Pre-registration Programmes Research Articles

Benefits and challenges of a pre-registration Masters occupational therapy programme: a student perspective

Benefits and challenges of a pre-registration Masters occupational therapy programme: a student perspective

The development of media-driven clinical skills through using the ‘e-skills portfolio’

Background: The‘e-skills portfolio’ has been developed to give students the opportunity to engage in a creative approach to learning the distinctive core skills of: electrotherapy, manual therapy and therapeutic exercise. This paper aims to review the development and implementation of this e-skills portfolio within a pre-registration MSc physiotherapy programme. Content: Students work in small groups, and capture (through film or images) practice of clinical skills through simulation in the university setting. The analysis of the e-skills portfolio involved a pluralistic approach to: analysing data collected from two student discussion groups (n=21); reviewing submitted portfolio content; and teaching team reflections. Findings were then coded, and the emergent themes identified. Emergent themes from the data included assessment of skills and feedback, reflective practice, employment, continuing professional development through peer and self-coaching, and resource access. Conclusions: Engagement in compiling the e-skills portfolio appears to promote students' continuing professional development through a critical process of peer- and self-coaching and deliberate practice. This practice of using the e-skills portfolio is based within an adapted action research model, and appropriate learning support, particularly in IT, is a crucial element in this process.

Speech and language therapy students: how do those with ‘non traditional’ university entry qualifications perform?

Entry to speech and language therapy (SLT) undergraduate pre-registration programmes in the UK is usually achieved through qualifications attained at school (e.g. A-levels). A smaller number of people who did not succeed academically at school enter through qualifications achieved post-schooling, e.g. Access to Higher Education courses. This second group of students are attractive recruits to SLT training programmes as they bring different experiences and backgrounds to the programme and to the SLT profession. However, there are no published studies that explore the academic performance or degree and employment outcomes of students who enter university through this route. To investigate the success of non-traditional entry students, specifically those with Access qualifications, on one pre-registration SLT undergraduate degree at a university in the UK. Success is measured in terms of module results, obtaining a degree, the ability to register as an SLT and first employment destination post-graduation. University applications were reviewed and students who entered via an Access course were identified for a ten-year period. Results for modules, individual assessments and final degree classification were obtained from their files and were compared against the mean score of traditional entry students on the years of the course covered by this study using a series of one sample t-tests. The students who entered through the non-traditional academic route are generally successful in completing their degree and in registering to work as an SLT. However, as a group they perform less well on the degree overall, on individual modules and on written examinations and they do not close this performance gap over the four years of the degree. In contrast, however, they perform on a par with their peers on other types of assessment (e.g. clinical placement, case study, data exercise). The Access students were more likely than traditional entry students to be working as an SLT six-months post-qualification. These results suggest that some types of assessment may be more effective at tapping the skills of students from non-traditional academic backgrounds, and that more tailored support could be provided for this group of students in tackling university written examinations throughout all years of the programme. Despite limited preparation for university-level study and mixed performance on assessment, students from non-traditional academic backgrounds can do well at university and successfully gain employment as SLTs.

Student life - Rapid response team

NURSING STANDARD The University of Glamorgan won the 2012 Times Higher Education Outstanding Support for Students award for a project addressing the needs and experiences of undergraduate nursing and midwifery students with disabilities and dyslexia. I lead the project in partnership with the faculty head of learning and teaching, the disability and dyslexia service manager and the faculty computer programmer. The team uses the Microsoft Offi ce SharePoint Server (MOSS) secure document management system to organise and share sensitive information about the needs of students who have disabilities. The UK Equality Act (2010) imposes a duty on public sector organisations, including higher education institutions, to make reasonable adjustments for disabled students (see box). The large number of staff involved in teaching pre-registration nursing programmes made it diffi cult for students to communicate their support needs. Now, appropriate adjustments are discussed with the student, assessed by the university and recorded on individual student support plans (ISPs), which are shared with staff in accordance with the Data Protection Act via the SharePoint system. The university’s Disability and Dyslexia Service (DDS) used to manage a shared folder containing students’ ISPs. However, staff and students said it was time-consuming to access and unresponsive to changing learning needs. The MOSS system allows sensitive information to be organised, managed and shared by the DDS and it can be updated quickly by students and lecturers. Research from the Higher Education Academy (HEA) suggests that students with disabilities who are given immediate support are more likely to have a positive learning experience. The HEA recommends therefore that students’ needs should be assessed and communicated promptly to tutors. That is, there should be systems in place for students to register their needs as soon as their courses start. The MOSS system has improved the student learning experience by speeding up information transfer between the DDS and lecturers. When a new ISP is added to SharePoint, the course leader receives an automatically generated email and can then discuss the student’s needs with DDS staff and the student. SharePoint has improved the way that students with disabilities and dyslexia can communicate their learning needs to those in a position to lend support. An icon that appears on staff computer desktops gives fast access to students’ ISPs and reduces the need for email. For example, when the exams offi cer was absent just before an exam, a SharePoint permission and 15 minutes of training enabled a team leader to identify students who needed exam support NS

