Major review of healthcare programmes
The Department of Health, in partnership with the Nursing and Midwifery Council, the Health Professions Council and the Strategic Health Authorities have contracted with the Quality Assurance Agency for Higher Education (QAA) to carry out reviews of all NHS-funded healthcare programmes in England during the period 2003-06.
QAA helps to provide public assurance that the quality and standards of higher education are being safeguarded and enhanced by conducting academic reviews of higher education provision.
Major review
Major review is a peer review process. It starts when higher education institutions in partnership with their commissioning Strategic Health Authorities evaluate their provision in a self-evaluation document. This document is submitted to QAA for use by a team of academic and practitioner reviewers who gather evidence to enable them to report their judgements on the academic and practitioner standards and the quality of learning opportunities. Review activities include meeting academic and clinical staff and students, scrutinising students' assessed work, visiting practice learning environments, reading relevant documents, and examining learning resources.
Full details of the process of major review can be found in the Handbook for major review of healthcare programmes, 2003.
Judgements
The range of judgements that reviewers may utilise when they have completed a major review are summarised below.
Academic and practitioner standards
Reviewers make one of the following judgements on standards:
- confidence, which may be expressed as
- limited confidence, or
- no confidence.
To reach this judgement, reviewers look at:
- learning outcomes
- the curriculum
- student assessment
- student achievement.
Confidence in academic and practitioner standards: a judgement that is made if reviewers are satisfied with current standards and with the prospect of those standards being maintained into the future. A judgement of limited confidence is made if standards are being achieved but the reviewers have doubts about the ability of the HEI and partner placement providers to maintain them into the future.
No confidence in academic and practitioner standards: a judgement that is made if arrangements are inadequate to enable standards to be achieved or demonstrated. If a failure to achieve standards has occurred in specific programme/s and/or mode/s and/or level/s only, and there is confidence in standards at other levels, the failing programme/s mode/s level/s will be identified separately.
Quality of learning opportunities
Reviewers make one of the following judgements for each of three elements of learning opportunities:
- commendable
- approved
- failing.
The three elements of quality of learning opportunities are:
- learning and teaching
- student progression
- learning resources and their effective utilisation.
Maintenance and enhancement of standards and quality
Reviewers also report the degree of confidence they have in the providers' ability to maintain and enhance quality and standards in the healthcare programmes under review.
Commendable - the provision contributes substantially to the achievement of the intended outcomes, with most elements demonstrating good practice.
Approved - the provision enables the intended outcomes to be achieved, but improvement is needed to overcome weaknesses. The summary report will normally include a statement containing the phrase 'approved, but...', which will set out the areas where improvement is needed.
Failing - the provision makes a less than adequate contribution to the achievement of the intended outcomes; significant improvement is required urgently if the provision is to become at least adequate.
Summary of the main review outcomes
Subject provision and overall aims
Programmes in operating department practice and radiography at Anglia Ruskin University and in occupational therapy and physiotherapy at the Colchester Institute in partnership with Essex Strategic Health Authority and North East London Strategic Health Authority were reviewed in the academic year 2005-06. Judgements were made about the academic and practitioner standards achieved and the quality of the learning opportunities provided.
The review covered the following programmes:
Occupational therapy
Pre-registration
- BSc (Hons) Occupational Therapy (part-time) ***
- BSc (Hons) Occupational Therapy (accelerated full-time) ***
Operating department practice
Pre-registration
- Diploma of Higher Education (DipHE) Operating Department Practice (full-time) ***
Physiotherapy
Pre-registration
- BSc (Hons) Physiotherapy (part-time) ***
Radiography
Pre-registration
- BSc (Hons) Radiography (Diagnostic Imaging) (two years full-time + two years part-time) ***
- DipHE Medical Imaging Practice (part-time)
- FdSc Radiotherapy and Oncology Practice (part-time)
- Certificate of Higher Education Mammographic Studies (full-time).
*** Programmes approved by the Health Professions Council.
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in occupational therapy, operating department practice, physiotherapy and radiography at Anglia Ruskin University and Colchester Institute in partnership with Essex Strategic Health Authority and North East London Strategic Health Authority.
Strengths
- The part-time, accelerated programme in occupational therapy allows students greater choice in their study patterns (paragraph 7).
- The tripartite approach, involving the Institute of Health and Social Care, practice staff and students in the design and development of the work-based curriculum in operating department practice, has resulted in a highly-relevant programme to meet future workforce demands (paragraph 17).
- To support operating department practice mentors, the Institute of Health and Social Care and the Essex Strategic Health Authority provide an effective training and updating programme to ensure that assessment is robust and fair (paragraph 20).
- The design and use of the standardised clinical assessment form in physiotherapy provides the basis for the rigorous assessment of practice (paragraph 31).
- The design of all radiography programmes has been responsive to workforce demands and the development a four-tier healthcare structure in the profession (paragraph 35).
- Given that students learn mainly in their workplace, the radiography curricula have strong practice foci, with curricular developments being fully informed by service managers and practitioners (paragraph 37).
Weaknesses
- The use of a marking grid to achieve standardisation of assessments has been introduced in occupational therapy, but is not always consistently applied by markers (paragraph 10).
- Operating department practice students are not always able to benefit fully from the feedback because they do not have their work returned in a timely manner (paragraph 21).
- There is no service-user involvement in curriculum development in physiotherapy (paragraph 26).
- There is variability in the timeliness of returning work to physiotherapy students (paragraph 29).
- Although the objective structured practical examinations in physiotherapy include theoretical and practical stations with separate marking criteria, the current approach to determining the final module mark and Pass/Fail threshold does not ensure that learning outcomes related to safety and effectiveness are fully addressed (paragraph 30).
- There is a lack of any formal written feedback to physiotherapy students on their performance in objective structured practical examinations to highlight strength or weakness in areas of professional competency (paragraph 30).
- FdSc Radiotherapy and Oncology students are unclear regarding the intended learning outcomes and have concerns that mentors are not always sure about the specific intended learning outcomes for the Foundation Degree and rely instead on their knowledge of the BSc (Hons) programmme (paragraph 34).
- There is some delay in returning radiography assignments to enable students' learning to benefit sufficiently from written feedback (paragraph 39).
- On the assistant practitioner radiography programmes, the level of performance expected to achieve grades 'very good 'or 'excellent' through the clinical appraisal assessments is unrealistic and beyond the scope of practice of assistant practitioners (paragraph 40).
- Currently, there is no mentorship training for mentors of assistant practitioners in the Foundation Degree (paragraph 40).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strength
- In radiography, the distance learning and teaching strategy is well organised and is clearly designed to meet the needs of the NHS, locally and nationally (paragraph 43).
Weaknesses
- The learning strategy for physiotherapy students, in particular, their understanding of self-directed study, remains unclear (paragraph 44).
- In the current programmes, except operating department practice, interprofessional education is under-developed (paragraph 47).
Student progression
The quality of student progression is commendable.
Strengths
- The appointment of student advisers in the Institute of Health and Social Care and of specialist higher education study skills support tutors at Colchester Institute are examples of initiatives to strengthen support and of strategies for reducing attrition rates (paragraph 49).
- Operating department practice students, who have not studied for some time, regard the 30-credit module on learning to learn as highly supportive for their progression in the programme (paragraph 49).
- Addenbrooks and Ipswich Hospitals send out high-quality induction and information packs, which are appreciated by radiotherapy students (paragraph 50).
- In all programmes, students receive high-quality support and advice on both campuses and in placements (paragraph 50).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strength
- The virtual learning environment materials in distance-learning radiography programmes are of a high quality and effectively support student learning (paragraph 55).
Weaknesses
- Occupational therapy and physiotherapy students reported that they find the opening hours of the library are restricted and do not address their needs, especially when they are on placement (paragraph 52).
- Institute of Health and Social Care staff do not always inform library liaison staff of the books students require (paragraph 52).
Maintenance and enhancement of standards and quality
Strengths
- Annual monitoring reports in the Institute of Health and Social Care and Colchester Institute provide detailed and evaluative analysis of the programmes, with clear indication of enhancement (paragraph 57).
- The relationship between the Institute of Health and Social Care, Colchester Institute and Essex Strategic Health Authority is robust and highly collaborative to ensure the quality of the provision (paragraph 59).
