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
Midwifery, Nursing and Operating Department Practice programmes at Bournemouth University, in partnership with Dorset and Somerset Strategic Health Authority (SHA), Avon, Gloucestershire and Wiltshire SHA and Hampshire and Isle of Wight SHA, were reviewed in the academic year 2004-05. Judgements were made about the academic and practitioner standards achieved and the quality of the learning opportunities provided.
The review covered the following programmes:
Pre-registration
- BSc (Hons) Clinical Nursing (Adult, Child, Mental Health, Learning Disability)* **
- Advanced Diploma Clinical Nursing (Adult, Child, Mental Health, Learning Disability)* **
- Diploma in Higher Education in Clinical Nursing (Adult, Mental Health)* **
- Graduate Diploma in Clinical Nursing (Adult, Child, Mental Health, Learning Disability)* **
- BSc (Hons) Midwifery**
- Advanced Diploma in Midwifery**
- Diploma in Higher Education in Operating Department Practice***
Post-registration
- BSc (Hons) Health Studies/BSc (Hons) Health Studies (Pathway)#
- DPS Health Care
- BSc (Hons) Psychosocial Interventions for Psychosis
- BSc (Hons) Therapeutic Interventions for Addictions
- BSc (Hons) Clinical Leadership
- BSc (Hons) Nurse Practitioner
- Return to Practice (Nursing)* **
- Enrolled Nurse Conversion Course**
- MSc Nurse Practitioner
- MA Practice Development
- MA Nursing
- MSc Public Health
- Postgraduate Diploma in Public Health with Community Specialist Practice **
- Supplementary and Extended Prescribing for Nurses, Midwives and Health Visitors
- BSc (Hons) Midwifery Practice
- MA Advanced Midwifery Practice
- Return to Midwifery Practice**
# The pathways within BSc (Hons) Health Studies are as follows:
Adult Intensive Care, Day Surgery Care, Aggression Management, Burns and Plastic Surgery, Cancer Care, Care of the Older Person, Diabetes Care, Emergency Care, Health Informatics, Clinical Practice, Severe and Enduring Mental Health Problems, Pain Management, Palliative Care, Peri-operative Care, Spinal Cord Rehabilitation, Ophthalmic Care, Critical Care in Spinal Cord Injury, Interprofessional Practice.
* These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the major review of healthcare programmes.
** These programmes are NMC approved.
*** This programme is 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 Midwifery, Nursing and Operating Department Practice at Bournemouth University in partnership with Dorset and Somerset Strategic Health Authority, Avon, Gloucestershire and Wiltshire Strategic Health Authority, and Hampshire and Isle of Wight Strategic Health Authority.
Strengths
- A wide range of appropriate assessment methods is used to ensure midwifery students achieve their modular and programme outcomes (paragraph 14).
- External examiners indicate that communication with the University midwifery staff is effective and confirm that the assessments are achieving the intended learning outcomes at diploma, degree and postgraduate levels (paragraph 15).
- An effective tripartite assessment system is used to assess students' practice and involves the student, practice midwife and midwifery teacher working together to grade the learner's performance (paragraph 17).
- In nursing, continuing professional development programmes, with contemporary and innovative intended learning outcomes, have been developed in conjunction with the partners. For instance, BSc (Hons) Clinical Leadership and BSc (Hons) Nurse Practitioner have proved successful in supporting students with their lifelong learning needs and the workforce requirements of the partner Strategic Health Authorities (paragraph 27).
- The employment of practice educators in nursing has resulted in a marked improvement in communication with, and support for, mentors in practice placements, and hence has helped curriculum development, but their distribution does vary considerably by location and branch (paragraph 29).
Good practice
- The Midwifery Forum, which brings together stakeholders from the midwifery provision, is valuable in supporting discussion concerning current developments in midwifery and their inclusion in the curricular, at both pre-registration and post-registration levels (paragraph 9).
- The practice placements have facilitated the development of case-loading for midwifery students (paragraph 10).
- Practice educators for operating department practice are a valuable resource for guidance on assessment for both students and mentors (paragraph 58).
Weaknesses
- The University recognises in its self-evaluation document that there is a need for more interprofessional learning, effectively implemented, on both the BSc (Hons) Midwifery and the Advanced Diploma in Midwifery. Therefore, the revised curriculum starting in September 2005 will include dedicated units of interprofessional learning (paragraph 11).
- At present, the campus-based element of the curriculum for the pre-registration nursing programmes has little interprofessional content. However, the School is due to introduce a new curriculum in September 2005 which will include interprofessional units covering six professional disciplines (paragraph 30).
- Students on pre-registration nursing programmes reported long delays in the return of feedback, well in excess of the six-week period indicated to them (paragraph 36).
- While learning disability staff in practice are well motivated to support the assessment of students, they report a lack of support and communication from the University (paragraph 38).
- Not all operating department practice mentors are fully familiar with the intended learning outcomes, partly because a written mentor handbook is not available (paragraph 47).
- The operating department practice programme has a unit focusing on interprofessional learning, yet this does not at present involve students from different professions. However, a common core interprofessional curriculum linking the programmes in nursing, midwifery, social work, operating department practice, occupational therapy and physiotherapy is due to be introduced in September 2005 for students at both the Bournemouth and Yeovil campuses (paragraph 51).
- Operating department practice students often do not receive high-quality written feedback (paragraph 56).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strengths
- The model of mentor and associate enables skills escalation and placement capacity to be assured (paragraph 71).
- The School publishes a journal, 'The Mentor', which is widely distributed to practice placements, utilising various approaches in disseminating information to clinicians (paragraph 71).
Good practice
- The School's business plan highlights its commitment to clinical sabbaticals for academics with a professional registration, to ensure that contemporary knowledge and evidence-based practice are delivered within the academic environment (paragraph 66).
Weaknesses
- Students value their clinical skills teaching, yet variation of access to the clinical skills laboratories exists across programmes (paragraph 63).
- In the learning disability branch, practice staff are not always clear about the learning outcomes and curriculum, hence affecting learning and teaching (paragraph 70).
- Visits to placements demonstrate that student evaluation processes vary considerably amongst clinical areas and, in operating department practice, processes have not yet been fully formalised (paragraph 73).
Student progression
The quality of student progression is commendable with the exception of the Advanced Diploma Clinical Nursing (Learning Disability).
Strengths
- Most students from the Bournemouth campus expressed high levels of satisfaction with the pastoral and academic support they receive from tutors on-campus and the University generally (paragraph78).
- Pre-registration nursing students are able to work alongside mentors for at least two-fifths of their week and, in some cases, more frequently. This is so even when students were able to self-roster, so allowing them more flexibility in meeting their other commitments (paragraph 83).
Weakness
- Although only one set of operating department practice students has completed their first year, and it is therefore difficult to identify trends, the loss of nine students, including three transfers out, from a group of 21 is high (paragraph 84).
The quality of student progression on the Advanced Diploma Clinical Nursing (Learning Disability) is approved.
Strengths
- Most students from the Bournemouth campus expressed high levels of satisfaction with the pastoral and academic support they receive from tutors on-campus and the University generally (paragraph 78).
- Pre-registration nursing students are able to work alongside mentors for at least two-fifths of their week and, in some cases, more frequently. This is so even when students were able to self-roster, so allowing them more flexibility in meeting their other commitments (paragraph 83).
