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
Occupational therapy, physiotherapy and podiatry programmes at the University of Brighton and the Surrey and Sussex Strategic Health Authority (SHA) were reviewed in the academic year 2004-05. Judgements were made about the academic and practitioner standards achieved and the quality of the learning opportunities provided.
The review covered the following programmes:
Pre-registration programmes:
- MSc Health Through Occupation (Occupational Therapy) (accelerated)
- BSc (Hons) Physiotherapy
- BSc (Hons) Podiatry
- BSc (Hons) Occupational Therapy (Crawley College)
- MSc Rehabilitation Science (Physiotherapy) (accelerated).
Post-registration programmes:
- BSc (Hons) Physiotherapy Studies
- BSc (Hons) Podiatry Studies
- BSc (Hons) Occupational Therapy Studies
- BSc (Hons) Acupuncture Studies
- BSc (Hons) Multidisciplinary Healthcare
- Return to Practice
- PgCert Clinical Education
- PgCert Podiatric Theory
- MSc Manipulative Physiotherapy
- MSc Occupational Therapy
- MSc Physiotherapy
- MSc Podiatry
- Professional Doctorate (Occupational Therapy, Physiotherapy, Podiatry).
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in occupational therapy, physiotherapy and podiatry, with the exception of the BSc (Hons) Occupational Therapy delivered by Crawley College, awarded by the University of Brighton in partnership with the Surrey and Sussex SHA.
Strengths
- The problem-based learning (PBL) philosophy of the MSc Health through Occupation extends through learning outcomes, curriculum design and assessment (paragraph 7).
- Learning outcomes are well articulated in occupational therapy course documentation, module handbooks and practice placement documentation. They are effectively communicated to students, clinical staff and the academic staff, and well understood by them (paragraph 9).
- The majority of MSc Health Through Occupation graduates secure jobs immediately following graduation, thereby demonstrating fitness to practice. Key strengths identified by employers are their level of confidence and good knowledge of the real world working situation (paragraph 24).
- The range of programmes that helps to open entry into physiotherapy from different academic routes, ensures that the continuing professional development needs of practising physiotherapists are addressed, and demonstrates a commitment to ensure that educational opportunities are 'needs led' (paragraph 31).
- The assessment tool in physiotherapy for Module PP109 Introduction to Health Psychology and Communication is particularly laudable and innovative (paragraph 41).
- Employers identified physiotherapy graduates' particular strengths in reflective practice and lifelong self-critical learning (paragraph 44).
- Podiatry students value their practice experience highly. The learning outcomes for placements are written in collaboration with NHS clinicians and students appreciate their clarity (paragraph 54).
- The assessment tool in podiatry for the module Introduction to Health Psychology and Communication is particularly commendable and innovative (paragraph 57).
Good practice
- The Professional Doctorate (Occupational Therapy) programme is innovative, responsive to service development needs and provides an example of good practice for the development of similar programmes in other HEIs (paragraph 8).
- The Professional Doctorate (Physiotherapy) programme is innovative, responsive to NHS service modernisation and staff development needs and offers an example of good practice for the development of similar programmes in other HEIs (paragraph 28).
- A standard clinical assessment form, used by a total of nine education providers, is issued by the BSc Physiotherapy and MSc Rehabilitation Science degrees, in order to reduce an otherwise confusing variety of documentation for clinical educators (paragraph 40).
- The Professional Doctorate (Podiatry) programme is innovative, responsive to service development needs and provides an example of good practice for the development of similar programmes in other HEIs (paragraph 49).
- The assessment of reflection in the podiatry course is underpinned by pedagogical research in this area by the staff teaching team (paragraph 58).
The reviewers have no confidence in the academic and practitioner standards achieved in the BSc (Hons) Occupational Therapy (Crawley College) awarded by the University of Brighton in partnership with the Surrey and Sussex SHA.
Weaknesses
- The rigour and validity of the assessment of the clinical placement component of the programme is compromised because of the omission of important elements in relation to the safe and ethical practice of occupational therapy in a patient-contact situation (paragraph 19).
- There is significant concern that marks awarded to clinical placement elements on the BSc (Hons) Occupational Therapy programme are consistently too high (paragraph 20).
- Both external examiners state that they do not consider that award classifications reflect accurately the true ability of all students. This concern has not been adequately addressed (paragraph 23).
Strengths
- Graduates from the BSc (Hons) Occupational Therapy (Crawley College) are valued by employers in the workplace (paragraph 24).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strengths
- Students are consistently enthusiastic about the use of PBL recognising that this approach equips them with the ability to enquire, to solve problems and proactively to develop their lifelong learning skills (paragraph 65).
