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
Health visiting, midwifery, nursing, operating department practice and paramedic science programmes at Coventry University in partnership with West Midlands South 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:
Health visiting
Pre-registration
- BSc (Hons) Specialist Nursing Practice (Community Nursing) - Health Visiting*
Midwifery
Pre-registration
- BSc (Hons) Midwifery (long course)*
- BSc (Hons) Midwifery (shortened course)*
- Return to Midwifery Practice*
Post-registration
- Diploma in Professional Development and Neonatal Nursing
- BSc (Hons) Midwifery Practice
Nursing
Pre-registration
- DipHE Adult Nursing*
- DipHE Mental Health Nursing*
- BSc (Hons) Adult Nursing*
- BSc (Hons) Child Nursing*
- BSc (Hons) Mental Health Nursing*
- BSc (Hons) Adult Nursing and Paramedic Sciences* **
- Enrolled Nurse Conversion Course leading to Diploma in respective branch of nursing*
- Return to Nursing Practice*
Post-registration
- BSc (Hons) Specialist Nursing Practice (Community Nursing) -District Nursing, Community Psychiatric Nursing, School Nursing*
- BSc (Hons) Specialist Nursing Practice - Palliative Care*
- BSc (Hons) Specialist Nursing Practice - Oncology*
- Certificate in Independent Nurse Prescribing*
- BSc (Hons) Nursing Practice
- BSc (Hons) Autonomous Emergency Practice* **
- BSc (Hons) Nursing Studies
- Diploma in Professional Studies in Healthcare Practice
Operating department practice
Pre-registration
- Diploma of Higher Education Operating Department Practice**
Paramedic science
Pre-registration
- Diploma in Professional Development in Paramedic Science**
- BSc (Hons) Adult Nursing and Paramedic Sciences* **
Post-registration
- BSc (Hons) Autonomous Emergency Practice* **.
* Nursing and Midwifery Council approved programme
** Health Professions Council approved programme
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in health visiting, midwifery, nursing, operating department practice and paramedic science at Coventry University in partnership with West Midlands South Strategic Health Authority.
Strengths
- The articulation and discussion of intended learning outcomes is integral to the health visiting mentor-preparation processes. These processes are based on strong support mechanisms that enable education, placement staff and specialist practice mentors to promote the effective interpretation of intended learning outcomes by all parties (paragraph 9).
- The design and delivery of the health visiting curriculum is innovative in enabling students to study and qualify on a part-time basis, while working in a primary care setting (paragraph 10).
- A recent development in the BSc Midwifery programmes is the integration of the Baby Friendly best practice standards (UNICEF 2002) into breast-feeding education for student midwives. This is a good example of how the University is supporting the Baby Friendly Initiative in clinical practice in the care of breastfeeding mothers and babies (paragraph 24).
- The Faculty has an interprofessional learning strategy that provides effective opportunities for students to learn with, from and about other disciplines, and this has impacted beneficially on the midwifery curriculum (paragraph 28).
- An effective feature of assessment of practice in pre-registration midwifery programmes is the triad assessment. This is a summative assessment of a clinical episode of care that is assessed by the mentor, link tutor and student and a grade awarded based on clearly-delineated criteria (paragraph 33).
- The articulation and discussion of intended learning outcomes is integral to the nursing mentor preparation processes. This is based on strong support mechanisms that enable teaching, placement staff and clinical practice teachers to promote the effective interpretation of intended learning outcomes (paragraph 46).
- A range of flexible, full and part-time routes enables qualified nurses to progress in their careers and to meet current and evolving healthcare delivery needs (paragraph 48).
- Interprofessional learning is well developed in pre-registration nursing programmes with generic interprofessional learning outcomes in many modules. Client-focused learning pathways, available on-line, are being developed with practice partners to aid integration into practice (paragraph 49).
- Students cited a helpful and informative model of assessment feedback provided in the BSc (Hons) Child Nursing programme. Each section of feedback is awarded a percentage of the overall mark so that students can identify precisely where they have done well or need to improve (paragraph 57).
- Clinical staff in operating department practice are involved in the preparation of the first practice experience by coming into the University to participate in the clinical skills formative assessment. This helps to develop confidence in the students and mentors in understanding the relationship between theory and practice in the curriculum (paragraph 67).
- The Diploma in Professional Development in Paramedic Science was the first such Health Professions Council approved programme nationally that enables paramedic technicians to apply for registration as paramedics. This, and the curriculum for the BSc in Autonomous Emergency Practice, were developed in an effective partnership with medical, nursing and paramedic representatives from across Coventry and Warwickshire (paragraph 81).
- Some interesting modes of assessment are employed in paramedic science, including the early use of advanced simulation mannequins to measure initial skills competence and instil confidence. This is then formatively assessed in the field under strict supervision, with experienced paramedic practitioners (paragraph 87).
Weaknesses
- The reviewers support the view of pre-registration nursing students and mentors that problems are caused by the late sequencing of anatomy and physiology components within the curriculum. This results in some students being less well prepared than they should be for their early placements (paragraph 50).
- Assessment feedback for the pre-registration BSc (Hons) Adult Nursing programme is provided on student work, but is often of poor quality in its content, constructiveness and legibility (paragraph 57).
- Practice staff and students in operating department practice reported that, in the first two modules in year one, the intended learning outcomes are not always sufficiently relevant to the theatre clinical context in which operating department practitioners practise (paragraph 62).
- The operating department practice curriculum does not yet offer any significant opportunities for the effective involvement of students in interprofessional learning. Where common core learning has taken place, operating department practice students do not see the relevance of the subject areas used, despite increased school-wide activity in this direction (paragraph 68).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strength
- Students on BSc (Hons) Child Nursing programme plan and execute an annual conference on current issues in child care and children's nursing. These conferences are well attended and do much to promote learning in this area, as well as illustrating initiative and achievement on the part of the students involved (paragraph 95).
Student progression
The quality of student progression in all disciplines with the exception of operating department practice is commendable.
Strengths
- A robust, four-year mentor-development cycle operated by the University appropriately prepares and updates sufficient mentors in line with professional, statutory and regulatory body requirements, and is implemented and attended by staff from across the broad range of placement provision (paragraph 108).
- Support and effective communication links are further strengthened by the placement facilitator role which promotes a collaborative, positive learning culture for students (paragraph 109).
- To assist in communicating with paramedic mentors and clinical staff in the field and the link tutors at the University, a mentor newsletter is widely used and on display in several practice areas. This has been produced to maintain effective communication channels and to give feedback on progress and achievement of students in general (paragraph 111).
Weakness
- The roles and responsibilities of link tutors are not clearly enough defined (paragraph 107).
The quality of student progression in operating department practice is approved.
Weakness
- There are insufficient mentors from the operating department practice professional group to provide a sufficiency of support in practice that is necessary to ensure equity of treatment and an effective promotion of student progression (paragraph 108).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strength
- Practice-based staff and mentor provision are particular strengths in the resourcing of nursing and midwifery programmes (paragraph 119).
Weakness
- There is inadequate provision of multiple copies of textbooks for the first-year, undergraduate interprofessional pathway and the pre-registration adult nursing programme (paragraph 114).
Maintenance and enhancement of standards and quality
Weakness
- The reviewers noted some instances where the appointment and use of external examiners fell short of the principles and precepts underpinning the Quality Assurance Agency Code of practice on external examining (paragraph 125).