Introduction
1 This report presents the findings of a review of the academic and practitioner standards achieved, and the quality of the learning opportunities provided, in the operating department practice (ODP) and radiography programmes at Anglia Ruskin University (ARU) and occupational therapy and physiotherapy programmes at Colchester Institute (CI) in partnership with Essex Strategic Health Authority (ESHA) and North East London Strategic Health Authority (NELSHA). The review was completed during the academic year 2005-06. CI was founded in 1976, following the merger of several educational institutions. The programme in occupational therapy is delivered under the CI's assessment regulations and is approved by ARU. Physiotherapy has been delivered and managed by CI under a franchise arrangement with ARU as the awarding body. Prior to 2004, it was approved by the University of Hertfordshire and there are two years of part-time students still on this programme, although they are not part of this major review. In 2005-06, the occupational therapy and physiotherapy programmes will transfer to the University of Essex as the awarding body. The Institute of Health and Social Care (IHSC) in ARU is responsible for the ODP and radiography programmes. The IHSC was established in January 2005, following the re-organisation of the University.
A Subject provision and overall aims
2 Disciplines are currently offered in the following programmes:
Occupational therapy
Pre-registration
- BSc (Hons) Occupational Therapy (part-time) ***
- BSc (Hons) Occupational Therapy (accelerated full-time) ***
Operating department practice
Pre-registration
- Diploma of Higher Education (DipHE) Operating Department Practice (full-time) ***
Physiotherapy
Pre-registration
- BSc (Hons) Physiotherapy (part-time) ***
Radiography
Pre-registration
- BSc (Hons) Radiography (Diagnostic Imaging) (two years full-time + two years part-time) ***
- DipHE Medical Imaging Practice (part-time)
- FdSc Radiotherapy and Oncology Practice (part-time)
- Certificate of Higher Education (CertHE) Mammographic Studies (full-time).
*** Programmes approved by the Health Professions Council (HPC).
3 The overarching aim of the IHSC is to provide high-quality and professionally-approved education and training that is intended directly to benefit patients, clients, users and carers and is responsive to local needs and national initiatives by:
- developing students' knowledge, values, conceptual understanding and skills, appropriate to a range of careers in health and social care
- sustaining an environment of professional and academic support to facilitate student achievement and possible further study
- ensuring that government initiatives in health and social care are reflected in the curricula and in research
- working in close collaboration with stakeholders to prepare students for employment or post-qualifying healthcare professional practice that meets local and national needs
- developing curricula that aim to ensure that the patient/client experience is at the centre of the student learning experience
- equipping students to be fit for purpose, practice and academic award
- providing a portfolio of pre-registration and Continuing Professional Development health and social care programmes, offering a variety of flexible entry opportunities, modes of study and exit points responsive to current and future practice
- promoting collaborative links between the National Health Service (NHS), other service providers and stakeholders and higher education that foster development and mutual benefit
- developing research and evidence-based practice in the cognate field of health and social care
- building upon strength and commitment to research and interprofessional work
- supporting these aims by rigorous quality management that ensures and enhances academic and practice standards and quality.
The ARU awards offered by CI are also subject to these aims.
B Academic and practitioner standards
B1 Occupational therapy
Intended learning outcomes
4 The intended learning outcomes (ILOs) are mapped against the draft Subject benchmark statement, the final version of which is now published by QAA, and incorporate the College of Occupational Therapists professional standards. HPC Standards of Proficiency were unavailable at validation in 2001. At this time, the requirements of the Joint Validation Committee and College of Professions Supplementary to Medicine were met. Regular updating has ensured that the ILOs meet the current HPC Standards of Proficiency. ILOs meet The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), the Health Professions Framework (HPF) and ARU's level descriptors. There are opportunities to negotiate interprofessional education (IPE) in practice, and CI is currently developing IPE outcomes for occupational therapy with physiotherapy for the new programmes in 2006-07. Key stakeholders, managers and practice staff inform the ILOs for practice placements.
5 The programme specifications clearly identify the ILOs for theoretical and practice learning. Students are well prepared for their placement ILOs, with the communication of ILOs taking place through induction days, pre-placement visits and information packs and handbooks. Placement staff are kept informed of the ILOs through advance written documentation, practice educator guides and placement assessment forms. Students value the process of negotiating individual ILOs for placements within a learning contract, and are able to draw on core knowledge and skills of occupational therapy to relate to specialist placements. Students also regard ILOs as providing focus and useful guides to their learning. Effective collaboration between the programme team and placement providers to develop ILOs is enabled through twice-yearly programme management committees.
Curricula
6 Both BSc (Hons) Occupational Therapy programmes meet the Standards of Proficiency required by the HPC. Subject providers plan and design curricula in close collaboration with ESHA and with practice partners. Programme committees are used to sharing information between stakeholders to inform curricular development and make modifications when needed. The flexibility of the working of the programme committee and the awarding body enables the curricula to be updated in a timely manner to ensure that national developments are incorporated. Experts in practice have been invited to develop and deliver elements of the curricula. ESHA works in close partnership with the IHSC, CI and practice partners to review the currency of the programme and its link to workforce planning.
7 In occupational therapy, IPE opportunities are widely available in practice, but the current curricula do not address IPE. Students' progression through the curricula is appropriate to their level and pace of study. The part-time programme in occupational therapy allows students greater choice in their study patterns, whereby they can work and study, which also facilitates the widening access policy of CI. In practice, students are guided to meet the challenges of the curricula by practitioners familiar with supporting students through their own continuing professional development and by taking the opportunity to participate in annual workshops that address standards of training and education, including mandatory health and safety matters. Students are well prepared for practice through the curricular content and design and there is appropriate emphasis to integrate theory and practice. Students and practitioners report that the current curricula provide the required scientific knowledge and clinical skills necessary for practice.
8 The four main themes of the curricula, science and medical studies, professional studies, professional skills and research skills, are included at each level of study, with each level demonstrating increasing challenges to ensure progression. Progression is ensured in the curricular design, content and organisation and is transparent to students who recognise the challenges of the different levels. Overall, both curricula are sufficiently well designed to enable students to achieve the ILOs.
Assessment
9 The BSc (Hons) Occupational Therapy programmes employ a variety of assessment methods which are appropriate for the levels of the programme and are mapped against the module ILOs. At level 1, most of the assessments are essays or based on case-studies, with the exception of one examination, in the biological perspectives module. At level 2, the methods include oral examinations, presentations, essays and the development of a skills portfolio. More student-centred investigation, analytical activities and research skills are included at level 3. The assessment strategy enables students to build upon prior learning and personal experience and is particularly well suited for evidence-based practice and developing reflective practice skills. The assessment strategy includes a well-developed practice assessment tool. The grading of practice contributes to the final award, is clearly explained in the programme handbook and understood by students.
10 The use of a marking grid to achieve standardisation of assessments has been introduced in occupational therapy, but is not always consistently applied by markers. This is not aligned with the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), Section 6: Assessment of students, Precept 8, published by QAA. The external examiner has highlighted this as an issue for attention and the programme team has identified a staff development strategy to discuss how to use the marking grid more effectively. An initial staff development workshop, focused on standardisation and enhancement of quality of marking across CI's Centre for Professional Healthcare and Education, was held in March 2006. Following the setting of similar assignments for the two-year and four-year programmes, the programme team has demonstrated vigilance to ensure that, in the future, assignments for the two intakes are sufficiently different to prevent any possible malpractices.
11 Students value the process of negotiating individual assessments at the start of each practice placement. Practice staff and students are clear about the assessment process for practice and appreciate the support visit by the programme team at both the halfway and final assessment points. Occupational therapy supervisors and students in practice placements sign an agreement that professional standards are met. Formative and summative feedback to students during practice placements is detailed and highly supportive to students. Cross-marking meetings are used effectively to moderate practice placement assessments. Opportunities are provided for preparation and support of staff from practice placements to undertake supervision and assessment. There is an effective partnership between staff in practice placements and the programme team at CI to ensure that the assessment of practice is rigorous and fair.
Student achievement
12 From their scrutiny of longitudinal samples of student work, the reviewers agree with the external examiner that students are achieving the ILOs and are fit for practice, purpose and award. In particular, as expected, students with higher grades demonstrate a more critical approach to their work, an ability to apply current theoretical knowledge for evidence-based practice and to identify information-gathering to inform clinical reasoning and intervention with clients. On average, over the last three years, 23 per cent of students achieved First class, 64 per cent Upper Second class and 13 per cent Lower Second class honours awards (Table 1a).
