Major review of healthcare programmes
The Department of Health, in partnership with the Nursing and Midwifery Council, the Health Professions Council and the Strategic Health Authorities have contracted with the Quality Assurance Agency for Higher Education (QAA) to carry out reviews of all NHS-funded healthcare programmes in England during the period 2003-06.
QAA helps to provide public assurance that the quality and standards of higher education are being safeguarded and enhanced by conducting academic reviews of higher education provision.
Major review
Major review is a peer review process. It starts when higher education institutions in partnership with their commissioning Strategic Health Authorities evaluate their provision in a self-evaluation document. This document is submitted to QAA for use by a team of academic and practitioner reviewers who gather evidence to enable them to report their judgements on the academic and practitioner standards and the quality of learning opportunities. Review activities include meeting academic and clinical staff and students, scrutinising students' assessed work, visiting practice learning environments, reading relevant documents, and examining learning resources.
Full details of the process of major review can be found in the Handbook for major review of healthcare programmes, 2003.
Judgements
The range of judgements that reviewers may utilise when they have completed a major review are summarised below.
Academic and practitioner standards
Reviewers make one of the following judgements on standards:
- confidence, which may be expressed as
- limited confidence, or
- no confidence.
To reach this judgement, reviewers look at:
- learning outcomes
- the curriculum
- student assessment
- student achievement.
Confidence in academic and practitioner standards: a judgement that is made if reviewers are satisfied with current standards and with the prospect of those standards being maintained into the future. A judgement of limited confidence is made if standards are being achieved but the reviewers have doubts about the ability of the HEI and partner placement providers to maintain them into the future.
No confidence in academic and practitioner standards: a judgement that is made if arrangements are inadequate to enable standards to be achieved or demonstrated. If a failure to achieve standards has occurred in specific programme/s and/or mode/s and/or level/s only, and there is confidence in standards at other levels, the failing programme/s mode/s level/s will be identified separately.
Quality of learning opportunities
Reviewers make one of the following judgements for each of three elements of learning opportunities:
- commendable
- approved
- failing.
The three elements of quality of learning opportunities are:
- learning and teaching
- student progression
- learning resources and their effective utilisation.
Maintenance and enhancement of standards and quality
Reviewers also report the degree of confidence they have in the providers' ability to maintain and enhance quality and standards in the healthcare programmes under review.
Commendable - the provision contributes substantially to the achievement of the intended outcomes, with most elements demonstrating good practice.
Approved - the provision enables the intended outcomes to be achieved, but improvement is needed to overcome weaknesses. The summary report will normally include a statement containing the phrase 'approved, but...', which will set out the areas where improvement is needed.
Failing - the provision makes a less than adequate contribution to the achievement of the intended outcomes; significant improvement is required urgently if the provision is to become at least adequate.
Summary of the main review outcomes
Subject provision and overall aims
Programmes in clinical psychology, occupational therapy, physiotherapy and speech and language therapy at the University of East Anglia in partnership with Norfolk, Suffolk and Cambridgeshire 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:
Clinical psychology
- Doctorate in Clinical Psychology ****
- Postgraduate Diploma in Cognitive Analytic Therapy (part-time) +
- Postgraduate Diploma in Cognitive Behavioural Therapy (part-time, last intake 2003, programme currently suspended)+.
Occupational therapy
Pre-registration
- BSc (Hons) Occupational Therapy ***
- MSc Occupational Therapy (first intake February 2005) ***.
Physiotherapy
Pre-registration
- BSc (Hons) Physiotherapy ***
- MSc Physiotherapy (first intake February 2004) ***.
Post-registration
- MSc/Postgraduate Diploma Health Sciences +
- MSc Manipulative Physiotherapy (last intake 2001).
Speech and language therapy
Pre-registration
- BSc (Hons) Speech and Language Therapy (first intake September 2004)***.
*** Approved by the Health Professions Council
**** Accredited by the British Psychological Society
+ These programmes are run on an interprofessional basis.
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in clinical psychology, occupational therapy, physiotherapy and speech and language therapy at the University of East Anglia in partnership with the Norfolk, Suffolk and Cambridgeshire Strategic Health Authority.
Strengths
- Summative assessment in clinical psychology is through an impressive range of coursework assignments, with problem-based learning tasks, case presentations and tape-process reports making a valuable contribution (paragraph 16).
- Feedback forms for clinical psychology are well designed and feedback is given within four weeks; this timely response enhances its educational value (paragraph 21).
- Interprofessional learning is effectively achieved in the BSc and MSc programmes in Occupational Therapy through the innovative joint curricula with physiotherapy programmes, which are valued by both students and practitioners (paragraph 29).
- Currency in the occupational therapy curriculum is ensured by influence from practitioners on joint conference days involving academic and clinical staff, where recent developments in practice are discussed (paragraph 30).
- Physiotherapy students are provided with wide-ranging experience of interprofessional learning (paragraph 47).
- There is strong integration of academic and placement learning in physiotherapy, which is achieved by close matching of practice placements to the academic curriculum (paragraph 48).
- Particularly detailed and specific grade descriptors have been developed for assessment of both academic assignments and practice and are being piloted in speech and language therapy (paragraph 70).
Good practice
- At the end of placements, Doctorate in Clinical Psychology trainees rate themselves for each clinical competency and this encourages reflective practice (paragraph 17).
- The conversation partner placements in speech and language therapy enhance the integration of theory and practice in the early stages of the programme (paragraph 66).
- The assessment of the conversation partner placement on the speech and language therapy programme is particularly well thought out (paragraph 67).
Weaknesses
- There is ongoing concern about the level of students' achievement in human sciences on the BSc Occupational Therapy (paragraph 40).
- Despite the changes made to the assessment of human sciences over the past two years, an external examiner has expressed concern about the standards being achieved in biological and physical sciences by students on the BSc Physiotherapy in year one (paragraph 58).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strengths
- E-learning is used particularly effectively across programmes (paragraph 73).
- The case materials utilised in teaching and learning are particularly appreciated by students and make a valuable contribution to the integration of theory and practice (paragraph 73).
- Video-recording is successfully employed to bring realism to learning (paragraph 73).
- Students consider that problem-based learning develops their reasoning skills and praise the quality of the triggers used (paragraph 74).
Weakness
- Students are critical of the method of delivery of the interprofessional learning programmes provided by the Centre for Interprofessional Practice (paragraph 76).
Student progression
The quality of student progression is commendable.
Strengths
- In respect of occupational therapy and physiotherapy, the contribution of the clinical placement facilitators is particularly highly valued (paragraph 83).
- Attrition rates for the Doctorate in Clinical Psychology, the BSc Occupational Therapy and the BSc Physiotherapy are low and demonstrate effective student progression throughout the programmes of study (paragraph 85).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strengths
- Annual appraisal of academic staff is used effectively to assess their ongoing training needs (paragraph 89).
- There is a good range of dedicated, specialist accommodation for occupational therapy, physiotherapy and speech and language therapy (paragraph 93).
Maintenance and enhancement of standards and quality
Strength
- There is proactive use of the external examiners in the process of enhancing the student experience (paragraph 102).
Good practice
- There is a particularly impressive clinical placement audit process for the Doctorate in Clinical Psychology (paragraph 103).
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 clinical psychology, occupational therapy, physiotherapy and speech and language therapy at the University of East Anglia (UEA) in partnership with Norfolk, Suffolk and Cambridgeshire Strategic Health Authority (NSCSHA). The review was completed during the academic year 2005-06.
2 NSCSHA oversees health services for a region of mixed urban and rural geography with no major conurbations. Particular features of its needs and services include the high proportion of elderly people, an emphasis on community work within rural areas, low ethnic diversity and pockets of high deprivation.
3 UEA, established in 1962 and based on a campus in Norwich, is a premier research and teaching university dedicated to the advancement of learning and the increase of knowledge both to satisfy the aspirations of individuals and to contribute to economic, social and cultural progress at regional, national and international levels.
4 The Institute of Health (IoH) is one of four faculties at UEA. Its culture is one of planned, steady expansion in collaboration with the educational needs of healthcare providers. Student numbers have increased over the last 15 years from approximately 60 to approximately 2,200 full-time equivalents (FTEs). This growth is testimony to the relationships developed between the University and its partners in health and social care. Some 150 FTE academic staff are employed in the IoH and 21 FTES are seconded; there is also a substantial contribution to activity from the large number of honorary appointments involving National Health Service (NHS) personnel, over 190 in total.
5 Within the IoH, provision in clinical psychology is delivered in the School of Medicine, Health Policy and Practice (MED), while programmes in occupational therapy, physiotherapy and speech and language therapy are the responsibility of the School of Allied Health Professions (AHP). The subjects under review represent only part of the health professional provision at UEA, which also educates students in nursing, midwifery and operating department practice (considered in a subsequent major review), as well as Medicine and Pharmacy, which, being Higher Education Funding Council for England - funded subjects, are not part of the review, but which play a significant part in the interprofessional environment and are included in the programme of interprofessional learning for students in the subjects included in this report.