Facilitating the transition to postgraduate attainment: the experience of one postgraduate, pre-registration physiotherapy programme

Students on the MSc Physiotherapy (pre-registration) programme at Manchester Metropolitan University work at postgraduate level, whilst studying to become physiotherapists. To facilitate the transition to postgraduate attainment, students participated in two sessions designed to inform them about assessment processes and standards. The hypothesis was that attainment as measured by first assignment mark in the first term would improve. In a pretest: post-test design, the pre-groups were students who completed the first assessment without the transition sessions (N = 35), and the post-groups those who completed the first assessment after the transition sessions (N = 38). Mean and highest marks were greater in both post-test groups compared to pretest groups; the lowest marks achieved were similar across all groups. Tests of normality and homogeneity were non-significant. An unrelated T-test found a significant difference in assessment performance between pre- and post-test groups. A significant improvement in performance followed the intervention, so the hypothesis was accepted.

Factors that enhance rates of completion: What makes students stay?

This study was one of four projects commissioned by NHS London to examine the readiness for work of nurses upon completion of their pre-registration programmes. The study examined the factors that contribute to students completing their nursing programmes. The objectives of the study were to explore understanding the factors that influence the attrition and completion rates of year 2 students on the adult field of a pre-registration nursing programme. An ethnographic case study methodology was employed in two large London NHS Acute trust hospitals, both partnered with the same Higher Education Institution. Data was collected between 2010 and 2011 through a combination of document review, non-participant observation in practice settings, focus groups and interviews A self-selected group of 50 year 2 student nurses from a total population of 200 participated in this study. All students were from the same cohort group at one London-based university who undertook practice learning experiences at two NHS Acute Trust hospitals. The study found a number of factors that impacted on retention which included student identify and the organisation, fostering resilience and clinical support. In addition the Higher Education Institute does not appear to be the most significant factor in a student's decision to continue on the programme, but that practice placement mentors and clinical placements have the greatest impact on student retention. The study is important in that its findings contradict much of the literature on student nurse attrition and retention in that the clinical placement experiences emerges as the most important factor in whether a student chooses to stay or leave the course.

Recruitment, selection and retention of nursing and midwifery students in Scottish Universities

High attrition rates from pre-registration nursing and midwifery programmes have been reported in both the UK and in other countries. A study was conducted to identify best practice in recruitment, selection and retention across Scottish Universities providing pre-registration programmes. A survey of all universities providing pre-registration programmes in Scotland was conducted. Semi-structured interviews were conducted with key personnel in each university. Documentary evidence was collected to supplement interview data and evidence recruitment, selection and retention practices. All universities in Scotland providing pre-registration nursing and/or midwifery programmes. All 10 identified universities agreed to take part and a total of 18 interviews were conducted. Semi-structured face to face and telephone interviews were conducted. Relevant documentary evidence was collected. All data were subject to thematic analysis. Universities are predominantly concerned with recruiting to the institution and not to the professions. Interviews are widely used, and are a requirement in the United Kingdom. However, there is no evidence base within the literature that they have predictive validity despite creating scales and scoring systems which are largely unvalidated. The study identified initiatives aimed at addressing attrition/retention, however most had not been evaluated often due to the multi-factorial nature of attrition/retention and difficulties with measurement. Recruitment selection and retention initiatives were rarely evaluated, and if so, adopted a relatively superficial approach. Evidence from existing studies to support practices was mostly weakly supportive or absent. The study highlights the need for a coordinated approach, supporting the development of a robust evidence base through the evaluation of local initiatives, and evaluation of new strategies. Evaluation strategies must take account of the local context to facilitate transferability of findings across different settings.

