Nursing and Midwifery Council mentor domains and outcomes and the NHS Knowledge and Skills Framework

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1 Nursing and Midwifery Council mentor domains and outcomes and the NHS Knowledge and Skills Framework

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3 Contents Preface 1 Introduction 2 Partnership Approach 3 Aims 4 The mentor and other practice education support roles 5 KSF core dimensions and NMC mentor outcomes 6 The mentor role and KSF levels 7 Uses of KSF and NMC mentor outcomes link 8 References 9 Glossary of Terms Appendix 1 Working Group Appendix 2 Indicative links between NMC mentor domains and KSF core dimensions Appendix 3 Mentor minimum KSF levels and associated role examples

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5 Preface This guidance will support the implementation and embedding of the Knowledge and Skills Framework (KSF) within NHS Boards. It clearly demonstrates the key part KSF can play within the nursing and midwifery mentoring role. At the same time it provides reassurance for the individual mentor that their mentoring activities will supply appropriate and relevant evidence for the KSF development review process. Anne Campbell KSF Implementation Lead Scottish Government Health Department The majority of nurses and midwives are committed to supporting students and undertaking mentorship preparation recognised by the Nursing and Midwifery Council. Becoming a mentor requires a commitment to keeping up to date, undertaking annual updates and triennial review of their mentorship role. It is important to recognise that this ongoing mentor development supports the NHS KSF and should not be seen as an additional requirement. This guidance makes explicit the links between mentorship preparation and role activity with the expected KSF dimensions. It clearly identifies the way in which each mentor outcome can be used as evidence to support achievement of the core dimensions of the KSF. It gives me great pleasure therefore to commend this guidance to every nurse, midwife and their manager as we strive to minimise any duplication in effort in addressing the requirements for continuous development within the professional roles. Colette Ferguson Associate Director of Nursing and Midwifery NHS Education for Scotland This guidance makes explicit the links between mentorship preparation and role activity with the expected KSF dimensions

6 NHS Education for Scotland (NES) and the Scottish Government are committed to the development of a robust practice education infrastructure and it is recognised that the implementation of the NHS KSF can support this Introduction The guidance and indicative links outlined in this document relate to the implementation of the NHS Knowledge and Skills Framework (KSF) (Department of Health 2004) and the Nursing and Midwifery Council (NMC) Standards to support learning and assessment in practice (2008). This guidance and indicative links focus upon the NMC mentor domains and their interrelationship to the KSF core dimensions. Although this document is intended for use by NHS nursing and midwifery mentors employed on Agenda for Change (NHS Staff Council 2007) terms and conditions and who are either undertaking mentor preparation programmes or on their NHS Board mentor register, it is anticipated that it will be of value for nursing or midwifery mentors across the independent healthcare sector. 1.1 Background and context NHS Education for Scotland (NES) and the Scottish Government are committed to the development of a robust practice education infrastructure, and it is recognised that the implementation of the NHS KSF can support this at an individual, directorate and organisational level through: Enabling individuals to be clear about the knowledge and skills they need to apply in their posts Enabling individuals access to appropriate learning and development Enabling organisations to audit the knowledge and skills that exist using a common framework and approach applicable to all staff Identification of skills and knowledge gaps within teams and the organisation and plan how to address them (DoH 2004:14,15) The National Approach to Mentor Preparation (NES 2007) outlined a core curriculum framework, guidance on portfolio development, and included a suggested mapping of the KSF core dimensions against the NMC mentor domains and outcomes. The revision outlined within this document has incorporated knowledge gained through the implementation of KSF and adoption of the core curriculum framework for mentor preparation educational programmes across NHS Scotland.

