Division of Nursing Reason for Change 2013 Nursing Curriculum Guidance for Mentors Completing the Practice Documentation All university pre-registration nursing and midwifery courses undergo a process of re-approval every 5 years to ensure that the courses remain current to contemporary healthcare practices, that they reflect NMC standards for pre-registration education, that they are reflective of service user needs and expectations and that they are fit for purpose. The UCS pre-registration nursing programmes (Adult, Mental Health and Childrens ) were last re-validated in 2009. The course teams, alongside key stakeholders (patients, NHS and other healthcare organsations, Local Education Board representatives and student reps) spent a huge amount of time reviewing the current provision in order to identity its strengths and areas which required review. In 2010 the NMC published a new set of standards for pre-registration nursing programmes which includes set of generic and field specific competencies and essential skills clusters that student nurses must have successfully been assessed as competent by the end of their course. The UCS 2013 Nursing Curriculum was validated and NMC approved in March 2013. The first cohort starts in September 2013 (Adult and Children s) and February 2014 (Adult and Mental Health). NMC (2010) Standards for Pre-registration Nursing Education The aim of the new standards are to enable nurses to provide flexible, high quality holistic care to service users within a rapidly changing health and social care environment. Nurses of tomorrow need to display critical and analytical thinking, the ability to problem solve, evaluate care and take action, manage change and lead service improvement in the 21st Century. Key areas: Delivery of high quality, evidence based care; act professionally with integrity; compassionate, respective care, protecting dignity; health promotion and education; partnership working; planning, designing, delivering, and improving services. Students no longer complete a Common Foundation Programme in Year 1 and the term branch has been replaced by fields of practice for each nursing prgramme. Fundamental to this and deeply embedded within the UCS Nursing Curriculum are the NHS Core Values and the 6Cs of Nursing which lay out the essential attributes that form the foundation of good nursing practice. All students must achieve competencies which have been laid out under four domains of practice DOMAINS OF NURSING COMPETENCIES 1. Professional Values 2. Communication and Interpersonal Skills 3. Nursing Practice and Decision Making 4. Leadership, Management and Team Working http://standards.nmc-uk.org/publisheddocuments/standards%20for%20pre-registration% 20nursing%20education%2016082010.pdf
Page 2 Ongoing Record of Achievement Students are still required to have a record of achievement which is a documentary record of all placement meetings and interviews. This record now contains an agreement between UCS and that student that they will abide by all placement, University and NMC policies and guidelines; student consent for UCS to share student information with practice; a mandatory training record; generic guidelines to support mentors; student guidance of escalating concerns and then yearly sections which include all the student interviews for each placement Orientation to Placement You must ensure that your student has a thorough orientation to your practice area as this is an essential part of helping your student settle in and feel that they belong to the team. You are now required to sign each element of the orientation on day 1 of the placement and the student s signature confirms that this did occur. Initial Interview To be completed in the first week of placement. Review any student action plans and all previous mentor interview records so that you are aware of your student s journey prior to date. The initial interview should be as supportive as possible as this makes or breaks the student/mentor relationship. Some tips for initial interview: Ask them to self-assess to identify strengths/they can bring to placement and areas they feel they need to develop Review the student s PAD document so that you can highlight skills which are achievable on your placement, which will help you identify learning opportunities and learning resources Review the off-duty to ensure that you work with them for a MINIMUM of 40% of the student s time in practice. If you are on nights or annual leave ensure the student knows who will be supporting them in your absence. Make sure this is clearly identified on the off-duty, Set a date for Mid-point interview. Write it in the initial interview form, on the off duty and in the team/ward/unit diary. If applicable to your placement (i.e Yr 1 Semester 2; Yr 2 Semester 4 or Yr 3 Semester 6) you MUST identify the date for the student s Integrated Practice Assessment (see page 11 in this guidance document)
