CHAPTER 4. Understanding the Practice Assessment Document
Chapter Aims
The purpose of this chapter is to explore the practice assessment document and the meaning of learning outcomes in more depth. After reading this chapter you will be able to:
• Explain the role of the practice assessment document in the student’s learning experience.
• Identify the key documents which state the level of competence a student must meet in order to enter the branch programme and the register.
• Problem solve the meaning of learning outcomes and plan learning accordingly.
The practice assessment document
Every student will come to their placement with a practice assessment document of some description. This document may be referred to as any of the following:
• clinical skills book
• assessment book
• assessment of practice record
• practice learning document
• placement assessment document.
Effectively, these documents or booklets are all the same thing because they have the same purpose as a record of the student’s learning and the mentor’s assessment. The structure and content will vary differently depending on the university; however, there are core features and it is one of these, the learning outcomes, which will be explored in this chapter. To ensure clarity and understanding the document will be referred to as the practice assessment document or PAD within this chapter.
A PAD is a record of what the university requires the student to achieve in practice in order to meet the standards the NMC requires for entry to the branch and the register. The PAD will become a record of the learning the student has undertaken and the mentor’s assessment of that learning.
Within the PAD there will be a list of learning outcomes, competencies or proficiencies, which are required to be assessed by the mentor and achieved by the student to progress further in their training. There could be statements or grids to be filled in requiring the mentor’s signatures and dates for verification of learning undertaken by the student. Box 4.1 represents some of the key features included within most PADs.
Box 4.1
Key features of practice assessment documents
Core features
• Student and placement details page
• Instructions on how to complete the booklet
• A list of learning outcomes
• Space to record assessment interviews
• Space to record the outcome of the assessment
• Ongoing Achievement Record.
Optional extras
• Space for a second attempt at practice to be documented
• Timesheet
• Contact details of university placements department or link lecturer
• Clinical skills advice detailing what the student can or can’t do
• Incident/accident form
• List of skills to be obtained
• Space to record action plans
• Space to record testimonies from other healthcare professionals, service users, etc.
Layout of the practice assessment document
PADs are developed by universities and provided to students before they attend placement. Although the content of a PAD is usually quite similar across universities, the layout and structure will be very different. There is no universal template for PADs, and as a result, universities are responsible for developing their own documents according to their interpretation of NMC guidelines.
All PADs will be structured to allow mentors to follow the practice assessment process. As a result they will all contain sections for documentation of interviews with students (initial, midpoint, final). However, there will be variable amounts of space allocated within the document where mentors are required to document progress.
In addition, many PADs allocate sections where students are required to maintain records, perhaps as reflective journals, evidence of achieving competence or commentaries related to their practice placement experience. In both cases the PAD should clearly indicate where mentors and students are to maintain records and what types of records should be maintained.
The PAD will also contain instructions detailing the mentor’s role in completing the book. It is essential to read or re-read these instructions as lack of familiarity with the book, and what is required of the mentor, can lead to errors. Errors made by mentors in the PAD can result in questions being asked about the accuracy of the assessment process, causing the student additional anxiety (see Case study 4.1).
Case study 4.1
A mentor speaks of her experience in documenting within a PAD
‘When I first became a mentor I didn’t really understand the importance of documenting within the student’s assessment book. I remember that students would show me their books and I would sign my name against their learning objectives without hesitation. For some reason I thought that I was signing to say that I agreed to assess the student on all the things listed in the book and never gave it a second thought. Then one day I overheard two students talking in the corridor and they were basically laughing and saying that it was easy to pass with me, I’d sign their books without even assessing them. I literally broke out in a sweat. For months I’d been signing students as competent without even realizing it. I just felt so stupid. As soon as I looked in the book I realized that the instructions were there, I had just never bothered to read them. I’d not gone to my mentor update either; it just wasn’t one of my priorities. Safe to say I learnt my lesson the hard way. I make a point now of reading everything about the assessment just to make sure I’m getting it right. As far as I’m concerned it’s worth the extra ten minutes to have peace of mind that I’m getting it right.’