The QUIPPED Project: Students’ Attitudes Toward Integrating Interprofessional Education into the Curriculum

Background: Healthcare learners are the future healthcare providers. The preparationthey receive in their pre-registration programs will be vital to ensuring that they practice patient-centred care. One approach to this learning model is interprofessional education (IPE).Methods and Findings: Learner attitudes towards interprofessional education and practice were obtained over a thirty-three month period from the Queen’s University Inter-Professional Patient-centred Education Direction (QUIPPED) project. Attitudes were measured by questionnaires based on a 6-point Likert scale. The learners received a number of opportunities to engage in IPE and demonstrated positive attitudes. The degree to which one or more educational initiatives can make a difference in attitude is limited. However, over the course of the project both statistically significant and clinically meaningful differences were found. Different health professional student groups, including medical, medical radiation technology, nursing, occupational therapy, and physical therapy learners varied in their attitudinal responses, demonstrating they have already acquired professional identity.Conclusions: Recommendations include offering varied opportunities to learners, and providing them with the tools to communicate and collaborate together. Limitations include a lack of empirical evidence as to whether IPE translates into interprofessional practice and better patient-centred care.

Can intuitive knowledge be taught in midwifery practice?

This paper critically analyses the notion of midwifery epistemology and the ontological view that intuitive knowledge, while in built, develops into tacit knowledge. through pre-registration midwifery programmes learning strategies are identified that enable students to develop tacit knowledge. the art of midwifery education, both pre-registrationand lifelong, is to learn to believe in an individual's intuition. intuitive knowledge is a type of knowing, the art of midwifery that is difficult to articulate but fundamental for best practice. Midwives rely on the model that childbirth is a normal phenomenon. the learner has to travel a complex and exciting journey, meeting academic requirements, fulfil Women's expectations and learn to listen to her/his inner self. through this process of learning, theoretical knowledge, developing clinical acumen and awareness of self, the sum of the parts is more than the whole.

Improving the content and face validity of OSCE assessment marking criteria on an undergraduate midwifery programme: A quality initiative

Objective Structured Clinical Examinations (OSCE's) have been adopted as a means of assessing midwifery students' clinical skills. The purpose of the OSCE is to provide a standardised method for the evaluation of clinical skill performance in a simulated environment. This paper describes how a quality improvement initiative using both internal and external expert review was utilised to improve OSCE assessment marking criteria. The purpose of the quality initiative was to review the content and face validity of the marking criteria for assessing performance. The design and choice of tools used to score students' performance is central to reliability and validity. 20 videos of students from year one of a midwifery preregistration programme undertaking an OSCE assessment on abdominal examination and 18 videos of students response to obstetric emergencies e.g. PPH, and shoulder dystocia were available for review. The quality initiative aimed to strengthen the reliability and validity of the OSCE in assessing student performance. Conclusion: the use of global rating scales allows for the capturing of elements of professional competency that do not appear on specific criteria for skills performance checklists.

Providing learning support to nursing students: A study of two universities

In universities where significant numbers of nursing students come from non-traditional backgrounds, and where an equally significant proportion of students have English as a second language, provision of learning support is essential to ensure success and progression, and to prevent attrition. This paper presents an evaluative study of the support services provided to undergraduate nursing students in two universities in the United Kingdom (UK). Both universities have significant numbers of students from non-traditional backgrounds and who have English as a second language, and both institutions have in place a large array of student support mechanisms. The aims of the study were to identify all existing student support mechanisms across the two universities, to illuminate the profile of students who enter pre-registration programmes at the two universities (age, gender, educational background) and to measure the perceptions of students of the use and usefulness of the support mechanisms provided by their university. Survey method evaluative research was the chosen research approach.Findings showed that the support services that appear to have the greatest impact on student success in their nursing programme are the programme leaders/module teachers, small study skills groups (known as APPL and L2L) and, for the 50% of students who required it, academic literacy and numeracy support sessions. For students who have English as a second language and with non-traditional entry qualifications, numeracy and academic literacy support is particularly valued.