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 health visiting, midwifery, nursing, operating department practice (ODP) and paramedic science programmes at Coventry University (the University) in partnership with West Midlands South Strategic Health Authority (WMSHA). The review was completed during the academic year 2005-06.
2 All of the provision is located within the Faculty of Health and Life Sciences (HLS). This Faculty was established in August 2005 as the result of a university-wide re-organisation. The Faculty comprises seven departments. The portfolio of programmes under review is managed by the Departments of Nursing, Midwifery and Health Care and Social and Community Studies. WMSHA covers the area formerly served by Coventry, Warwickshire, Worcestershire and Herefordshire Health Authorities. It serves a population of 1.55 million across mixed urban and rural communities and includes eight Primary Care Trusts (PCTs), five National Health Service (NHS) Hospital Trusts, one Mental Health Trust and two Ambulance Trusts.
A Subject provision and overall aims
3 Health visiting, midwifery, nursing, operating department practice and paramedic science provision is currently offered in the following programmes:
Health visiting
Pre-registration
- BSc (Hons) Specialist Nursing Practice (Community) - Health Visiting*
Midwifery
Pre-registration
- BSc (Hons) Midwifery (long course)*
- BSc (Hons) Midwifery (shortened course)*
- Return to Midwifery Practice*
Post-registration
- Diploma in Professional Development and Neonatal Nursing
- BSc (Hons) Midwifery Practice
Nursing
Pre-registration
- DipHE Adult Nursing*
- DipHE Mental Health Nursing*
- BSc (Hons) Adult Nursing*
- BSc (Hons) Child Nursing*
- BSc (Hons) Mental Health Nursing*
- BSc (Hons) Adult Nursing and Paramedic Sciences* **
- Enrolled Nurse Conversion Course leading to Diploma in respective branch of nursing*
- Return to Nursing Practice*
Post-registration
- BSc (Hons) Specialist Nursing Practice (Community) - District Nursing, Community Psychiatric Nursing, School Nursing*
- BSc (Hons) Specialist Nursing Practice - Palliative Care*
- BSc (Hons) Specialist Nursing Practice - Oncology*
- Certificate in Independent Nurse Prescribing*
- BSc (Hons) Nursing Practice
- BSc (Hons) Autonomous Emergency Practice* **
- BSc (Hons) Nursing Studies
- Diploma in Professional Studies in Healthcare Practice
Operating department practice
Pre-registration
- Diploma of Higher Education Operating Department Practice**
Paramedic science
Pre-registration
- Diploma in Professional Development in Paramedic Science**
- BSc (Hons) Adult Nursing and Paramedic Sciences* **
Post-registration
- BSc (Hons) Autonomous Emergency Practice* **.
* Nursing and Midwifery Council (NMC) approved programme
** Health Professions Council (HPC) approved programme
4 The overall aims of the provision are to:
- enable students to acquire the knowledge, understanding and skills to develop and enhance fitness for practice, purpose and award
- facilitate the three strands of teaching and learning: uni-professional, interprofessional and common core learning
- focus upon teaching and learning strategies that are evidence-based and applicable to practice
- develop students' ability to understand the role and importance of evidence-based practice
- develop skills associated with lifelong learning and reflection in order to produce practitioners who are committed to continuing professional development and high standards of care
- ensure currency of curricula through ongoing partnership working with stakeholders.
B Academic and practitioner standards
B1 Health visiting
Intended learning outcomes
5 Intended learning outcomes (ILOs) are successfully devised to meet the NMC regulatory requirements for registration onto the third part of the professional register. They also appropriately reflect the Subject benchmark statement for health visiting and The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), both published by QAA.
6 The ILOs for the health visiting award are explicitly defined within the programme specification and the module handbooks and clearly reflect the aims of the programme. Effective communication of the ILOs to all stakeholders is achieved by dissemination through handbooks and electronic mechanisms. Students and mentors expressed satisfaction with the process of disseminating ILOs, and consistently reported they understood these.
7 External examiners and practice staff met by the reviewers on placement visits confirm the appropriateness of the ILOs. Scrutiny of students' work by the reviewers also substantiates that ILOs are relevant to professional practice in health visiting and to the learning needs of students.
8 Practitioners are involved in the development of ILOs and, as a consequence, ILOs reflect contemporary practice. The programme team shows commitment to embracing the new requirements of the NMC, the public health agenda and the emerging health professions framework.
9 The articulation and discussion of ILOs is integral to the health visiting mentor-preparation processes. These processes are based on strong support mechanisms that enable education, placement staff and specialist practice mentors (SPMs) to promote the effective interpretation of ILOs by all parties.
Curricula
10 The Faculty offers a flexible health visiting programme which was developed in 2001 and which complies with NMC requirements. The design and delivery of the curriculum is innovative in enabling students to study and qualify on a part-time basis, while working in a primary care setting. The programme is regularly reviewed and discussed with partners at the Partnership meetings and professional development meetings; appropriate changes, for example, the strengthening of the public health agenda element, are made in accordance with current university and NMC regulations.
11 The programme is valued by the local health community and reflects local and national priorities and needs. Positive and successful efforts are made to ensure that the curriculum reflects the changing role of the health visitor in the community, and this has been highlighted by NMC visitors and external examiners. Module descriptors provide evidence of an appropriate intellectual and professional challenge for students to maintain this currency by the need to confront local and national developments in healthcare.
12 Seventy-five per cent of the programme is shared with other specialist nursing practice (community nursing) routes, and students recognise and report that this enhances their appreciation of other professional roles. Interprofessional learning (IPL) is promoted and enhanced in practice, with opportunities for students to learn about common issues, such as child protection, with other health and social care professionals. In some practice areas, there are joint learning opportunities with General Practice trainees and medical students. Additionally, collaborative working is encouraged throughout practice learning experience, for example, with the involvement of health visiting students in multiprofessional case discussions.
13 Relevance to practice is particularly noted and commended by external examiners for the programme. This relationship is reflected in module design, where theory is related to practice throughout and students work to achieve competencies linked to module outcomes. Practice relevance is enhanced by the use of reflective activity, portfolio development and learning contracts, working with up-to-date SPMs. Following recent evaluation and feedback from students and annual monitoring by the NMC, the current programme action plan indicates that grading of practice portfolios, not currently practised, will be considered in the forthcoming programme review and approval event in order to reflect the value of practice learning.
14 Students have an opportunity to experience a practice setting other than their host health visiting placement. This period of alternative practice helps to broaden students' understanding, and they present reports of this experience at a review day attended by mentors and external examiners. Former students report that the present programme is coherent in its design and that the curriculum prepares them well for registration and for the contemporary role of the health visitor.
Assessment
15 A wide range of assessment modes is utilised in both the campus and placement settings. Assessment methods appropriately reflect the University's assessment policies and ensure that the measurement of the achievement of ILOs by students is equitable and transparent. In this respect, assessment also accords with the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), Section 6: Assessment of students, published by QAA. Assessment procedures are clearly stated in student handbooks, and students are aware of the expectations regarding assessment and assessment criteria.
16 The assessment methods selected are appropriate for demonstrating that students have achieved the ILOs and link theory to practice. Comprehensive information on grading is set out in student handbooks and clear criteria are provided for marking, which are also accessible to internal moderators and external examiners. Students consistently report that assessment criteria are used effectively in feedback on their work and that feedback is clear and helpful.