Page 3 Midpoint Interview This is your opportunity to review your student s competence and progress through the first half of their placement. This is a valuable opportunity for you to evaluate your student s experience and your own mentorship practice to ensure that you are able to provide effective support to your learner. Some tips for Mid-point Interview: Ask the student to self-assess their progress so far Ask colleagues for feedback on the student, ask them to identify the student s strengths and areas to develop Review the initial learning outcomes. How much have these been achieved? What new opportunities are now available? You should have been using continuous assessment with your student so mid-point should be predominantly about discussing progress to date and future learning goals Set some new learning outcomes (if appropriate) for the second half of the placement Final Interview The final interview is the summative assessment of your student. You must ensure that you use the specified assessment criteria within the PAD document and that you follow the principles of assessment: Reliability, Validity, Objectivity Tips for final Interview: Ask the student to self-assess their progress during the whole placement Get them to identify areas they wish to enhance during their next placement Ask colleagues for feedback on the student, ask them to identify the student s strengths and areas to develop Review the Skills Document to highlight student strengths and skills that they need to continue to develop The more detailed the feedback you provide in all interviews the better. Your documented comments are a record of your assessment decisions and provide a written rationale for a pass or refer in practice. Your comments are essential for the sign off mentor to decide whether the student is fit to progress to registration. Please be specific. DO NOT just write to continue.., this is non-descript and adds no real value. You do not want the student to continue at that level of practice, the student should be continuously progressing io order to successfully achieve NMC (2010) standards.
Page 4 Ongoing Record of Achievement Evaluation of student professional conduct This evaluation enables you to give feedback to the student and UCS personal tutors about the students professional conduct whilst on placement. Please ensure any absence is recorded accurately as numbers of hours as students are required by the NMC to have completed a minimum of 2300 hours over the three year programme in order to register. Service User Involvement in the Summative Assessment in each placement The NMC introduced this requirement in March 2011. For placements of 4 weeks or longer you need to gain opinion from 2 service users that the student has regularly provide or lead care for. In final placement the student must have feedback from 3 service users. Service users can feedback on the student s abilities to: Communicate Give compassionate, dignified and respective care Care Respect service user views whilst promoting and respecting choice However you must ensure that any service user feedback is discussed with the student to provide them with a right of reply. You need to consider how you will select the service users and how will document your discussions. You will need to prepare each service user so that they understand their role thoroughly. You need to ensure that when selecting service users you not acting in a paternalistic way. Even if a service user is unwell, elderly or confused they may wish to give feedback.
Page 5 Record of visits / learning opportunities away from the allocated placement The NMC (2010) standards recognize that in order for students to full understand and appreciate the patient journey student may engage in visits to other departments, teams or health and social care professionals. However these visits must be relevant to the patient / client group that the main placement supports. Any visit MUST be approved by the named mentor as relevant and appropriate to their practice specialty. This page should be completed in part by the student and signed by either a qualified mentor or a qualified health or social care professional responsible for supervising the student during the visit. Record of Meetings between student and mentors If you are supporting a student with specific learning needs or a student who is under-achieving in practice each time you give constructive, goal-centred feedback to the student you must record your discussions within the Record of Achievement. This record evidences the support provided to the student and provides a timely audit trail on agreed actions and the outcomes of your discussions. This is especially useful if you are a sign off mentor to a student in final placement as each sign off mentor must meet with their final placement student for 1 hour per week per final placement student to provide them with feedback on their progress and areas for development. The NMC stipulates that this time must be protected. This has been incorporated within organizational mentor policies. The 1 hour protected time can be split. If you are supporting a student who is not achieving in practice you MUST complete this record for all meetings you have with your student. You must inform UCS using the guidance provided at the front of the PAD document if you have any concerns about the student s progress.