13 In their meetings with the reviewers, students stated that they regarded the programme provided them with the knowledge and skills to practise with confidence and safety. On graduating, students successfully secure employment, with 66 per cent working locally (Table 2a). There is high local retention of graduates in the workforce, and stakeholder confidence leads to the provision being annually commissioned since 1995.
Summary of academic and practitioner standards for occupational therapy
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Occupational Therapy at Anglia Ruskin University and Colchester Institute in partnership with Essex Strategic Health Authority.
Table 1a: Completion and achievement statistics for all award-bearing programmes in occupational therapy
| Programme (Award bearing only) |
Cohort | Degree classification | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| Occupational Therapy (part-time, four-year) |
Sep-01 | 4 | 21 | 12 | 63 | 3 | 16 | ||||||
| Occupational Therapy (accelerated, two-year) |
Sep-00 | 5 | 26 | 11 | 58 | 3 | 16 | ||||||
| Sep-02 | 4 | 22 | 13 | 72 | 1 | 6 | |||||||
Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes in occupational therapy
| Programme (Award bearing only) |
Further Study |
Local Employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| Occupational Therapy (part-time, four-year) | ||||||||||
| Sep-01 | 17 | 68 | 1 | 4 | 7 | 28 | ||||
| Occupational Therapy (accelerated, two-year) | ||||||||||
| Sep-00 | 15 | 66 | 4 | 17 | 4 | 17 | ||||
| Sep-02 | 17 | 81 |
1
|
5
|
3 | 14 | ||||
Strength
- The part-time, accelerated programme in occupational therapy allows students greater choice of their study patterns (paragraph 7).
Weakness
- The use of a marking grid to achieve standardisation of assessments has been introduced in occupational therapy, but is not always consistently applied by markers (paragraph 10).
B2 Operating department practice
Intended learning outcomes
14 The ILOs have been developed to meet the Association of Operating Department Practitioners' proficiencies and the general healthcare benchmark statement, published by QAA. HPC Standards of Proficiency were unavailable at the time of validation in 2002, but the programme is aligned with these standards. The ILOs are set at appropriate levels for the CertHE and DipHE in accordance with the FHEQ. The ILOs are clearly set out in the programme specifications and are aligned with ARU's level descriptors. They also make reference to the Southern England Consortium for Credit Accumulation and Transfer. Knowledge and understanding, intellectual and transferable skills and the practical skills for clinical practice are clearly indicated in the ILOs. Individual modules have more specific ILOs relating to each of the categories of the general ILOs.
15 Students are able to access information on ILOs through the student handbook, posted information packs, discussions and explanations provided during induction. Students said that they have a clear understanding of the ILOs and found them helpful guides to their learning. Practice staff are sent updated information packs prior to students' arrival and are fully aware of the placement ILOs. The practice facilitators have had input into the development of the ILOs through their membership of a working party and through regular meetings with IHSC staff. Mentors work with students at the beginning of a placement and discuss the ILOs, which can be adapted to match the placement. The ESHA supports the mentors' understanding of the ILOs at mentor-update sessions.
Curricula
16 Curricular design and development have been informed by, and benefited from, a collaborative working relationship between practice partners, the ESHA and the IHSC. The ODP programme is based on several key principles, namely, it is predominantly work-based, practice-led, patient and client-focused, and evidence-based. There is an appropriate balance of theory and practice, at 36 per cent and 54 per cent respectively, with 10 per cent based on an independent study component. The curriculum is well designed around these key themes and the careful sequencing of modules ensures progression and integration. The modules include an understanding of accountability in practice, of biological science emphasising normal and altered physiology, critical incident analysis and research awareness.
17 Curricular design, monitoring and modifications are fully informed by all stakeholders, and the IHSC is particularly responsive to student feedback to implement continuous improvements. As befits such a work-based curricular, there has been a strong contribution from practice staff to curricular design. The curriculum is comprehensive, up to date and informed by current practice underpinned by relevant theoretical knowledge. The tripartite approach, involving the IHSC, practice staff and students in the design and development of the work-based curriculum in ODP, has resulted in a highly-relevant programme to meet future workforce demands. Students are introduced to practice early in the programme, through placements and other practice-focused activities. The links between theory and practice are secured through a schedule of main core placements, with which students are linked for most of their practice experience, and associate core placements that supplement their experiences.
18 Service users have had some input into the curriculum, in particular, regarding the IPE module. This is reinforced through IPE opportunities in the workplace. Students have opportunities to learn from a range of practitioners, including anaesthetists, specialist nurses and specialist operating department practitioners. The wide range of learning experiences outlined in the curriculum design enables students to develop relevant knowledge and skills that are transferable in a number of practice settings. There are opportunities for students to progress to programmes in health and social care. The curriculum design embraces widening access, with an early module that prepares students in study skills, and includes key components of preparing students for practice placements through the delivery of mandatory health and safety training. Practitioners work in partnership with IHSC staff to identify current evidence-based research to support curriculum development. Minor and major modifications to the curriculum are implemented through a transparent process of programme monitoring meetings and annual review.
Assessment
19 The assessment strategy is clearly set out in the student handbook. It includes information on how assessments are related to levels and to progression points. The strategy is designed to assess students continuously and to identify those who are experiencing difficulties coping with the demands of the programme or who are not achieving the expected standards. The strategy is well-developed and includes a summative progression point after one year to assess students' ability to progress. There is a range of assessment methods that place emphasis on the work-based nature of the programme and include portfolios, case-studies and reflective summaries for practice assessments. Presentations are used for the analysis of data and discussing practice. Theoretical modules, such as anatomy and physiology, involve students producing workbooks. Direct observation of practice and assessment of the underpinning knowledge through practice-based assignments form the basis of assessment of the practice modules. Students appreciated the provision of exemplar practice portfolios to guide them in producing their own portfolios.
20 The assessment strategy has been developed through close partnership with practice staff who are directly involved in the assessment of practice-related skills. To support ODP mentors, the IHSC and the ESHA provide an effective training and updating programme to ensure that assessment is robust and fair. Mentor updates are provided by the IHSC, which includes staff delivering the module in the Trusts, and there are plans to develop a distance-learning package. There is excellent support for mentors to undertake practice supervision and assessment. The IHSC maintains a live register of ODP mentors. Trusts have built in time and resources to support staff to undertake this training. Mentors also receive support from practice facilitators. Provision is made to accommodate mentors who work on a part-time basis. Mentors are very clear about the proficiencies to be achieved, the assessment process, including the moderation process, the marking criteria and how these relate to the ILOs.
21 Students value the formative feedback they receive from personal tutors prior to submitting assessed work. Written and oral feedback on students' assignments is constructive and detailed. However, ODP students are not always able to benefit fully from the feedback because they do not have their work returned in a timely manner. This does not align with the Code of practice, Section 6: Assessment of students, Precept 12. Students are not provided with dates for return of assessed work and sometimes start assignments before having previous assignments returned, although they can now receive provisional marks. The programme team has responded to the external examiner's comments regarding the uncritical use of photocopy materials in assignments and ensuring that students adhere to confidentiality regulations. The reviewers were assured that students are fully aware of the requirements regarding these matters.
Student achievement
22 Longitudinal samples of student work scrutinised by the reviewers showed that students are achieving the ILOs. The external examiner confirms that student achievement is comparable with ODP programmes in other institutions and that students are fit for purpose, practice and award. Students demonstrate awareness of current practices in the operating theatre environment, an ability to evaluate their own practices and to use subject knowledge in practice. Students achieving higher marks show a higher level of critical awareness and make use of a wider range of evidence. On average, over the last three years, 94 per cent of the students have achieved the award (Table 1b).
23 Upon qualification, the students confirm that they feel prepared for their role and confident to practice. In Table 2b 'Other' indicates that ODP students undertaking the programme as they worked. Employers spoke highly of the students' technical abilities, their high level of commitment and their ability to work as part of a multidisciplinary team.
Table 1b: Completion and achievement statistics for all award-bearing programmes in operating department practice
| Award | Cohort |
P
|
F
|
||
|---|---|---|---|---|---|
| No. | % | No. | % | ||
| DipHE Operating Department Practice (New 2001) |
Sep-02 |
22
|
100
|
||
| Sep-03 |
16
|
80
|
4
|
20
|
|
| Feb-04 |
2
|
100
|
|||
Table 2b: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes in operating department practice
| Programme (Award bearing only) |
Further Study |
Local Employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| DipHE Operating Department Practice (New 2001) | ||||||||||
| Sep-02 |
25
|
96
|
||||||||
| Sep-03 |
1
|
4
|
27
|
100
|
||||||
| Feb-04 |
2
|
100
|
||||||||
* 'Other' students were already employed and undertaking the programme while they worked.