17 Work scrutinised by the reviewers confirmed that marks awarded are appropriate, and ILOs are consistent with NMC requirements, the Subject benchmark statement and the FHEQ. There was also sound evidence of parity in marking and moderation, and this is corroborated by external examiners. Faculty regulation of assessment is robust and a marking and moderation panel is effectively utilised. The reviewers confirm the judgement of external examiners that academic and practice standards are being properly assessed.
18 Practice staff are appropriately engaged in the assessment of practice, and they work effectively with university staff in meeting both the institutional and professional requirements. SPMs are prepared, and updated in line with professional and regulatory requirements, for their role in assessment of practice through a four-year mentor-development cycle, which is both innovative and effective.
Student achievement
19 The reviewers scrutinised a wide range of assessed work from a representative sample of students following the health visiting pathway on the BSc (Hons) Specialist Nursing Practice (Community Nursing) programme. This demonstrated that the ILOs had been achieved and verified that health visiting students achieve fitness for practice, purpose and award. Students display a sound grasp of professional issues and are able to integrate theory and practice in their written work and practice portfolios. External examiners' reports and the views expressed by mentors, employers and representatives of the SHA all confirm the reviewers' judgements.
20 The statistics in Table 1a relating to the final summative assessment demonstrate that most students achieve an Upper Second class honours degree classification. The award of a First class honours degree was achieved by one student in the three years covered by the completion and achievement data in the table. Only one student has not successfully completed the programme.
21 Health service managers and the WMSHA confirm the employability of health visiting graduates from this programme. NHS employers met during practice visits indicated their satisfaction with the standards and clinical competence shown by their newly-qualified staff. No employment statistics are available for the post-qualification programmes, although the programme team relate that most health visiting students are seconded by local Trusts and gain employment on successful completion of the programme.
Table 1a: Completion and achievement statistics for all award-bearing programmes in health visiting
| Programme | Cohort |
Diploma | Diploma | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc Hons Specialist Community Nursing Practice Health Visiting |
Sept 2003 | 5 | 63 | 2 | 25 | 1 | 15 | ||||||||||
| Sept 2004 | 7 | 88 | 1 | 12 | |||||||||||||
| Sept 2005 | 1 | 11 | 5 | 56 | 2 | 22 | 1 | 11 | |||||||||
Summary of academic and practitioner standards for health visiting
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Health Visiting at Coventry University in partnership with West Midlands South Strategic Health Authority.
Strengths
- The articulation and discussion of intended learning outcomes is integral to the health visiting mentor-preparation processes. These processes are based on strong support mechanisms that enable education, placement staff and specialist practice mentors to promote the effective interpretation of intended learning outcomes by all parties (paragraph 9).
- The design and delivery of the curriculum is innovative in enabling students to study and qualify on a part-time basis, while working in a primary care setting (paragraph 10).
B2 Midwifery
Intended learning outcomes
22 ILOs for the midwifery programmes have been designed in collaboration with the SHA, Trusts and Heads of Midwifery. The ILOs are clearly stated in programme documentation. The programme specifications provide evidence of how the ILOs are cross-referenced to, and informed by, the Subject benchmark statement for midwifery, the NMC Standards of Proficiency (SoPs), the European Union (EU) Midwives Directive and the University's code of practice for academic and professional skills development. The ILOs reflect the aims of the provision and meet NMC requirements, thus ensuring that students are fit for practice, purpose and award. They also conform to the FHEQ in terms of the levels of challenge and outcomes expected.
23 Several mechanisms, such as mentor-preparation events, tripartite meetings and information bulletins, are in place that effectively communicate the intended ILOs to mentors. This information is provided for students in programme handbooks and is available in electronic form through WebCT, an internet-based teaching forum. Students and mentors reported that they understand the ILOs. Placement areas have copies of programme documentation and student profiles to facilitate the relevant application of ILOs to practice and to student learning goals.
24 A recent development in the BSc Midwifery programmes is the integration of the Baby Friendly best practice standards (UNICEF 2002) into breast-feeding education for student midwives. This is a good example of how the University is supporting the Baby Friendly Initiative in clinical practice in the care of breastfeeding mothers and babies. ILOs are mapped against both theory and practice modules throughout the programmes and are due to be incorporated into the midwifery continuing professional development (CPD) programmes when re-approved in 2006. The ILOs for midwifery CPD are developed in collaboration with the local NHS Trusts.
25 The BSc (Hons) Midwifery Practice is scheduled for review and re-approval in 2006, when current and former students and employers will be invited onto the review panel. The ILOs reflect the changing needs of service and contemporary developments and enable practitioners to meet the requirements for post-registration education and practice.
Curricula
26 The pre-registration midwifery curricula have been developed in collaboration with Coventry University, WMSHA, the commissioning NHS Trusts in Coventry and Warwickshire, former students and users of the maternity services. Local and national initiatives that may impact upon service delivery and curricula content are determined by consulting with the Midwifery Professional Advisory Group. Membership includes heads of midwifery from the sponsoring NHS Trusts in which students are placed for their clinical practice.
27 Students are enabled to achieve the ILOs through a clear progression of skills acquisition and knowledge, with emphasis placed on the delivery of woman-centred care and safe, competent practice. Students are well supported in the clinical curriculum by appropriately-prepared mentors, and clinical staff have good communication links with academic staff. Clinical placements are positively evaluated by students.
28 The Faculty has an IPL strategy that provides effective opportunities for students to learn with, from and about other disciplines, and this has impacted beneficially on the midwifery curriculum. A common-core learning pathway ensures that students study shared core modules such as Welfare Health and Inequality and are able to participate in multiprofessional seminar groups. The appointment of an IPL coordinator demonstrates a commitment to IPL and aims to provide consistent guidelines for students and support mechanisms.
29 Theory and practice are weighted equally within the pre-registration midwifery programmes, with good integration of theory and practice through a range of teaching and learning methods such as case loading, critical-incident analysis and workshops. The lengthening of the pre-registration BSc (Hons) Midwifery (shortened course) programme from 78 to 88 weeks aims to facilitate shared teaching and learning and is appropriate in enabling students to meet the NMC requirements and achieve the required academic credit. This initiative has been given the full support of the WMSHA. Flexibility has been incorporated into the curricula to enable students to step off the programme at the end of year two and to extend year three over two years. This is an appropriate attempt to meet student needs and to reduce attrition.
Assessment
30 Assessment within the midwifery programmes appropriately reflects the Faculty's assessment policy and is conducted with due regard for the principles of the Code of practice, published by QAA. The University also has an assessment parity and compensation policy to which midwifery programmes conform. Student handbooks for pre and post-registration midwifery programmes include clear explanations of assessment practice. The reviewers' scrutiny of student work indicates that assessment is rigorously conducted and that the parity policy is being adhered to.
31 Both pre-registration programmes include assessments in theory and practice which are mapped appropriately against the ILOs. Assessment in practice is through practice grids and a clinical skills competence logbook, both of which have been developed in partnership with clinical colleagues.
32 In clinical practice, the assessment process is the responsibility of mentors supported by link tutors and practice educators. Mentors and students identify that they have good access to communication with link tutors. Students and mentors record the students' clinical experience in a logbook. They also contribute to a student midwifery profile that records development in achieving clinical practice skills. Students and mentors identified that they were given clear written and verbal information from the University regarding the completion of these documents.
