Location of additional copies Summary (flowchart) of monitoring Section 2, 3 None Required student progress (Fig 1 and Fig 2) Confidentiality Agreement Section 4 Section 5 Specific Clinical Placement Learning Section 4 Section 5 Objectives Teaching and Learning Plan Section 4 Section 5 Psychomotor and Psychosocial Section 4 None required Skills/Interventions Weekly Clinical Feedback Summary Section 4 None Required (contains Performance Criteria) Weekly Clinical Feedback Summary Section 3 None Required Guidelines Students At Risk of not Section 4 Section 5 progressing/completing the course Teaching Assistance Section 4 Section 5 Clinical Appraisal tools Section 4 None Required Anecdotal Notes Section 4 Section 5 Record of staff supervising students Section 4 None Required Student Reflection/Evaluation of Clinical Experience Section 4 None Required 10

16 HCNUR 1141 CLINICAL PRACTICE IN AUSTRALIA Summary (Flowchart) of Monitoring Student Progress - WEEKLY Fig 1: Process and Outcomes of Normal Weekly Monitoring of Student Progress: Weeks 1 8 Develop and implement weekly objectives & strategies as per Teaching & Learning Plan ST/PR/CE Undertake Clinical Placement Demonstrate: Psychomotor & Psychosocial Knowledge/Skill/ Intervention Weekly Clinical Outcome= Satisfactory (S) Signed Confidentiality Document Feedback PR/CE/ST Continue process & refer to Overall & Specific Objectives ST (PR/CE) Outcome = Unsatisfactory (US) Key: PR = Preceptor CE = Clinical Educator CC = Course Coordinator ST=Student Normal progression in course Weeks 1-4 write an Anecdotal Note documenting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg. theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. Weeks 5-8 write Complete Clinical At Risk Document noting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg. theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. ST/PR/CE Note: If a student demonstrates unsafe practice or unprofessional conduct at any time, they must be immediately removed from the practice area, counselled and CC informed without delay. An at risk form must be completed as per requirements:, the matter must be described in relation to ANMC Competencies and specific examples provided. Students must not return to the clinical area until CC has met with the student, and full consideration given to progress in Course. CC will consult with UB Program Coordinator throughout this time. PR/CE/CC Outcome = Satisfactory (S) Outcome = Unsatisfactory (US) Complete Clinical at Risk Form & refer to CC immediately & at any time during 1-8 PR/CE CC will inform UB Program Co-ordinator PR/CE WEEKLY Monitoring 11

17 HCNUR 1141 CLINICALPRACTICE IN AUSTRALIA: Summary (Flowchart) of Monitoring Student Progress MIDWAY & COMPLETION Fig 2: Process and Outcomes for Midway Assessment and Completion of Assessment HCNUR 1141 Week 4 & By Week 8 Formal Assessment Complete: Midway Clinical Appraisal Tool (Week 4) & Final/Completion Clinical Appraisal Tool (by Week 8) PR/CE ANMC Competencies met at required level? YES ANMC Competencies met at required level? Continue Normal Weekly Monitoring (at Week 4) or Complete Course (by Week 8) PR/CE NO Course Coordinator may request a meeting with the student to discuss progress in Course PR/CE Key: PR = Preceptor CE = Clinical Teacher CC = Course Coordinator Normal progression in course Complete Clinical At Risk Document for achieving any rating less than required. Forwards documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary PR/CE MIDWAY AND COMPLETION MONITORING Continue Weekly Monitoring (Weeks 5-8) PR/CE If Final/Completion Assessment is US (by week 8) refer to UB Programs Manager for consideration of Academic Progress CC 12