Summary of academic and practitioner standards for operating department practice
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Operating Department Practice at Anglia Ruskin University with Essex Strategic Health Authority.
Strengths
- The tripartite approach, involving the Institute of Health and Social Care, practice staff and students in the design and development of the work-based curriculum in operating department practice, has resulted in a highly-relevant programme to meet future workforce demands (paragraph 17).
- To support operating department practice mentors, the Institute of Health and Social Care and the Essex Strategic Health Authority provide an effective training and updating programme to ensure that assessment is robust and fair (paragraph 20).
Weakness
- Operating department practice students are not always able to benefit fully from the feedback because they do not have their work returned in a timely manner (paragraph 21).
B3 Physiotherapy
Intended learning outcomes
24 The ILOs meet the Chartered Society of Physiotherapy (CSP) requirements, ARU's level descriptors, the HPF, and are mapped against the Subject benchmark statement for physiotherapy and HPC Standards of Proficiency. ILOs for IPE with occupational therapy will be developed in 2006-07. The general ILOs make appropriate reference to systematic, conceptual and critical thinking, awareness of ethical and cultural issues and the demonstration of an understanding of the scientific knowledge base of the discipline. Each of the three levels of study has clearly-stated ILOs under three categories, namely, the development of subject-specific knowledge and understanding, cognitive and intellectual skills, subject-specific practical skills and transferable skills. IPE developments since January 2006 have included discussion on adapting ILOs for this form of learning.
25 ILOs are documented in programme specifications, the student handbook and, for clinical practice, in a placement briefing pack supplemented by tutorial preparation for students prior to their placements. The practice educator guide supplies detailed information, and the placement assessment form lists the ILOs and how these relate to assessment. Practice educators discuss and customise ILOs with the students during the first week of a placement. These are then monitored throughout the clinical practice. More specific ILOs are included in module handbooks. Key stakeholders, including managers and practice staff, have informed the construction and the review of the ILOs. Students reported that they were fully aware of the ILOs and that they found them helpful guides for their learning. In particular, they appreciated the opportunity to negotiate individualised clinical practice ILOs with their practice placement educator.
Curricula
26 The BSc (Hons) Physiotherapy curriculum meets the HPC's SoP and the CSP's professional requirements to develop students into autonomous practitioners. The curriculum is well designed to enable students to achieve the ILOs in theory and practice at each level. Curricular development has been informed by a number of stakeholders, including ESHA, external examiners and partner practice placement providers. Curriculum annual review enables curriculum changes to respond to professional regulatory body and service needs; however, there is no service-user involvement in curricular development in physiotherapy. This part-time, four-year programme has a curriculum flexible enough to meet the needs of students who have work and domestic commitments. There is a balance between the theoretical underpinning of physiotherapy and the opportunities to apply these in practice. Curricular design encourages a close integration of theory and practice and the development of key skills that are transferable in a number of clinical settings. A key theme, successfully embedded in the theoretical and clinical modules of the curriculum, is to enable the student to manage client care more effectively in the practice setting by taking account of the psychosocial and physical needs of individuals.
27 The modules in the curriculum include the necessary scientific knowledge required for physiotherapy students to be provided with the theoretical basis for evidence-based practice. Throughout the four years, students are able to develop an understanding of musculoskeletal and cardiovascular-pulmonary science and to relate these to practice. Students and practitioners have reported some concerns relating to curriculum delivery and the difficulties of matching the theory/practice interface. ESHA has identified and is addressing some of the difficulties in securing quality clinical placements to enable the delivery of the curriculum in practice. A forum has been developed to address current challenges associated with placement capacity and quality. CI has been responsive in staggering practice placements and encouraging flexible student attendance to enhance appropriate student progression through the components of the curriculum. In the current physiotherapy curriculum, there is no reference to IPE, although there are some opportunities in clinical practice. There are plans to develop IPE in the new curriculum for 2006-07.
Assessment
28 The assessment strategy is set out in the programme handbook and includes guidelines for the presentation of work, links between assessment and ILOs at the different levels and assessment criteria. Practice is graded and contributes to the final award, although the precise nature of the contribution is not clearly indicated in the handbook. Module definition forms outline the various assessment methods for each module. These include practical examinations, such as objective structured practical examinations (OSPEs), essays on evidence-based practice, clinical reasoning essays, case analysis, a presentation and a critical review of a published research report. Students are required to complete a final summative assessment for clinical practice using a common regional assessment form. Overall, the assessment methods are sufficiently varied to enable students to demonstrate the progressive achievement of the ILOs in theory and practice.
29 The University Senate Code of Practice on Assessment of Students establishes clear policy and procedures for marking, moderation and feedback on student work, including the requirement that student work is returned within 20 working days. For physiotherapy, CI is subject to ARU's assessment regulations. However, there is variability in the timeliness of returning work to physiotherapy students. The external examiner has commented on the variability in the quality of written feedback to students. This has been discussed at CI's Centre for Higher Education Board of Study and has led to staff development sessions aimed at improving and achieving greater standardisation of assessment practices. In meetings with the reviewers, students reported that they were not made aware of agreed dates for return of assessed written work and were unaware of the University's policy for return of assessed work within four weeks.
30 The use of OSPEs in level 1 provides an appropriate practical emphasis to the achievement of the ILOs. Students appreciate this method of assessment because they see it as an opportunity to test their ability to relate theory and practice. Although the OSPEs in physiotherapy include theoretical and practical stations with separate marking criteria, the current approach to determining the final module mark and Pass/Fail threshold does not ensure that learning outcomes related to safety and effectiveness are fully addressed. Additionally, there is a lack of any formal written feedback to physiotherapy students on their performance in OSPEs to highlight strength or weakness in areas of professional competency. This is not aligned with the Code of practice: Section 6: Assessment of students, Precept 12. Feedback is limited to a final mark. Students are able to seek verbal feedback from tutors on their OSPE performance, but rarely do so. Although the OSPEs will be retained in the new programme, the programme team recognises the need for improvement in this area, which will be incorporated in a revised assessment strategy.
31 Preparation and support for clinical assessment are thorough. Practice educators report high levels of satisfaction with the support provided by tutors for assessing students. Students and practice staff are familiar with the expectations and assessment process for practice placement assessment. The halfway placement review and feedback to students on their performance is particularly valued by students as a positive opportunity to learn and improve. During practice placement visits, students consistently reported to the reviewers their satisfaction with the support and constructive formative feedback from practice educators. Clinical educators are familiar with, and spoke positively about, the clinical assessment documentation. The assessment is carried out through a standardised criterion-based form developed by nine institutions in the southeast of England. The design and use of the standardised clinical assessment form in physiotherapy provides the basis for the rigorous assessment of practice.
Student achievement
32 There are no completed cohorts for physiotherapy. A small sample of assessed student work from level 1 was scrutinised by the reviewers. The work demonstrated achievement of the ILOs and the standards achieved are as expected for this level. Student work showed evidence of a reasoned understanding of physiotherapy assessment and intervention processes and of the theoretical elements of anatomy, physiology and pathology. External examiner reports confirm that students are achieving the standards of proficiency and achievement of ILOs.
Summary of academic and practitioner standards for physiotherapy
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programme in Physiotherapy at Anglia Ruskin University and Colchester Institute with Essex Strategic Health Authority.
Strength
- The design and use of the standardised clinical assessment form in physiotherapy provides the basis for the rigorous assessment of practice (paragraph 31).
Weaknesses
- There is no service-user involvement in curriculum development in physiotherapy (paragraph 26).
- There is variability in the timeliness of returning work to physiotherapy students (paragraph 29).
- Although the objective structured practical examinations in physiotherapy include theoretical and practical stations with separate marking criteria, the current approach to determining the final module mark and Pass/Fail threshold does not ensure that learning outcomes related to safety and effectiveness are fully addressed (paragraph 30).
- There is a lack of any formal written feedback to physiotherapy students on their performance in objective structured practical examinations to highlight strength or weakness in areas of professional competency (paragraph 30).