33 An effective feature of assessment of practice in pre-registration midwifery programmes is the triad assessment. This is a summative assessment of a clinical episode of care that is assessed by the mentor, link tutor and student and a grade awarded based on clearly-delineated criteria. Students were critical of the narrow range of grades awarded, reporting that the higher grades are difficult to achieve. However, the reviewers found this not to be the case, with a wide range of grades being awarded, including examples of higher grades. Previous students identified the triad as being stressful, but they did acknowledge that it reflected their future practice as midwives.
34 Midwifery programmes (both long and short) include a wide range of assessments. New assessments have been developed, including on-line examinations, posters and objective structured clinical examinations (OSCEs). University staff identify that the Course Planning Team's rationale for new developments was centred round enhancing the range of assessment to meet the different learning styles of students. Midwifery students report favourably on their range of assessments, and external examiners state that the assessments are varied and clearly identify what is expected of students.
35 Students reported that written assessments are announced at the beginning of a module and tutorials are available as needed. Written assessments are managed through established marking, moderating and external examiner processes. The reviewers examined a range of student work and identified the marking and moderating process to be sound. The external examiner identified the good quality of the feedback to students and the reviewers endorse this. Students state that feedback is given within six weeks of submission of assessments.
Student achievement
36 The reviewers scrutinised a range of student work, including longitudinal samples of the complete work of individual students and samples from representative modules. This scrutiny provided confirmation of the appropriate standards being reached in written work by midwifery students that had been attested to by external examiners. There is also clear evidence of student progression and achievement in the logbooks and profile documentation seen by the reviewers.
37 Visits to practice areas enabled the reviewers to talk to students and their supervisors in practice, and these discussions confirmed that students are achieving the required standards in their professional practice. Student achievement reflects the ILOs set out within modules. Students display good professional and working experience.
38 Midwifery taster days have been introduced to equip potential students with a better understanding of the role of the midwife and better able to make an informed choice on selecting the appropriate programme. Recent students identify that the days were informative and helpful in assisting them in their choice of programme and the subsequent successful achievement of learning goals.
39 Table 1b shows small numbers recruited for midwifery programmes (between 11 and 21 students). The degree classifications show that the majority of students achieve a Lower Second class award, or above.
40 Table 2b identifies that, of the students from the BSc (long) 2005 and (shortened) 2003 programme, all were employed following completion of their programme. The local NHS heads of midwifery employ many newly-qualified midwives from these programmes. Heads of midwifery and former students identify that graduates are fit for purpose and practice on completion of their programme. The standards achieved meet the NMC SoPs and successful graduates are fit for practice and award.
Table 1b: Completion and achievement statistics for all award-bearing programmes in midwifery
| Programme | Cohort |
Diploma | Diploma | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc Hons Midwifery (Long) |
2004 | 2 | 11 | 3 | 16 | 11 | 58 | 2 | 11 | 1 | 5 | ||||||
| 2005 | 1 | 8 | 4 | 31 | 3 | 23 | 3 | 23 | 1 | 8 | 1 | 8 | |||||
| BSc Hons Midwifery (shortened) |
2004 | 6 | 60 | 3 | 30 | 1 | 10 | ||||||||||
| 2005 | 1 | 20 | 1 | 20 | 2 | 40 | 1 | 20 | |||||||||
| DipHE Midwifery (shortened) |
2003 | 8 | 100 | ||||||||||||||
| Diploma in Neonatal Nursing |
2003 | 7 | 100 | ||||||||||||||
| Diploma in Neonatal Nursing |
2004 | 9 | 90 | 1 | 10 | ||||||||||||
| 2005 | 3 | 75 | 1 | 25 | |||||||||||||
| BSc Hons Midwifery Practice |
2003 | 4 | 57 | 3 | 43 | ||||||||||||
| 2004 | 1 | 100 | |||||||||||||||
| 2005 | 1 | 100 | |||||||||||||||
Table 2b: Employment statistics for all pre-registration programmes and exception reporting for post-qualification programmes in midwifery
| Programme | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | No | % | |
| BSc (Hons) Midwifery (long) 2003 (17 students) |
7 | 41 | 9 | 53 | 1 | 6 | ||||
| BSc (Hons) Midwifery (Long) 2004 (18 students) |
13 | 72 | 2 | 11 | 3 | 17 | ||||
| BSc (Hons) Midwifery (Long) 2005 (12 students) |
10 | 83 | 2 | 17 | ||||||
| BSc (Hons) Midwifery (shortened) 2003 (8 students) |
4 | 50 | 4 | 50 | ||||||
| BSc (Hons) Midwifery (shortened) 2004 (10 students) |
10 | 100 | ||||||||
| BSc (Hons) Midwifery (shortened) 2005 (4 students) |
2 | 50 | 2 | 50 | ||||||
| Return to Midwifery Practice 2003 (1 student) |
1 | 100 | ||||||||
| Return to Midwifery Practice 2004 (3 students) |
3 | 100 | ||||||||
| Return to Midwifery Practice 2005 (1 student) |
2 | 100 | ||||||||
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 Coventry University in partnership with West Midlands South Strategic Health Authority.
Strengths
- A recent development in the BSc Midwifery programmes is the integration of the Baby Friendly best practice standards (UNICEF 2002) into breast-feeding education for student midwives. This is a good example of how the University is supporting the Baby Friendly Initiative in clinical practice in the care of breastfeeding mothers and babies (paragraph 24).
- The Faculty has an interprofessional learning strategy that provides effective opportunities for students to learn with, from and about other disciplines, and this has impacted beneficially on the midwifery curriculum (paragraph 28).
- An effective feature of assessment of practice in pre-registration midwifery programmes is the triad assessment. This is a summative assessment of a clinical episode of care that is assessed by the mentor, link tutor and student and a grade awarded based on clearly-delineated criteria (paragraph 33).
B3 Nursing
Intended learning outcomes
41 ILOs are clearly defined for all the nursing programmes, reflecting the Subject benchmark statement, NMC regulatory requirements and the overall aims. They also reflect the FHEQ, with clearly differentiated outcomes articulated at the appropriate levels.
42 Successful achievement of the ILOs in pre-registration programmes satisfies the SoPs and competencies outlined by the NMC for registration; ensuring students are fit for practice, purpose and award. External examiners and practice staff confirm the appropriateness of the ILOs. The Return to Nursing Practice programme was reviewed in December 2005 to ensure that ILOs adequately reflected the NMC SoPs.
43 Post-registration programmes are mapped against NMC SoPs and professional competencies where appropriate. The ILOs for specialist practice and CPD programmes effectively prepare students as specialist practitioners.
44 A collaborative approach is employed in the development of ILOs and reflects contemporary practice and the strategic aims of the University. The programme team is committed to embracing new requirements and directions of the NMC and SHA. ILOs are integrated within the programmes and mapped to mandatory skills and core transferable/key skills, and meet EU Directives.
45 The ILOs for all the nursing awards are clearly defined within the programme and module handbooks. Effective communication of the ILOs is achieved by dissemination through student preparation, handbooks and electronic mechanisms and the four-year mentor cycle.
46 The articulation and discussion of ILOs is integral to the nursing mentor preparation processes. This is based on strong support mechanisms that enable teaching staff, placement staff and mentors to promote the effective interpretation of ILOs.