A Subject provision and overall aims
Clinical psychology, occupational therapy, physiotherapy and speech and language therapy are currently offered in the following programmes:
Clinical psychology
- Doctorate in Clinical psychology ****
- Postgraduate Diploma (PgDip) in Cognitive Analytic Therapy (part-time) +
- PgDip in Cognitive Behavioural Therapy (CBT) (part-time, last intake 2003, programme currently suspended)+
Occupational therapy
Pre-registration
- BSc (Hons) Occupational Therapy (OT) ***
- MSc Occupational Therapy (first intake February 2005) ***.
Physiotherapy
Pre-registration
- BSc (Hons) Physiotherapy (PT)***
- MSc Physiotherapy (first intake February 2004) ***.
Post-registration
- MSc/PgDip Health Sciences +
- MSc Manipulative Physiotherapy (last intake 2001).
Speech and language therapy
Pre-registration
- BSc (Hons) Speech and Language Therapy (SLT) (first intake September 2004)***.
*** Approved by the Health Professions Council (HPC)
**** Accredited by the British Psychological Society (BPS)
+ These programmes are run on an interprofessional basis
6 The IoH is committed to the delivery of the highest quality teaching for health professionals of the future and to research. Its goal is to equip graduates with the knowledge, skills, attitudes and competencies required for the delivery of the best possible healthcare to improve the nation's health and wellbeing. The health professional educational programmes in IoH have been based on four key principles, to:
- promote client-centred care and evidence-based practice
- provide students with experience in a range of practice settings and academic experience that is based on the workforce needs and employment opportunities in the UK
- maximise opportunities for appropriate interprofessional working
- deliver education that integrates theory and practice throughout programmes.
Based on the IoH key principles, the programmes of healthcare education aim to develop healthcare professionals who are:
- competent to practise, using knowledge and skills specific to their profession to enable individuals and groups to optimise their health and social wellbeing
- lifelong learners, capable of using reflection within a framework of continuing professional development
- critical in evaluating their practice, seeking to base their work on research evidence and able to contribute to the culture of enquiry within their profession
- flexible and responsive to change and able to manage themselves and others within changing contexts of health and social care
- able to operate in interdisciplinary teams, working effectively with different professionals, agencies and individuals.
B Academic and practitioner standards
B1 Clinical psychology
Intended learning outcomes
7 The intended learning outcomes (ILOs) for the ClinPsyD are comprehensive, appropriate for the level of award and are consistent with The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), the Subject benchmark statement for clinical psychology, and the BPS accreditation requirements. The programme specification outlines the ILOs and they are published in the programme handbook and on the supervisors' website. They are concordant with the programme's aims to develop trainees who can draw on a broad range of psychological models and theories to inform their clinical and research work. The ILOs relate to a series of skills, knowledge and values across clinical, academic and research work, encompassing knowledge and understanding, cognitive skills, practical and subject specific skills. Clinical staff make use of the ILOs in developing placement contracts.
8 The ILOs for the Postgraduate Diploma in CAT and the CBT are clearly articulated in the programme specifications. They are entirely appropriate for specialised interprofessional programmes at postgraduate level. The CBT programme is currently suspended while an alternative funding stream is sought.
9 The ILOs relate to the aims of the IoH, and thereby the University's aims. ILOs are disseminated to clinical supervisors through the programme handbook and the supervisors' website, and to students through the handbook. External examiners agree that the ILOs are appropriate to delivery of the programmes, in terms of level of award and relevance to professional practice, ensuring that trainees are fit for practice, purpose and award. ILOs are reviewed periodically, including by the Course Training Committee.
Curricula
10 The ClinPsyD is a pre-registration, postgraduate research degree. It provides an integrated academic, clinical practice and research education for psychology graduates who have relevant work experience.
11 The curriculum effectively supports the acquisition of ILOs informed by the recent core competency based BPS Accreditation Criteria, the Subject benchmark statement for clinical psychology and the FHEQ. Interprofessional learning (IPL) is effectively incorporated within clinical placements, and there are plans to introduce IPL into the academic curriculum with other postgraduate programmes, such as psychiatry or general medical practitioner training. Currency is ensured by the involvement of practitioners in the planning and delivery of the academic, research and clinical components of the curriculum, and partnership is fostered by collaborative research by staff, trainees and practitioners. Research and continuing professional development (CPD) activity by staff ensure that the curriculum is informed by current evidence, scholarship and knowledge of good practice in teaching.
12 The central role of the client/patient in the curriculum is effectively achieved through use of problem-based learning (PBL) and other experiential learning. Effective theory-practice integration is achieved through preparation of trainees for clinical placements, use of placement materials in teaching sessions, training workshops for clinical supervisors and involvement of supervisors in the programme committee. Skills-based learning sessions and placement learning effectively foster the development of competence and safe practice as well as promoting self-reflection and lifelong learning.
13 The CBT and CAT programmes are offered on an interprofessional basis and IPL is built into the curriculum. They provide high-quality training for health and social service professionals who have already gained initial counselling and therapy skills and who are using these skills in professional practice.
Assessment
14 Assessment on the ClinPsyD complies with the University regulations and procedures, which are themselves consistent 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. Programme review and accreditation ensured that the assessment process takes account of BPS requirements.
15 The award of the ClinPsyD is based upon successful performance in clinical placements and related assignments, together with academic assignments and a thesis and oral examination presenting the results of original research. The ILOs are assessed by academic assignments and, on clinical placements, through the Supervisor's Assessment of Trainee Form (SAT). A key influence on decisions made by the Board of Examiners is the recommendation made by the clinical supervisor in the detailed SAT report. The purpose of assessment is to ensure that all the BPS competencies have been met by the trainee. Assessment tasks are clearly mapped against these competencies, although the relationships with the ILOs are not so explicit.
16 A wide range of appropriate assessment methods is used on the ClinPsyD, CBT and CAT. Summative assessment in clinical psychology is through an impressive range of coursework assignments, with PBL tasks, case-presentations and tape-process reports making a valuable contribution. The tape-process reports have been introduced to replace one of the oral presentations. The trainee makes a taped record of a representative piece of their therapy work. Formative assessment occurs in case discussion and on supervised clinical practice. Interprofessional learning is assessed during case presentations.
17 Placement learning is assessed by the SAT and an oral presentation of clinical work. Supervisors are encouraged to be involved in assessing the presentations and are generally very keen to do so, as they see this as a valuable link between theory and practice. Supervisors are also positive about the value of the log of clinical experience completed by the trainee during practice. At the end of placements, ClinPsyD trainees rate themselves for each clinical competency and this encourages reflective practice. These ratings are discussed with the supervisor and, after feedback, self-ratings are modified if necessary.
18 Guidelines for trainees provide clear information about the nature of the work expected and how it will be evaluated. Internal examiners apply consistent marking criteria. Examining processes have been commended by external examiners. All ClinPsyD assignments, with the exception of theses, are double-marked by two internal examiners who agree an overall grade. All theses are scrutinised by an internal and an external examiner. In response to comment from the external examiner, new CAT markers will be supported by training linked to the ClinPsyD and paired with more experienced markers.
19 External examiners' reports are clear and helpful. It is evident that they play an important role in monitoring assessment and the qualifications awarded. Responses are made to external examiners' reports within the first term of the following academic year, to allow time for monitoring action plans arising from comments and suggestions.
20 Supervisors find assessment documentation clear and comprehensive. To ensure consistency in placement assessment, regular workshops and updates are held for new and experienced supervisors. Attendance is not mandatory but, before a trainee commences a placement, new supervisors are briefed on the UEA programme. Information provided by the University enables supervisors with limited experience to apply marking criteria to differentiate between trainees' skill levels. Many supervisors find that the mid-placement review visit from the University tutor provides a useful opportunity for updating on assessment and reflecting on their own skills. Considerable support is provided for supervisors involved in assessing oral presentations. Supervisors have contributed to the design of assessment processes for the ClinPsyD and provide feedback on their operation.
21 Trainees on the ClinPsyD generally receive high-quality written feedback. Feedback forms for clinical psychology are well designed and feedback is given within four weeks; this timely response enhances its educational value. This may be extended by a week in the event of staff illness.
Student achievement
22 A wide range of student work from the ClinPsyD and CAT was scrutinised by the reviewers. This included essays, case-reports, case-presentations, thesis proposals, service research projects, dissertations and placement evaluations from all levels of the programmes. The reviewers were able to verify that students are achieving the ILOs.
23 The completion and achievement statistics for the ClinPsyD, CAT and CBT in Table 1a show a 100 per cent achievement level. The external examiners expressed concern about the number of extensions permitted for the 2001 and 2002 entry cohorts in the ClinPsyD. The programme team responded to this by undertaking a review of all extensions granted and concluded that the large number was not caused by any systematic factors intrinsic to the programme. However, the programme team is considering whether the timetable for thesis preparation should be revised.
24 Graduates from the ClinPsyD have a high level of success in gaining employment as qualified clinical psychologists. This is supported by the data in Table 2a, with 100 per cent of the 1999 entry cohort employed, 95 per cent of the 2000 and 2001 cohorts and 91 per cent of the 2002 cohort. Of these, two-thirds are employed locally. Visits to clinical placements established that the supervisors were satisfied with the academic and professional standard of the students from the programme and attested to their employability.