18 2.2 Detailed Overview Confidentiality Agreement The Confidentiality Agreement is to be signed by the student, and the Course Coordinator or delegate prior to attending clinical placement. This Agreement is to be retained in this Booklet, as evidence of agreeing to the terms and conditions outlined, as relating to all clinical placements. Clinical Educators and Preceptors should check that the Agreement is signed, and that students are aware of their legal obligations. Students must take this Agreement with them to all clinical placements, along with all components of this Booklet, and any other documentation as directed Specific Clinical Placement Learning Objectives These clinical learning objectives provide the framework for clinical placement for all students. They are to be read in conjunction with the aims and objectives of HCNUR 1141 Clinical Practice in Australia and other Course Descriptors (aim, objectives and content) relating to the Program. Objectives are also to be related to the ANMC (2006) National Competency Standards for the Registered Nurse Teaching & Learning Plan Each student is expected to document their individual learning objectives and strategies to be implemented on the weekly Teaching and Learning Plan. This Plan may be utilised, in relation to weekly assessments or midway/final assessment, in the areas identified as unsatisfactory Psychomotor and Psychosocial Skills/Interventions Whilst undertaking clinical placement students will be expected to perform as many psychomotor skills listed within the Psychomotor and Psychosocial Skills/Interventions section as possible in an effort to meet objectives and consolidate their competence. Opportunities will be provided within the clinical environment to practice these skills and a final ANMC domain score will be allocated by the Preceptor/Clinical Educator, after discussion with the student. Although it is possible that not all skills are achieved, a considerable effort needs to be made to in the clinical environment to achieve a satisfactory level of clinical competence. Students may also undertake skills not covered in the specific objectives, or listed in the Psychomotor and Psychosocial Skills/Interventions. These skills/interventions can be documented in the area titled: Other Psychomotor and Psychosocial Skills/Interventions Clinical Feedback Summary Weekly Clinical Feedback Summary This Weekly Clinical Feedback Summary (contains performance criteria) form is used for monitoring student progress each week, enabling ongoing, documented, and formative assessment of Students, and provides an opportunity for supportive feedback from Clinical Educators, and Course Coordinators. The Weekly Feedback Summary Guidelines assist with determining the rating of Satisfactory (S) or Unsatisfactory (US) against each performance criteria outlined in the Weekly Clinical Feedback Summary. These Guidelines provide a sound foundation to base initial and ongoing assessment of students, and clear guidance to areas in need of improvement. If a particular criteria is not observed, this is indicated by N. 13

19 Process Clinical Educators will discuss progress with students and award either S (Satisfactory), US (Unsatisfactory) or N (Not Observed) to each performance criterion at the end of each week. Based on the outcome of the assessment, the Clinical Educator will provide guidance about the ways in which the student could improve upon their current practice for the coming weeks or demonstrate the practice awarded N. This guidance is to be written as objectives and strategies, on the Teaching and Learning Plan, and an Anecdotal Note written. Outcome It is envisaged that the majority of students will meet satisfactory performance (S) on most of the criteria listed for each weekly summary. The overall aim is for students to meet the required competence level at the formal midway and final/completion assessment. However if students have not been successful in achieving an S rating, the following process is to be followed Process if US (Unsatisfactory) rating is achieved Weeks 1-4 Students receiving an US rating for any performance criteria during Weeks 1-4 must have an Anecdotal Note completed indicating the specific ANMC Domain that relates to the criterion. Weeks 5-8 Students receiving an US rating during weeks 5-8 must have an At Risk form completed. In the event that a discrepancy arises, a discussion may take place that enables the student and Clinical Educator to reach an equitable outcome. However, the Clinical Educator will always make the final assessment based on the discussion, forming the final grade S or U/S to allocate to the student Weekly Clinical Feedback Guidelines The aim of these Guidelines is assist Clinical Educators and Preceptors to interpret the performance criteria outlined in the Weekly Clinical Feedback Summary document (outlined above). The statements listed in the Guidelines are intended as a guide only and should not be used in a prescriptive or encompassing manner. Each criterion is numbered and the information (dot points) may be used for interpretation, grading and to assist student feedback Clinical At Risk Report This form is to be used if a student is considered to be unsatisfactory (US): At the midway/completion assessment, or In any of the performance criterion during Weeks 4-8 Process If the rating of US is awarded: A Clinical at Risk Report is to be completed and specific example(s)/exemplars provided. These exemplars are to be directly related to the Performance Criteria outlined in the Weekly Clinical Summary Guidelines and the specific ANMC domains. The Clinical at Risk Report is to be signed by both the Preceptor/Clinical Educator, and the student and forwarded (faxed) to the Course Coordinator; and 14