Curricula
47 Pre-registration nursing curricula are jointly planned and designed with a range of stakeholders, including clinicians and mentors. User involvement in planning, particularly in the mental health branch, was commended in the pre-registration programme approval event in May 2005. Both the new, pre-registration curriculum and its predecessor were well designed with reference to national and local benchmarks and with sensitivity to local needs. The 2005 curriculum is based on the NHS improvement plan and reflects current care arrangements. Routes are available within this programme for enrolled nurse conversion and also offer opportunities for cross-branch conversion. There is a variety of ways in enabling students to meet EU requirements and clear guidance is provided to help adult branch students take advantage of all their experiences in doing this, for example, by including voluntary work or previous employment experiences in their submissions.
48 Post-registration nursing programmes reflect local and national priorities and are regularly reviewed by the Nursing Board of Studies and Partnership meetings. National Service Frameworks have been appropriately considered. A range of flexible, full and part-time routes enables qualified nurses to progress in their careers and to meet current and evolving healthcare delivery needs. An example is the BSc (Hons) Nursing Practice which has multiple exit routes at diploma and degree level in 13 areas of nursing, including critical care, cancer care, care of the older person and minor injuries and minor illness. Programme content is reported by managers and practice staff to be current and appropriate to the learning needs of students.
49 IPL is well developed in pre-registration programmes with generic interprofessional learning outcomes in many modules. Client-focused learning pathways, available on-line, are being developed with practice partners to aid integration into practice. These are reported to be valued by students in enabling them to learn about other professional roles and approaches to care. Further opportunities are available for interprofessional learning in practice with, for example, physiotherapy and medical students. Although less well developed in post-registration programmes, qualified nurses study together with other professional groups in modules such as Research and Clinical Practice Development. The BSc (Hons) Specialist Nursing Practice (Community Nursing) programme provides extensive opportunities within the University and in practice for district nursing, school nursing, health visiting and community psychiatric nursing students to learn together.
50 Curriculum content within modules in both pre and post-registration programmes is kept up to date through regular review with Trust and SHA staff and through student module evaluations. Post-registration students confirmed that content was professionally relevant and linked well with their practice. However, the reviewers support the view of pre-registration students and mentors that problems are caused by the late sequencing of anatomy and physiology components within the curriculum. This results in some students being less well prepared than they should be for their early placements.
51 Learning opportunities in practice for pre-registration students are offered through a range of experiences which comprise 50 per cent of each programme. Placements within the common foundation programme aid development of key skills, supported by modules in the University. Adult branch placements are organised through six different settings, reflecting both health and social care. There are instances when some students perceive their range of placements to be imbalanced and they report shortfalls in surgical experience. However, the reviewers judged that clear arrangements are in place to enable a full range of experiences to be provided for students but that these arrangements had not been communicated to students effectively.
Assessment
52 The reviewers found a wide range of assessment strategies in both the campus and placement settings, which reflect the Faculty's assessment policy on equity. Assessment procedures and processes are clearly stated in handbooks, and preliminary, mid-point and final interviews are undertaken to support student assessments. Students state they are clear about the expectations regarding assessment criteria.
53 Assessment methods are appropriate and enable students to demonstrate achievement of academic and practice ILOs, as well as NMC SoPs and competencies. Assessment grading and criteria are listed in student handbooks and students and external examiners confirm this is helpful.
54 The oversight and regulation of assessment is robust and effectively utilises an internal marking and moderation panel. External examiners confirm that academic and practice standards are being met and assessments are fit for purpose. The scrutiny of assessed work by the reviewers demonstrates parity in marking and moderation, and this is corroborated by external examiners
55 Practitioners are significantly involved in the assessment of practice, and work effectively with university staff in meeting both the institutional and professional requirements. Mentors are well prepared, and updated in line with professional requirements, for their role in assessment of practice through a four-year mentor-development cycle, which is innovative and effective. An electronic system maintains records of mentor preparation and updates, with staff automatically notified and recalled by the University to ensure currency.
56 Students, mentors and teaching staff have a very clear understanding of the processes involved when managing students who are underachieving or failing in practice. This is noted as a particular strength within the placement environment, and mentors are able to cite examples of how they have managed failing or underachieving students and the support received from education colleagues to address issues. This is a good example of enhancing assessment credibility.
57 Assessment feedback for the pre-registration BSc (Hons)/Diploma in Adult Nursing programme is provided on student work, but is often of poor quality in its content, constructiveness and legibility. Students cited a helpful and informative model of assessment feedback provided in the BSc (Hons) in Child Nursing programme. Each section of feedback is awarded a percentage of the overall mark so that students can identify precisely where they have done well or need to improve.
Student achievement
58 The assessed work reviewed for pre-registration and post-qualifying nursing programmes covered a wide range of programmes and a number of different assessment methods. This demonstrated that the ILOs had been achieved and verifies that students on these programmes achieve fitness for purpose, practice and award. Scrutiny of external examiners' reports and also the comments expressed by mentors, employers and representatives of the SHA confirm these views.
59 Statistics relating to the final summative assessment demonstrate successful student achievement across the whole range of nursing programmes reviewed. Most students on pre-registration programmes achieve Upper or Lower Second class degrees, and only small numbers of students have failed either the undergraduate or diploma adult nursing programme. A small number of students have achieved a First class honours degree in the undergraduate mental health and child nursing programmes, although First class honours have not been achieved by any undergraduate adult nursing student in the years covered by the completion and achievement statistics in Table1c. The same trends and pattern of achievement are apparent with the post-qualifying programmes.
60 The statistics show that no students have failed any of the undergraduate post-qualifying programmes, although one external examiner's report identifies poor results in some post-qualifying modules, particularly the pain management and ophthalmic modules. All students have passed the Certificate in Independent Nurse Prescribing in the past few years; however, small numbers of students consistently fail the Return to Nursing Practice programme.