25 The external examiners' reports are complimentary about the achievement of the learning outcomes on ClinPsyD and on both postgraduate diplomas, although currently the CBT programme is not running.
Table 1a: Completion and achievement statistics for all award-bearing programmes in clinical psychology
| Programme | Cohort |
Doctoral programmes |
Doctoral programmes |
||
|---|---|---|---|---|---|
| Pass | Fail | ||||
| No. | % | No. | % | ||
| Doctorate in Clinical Psychology | Oct 1999 | 19 | 100 | 0 | 0 |
| Oct 2000 | 19 | 100 | 0 | 0 | |
| Oct 2001* | 18 | 100 | 0 | 0 | |
| Oct 2002** | 11 | 100 | 0 | 0 | |
* plus 4 permitted extensions - students yet to complete
** plus 12 permitted extensions - students yet to complete
| Programme | Cohort |
PgDiploma programmes |
PgDiploma programmes |
||
|---|---|---|---|---|---|
| Pass | Fail | ||||
| No. | % | No. | % | ||
| PgDip in Cognitive Analytic Therapy | Sept 2000 | 7 | 100 | 0 | 0 |
| Sept 2003 | 6 | 100 | 0 | 0 | |
| PgDip in Cognitive Behavioural Therapy | Sept 2001 | 8 | 100 | 0 | 0 |
| Sept 2002 | 3 | 100 | 0 | 0 | |
| Sept 2003 | 7 | 100 | 0 | 0 | |
Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes in clinical psychology
| Programme | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | No | % | |
| Doctorate in Clinical Psychology | ||||||||||
| October 1999 | 0 | 0 | 13 | 68 | 6 | 32 | 0 | 0 | 0 | 0 |
| October 2000 | 0 | 0 | 13 | 68 | 5 | 27 | 0 | 0 | 1 | 5 |
| October 2001* | 0 | 0 | 12 | 67 | 5 | 28 | 0 | 0 | 1 | 5 |
| October 2002** | 0 | 0 | 7 | 64 | 3 | 27 | 0 | 0 | 1 | 9 |
* plus 4 permitted extensions - students yet to complete
** plus 12 permitted extensions - students yet to complete
Summary of academic and practitioner standards for clinical psychology
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Clinical Psychology at the University of East Anglia in partnership with Norfolk, Suffolk and Cambridgeshire Strategic Health Authority.
Strengths
- Summative assessment in clinical psychology is through an impressive range of coursework assignments, with problem-based learning tasks, case presentations and tape-process reports making a valuable contribution (paragraph 16).
- Feedback forms for clinical psychology are well designed and feedback is given within four weeks; this timely response enhances its educational value (paragraph 21).
Good practice
- At the end of placements, Doctorate in Clinical Psychology trainees rate themselves for each clinical competency and this encourages reflective practice (paragraph 17).
B2 Occupational therapy
Intended learning outcomes
26 The ILOs for the BSc (Hons) and MSc OT are outlined in the programme specification and match FHEQ criteria, the Subject benchmark statement for occupational therapy, published by QAA, the College of Occupational Therapists (COT) and HPC standards and IoH requirements. Their currency is reviewed through the University's quality assurance procedures. In developing ILOs, appropriate attention has been paid to relevant HPC guidance. The ILOs are developed and reviewed through workshops with clinicians/placement educators. The programmes have been designed to meet outcomes at the appropriate award level in line with the COT curriculum framework. The ILOs for the levels of the award are differentiated in the revalidation document.
27 The ILOs are communicated through programme and placement handbooks. It was apparent from the reviewers' meetings with students and practitioners that they were all fully aware of the ILOs and understood their significance.
Curricula
28 The BSc (Hons) OT is run jointly with the BSc (Hons) PT. There is a single programme specification and joint validation by COT and the Chartered Society of Physiotherapy (CSP). The MSc OT is an accelerated route to professional qualification, open to candidates who already have a first degree. It has been developed in conjunction with the MSc PT. There is shared delivery of approximately half of these OT/PT programmes. One unit in each year of the BSc programme is also shared with the BSc (Hons) SLT.
29 Both the BSc and MSc curricula are informed by the COT Curriculum Framework, the Subject benchmark statement for occupational therapy, the FHEQ and the HPC Standards of Proficiency: Occupational Therapy. IPL is effectively achieved in the BSc and MSc programmes in OT through the innovative joint curricula with physiotherapy programmes, which are valued by both students and practitioners. Students gain further exposure to IPL through their involvement in sessions organised by the Centre for Interprofessional Practice (CIPP). These sessions include students from across all the professions represented in the IoH and are aimed at promoting interaction between health professionals. This initiative has been commended by external examiners.
30 Currency in the OT curriculum is ensured by influence from practitioners on joint conference days involving academic and clinical staff, where recent developments in practice are discussed. Theory effectively underpins practice through careful preparation of students and placement educators for practice placements. The role of the clinical placement facilitators (CPFs) is central to this preparation and to the accredited practice educator scheme (APPLE) to support CPD for placement educators. Specialist lecturers and visiting tutors help to ensure the curriculum is evidence-based. External examiners' reports commend the integration of academic and placement learning.
31 The client/patient focus is held at the centre of learning through use of case material provided by clinicians and by PBL methodology in the MSc. The development of competence and safe practice is achieved through practice-based learning sessions and placement learning. The BSc curriculum effectively facilitates student progression by provision of a range of specialist third-year options which build on basic skills, and by placement learning contracts and pre-placement analysis of student needs.
Assessment
32 The assessment of BSc and MSc OT programmes complies with university regulations and procedures. Review and revalidation ensure that the requirements of COT and HPC are met. Practices are consistent with the Code of practice.
33 The assessment for each unit reflects its ILOs and is supportive to student progression. There is a range of assessment methods employed which, together, ensure that all the ILOs, relating to both academic and practice learning, are tested. The assessment strategy for both the BSc and MSc is aimed at the development of problem-solving and analytical skills. The method of testing students' knowledge in anatomy and physiology has been revised in response to concerns expressed both in practice and by external examiners. An unseen course test has replaced coursework assignments. Students are prepared for the summative assessment by a formative test which follows the same format. External examiners are complimentary about the efforts made to address the problem. Students comment particularly favourably on the workbooks which prepare them for the written test.
34 Specific skills and competencies are assessed both formatively and summatively. In order to achieve the award, students are required to provide evidence that they have achieved each of the practice competencies. Placement performance in years two and three contributes to the final honours classification. The documentation on practice placement is clear and comprehensive, and practice educators consider that students have been well prepared for practice assessment.
35 Clear, written information is provided for students about the assessment structure, and how it will be evaluated, together with guidelines on each assignment. Submission dates are notified well in advance to enable students to plan their work. First-year BSc students receive support with assignments on an individual basis. However, in the interests of equity of treatment for all students, advice is provided on each assignment in the second year in a briefing and question-and-answer session for all students. Some students perceive this move to collective guidance as a loss. In the third year, students receive individual support with their dissertations. MSc assessments reflect the key requirements for newly qualified occupational therapists, pitched at an appropriate level for postgraduate students. Appropriate marking criteria have been devised for the MSc programme and clear guidelines are provided to assist academic markers and placement educators.
36 Marking is consistently fair and equitable. Anonymous marking is employed wherever practicable. First-year work is single-marked, and second and third-year work double-marked. The reviewers saw evidence that moderation is being carried out according to these guidelines. Some students have expressed concern that it is particularly difficult to achieve high grades for practice placement. However, staff are confident that this is not the case but continue to monitor the situation. External examiners play a full role in the assessment process and their concerns are promptly responded to.
37 Academic staff attend assessment workshops, occasional markers are supported by experienced staff and new markers have mentors. To assist the quality and consistency of placement assessment, initial training is provided for practice educators, who generally feel well prepared for their assessment role. Additional workshops take place both at the University and in practice placement settings to inform practice educators of academic developments and to disseminate good practice in placement education. Practice educators assess students' performance at the half-way and final stages of placements, and give high-quality feedback to students. Clinicians also assist in marking second-year IPL reflective statements and third-year presentations. Practitioners were involved in the design of assessment on the programmes and have many opportunities to discuss assessment issues with academic staff.
38 Each assignment is given formative feedback as well as a mark. Written feedback is generally very clear and helpful, although some students feel that more detailed feedback could be provided on PBL. Standardised forms have been developed for feedback on OT assignments. They provide valuable guidance on core skills such as referencing, structure, grammar and syntax. There is no university standard for the return of marked work but students are informed of deadlines by which they can expect work to be returned. Tutors respond promptly to requests to discuss feedback.
Student achievement
39 A wide range of assessed student work, reflecting all levels available from both the BSc and MSc programmes, was scrutinised, including assessed coursework, practice placement reports, journal article assignments, professional literature review, reflective essays and critical appraisal essays. This provided evidence to confirm the judgement of the external examiners that students are achieving the ILOs and are producing work of an appropriate standard for the level of the awards.