Page 6 Ongoing Record of Achievement Action Plan Action planning is an essential part of supporting a student who is under-achieving in practice. When you are considering the section for areas of practice that requires development, write the specific competencies / skills from the PAD document that they need to address. Within the plan break this down into two components; a plan of action for the student and a plan of action for you as the mentor. Consider what resources are available. Support is available from your Link Lecturing teams Clinical Practice Facilitators or Practice Education Facilitators. Make sure the student signs the action plan, this evidences that you have informed the student of concerns and that they agree to the action plan. Please remember that mid-point interview is the latest point in which to rise concerns as the student must be given adequate time to improve. If you have any concerns you must contact the university as soon as possible. Short Placement Meeting Form To be completed for all placements less than 4 weeks. Clear learning outcomes must be identified within the first few days of placement and progress reviewed and commented on at the end of the short placement. End of Programme Declaration by Sign off Mentor To be completed by the sign off mentor to confirm that the student has met all NMC generic and field competencies, That the student is fit to practice and is, in the sign off mentor s opinion, competent to be entered onto the professional register as a registered nurse. Absences Record Please complete this record for all times that the student is absent from allocated time in placement or visits to other teams/areas Meeting EU Requirements In order to qualify as a registered nurse all students must evidence that they have met EU requirements in specific aspects of care (General and Specialist Medicine; General and Specialist Surgery; Childcare and Paediatrics; Maternity; Mental Health; Care of the Elderly; Community Nursing). The student must provide evidence of the clinical instruction they have received in practice and must identify the placement areas this instruction took place in. If your placement area comes under one of these areas of care, you, as the student s named mentor must sign to verify that the clinical instruction took place.
Page 7 Practice Assessment Document (Competencies and Skills) The NMC has replaced the term branch to fields of practice. From day 1 students will be taught in their own specific fields (Mental Health, Children s or Adult Nursing), although they will participate in shared learning as well as field specific theory sessions in university. The Essential Skills Clusters remain the same as with the previous NMC requirements. NMC requires students to demonstrate achievement of both generic and field specific competencies throughout the whole three year s. The generic competencies apply to all nurses of all fields as they are the foundation competencies for safe nursing practice. The field specific competencies enable the students to develop the psychomotive, attitudinal and cognitive skills to be able to provide safe and competent care to patients and clients focused on each field of practice. The UCS course teams have worked hard to ensure that the Practice Assessment Documents follow the format you are already fairly familiar with, so the assessment criteria or Level of Performance, Supervision and Practice and Conditions of Competence are unchanged. A mentor signature sheet must be completed for all mentors who complete and sign off competencies and skills within the PAD. This enables UCS to cross reference your signature to the signatures provided against each competency and skill as a prevention against forgery. When you sign this you are also confirming that you have attended a mentor update in the last 12 months and that your triennial review is up to date as per NMC (2008) Standards to support learning and assessment in practice. Levels of Performance, Supervision & Practice, and Conditions of Competent Practice YEAR 1 Level of supervision and support Direct Observa- on to Close Supervision Level of prac ce Competence Achieved Competence Not Achieved Observes, par cipates, assists in prac- ce Safe in all care under supervision Performs with few prompts Can discuss per nent research underpinning some prac ces Displays a professional a tude towards pa ents and staff Beginning to assess, plan and implement care Within level of prac ce, responds appropriately in situa- ons requiring urgency Can explain the ra onale underpinning prac ce Unsafe in care Requires detailed and explicit instruc ons Cannot explain the ra onale underpinning prac ce Displays an unprofessional a tude towards pa ents and staff Within level of prac ce, does not respond appropriately in situa ons requiring urgency Did not par cipate in daily rou- ne