7 2. Partnership approach The National Approach to Mentor Preparation (NES 2007) was developed through stakeholder engagement. To build upon this, and to maintain the partnership approach to KSF implementation, the principles and best practice of partnership working (NHS Staff Council 2007:243) were adopted throughout. A working group (Appendix 1) was established with membership from: Scottish Government KSF Lead Royal College of Nursing NHS Education for Scotland Nursing and midwifery Practice Education Facilitators Mentors 3. Aims The aims of the working group was to: Establish indicative links between KSF core dimensions and the NMC mentor domains and outcomes Identify minimum KSF levels for the nursing and midwifery mentor role Provide examples of how mentors could evidence achievement against the identified KSF core dimension levels 4. The mentor and other practice education support roles A scoping exercise across nursing and midwifery (NES 2009a) confirmed that there is a multiplicity of practice education support roles in NHS Scotland. The mentor role as defined by the NMC (2008:19), is one such practice education support role, and is therefore one way that nurses and midwives can demonstrate achievement of their respective KSF core dimensions. This would be further supplemented with examples provided from within the context of the nurse or midwifery mentors clinical role. It is important to highlight, however, that Core Dimension 2 Personal and people development is a requirement of ALL NHS posts covered by Agenda for Change. Nurses and midwives can demonstrate achievement of this dimension through a variety of ways, mentoring being one of them. Other role examples which would support achievement of core dimension 2 include a clinical supervisor, clinical coach as part of the Early Clinical Careers Fellows initiative and a Scottish Vocational Qualification (SVQ) assessor.

8 5. KSF core dimensions and NMC mentor outcomes The NMC Standards to support learning and assessment in practice (2008) have clearly defined the nursing and midwifery mentor role in terms of: educational preparation requirements role clarity continuing professional development expectations This role consistency and clarity has enabled indicative links with KSF to be developed to support the consolidation of KSF within NHS Boards and will be useful for: managers who will undertake triennial reviews with their staff who are mentors (from September 2010 onwards) individual mentors about how they evidence their mentoring activities in KSF terms. The NMC development framework to support learning and assessment in practice and therefore the NMC mentor domains, takes account of the NHS KSF (NMC 2008:10). The interrelationship and indicative links between the NMC mentor domains and the KSF are outlined in Appendix The mentor role and KSF levels The majority of nurse and midwifery mentors will be located within Agenda for Change pay bands 5 and 6, and will already have KSF outlines in place for their respective posts. This guidance and indicative links have been developed to clarify the relationship between the NMC mentor domains and outcomes and the KSF core dimensions to enable individual mentors to integrate their evidence of mentor preparation, mentor continuing professional development through annual updating activities in readiness for their triennial review. As stated previously, national KSF guidance (DoH 2004) highlights how KSF post outlines will assist staff to identify the knowledge and skills requirements of their current and future career steps. It is recognised that these requirements are not, however, fixed and may need to be reviewed by local agreement as part of service development or changes in professional standards as agreed by the relevant professional body (NHS Staff Council 2007:section 6.2.4). Identification of minimum KSF levels as part of this process is intended to provide consistency of role and evidence expectations for KSF outline and development review purposes and highlight the contribution mentors make across NHS Scotland. Individual mentors may exceed these minimum levels and evidence this through KSF development reviews with their managers. The mentor minimum KSF levels and associated examples are included in Appendix 3.

9 7. Uses of KSF and NMC mentor link This work has been undertaken to support the implementation and consolidation of KSF activity within NHS Boards at: 8. References Department of Health (2004) The NHS Knowledge and Skills Framework (NHS KSF) and the Development Review Process. Department of Health. Strategic level through HEAT targets KSF Leads Managers Individual mentors Highlighting KSF as an integral part of the nursing and midwifery mentor role Consistency of KSF levels within the nurse and midwife mentor role Links between evidence for KSF development reviews and triennial reviews. Early identification of individuals for Clinical Education Careers (NES 2009b) Reinforce all mentoring activities are appropriate evidence for KSF core dimensions. Integration of portfolio development for KSF and mentor role. NHS Education for Scotland (2007) National Approach to Mentor Preparation for Nurse and Midwives. Core Curriculum Framework. NHS Education for Scotland. NHS Education for Scotland (2009a) Glossary of titles associated with Practice Education support roles used for Nursing and Midwifery in NHS Education for Scotland (NES). NHS Education for Scotland NHS Education for Scotland (2009b) Clinical Education Career Framework, Progress to date. NHS Education for Scotland. nhs.uk/practice_education/work/careerspathway/ documents/framework.pdf (accessed 12/10/09) NHS Staff Council (2007) NHS terms and conditions of service handbook. NHS Staff Council Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice. Nursing and Midwifery Council.