Weaknesses
- On the learning disability provision, visits from link lecturers have been infrequent. Little education or training provision has been offered to staff on site, and mentorship updates have been through generic rather than specific learning disability provision (paragraph 80).
- The loss of students from the learning disability branch is a matter of concern. While students may not always have left the programme, movements out of groups, for whatever reason, affect the academic viability of the remaining cohorts. (paragraph 84).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strengths
- Library facilities at Bournemouth and Portsmouth are excellent, fully supporting learning and the curriculum, and providing parity of experience for midwifery students (paragraph 86).
- Information technology facilities are fully supportive of the learning requirements of the students on the provision and of the curriculum, and are excellent (paragraph 87).
- Lecturer practitioners, practice educators, and also link tutors in midwifery, are used to support clinical educators and are effective (paragraph 91).
Weaknesses
- Recent resource plans have identified the need to eliminate the current long round trip required when transporting nursing students from Yeovil to Bournemouth for clinical skills laboratory aspects of the curriculum (paragraph 85).
- Some students in the learning disability branch and operating department practice report that they have never formally evaluated their practice experience (paragraph 92).
Maintenance and enhancement of standards and quality
Strengths
- Student feedback on programmes is effectively gathered through a number of student committees, the minutes of which form part of the Annual Report on Programme Monitoring (paragraph 96).
- There is effective collaboration between the partners at programme level through liaison by programme teams and bodies such as the Midwifery Forum and nursing executive meetings (paragraph 97).
Weakness
- Feedback on module processes by students within the Annual Report on Programme Monitoring is of variable quality (paragraph 96).
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 Midwifery, Nursing and Operating Department Practice (ODP) at Bournemouth University (the University) in partnership with Dorset and Somerset Strategic Health Authority (SHA), Avon, Gloucestershire and Wiltshire SHA, and Hampshire and Isle of Wight SHA. The review was completed during the academic year 2004-05.
2 The University's origins lie in the former Bournemouth Municipal College founded early in the twentieth century. The Dorset Institute of Higher Education was formed in 1976 following a rationalisation of further and higher education in Dorset. The Dorset Institute was re-designated Bournemouth Polytechnic in 1990 and subsequently, in 1992, Bournemouth University. In December 2004, the University had approximately 15,011 students, of which 9,349 were full-time undergraduates, 3,912 part-time undergraduates, 1,158 full-time postgraduates (including 89 research students) and 592 part-time postgraduates (including 121 research students). In May 2005, the University had 646 (563 full-time equivalent (FTE)) academic staff and 656 (570 FTE) support staff. The University is located on two sites, the Talbot and Lansdowne Campuses, within the Bournemouth and Poole conurbation. The academic provision under review is located in the Institute of Health and Community Studies (IHCS), one of the University's six schools, and is based at the Lansdowne Campus in Bournemouth. IHCS also has sites at Portsmouth for some midwifery provision and at Yeovil for some nursing and ODP programmes. The University Centre Yeovil is a collaboration with the University of Exeter and Yeovil College. All the University's academic programmes are positioned within a unit-based, credit-rated curriculum framework structure, which retains the integrity of the programme as its guiding operational principle.
3 The University works in partnership with the three SHAs of Dorset and Somerset, Avon, Gloucestershire and Wiltshire, and Hampshire and the Isle of Wight as well as a network of National Health Service (NHS) Primary Care, Acute and Specialist Trusts. The areas served by the University programmes include the rural counties of Dorset and Somerset, South Wiltshire, Hampshire and the Isle of Wight. The organisations responsible for workforce development within the SHAs work closely with health and social care employers, statutory and independent, to plan and develop the NHS workforce and to manage practice placement learning and teaching.
A Subject provision and overall aims
4 Midwifery, Nursing and ODP provision is currently offered in the following programmes:
Pre-registration
- BSc (Hons) Clinical Nursing with professional registration (Adult, Child, Mental Health, Learning Disability)* **
- Advanced Diploma Clinical Nursing with professional registration (Adult, Child, Mental Health, Learning Disability)* **
- Diploma in Higher Education in Clinical Nursing with professional registration (Adult, Mental Health)* **
- Graduate Diploma in Clinical Nursing with professional registration (Adult, Child, Mental Health, Learning Disability)* **
- BSc (Hons) Midwifery**
- Advanced Diploma in Midwifery**
- Diploma in Higher Education in Operating Department Practice***
Post-registration
- BSc (Hons) Health Studies/BSc (Hons) Health Studies (Pathway)#
- DPS Health Care
- BSc (Hons) Psychosocial Interventions for Psychosis
- BSc (Hons) Therapeutic Interventions for Addictions
- BSc (Hons) Clinical Leadership
- BSc (Hons) Nurse Practitioner
- Return to Practice (Nursing) *
- Enrolled Nurse (EN) Conversion Course**
- MSc Nurse Practitioner
- MA Practice Development
- MA Nursing
- MSc Public Health
- Postgraduate Diploma (PgDip) in Public Health with Community Specialist Practice**
- Supplementary and Extended Prescribing for Nurses, Midwives and Health Visitors
- BSc (Hons) Midwifery Practice
- MA Advanced Midwifery Practice
- Return to Midwifery Practice**
#The pathways within BSc (Hons) Health Studies are as follows:
Adult Intensive Care, Day Surgery Care, Aggression Management, Burns and Plastic Surgery, Cancer Care, Care of the Older Person, Diabetes Care, Emergency Care, Health Informatics, Clinical Practice, Severe and Enduring Mental Health Problems, Pain Management, Palliative Care, Peri-operative Care, Spinal Cord Rehabilitation, Ophthalmic Care, Critical Care in Spinal Cord Injury, Interprofessional Practice.
* These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the major review of healthcare programmes.
** These programmes are NMC approved.
*** This programme is approved by the Health Professions Council (HPC).
5 The aim of the programmes is to meet the needs of those intending to become either a registered nurse, midwife or operating department practitioner, or wishing to engage in continuing professional development in one of the above fields. This is in keeping with the University's mission as a vocational university and, in particular, with one aspect of the IHCS's mission statement: 'through educational activities and working in partnership with agencies and students to help continually improve health and community care services primarily in the local region, but also nationally and internationally'.
B Academic and practitioner standards
B1 Midwifery
Intended learning outcomes
6 The intended learning outcomes (ILOs) for the all midwifery programmes are properly mapped against relevant NMC competencies and requirements for fitness to practice and European Union (EU) directives, the Subject benchmark statement for midwifery, The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), the National Service Framework (NSF) for Children and Maternity Services, both for theoretical work and for clinical practice experience. Useful handbooks and unit guides provide dissemination of the ILOs to students. A mentor handbook gives appropriate guidance to staff in practice on the ILOs. Programme specifications are freely available and also provide valuable information.
7 The ILOs for the pre-registration programmes have clearly been developed with the interests of stakeholders and partners taken fully into account, through a number of forums involving substantial input from clinical staff, as well as government and NMC directions and reports on midwifery. The BSc (Hons) Midwifery and Advanced Diploma in Midwifery programmes continue to be delivered on the Bournemouth and Portsmouth Campuses with identical ILOs. The ILOs are carefully designed to enable students to become competent and reflective practitioners of midwifery, basing their practice on research, the concept of holistic care and commitment to lifelong learning.
8 The Return to Midwifery Practice programme ILOs are entirely congruent with the NMC requirements for returning to practice. Other programmes, designed for practising midwives, involve ILOs that are fully consistent with the level of study and provide valuable opportunities for professional development.