A systematic review to appraise the evidence relating to the impact and effects of formal continuing professional education on professional practice

The literature relating to post-registration education showed that registered nurses demand higher education in order to keep up with pre-registrants. The systematic review of the literature also suggested that registered nurses undertake higher education for personal reward but that it may have no direct benefit to patient care. This review was undertaken as part of an MSc in Health and Social Care Education. The review included 21 papers on registered nurses who had completed individual modules and full educational pathways, but did not consider mandatory study sessions or pre-registration programmes. Each article was critically appraised, data was extracted, tabulated, and synthesised using a narrative synthesis approach. The findings showed that diploma level students (those obtaining a qualification at an academic level equivalent to the 2nd year of a degree programme, but already professionally registered) acquired more knowledge during their studies. They were able to transpose them into practical skills and enhance the skills required for registration; but the literature also shows that these changes could not be maintained, due to other influences. Students of Bachelors and Masters Education developed academically and professionally, and whilst these effects advance more gradually, they are apparent long-term. All registered nurses, regardless of the level of academic study, met a number of barriers to implementing newfound knowledge and skills; and managerial constraints were found to be the most prominent. Overall findings indicate that post-registration higher education undertaken by nurses does positively influence professional practice.

What are pre-registration nurses taught about caring for children?

Nurse education curricula have to be continually reviewed to ensure that content remains applicable to contemporary healthcare developments. In this article, the authors report the findings of a research study that investigated the children's nursing component taught in all non-children's BSc Nursing degree programmes in Irish colleges. The aim of the study was to identify how European Union directives and national curriculum guidelines are interpreted in colleges, and to clarify the preparation that non-children's pre-registration nursing students receive with respect to caring for children. The authors explored aspects related to children's nursing in all non-children's undergraduate pre-registration programmes, including curriculum content and its delivery, assessments and practice experiences. Data were collected by a specifically designed questionnaire based on the Requirements and Standards for Nurse Education Programmes (An Bord Altranais, 2005a; b). A university ethics committee provided ethical approval. The response rate was 54%(n=7), and data were analysed using SPSS 16 and content analysis. The authors' findings illustrated that the requirements and standards of all nursing programmes are interpreted in a variety of ways regarding children's nursing. Nationally, nursing content related to children needs to be reviewed in all nursing programmes to ensure consistency among providers. Healthcare requirements for children and families need to be heightened within curricula for all disciplines.

Enquiry-based learning in midwifery: the lecturer's experience

In September 2008, an enquiry-based learning (EBL) approach was implemented for the first time into the University of Hertfordshire's (UH) pre-registration midwifery programme. An evaluation of this approach was therefore required. This study explored the lecturers' experiences of using EBL within the first year of its implementation. A qualitative methodological approach using a phenomenological design were used and two of the main themes that emerged are presented in this paper: ‘facilitation of EBL’ and ‘EBL and the midwifery curriculum.’ Conclusions drawn from this study found that overall, EBL is a useful approach within the midwifery curriculum but it should be supported by key lectures that address foundational knowledge in midwifery. The method of facilitation is a key factor in the effectiveness of this approach and staff reflection is deemed to be an important aspect in supporting facilitators to develop in their role. Recommendations are made for the future development of this approach.

Keeping it personal

Rules about obtaining consent for using patient data in student assignments are unclear, says Bernadette Devlin

Simulated practice learning in a preregistration programme

Following the publication of the Nursing and Midwifery Council's (NMC) (2007) Simulation of Practice Learning Project, simulated practice learning opportunities are now to be incorporated into preregistration undergraduate nursing programmes across the UK. Since 2008, the Faculty of Health and Life Sciences at Oxford Brookes University has incorporated simulated practice learning into their curriculum to contribute towards students' 2300 direct clinical care hours. This paper presents the findings of an evaluation project that was conducted by academic staff within the faculty to ensure that they could continue to meet the principles set out by the NMC for auditing simulated learning environments used by higher education institutes (HEIs), and to meet the Essential Skills Clusters (NMC, 2010a) for registration as part of the quality assurance processes. The evaluation took place over 2days, with a total of 52 participants, including practice partners, mentors, practice educators, academic staff and students from all four branches of nursing (adult, mental health, learning disability and children). Results indicated that the support of direct care hours through simulated practice learning can permit students to practice essential clinical skills in a designated clinical skills suite. These learning experiences can also offer positive outcomes and the opportunities to maintain partnership for students, placement partners, and mentors.