20 The Clinical Educator must immediately inform the Course Coordinator by telephone regarding the matter identified at risk At Risk due a deficit in clinical skills/provision of care The Clinical at Risk Report enables the Clinical Educator to expand upon those areas where the student is deemed unsatisfactory and in need of improvement. In the event that a student is deemed at risk relating to clinical skills the student must be Counselled, and appropriate the area of unsatisfactory practice documented and a Teaching Assistance Request can be implemented (see below); and Following discussion with the Course Coordinator, the Clinical Educator will develop teaching and learning strategies with the student, utilising an additional Teaching and Learning Plan or a specific learning contract provided by the Course Coordinator, with the aim for the student to improve in the area identified as unsatisfactory At Risk Due To Unprofessional Conduct If unsafe or unprofessional conduct is demonstrated at any time during the clinical practice placement, the Student must immediately be removed from the practice area and a Clinical At Risk Report completed by the Preceptor/Clinical Educator and the Course Coordinator contacted for progress advice; and Student must not return to the clinical area until authorised by the Course Coordinator to do so; and the Course Coordinator will meet with the student, and progress will be determined Teaching Assistance Request It is expected that students will practice /demonstrate clinical skills/interventions in the clinical area under the supervision of the Clinical Educator/Preceptor. However, if the Clinical Educator/Preceptor deems that the student requires additional support other than what they can provide in the clinical area, a Teaching Assistance Request is to be completed, and forwarded to the Course Coordinator. Whilst the laboratory is available for student use throughout the course, students are encouraged to practice their skills in context under the supervision of the Preceptor/Clinical Teacher, in the clinical area Clinical Appraisal Tools (Midway and Completion) The Clinical Appraisal Tools used in this course has been outlined in Section 1. The bold numbers on the Clinical Appraisal Tools (mid-way assessment and the completion assessment) indicate the expected level of competency performance for each ANMC Domain Midway Clinical Appraisal Clinical Educators and Students will discuss the competency criteria listed, and both allocate the perceived rating achieved. Including student self assessment enables discussion of discrepancies and perceptions at the time of assessment. The outcome of student and Clinical Teacher s assessment also provides the basis for the completion of an At Risk Report and development of a teaching and learning plan. Process if a rating less than required is achieved in any ANMC Domain If a student is assessed as achieving a rating less than required for any ANMC domain the Clinical Educator will: Complete a Clinical at Risk Report indicating the area/domain/specific criteria that student is not yet achieving to the required level, and provide an exemplar. 15

21 Contact the Course Coordinator regarding students who do not meet the expected level in any of the ANMC Domains to ensure objectivity, and a base line for implementing any subsequent required strategies and interventions; and Develop appropriate strategies and interventions to achieve expected outcomes (including counselling of student), and confirm with the Course Coordinator Final/Completion Clinical Appraisal Clinical Educators and Students will discuss the competency criteria listed, and both allocate the perceived rating achieved. However, the rating awarded by the Clinical Educator is the final rating for the domain assessed. The Course Coordinator will award the overall rating for HCNUR 1141 based on overall assessment outcomes. The overall rating achieved will be either C (Competent achievement of required level in all ANMC Domains) or NC (Not Competent achieved less that the required level, in any ANMC Domain). The final rating (C or NC) is required to be ratified by the University of Ballarat, Academic Programs Committee before the final grade is confirmed/awarded for the course. Process if US (Unsatisfactory) is awarded in final/completion assessment If a student is assessed as NC (that is, one or more ANMC Domains have been assessed as less than the level of achievement required) the Clinical Educator will: Complete a Clinical at Risk Report indicating the area/domain/specific criteria not yet competent and provide an exemplar; Contact the Course Coordinator regarding any students who do not meet the expected level in any of the ANMC Domains to ensure objectivity, and a base line for implementing an subsequent required strategies and interventions; and Suggest recommendations, and confirm with Course Coordinator. Develop appropriate strategies and interventions to achieve expected outcomes (including counselling of student). The Course Coordinator will Meet with the student, provide counselling and continually monitor student progress; and Inform the University Program Manager of progress in the area NC, who will provide input and supervision where required, and ensure University processes in relation to monitoring students at risk are implemented. The University Program Manager will also inform the NBV regarding outcome of final assessment, and recommendations Anecdotal Notes An Anecdotal Note is to be completed at any time during the course, and in particular, during Weeks 1-4 to highlight areas of difficulty, or unsatisfactory practice, and ensure timely interventions. A particular example/exemplar of the issue/problem must be documented, and how this example relates specifically to the ANMC Domains. This ensures objectivity, and a base line for implementing required strategies. 16