Page 8 Year 2 Level of supervision & support Close Supervision to Minimal Supervision Level of prac ce Competence Achieved Competence Not Achieved Ac ve par cipa- on Planning most ac vi es and leading some prac ce Safe in all care with guidance Does not require promp ng in prac- sed ac vi es Beginning to priori se care Able to assess, plan and implement care Can explain the ra onale underpinning prac ce Displays a professional a tude towards pa ents and staff Beginning to evaluate effec veness of care Beginning to involve clients in their care Within level of prac ce, responds appropriately in situa ons requiring urgency Can discuss per nent research underpinning prac ce Unsafe in care Performance lacks completeness Requires promp ng in prac sed ac vi es Not able to assess, plan and implement care Cannot explain the ra onale underpinning prac ce Displays an unprofessional a tude towards pa ents and staff Did not par cipate in daily rou- ne Within level of prac ce, does not respond appropriately in situa ons requiring urgency Year 3 Level of supervision & support Level of prac ce Competence Achieved Competence Not Achieved Minimal Supervision to Indirect Supervision Ac ve par cipa on Planning all ac vi es and leading most prac- ce Safe in care with minimal guidance Demonstrates an appropriate professional a tude Unsafe in care Displays an unprofessional a tude towards pa- ents and staff Does not require promp ng Requires promp ng For specialist prac ce placements where students can only observe prac ce: Ac ve par cipa on in discussions with mentors on planning ac vi- es Students must also demonstrate valid contribu ons to leading aspects of prac ce Able to assess, plan, implement care Able to evaluate effec veness of care and make changes to care plans Is organised and efficient Ac vely involves clients in their care Cri ques evidence based prac ce and how evidence is implemented in prac ce Within level of prac ce, responds appropriately in situa ons requiring urgency Unable to organise care Cannot explain the ra- onale underpinning prac ce Does not consider evidence based prac ce Did not par cipate in daily rou ne Within level of prac ce, does not respond appropriately in situa ons requiring urgency
Page 9 Practice Assessment Document (Competencies and Skills) Preparation for Placement This form is for each student to complete either before they start their placement with you or after a brief period of orientation but always before the initial interview. This allows the student time to experience the clinical area, to discover the types of patients and clients you support and enables them to start to formulate learning objectives and to identify potential learning opportunities for the placement. You may need to help the student actually articulate those objectives to ensure that they are SMART (Specific, Measureable, Achievable, Realistic and Time bound).. You must review this form with the student and use this as a foundation for the initial interview. The form requires you to note the Link Lecturer s name and it may be useful for you to also record here the Link Lecturer s telephone number and email address for quick reference if required. There is a form for each placement which must be completed. Competencies The first section within the PAD is the NMC generic and field specific competencies. The competencies must be completed across each year and comprise of a formative and summative assessment. Competencies are presented under each NMC domain and start with a generic competency with field specific competencies listed underneath. Competencies can only be signed off when students are on placement for 4 weeks or longer. They are not applicable to short placements. The formative assessment can be completed at any point, however we would expect that this formative assessment will have been completed by mid-point interview and will form a basis for your mid-point interview review. Please note that these competencies should be spread across the year, some can be completed in the first placement but not all of them. During formative assessment you need to assess and discuss the student s progress toward meeting the competencies against the Level of performance, supervision, and practice and conditions of competence practice relevant to the student s year on the course.. The summative assessment should be completed towards the end of the placement using all the assessment principles to ensure the validity, objectivity and reliability of your assessment. Use the levels of performance, ask colleagues for feedback, review the service user feedback, ask the student to self assess again as well as your own observations of their practice. You must make sure that as well has being able to perform the competency in practice the student must demonstrate a level of understanding and knowledge of the evidence base comparative to their year in training, and that their professional attitude, and behaviour is also appropriate.