61 The employability of former students of Coventry University is confirmed by health service managers and the SHA. The SHA works in partnership with the University to identify appropriate numbers on pre-registration nursing programmes. The employment statistics for the pre-registration programmes demonstrate that the majority of students gain employment locally. No unemployment is identified for former students of the pre-registration programmes reviewed although, on occasions, quite large percentages of former students have not responded to requests from the University for details of their current employment status. NHS employers met during practice visits indicated their satisfaction with the standards and clinical competence shown by their newly-qualified staff. Table 1c: Completion and achievement statistics for all award-bearing programmes in nursing
Table 1c: Completion and achievement statistics for all award-bearing programmes in nursing
| Programme | Cohort |
Diploma | Diploma | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc (Hons) Nursing | Sept 2003 | 10 | 43 | 13 | 57 | ||||||||||||
| Sept 2004 | 4 | 15 | 1 | 4 | 2 | 8 | 2 | 8 | 14 | 54 | 3 | 11 | |||||
| Sept 2005 | 5 | 16 | 4 | 13 | 6 | 19 | 4 | 13 | 1 | 3 | 5 | 16 | 6 + 1 resitting |
19 | |||
| Diploma in Nursing/BSc | Sept 2004 | 38 | 41 | 50 | 54 | 5 | 5 | ||||||||||
| Feb 2005 | 22 | 26 | 63 | 74 | |||||||||||||
| Sept 2005 | 91 | 89 | 2 | 2 | 9 | 9 | |||||||||||
| Enrolled Nurse Conversion | Sept 2004 | 9 | 100 | ||||||||||||||
| Sept 2005 | 9 | 100 | |||||||||||||||
| Diploma in Operating Dept Practice |
Sept 2005 | 15 | 94 | 1 | 6 | ||||||||||||
| BSc (Hons) Specialist Nursing Practice (Community) |
Sept 2003 | 8 | 53 | 5 | 33 | 2 | 13 | ||||||||||
| Sept 2004 | 5 | 56 | 4 | 44 | |||||||||||||
| Sept 2005 | 5 | 71 | 2 | 29 | |||||||||||||
| BSc (Hons) Specialist Nursing Practice (Oncology) |
Sept 2003 | 1 | 50 | 1 | 50 | ||||||||||||
| Sept 2004 | 1 | 20 | 4 | 80 | |||||||||||||
| Sept 2005 | 4 | 80 | 1 | 20 | |||||||||||||
| BSc (Hons) Specialist Nursing Practice (Palliative Care) |
Sept 2003 | ||||||||||||||||
| Sept 2004 | 1 | 50 | 1 | 50 | |||||||||||||
| Sept 2005 | |||||||||||||||||
| BSc (Hons) Nursing Studies |
Sept 2003 | 2 | 29 | 2 | 29 | 1 | 14 | 2 | 29 | ||||||||
| Sept 2004 | 2 | 33 | 4 | 68 | |||||||||||||
|
Sept 2005 |
1 | 6 | 6 | 35 | 3 | 18 | 7 | 41 | |||||||||
| BSc (Hons) Nursing Practice |
Sept 2003 | 1 | 50 | 1 | 50 | ||||||||||||
| Sept 2004 | 8 | 89 | 1 | 11 | |||||||||||||
| Sept 2005 | 2 | 22 | 2 | 22 | 5 | 56 | |||||||||||
| BSc (Hons) Autonomous Emergency Practice |
Sept 2004 | 6 | 100 | ||||||||||||||
| Sept 2005 | 1 | 100 | |||||||||||||||
Table 2c: Employment statistics for all pre-registration programmes and exception reporting for post-qualification programmes for nursing
| Programme | Cohort | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | No | % | ||
| BSc (Hons) Nursing (all branches) |
Sept 2003 (23 students) |
11 | 48 | 2 | 9 | 10 | 43 | ||||
| 2004 (23 students) |
1 | 4 | 18 | 78 | 2 | 9 | 2 | 9 | |||
| 2005 (27 students) |
18 | 67 | 1 | 4 | 8 | 30 | |||||
| Diploma in Nursing (all branches) |
Sept 2004 (88 students) |
58 | 66 | 12 | 14 | 18 | 21 | ||||
| Feb 2005 (85 students) |
42 | 49 | 5 | 6 | 38 | 45 | |||||
| Sept 2005 (93 students) |
71 | 76 | 8 | 9 | 14 | 15 | |||||
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 Coventry University in partnership with West Midlands South Strategic Health Authority.
Strengths
- The articulation and discussion of intended learning outcomes is integral to the nursing mentor preparation processes. This is based on strong support mechanisms that enable teaching, placement staff and clinical practice teachers to promote the effective interpretation of intended learning outcomes (paragraph 46).
- A range of flexible, full and part-time routes enables qualified nurses to progress in their careers and to meet current and evolving healthcare delivery needs (paragraph 48).
- Interprofessional learning is well developed in pre-registration programmes with generic interprofessional learning outcomes in many modules. Client-focused learning pathways, available on-line, are being developed with practice partners to aid integration into practice (paragraph 49).
- Students cited a helpful and informative model of assessment feedback provided in the BSc (Hons) Child Nursing programme. Each section of feedback is awarded a percentage of the overall mark so that students can identify precisely where they have done well or need to improve (paragraph 57).
Weaknesses
- The reviewers support the view of pre-registration students and mentors that problems are caused by the late sequencing of anatomy and physiology components within the curriculum. This results in some students being less well prepared than they should be for their early placements (paragraph 50).
- Assessment feedback for the pre-registration BSc (Hons)/Diploma Adult Nursing programme is provided on student work, but is often of poor quality in its content, constructiveness and legibility (paragraph 57).
B4 Operating department practice
Intended learning outcomes
62 The ILOs, developed in partnership with practice colleagues, are appropriately informed by the Association of Operating Department Practitioners (AODP) Curriculum Document and, more recently, by the Subject benchmark statement, published by QAA. The preparation for the review and approval of the programme planned for May 2006 will be informed by the SoPs and Standards of Education and Training published by the HPC in 2005. The ILOs are complemented by a skills practice grid for confirming skills acquisition. They include reference to knowledge and understanding, practical outcomes, and transferable skills. They are set at appropriate levels for certificate and intermediary awards in line with the FHEQ. However, practice staff and students reported that, in the first two modules in year one, the ILOs are not always sufficiently relevant to the theatre clinical context in which ODPs work.
63 Module and programme handbooks and the programme specification spell out ILOs clearly and students confirmed they understood what was expected of them. The module outcomes are clearly relayed to the student at the start of each module, with personal tutor arrangements in place to offer further support in their understanding. Clinical placement coordinators are in place within each unit and work closely with students to ensure they are familiar with the ILOs for placements. Mentors felt they took time to understand ILOs fully in relation to practice and assessment, and sometimes they needed further guidance.
Curricula
64 The design of the curriculum for the DipHE in ODP two-year, full-time programme enables students to develop and demonstrate the necessary practical skills and competencies that are pre-requisites for professional registration. The programme team provided evidence of the programme mapped against the HPC SoPs and the AODP requirements. However, the programme will also need to be aligned to the HPC requirements in relation to the Standards of Education and Training, and work is progressing to ensure that this occurs prior to the HPC accreditation event in May 2006. Overall, all stakeholders are very committed to ensuring the effective delivery of the curriculum and this is helped by a continued and constructive dialogue between the HEI, SHA and Trusts.
65 The sequencing of the present curriculum has resulted in limited coverage of anatomy and physiology and other specifically-related subject matter for ODP practice. The students confirmed that the lack of anatomy and physiology in the first year did undermine their learning in practice. However, the reviewers are reassured by evidence from staff that this will be addressed successfully in the new curriculum due to be validated in 2006. In the interim period, the team is directing students in the module to guided reading, on-line resources and the use of the skills laboratory. Students have found that the rotation between Trusts for the practice elements of the programme has not always been conducive to effective learning. However, this has recently been changed to ensure that any specialist placements not available within the 'host' hospital are provided in other placement sites.
66 The curriculum provides for only the minimum threshold coverage of the HPC SoPs and Subject benchmark statement on post-operative recovery care, published by QAA. The reviewers consider that the necessary parity of clinical experience enjoyed by students across clinical areas was just being met.
67 There is an effective structure to promote the practice curriculum involving a Clinical Coordinator (CC) who is responsible for the practice element of the curriculum delivery. CCs are instrumental in ensuring the student has an assigned mentor and practical experience. Clinical staff are involved in the preparation of the first practice experience by coming into the University to participate in the clinical skills formative assessment. This helps to develop confidence in the students and mentors in understanding the relationship between theory and practice in the curriculum. Although the curriculum has a patient focus, the opportunities for service-user involvement are still limited. However, a number of opportunities have been identified to develop this aspect, for example, in the development of links with the Patient Advisory Liaison groups.
68 The ODP curriculum does not yet offer any significant opportunities for the effective involvement of students in IPL. Where common core learning has taken place, ODP students do not see the relevance of the subject areas used, despite increased school-wide activity in this direction.
Assessment
69 Students are able to demonstrate their achievement of the ILOs through a range of appropriate summative assessment methods in accordance with the Code of practice, published by QAA. In addition, students experience formative assessment from OSCEs, in order to assess skill acquisition. Assessments are clearly linked to practice, and contribute to the development of practice knowledge.