Curricula
9 All the programmes in the midwifery provision are designed to meet the relevant requirements of the NMC and the Subject benchmark statement. The level of study is appropriately aligned with the FHEQ for all programmes. The curriculum has been developed with the involvement of key stakeholders as well as users of the service. For instance, the Midwifery Forum, which brings together stakeholders from the midwifery provision, is valuable in supporting discussion concerning current developments in midwifery and their inclusion in the curriculum at both pre-registration and post-registration levels. The two pre-registration programmes are suitably differentiated in their academic and clinical content. The students believe that these programmes prepare them properly for practice and this is confirmed by employers.
10 Practice accounts for 50 per cent of the pre-registration programmes. The practice environments are audited and there is strong evidence of support for learners in the practice placements from the mentors and link lecturers. The practice placements have facilitated the development of case-loading for midwifery students. However, some concerns were expressed in the annual report concerning midwifery-specific learning opportunities in the gynaecology placements where there are significant numbers of adult nurse students. The programme team continues to monitor this area.
11 The University recognises in its self-evaluation document (SED) that there is a need for more interprofessional learning, effectively implemented, on both the BSc (Hons) Midwifery and the Advanced Diploma in Midwifery. Therefore, the revised curriculum starting in September 2005 will include dedicated units of interprofessional learning. For pre-registration students at Portsmouth this will involve bringing in students from elsewhere in the provision. Enquiry-based learning is a feature of the present curriculum, although not assessed, and continues to be evaluated positively. This aspect will be further developed in the new curriculum.
12 In response to midwifery practice drivers, the BSc (Hons) Midwifery Practice fulfils the needs of the partners to ensure that midwives underpin their initial qualification with innovative, contemporary and evidenced-based units of learning. The other post-registration programmes also effectively fulfil students' needs, in particular, fostering a critical reflective approach to the analysis of evidence and the contemporary role of the midwife.
13 The Return to Midwifery Practice programme is suitably designed to return unregistered midwives to the NMC register. The learning required is delivered through open and flexible learning study packs with tutorial support. Practice placements are negotiated on an individual basis with the Local Supervising Authority Midwifery Officer who advises on the timeframe for return.
Assessment
14 The School has an assessment strategy and guidelines developed in the context of the University's guidance and based on NMC precepts and suitable consideration of the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), published by QAA. A wide range of appropriate assessment methods is used to ensure midwifery students achieve their modular and programme outcomes. Assessments have been modified in response to students', external examiners' and practice staff evaluations. Students consider their assessments fair, and find personal tutors accessible and the support they offer effective in helping to achieve the academic level required on all programmes.
15 Assignments and examinations are second-marked and dissertations double-blind marked, but the system of moderation is not always clear to the outside reader. Samples of students work are sent for external scrutiny, but external examiners have noted that these are not always representative. External examiners indicate that communication with the University's midwifery staff is effective and confirm that the assessments are achieving the ILOs at diploma, degree and postgraduate levels.
16 Students reported timely and useful feedback. However, external examiners have expressed some concerns related to the use of different comment sheets for general and individual comment. After looking at student work, the reviewers agree with the external examiners that the use of different grids could lead to some student confusion.
17 Fifty per cent of the assessment is undertaken in practice for pre-registration programmes, but is variable in the Return to Midwifery Practice programme, reflecting the experience and needs of individual students. An effective tripartite assessment system is used to assess students' practice and involves the student, practice midwife and midwifery teacher working together to grade the learner's performance. Practice skills are assessed using the NMC Midwifery Competencies and logged within the practice portfolio. Mentors report that they are well prepared for their role, and that they are updated regularly. They have good practice documentation, are clear about their responsibilities and indicate that practice assessments are appropriate to the students' level of study. Students also confirm that they are well supported in practice while preparing for and undertaking their assessment tasks. On master's programmes, there is no practice requirement built into the programme, but students are expected to be working in practice during their studies.
Student achievement
18 External examiners' reports indicate that the content and level of students' work at pre-registration level programmes, including Return to Midwifery Practice, achieve the required professional and academic standards and are comparable with other institutions. The reviewers confirm this view after sampling students' work. All the midwifery external examiners report meeting groups of students.
19 While the numbers are relatively small, the level of achievement of midwifery graduates is above average, with a high percentage being awarded a First class degree (Table 1a) and the majority achieving at least an Upper Second. External examiners confirm this grading is appropriate. Diplomates also perform well, with 58 per cent attaining a distinction in their programme. On average, over 40 per cent gain employment with local NHS providers (Table 1a). The Return to Midwifery Practice programme has a 79 per cent pass rate.
20 The post-registration midwifery programmes have an overall pass rate of 81 per cent, with 65 per cent gaining a pass at H level; the number of students achieving this level has also improved over time from 51 per cent in 2001 to 90 per cent in 2004. The master's midwifery programme is a small one and a significant proportion of students do not attain the full award. To date, the programme has had three graduates, one being awarded the PgDip and two the MA.
21 Mentors apply a rigorous and successful process for dealing with unsafe or failing students. Students and clinical staff also considered the programme prepared them for practice and employment, and the majority of midwifery students are employed in the South West region after qualifying. The local NHS employed 39 per cent of the graduates and 51 per cent of the diplomates (Table 2a). Employers confirm that students gaining the awards are suitably skilled.
Summary of academic and practitioner standards for midwifery
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Midwifery at Bournemouth in University partnership with Dorset and Somerset Strategic Health Authority, Avon, Gloucestershire and Wiltshire Strategic Health Authority, and Hampshire and Isle of Wight Strategic Health Authority.
Strengths
- A wide range of appropriate assessment methods is used to ensure midwifery students achieve their modular and programme outcomes (paragraph 14).
- External examiners indicate that communication with the university midwifery staff is effective and confirm that the assessments are achieving the intended learning outcomes at diploma, degree and postgraduate levels (paragraph 15).
- An effective tripartite assessment system is used to assess students' practice and involves the student, practice midwife and midwifery teacher working together to grade the learner's performance (paragraph 17).
Good practice
- The Midwifery Forum, which brings together stakeholders from the midwifery provision, is valuable in supporting discussion concerning current developments in midwifery and their inclusion in the curriculum, at both pre-registration and post-registration levels (paragraph 9).
- The practice placements have facilitated the development of case-loading for midwifery students (paragraph 10).
Weakness
- The University recognises in its self-evaluation document that there is a need for more interprofessional learning, effectively implemented, on both the BSc (Hons) Midwifery and the Advanced Diploma in Midwifery. Therefore, the revised curriculum starting in September 2005 will include dedicated units of interprofessional learning (paragraph 11).