Documenting assessment
Obviously the PAD will contain a section where a mentor is required to carry out an assessment. Usually this will mean signing or initialling your name against a list of competencies. You may be required to decide if learning outcomes have been achieved or not achieved; in some cases you may even be expected to grade a student according to a marking grid or pre-determined criteria set by the university. Regular mentor updating should ensure that you are familiar with the system used by your university in assessing students, so this is a vital aspect of your preparation before the student arrives. The PAD should also contain instructions regarding the assessment process required, so you should take the time to read this and clarify any areas you are unsure about.
Learning contracts
Most PADs will contain an area for mentors and students to develop learning contracts. Learning contracts are an agreement between the mentor and the student detailing what both parties are to do to enable the student to learn. They are sometimes referred to as action plans or development plans. As we will discover in Chapter 5, the initial interview is an ideal time to develop a learning contract. There may be other occasions such as the midpoint interview when learning contracts are useful. Likewise, learning contracts are vital if a student is underperforming or a new learning opportunity has arisen and it is necessary to document an agreement as to how the student will engage with this learning. There will usually be space in the PAD to document the learning contracts. Sometimes these are included as pre-printed templates within the PAD, often coinciding with the formal interview stages.
What if I run out of space to document?
When designing a PAD, universities will try to predict the amount of space required by mentors to complete the required assessment documentation. If the space required is not sufficient then it is advisable to contact a link lecturer from the university who will discuss the options open to you. As the PAD is a formal assessment document it is important that all relevant information is recorded, and not simply left out due to a lack of writing space. It may be that you are advised to record additional documentation on headed paper, giving a copy to the student and the link lecturer if necessary.
You may find that more space is required within a PAD if a mentor or student identifies a specific learning need which could impact on the student’s ability to achieve one or more learning outcomes. If there are multiple issues being addressed then the learning contract or action plan may be quite lengthy in order to specifically address that need.
For example, a student could be struggling with their documentation skills, as reflected in their nursing notes, assessments, care plans, discharges and/or referrals. To enable the student to develop these skills alongside the other learning opportunities you could document an action plan that included some of the following aspects:
• using an English and nursing dictionary when writing records
• using the 16 Principles of Good Record Keeping listed in the NMC’s guidance on Record Keeping as a checklist for their documentation
• writing rough copies of documentation so that you can check the work and provide feedback
• using your organization’s policy on record keeping to critique other professionals’ entries.
If your plan for supporting the student is quite detailed with a number of aspects and variables then the resulting learning contract may also require considerable space in order to document it fully. Don’t be afraid to document what is required as there is no standard for how much documentation each student will require to support their learning.
Using the practice assessment document during placement
Students can be very protective regarding their PADs, as replacing the document can be quite difficult if lost. For this reason students may avoid regularly bringing their PAD to placement for fear of losing or damaging it. They may bring in photocopies of what they perceive as the relevant pages. It is not uncommon for students to have one PAD that will cover several placements, modules or years in the programme and the corresponding practice assessments for these placements. The student’s response to protect the PAD is understandable when the state of the PAD is viewed as a reflection of the student’s presentation and organizational skills.
While anxiety about their PAD is understandable it is not acceptable for a student to ask you to fill in the photocopied sheets or decline for you to see and write in the original. To avoid anxiety it is a good idea to establish with the student at the beginning of the placement what access you will require to their PAD and where it may be safely stored to prevent damage (see Case study 4.2).
Case study 4.2
A mentor’s experience of using the PAD
‘On the first day of the placement I discussed with my student that I would need to have access to his PAD regularly throughout the placement so we could review his learning outcomes together. This seemed to really worry him and he stated that he would prefer not to bring his PAD to placement. He explained that his mentor the year before had taken his book home and it had been lost. He had a very difficult time getting a replacement copy and his learning during the placement had suffered as a result. Once I knew what the problem was the solution was easy. I showed him a locker on the ward where he could keep his book during the placement and supplied him with the combination lock. I assured him that we would always document in it together and that I would never want to take it away from him. Not only did we find a solution that suited us both, we were able to establish a level of trust and respect from the very beginning.’