Page 10 Practice Assessment Document (Competencies and Skills) Examples of Competencies Adult Nursing Domain 1: Professional Values Generic standard for competence All nurses must act first and foremost to care for and safeguard the public. They must practise autonomously and be responsible and accountable for safe, compassionate, person-centred, evidence-based nursing that respects and maintains dignity and human rights. They must show professionalism and integrity and work within recognised professional, ethical and legal frameworks. They must work in partnership with other health and social care professionals and agencies, service users, their carers and families in all settings, including the community, ensuring that decisions about care are shared. Field standard for competence Adult nurses must also be able at all times to promote the rights, choices and wishes of all adults and, where appropriate, children and young people, paying particular attention to equality, diversity and the needs of an ageing population. They must be able to work in partnership to address people s needs in all healthcare settings. COMPETENCIES 1. All nurses must prac se with confidence according to The code: Standards of conduct, performance and ethics for nurses and midwives (NMC 2008), and within other recognised ethical and legal frameworks. They must be able to recognise and address ethical challenges rela ng to people s choices and decision-making about their care, and act within the law to help them and their families and carers find acceptable solu ons. 1. 1 Adult nurses must understand and apply current legisla on to all service users, paying special a en on to the protec on of vulnerable people, including those with complex needs arising from ageing, cogni ve impairment, long-term condi- ons and those approaching the end of life. Forma ve assessment point Mentor Date ini als Summa ve assessment point Mentor Date ini als Mental Health Nursing Domain 1: Professional Values Generic standard for competence (as above) Field standard for competence Mental health nurses must work with people of all ages using values-based mental health frameworks. They must use different methods of engaging people and work in a way that promotes positive relationships focused on social inclusion, human rights and recovery, that is, a person s ability to live a self-directed life, with or without symptoms, that they believe is meaningful and satisfying. COMPETENCIES 1. All nurses must prac se with confidence according to The code: Standards of conduct, performance and ethics for nurses and midwives (NMC 2008), and within other recognised ethical and legal frameworks. They must be able to recognise and address ethical challenges rela ng to people s choices and decision-making about their care, and act within the law to help them and their families and carers find acceptable solu ons. Forma ve assessment point Mentor ini als Date Summa ve assessment point Mentor ini- als Date 1. 1 Mental health nurses must understand and apply current legisla on to all service users, paying special a en on to the protec on of vulnerable people, including those with complex needs arising from ageing cogni ve impairment, long-term condi ons and those approaching the end of life.
Page 11 Practice Assessment Document (Competencies and Skills) Examples of Competencies Children s Nursing Domain 1: Professional Values Generic standard for competence (as above) Field standard for competence Children s nurses must understand their role as an advocate for children, young people and their families, and work in partnership with them. They must deliver child and family-centred care; empower children and young people to express their views and preferences; and maintain and recognise their rights and best interests. Forma ve assessment point Summa ve assessment point COMPETENCIES Mentor ini- als Date Mentor ini als Date 1. All nurses must prac se with confidence according to The code: Standards of conduct, performance and ethics for nurses and midwives (NMC 2008), and within other recognised ethical and legal frameworks. They must be able to recognise and address ethical challenges rela ng to people s choices and decision-making about their care, and act within the law to help them and their families and carers find acceptable solu ons. 1. 1 Children s nurses must understand the laws rela ng to child and parental consent, including giving and refusing consent, withdrawal of treatment and legal capacity (can discuss principles). Integrated Practice Assessment (Practice Assessment 1,2,3) This is a new addition to the 2013 nursing curriculum and involves you assessing students providing specific care for a service user. It must be with a patient or client that the student has had regular contact with and has been providing care for. These assessments can only be completed on placements of 4 weeks or longer and there is one specific practical assessment for each year of the course. They can not be completed in short placements. Discuss the assessment with the student and the service user (you must gain consent from the service user),. You must discuss this at the initial interview and begin to plan with the student when this assessment will occur. The date for the assessment must be finalized by mid-point interview. For each assessment the NMC competencies and skills are listed and you must assess the student s performance against them as well as the level expected for that student s year on the course. The competencies highlighted within each assessment directly contribute to and are mapped against the generic and field competencies and the Essential Skills Clusters within the PAD so avoid repetition. The assessment can be completed by the student s allocated mentor or another nurse who is a qualified and active mentor. A Clinical Practice Facilitator, Practice Educator or Link Lecturer can only complete these assessments as a last resort, and only if they registered in the same field as the student they are assessing,and that they have clinical currency and capability.