Table 1a: Completion and achievement statistics for all award-bearing programmes in midwifery
| Programme | Cohort | Diploma programmes | Diploma programmes | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| BSc (Hons) Midwifery | Sep 1999 | 8 | 73 | 2 | 18 | 1 | 9 | 0 | 0 | 0 | |||||||
| Sep 2000 | 4 | 33 | 6 | 50 | 1 | 8 | 1 | 8 | |||||||||
| Sep 2001 | 6 | 46 | 4 | 31 | 3 | 23 | 0 | ||||||||||
| AdvDip Midwifery | Feb 2000 | 31 | 97 | 1 | 3 | ||||||||||||
| Feb 2001 | 36 | 100 | 0 | ||||||||||||||
| Sep 2001 | 31 | 100 | 0 | ||||||||||||||
| BSc (Hons) Midwifery Practice | May 2000 | 3 | 43 | 2 | 27 | 1 | 14 | 1 | 14 | ||||||||
| May 2001 | 2 | 25 | 2 | 25 | 3 | 38 | 1 | 13 | |||||||||
| May 2002 | 9 | 31 | 17 | 59 | 3 | 10 | |||||||||||
| May 2003 | 5 | 71 | 2 | 29 | |||||||||||||
| Sept 2003 | 3 | 43 | 3 | 43 | 1 | 14 | |||||||||||
| Programme | Cohort | ||||||||
| PGCert | PgDip | Masters | Fail | ||||||
| No. | % | No. | % | No. | % | No. | % | ||
| MA Professional Development (Midwifery) | 2001-02 | 1 | 50 | 1 | 50 | ||||
| 2002-03 | 1 | 100 | |||||||
Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes
| Programme (Award bearing only) |
Output |
Further study | Local employers | Employers elsewhere | Unemployed | Other* | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | ||
| AdvDip Midwifery | Feb 03 | 17 | 63 | 8 | 30 | 2 | 7 | ||||
| Feb 04 | 13 | 37 | 5 | 14 | 7 | 20 | 10 | 29 | |||
| Sep 04 | 16 | 52 | 10 | 32 | 2 | 7 | 3 | 10 | |||
| BSc Midwifery | Sep 02 | 4 | 33 | 4 | 33 | 4 | 33 | ||||
| Sep 03 | 5 | 39 | 8 | 62 | |||||||
| Sep 04 | 1 | 8 | 6 | 46 | 2 | 15 | 2 | 15 | 2 | 15 | |
B2 Nursing
Intended learning outcomes
22 The aims and ILOs of the nursing programmes are set out clearly in the programme and unit specifications. They have been developed within the University's programme development and approval process, which ensures appropriate standardisation, scrutiny, consistency and integrity of programmes and awards.
23 The programmes are designed, in collaboration with the local user forums, to meet the standards of the key stakeholders, the Pre-registration Nursing Framework approved in 2001 and 2003, including the Subject benchmark statement for nursing and the FHEQ, both published by QAA. The programmes incorporate entry to branch outcomes and entry to register competencies of the NMC. ILOs are also specific to individual branch programmes. Useful programme specifications are available to stakeholders.
24 Pre-registration programme outcomes enable students to be fit for practice, purpose and award and for professional standing. Overall, outcomes for the various nursing programmes are appropriate and designed to enable students to achieve competencies and the knowledge necessary to become effective, safe practitioners. There is good integration of theory and practice, and the majority of practice placements areas are effective in allowing students to achieve learning outcomes.
25 Learning outcomes for all pre-registration programmes and Return to Practice (Nursing) and EN Conversion programmes are stated clearly in student handbooks and relevant unit guide documentation. Generally, dissemination of these documents to students and clinicians is effective. Students consider the ILOs as part of the unit evaluation process. There is a clear mentor handbook. Post-registration students also indicate that they are well informed about the requirements of their programme.
26 ILOs are appropriately related to levels of learning in the various programmes. They are differentiated for diploma, honours and postgraduate degrees and, as such, meet the descriptors for each of these levels as outlined in FHEQ. Outcomes are also made clear to nursing students and practice mentors through mentor updates.
27 In nursing, continuing professional development (CPD) programmes, with contemporary and innovative ILOs, have been developed in conjunction with the partners. For instance, BSc (Hons) Clinical Leadership and BSc (Hons) Nurse Practitioner have proved successful in supporting students with their lifelong learning needs and the workforce requirements of the partner SHAs.
Curricula
28 Curricular development is a collaborative process, including the University team, mentors and other representatives from clinical practice. Service-user representatives are included in specific nursing programmes, particularly in mental health. The programmes are designed to meet external reference points, such as NMC requirements and Subject benchmark statements, and are aligned with the FHEQ. The curriculum content is designed to allow students to meet ILOs of the programme and to develop appropriate subject knowledge, clinical competence, transferable skills and professional values both on campus and in practice placements.
29 Practice-based learning is central to the curricula and constitutes 50 per cent of the curricula on the pre-registration programmes. Progression through the curricula is evidenced by the use of the practice profile, which serves to reinforce the centrality of patients and clients to the nursing programmes, both for pre and post-qualifying awards. Changes to practice placement patterns of allocation and the associated assignment schedule is due to student evaluations and programme monitoring, and has resulted in the re-introduction of a block-placement system since September 2004. This change is being monitored by the head of practice education and the programme leaders. The employment of practice educators in nursing has resulted in a marked improvement in communication with, and support for, mentors in practice placements and has helped curricula development, but their distribution varies considerably by location and branch.
30 At present, the campus-based element of the curricula for the pre-registration nursing programmes has little interprofessional content. However, the School is due to introduce a new curriculum in September 2005 which will include interprofessional units covering six professional disciplines. At the same time, the University is seeking to respond to the major changes in national health and social policy that have had a direct impact on healthcare provision, including the modernisation agenda and NSFs. These factors will also influence the ongoing review of the post-registration programmes. 2003 saw the development and introduction of enquiry-based learning to the branch programmes and this has proved popular with some students; however, engagement and attendance have been problematic.
31 The Return to Practice (Nursing) programme is run at the University and also at the Royal United Hospital, Bath, under a franchise arrangement and, overall, properly prepares students for a return to practice. Although the programme was reviewed last academic year, some of the content is too adult-centric, to the detriment of the smaller branches which have so far had no students on this curriculum. Moreover, the interpretation of the curriculum differs somewhat between the two sites.
32 The curriculum of the EN Conversion Course is designed to enable enrolled nurses to achieve the competencies indicated by NMC requirements, including the EU directives for pre-registration nursing. The curriculum is predicated on an open-learning pack validated by the University of York. Additional units are provided in order to meet the specific three pathways leading to registration on the relevant part of the register. Practice placements are organised within the student's home Trust, and study time, one study day a week, is arranged through the manager of the service area. Managers are also responsible for providing a suitable mentor.
33 The University works with its partners in the independent and public sectors to research contemporary issues that are relevant to the NHS. Research is pivotal to the development and delivery of higher education and the University places research practice at the core of its activities.
34 The post-qualifying and master's level programmes are designed to address the government health and social care agendas. The structure of the provision is now under review at the University. The aim is to reduce the complexity, which has built up over a number of years as the University responded in an enterprising way, to perceived demand. The need for review is also recognised by the partners since the take-up on some units has been less than expected, sometimes due to budgetary constraints within the partner SHAs. However, several programmes, for instance the BSc (Hons) Nurse Practitioner and BSc (Hons) Clinical Leadership, have become successful and valued by students. The post-registration and postgraduate provision also includes a number of well-designed programmes that bring together students from a number of different professions.
Assessment
35 The University and the School provide an assessment strategy and guidelines which have been developed with proper consideration of the Code of practice, published by QAA, and informed by NMC precepts. Assessments on the provision enable the students to meet the ILOs as specified in the programme specifications and unit directories. The academic assessments are reviewed periodically to ensure that they employ a range of strategies, and external examiners report that they are involved in assessment developments. Students find the theory assessments challenging, particularly those who have not undertaken academic work previously, such as the Return to Practice (Nursing). Except on the Advanced Diploma (Learning Disability) and the BSc Nurse Practitioner, students on a range of programmes reported that they have good tutorial support to assist them in undertaking their assessments at the appropriate level.