10 9. Glossary of Terms Appendix 1 - Working Group. Agenda for Change An employment framework for NHS staff (excluding Doctors, Dentists and Directors) which has:- Job evaluation and national pay system Harmonised terms and conditions KSF and development reviews Anne Campbell KSF Implementation Lead, Scottish Government Belinda Emmens Practice Education Coordinator (North) NHS Education for Scotland Clinical Education Career Framework Relates to roles within and across health care organisations and educational institutions either as an educationalist or a part of another role. Anne Lackie Practice Education Facilitator, NHS Forth Valley Clinical Supervisor Early Clinical Career Fellows Mentor Provides clinical guidance and enables reflection and professional development Identify newly qualified registrants to develop their careers over a 3 year fellowship. The participants benefit from clinical support mechanisms, action learning, part-time academic study and protected learning time. A registrant who, following successful completion of an NMC approved mentor preparation programme or comparable preparation that has been accredited by an AEI as meeting the NMC mentor requirements has achieved the knowledge, skills and competence required to meet the defined outcomes (NMC 2008:19) Ross McCulloch RCN Staff Representative, NHS Greater Glasgow and Clyde Heather Paton Health Visitor, NHS Grampian Margaret Wickham Practice Education Facilitator, NHS Grampian NHS Knowledge and Skills Framework Defines and describes the knowledge and skills which NHS staff need to apply in their work in order to deliver quality services. It provides a single, consistent, comprehensive and explicit framework on which to base review and development for all staff. SVQ Assessor An individual who is competent to assess vocational qualifications.

11 Appendix 2 - Indicative links between the Nursing and Midwifery Council mentor domains and outcomes and the NHS Knowledge and Skills Framework core dimensions NMC Domains and Outcomes for a Mentor KSF Core Dimensions Demonstrate effective relationship building skills sufficient to support learning, as part of a wider interprofessional team, for a range of students in both practice and academic learning environments DOMAIN ESTABLISHING EFFECTIVE WORKING RELATIONSHIPS Demonstrate an understanding of factors that influence how students integrate into practice settings Core 1 Communication Providing ongoing and constructive support to facilitate transition from one learning environment to another Core 2 Personal and people development Have effective professional and interprofessional working relationships to support learning for entry to the register Core 6 Equality and diversity Facilitate learning for a range of students, within a particular area of practice where appropriate, encouraging self-management of learning opportunities and providing support to maximise individual potential DOMAIN FACILITATION OF LEARNING Use knowledge of the student s stage of learning to select appropriate learning opportunities to meet individual needs Core 1 Communication Facilitate the selection of appropriate learning strategies to integrate learning from practice and academic experience Support students in critically reflecting upon their learning experiences in order to enhance future learning Core 2 Personal and people development Core 6 Equality and diversity

12 NMC Domains and Outcomes for a Mentor KSF Core Dimensions Assess learning in order to make judgements related to the NMC standards of proficiency for entry to the register or for recording a qualification at a level above initial registration DOMAIN ASSESSMENT AND ACCOUNTABILITY Foster professional growth, personal development and accountability through support of students in practice Demonstrate a breadth of understanding of assessment strategies and ability to contribute to the total assessment process as part of the teaching team Provide constructive feedback to students and assist them in identifying future learning needs and actions. Manage failing students so that they may enhance their performance and capabilities for safe and effective practice or be able to understand their failure and the implications of this for their future Be accountable for confirming that students have met or not met the NMC competencies in practice and as a sign-off mentor confirm that students have met or not met the NMC standards of proficiency and are capable of safe and effective practice Core 1 Communication Core 2 Personal and people development Core 5 Quality Core 6 Equality and diversity Determine strategies for evaluating learning in practice and academic settings to ensure that the NMC standards of proficiency for registration or recording a qualification at a level above initial registration have been met DOMAIN EVALUATION OF LEARNING Contribute to evaluation of student learning and assessment experiences, proposing aspects for change resulting from such evaluation Participate in self and peer evaluation to facilitate personal development and contribute to the development of others Core 2 Personal and people development Core 5 - Quality