B4 Radiography
Intended learning outcomes
33 The ILOs have been developed in all four programmes to take account of the views and needs of the health service. The ILOs for the BSc (Hons) Radiography programme are mapped against the Subject benchmark statement for radiography, the HPC Standards of Proficiency, the College of Radiography (CoR) curriculum framework and ARU's level descriptors. The benchmarks and standards have also informed the assistant practitioner programmes that are approved by the CoR to allow for career progression to registerable degree programmes. The ILOs for the FdSc have been developed in consultation with practice staff to meet workforce demands at local and national level. They are aligned with the Foundation Degree qualification benchmark, published by QAA. Logbooks of clinical experience contain ILOs and the display of the ILOs in practice areas for all mentors to view helps support their awareness.
34 The concept of ILOs is explained to all students at the beginning of the programme and of each module. Students access guides to the ILOs through a variety of posted, paper-based material in a beginner's pack, programme and module handbooks and programme specification forms. FdSc students also receive a CD-ROM and utilise the virtual learning environment (VLE) to access ILOs. The local supervisors for the DipHE Medical Imaging Practice are key links with the IHSC for developing and ensuring that students understand the ILOs. Reference lists of which workbooks, with ILOs for all programmes, are provided for students and for local supervisors at the beginning of each programme. FdSc students choose their own mentors and negotiate some of their ILOs. FdSc Radiography and Oncology students are unclear regarding the ILOs and have concerns that mentors are not always sure about the specific ILOs for the FdSc and rely instead on their knowledge of the BSc (Hons) programme. Currently, mentor training is not offered by the IHSC for the new FdSc programme. External examiners confirm that the ILOs for radiography programmes are appropriate, clearly stated and meet the CoR's requirements in the case of the BSc (Hons) Radiography programme.
Curricula
35 The four radiography programmes are innovative in providing distributed learning, enabling students to remain in the workplace. Practice managers report that they have acted in advisory capacities for curricular design. The design of all radiography programmes has been responsive to workforce demands and the development of a four-tier healthcare structure in the profession. The FdSc Radiotherapy and Oncology Practice curriculum has been fully informed in design by the National Pilot Scheme for Assistant Practitioner Training, a scheme informed by a national scoping exercise. The FdSc provides distributed e-learning in the delivery of the programme, contributing to widening access over a large geographical area. Programme and module handbooks clearly indicate the way the integration of theory and work-based learning are to be achieved. This is also supported through close collaboration between employers and IHSC staff.
36 The curriculum designs across all routes are relevant and up to date, portraying appropriate academic levels of study. Curricular design ensures intellectual and clinical progression through requiring increasingly complex and challenging knowledge and understanding. The DipHE in Medical Imaging demonstrates a clear progression route for students on completing the award. FdSc students completing the Radiotherapy and Oncology Practice Award have less explicit routes of progression. Current routes for FdSc students do not lead to professional registration, but can access IHSC's BSc (Hons) Health and Social Care and other programmes elsewhere. Mammography students exiting the CertHE are limited in progression due to the nature of their award and its scope of practice as defined by the College of Radiographers. In radiography, students completing the DipHE in Medical Imaging may progress to part-time study on the BSc (Hons) Radiography and subsequently achieve registration with the HPC. This is an effective and flexible strategy that enables employers to match staffing skill mix with local service delivery needs. This is welcomed by employers and addresses the College of Radiographers' guidance on student progression. Students said that they were highly motivated to progress to the BSc (Hons) and registration, and anticipate support from their employers to achieve this. There is currently no similar route for those students on the CertHE or the FdSc, although one is planned for the FdSc from September 2007.
37 The IHSC, in collaboration with the ESHA, is extremely responsive to service needs. Changes in the curricula can be proposed throughout the year and addendums can be made to ensure the curricula is responsive to professional body policies and any changes in legislation. Students are informed of addendums through email correspondence. Local supervisors, practitioners and students are involved in any changes. Given that students learn mainly in their workplace, the radiography curricula have strong focus on practice, with curricular developments being fully informed by service managers and practitioners. Interprofessional learning opportunities are promoted in practice; however, the radiography curricula do not include clear IPE strategies.
Assessment
38 All radiography programmes use a range of assessment methods that are clearly mapped with the ILOs for all the modules and reflect a strong focus on practice-based learning and on the integration of theoretical knowledge. Assessment methods include logbooks, essays, case-studies, reflective work and portfolios. Assessment information provided for students is clear and detailed and includes marking schemes and procedures for internal moderation. Students are provided with clear schedules of assessment to enable them to plan their work, which is particularly significant given the distance-learning methods. Assessment methods in all programmes enable students to demonstrate achievement of the ILOs. Student work on all programmes is thoroughly marked and moderated to ensure consistency and fairness.
39 The University Senate Code of Practice on Assessment of Students establishes clear policy and procedures for marking, moderation and feedback on student work and specifies the return of work within 20 working days. Written feedback on assignments is detailed, linked to ILOs and identifies how students can improve their performance. The feedback is valued by students and recognised by external examiners as highly supportive. Students reported that, while acknowledging the efforts of staff, there is some delay in returning radiography assignments to enable students' learning to benefit sufficiently from written feedback. This is not aligned with the Code of practice, Section 6: Assessment of students, Precept 12. Students reported that sometimes they did not receive feedback before commencing on their next assignment.
40 On the assistant practitioner radiography programmes, the level of performance expected to achieve grades 'very good' or 'excellent' through the clinical appraisal assessments is unrealistic and beyond the scope of practice for assistant practitioners. Specifically, the criterion to achieve a grading of 'very good' requires students to 'demonstrate an exceptional level of competence and care, greater than that displayed by most competent practitioners', while the criterion for achieving the 'excellent grade' requires students to 'demonstrate a truly outstanding level of competence and care' and is far in excess of that normally displayed by competent practitioners. There is a reluctance of practitioners to provide written feedback to justify the grade for FdSc students, which is required when 'very good' or 'excellent' grades are awarded. Currently, there is no mentorship training for mentors of assistant practitioners in the FdSc. The supervisor handbook for the FdSc is clearly written and provides detailed guidance for supervisors, although not all mentors had received the document.
Student achievement
41 The DipHE Medical Imaging Practice is the only radiography programme with a completed cohort; therefore, the reviewers could not make judgements about the final student achievement of the other three programmes. The reviewers scrutinised longitudinal samples of student work from all four programmes. For the DipHE, there were examples of high-quality work, which demonstrated progression as the students moved through the programme. In particular, students were able to make use of their workplace to produce written work which was reflective and made use of evidence when applying theory to their practice. The external examiners commented that student achievement is comparable with that of students on similar programmes elsewhere. Over the last two cohorts, 94 per cent of the students achieved the award (Table 1c). DipHE students are fit for practice, purpose and award. BSc (Hons) and FdSc students demonstrate that they were achieving the ILOs for the level of study. Employers are satisfied with the way students are able to make us of their subject knowledge and skills, act appropriately in sometimes high-pressure situations and work effectively in a team. Table 2c indicates under 'other' that the DipHE Radiography Medical Imaging Practice students are already in employment and were undertaking the programme as they worked. All students on the assistant practitioner programmes are employed in local Trusts.
Table 1c: Completion and achievement statistics for all award-bearing programmes in radiography
| Award | Cohort |
P
|
F
|
||
|---|---|---|---|---|---|
| No. | % | No. | % | ||
| DipHE Radiography | Sep-02 | 14 | 88 | 2 | 12 |
| DipHE Medical Imaging Practice |
Sep-03 | 24 | 100 | ||
Table 2c: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes in radiography
| Programme (Award bearing only) |
Further Study |
Local Employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| DipHE Radiography Sep-02 |
20 | 100 | ||||||||
| DipHE Medical Imaging Practice Sep-03 |
28 | 100 | ||||||||
* 'Other' students are already employed and underyaking the programme while they worked.
Summary of academic and practitioner standards for radiography
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Radiography at Anglia Ruskin University with Essex Strategic Health Authority.
Strengths
- The design of all radiography programmes has been responsive to workforce demands and the development of a four-tier healthcare structure in the profession (paragraph 35).
- Given that students learn mainly in their workplace, the radiography curricula have strong practice foci, with curricular developments being fully informed by service managers and practitioners (paragraph 37).
Weaknesses
- FdSc Radiography and Oncology students are unclear regarding the intended learning outcomes and have concerns that mentors are not always sure about the specific intended learning outcomes for the Foundation Degree and rely instead on their knowledge of the BSc (Hons) programmme (paragraph 34).
- There is some delay in returning radiography assignments to enable students' learning to benefit sufficiently from written feedback (paragraph 39).
- On the assistant practitioner radiography programmes, the level of performance expected to achieve grades 'very good 'or 'excellent' through the clinical appraisal assessments is unrealistic and beyond the scope of practice of assistant practitioners (paragraph 40).