36 Coursework assignments and examinations are second-marked and dissertations are double-blind marked. A quota is sent for external scrutiny. There is a good relationship between the external examiners and the University and, overall, the external examiners confirm that the assessments are appropriate for the expected outcomes at diploma, degree and master's levels. However, students on pre-registration nursing programmes reported long delays in the return of feedback, well in excess of the six-week period indicated to them, which reduces the formative element of feedback. Some external examiners indicate that they do not always receive programme briefs and guidance related to the levels being assessed.
37 The University has generic marking criteria for all programmes. The School introduced a new marking feedback form in 2002-03 in response to external examiners' concerns to ensure greater consistency in marking and student feedback on academic assignments. However, after scrutiny of the students' work and discussions with students themselves, the reviewers conclude that the form has not fully resolved the problem. There is considerable variation in the value of the comments made by markers and in the reliability of the tick placed in the box grid to reflect grades awarded. In addition, there are specific criteria used for assessing independent assignments and, while the written comments made are helpful, it was difficult to discern how the scores reflected the percentages assigned to each criterion.
38 Practice accounts for 50 per cent of the diploma and undergraduate programmes leading to registration, and requires the mentor to sign that the student has achieved the programme benchmarks. The student also has to provide a portfolio of evidence of their practice learning at the appropriate level, which is then verified by their personal tutor at the end of each placement. The practice element of the Return to Practice (Nursing) and EN Conversion Course is variable, and graduate and master's level programmes expect participants to engage in practice. Mentors report that they are appropriately prepared and are updated regularly. They also felt that the assessments properly prepared the students for practice and employment. However, while learning disability staff in practice are well motivated to support the assessment of students, the students report a lack of support and communication from the University.
39 Some students report that they are uncertain that all mentors understand fully the practice assessment document, which is not placement-specific but is used for multiple placements over one year. Mentors consider the practice documents complicated for undergraduate and diploma students, but felt that they have support and information to understand their role, helped by a written guide from the University.
Student achievement
40 External examiners' reports confirm that students are achieving the professional and academic levels required of the various programmes. There was a consensus between the reviewers and the external examiners with regard to students' work being comparable with that at other institutions.
41 The Return to Practice (Nursing) programme delivered at Bournemouth and Bath has attracted over 300 students since it began in September 2000. Bournemouth has a persistently lower Pass rate than Bath; nevertheless, the programme has a 79 per cent success rate and the students are offered employment on completion within the local NHS providers. There were small intakes to the EN Conversion Course programmes with an equally good Pass rate and an appropriate level of achievement.
42 The majority of post-registration nursing students undertake units within the BSc (Hons) Health Studies. The post-registration programmes have a 74 per cent success rate and there has been a marked increase in the number of students achieving at level H, for example, from 13 per cent in 2001 to 52 per cent in 2003. The stand-alone prescribing programmes had an initial high intake, of which 67 per cent of the students were successful. Although the credit level doubled for the extended prescribing programme and there was a much smaller group in the following year, there was a considerable improvement in the Pass rate. However, when the supplementary element to the programme was added and the credit rating increased again, non-achievement also increased. The nurse practitioner and clinical leadership programmes also demonstrate improving levels of student achievement over time.
43 The University has developed programmes for nursing at both postgraduate diploma and master's level. These programmes in nursing generally attract small numbers of students, although there have been seven graduates at master's level and 10 PgDip graduates from a more successful programme in public health. Moreover, many students undertake individual modules as part of a CPD programme.
44 Mentors and service managers on pre-registration nursing programmes were able to give examples of how they dealt with unsafe or failing students. They also felt that the programme prepared the students for practice and employment, and this is generally confirmed by the students. Employers indicated that pre-registration students are appropriately skilled for employment when they achieve their award, and that students gaining a post-registration award also meet their requirements.
45 The reviewers and the external examiners find the grade of award on pre-registration nursing programmes, reported in Table 1b, to be a suitable reflection of student achievement and comparable with other institutions. There is an appropriate range of grades and while the proportion of students getting a First or Upper Second class of degree has varied over the period reported, it has always been above 40 per cent. Information in Table 2b indicates that the vast majority of the pre-registration diplomates and graduates are in employment, with some in post with local NHS providers. However, in some areas the percentage of unknowns in the outputs is quite high.
Summary of academic and practitioner standards for nursing
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Nursing at Bournemouth University in partnership with Dorset and Somerset Strategic Health Authority, Avon, Gloucestershire and Wiltshire Strategic Health Authority, and Hampshire and Isle of Wight Strategic Health Authority.
Strengths
- In nursing, continuing professional development programmes, with contemporary and innovative intended learning outcomes, have been developed in conjunction with the partners. For instance, BSc (Hons) Clinical Leadership and BSc (Hons) Nurse Practitioner have proved successful in supporting students with their lifelong learning needs and the workforce requirements of the partner Strategic Health Authorities (paragraph 27).
- The employment of practice educators in nursing has resulted in a marked improvement in communication with, and support for, mentors in practice placements, and hence has helped curriculum development, but their distribution does vary considerably by location and branch (paragraph 29).
Weaknesses
- At present, the campus-based element of the curriculum for the pre-registration nursing programmes has little interprofessional content. However, the School is due to introduce a new curriculum in September 2005 which will include interprofessional units covering six professional disciplines (paragraph 30).
- Students on pre-registration nursing programmes reported long delays in the return of feedback, well in excess of the six-week period indicated to them (paragraph 36).
- While learning disability staff in practice are well motivated to support the assessment of students, they report a lack of support and communication from the University (paragraph 38).