- Students are complimentary about the quality of teaching at all levels across all programmes (paragraph 68).
Good practice
- Students who have experienced it are unanimously positive about the student:staff ratio of 2:1 model of supervision for physiotherapy, which the School is keen to promote and extend. They cite the benefits of peer support and increased confidence in trying new experiences and testing out learning with each other (paragraph 71).
Weaknesses
- The pre-registration occupational therapy students at Crawley College have relatively few formal opportunities for IPL (paragraph 66).
- In occupational therapy, clinical educators who have undertaken practice education training in other institutions are not always sufficiently aware of how to incorporate PBL into the placement (paragraph 70).
Student progression
The quality of student progression is commendable.
Strengths
- For those students who have been out of education for more than five years, the School offers a system to identify and give good-quality support to those who may find difficulty bridging the gap between undergraduate and postgraduate study (paragraph 76).
- Clinical educators are provided with comprehensive guidelines and support for their role in supporting, training and assessing students, and feel well prepared to support students during their placement experience (paragraph 81).
- The attrition rates are generally below 10 per cent for 2001, 2002 and 2003 entries to all pre-registration health professional programmes (paragraph 83).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strengths
- Handbooks of creditable quality on all programmes, for both campus and practice-based learning, are very well regarded by both students and practice placement staff (paragraph 87).
- The number and expertise of academic and clinical staff at the University fully support the programmes (paragraph 88).
- The high quality and comprehensive range of equipment in the human movement laboratory at the University contribute significantly to the quality of student learning (paragraph 90).
- Placements are of a high quality, with problems addressed quickly by linking with the relevant school staff who also undertake visits to each placement (paragraph 92).
Good practice
- Studentcentral, the School's virtual learning environment, is integral to the School's learning and teaching provision; students confirm that they make regular use of it to enhance learning, and it provides them with valuable discussion fora and programme and module information (paragraph 87).
- The PPIMS physiotherapy placement management system involves a number of other universities and SHAs, brings a range of benefits to placement quality and is well regarded by practice staff (paragraph 91).
Weaknesses
- The limited amount of time for physical access to University library facilities, particularly in evenings and at weekends during placement periods, has been explored at length by the University but continues to be a source of negative student comment (paragraph 85).
- Students and placement staff identified difficulty with IT access and facilities in placements (paragraph 86).
Maintenance and enhancement of standards and quality
Strengths
- The self-evaluation document is excellent and provided a sound basis for the review (paragraph 93).
- The School has thorough systems of programme review in line with its commitment to quality assurance (paragraphs 93).
Weaknesses
- The quality of the pre-registration BSc (Hons) Occupational Therapy (Crawley College) programme has continued to be a matter of ongoing concern for all stakeholders (paragraph 96).
Introduction
1 This report presents the findings of a review of the academic and practitioner standards achieved, and the quality of the learning opportunities provided, in occupational therapy, physiotherapy and podiatry programmes at the University of Brighton (the University) in partnership with the Surrey and Sussex Strategic Health Authority (SHA). The review was completed during the academic year 2004-05.
2 The University took its present title in 1992. It has developed over sites in Brighton, Hastings and Eastbourne. There are now more than 17,800 students registered for the University's awards. The programmes under review are offered by the School of Health Professions which is one of four schools in the Faculty of Health, based in Eastbourne. There are currently 475 full-time equivalent (FTE) students on pre-registration programmes, together with 43 part-time students at Crawley College. There are 231 students on post-registration programmes, with a further 22 registered for single modules. There are approximately 65 FTE staff responsible for the programmes, of whom 48 are academic and research staff.
3 The Surrey and Sussex SHA, one of the largest of the 28 SHAs, serves a population of approximately 2.5 million and a geographical patch stretching from London to the Sussex coast, and from Chichester in the west to Camber Sands in the east. It provides leadership, coordination and support to the National Health Service (NHS) across this area. The SHA is accountable to the Department of Health which monitors its performance against targets set out in the NHS Plan. The SHA places contracts with the School and Crawley College for pre-registration programmes in occupational therapy, physiotherapy and podiatry. Post-registration programmes and modules are not currently commissioned by the SHA, but person training day money contributes to a small extent to financing this provision.
A Subject provision and overall aims
4 Occupational therapy, physiotherapy and podiatry are currently offered in the following programmes:
Pre-registration programmes
- MSc Health Through Occupation (Occupational Therapy)(accelerated)
- BSc (Hons) Physiotherapy
- BSc (Hons) Podiatry
- BSc (Hons) Occupational Therapy (Crawley College)
- MSc Rehabilitation Science (Physiotherapy) (accelerated).