Page 12 Practice Assessment Document (Competencies and Skills) Assessment 1 Communica on with a Service user Year 1 Semester 2 Assessment 2 Individualised Care of a Service User Year 2 Semester 4 Assessment 3 Medicines Management Year 3 Semester 6 Year 1 Integrated Practical Assessment Practice Assessment 1: Communicating with a service user Explanation This assessment is based on the student being observed communicating with a service user. The assessment is designed to comprehensively assess a student in the practice setting. Either the student s mentor, another mentor from the clinical area; a Clinical Practice Facilitator/Practice Educator or the Link Lecturer can undertake this assessment It must be undertaken in semester 2 during a placement lasting four weeks or longer. At the initial interview the mentor and student should discuss if this assessment will be undertaken. The date for the assessment should be finalised at the mid-point interview. Competency that underpins the assessment: Domain 2: Communication and interpersonal skills All nurses must build partnerships and therapeutic relationships through safe, effective and non-discriminatory communication. They must take account of individual differences, capabilities and needs. If student is successful in the assessment they will also have achieved the following Essential Skills:- 3.2 Engages with people in a way that ensures dignity is maintained through appropriate use of the environment, self and skills and adopting an appropriate attitude 5.1 Is attentive and acts with kindness and sensitivity. 5.3 Interacts with the person in a manner that is interpreted as warm, sensitive, kind and compassionate, making appropriate use of touch. 6.3 Always seeks to confirm understanding 6.4 Responds in a way that confirms what a person is communicating 6.5 Effectively communicates people s stated needs and wishes to other professionals.
Page 13 Practice Assessment Document (Competencies and Skills) Year 1 Practical Assessment (continued) Assessment criteria: Communica ng with a service user Assessment Criteria Achieved Not Achieved Justifying Comments 1. Establishes a rapport with the service user. This must include: Greets service user and anyone else present and introduces self. Explains the purpose of the interaction if there is one, and gains informed consent. Demonstrates compassion, comfort, dignity, safety and privacy at all times. Understands the principles of confidentiality and can explain them to the service user. 2 Demonstrates the use of effective communication skills. This must include: Use of appropriate verbal and non-verbal communication skills to engage and respond with the service user. Demonstrates empathy with the service user throughout the interaction. Gives time and space for the service user to respond to and pose questions, if appropriate 3. Engages the service user in a warm and friendly way. This must include: Is attentive and acts with warmth and kindness. Responds appropriately to the physical and emotional responses of the service user. Listens to, watches for and responds to verbal and non-verbal cues. Asks appropriate questions and obtains information in a sensitive manner. 4. Closes the interaction appropriately This must include: Seeks to confirm understanding of what has been said. Summarises the conversation briefly if required. Manages leave taking skills in a caring way. Always maintains appropriate professional boundaries. Date of Assessment: Name of Assessor: Student descrip on of the episode that was assessed: Assessor s Overall Comments: Result Pass Refer Student signature: Date: Assessor signature: Date:
Page 14 Practice Assessment Document (Competencies and Skills) Essential Skills Clusters The NMC essential skills clusters are focused upon: Care, compassion and empathy; Organisational aspects of care; Infection control and prevention; Nutrition and fluid management and Medicines management. Skills can only be assessed in placements of four week or longer and only nurses who are active mentors should be assessing and signing skills (NMC, 2008). There have been a couple of changes within how the achievement of these skills are recorded so that the student is given several opportunities to practice the skill before being assessed as competent. For each skill the student must have a signature from a registered health professional confirming that they have had the opportunity to practice each skill. The student is then expected to continue to practice each skill as the learning opportunities arise and when they feel they are ready to be assessed by their named mentor the student should self-assess themselves against the year s level of performance, supervision and practice and conditions of competence (found at the beginning of the PAD skills book). This self-assessment should form part of your discussions throughout the placement and should be considered when you are making your assessment decision as to whether the student is safe and competent in that skill. Remember to get feedback from your colleagues who have observed your student s practice as well as the service users. ESSENTIAL SKILLS CLUSTER: Care, compassion and communication Skill practiced by s student Student Self- Assessment Competency achieved COMPETENCY Signature of Registered Professional Date Student Signature Date Mentor Signature Date 1 As partners in the care process, people can trust a newly registered graduate nurse to provide collaborative care based on the highest standards, knowledge and competence 1. 1 Articulates the underpinning values of The code: Standards of conduct, performance and ethics for nurses and midwives (The Code) (NMC, 2008). 1. 2 Works within limitations of the role and recognises own level of competence. 1. 3 1. 4 1. 5 Promotes a professional image. Shows respect for others. Is able to engage with people and build caring professional relationships.