Table 1b: Completion and achievement statistics for all award-bearing programmes in nursing
| Programme | Cohort (Each of the last 3 cohorts) |
Diploma programmes | Diploma programmes | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| AdvDip Clinical Nursing (all branches) | Sep 2000 | 175 | 90 | 19 | 10 | ||||||||||||
| AdvDip Clinical Nursing (Adult only) | Feb 2001 | 63 | 93 | 5 | 7 | ||||||||||||
| AdvDip Clinical Nursing (all branches) | Sep 2001 | 137 | 88 | 19 | 12 | ||||||||||||
| BSc (Hons) Clinical Nursing (all branches) | Sep 1999 | 4 | 10 | 20 | 49 | 14 | 34 | 0 | 0 | 3 | 7 | ||||||
| BSc (Hons) Clinical Nursing (all branches) | Sep 2000 | 2 | 7 | 10 | 35 | 12 | 41 | 2 | 7 | 0 | 3 | 10 | |||||
| BSc (Hons) Clinical Nursing including cross conversion | Sep 2001 | 8 | 15 | 27 | 50 | 17 | 32 | 2 | 4 | 0 | 0 | ||||||
| BSc (Hons) Psychosocial Interventions in the Management of Psychosis | April 2002 | 3 | 38 | 3 | 38 | 1 | 13 | 1 | 13 | ||||||||
| Oct 2002 | 2 | 50 | 2 | 50 | |||||||||||||
| June 2003 | 2 | 29 | 3 | 43 | 2 | 29 | |||||||||||
| DPS Psychosocial Interventions in the Management of Psychosis | Oct 2001 | 2 | 66 | 1 | 33 | ||||||||||||
| April 2002 | 1 | 50 | 1 | 50 | |||||||||||||
| Oct 2002 | 1 | 100 | |||||||||||||||
| Programme | Cohort | Diploma programmes | Diploma programmes | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| BSc (Hons) Nurse Practitioner | Feb 2002 Bmth | 2 | 14 | 6 | 42 | 6 | 42 | ||||||||||
| Apr 2002 - Bicton | 1 | 6 | 8 | 50 | 7 | 43 | |||||||||||
| Oct 2002 - Bmth |
3 | 20 | 8 | 53 | 4 | 27 | |||||||||||
| BSc (Hons) Nursing | 2000-01 | 3 | 17 | 9 | 50 | 1 | 5 | 1 | 5 | 4 | 2 | ||||||
| 2001-02 | 2 | 9 | 16 | 70 | 3 | 13 | 1 | 4 | 1 | 4 | |||||||
| 2002-03 | 8 | 73 | 2 | 18 | 1 | 9 | |||||||||||
| EN>RN Conversion Course | Jan 2001 | 8 | 73 | ||||||||||||||
| Sep 2001 | 17 | 85 | |||||||||||||||
| Sep 2002 | 18 | 69 | |||||||||||||||
| Diploma in Professional Studies in Nursing/Clinical Practice | 2001-02 | 73 | 99 | 1 | 1 | ||||||||||||
| 2002-03 | 50 | 98 | 1 | 2 | |||||||||||||
| 2003-04 | 31 | 94 | 2 | 6 | |||||||||||||
| BSc (Hons) Clinical Leadership | Jan 2001 | 5 | 50 | 3 | 30 | 1 | 10 | 1 | 10 | ||||||||
| Jan 2002 | 7 | 70 | 3 | 30 | |||||||||||||
| Jan 2003 | 1 | 6 | 10 | 56 | 6 | 33 | 1 | 6 | |||||||||
| Programme | Cohort | ||||||||
| PGCert | PgDip | Masters | Fail | ||||||
| No. | % | No. | % | No. | % | No. | % | ||
| MA Professional Development (Practice) |
2000-01 | 2 | 67 | 1 | 33 | ||||
| 2001-02 | 4 | 80 | 1 | 20 | |||||
| MA Professional Development (Health & Community Studies) |
2000-01 | 1 | 100 | ||||||
| 2001-02 | |||||||||
Table 2b: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes
| Programme (Award bearing only) |
Output |
Further study | Local employers | Employers elsewhere | Unemployed | Other* | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | ||
| AdvDip Clinical Nursing (all branches) | Sep 03 | 108 | 62 | 22 | 13 | 44 | 25 | ||||
| AdvDip Clinical Nursing (Adult only) | Mar 04 | 42 | 67 | 2 | 3 | 3 | 5 | 16 | 25 | ||
| AdvDip Clinical Nursing (all branches) | Sep 04 | 71 | 54 | 26 | 20 | 2 | 2 | 33 | 25 | ||
| BSc (Hons) Clinical Nursing (all branches) | Sep 02 | 18 | 53 | 13 | 38 | 3 | 9 | ||||
| BSc (Hons) Clinical Nursing (all branches) | Sep 03 | 11 | 44 | 4 | 16 | 10 | 40 | ||||
| BSc (Hons) Clinical Nursing including cross conversion | Sep 04 | 22 | 41 | 6 | 11 | 26 | 48 | ||||
B3 Operating department practice
Intended learning outcomes
46 The ILOs for the DipHE in ODP were developed to be in line with the requirements of the Association of Operating Department Practitioners (AODP) Curriculum Document (2001), and they reference across to the AODP Curriculum Framework Document (1999), the National Occupational Standards (1991) and the FHEQ. Operating department practitioners were accepted onto the HPC register for statutory registration in 2004 and the ILOs meet the requirements laid down by the HPC.
47 The ILOs are communicated to students and clinical staff through the programme handbook. A programme specification is available. However, not all ODP mentors are fully familiar with the ILOs, partly because a written mentor handbook is not available.
48 The reviewers were informed that there had been significant modifications to the programme ILOs within the first year of delivery. The units concerned are Anatomy and Physiology (certificate (C) level), Clinical Anatomy and Physiology (level C), Legal and Ethical Aspects of Care (level C) and Educational Development (level C). The changes involved altering the weighting and nature of the respective unit ILOs and were in response to student and clinical placement requests. This substantial level of change may reflect the statement by representatives of the employers that the programme was introduced quickly due to workforce requirements.
Curricula
49 The curriculum was originally designed to meet the requirements set out in the document Diploma (HE) in Operating Department Practice-Curriculum Document (AODP2001). Its outcomes are in line with the intermediate level as defined in the FHEQ.
50 The programme was validated in July 2003 and the first cohort started at the Bournemouth Campus in September of that year. The first intake of students at the Yeovil Campus occurred at the beginning of this academic year. As yet, no students have completed the programme. The appropriate subject benchmark statement has suitably informed the programme curriculum. Input from theatre personnel through the contract management group helps to ensure the currency of the curriculum. Curriculum development and innovation will also be enhanced as the programme team continues to increase in size from its original base of one during much of the first year of operation.
51 The ODP programme has a unit focusing on interprofessional learning, yet this does not at present involve students from different professions. However, a common core interprofessional curriculum linking the programmes in nursing, midwifery, social work, ODP, occupational therapy and physiotherapy is due to be introduced in September 2005 for students at both the Bournemouth and Yeovil Campuses.
52 The ODP programme is designed to run over two years with a minimum of 3,000 defined hours per student and with an equal balance between theory and practice. The curriculum places the attainment of clinical skills entirely in the practice placement, so ODP students do not use the laboratories at Bournemouth. It is properly designed to allow students to gain the necessary competencies to practice in anaesthetic, surgical and recovery environments and covers all patient groups from infants through to the older adult. Many of the skills learned are transferable, as time in the practice placement does not enable the student to address every speciality within each of the three working environments cited. The focus of the level C unit Educational Development on critical analysis and reflection and that of the level 1 unit Nature of Enquiry on research evaluation and the development of rationale for practice should serve to enable ODP students to be equipped for the requirements of CPD on completion of this programme.
Assessment
53 The School has an assessment strategy which is informed by the University's published requirements and by the Code of practice Section 6: Assessment of students. This provides a suitable framework for assessment procedures on all school programmes, including ODP.
54 A variety of assessment methods is used to enable students to demonstrate achievement of the learning outcomes. However, it is recognised within the Annual Report on Programme Monitoring (ARPM) that further preparation and explanation is required to provide more clarity to enable students to conceptualise the relevance of specific ILOs within the assessment process. The reviewers sampled the academic assessments given to students and found them appropriate in nature and level.
55 Students are encouraged to seek feedback on draft essays by email, and they value this facility. However, students report some delays in receiving a response prior to submission, leading them to be unsure of the quality of their work when this occurs. However, this process represents useful formative feedback.
56 A generic feedback grid is employed to enable structured feedback to be communicated to the students. All assessment feedback grids on ODP sampled by the reviewers were incomplete, and it was confirmed by students that this is the case in many instances. Even when grids are complete, students indicated that, in some cases, they could not see how it reflected the final mark awarded. As a result, ODP students often do not receive high-quality written feedback. However, students are able to access the well-developed academic level descriptors within the programme handbook. These enable them to confirm what the mark awarded equates to in terms of the quality of work produced. There is evidence of second-marking being undertaken.