40 However, there is ongoing concern about the level of students' achievement in human sciences on the BSc Occupational Therapy. External examiners comment on the weak marks profile for the OT students compared with the corresponding BSc PT students, although they add that this reflects the national picture. They also express the concern that it is possible for a student to pass the unit with a weak profile, although the situation has improved since the introduction of an unseen course test. The team is aware of the problem and is actively investigating ways in which student achievement in this module can be improved. These include workshops involving external examiners, the introduction of a formative assessment which mirrors the format of the summative test, further learning support for failing students and pre-programme reading. Pre-admissions support is being considered.
41 The degree classification statistics (Table 1b) show a high level of achievement on the BSc programme, with 92 per cent of the 2000 entry cohort, 98 per cent of the 2001 cohort and 97 per cent of the 2002 cohort gaining a First or Second class honours degree. The quality of student achievement is supported by the external examiners' reports for these three years. There are no statistics for the MSc Occupational Therapy as the first cohort has not yet graduated.
42 BSc (Hons) graduates have a high level of success in gaining employment, 86 per cent being employed from the 2000 entry cohort, with an additional 3 per cent undertaking further study; 96 per cent from the 2001 entry cohort are employed and 78 per cent from the 2002 entry cohort (Table 2b). Of these, just under half work in local services. There are 50 per cent of the 2000 cohort, 50 per cent of the 2001 and 36 per cent of the 2002 entry cohorts being employed locally (Table 2b).The employment situation is being monitored by the SHA and University with the recognition that many local Trusts are facing financial problems that may affect recruitment and opportunities for graduates
43 In 2005 a managers' and graduates' survey showed that the students feel that they have met the learning outcomes of the programme and these students were welcomed by the managers as employees. This final comment was supported by the clinicians and managers met by the reviewers during placement visits.
Table 1b: Completion and achievement statistics for all award-bearing programmes in occupational therapy
| Programme | Cohort |
Degree classification | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||
| No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc Occupational Therapy | Sept 2000* | 4 | 10 | 17 | 44 | 15 | 38 | 1 | 3 | 0 | 0 | 2 | 5 |
| Sept 2001 | 4 | 9 | 26 | 56 | 15 | 33 | 1 | 2 | 0 | 0 | 0 | 0 | |
| Sept 2002 | 3 | 7 | 20 | 45 | 20 | 45 | 2 | 4 | 0 | 0 | 0 | 0 | |
* plus 1 intercalator not yet completed
Table 2b: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes in occupational therapy
| Programme | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | No | % | |
| BSc Occupational Therapy | ||||||||||
| September 2000* | 1 | 3 | 19 | 51 | 13 | 35 | 0 | 0 | 4* | 11 |
| September 2001 | 0 | 0 | 23 | 50 | 21 | 46 | 0 | 0 | 2** | 4 |
| September 2002 | 0 | 0 | 16 | 36 | 19 | 42 | 0 | 0 | 10 | 22 |
* plus one intercalator not yet completed, 3 unknown, 1 employed in retail
** 1 unknown, 1 travelling
Summary of academic and practitioner standards for occupational therapy
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Occupational Therapy at the University of East Anglia in partnership with Norfolk, Suffolk and Cambridgeshire Strategic Health Authority.
Strengths
- Interprofessional learning is effectively achieved in the BSc and MSc programmes in Occupational Therapy through the innovative joint curricula with physiotherapy programmes, which are valued by both students and practitioners (paragraph 29).
- Currency in the occupational therapy curriculum is ensured by influence from practitioners on joint conference days involving academic and clinical staff, where recent developments in practice are discussed (paragraph 30).
Weakness
- There is ongoing concern about the level of students' achievement in human sciences on the BSc Occupational Therapy (paragraph 40).
B3 Physiotherapy
Intended learning outcomes
44 ILOs for the pre-registration BSc (Hons) and MSc PT comply with the Subject benchmark statement for physiotherapy, published by QAA, the professional tandards of CSP and HPC Standards of Proficiency. They are consistent with the FHEQ. They also reflect the mission and aims of the IoH.
45 The MSc Manipulative Physiotherapy has clearly defined ILOs, to enable qualified physiotherapists to enhance their professional knowledge and skills at a level appropriate to the award of an MSc. The MSc/PgDip Health Sciences is an interprofessional programme. The ILOs are appropriately framed to give health professionals the opportunity to explore and enhance their own practice within a wider context and develop their research skills.
46 The ILOs are clearly stated in validation/revalidation documents as well as the student programme handbooks and placement handbooks. Clinicians are involved in the ongoing development of ILOs through workshops. A review of the ILOs will take place as part of the re-approval exercise in 2007. Both students and practice educators are aware of the ILOs and their role in student learning.
Curricula
47 The BSc PT is run jointly with the BSc OT. There is a joint programme specification and joint validation by the CSP and COT. The MSc Physiotherapy is a fast-track programme to professional qualification, in the same way as the MSc Occupational Therapy. Since the launch of the latter in February 2005, there has been considerable shared teaching across the two programmes. IPL is a clear component of the BSc and the MSc programmes in physiotherapy through joint curricula with OT. One unit in each year of the BSc programme is also shared with the BSc SLT. In addition, PT students participate in the IPL sessions provided by the CIPP in the same way as those from OT. Through these routes, and through their experience on practice placement, PT students are provided with wide-ranging experience of IPL.
48 The BSc and MSc curricula are informed by the Curriculum Framework for Qualifying Programmes in Physiotherapy, the Subject benchmark statement for physiotherapy and the FHEQ. The curricula maintain currency through the research and CPD activity of staff. Specialist lecturers and visiting tutors help to ensure the curriculum is evidence-based. There is strong integration of academic and placement learning in physiotherapy, which is achieved by close matching of practice placements to the academic curriculum. This integration has been commended by external examiners. The Accredited Practice Educator Scheme (ACE) is being introduced to enhance curriculum delivery in practice.
49 Both BSc and MSc programmes place the client/patient at the centre of the learning experience. In the MSc this is facilitated by the use of PBL, and on the BSc through integration of placement and academic learning. Practical-based learning sessions and placement learning emphasise the development of competence and safe practice. Professional development is a key theme throughout programmes. A diverse range of options is offered to students in the third year of the BSc. This enables them to advance their basic skills and further their specialist interests.
50 The MSc Health Sciences provides another example of the strong interprofessional emphasis in the IoH. The programme reflects multidisciplinary approaches to healthcare. It brings together students with a wide range of professional backgrounds to explore the theory and practice of healthcare. The core of the MSc is a unit in research methods that leads to a dissertation in the student's own area of interest. Through this dissertation, students are encouraged to provide new perspectives on their professional roles and the future development of healthcare services. A themed route on the MSc Health Sciences has now replaced the MSc Manipulative Physiotherapy.
Assessment
51 Assessment of the BSc and MSc PT and the MSc Health Studies complies with UEA regulations and procedures. The requirements of CSP and HPC are met and practices are consistent with the Code of practice.
52 Assessment in physiotherapy is based mainly on coursework assignments that are designed to test the ILOs. There is clear mapping of the ILOs against assessment. On the MSc, wherever possible, assessment is linked to practice in order to enhance the integration of theory and practice. Assignments are appropriate both to test acquisition of professional competencies and academic performance at postgraduate level. The assessment strategy on the BSc is designed to encourage student progression by developing problem-solving and analytical skills. A mapping exercise has been undertaken to ensure that a diversity of assessment methods is being employed on the BSc.
53 Practice skills and competencies are assessed both formatively and summatively to foster student achievement. There has been considerable debate over the desirability of the grading of placements. The programme team considers that the award of grades is an important recognition of the vital role of practice and motivates the students. However, it has led, in some instances, to concerns being expressed by students over the level of grades awarded and the danger that some students might focus too much on the grade they achieve at the expense of taking full advantage of the breadth of experience offered by each placement.
54 During 2003, there was a concern about the relatively low level of knowledge of anatomy and physiology displayed by students when they were in practice. To address this problem, the School, with the support of the external examiners, has completely revised the testing of these subjects. In place of coursework assignments, students now undertake an unseen written test. In preparation for the test, students complete workbooks and, from this year, there is a formative assessment which follows the same format as the final test. Students are very positive about the value of the workbooks. External examiners write positively about the efforts to overcome the problem.
55 Students are provided with clear guidelines on assessment methods, submission dates and marking criteria. Information on practice assessment ensures that students are well prepared and practice educators confirm this. MSc Health Sciences and PT students are issued with particularly helpful guidelines on the writing of dissertations. First-year BSc students are given individual guidance, when required, on the completion of assignments, including advice on plans and drafts. In order to ensure equity of support, information on second-year assignments is given on a group basis, with a single session devoted to briefing and questions on each assignment. While students recognise the reason for this approach, some of them consider that the withdrawal of individual support leaves them without adequate guidance.