70 Students are clear regarding the assessment requirements, stating that they are provided with comprehensive written and verbal information. Assessment of practice is an integral part of the strategy and meets AODP requirements within the 2001 National Curriculum. Practice assessment is recorded through the use of a practice grid, which students find easy to use. All students demonstrated their understanding of assessment outcomes and their own responsibility for completing the assessments on time.
71 Standard faculty marking criteria have been well utilised within ODP. The reviewers saw a range of work and marking feedback from module samples and longitudinal studies. The marked work feedback was generally typed and clear, and provided constructive feedback valued by the students. The exception to this was during year one, where the reviewers noted handwritten feedback on two modules that was at times illegible.
72 The reports from the recently-appointed external examiner comment favourably on the process of both theory and practice assessment. The assessment strategy demonstrates progression from year one to year two through an appropriate measurement of clearly differentiated learning outcomes. However, students reported that they were not prepared for the transition between the academic years.
73 Mentors are well informed regarding the use of the practice grid, as this adopts the same template for all practice-based disciplines. The four-year cycle programme of mentor development is available for ODP mentors, but there is limited uptake for this due to difficulties in releasing staff from practice commitments. In one placement visit, students reported very good support from the practice facilitator who met with them weekly to ensure assessment was appropriate to their needs. Students commented on the good support from the course team in relation to the module assessments, but stated that it could be very difficult to contact them at times.
Student achievement
74 Students are achieving the ILOs at levels that are consistent with the requirements of the AODP and HPC for professional registration. The external examiner's report confirms that standards of academic work are comparable with other institutions, and of an appropriate level.
75 The student work seen by the reviewers demonstrated the achievement of an appropriate standard. The achievement of practice outcomes is well supported by clinical staff, who have clear information regarding the module requirements, although the process of dealing with failure in practice is not consistently understood by the mentors or students. However, mentors in one placement area were able to demonstrate a sound knowledge of the process for supporting failing students and had a flow chart within the practice areas to support them through that process.
76 Clinical staff and managers confirmed that students were adequately prepared for practice, and fit for purpose on completion. This was further stated by second-year students. However, commitment to lifelong learning was not evident from the students met, or from the SHA in relation to operating department practitioners. No students indicated that they planned to go on to further study. There is little in the way of specific CPD for ODP practitioners; however, there are a number of modules within the Department of Professional Studies and the BSc programme that are relevant and have been taken up by practitioners and paid for under the block contract.
77 Statistical data are limited, as just one cohort has completed to date. Table 1d demonstrates a 58 per cent pass rate for the DipHE, and one student achieved an exit award in the form of a certificate of achievement. All students have successfully been employed following qualification, with 93 per cent (14) entering local employment (Table 2d). Attrition from the first cohort was high at 37.5 per cent, but this was due to a number of reasons and no particular trend is yet evident.
Table 1d: Completion and achievement statistics for all award-bearing programmes in operating department practice
| Programme | Recruited number | Cohort |
Diploma | Other Qualifications * |
||
|---|---|---|---|---|---|---|
| No. | % | No. | % | |||
| DipHE in Operating | 24 | Sept 2005 | 14 | 58 | 1 | 4 |
* one student received a Certificate of Achievement
Table 2d: Employment statistics for all pre-registration programmes and exception reporting for post-qualification programmes in operating department practice
| Programme | Cohort | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | No | % | ||
| DipHE in Operating Department Practice (15 students) |
Sept 2005 | 14 | 91 | 1 | 7 | ||||||
Summary of academic and practitioner standards for operating department practice
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programme in Operating Department Practice at Coventry University in partnership with West Midlands South Strategic Health Authority.
Strength
- Clinical staff are involved in the preparation of the first practice experience by coming into the University to participate in the clinical skills formative assessment. This helps to develop confidence in the students and mentors in understanding the relationship between theory and practice in the curriculum (paragraph 67).
Weaknesses
- Practice staff and students reported that, in the first two modules in year one, the intended learning outcomes are not always sufficiently relevant to the theatre clinical context in which operating department practitioners practise (paragraph 62).
- The ODP curriculum does not yet offer any significant opportunities for the effective involvement of students in IPL. Where common core learning has taken place, operating department practice students do not see the relevance of the subject areas used, despite increased school-wide activity in this direction (paragraph 68).
B5 Paramedic science
Intended learning outcomes
78 ILOs for all theory modules have been mapped against the relevant HPC standards and reinforce the theory/practice link well. The Faculty provides a flexible and varied context for achieving ILOs in the pre and post-registration paramedic science programmes. This maps against generic health professions and the Subject benchmark statement for nursing, as well as the University's own code of practice for academic and professional skills development. The development of the ILOs was a direct result of pilot work undertaken by the University in partnership with local emergency care networks and the Modernisation Agency.
79 The ILOs are fit for purpose and are conducive to promoting the vocational elements of the programme. They are clearly described in programme handbooks, and students and practice staff considered them to be understandable and relevant within their professional context. ILOs are in line with the guidelines of the FHEQ and the external examiner's report confirms that they promote achievement at the appropriate level and are mapped against the Subject benchmark statement.
80 ILOs are communicated and disseminated effectively by a variety of means, including WebCT and the programme handbook. Students reported that they were able to access the information while on placement or, if part-time students, within the work environment.
Curricula
81 Paramedics are a new profession and have only recently undertaken their pre-registration education at the Faculty of Health and Life Sciences. The Diploma in Professional Development in Paramedic Science was the first such HPC-approved programme nationally that enables paramedic technicians to apply for registration as paramedics. This, and the curriculum for the BSc in Autonomous Emergency Practice, were developed in an effective partnership with medical, nursing and paramedic representatives from across Coventry and Warwickshire. The curriculum for the degree in Adult Nursing and Paramedic Science was designed as a pre-registration programme and developed to meet perceived service needs at the time. Recruitment to this programme has now ceased because of further service development in post-registration provision. All these programme developments have been the drivers for the enhanced roles within pre-hospital healthcare, in particular, the roles of nurses and paramedics. The enthusiasm shown towards these new programmes was noted by the reviewers. There is a high demand and high expectation from staff within practice for further professional opportunities and the WMSHA currently funds mentor development and Emergency Care Practitioner places. From 2005-06, the SHA will be funding up to 20 places a year for mentor development.
82 Although paramedic science programmes offer differing curriculum content to promote the ILOs, there was evidence that all curricula are fit for purpose and reflect the HPC competencies. The self-evaluation document (SED) claims, with some justification, that programmes are delivered by a diverse range of practitioners from various disciplines and that this has enhanced the students' learning experience and supports IPL within the University. The appointment of an honorary professor in cardiac nursing supports the post-registration programme in autonomous emergency practice, as well as the pre-registration, pre-hospital programmes.
83 Post-registration students on the autonomous emergency practice programme felt that they benefited from experiencing time within the major and minor injuries departments within the hospital setting. They gain much by way of professional insight and by reflecting upon this experience they felt it had contributed to the success of the rest of the programme.
84 Student work is congruent to the developing trends within the pre-hospital environment and reflects curriculum content to support this. The clear sense in which the current curriculum matches vocational needs and is relevant to practice placement settings is further supported by the external examiner's report.