13 NMC Domains and Outcomes for a Mentor KSF Core Dimensions Create an environment for learning, where practice is valued and developed, that provides appropriate professional and interprofessional learning opportunities and support for learning to maximise achievements for individuals DOMAIN CREATE AN ENVIRONMENT FOR LEARNING Support students to identify both learning needs and experiences that are appropriate to their level of learning Use a range of learning experiences, involving patients, clients, carers and the professional team, to meet defined learning needs Identify aspects of the learning environment which could be enhanced negotiating with others to make appropriate changes Act as a resource to facilitate personal and professional development of others Core 1 Communication Core 2 Personal and people development Core 3 Health, safety and security Core 4 Service improvement Core 6 Equality and diversity Support learning within a context of practice that reflects health care and educational policies, managing change to ensure that particular professional needs are met within a learning environment that also supports practice development DOMAIN CONTEXT OF PRACTICE Contribute to the development of an environment in which effective practice is fostered, implemented, evaluated and disseminated Set and maintain professional boundaries that are sufficiently flexible for providing interprofessional care Initiate and respond to practice developments to ensure safe and effective care is achieved and an effective learning environment Core 1 Communication Core 4 Service improvement Core 5 - Quality

14 NMC Domains and Outcomes for a Mentor KSF Core Dimensions Apply evidence-based practice to their own work and contribute to the further development of such a knowledge and practice evidence base DOMAIN EVIDENCE-BASED PRACTICE Identify and apply research and evidence based practice to their area of practice Contribute to strategies to increase or review the evidence base used to support practice Core 5 Quality Support students in applying an evidence base to their own practice Demonstrate leadership skills for education within practice and academic settings DOMAIN LEADERSHIP Plan a series of learning experiences that will meet students defined learning needs Be an advocate for students to support them accessing learning opportunities that meet their individual needs, involving a range of other professionals, patients, clients and carers Prioritise work to accommodate support of students within their practice roles Core 1 Communication Core 2 Personal and people development Core 6 Equality and diversity Provide feedback about the effectiveness of learning and assessment in practice

15 Appendix 3 - Mentor minimum KSF levels and associated role examples KSF Core Dimension Suggested examples of application for NMC mentor roles CORE DIMENSION 1 - COMMUNICATION Level 3: Develop and maintain communication with people about difficult matters and/or in difficult situations Indicators The worker: a) identifies the range of people likely to be involved in the communication, any potential communication differences and relevant contextual factors b) communicates with people in a form and manner that: is consistent with their level of understanding, culture, background and preferred ways of communicating is appropriate to the purpose of the communication and the context in which it is taking place encourages the effective participation of all involved The mentor: Develops communication networks with range of professionals involved in student support, Nursing, Allied Health Professionals, Medical, Higher Education Institutions, Managers a) Maintains effective communication with the wider members of the Practice Team for example Practice Education Facilitators, Lecturers a) Is responsible for ensuring their written communications are accurate, appropriate and reviewed with the student.- b) f) Demonstrates the ability to challenge students in a discreet manner where issues have arisen within their placement. - b) Demonstrates the ability to recruit professional opinion from team members regarding their student s performance - b) Delivers assessments giving positive and constructive feedback using a range of communication methods b) Adapts communication methods to take into account students of different ages, backgrounds and life experiences b) Communicate with students at a level that is appropriate to their needs and to their stage within the course b) Continues over the page

16 KSF Core Dimension Suggested examples of application for NMC mentor roles Indicators The worker: c) recognises and reflects on barriers to effective communication and modifies communication in response d) provides feedback to other workers on their communication at appropriate times e) keeps accurate and complete records of activities and communications consistent with legislation, policies and procedures. f) communicates in a manner that is consistent with relevant legislation, policies and procedures. The mentor: Demonstrates a variety of different styles and methods of communication in response to varying situations for example to identify learning need or as part of a cause for concern b) Utilises effective communications skills to encourage and enhance learning within the clinical learning environment that is appropriate to the needs and stage of the learner b) Effectively communicate with learners in order to transfer knowledge and skill and promote learning b) Demonstrates discretion in identifying deficits in the student s performance and activates timely discussion and referral to practice education team/hei - b) Contributes to discussion with the student and PEF to enable issues of concern to be clearly identified b) f) Provides the student nurse/learner with feedback at their initial, interim and final assessments, which is constructive, specific, related to the student s level of achievement and stage within the programme. c) d) f) Complies with Data Protection and confidentiality when working with the student in the clinical area and whilst completing student assessment processes and documentation. e) Activates and maintain a record of meetings and conversations with students regarding any cause for concern e) Maintains all the appropriate documentation regarding concerns and ensure these are submitted to the HEI as required e) Demonstrates an understanding of the HEI documentation and keeps up to date with changes e) Ensures all mentor updating activity is appropriately recorded on the mentor register - e) Is aware of personnel who are required to be informed under such circumstances as student sickness and clinical environment auditing f)