56 Marking of the student work scrutinised by the reviewers was generally fair and equitable. Although there is generally a high level of consistency among markers, there was some concern expressed by an external examiner that the marking of the reflective essays is not as well standardised. Clear marking guidelines, specific to each level of award, assist academic markers and placement educators. Wherever possible the anonymity of the student is preserved on assignments. Double-marking and moderation is carried out according to the publicised guidelines. Training in assessment is available to both academic staff and practice educators and there is appropriate support available for those new to marking or who undertake the activity infrequently. Feedback provided to students on their assignments is generally timely and supportive to student learning. External examiners are fully involved in the assessment process and timely response is made to their comments.
Student achievement
57 A wide range of assessed student work was scrutinised during the review. This was drawn from the pre-registration BSc (Hons) PT, MSc PT and the post-registration MSc Health Sciences and MSc Manipulative Physiotherapy. The work included essays, reports, learning contracts and dissertations. It provided evidence to confirm the judgement of the external examiners that students are achieving the ILOs and are producing work of an appropriate standard for the level of the awards. This view was supported by a 2005 managers' and graduates' survey which showed that students feel that they have met the learning outcomes of the programme and these students were welcomed by the managers as employees.
58 Despite the changes made to the assessment of human sciences over the past two years, an external examiner has expressed concern about the standards being achieved in biological and physical sciences by students on the BSc PT in year one. The examiner suggests that they are not consistent with national standards or HPC Standards of Education and Training Guidance for Education Providers (SETs) and considers that, while higher-achieving students do attain appropriate standards, students with lower grades are demonstrating poor performance and still passing. The School's view is that through further study in years two and three, all students achieve the HPC SETs at graduation (when the SETs apply), but it is actively investigating ways in which student achievement in the year one unit in Human Sciences can be improved. Workshops involving external examiners are taking place, formative assessment has been brought into line with the summative, and further learning support for failing students provided. Pre-programme reading is provided and pre-admissions support is being considered.
59 External examiners confirm a high level of achievement by students on the postgraduate programmes. This is also supported by the work reviewed on both the MSc Health Sciences and the MSc Manipulative Physiotherapy and comments from students on both programmes, who felt well prepared for their role. Recruitment to the MSc Manipulative Physiotherapy has now ended and been replaced by a themed route within the MSc Health Sciences.
60 The profile of awards on the BSc (Table 1c) shows a very high level of achievement on the programme with 100 per cent of the 2000, 2001 and 2002 entry cohorts gaining a First or Second class honours degree. The high achievement of the students is endorsed by the external examiners' reports for these three years. There is also a 100 per cent achievement rate in the post-registration programmes. The first cohort on the pre-registration MSc PT is yet to complete.
61 Graduates have a high level of success in gaining employment, despite the national trend, although the statistics do show a decline. A 100 per cent of the 2000 entry cohort, 94 per cent of the 2001 entry cohort and 72 per cent of the 2002 cohort have been successful in gaining employment (Table 2c). This situation is being monitored by the SHA and the University with the recognition that many local Trusts are facing financial problems that may affect recruitment and opportunities for graduates. Under half of the graduates work in local services: 40 per cent in 2000, 47 per cent in 2001 and 34 per cent in 2002.
Table 1c: Completion and achievement statistics for all award-bearing programmes in physiotherapy
| Programme | Cohort |
Degree classification | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||
| No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc Physiotherapy | Sept 2000 | 4 | 8 | 38 | 81 | 5 | 11 | 0 | 0 | 0 | 0 | 0 | 0 |
| Sept 2001 | 2 | 4 | 38 | 85 | 5 | 11 | 0 | 0 | 0 | 0 | 0 | 0 | |
| Sept 2002* | 6 | 13 | 31 | 66 | 10 | 21 | 0 | 0 | 0 | 0 | 0 | 0 | |
* plus 1 intercalator not yet completed
| Programme | Cohort |
Master's programmes |
Master's programmes |
||
|---|---|---|---|---|---|
| Pass | Fail | ||||
| No. | % | No. | % | ||
| MSc Health Sciences | 1998-99 | 28* | 100 | 0 | 0 |
| 1999-2000 | 18** | 100 | 0 | 0 | |
| 2000-01 | 21*** | 100 | 0 | 0 | |
* of which 7 awarded PgDip
** of which 5 awarded PgDip
*** of which 6 awarded PgDip, 2 awarded PgCert
| Programme | Cohort |
PgDiploma programmes |
PgDiploma programmes |
||
|---|---|---|---|---|---|
| Pass | Fail | ||||
| No. | % | No. | % | ||
| PgDip Health Sciences | 1998-99 | 1 | 100 | 0 | 0 |
| 1999-2000 | 5 | 100 | 0 | 0 | |
| 2000-01 | 2 | 100 | 0 | 0 | |
| Programme | Cohort |
Master's programmes |
Master's programmes |
||
|---|---|---|---|---|---|
| Pass | Fail | ||||
| No. | % | No. | % | ||
| MSc Manipulative Physiotherapy | Sept 1997 | 2 | 100 | 0 | 0 |
| Sept 1998 | 2 | 100 | 0 | 0 | |
| Sept 1999 | 2* | 100 | 0 | 0 | |
* of which 1 awarded PgDip
Table 2c: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes in physiotherapy
| Programme | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | No | % | |
| BSc Physiotherapy | ||||||||||
| September 2000 | 0 | 0 | 19 | 40 | 28 | 60 | 0 | 0 | 0 | 0 |
| September 2001 | 0 | 0 | 21 | 47 | 21 | 47 | 0 | 0 | 3* | 6 |
| September 2002 | 0 | 0 | 16 | 34 | 18 | 38 | 0 | 0 | 13** | 28 |
* 2001 other - 1 travelling, 1 employed in sales, 1 employed in hospitality
**2002 other - all unknown except 1 x office temp
Summary of academic and practitioner standards for physiotherapy
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Physiotherapy at the University of East Anglia in partnership with Norfolk, Suffolk and Cambridgeshire Strategic Health Authority.
Strengths
- Physiotherapy students are provided with wide-ranging experience of interprofessional learning (paragraph 47).
- There is strong integration of academic and placement learning in physiotherapy, which is achieved by close matching of practice placements to the academic curriculum (paragraph 48).
Weakness
- Despite the changes made to the assessment of human sciences over the past two years, an external examiner has expressed concern about the standards being achieved in biological and physical sciences by students on the BSc Physiotherapy in year one (paragraph 58).
B4 Speech and language therapy
Intended learning outcomes
62 The ILOs for the BSc (Hons) SLT were informed by the HPC Standards of Proficiency, the professional standards as articulated by Royal College of Speech and Language Therapists (RCSLT) and the Subject benchmark statement for speech and language therapy, and are consistent with the FHEQ, both published by QAA. They are defined in the programme specification as a series of competencies and knowledge and understanding of pertinent subject areas, specific cognitive skills and practical, subject-specific skills. A curriculum map demonstrates how the ILOs relate to the aims of IoH provision and the interests of local Trusts and the SHA.
63 ILOs are outlined in the validation document (2004) and in the programme information on the virtual learning environment (VLE). Specific learning goals for clinical placements are outlined in the student general placement information, and in the Placement Educators' Handbook. Monitoring of the ILOs takes place through feedback from external examiners' reports, and feedback from clinical staff at consultation days. Both students and clinicians are aware of the ILOs.
Curriculum
64 The curriculum of the recently-introduced BSc SLT has been designed taking full account of the Subject benchmark statement for speech and language therapy and the FHEQ. The validation report confirms that the curriculum meets the professional standards of the RSCLT. It was developed in close collaboration with local NHS staff and service-user groups.
65 Effective currency of the curriculum is ensured through collaborative development and delivery with clinical partners. The evidence base for the curriculum is ensured through research and CPD activity by staff. During their first year, students participate in the CIPP IPL sessions and, for subsequent years, tailor-made arrangements are being put in place involving other relevant groups such as trainee teachers.
66 The client/patient is held at the centre of the curriculum through PBL and through involvement of service users as trainers and formative assessors. Use of PBL effectively promotes study skills, self-directed study and intellectual progression. Practice placements in formal SLT settings start for students on the BSc on the second year of their programme. For first-year students, working in conjunction with the community disability network Connect UK, a scheme of conversation partner placements has been developed. During the early part of their programme, students make weekly visits to adults with aphasia for the purposes of supported conversation and then have a block placement with children and adolescents to develop play partner and conversation partner skills. The conversation partner placements in SLT enhance the integration of theory and practice in the early stages of the programme. Integration is further enhanced by a series of practical workshops, including input from SLT practitioners and use of placement material in teaching. The SLT programme supports a gradual learning process across the three years. Student progression is managed through three distinct but interlinked levels: conversation partner, therapy facilitator and pre-registration SLT.
Assessment
67 Assessment practice on the BSc SLT complies with the requirements of the RCSLT and HPC and university requirements. Assessments are clearly mapped against the ILOs on all the three levels of the curriculum. Tasks have been designed to test progressively the application of theory to practice, critical analysis, clinical reasoning and reflective practice. Assignments are appropriately matched to the levels and curriculum content. An extensive range of formative and summative assessments is employed. The assessment of the conversation partner placements on the SLT programme is particularly well thought out. It includes assessment and formative feedback from service users, and self and peer assessment. Self and peer assessment also occur in IPL.