22 These Anecdotal Notes may also be used by clinical educators/preceptors/ward staff to provide positive feedback on students who are performing in the clinical area to a level beyond expectation, or in a particular instance that indicates an exceptional demonstration of professionalism. This feedback may contribute to determining if a student is eligible to be considered for undertaking clinical placement in a speciality area. To ensure privacy Anecdotal notes written of a confidential nature (for example counselling relating to a person issue/nature) must be written on an additional form and forwarded in a sealed envelope to the Course Co-ordinator. These type of confidential notes must not be retained in this Clinical Education Objectives and ANMC Domain Booklet. 2.3 Reflection/Evaluation of Clinical Experience Students complete this evaluation form and reflect on their experiences in the clinical area in relation to the knowledge, skills, values, confidence and competence acquired, and discuss with the Clinical Teacher. 2.4 Summary of the Process of Monitoring Student Progress A visual representation (flowchart) of the process of monitoring student progress, possible outcomes, associated documentation and reporting mechanisms is provided in Fig 1 and Fig 2 (following). 17

23 SECTION 3 QUICK REFERENCE: MONITORING OF STUDENT PROGRESS FOR USE BY STUDENTS AND CLINICAL EDUCATORS/PRECEPTORS 18

24 3.1 Summary (Flowchart) of Monitoring Student Progress - Weekly Summary (Flowchart) of Monitoring Student Progress - WEEKLY Fig 1: Process and Outcomes of Normal Weekly Monitoring of Student Progress: Weeks 1 8 Develop and implement weekly objectives & Undertake Clinical Placement Weekly Clinical Outcome= Satisfactory (S) Signed Confidentiality Document strategies as per Teaching & Learning Plan ST/PR/CE Demonstrate: Psychomotor & Psychosocial Feedback PR/CE/ST Continue process & refer to Overall & Specific Objectives Knowledge/Skill/ Intervention ST (PR/CE) Outcome = Unsatisfactory (US) Key: PR = Preceptor CE = Clinical Educator CC = Course Coordinator ST=Student Normal progression in course Weeks 1-4 write an Anecdotal Note documenting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. Weeks 5-8 write Complete Clinical At Risk Document noting each criterion rated US and develop a Teaching and Learning Plan (objectives, strategies, activities, resources, review date) in relation to the area assessed as US. Forward documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary. ST/PR/CE Note: If a student demonstrates unsafe practice or unprofessional conduct at any time, they must be immediately removed from the practice area, counselled and CC informed without delay. An at risk form must be completed as per requirements:, the matter must be described in relation to ANMC Competencies and specific examples provided. Students must not return to the clinical area until CC has met with the student, and full consideration given to progress in Course. CC will consult with UB Program Coordinator throughout this time. PR/CE/CC Outcome = Satisfactory (S) Outcome = Unsatisfactory (US) Complete Clinical at Risk Form & refer to CC immediately & at any time during 1-8 PR/CE CC will inform UB Program Co-ordinator PR/CE WEEKLY Monitoring 19