Page 15 Questions and Queries Are all students completing a degree programme now? Yes, the NMC states the minimum level of all preregistration nursing and midwifery programmes is now level 6 or degree level. Midwifery has been Degree entry since 2009, whilst Nursing in Scotland, Wales and Northern Ireland has also bee Degree entry for a number of years. England is the last UK country to go to degree entry for nursing. This is to ensure nursing and midwifery is comparable to all other health professions which have been Degree level entry for a number of years. Do students still complete a Common Foundation Programme in Year 1? No, students are in the fields of practice (mental health, adult, children s nursing) from day 1 of the course Why are there now generic and field competencies? Are they in each year? Following an extensive consultation with key stakeholders (patients, service user groups, nurses, academics and healthcare organsations) it was clear that some competencies are generic across the different fields of practice and must be demonstrated by all nurses regardless of speciality. Field specific competencies are those specific skills only relevant to a specific field of nursing practice. All competencies have to be assessed across the three years. UCS and practice representatives worked together to identify relevant competencies for each year of the programme. Will students have placements in all areas? The NMC and EU requires students to gain a wide range of practice placement experiences to reflect current and future service provision. Due to the number of placements students can attend during a three year programme it is impossible for them to attend every possible placement, however students will have placements in the NMC specified areas of practice. Why can t competencies and skills be signed off in placements less than 4 weeks in duration? The NMC states that in order to assess students competence they must have been in practice for a minimum of 20 days.
Why have the Integrated Practice Assessments been introduced? Why do they differ from other competencies? These assessments have been introduced as they focus on fundamental areas of practice which have been highlighted as issues by the NMC, Francis reports (2010, 2013) and Keogh report (2013). These assessments will enable you to assess holistic care delivery with a specific focus rather than focusing on the achievement of individual skills as a tick box exercise. The competencies that underpin these assessments are specific NMC generic and field competencies as highlighted in the PAD document. What do I do if I feel the student is not ready to undertake the Integrated Practice Assessment? You should have discussed the Integrated Practice Assessment at initial interview and planned how you were going to support the student in developing those competencies within your placement. The student s progress should have been discussed at midpoint interview and an assessment date arranged. If they are not making satisfactory progress you must tell them and devise an action plan. If the student is still not ready and you feel they are not competent you must liaise with your Link Lecturing team and CPF (if available). If the student is not competent then you have no option but to refer them in practice. How many competencies should the student achieve on each placement? What happens if the competencies are not achieved? What happens if all left to final placement in year? Within the essential skills clusters, what happens if the students self-assessment is different to mine? Ideally 50% of the competencies and skills should be completed in Semester 1 and 50% in Semester 2. However this will not be prescribed by UCS due to the unique nature of some placement areas. As mentors you must support students achievement of all competencies and skills by the end of each year. However if the student is not progressing as expected you must seek support from your link lecturing team. At the personal tutor interview at the end of each semester, if students have not had any competencies or skills signed off the personal tutor will ask the student to return to practice to have a selection signed. Students complete the self-assessment if they feel competent, however this is a point of discussion between you and the student. If you disagree you must tell the student why and provide specific examples. If the student is not achieving you must follow due process. For further information, link lecturing team contact details and guidance on mentorship go to: http://www.ucs.ac.uk/practicelearning