Post-registration programmes:
- BSc (Hons) Physiotherapy Studies
- BSc (Hons) Podiatry Studies
- BSc (Hons) Occupational Therapy Studies
- BSc (Hons) Acupuncture Studies
- BSc (Hons) Multidisciplinary Healthcare
- Return to Practice
- PgCert Clinical Education
- PgCert Podiatric Theory
- MSc Manipulative Physiotherapy
- MSc Physiotherapy
- MSc Occupational Therapy
- MSc Podiatry
- Professional Doctorates (Occupational Therapy, Physiotherapy, Podiatry).
5 The School of Health Professions aims to:
- prepare graduates to be skilled and effective workers, fit for purpose, practice and award, in the health care professions
- provide high quality and well-managed education and training
- value equally academic and professional skills
- offer a comprehensive range of modules and courses that provide an 'education escalator' from pre-registration to PhD for students in the relevant allied health professions
- expand the research culture and research expertise in the allied health professions, to help foster evidence-based practice
- maintain and increase the national and international reputation of the School staff and its courses
- work collaboratively with the SHA, Trusts and other stakeholders.
B Academic and practitioner standards
B1 Occupational therapy
Intended learning outcomes
6 The intended learning outcomes align with and support the overall aims of the provision. Outcomes for the pre-registration BSc (Hons) Occupational Therapy (Crawley College) and MSc Health Through Occupation reflect the subject benchmark statements, published by QAA, and the Health Professions Council (HPC) standards of proficiency for occupational therapy.
7 Intended outcomes emphasising the practice of occupational skills in the MSc Health Through Occupation course are in line with contemporary theoretical developments of occupational science within the profession, and anticipated the 2004 College of Occupational Therapy curriculum framework. The problem-based learning (PBL) philosophy of this programme extends through learning outcomes, curriculum design and assessment. It appropriately emphasises the development of generic outcomes that underpin fitness for practice of new graduate occupational therapists. Curricula have been developed and are reviewed with employer involvement.
8 Learning outcomes for post-qualifying and postgraduate courses are accurately matched to the levels defined in The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ). The Professional Doctorate (Occupational Therapy) programme is innovative, responsive to service development needs and provides an example of good practice for the development of similar programmes in other higher education institutions (HEIs). Pre-registration and postgraduate programmes provide appropriate opportunities to enable students to achieve interprofessional learning (IPL) outcomes. These opportunities are limited for students on the BSc (Hons) Occupational Therapy.
9 Learning outcomes are well articulated in course documentation, module handbooks and practice placement documentation. These are effectively communicated to students, clinical staff and the academic staff, and well understood by them.
Curricula
10 The School demonstrates a strong ongoing commitment to providing a breadth of programmes from level 1 to doctorate, with Foundation Degrees planned. The BSc (Hons) Occupational Therapy part-time degree is an in-service course currently offered over a four-year period at Crawley College through a partnership agreement with the University. The programme at Crawley College will discontinue once the current third and fourth-year students have completed their degrees. The SHA has awarded the contract for the four-year part-time course to the University. The range of post-registration programmes helps to ensure occupational therapists have the opportunity to meet their continuing professional development (CPD) needs.
11 The curricula conform to the University's Common Academic Framework and General Examination and Assessment Regulations, both of which are informed by the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), published by QAA. The curricula and learning outcomes are developed using the professional, statutory and regulatory body (PSRB) guidelines and the Subject benchmark statements for occupational therapy, and have involved the SHA, employers and service users.
12 All new programmes are subject to validation and a decision regarding fitness for award. Pre-registration programmes are validated/approved by the HPC, accredited by professional bodies and commissioned by the SHA. Post-registration programmes are validated by the PSRBs, as appropriate, to determine fitness for practice and fitness for purpose. Employers and service users are also involved in programme development, validation and revalidation. The employers value this in relation to the current programmes in the University, but would welcome more direct channels of communication with the SHA to influence future commissioning of CPD for allied health professionals.
13 PBL is a strength of the MSc Health Through Occupation. The subject staff are recognised nationally as experts in PBL. To ensure the 'trigger' cases are evidence based and clinically focused, they have been written with clinicians and based on their patients. Students find PBL an effective learning process that enhances their self-directed learning and clinical reasoning skills. Practice placement educators see students as strongly self-directed learners.
14 The placement pattern, PBL, a lecturer practitioner and an extensive range of staff activities such as research, clinical practice, academic writing and professional consultation, enhance the links between theory and practice on the pre-registration MSc Health Through Occupation. The BSc (Hons) Occupational Therapy pre-registration programme uses case-study material within the curriculum to enhance these links. Students on the BSc find that the placements challenge their theory base effectively.