25 Summary (Flowchart) of Monitoring Student Progress MIDWAY AND COMPLETION Fig 2: Process and Outcomes for Midway Assessment and Completion of Assessment HCNUR 1141 Week 4 & By Week 8 Formal Assessment Complete: Midway Clinical Appraisal Tool (Week 4) & Final/Completion Clinical Appraisal Tool (by Week 8) PR/CE ANMC Competencies met at required level? YES ANMC Competencies met at required level? Continue Normal Weekly Monitoring (at Week 4) or Complete Course (by Week 8) PR/CE NO Course Coordinator may request a meeting with the student to discuss progress in Course PR/CE Key: PR = Preceptor CE = Clinical Teacher CC = Course Coordinator Normal progression in course Complete Clinical At Risk Document for achieving any rating less than required. Forwards documents/refer to CC. Student counselled and student support offered if necessary. Teaching & Learning Plan developed: Specific objectives & strategies implemented eg theory, remedial clinical instruction, and laboratory instruction. Consider Request for Teaching in laboratory only if necessary PR/CE MIDWAY AND COMPLETION MONITORING Continue Weekly Monitoring (Weeks 5-8) PR/CE If Final/Completion Assessment is US (by week 8) refer to UB Programs Manager for consideration of Academic Progress CC 20

26 3.2 Weekly Clinical Feedback Summary Guidelines (To be consulted when determining weekly feedback for specific items listed on the Clinical Feedback Summary form) Clinical Educators / Preceptors/Registered Nurses are to complete a Weekly Clinical Feedback Summary at the end of each week the student is on a clinical placement; Anecdotal Notes are used for providing students with positive feedback and areas of improvement including an unsatisfactory (US) grade in the student s weekly report. All unsatisfactory grades must be supported by outlining a specific example as to why the U score was achieved. This example is to be directly related to the ANMC (2006) Competencies. When an US grade is awarded, the Weekly Clinical Feedback Summary is to be photocopied and sent to the Course Coordinator immediately with the attached Anecdotal Note and Teaching Learning Plan which outlines the objectives and strategies to be implemented to convert the score from U to S (Satisfactory). In the event that the student is demonstrating unsafe practice or unprofessional conduct, the student is to be immediately removed from the clinical area, The Course Coordinator is to be notified immediately of the counselling undertaken, and a Clinical At Risk Report completed, in addition to the documentation outlined above. The student will not return to clinical practice until approved to do so by the Course Coordinator or/and the University Program Manager. The following statements are provided to help educators interpret the Performance Criteria on the Weekly Clinical Feedback Summary form. The statements are intended as a guide only and should not be used in a prescriptive or all encompassing manner. It is envisaged that the majority of students would meet satisfactory performance on clinical placement. A small number of students may receive an unsatisfactory grading for one or more criteria. Each criterion is numbered and the following dot points may be used for interpretation, grading and to assist student feedback. Table 6: Weekly Clinical Feedback Summary Guidelines 1 Adheres to School of Nursing Attendance Policy ie. Attends for required clinical hours, notifies appropriate person regarding absence: Student is on time for aspects of NCHUR0031 Meets at appropriate place; If absent: o Informs the Course Coordinator if absent from theoretical class o Informs Clinical Educator and RN prior to the commencement of the shift or the Course Coordinator on a Friday prior to the commencement of class. o Absence is valid (i.e Supported by medical certificate or other appropriate, documentation) and same is forwarded to the Course Coordinator. o Completes the University absentee form and forwards same to the Course Coordinator. 2 Adheres to University and School policy (excludes Criteria 1 - Attendance Policy). Individual clinical placement objectives developed and brought to the clinical placement from Day 1 onwards and each theoretical class Objective and Domain booklet maintained, available for sighting and use on clinical placement and theoretical classes. Wears correct uniform and adhered to dress code as per School of Nursing Handbook, ID requirements met (ID card and name badge worn); Has current Police Check available for sighting on request both on clinical placement, and theoretical class. 21