- Currently, there is no mentorship training for mentors of assistant practitioners in the Foundation Degree (paragraph 40).
C Quality of learning opportunities
Learning and teaching
42 Learning and teaching opportunities for all programmes ensure that students are able to achieve the ILOs. The methods encourage progressive development of students; in particular, there is a move from more structured learning at level 1 towards using methods at other levels that encourage student autonomy. There is emphasis on the acquisition of transferable skills and the use of information technology in healthcare settings. Strategies and learning methods are set out in programme specifications and handbooks and include lectures, tutorials, case studies and vignette work, skills workshops and reflective exercises. More specifically, in ODP, there is emphasis on scenarios of peri-operative, anaesthetic and surgical interventions to enable students to address the importance of the holistic nature of patient care. While the learning and teaching strategy for CI provides a well thought-out generic approach for post-16 education, it does not make sufficient reference to higher education. The success of the strategy to emphasise practice-based learning and place the patient experience at the centre of the integration of theory and practice is confirmed by students on all programmes. Processes for monitoring and actioning student feedback on learning and teaching are thorough and boards of study provide analysis of student evaluations. While the student response from the distance learning radiography students is low, IHSC is addressing this by using different means to obtain feedback, for example, on the assessment front sheet.
43 In radiography, the distance learning and teaching strategy is well organised and is clearly designed to meet the needs of the NHS, locally and nationally. The distance-learning strategy adopted in radiography is focused upon practice-based, distance learning and makes use of supervised practice self-directed study guides, study days, a resource-based study guide and case-studies. It is aligned with the Code of practice, Section 2: Collaborative provision and flexible and distributed learning (including e-learning). Given the centrality of distance learning in radiography, the programme handbook and the self-evaluation document (SED) say very little about the strategy. However, there is information on the VLE that provides detailed guidance, and distance learning is explained to students at their induction. Hard-copy materials are available as back-up, and these and online sources are regularly updated. Radiography students considered that they were able to access materials and engage in online discussion forums, and that distance learning enables them to achieve the ILOs.
44 In physiotherapy, the learning strategy is set out in the validation document and in the student handbook. The strategy outlines the students' participation in the learning process, with emphasis on students becoming self-directed and flexible learners on graduation, on interactive classes with little if any formal lecturing and encouraging the active participation of students. The Placement Learning Handbook in physiotherapy provides clear guidance for students and practice staff. Physiotherapy staff work as facilitators for students who work in small groups or on their own on prescribed activities, with limited scheduled contact time. In their discussions with the reviewers, physiotherapy students said that the learning and teaching strategy was not always clear to them and that it did not always work out as intended. Students also said that they did not always receive the contact time as planned, that some staff arrived late and there was some confusion over the start time for sessions. Physiotherapy staff explained that there was some misperception on the part of students regarding the strategy and the reviewers accepted the case that, with some cancellations due to staff illness, sessions had not been delivered. Nevertheless, the learning strategy for physiotherapy students, in particular, their understanding of self-directed study, remains unclear.
45 Learning opportunities in placements ensure that students can apply theory to practice. Placement strategies are aligned with the Code of practice, Section 9: Placement learning. Health and safety are given due consideration on campus and placements. Both institutions have documented policies. At the start of placements, students are informed of local health and safety arrangements and placement providers are aware of their responsibilities for ensuring that opportunities for learning are in place. A range of practice settings for all programmes ensures that students have every opportunity to meet the ILOs and to experience a range of health and social care settings. The reviewers' visits to practice confirmed the close working relationship between the IHCS and CI to ensure that learning and teaching opportunities are in place. The quality of learning and teaching on placement is monitored by tutor visits, which are valued by educators. Students are prepared for placement learning and, where possible, undertake a pre-placement visit. Examples of helpful pre-placement information packs, which practice staff are encouraged to produce, were seen during placement visits. Despite experiencing difficulties in finding suitable placements in occupational therapy and physiotherapy, staff at CI, in cooperation with ESHA, have developed a strategy to ensure that students undertake a balanced range of placements. A number of forums between the higher education institutions in the area, placement providers and the ESHA review placement capacity, for example, through the Executive Advisory Group on Pan Essex Education. Although there is no requirement to undertake audits in occupational therapy, CI recognises that there is no formal system in place to ensure the quality of placements, although students provide information about their placements to the programme team.
46 Research to support learning and teaching is limited in all programmes. In radiography, a visiting professor has been employed to focus upon research and support staff. Staff have numerous opportunities for in-house training. The IHSC's strategy for staff development reflects the view that investment in staff is central to the delivery of quality learning, a view shared by CI. Probationary support, annual appraisal and peer-graded classroom observation at CI encourage staff to engage in a range of development opportunities. Peer observation of teaching is required and implemented by both institutions. There is some peer observation of teaching in practice placements, although this depends more on individual practice educators.
47 The geographical distance between the IHSC and CI places some limits on opportunities for IPE and is acknowledged by programme teams and the ESHA. The revalidated programmes for occupational therapy and physiotherapy will have increased emphasis on IPE. All programmes have opportunities for IPE on placement, for example, radiographers and paramedics, ODP students and nurses and occupational therapy and physiotherapy. However, in the current programmes, except ODP, IPE is under-developed.
The quality of learning and teaching is commendable.
Strength
- In radiography, the distance learning and teaching strategy is well organised and is clearly designed to meet the needs of the NHS, locally and nationally (paragraph 43).
Weaknesses
- The learning strategy for physiotherapy students, in particular, their understanding of self-directed study, remains unclear (paragraph 44).
- In the current programmes, except operating department practice, interprofessional education is under-developed (paragraph 47).
Student progression
48 All programmes recruit well and meet their commissioned numbers. Recruitment and selection are shared between academic and clinical staff across all the provision being reviewed. Accurate and well-designed information is available to prospective students providing them with programme information. Students in both institutions spoke positively about their experiences of the induction programmes. Programme and module guides are detailed and user-friendly for students. The recruitment and admissions process is aligned with the Code of practice, Section 10: Recruitment and admissions, published by QAA.
49 Students on all programmes were highly appreciative of the range and depth of support they receive from staff on campuses and clinical placements. Students benefit from academic guidance through the personal tutor system have access to programme and module leaders and clearly understand the system. IHSC and CI tutors' visits to students while they are on placement enhance placement support. There is a clear strategy in physiotherapy for an expanded tutorial system with twice-weekly, early evening study skills sessions. The appointment of student advisers in the IHSC, and of specialist higher education study skills support tutors at CI, are examples of initiatives to strengthen support and of strategies for reducing attrition rates. Distance-learning students in radiography use peer support locally and SMART (self-monitoring, assessment and reporting technology) groups. Peer support is more limited where there are only one or two students on placement at any one time. These students rely heavily on support through the local supervisor and the programme leader. Students acknowledge appropriate support for study skills during the induction sessions and on study days. ODP students, who have not studied for some time, regard the 30-credit module on learning to learn as highly supportive for their progression in the programme.
50 Pre-placement briefings are well received by students. Information packs are not consistently provided by placements prior to physiotherapy students attending, and students feel that this information would be useful prior to all placements. Physiotherapy students are responsible for contacting their supervisor prior to placement, a system that is well understood by students who acknowledge their responsibility for this and are satisfied with the arrangements. Addenbrooks and Ipswich Hospitals send out high-quality induction and information packs, which are appreciated by radiotherapy students. A variety of effective approaches are used in training and updating clinical staff in order to enhance their effectiveness in supporting students on placement. Educators are aware of their responsibilities for supporting weak students. Placement educators are very positive, enthusiastic and supportive in providing students with advice and guidance. Students value the support provided by the local supervisor role in radiography (diagnostic imaging). It is more effective where there is a formal arrangement of a fractional appointment between Trust and the IHSC. Local supervisors on a fractional appointments in radiography work closely with the IHSC in putting into effect the arrangements for student support. In ODP, practice facilitators are allocated one day a week for student support. Physiotherapy and occupational therapy students receive 'halfway' feedback on their clinical progress, which is valued by students, clinical staff and academic staff, as it provides students with feedback on their progress. Students generally feel well supported during practice placements, with clear guidance and explanations of procedures and protocol. In all programmes, students receive high-quality support and advice on both campuses and in placements.