17 KSF Core Dimension Suggested examples of application for NMC mentor roles CORE DIMENSION 2 - PERSONAL AND PEOPLE DEVELOPMENT Level 3: Develop oneself and contribute towards the development of others Indicators The worker: a) reflects on and evaluates how well s/he is applying knowledge and skills to meet current and emerging work demands and the requirements of the KSF outline for his/ her post b) identifies own development needs and sets own personal development objectives in discussion with his/ her reviewer c) takes responsibility for own personal development and maintains own personal development portfolio d) makes effective use of learning opportunities within and outside the workplace evaluating their effectiveness and feeding back relevant information e) enables others to develop and apply their knowledge and skills in practice The mentor: As part of their mentor preparation programme, undertakes a self-assessment against the NMC mentor outcomes, and in discussion with their supervising mentor, develops a learning action plan which details how they will achieve the NMC mentor outcomes b) Reports to their supervising mentor and/or line manager how they are progressing within their mentor preparation programme and applying their learning in their approach to mentoring students/learners. b) Identifies areas where further development is necessary, e.g. teaching skills, giving feedback, student programme b) Seeks support of PEF to further develop skills for dealing with complex issues and student lack of progress or failure b) Seeks opportunities to further develop own mentoring skills and contribute to the development of other mentors b) d) f) Develops their mentor preparation portfolio based on the guidelines in the National Approach to Mentor Preparation (NES 2007) and the Higher Education Institution requirements c). Participates in annual updates and triennial review c) d) Enables students to meet the requirements of their education programmes by planning, coordinating, assessing and providing feedback on learning experiences e) f) Continues over the page

18 KSF Core Dimension Suggested examples of application for NMC mentor roles Indicators The worker: f) contributes to the development of others in a manner that is consistent with legislation, policies and procedures g) contributes to developing the workplace as a learning environment. The mentor: Supports the provision of local orientation for new students f) g) Works closely with own colleagues to ensure student receives appropriate support in the clinical area in the mentors absence - g) Participates in audits of the learning environment including Higher Education Institutions and Quality Standards for Practice Placements g)

19 KSF Core Dimension Suggested examples of application for NMC mentor roles CORE DIMENSION 3 HEALTH, SAFETY AND SECURITY Level 2: Monitor and maintain health, safety and security of self and others Indicators The worker: a) identifies and assesses the potential risks involved in work activities and processes for self and others b) identifies how best to manage the risks c) undertakes work activities consistent with: legislation, policies and procedures the assessment and management of risk d) takes the appropriate action to manage an emergency summoning assistance immediately when this is necessary e) reports actual or potential problems that may put health, safety and security at risk and suggests how they might be addressed The mentor: Ensures the student/learner is appropriately inducted/orientated into the clinical area, and where appropriate reasonable adjustments are put in place in consultation with Practice Education Facilitators and line managers - a) c) Understands requirements for placement providers with regard to supporting learners on clinical placement a) c) Understands responsibilities for supporting young people within the clinical area if appropriate a) c) Assess risk for activities in which student is involved a) c) Ensures placement area follows NES Quality Standards for Practice Placements (QSPP) and complies with audits completed by HEI a) c) Ensures students are aware of health and safety policies and procedures applicable within placement area f) Advises students and learners about policies and procedures to ensure safe working practices whilst on clinical placement f) f) supports others in maintaining health, safety and security