68 Clinical practice contributes towards the honours classification of the award and must be passed. Clinicians are involved in the assessment process in a variety of ways. At the programme design stage, they were extensively consulted on processes to be used. After comments from practice educators, placement assessment forms were altered to differentiate more clearly between the different skills and competences required in the second and third year. Practice educators are paired with academic staff to assess conversation partner presentations and other material as part of the end-of-year SLT portfolio. They are also involved in the assessment of the SLT portfolio. Training in the accurate and consistent use of assessment processes forms part of the agenda for placement educator training workshops. Feedback has been positive about the first two such workshops, and there will be two more before the first clinical placements take place. Participation in the workshops is not mandatory but clinicians are encouraged to attend. The intention is also to run further sessions aimed at more experienced educators.
69 Students receive clear written guidance on the nature of the work expected and how it will be evaluated. Additional guidance is provided to first-year students in the form of scheduled workshops on individual assignments. Each assignment is given formative feedback as well as a mark. Feedback seen by the reviewers was constructive and supportive to student learning. Students have the opportunity to discuss the feedback with their personal tutor.
70 Particularly detailed and specific grade descriptors have been developed for assessment of both academic assignments and practice and are being piloted in SLT. Appropriate standards of assessment are applied consistently. Marking of student work scrutinised by the reviewers was fair and equitable, and there was clear evidence of moderation of academic work. Examination scripts are double-marked. It is evident that external examiners play a key role in monitoring assessment and their concerns are promptly responded to.
Student achievement
71 Scrutiny of the student work made available to the reviewers confirms that the students are achieving the set ILOs. This aligns with the view of the external examiner. A wide range of work was reviewed, including class tests, anatomy and physiology multiple-choice questions/short answers, essays, team poster and assignments.
72 This is a new programme and, at the moment, there is no evidence available concerning student achievement beyond the first year. Feedback on the first year highlights that the students are achieving the standard in line with other universities and the best students are producing very high-quality work. The external examiner offered particular praise for the commitment of the team in providing a learning environment that is conducive to high achievement by students and underpinned by strong research.
Summary of academic and practitioner standards for speech and language therapy
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Speech and Language Therapy at the University of East Anglia in partnership with Norfolk, Suffolk and Cambridgeshire Strategic Health Authority.
Strength
- Particularly detailed and specific grade descriptors have been developed for assessment of both academic assignments and practice and are being piloted in speech and language therapy (paragraph 70).
Good practice
- The conversation partner placements in speech and language therapy enhance the integration of theory and practice in the early stages of the programme (paragraph 66).
- The assessment of the conversation partner placements on the speech and language therapy programme is particularly well thought out (paragraph 67).
C Quality of learning opportunities
Learning and teaching
73 The University's mission statement and its learning and teaching and research strategies provide a coherent direction for the planning, implementation and evaluation of learning and teaching opportunities for students in undergraduate and postgraduate programmes. A wide range of learning and teaching methods is employed, including e-learning. E-learning is used particularly effectively across programmes. The VLE supplied is actively used by staff and students not just for communication but to promote access to learning materials and enhance learning. The case materials used in teaching and learning are particularly appreciated by students and make a valuable contribution to the integration of theory and practice. Students also select their own patient data to discuss in their assessments. In addition to case presentations, this helps to put the patient/client at the centre of students' learning. Videorecording is successfully employed to bring realism to learning. For example, it is used in SLT to highlight best practice and to develop reflection and self-appraisal.
74 Practice-based learning (PBL) is positively viewed by most students on those programmes where it is employed; BSc SLT and MSc OT/PT pre-registration. On the MSc, students are given a formal induction into the methodology. Students consider that PBL develops their reasoning skills and praise the quality of the triggers used. Some students are reluctant participants in the presentations but recognise that the skills acquired are valuable. On the BSc OT/PT, students apply the knowledge gained from lectures to case-studies, using scenario-based problem-solving rather than PBL. Independent learning is also developed in undergraduate programmes, for example, by the use of workbooks in human sciences. Some students expressed the view that they would appreciate greater feedback on the use of these workbooks. In response to this, students have arranged a workshop to discuss the more difficult questions.
75 PBL is generally well organised. Students feel well prepared for placements. Students and trainees report overall positive learning environments in placements with ample opportunities and support to achieve the ILOs. Theory and practice are well integrated. In physiotherapy, where placements are organised to correspond to the preceding academic module, the integration between theory and practice is particularly impressive. In the few instances where this synchrony did not occur, appropriate changes were made in the placements of physiotherapy students to promote academic and practice integration.
76 Students gain experience of IPL through a variety of mechanisms in both placement and academic settings. In clinical psychology, IPL is currently confined to the trainees' placement learning. Shared learning is widespread, most particularly in OT and PT where students engage in common learning in approximately 50 per cent of their programmes. The approach is flexible, however. For example, PT and OT MSc students are now taught separately for human sciences, in recognition of the fact that their prior experience in this area is generally very different. Some of the learning on the joint OT/PT modules is shared teaching, with both groups attending the same lectures. Other sessions are genuinely interprofessional, with students working in small groups on specific cases, bringing their different professional perspectives to bear. Especially in the later years of their studies, students confirm the benefits of IPL in breaking down stereotypes about other professions and clarifying their own professional roles. The sessions organised by the CIPP bring together students from OT, PT, SLT, midwifery, nursing, medicine, pharmacy, operating department practice and paramedic sciences. The intention behind this programme is laudable and students recognise the value of gaining an insight into the culture and perceptions of other professions and of the team-building aspect of the exercise. However, students are critical of the method of delivery of the IPL programmes provided by the CIPP. Some students described the case-studies selected as not useful, were critical of the assessment method and considered the timing of the programme problematic. Although students were very forthcoming in their comments to the reviewers, the extent and nature of their criticism does not appear to be reflected in the CIPP's own evaluation of the programmes. However, the AHP team confirm that they are aware of negative student feedback, and it will be raised at the CIPP steering group.
77 Research and scholarship actively inform staff teaching and ensure its relevance and currency. Service users make a valuable contribution to learning in both academic and placement settings. This comes in a variety of ways: teaching sessions by patients/clients and carers, use of conversation partners, and expert patients in a clinical setting.
78 Peer review of teaching operates to enhance the quality of teaching. Probationers are required to undergo this review as part of the induction process. Arrangements for other staff vary within the University. AHP staff are required to be peer reviewed at least every two years, while there is no stated time frame for clinical psychology staff. Results are fed into the staff appraisal and management review process. Guest lecturers and external lecturers are not part of this formal review process. For feedback on their contributions, AHP adopts an informal mechanism, whereas there is systematic collation of feedback on external contributors to the clinical psychology programmes. Clinical psychology staff plan to discuss peer observation with their external lecturers in the near future.
The quality of learning and teaching is commendable.
Strengths
- E-learning is used particularly effectively across programmes (paragraph 73).
- The case materials utilised in teaching and learning are particularly appreciated by students and make a valuable contribution to the integration of theory and practice (paragraph 73).
- Videorecording is successfully employed to bring realism to learning (paragraph 73).
- Students consider that problem-based learning develops their reasoning skills and praise the quality of the triggers used (paragraph 74).
Weakness
- Students are critical of the method of delivery of the interprofessional learning programmes provided by the Centre for Interprofessional Practice (paragraph 76).
Student progression
79 The University has clear admissions and selection procedures for all programmes. All prospective students for the pre-registration programmes under review are interviewed before an offer of a place on a programme is made. Applicants for the BSc OT/PT/SLT are interviewed by both a member of AHP and a practising clinician. NHS partners are involved in planning the admissions criteria, shortlisting and interviewing for the ClinPsyD. Applicants with disabilities are invited to attend a visit day during which they have the opportunity to meet with the disability coordinator to find out about programme delivery, physical access and accommodation needs. Structured induction days are held for all students accepted to the programmes.
80 Handbooks for all programmes offer information about campus and practice-based support. All students are allocated an adviser, whom they are required to meet at least three times in an academic year, for academic and professional advice and pastoral support. Students understand how to contact their adviser for individual appointments, and sessions on a one-to-one basis between student and adviser are timetabled in the ClinPsyD programme. In addition, students on the BSc OT, PT and SLT are expected to attend a timetabled group session with their adviser at least three times a year. Students are happy with the support received from advisers.
81 The Dean of Students' Office offers advice on careers, counselling, grant and loan funds and learning enhancement and also gives support to students with physical or sensory disabilities or specific learning difficulties. Learning enhancement tutors use a range of resources, including guidance on academic writing, supported by leaflets and a website. There is a system of residential tutors who provide peer support and play a key role in promoting the welfare of students in UEA accommodation.