57 There is some lack of standardisation with regard to assessment of ODP students in placement. Some mentors do not yet have a thorough knowledge of the students' practice profile, the subject benchmark statement and ILOs contained within it, or the exact nature of the evidence required from the students to achieve the ILOs successfully. In some clinical areas, mentors are having difficulty switching from the National Vocational Qualification (NVQ) assessment philosophy used previously for ODP education. This situation has led to discrepancies occurring across both single clinical areas and between Trusts. However, the University staff are working with their partners to improve mentor knowledge on this new programme.
58 Mentors undertaking assessment have teaching and assessing qualifications such as the NVQ assessors' award and the ENB 998. However, very few have undertaken a specific mentorship qualification like the Mentorship Preparation module offered by the University. Practice educators for ODP are a valuable resource for guidance on assessment for both students and mentors, although the impact of practice educators varies considerably between placements. This is being addressed in the contract management action plan.
Student achievement
59 This is a new programme that commenced in September 2003 with 21 students. The first cohort of students is now in its second year. Therefore, final student achievement and employment data for this group of students were not included in the SED. The pass rate for the first year is low at 57 per cent, but those not progressing include three transfers. The external examiner has indicated concern regarding appropriate 'start-up' support for the team, students and clinical colleagues.
60 The remaining 12 students have achieved the first-year units with only two resubmissions in the Clinical Anatomy and Physiology unit. The external examiner did not look at any assessments in the first year of the programme, which is allowed under the University's regulations, but noted that the documentation so far reviewed indicated a good level of quality. The reviewers considered student work and found that it meets the academic requirements of the award. Overall, while there are variations in the value of different placements, students are meeting the necessary practitioner outcomes.
61 The University and local healthcare providers through the contract management group are considering questions of student support and preceptorship on completion of the programme, and a support programme over 18 months has already been agreed within one local Trust for all new theatre staff.
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 Bournemouth University in partnership with Dorset and Somerset Strategic Health Authority, Avon, Gloucestershire and Wiltshire Strategic Health Authority, and Hampshire and Isle of Wight Strategic Health Authority.
Good practice
- Practice educators for operating department practice are a valuable resource for guidance on assessment for both students and mentors (paragraph 58).
Weaknesses
- Not all operating department practice mentors are fully familiar with the intended learning outcomes, partly because a written mentor handbook is not available (paragraph 47).
- The ODP programme has a unit focusing on interprofessional learning, yet this does not at present involve students from different professions. However, a common core interprofessional curriculum linking the programmes in nursing, midwifery, social work, operating department practice, occupational therapy and physiotherapy is due to be introduced in September 2005 for students at both the Bournemouth and Yeovil campuses (paragraph 51).
- Operating department practice students often do not receive high-quality written feedback (paragraph 56).
C Quality of learning opportunities
Learning and teaching
62 The School's current learning and teaching strategy addresses four key strategic priorities: increasing flexibility, enhancing collaborative learning and working practices, encouraging a supportive, student-centred approach and maintaining the highest quality of learning and teaching underpinned by an evidence-based approach. There is developing collaboration between the School and its partner SHAs to implement this strategy.
63 An array of teaching and learning approaches is evident within academic and practice settings, including lectures, seminars, small-group work, role play, experiential learning, problem-based learning, evidence-based practice, case studies, action-learning groups and clinical skills sessions. Students value their clinical skills teaching, yet variation of access to the clinical skills laboratories exists across programmes. For instance, ODP students undertake all their clinical skills development in placements. Staff indicated that more opportunity to use the skills laboratories would be useful on the Bournemouth version of the Return to Practice (Nursing) programme.
64 The School's website demonstrates its commitment to developing a range of flexible and blended learning curriculum activities, including e-learning. The developing virtual learning environment (VLE) assists students in enhancing and extending their knowledge and is valued by students who have accessed it. Currently, the University is planning the extension of VLE use to more units and programmes.
65 While currently limited, the interprofessional learning academic agenda is starting in earnest for pre-registration programmes from September 2005. However, there are valuable opportunities for such learning in practice, examples include, ward rounds, interactions with allied health professionals and shared learning sessions. Interprofessional learning also features in post-registration programmes.
66 Academic teaching is appropriately informed by lecturers' subject background and clinical experience, and enhanced by staff development. The School's business plan highlights its commitment to clinical sabbaticals for academics with a professional registration, to ensure that contemporary knowledge and evidence-based practice are delivered within the academic environment. One example of this was the ODP lecturer spending one day a week working in the local Trust. Students indicated that they valued this highly.
67 The School is increasing the amount of research undertaken by staff, including doctorates, which helps to inform the learning process for students. Conference activity is encouraged and suitably resourced, and academic staff are supported to attend relevant clinical updates. New academic staff receive an induction programme, undertake a teaching qualification and are provided with appropriate guidance and support. Peer observation is universal across the School and plays a positive role in enhancing the quality of learning and teaching.
68 Overall, there are good working relationships between the School and practice placements to provide and enhance learning and teaching. For instance, within midwifery, link tutors support practice placements and students comment positively on the value of this role.
69 The practice educator remit is to support clinicians in creating a supportive learning environment. Visits to practice placements confirmed that clinicians, students and post-holders value these positions as very positive in supporting student learning. Where placements have a practice educator in post, it also promotes and supports the relationship between the partners. However, the arrangements for student support in practice vary by programme and by Trust, creating differing standards of support for learning.
70 The reviewers saw many high-quality learning environments offered by practice placements. There is a clear procedure for the auditing of practice placements and audits are undertaken by practice educators or, in their absence, link tutors. Students comment that placements provide relevant experience, enabling them to meet their learning outcomes. Learning outcomes and benchmark statements are generally understood by practice staff and facilitate a structured approach to learning in clinical environments. However, in the learning disability branch, practice staff are not always clear about the learning outcomes and curriculum, hence affecting learning and teaching.
71 All mentors and clinical assessors have assessor qualifications and report feeling well prepared for the role. The School provides an associate mentors' programme to enhance the numbers of staff able to support students in practice, importantly supporting more junior staff in the development of mentoring skills through supervision. The model of mentor and associate enables skills escalation and placement capacity to be assured. Mentors attend updates that are delivered by the practice educators or link tutors; if unable to attend, flexible approaches are offered. The School publishes a journal, The Mentor, which is widely distributed to practice placements, using various approaches in disseminating information to clinicians. Mentors are encouraged to feed back on issues of concern, and mentors met by the reviewers stated that lecturing staff are effective in resolving matters of concern.
72 Mentor details are included within the Clinical Learning Environment Audit Tool (CLEAT). Trusts maintain their mentor registers within the practice areas, and the School holds a copy of these details within a developing database. Hence professional regulation requirements are met in relation to mentorship preparation, and the update and maintenance of a live register, and student learning and teaching in practice are properly supported.
73 Placement learning evaluations are analysed and fed back to the practice educator and Associate Heads of Practice Education based within the Trusts. Visits to placements demonstrate that student evaluation processes vary considerably among clinical areas and, in ODP, processes have not yet been fully formalised.
The quality of learning and teaching is commendable.
Strength
- The model of mentor and associate enables skills escalation and placement capacity to be assured (paragraph 71).
- The School publishes a journal, The Mentor, which is widely distributed to practice placements, utilising various approaches in disseminating information to clinicians (paragraph 71).
Good practice
- The School's business plan highlights its commitment to clinical sabbaticals for academics with a professional registration, to ensure that contemporary knowledge and evidence-based practice are delivered within the academic environment (paragraph 66).