How can we maximize nursing students’ learning about research evidence and utilization in undergraduate, preregistration programmes? A discussion paper

This article presents a discussion on how to maximize nursing students' learning about research for evidence-based practice in undergraduate, preregistration programmes. Evidence-based practice may use information from many sources, including research. Research utilization concerns the translation of research findings into practice. Thus, while evidence-base practice may not be solely research-based and hence more than research utilization, research remains an important ingredient in ensuring quality and cost-effective care and an academic requirement for nursing students undertaking a science degree-level qualification. Nevertheless, how educators can best support research-related learning and application remains uncertain and requires discussion. MEDLINE, CINAHL, Social Science Citation Index, British Nursing Index, and Intute were searched for papers published 1980-2011 using the following search terms: research, research utilization, evidence-based practice, learning, teaching, education, training, nursing, health, and social care. Nursing students need to be able to value the relevance, authority, and utility of nursing research for patient care through embedding research learning in both academic and practice-based settings. Students can be supported in learning how to access, understand, and appraise the authority of research through weaving these skills into enquiry-based learning. Furthermore, encouraging students to undertake research-based practice change projects can support research utilization and development skills. Research should be fully embedded throughout nursing curricula beyond the confines of 'research classes', integrating learning in academic and practice-based settings. Although this requires synergistic and integrated support of student learning by nurse educators, managers, clinical practitioners, researchers and policymakers; nurse educators have a pivotal role.

Made to measure

NURSING STANDARD I have lost count of the articles, editorials and opinion pieces in national newspapers about the state of nursing and the perceived poor standard of nursing care. Such articles induce a heavy, sinking feeling in proud registered nurses and nurse educators. I imagined that current cohorts of nursing students undertaking their pre-registration programmes in the UK are worried by this negative publicity. They may well feel that their chosen profession has let them down and that the image of nursing in the press does not reflect the compassionate ideals they aspire to. Yet on further reflection, I see hope in these difficult times. I do not say this lightly – this is no time to be flippant or ignore the facts. The core of nursing has always been, and continues to be, care, compassion and communication. The Nursing and Midwifery Council endorses and reinforces this position through its essential skills clusters (see box), which are incorporated in the standards for pre-registration nursing education.

Evaluating enquiry-based learning in a new pre-registration programme

In accordance with the need to provide contemporary midwifery education which meets the Nursing and Midwifery Council (NMC) (2009) standards, the pre-registration midwifery education programme at the University of Hertfordshire underwent a major curriculum development in 2008, which afforded the opportunity to review the existing learning and teaching strategies. The curriculum development team were keen to develop an education programme which would enable student midwives to develop the necessary skills associated with adult learning and encourage individual responsibility for life-long learning ( NMC, 2010 ) in the belief that such skills would help prepare student midwives to be better equipped to cope with both the demands of the programme and the challenges of contemporary midwifery practice. The learning and teaching strategy of enquiry-based learning (EBL) was introduced as a key feature throughout the 3-year midwifery programme. This article presents an evaluation of the introduction of EBL for a group of first-year students as they progressed through the first year of their midwifery training. It reports on some of the emerging themes from the students' perspectives from their experience of EBL and on the resulting changes which occurred in response to the findings from a series of facilitated student focus group meetings.

A dignified approach to improving the patient experience: Promoting privacy, dignity and respect through collaborative training

Globally there is a plethora of literature surrounding patients’ privacy, dignity and respect, consequently highlighting the need for healthcare professionals to ensure such basic human rights are upheld when delivering care. For qualified practitioners this is further emphasised through the professional bodies and their varying codes of practice. To ensure privacy, dignity and respect move from rhetoric to reality in professional practice many pre-registration programmes promote service user involvement. Evidence suggests that involving service users in the delivery of educational programmes by directly telling their own stories enhances patient centred care. However given a number of recent patient surveys and/or audits reporting the lack of privacy, dignity and respect in health and social care settings there seems to be a growing need to reaffirm practitioners’ knowledge, skills and values once qualified and practising in healthcare organisations. This paper reports on a project in a UK NHS Mental health Trust where service users, in collaboration with Trust staff, planned and delivered a series of privacy and dignity workshops to healthcare practitioners with the aim of improving the patient experience. Although the project took place within a Mental Health Trust the issues of privacy, dignity and respect apply to all healthcare sectors.