82 During meetings with students on the BSc OT and the BSc PT programmes, the reviewers found that students were generally satisfied with the level of assignment pre-submission advice from AHP staff available to them in year one and the dissertation-specific support offered in year three. Individual pre-submission advice for students in year two has been withdrawn as a result of staff members' concerns that the numbers of students seeking pre-submission advice was increasing, that some individual students were questioning multiple members of AHP about the same assignments, and that some students, having received feedback on their approach to an assignment, were relaying information to other students outside of the specific and personal context. Although pre-submission assignment-specific support has been withdrawn, AHP staff have implemented alternative practices to offer second-year students support with assignments. The student handbook has been refined to state clearly and explicitly the assessment task and criteria, assignment feedback has been developed to include the annotation of scripts across all years, and unit coordinators can give email feedback to the whole cohort to clarify issues raised by students in relation to specific assignments. Staff also hold one-off group pre-submission sessions relating to each unit of study. External examiners support this strategy. Students are aware that individual pre-submission-specific advice is withdrawn during year two and that, instead, there are group supervisions. However, they did not feel so fully informed about the other strategies in place. Generally, students expressed dissatisfaction to the reviewers about the current arrangements for year two pre-submission assignment support.
83 For the programmes in OT and PT, specific, placement-related tutorials and placement handbooks offer preparatory information. For the physiotherapy students, the placement team is always able to allocate students to a placement which matches the order of the academic curriculum. Clinical psychology trainees undertake pre-placement visits and agree learning contracts with their supervisors as a means to structure progression while on placement. AHP operates effective mechanisms to offer practice-based support for students and practice educators. University staff undertake a minimum of one placement visit for all placements except the elective to monitor student progress. Students, clinical psychology trainees and practice educators and clinical psychology supervisors were unanimously positive about the support received from university staff and CPFs. In respect of OT and PT, the contribution of the CPFs is particularly highly valued. Students cited timely and effective contact from university staff. Practice educators and supervisors particularly value the assistance they receive when a student is experiencing difficulties during the placement.
84 A systematic approach to the evaluation of placement education is in place. This consists of student feedback from placement, visits from school staff and CPFs, and feedback from practice educators and supervisors. Practice educators and supervisors are offered educator courses, update days, either at the University or in their workplace, and comprehensive practice placement handbooks to support them in their role as student educators.
85 Attrition rates for the ClinPsyD, the BSc OT and the BSc PT are low and demonstrate effective student progression throughout the programmes of study. No more than a single student has withdrawn from each of the recent cohorts on the ClinPsyD. On the BSc OT, withdrawals average 8 per cent over the past three cohorts and, on the BSc PT, withdrawals and discontinuation account for only 6 per cent on average of those enrolled. No cohort has yet completed on SLT, but no students have withdrawn or discontinued to date.
The quality of student progression is commendable.
Strengths
- In respect of occupational therapy and physiotherapy, the contribution of the clinical placement facilitators is particularly highly valued (paragraph 83).
- Attrition rates for the Doctorate in Clinical Psychology, the BSc Occupational Therapy and the BSc Physiotherapy are low and demonstrate effective student progression throughout the programmes of study (paragraph 85).
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. | % | ||
| Doctorate in Clinical Psychology | |||||||||
| October 2000 | 20 | 1 | 5 | 0 | 0 | 0 | 0 | 0 | 0 |
| October 2001 | 22 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| October 2002 | 24 | 1 | 4 | 0 | 0 | 0 | 0 | 0 | 0 |
| BSc Occupational Therapy | |||||||||
| September 2000 | 45 | 3 | 7 | 1 | 2 | 3 | 7 | 0 | 0 |
| September 2001 | 50 | 4 | 8 | 0 | 0 | 0 | 0 | 0 | 0 |
| September 2002 | 50 | 4 | 8 | 0 | 0 | 1 | 2 | 0 | 0 |
| BSc Physiotherapy | |||||||||
| September 2000 | 50 | 3 | 6 | 1 | 2 | 1 | 2 | 0 | 0 |
| September 2001 | 50 | 3 | 6 | 0 | 0 | 1 | 0 | 1 | 2 |
| September 2002 | 50 | 2 | 4 | 1 | 2 | 1 | 2 | 0 | 0 |
Learning resources and their effective utilisation
86 There are strong links between NSCHA and UEA through the Course Training Committee for clinical psychology and the Regional Managers Forum for OT/PT. The primary partnership between Trust partners and the IoH is through service managers, but involvement of the University with Trusts at board level is envisaged for the future.
87 The University has an overall strategy for the provision of learning resources to enhance the quality of the learning and teaching environment. There is evidence of investment in, and maintenance of, high-quality learning resources, and the provision of resources can be seen to contribute to the learning experience in a variety of positive ways. The learning resources underpin the provision and contribute effectively to the achievement of the ILOs.
88 Academic staff are involved in determining resource needs. There is a process of budget and resource review, in which staff are involved in the identification of emerging needs, which are handled responsively. Resources are devolved down to individual schools. There is dedicated teaching space linked to resource need and staff are responsible for room bookings. Appropriate, dedicated teaching space is available for AHP. More generally, zoning for IoH provision is being developed.
89 The University's recognition that its academic staff are fundamental to the delivery and success of programmes is facilitated by recruitment and appointment policies, teaching fellowships and mentoring. The programmes under review have an adequate number of staff with the appropriate expertise to facilitate the students' learning experience. Annual appraisal of academic staff is used effectively to assess their ongoing training needs. A development plan is formulated, including support and funding for research projects. This contributes to the quality of delivery of the programmes.
90 Placement learning is an integral part of all programmes and an opportunity to apply theory to practice. In clinical psychology, supervisors are responsible for trainees on placement. Practice educators are qualified practitioners who support OT and PT students during practice. In addition, the SHA has funded CPFs who provide an excellent service in supporting the practice educators and act as a link with the University. CPFs play a highly valuable and distinct role. They provide education and support for both students and placement educators and are valued highly by all placement educators. They have initiated the development and introduction of resource files to most areas used for OT and PT placements, and these are greatly appreciated by students. The continuity of funding for CPFs is uncertain. The value of the role is recognised by both the SHA and the University, and consideration is being given to strategies that will maintain the important service that CPFs provide. Practice educators receive initial training from the University but there is no formal requirement from the professional bodies for training or updates. The University runs regular workshops and updates for clinical educators that are led by the placement facilitators, with the content of programmes being determined by the needs of the clinicians. Some PT and OT clinical educators have also accessed the ACE and APPLE schemes which will give them a nationally-recognised qualification in clinical education. At the time of the review, no students of SLT had yet embarked on practice placements and thus no placements were visited by the reviewers. However, in discussions with staff, the reviewers were reassured that arrangements are already in place to provide appropriate clinical experience for students when the time comes.
91 Students give feedback on practice placements to the University which is then discussed with personal advisers and relayed back to the placement providers as a report. Clinicians and students recognise the importance of this system in enhancing the quality of placements. CPFs are actively involved in this feedback process.
92 Clinical psychology trainees give individual feedback direct to supervisors. They find that this can be rather daunting if they have negative comments to make about the quality of supervision, especially given the crucial role of the supervisor in the assessment of the trainee. In the event of such a problem, it is recommended in the programme handbook that students approach their adviser.
93 There is a good range of dedicated, specialist accommodation for OT, PT and SLT. This includes creative therapy areas, a lecture theatre, a multisensory room shared with social services, anatomy rooms and controlled access to cadavers. OT and PT students report no problems with the standard of accommodation or its appropriateness. The clinical psychology trainees raised problems over the teaching accommodation allocated to their subject in the University, describing it as not always conducive to the approach to teaching and learning on their programme. ClinPsyD trainees also experience a lack of space on placement. This latter problem is recognised by the University and is the subject of dialogue with the Trusts. SLT programmes have a communication laboratory with PCs and software for speech and video analysis. Students also use videos as a specialist resource, with one camera between two students. These are particularly utilised when students are involved in conversation partner placements in their first year, both with adults and children. The placement with adults gives students the opportunity to develop skills in facilitating communication with adults with aphasia. Feedback is then given to the student by the conversation partner. This process is valued by the students and service users and is a good example of collaboration between the University and service users.
94 The provision of information technology (IT) facilities at the University is extensive. The VLE is generally well used by students and can be accessed by any computer. The 24-hour IT area located in the university library is appreciated by students. MSc and ClinPsyD students are also able to borrow laptop computers. There is additional technical support within AHP which is valued by both staff and students.
95 For 39 weeks a year, the library is open seven days a week for a total of at least 76.5 hours a week, 0830 to 2100 Monday to Friday, 1100 to 1700 on Saturday and 1100 to 1900 on Sunday. Some students reported that they would prefer the library to open earlier on Saturday and Sunday. The library staff offer support to students and staff in accessing books, journals and electronic journals and searches, both on induction and in regular training sessions. Students spoke positively to the reviewers about library holdings, particularly the e-journals. Availability of books was not seen as a problem. Students and trainees also have access to Trust and hospital libraries.
96 Service users and clinicians are an important learning resource. The University involves clinicians in interviewing, teaching and assessment of academic assignments as well as competencies in practice. Videos of assessments and treatments are shown as a teaching aid, to demonstrate the application of theory to practice. Service users are increasingly being invited into the classroom setting, to allow students the opportunity to experience real life presentation of pathology and disease.