20 KSF Core Dimension Suggested examples of application for NMC mentor roles CORE DIMENSION 4 SERVICE IMPROVEMENT Level 2: Contribute to the improvement of services Indicators The worker: a) discusses and agrees with the work team the implications of direction, policies and strategies on their current practice the changes that they can make as a team the changes s/he can make as an individual how to take the changes forward b) constructively makes agreed changes to own work in the agreed timescale seeking support as and when necessary c) supports others in understanding the need for and making agreed changes d) evaluates own and other s work when required to do so completing relevant documentation e) makes constructive suggestions as to how services can be improved for users and the public f) constructively identifies issues with direction, policies and strategies in the interests of users and the public. The mentor: Discusses as part of ward/departmental team meetings issues relating to mentoring, such as: Development of learning packages Mentor capacity issues (i.e. number of students) Feedback/suggestions from students a) Contributes to improvements in local student induction and local orientation - a) b) Encourages students to provide constructive feedback on the clinical learning environment and implements suggestions c) Encourages and supports students to understand the need for change and evidence based practice c) Responds to informal feedback and formal evaluations from students about their clinical experience d) Provides feedback to the Practice Education Facilitator(s) issues/suggestions around for example, student placements, assessment documentation and student preparedness for clinical placement. e) Contributes to the improvement of the clinical learning environment by keeping up to date, encouraging and sharing best practice and makes constructive suggestions as to how the clinical learning environment may be improved. e) Uses cause for concern processes to advise HEIs of deficit of knowledge in practice demonstrated by student. f)

21 KSF Core Dimension Suggested examples of application for NMC mentor roles CORE DIMENSION 5 QUALITY Level 2: Maintain quality in own work and encourage others to do so Indicators The worker: a) acts consistently with legislation, policies, procedures and other quality approaches and encourages others to do so b) works within the limits of own competence and levels of responsibility and accountability in the work team and organisation c) works as an effective and responsible team member d) prioritises own workload and organises own work to meet these priorities and reduce risks to quality e) uses and maintains resources efficiently and effectively and encourages others to do so f) monitors the quality of work in own area and alerts others to quality issues. The mentor: Acts an effective role model, working within organisational and departmental policies and procedures and ensuring their nursing care delivery is timely, evidence-based, patientcentred and respectful of their patient s personal preferences. a), b), c), d), e), f) Provides positive support for learners to be involved with the delivery of high quality patient care and experience a) Raises students awareness of best clinical practice guidelines e.g. SIGN a) Acts consistently within the NMC Standards for mentorship to ensure the clinical learning environment is of a safe and high standard. a) b) Assesses and completes practice assessment documentation of students on practice placement. b) Ensures that student assessments are planned in advance and highlighted on the ward/ departmental rota. c) Carries out/contributes to audit of placement area f) Raises issues of concern regarding student performance with student/practice education staff/hei f) Addresses issues of concern raised by student about placement, e.g. reporting to manager, practice education, HEI f)

22 KSF Core Dimension Suggested examples of application for NMC mentor roles CORE DIMENSION 6 EQUALITY AND DIVERSITY Level 2: Support equality and value diversity Indicators The worker: a) recognises the importance of people s rights and acts in accordance with legislation, policies and procedures b) acts in ways that: acknowledge and recognise people s expressed beliefs, preferences and choices respect diversity value people as individuals c) takes account of own behaviour and its effect on others d) identifies and takes action when own or others behaviour undermines equality and diversity. The mentor: Demonstrates an understanding of the local equality & diversity Policies a) Recognises the rights of students as detailed within the NMC requirements and QSPP. a) Demonstrates the ability to deal discreetly and manage any matters arising which affect a student b) Demonstrates positive approach to students where issues of equality & diversity that may affect their clinical placement b) Ensures that reasonable adjustments (where required) are implemented for student nurses/ midwives and that these do not disadvantage the students learning experience. b) Ensures that access to learning opportunities within the clinical area are based upon the students learning outcomes, stage within the education programme and achievement of Essential Skills Clusters etc. b) Follows HEI/practice education standards for students with additional support needs. b) Acknowledges deficits in own understanding of complex equality & diversity issues and seek appropriate support b) Acts as an advocate for students to ensure access to learning opportunities. b) Reflects on interpersonal interaction with students c) Reports when behaviour of others does not demonstrate respect for equality and diversity. d)

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24 Further copies of this document are available, on request, in audio and large print formats and in community languages. Please call Spring 2010 NHS Education for Scotland Thistle House 91 Haymarket Terrace Edinburgh EH12 5HD

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