85 Most paramedic science students met by the reviewers felt that the IPL module within the curriculum was appropriate to their needs, and was an enjoyable area. Previous cohorts of students finished their programmes at the University; however, students now finish with a seven-week practice placement. This is beneficial, as it provides an opportunity for students to consolidate their knowledge and professional understanding in the work setting. It is fully supported by the students.
86 Current operational demands mean that it is difficult to release staff for academic development; thus, at present, there is no demand to develop academic development programmes specifically for paramedics, although this will be revaluated in the future. However, in line with the Skills Escalator in a professional context, there are 30 places for the Emergency Care Practitioner courses currently funded by the SHA over and above the block contract.
Assessment
87 Paramedic science students are exposed to a full range of assessments, including essays, multiple-choice and oral examinations, case studies, critical-incident analysis, dissertations and practice portfolios. These are appropriate to the type and level of work. Some interesting modes of assessment are employed, including the early use of advanced simulation mannequins to measure initial skills competence and instil confidence. This is then formatively assessed in the field under strict supervision, with experienced paramedic practitioners. Students on all the programmes are drawn from the local service and have assessment of practice grids which have been developed in partnership between mentors and assessors in the practice field, and with the staff at the University.
88 The use of portfolios integrates the assessment of practice and theory. The assessment processes conform to the University's assessment policy and to the Code of practice, published by QAA. They also fall within the newly-introduced (2003) assessment and compensation policy that balances the module workload of the student.
89 The reviewers scrutinised a wide range of samples of students' written work and the practice portfolios. These showed that assessments relate well to ILOs and are appropriate to curriculum content and level, as well as clearly reflecting assignment and marking guidelines. Both undergraduate and postgraduate students expressed their appreciation of the timely and constructive written feedback they receive from staff and the readiness with which tutors offer face-to-face tutorials.
90 The assessment of professional practice involves mentors and supervisors and is carried out by practice educators, many of whom have undertaken an accredited mentoring course in their own time, using annual leave to attend. Module handbooks provide comprehensive information on areas for assessment, standards, methods, criteria and deadlines. Students confirmed they found these helpful.
91 The external examiner has expressed confidence in the assessment process and the integrity of awards. There are appropriate arrangements to ensure the consistency of the marking and internal moderation of assignments. Clear marking criteria specific to each academic assessment are provided in student handbooks. The reviewers concur with the external examiner that the assessment process overall is fair and reliable.
Student achievement
92 The reviewers examined a variety of student work, met with a wide range of paramedic students and had meetings with managers, educators and faculty staff. On the basis of this evidence, the reviewers are able to attest to the appropriate and sometimes high standards being achieved. Students met were enthusiastic, knowledgeable and forward-thinking.
93 The clinical assessment profiles used on the paramedic programmes provide clear evidence that students are satisfying attendance, competence and EU Directive requirements. Clinical staff and managers in the practice setting confirmed the opinions of the reviewers that paramedic students were well prepared for the clinical placements and are fit for both practice and purpose.
94 The autonomous emergency practitioners programme is flexible, allowing practitioners to step on and off the programme to achieve awards at certificate, diploma and degree level. Thirty eight autonomous emergency practitioners have completed the programme, with seven awards at degree level, which are shown in Table 1e, 25 at diploma and six at certificate level. Forty-five students are still in the programme, with potentially some of the students who have stepped off the programme returning to their studies. The other three programmes have not yet completed and gone to examination boards. The BSc Adult Nursing and Paramedic Sciences programme has ceased after only two cohorts, following changes to the workforce development needs within the service. The attrition rates for this programme have been relatively high for the first cohort for a variety of reasons not related to academic achievement, and the students from the second cohort met by the reviewers expressed the need to develop further their ambulance clinician role. There is no table for the employment statistics.
Table 1e: Completion and achievement statistics for all award-bearing programmes in paramedic science
| Programme | Cohort |
Diploma | Diploma | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc (Hons) Autonomous Emergency Practice |
Sept 2004 | 6 | 100 | ||||||||||||||
| Sept 2005 | 1 | 12 | 7 | 88 | |||||||||||||
Summary of academic and practitioner standards for paramedic science
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Paramedic Science at Coventry University in partnership with West Midlands South Strategic Health Authority.
Strengths
- The Diploma in Professional Development in Paramedic Science was the first such Health Professions Council approved programme nationally that enables paramedic technicians to apply for registration as paramedics. This, and the curriculum for the BSc in Autonomous Emergency Practice, were developed in an effective partnership with medical, nursing and paramedic representatives from across Coventry and Warwickshire (paragraph 81).
- Some interesting modes of assessment are employed, including the early use of advanced simulation mannequins to measure initial skills competence and instil confidence. This is then formatively assessed in the field under strict supervision, with experienced paramedic practitioners (paragraph 87).
C Quality of learning opportunities
Learning and teaching
95 The programmes in the Faculty base their learning and teaching strategy on the University's strategy, produced in 2002. This is based appropriately on four core values: commitment to high standards and quality; supportive, fair and equitable treatment throughout; self-critical and honest appraisal; and innovation and enterprise in an environment of academic freedom. Supporting the strategy is the Interprofessional Learning Strategy Joint Staff Conference and the Sharing Good Practice and Innovation Conference. The University was successful in gaining three Centre for Excellence in Teaching and Learning awards. Healthcare programmes benefit from all these initiatives and embrace learning and teaching methods of sufficient variety and breadth to enable the ILOs and curricula to be effectively implemented. Students in all programmes confirmed that the quality of teaching and the rigour of their learning were well secured by the methods employed. Students on the BSc (Hons) Child Nursing programme plan and execute an annual conference on current issues in child care and childrens' nursing. These conferences are well attended and do much to promote learning in this area, as well as illustrating initiative and achievement on the part of the students involved.
96 A Teaching, Learning and Assessment Committee meets four times throughout the academic year. Attendance at these meetings is normally good, though it declined throughout the period of re-validation of the health professional programmes and the restructuring of the University. The Committee exercises an overarching influence over the development of learning and teaching across the Faculty and has been responsible for promoting a number of seminars on pedagogic issues. There is limited evidence of pedagogic research, although this, and innovation, are deemed to be a key part of developing teaching and learning. Two staff members from the Faculty of Health and Life Sciences have been seconded to the Centre for Higher Education Development in the University to focus specifically on work-based and research-led learning.
97 WebCT has had considerable investment injected into the project by Coventry University to support students' learning in placements. Evidence given to the reviewers suggests that WebCT has had varying impact, with some student groups confirming its effectiveness as a learning and teaching tool and others less enthusiastic.
98 It is envisaged by faculty staff that the implementation of the new ARC database will support the use of robust placement data, including the incorporation of the live mentor database, which will greatly assist the promotion of effective learning in practice through the faculty placement unit. At the time of the review, there was insufficient evidence to evaluate the success of ARC but it clearly has potential. The current audit document being used is dated. A new learning environment profile has been developed in partnership with the SHA and is being piloted to monitor the quality of the learning environment. Again, it is too early for any evaluation of its use.
99 The SED refers to mentorship and mentor updates, either in the form of a mentor conference, distance-learning package, or in-house mentor development updates. The reviewers consider that these arrangements are working well in most instances and that there are sufficient mentors with recent up-dating and development to provide adequate support to students.
100 IPL is promoted throughout the Faculty, with some positive feedback from health visiting, nursing and paramedic science students. However, the common core pathway was not valued by ODP students, who felt that the teaching of this part of the curriculum was not relevant to their needs.
101 Learning opportunities across all disciplines reflect current practice and support the vocational elements of th