51 From Table 3, it can be noted that withdrawal rates for the programmes are generally satisfactory. In occupational therapy, for the four-year programme, withdrawal is 6 per cent on average for the last three years. For the accelerated two-year programme, it is 6 per cent. For the same period, for ODP, the rate is 9 per cent and for physiotherapy, an average of 15 per cent of the students have so far withdrawn from the two intakes in September 2004 and January 2005. Across the provision in radiography, final attrition rates cannot be determined because, so far, there have been no completed cohorts. In the BSc (Hons) Radiography, for the March 2005 cohort, four out the original 10 students have so far withdrawn.
Table 3: Recruitment and attrition statistics
| Award title | Recruited number |
Withdrawal | Transfer in | Transfer out | Discontinuation | ||||
|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | ||
| BSc (Hons) Occupational Therapy (part-time four year) (CI) | |||||||||
| Sep-01 |
25
|
3
|
12
|
4
|
16
|
||||
| Sep-02 |
1
|
1
|
100
|
||||||
| Sep-03 |
26
|
2
|
8
|
||||||
| BSc (Hons) Occupational Therapy (accelerated two year) (CI) | |||||||||
| Sep-00 |
23
|
4
|
17
|
||||||
| Sep-02 |
21
|
4
|
19
|
3
|
14
|
1
|
5
|
||
| Sep-03 |
1
|
1
|
100
|
||||||
| DipHE Operating Department Practice (new 2001) | |||||||||
| Sep-02 |
26
|
3
|
12
|
1
|
4
|
||||
| Sep-03 |
27
|
4
|
15
|
4
|
15
|
||||
| Feb-04 |
2
|
||||||||
| BSc (Hons) Physiotherapy (CI) | |||||||||
| Sep-04 |
25
|
5
|
20
|
1
|
4
|
||||
| Jan-05 |
20
|
2
|
10
|
1
|
5
|
||||
| Sep-05 |
27
|
1
|
4
|
||||||
| BSc (Hons) Radiography (Diagnostic Imaging) | |||||||||
| Sep-04 |
8
|
||||||||
| Mar-05 |
10
|
4
|
40
|
||||||
| Sep-05 |
8
|
1
|
12
|
||||||
| DipHE Medical Imaging Practice | |||||||||
| Sep-02 |
20
|
4
|
20
|
||||||
| Sep-03 |
28
|
1
|
3
|
||||||
| Jan-04 |
9
|
1
|
11
|
||||||
| FdSc Radiotherapy and Oncology Practice | |||||||||
| Jan-04 |
10
|
2
|
20
|
||||||
| Jan-05 |
9
|
||||||||
| Jan-06 |
9
|
||||||||
| CertHE Mammographic Studies | |||||||||
| Sep-04 |
2
|
1
|
50
|
||||||
| May-05 |
6
|
||||||||
| Sep-05 |
2
|
||||||||
The quality of student progression is commendable.
Strengths
- The appointment of student advisers in the Institute of Health and Social Care and of specialist higher education study skills support tutors at Colchester Institute are examples of initiatives to strengthen support and of strategies for reducing attrition rates (paragraph 49).
- Operating department practice students, who have not studied for sometime, regard the 30-credit module on learning to learn as highly supportive for their progression in the programme (paragraph 49).
- Addenbrooks and Ipswich Hospitals send out high-quality induction and information packs, which are appreciated by radiotherapy students (paragraph 50).
- In all programmes, students receive high quality support and advice on both campuses and in placements (paragraph 50).
Learning resources and their effective utilisation
52 There is clear, collaborative working between ESHA, the IHSC and CI for the deployment of resources, both in practice and on campus. Externally, there is effective partnership working between the IHSC, CI, the ESHA, the Trusts and the private and voluntary sectors to ensure that learning resources are in place and used effectively. Provision of resources across all the campuses (Colchester, Chelmsford and Cambridge) is supportive of students' learning. Physiotherapy and occupational therapy programmes are delivered from CI and are well supported by learning resources to ensure that students are able to achieve the ILOs. CI's library offers written and electronic sources, including support on accessing library services and learning support. Students value the support they receive from the library staff in accessing and searching journals. Academic staff liaise with the library staff about the numbers of books available and types of books required. Occupational therapy and physiotherapy students reported that they find the opening hours of the library are restricted and do not address their needs, especially when they are on placement when they have some distance to travel to return to the library after normal working hours. The library at the Rivermead Campus in Chelmsford has a Charter mark award. Students have access to three specialist staff for support in the library. There has been extensive investment in electronic, full-text journals. The library provides spaces conducive to private study and a wide range of key texts, some held as multiple copies and short loans. Students receive guidance from well-informed specialist librarians, but IHSC staff do not always inform library liaison staff of the books students require.
53 Students have commented positively about the quality of the specialist facilities for occupational therapy and physiotherapy. The specialist occupational therapy teaching areas include, for example, a fully-equipped Activities of Daily Living Suite to assess activities of daily living, including a kitchen with a height-adjustable work surface. In physiotherapy, there are practical laboratories with anatomical learning aids for the development of practical skills in neurology and musculoskeletal physiotherapy. Students also have access to a fully-equipped biology laboratory. Students at CI reported that the general learning environment is not always conducive to higher education students, especially when they have to study alongside younger students. At the Chelmsford Campus, there is a dedicated area for skills development, which has four mock wards, including one dedicated to manual handling. ODP and radiography students use this facility extensively to address their learning needs in manual handling. ODP students also have the opportunity to practise on specific pieces of equipment, such as anaesthetic machines and ventilators in the critical care laboratory, where they can use peer assessment and simulated scenarios. In 2007, a new, dedicated building with specialist teaching and staff accommodation, will be available on the Rivermead Campus. The specialist learning resources in both institutions underpin the learning and teaching strategies.
54 While on placement, students on all programmes use a wide range of resources, including internet and intranet access, text books, journals, hospital libraries and resource rooms, and report many opportunities to experience other types of learning resources gained through IPE and inter-departmental visits, for example in, surgery. Students on all programmes report positively on the learning resources and experiences on practice placements. Placement tutors provide continuity and links between the ISHC and CI and placements, to ensure that learning resources are in place.
55 Occupational therapy and physiotherapy students have described extensive problems with accessing online services at CI associated with log-in problems, which has taken some time to address. This has led to limited use of this resource by many students. During the review, CI reported, and the reviewers confirm, that the problem had been corrected. FdSc students access their learning materials at a distance, through e-learning. There were initial log-in problems, but these have now been overcome. FdSc students on the first cohort were issued with their own laptops through one-off finding. The VLE materials in distance learning radiography programmes are high quality and effectively support student learning. They are complemented with paper copies and contain a comprehensive range of materials both for learning and for discussion forums, accessible to both academics and students with direct access to electronic journals. Students report positively about this resource. Students have access to all NHS databases.
56 In occupational therapy and physiotherapy, it is recognised by CI that there have been difficulties in delivering the programmes due to shortages of staff. These will be addressed through new appointments that have been agreed to focus particularly on academically-experienced lecturers. IHSC and CI staff are able to identify their developmental needs with their managers, through individual performance review. Staff in both institutions also maintain links with professional bodies and act as external examiners. All programmes are well supported by technical and administrative staff.
The quality of learning resources and their effective utilisation is commendable.
Strength
- The virtual learning environment materials in distance-learning radiography programmes are of a high quality and effectively support student learning (paragraph 55).
Weaknesses
- Occupational therapy and physiotherapy students reported that they find the opening hours of the library are restricted and do not address their needs, especially when they are on placement (paragraph 52).
- Institute of Health and Social Care staff do not always inform library liaison staff of the books students require (paragraph 52).
D Maintenance and enhancement of standards and quality
57 The policy and procedures for the internal quality assurance of the programmes in the IHSC are clearly defined in the terms of reference of the IHSC's Academic Quality and Approvals Committee. Links between the IHSC and CI are appropriately rigorous to ensure that annual monitoring undertaken by CI is overseen by the University. Occupational therapy is delivered and managed under ARU's quality assurance process and assessment regulations. The physiotherapy programme operates under a franchise arrangement with ARU. The synoptic report produced by CI provides detailed summaries of the review and action plans for the occupational therapy programme. The University's responses, through the IHSC, are suitably addressed by CI. Higher education programmes in CI are monitored through the Higher Education Board of Study and the Higher Education Management Group. Annual monitoring reports in the IHSC and CI are evaluative, make reference to and use statistical information, and provide action plans for all elements of the programmes, including curricula, assessment and learning and teaching. In all the external examiners' reports available to the reviewers, there were highly detailed responses from the ARU Senate, IHSC and CI, with clear indications that the reports have been used to enhance the provision. Some external examiners' reports say little about practice learning and resources, although practice assessment is given more detailed attention. Annual monitoring and validation reports include indications of how the programme teams respond to external reference points, including the Code of practice, the HPC SoP, the relevant professional body requirements and NHS initiatives. Annual monitoring reports in the IHSC and CI provide detailed and evaluative analysis of the programmes, with clear indication of enhancements.