The quality of learning resources and their effective utilisation is commendable.
Strengths
- Annual appraisal of academic staff is used effectively to assess their ongoing training needs (paragraph 89).
- There is a good range of dedicated, specialist accommodation for occupational therapy, physiotherapy and speech and language therapy (paragraph 93).
D Maintenance and enhancement of standards and quality
97 The self-evaluation document (SED) is informative and enabled a review of pertinent issues. These were explored and clarified during the visits by the reviewers. However, the SED is not evaluative and did not examine, for example, the issue of the poor performance of OT and PT students in human sciences, although it was referred to in the SED appendices and well documented elsewhere in the information provided for the reviewers. The SED also made it difficult to discriminate between the OT and PT programmes, although the reviewers found that there are, in fact, some significant differences.
98 The University keeps its regulatory procedures continually under review. The IoH and Schools of AHP and MED and Practice have clear practices which facilitate and maintain quality and enable development opportunities. A range of mechanisms for the monitoring and development of quality is in place at university, faculty and programme level. These are explicit and readily tracked to the student experience.
99 The IoH Learning and Teaching Quality Committee is responsible for processing and agreeing changes to programme content. Agreed changes are conveyed through students' and educators' handbooks and annual managers' meetings. The University is currently implementing a new and enhanced student record system. This will complement previously mentioned monitoring procedures and add clarity to understanding components of the student experience. Standardisation of marking schemes and feedback to students is explicit within individual programmes and transparent in examples of student work.
100 External reference points are fully taken into account in the development of programmes and procedures. Professional, statutory and regulatory body requirements, FHEQ and subject benchmark statements are referred to in the development of each undergraduate programme. Benchmarks are not applied to postgraduate ILOs except in instances of pre-registration M-level courses and the ClinPsyD. University and school procedures take cognisance of the relevant sections of the Code of practice, notably in respect of placement learning and external examining.
101 Numerous examples of collaborative involvement of the SHA, managers, clinicians, service users and students were cited during the review. This collaboration contributes to the development of the curricula, formulation of the ILOs, provision and audit of placement, assessment of practice, training and update for clinicians. There is evidence of a strong partnership between the University, the SHA and Trusts in terms of commitment to student education. Additionally, there is a desire to continue to enhance and expand this relationship in the context of health, social and educational change across the region.
102 The process of maintaining and enhancing the quality of the student experience is evident through a range of consultative processes. Student handbooks give explicit information on lines of communication. Students consider the University to be responsive and were able to give the reviewers several examples where action had been taken in response to their concerns. Mechanisms for identifying issues regarding student progression and achievement are effective in highlighting issues for change, and the University is responsive to such indicators. The University also takes timely action over concerns expressed by external examiners. There is proactive use of the external examiners in the process of enhancing the student experience. For example, external examiners have been closely involved in the process of trying to find a solution to weak performance by OT/PT students in human sciences.
103 Students and practice educators play an important role in offering feedback to the University on the practice placement experience. Responses to student and educator evaluations of programmes is evidenced through annual monitoring and development processes and located in action plan documentation. There is a particularly impressive clinical placement audit process for the ClinPsyD, involving audit triangulation with the Trust's own evaluation of clinical education, the trainee feedback on their experience and the University's statistics on student progression and achievement. The SHA and University show a joint determination to overcome challenges, such as local issues of recruitment and job availability and funding for CPFs.
Strength
- There is proactive use of the external examiners in the process of enhancing the student experience (paragraph 102).
Good practice
- There is a particularly impressive clinical placement audit process for the Doctorate in Clinical Psychology (paragraph 103).
Action plan
July 2006
University of East Anglia and East of England Strategic Health Authority (formerly Norfolk, Suffolk and Cambridgeshire Strategic Health Authority)
We have discussed and agreed the following action plan:
Title of organisation (Lead SHA/WDC):
East of England Strategic Health Authority
(formerly Norfolk, Suffolk and Cambridgeshire Strategic Health Authority)
Signature: Mr Paul Steward
Position: Head of Education and Commissioning
Title of organisation (HEI):
University of East Anglia
Signature: Dr Jill Robinson
Position: Associate Dean for Learning and Teaching, Institute of Health
| Component | Strengths/Weaknesses | Actions to be taken | Target completion date/s | Constraints preventing delivering the action required | Impact of not delivering the action required | Lead responsibility (organisation/s and person/s)Name and title of organisation | Evidence of quality enhancement |
|---|---|---|---|---|---|---|---|
Academic and practitioner standards |
Strengths
|
Publish article on case presentations in professional journal (special edition on innovations in clinical psychology training) |
December 2006 |
Staff time for publication/ developmental work outside of core activities |
Benefits of clinical psychology's experience would not be demonstrated across sector |
Co-Directors, ClinPsyD programme |
Take up by other programmes of methods used |
Inform further development of assessment arrangements for relevant unit of UEA's MB/BS programme |
July 2006 |
|
|
|
|
||
|
Continue use of current feedback forms and maintain four-week quality standard in clinical psychology |
Ongoing monitoring for clinical psychology, with review of feedback times by July 2007 |
Any reduction in available staff resources (faculty or support staff) |
Deterioration in educational value of feedback to trainees |
Co-Directors, ClinPsyD programme |
Maintenance of standard set in clinical psychology |
|
Consider feedback form arrangements on comparative basis across IoH |
July 2007 |
|
Benefits of clinical psychology's experience would not be shared |
IoH Associate Dean for Learning and Teaching |
Adaptations to other programmes' use of feedback forms, based on examples of good practice |
||
|
Continue to emphasise interprofessional learning as an important underpinning for all pre-registration curricula and specifically recognise and describe this strength, internally and externally, in planning for re-approval of the BSc programmes in 2007 |
Spring 2007: re-approval by HPC and UEA and re-accreditation by professional bodies of BSc OT, PT and SLT u/g curricula |
Any reduction in available staff resources (faculty or support staff) |
Risk lack of recognition of this strength, with potentially adverse impact upon re-approval process, student recruitment and employer awareness |
Course Directors for all pre-registration programmes, in conjunction with CIPP Director |
Recognition by HPC and professional bodies of IPL at re-approval event/ re-accreditation |
|
Articulate to students and other stakeholders the many dimensions of IPL, including experience on practice placement, linkage with physiotherapy and speech and language therapy and engagement with all pre-registration programmes covered by UEA's Centre for Interprofessional Practice (CIPP) where students from nine professions experience IPL |
June 2007 |
|
|
|
Positive student, practitioner and employer feedback |
||
Continue to evaluate IPL in annual course monitoring |
March each year: review of annual monitoring data |
|
|
|
Positive, explicit outcomes regarding IPL evident in annual monitoring of all pre-registration programmes |
||
Engage with CIPP dissemination (published widely, nationally and internationally) |
December 2007: review of publications/ dissemination strategy |
|
Benefits of innovative joint curricula and other IPL components would not be demonstrated across the sector |
|
Acceptance rate of publications/ dissemination of materials regarding IPL |
||
|
Continue with external consultations in range of fora informing curricula for both BSc and MSc pre-registration programmes |
March each year: review of annual monitoring data |
Any reduction in resource affecting ability of UEA and/or NHS staff to contribute |
Risk loss of currency |
Course Directors for all pre-registration programmes, in collaboration with OT service managers in Trusts |
Currency explicitly addressed in ongoing annual monitoring of all pre-registration programmes |
|
Specifically, involve clinical staff and service users, as well as academic staff, in curricula planning and design being undertaken as part of re-approval process for BSc programmes |
Spring 2007: re-approval by HPC and UEA and re-accreditation by professional bodies of BSc OT, PT and SLT u/g curricula |
|
|
|
Recognition by HPC and professional bodies of currency at re-approval/ re-accreditation event |
||
|
Continue to emphasise interprofessional learning as an important underpinning for all pre-registration curricula and specifically recognise and describe this strength, internally and externally, in planning for re-approval of BSc programmes in 2007 |
Spring 2007: re-approval by HPC and UEA and re-accreditation by professional bodies of BSc OT, PT and SLT u/g curricula |
Any reduction in available staff resources (faculty or support staff) |
Risk lack of recognition of this strength, with potentially adverse impact upon re-approval process, student recruitment and employer awareness |
Course Directors for all pre-registration programmes, in conjunction with CIPP Director |
Recognition by HPC and professional bodies of IPL at re-approval event/ re-accreditation |
|
Articulate to students and other stakeholders the many dimensions of IPL, including experience on practice placement, linkage with occupational therapy and speech and language therapy and engagement with all pre-registration programmes covered by UEA's Centre for Interprofessional Practice (CIPP) where students from nine professions experience IPL |
June 2007 |
|
|
|
Positive student, practitioner and employer feedback |
||
Continue to evaluate IPL in annual course monitoring |
March each year: review of annual monitoring data |
|
|
|
Positive, explicit outcomes regarding IPL evident in annual monitoring of all pre-registration programmes |
||
Engage with CIPP dissemination (published widely, nationally and internationally) |
December 2007: review of publications/ dissemination strategy |
|
|
|
Acceptance rate of public |