Weaknesses
- Students value their clinical skills teaching, yet variation of access to the clinical skills laboratories exists across programmes (paragraph 63)
- In the learning disability branch, practice staff are not always clear about the learning outcomes and curriculum, hence affecting learning and teaching (paragraph 70).
- Visits to placements demonstrate that student evaluation processes vary considerably amongst clinical areas and, in operating department practice, processes have not yet been fully formalised (paragraph 73).
Student progression
74 Recruitment to target for pre-registration programmes has been variable across the provision. Shortfalls have occurred in recruitment to the pre-registration child, mental health and learning disability nursing branches, but this is most significant in the learning disability branch, whose level of under-recruitment has steadily risen over the three-year period reported. Attempts to redress shortfalls have been made by over-recruitment to the adult branch and through the introduction of the DipHE programme, although this is only offered to adult and mental health students. Recruitment to the pre-registration midwifery and ODP programme are in line with targets.
75 There are a number of general initiatives in place to support the recruitment process. These include close relationships between partner further education colleges and increased, secured, secondment opportunities. These have helped the University to widen participation. In addition, the programme offers a 'taster day' for prospective students in the summer.
76 Recruitment to the CPD framework is variable between programmes and over time. Non-release of staff to attend programmes is reported by the University. Nursing practitioners indicated that the main reasons for this is are the requirement to commit to programmes two years in advance, as well as the difficulty in releasing any significant number of staff at any given time. In some instances, programmes and units are delivered to small numbers of students and flexible modes of delivery used, including some use of the VLE. All the partners recognise the need to increase the number of students and improve resource use on post-registration programmes.
77 The University provides a suitable induction for students when they start at the University, and this is valued by them. However, some students on ODP feel that they would benefit from more knowledge about clinical skills before going out on placement. Appropriate programme and module guides are available, and more useful information to inform and support students is available on the School's website.
78 A variety of student support mechanisms is offered. Most students from the Bournemouth Campus expressed high levels of satisfaction with the pastoral and academic support they receive from tutors on Campus and the University generally. However, some students on ODP and at the Yeovil Campus are less well supported due to fewer staff being available for these tasks. The level of support for Return to Practice (Nursing) nursing students is consistent and valued by students at both sites.
79 Some disparity in support is also evident across practice settings in nursing, with those supported by practice educators generally better placed than those reliant on link lecturers. For example, practice educators generally provide a high level of support, including educational and training provision to staff, including mentorship updates. Where mentors are supported by practice educators, they generally have a good understanding of the provision and the assessment requirements. Students confirm that in these circumstances they feel well supported in their learning.
80 Conversely, nursing areas that rely on link lecturers generally receive less support. Moreover, on the learning disability provision, visits from link lecturers have been infrequent. Little education or training provision has been offered to staff on site, and mentorship updates have been through generic rather than specific learning disability provision.
81 While there is evidence that most mentors feel adequately supported, there are some concerns by students that mentors are not always aware of students' learning needs or the level and amount of work required for practice placements. This was particularly evident in ODP provision.
82 The University mentor journal is available to all mentors and contains relevant and current material on matters such as how to help failing students in practice and on a number of broad issues relating to supporting students in the practice setting. The journal represents a helpful aid to communication across the whole partnership.
83 Pre-registration nursing students are able to work alongside mentors for at least two-fifths of their week and, in some cases, more frequently. This is so, even when students were able to self-roster, so allowing them more flexibility in meeting their other commitments.
84 Student progression generally across the provision is good, including the post-registration master's programmes included in Table 3, especially given the considerable success the University has had in widening participation. Because of the flexibility of the provision, and because of personal circumstances, there is substantial transference in and out of particular cohorts, but this allows students to continue on the programmes, whenever possible. However, although only one set of ODP students has completed their first year, and it is therefore difficult to identify trends, the loss of nine students, including three transfers out, from a group of 21 is high (Table 3). Equally, the loss of students from the learning disability branch is a matter of concern. While students may not always have left the programme, movements out of groups, for whatever reason, affect the academic viability of the remaining cohorts. For example, the group starting in year 2002-03, currently comprises four of the original 10 students, plus two deferring from the previous cohort, and year 2003-04 has just three of the original 10 students, including two students who have deferred from the previous cohort. Of those 10, three have withdrawn, one has transferred to the mental health branch, two indicated deferral to the 2004-05 cohort and three are hoping to return into the 2005-06 cohort. The reviewers recognise that there are some structures in place to support the recruitment to the learning disability branch, particularly from the local area. However, the number of students leaving is high and has negative implications for the small number remaining, in terms of peer support and learning.
Table 3: Recruitment and attrition statistics for pre-registration and NMC recordable qualifications
| Award title | Recruited number |
Withdrawal | Transfer in | Transfer out | Discontinuation | ||||
|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | ||
| DipHE Clinical Nursing (all branches) Started in 2002 with year 2 transfers in from Adv Dip | |||||||||
| Sep 2002 | 0 | 1 | 6 | 16 | 100 | 2 | 13 | 0 | 0 |
| Sep 2003 | 57 | 4 | 7 | 1 | 2 | 3 | 5 | 2 | 4 |
| AdvDip Clinical Nursing (all branches) | |||||||||
| Sep 2001 | 288 | 50 | 17 | 6 | 2 | 83 | 29 | 18 | 6 |
| Sep 2002 | 318 | 56 | 18 | 49 | 15 | 92 | 29 | 10 | 3 |
| Sep 2003 | 246 | 17 | 7 | 19 | 8 | 24 | 10 | 6 | 2 |
| BSc Clinical Nursing (all branches) including Cross Conversions | |||||||||
| Sep 2001 | 33 | 7 | 21 | 36 | 109 | 6 | 18 | 0 | 0 |
| Sep 2002 | 47 | 4 | 8 | 45 | 96 | 7 | 15 | 3 | 6 |
| Sep 2003 | 46 | 0 | 0 | 2 | 4 | 0 | 0 | 0 | 0 |
| Graduate Diploma (Adult and Mental Health) | |||||||||
| Sep 2003 | 6 | 1 | 17 | ||||||
| Return to Practice (Nursing) | |||||||||
| 2001-02 | 81 | 16 | 20 | ||||||
| 2002-03 | 76 | 6 | 8 | ||||||
| 2003-04 | 66 | 4 | 6 | ||||||
| EN>RN Conversion | |||||||||
| 2001-02 | 20 | 2 | 10 | ||||||
| 2002-03 | 26 | 2 | 8 | ||||||
| 2003-04 | 17 | ||||||||
| Nurse Prescribing (Model) | |||||||||
| 2000-01 | 130 | 31 | 24 | ||||||
| 2002-03 | 5 | ||||||||
| Extended Prescribing | |||||||||
| 2002-03 | 20 | 2 | 10 | ||||||
| Extended and Supplementary Prescribing | |||||||||
| 2003-04 | 24 | 6 | 25 | ||||||
| MA Health & Social Care Education | |||||||||
| 2001-02 | 4 | ||||||||
| 2002-03 | 6 | 2 | 33 | 3 | 50 | ||||
| 2003-04 | 6 | 1 | 16 | ||||||
| MA Health & Social Care Practice Education | |||||||||
| 2001-02 | 5 | 1 | 20 | ||||||
| 2002-03 | 14 | 2 | 14 | 3 | 21 | </ | |||