58 Although the SED did not clearly articulate the processes for student involvement in the IHSC's and CI's quality process, the reviewers were satisfied that these are in place. In the IHSC, these include focus-group meetings, evaluations of clinical practice, the University's module evaluation form and membership of programme meetings. At CI, students are able to attend programme meetings and complete questionnaires, although they do not always take up these opportunities.
59 The relationship between the IHSC, CI and ESHA is robust and highly collaborative to ensure the quality of the provision. Regular quarterly meetings between the ISHC and the Chief Executive of the ESHA, the Vice Chancellor of ARU, the Dean and the business managers are used to oversee the effectiveness of the implementation of the commissioning contract, such as placement availability, resources and areas for development. Regular Audit Committee meetings ensure that issues raised in audit reports are dealt with effectively and brought to the attention of the Audit Policy Group. Physiotherapy placements are audited using a tool developed through the Placement Practice Information Management System.
60 The SED provided the reviewers team with an honest and accurate guidance to the provision. Though mainly descriptive, where it was evaluative, there were indications of identifying problems and of demonstrating enhancement strategies. It was particularly clear on learning and teaching in practice. The document was written in a collaborative manner between the IHSC, CI and the ESHA.
Strengths
- Annual monitoring reports in the Institute of Health and Social Care and Colchester Institute provide detailed and evaluative analysis of the programmes, with clear indication of enhancement (paragraph 57).
- The relationship between the Institute of Health and Social Care, Colchester Institute and Essex Strategic Health Authority is robust and highly collaborative to ensure the quality of the provision (paragraph 59).
Action plan
Major review of healthcare programmes
June 2006
Anglia Ruskin University
East of England Strategic Health Authority (Essex Strategic Health Authority)
We have discussed and agreed the following action plan:
Title of organisation (Lead SHA/WDC): East of England Strategic Health Authority (formerley Essex Strategic Health Authority)
Name: Michelle Gallisent
Position: Head of Education and Development
Title of organisation (HEI): Anglia Ruskin University
Name: Lesley Dobrée
Position: Pro Vice-Chancellor (Quality and Enhancement)
| Component | Strengths/Weaknesses | Actions to be taken | Target completion date/s | Constraints preventing delivering the action required | Impact of not delivering the action required | Lead responsibility (organisation/s and person/s)Name and title of organisation | Evidence of quality enhancement |
|---|---|---|---|---|---|---|---|
Academic and practitioner standards |
Strengths | ||||||
|
Maintain programme in its current study mode. | Sep-06 | None | Failure to meet SHA contractual requirements. Potential decrease in applications and increase in retention rates. | Programme Leader, Colchester Institute | Student evaluations | |
|
Maintain approach in curriculum development taking place in autumn 2006 and in delivery from September 2007. | Sep-07 | None | Failure to meet future workforce demands. | Programme Leader, IHSC | Student evaluations Feedback from employers | |
|
Continue with provision of Mentorship in Public Service programme. Additionally, the Radiography team propose utilising aspects of this good practice within their programmes. | Sep-07 | Availability of funding from SHA and pressures on service to release staff for training. | Weakening of practice mentor abilities to provide consistent and robust assessment of students. | Programme Leader, IHSC | Student evaluations Feedback from practice mentors | |
|
Continue use of standardised form. Additionally, a revised version has been drafted using a working group of clinical educators. | Sep-06 | None | Potential reduction in the ability to ensure rigorous assessment of practice. | Programme Leader | Student evaluations External examiner reports | |
|
Continue with constant review of the pathways in conjunction with service users to enable and inform these developments. This is well established practice within Radiography. | Sep-06 | None | Programmes which are less responsive to workforce demands. | Programme Leaders, IHSC | Employer feedback HPC monitoring report | |
|
Continue with the theory/practice relationship which is seen as a strength of the programme from service users and their input is sought and encouraged for developmental purposes. | Sep-06 | Availability of suitable learning environment in practice | A weakening of the strong practice foci which would not be in line with the programme outcomes. | Programme Leaders, IHSC | Student evaluations Employer feedback | |
| Weaknesses | |||||||
|
Programme Leader to reinforce use of marking grid and monitor its use. Additionally, grid will be reviewed at Assessment Workshops held within the Centre for Health and Care. | Dec-06 | None | Inconsistent usage of marking grid leading to inequity of treatment of students. | Head of Centre & Programme Leader, Colchester Institute | External examiner reports | |
|
All module leaders to be informed that student feedback must be given in an appropriate time frame. This will be carried out at Module Leaders meetings and reinforced at Programme/Pathway meetings. | Jan-07 | None | Students would have the right to complain. | Programme Leader/Pathway Leader, IHSC | Monitoring of date that feedback is sent back to students | |
|
Investigate the opportunity with local NHS colleagues to use service users in curriculum development. | Sep-07 | Ethical considerations of accessing patients | Curriculum may not meet the needs of service users. | Programme Leader, Colchester Institute | User involvement demonstrated in AMER | |
|
All work to be marked and moderated and returned within strict deadline of 4 weeks regardless of circumstances. |
Immediate effect | None | Not in keeping with University Regulations. Non-timely feedback to students. | Programme Leader, Colchester Institute | Student feedback | |
|
From September 2006 all OSPE for all students (irrespective of level of study) stations must be passed, as validated for the new programme. This will ensure safety and competence. Additionally, clearer criteria will be utilised to ensure that learning outcomes related to safety and effectiveness are fully addressed.
|
Immediate effect | None | Potential unsafe/non-competent practice by students. | Programme Leader, Colchester Institute | New programme document | |
|
Written feedback from OSPE will be collated onto a formal feedback form. At present students are able to get verbal feedback from their personal tutor based upon the individual feedback forms.
|
Immediate from next OSPE examinations | None | Documented feedback for the students not available to them. | Programme Leader, Colchester Institute | Student feedback | |
|
The learning outcomes are clearly depicted in the study materials and this will be more clearly communicated to practice staff. The interpretation of the professional clinical application of these learning outcomes in placement is evolving. Standardisation of AP roles will emerge from the PSBs in the future and this will inform the practice. Student and supervisor training will highlight these developments and reinforce the programme and module learning outcomes criteria.
|
Sep-07 | Continued uncertainty amongst students and practice staff regarding the specific intended learning outcomes for the FdSc. | Programme Leader, IHSC | Feedback from practice staff Student evaluations | ||
|
All module leaders to be informed that student feedback must be given in an appropriate time frame. This will be carried out at Module Leaders meetings and reinforced at Programme/Pathway meetings. |
Sep-06 | None | Prevention of students' ability to benefit from timely feedback. | Programme Leader, IHSC | Student evaluations | |
|
Within the existing pathways, the descriptors will be removed for two assessment rounds (as a pilot) and then reviewed (in May 2007). Possible rewording of the descriptors, if reinstated, to detail 'within the roles and responsibilities of the student at this stage of their training' is under consideration.
|
Sep-07 | None | Continued uncertainty for assistant practitioners regarding the application of the assessment criteria for "very good" or "excellent" grading. | Programme Leader, IHSC | Feedback from practice Student evaluations | |
|
This is under development using advice from the ODP programme leader. A supervisor training day is scheduled for 8/9/06 in addition to enhanced induction sessions. A newly validated FDL Radiography module 'Supporting Learners within a Clinical Environment' offers a formal route for this development. This has now commenced under a fee waiver scheme and the take up from Radiotherapy practitioners has been good.
|
Dec-06 | Service pressures impacting on the availability of mentors to attend. | Potential inconsistencies of practice among mentors | Programme Leader, IHSC | Student evaluations Feedback from practice mentors | |
Quality of |
Strengths | ||||||
|
This remains our focus to attract students and service users to enable work-based learning within radiography pathways.
|
Sep-06 | None | Programme which does not meet the needs of the NHS | Programme Leader, IHSC | Feedback from SHA | |
| Weakness | |||||||
|
The student handbook and module guides will explicitly advise students the rationale and process of self-directed study as well as identifying supporting members of staff. | Immediate | None | Students not clear of learning strategy | |||