Assessment
15 The assessment process for the MSc Health Through Occupation conforms to the University's Assessment Policy, and reflects the guidelines contained in the Code of practice, published by QAA. The MSc also complies with the additional and more detailed school-level guidelines on assessment. External examiner feedback about the degree is positive, and confirms that assessments are in line with master's-level standards and professional standards for occupational therapy.
16 In the MSc Health Through Occupation, assessment tools are used that properly reflect the PBL philosophy which is in turn strongly supported by staff scholarship. The programme includes a number of innovative assessments. Within the module Occupational Therapy: Teams, students are required to draw up and then present a multidisciplinary care plan, followed by a reflection upon their learning experience of working together as a team.
17 Learning outcomes for practice placements are set and assessed at level 3, and campus-based modules, including the dissertation, are set and assessed at master's level in the MSc Health Through Occupation. Fieldwork educators have received specific guidance in the assessment of students using a PBL approach. Detailed information about the process of practice placement assessment is provided to students and to educators in the form of a comprehensive Professional Practice Education Handbook.
18 The BSc (Hons) Occupational Therapy degree delivered at Crawley College is assessed at levels 1, 2 and 3. The standard of assessed work is generally good and demonstrates the use of a wide range of innovative assessment tools and a consistent standard of marking. There is evidence of the use of anonymous marking, of moderation between assessors and of the provision of extensive written feedback to students on the content of their work. However, both external examiners are critical of the processes operated at the College in relation to examination board polices and procedures and to the lack of action taken in response to previous reports until 2004. They attribute this to a difficulty in programme management and to the lack of a programme leader presence.
19 The rigour and validity of the assessment of the clinical placement component of the BSc (Hons) Occupational Therapy (Crawley College) programme is compromised because important elements in relation to the safe and ethical practice of occupational therapy in a patient-contact situation are not assessed on every placement. Feedback from occupational therapy managers and clinicians indicates that the clinical placement assessment form for the BSc was not user-friendly and had been the subject of a number of iterative changes. The ones used to assess students at levels 2 and 3 do not properly address the HPC Standards of Proficiency for Occupational Therapy, March 2004, Standards 1a, 2b and 3a. In every patient contact situation, students should demonstrate professional accountability, to include maintenance of confidentiality and informed consent, and the ability to operate safely. These competences are not specifically identified in the current practice learning assessment forms for levels 2 and 3.
20 The reviewers agree with the external examiners that marks awarded to clinical placement elements on the BSc (Hons) Occupational Therapy (Crawley College) programme are consistently too high and not in due proportion to the marks awarded to academic modules delivered from within the College. This was noted by both external examiners in previous years. The system of calculation of marks on placement modules involves the allocation of percentages to 15 individual competencies, with the final module mark calculated by taking the mean of all of the discrete competency sections. This scoring system may inflate the overall grading, underplays the role of overall professional judgement of practice competence and, consequently, may drive up marks for the clinical placement element to a level which does not accurately reflect students' achievement.
21 Overall, the reviewers are not confident of the rigour and validity of the assessment of the clinical placement component of the BSc (Hons) Occupational Therapy (Crawley College) programme, because of the omission and lack of clarity of important elements in relation to the safe and ethical practice of occupational therapy in a patient-contact situation and because of the inappropriate distortion of marks as a result of consistent over-marking.
Student achievement
22 Students on all post-registration courses demonstrate achievement of the intended learning outcomes. Pre-registration students on the MSc Health Through Occupation (Occupational Therapy), effectively demonstrate achievement of outcomes in line with the FHEQ, the Subject benchmark statement for occupational therapy, and HPC standards of proficiency.
23 For the BSc (Hons) Occupational Therapy (Crawley College), external examiners report the overall level of student achievement to be satisfactory and generally in line with standards achieved in similar honours degree programmes elsewhere in occupational therapy. The sample of assessed student work seen by the reviewers provided further evidence to support the overall satisfactory level of student achievement. Also, the profile of degree classifications indicates that the majority of students obtain Upper and Lower Second class honours awards (Table 1a). However, the annual reports of both external examiners raise repeated concerns that the high marks awarded for the practice education modules inflate the degree classifications. Consequently, both external examiners state that they do not consider that these award classifications reflect accurately the true ability of all students. During the academic year 2003-04, an attempt was made to address this issue. However, the College and the University have not yet fully addressed the continuing concerns of one external examiner about the contribution of the fieldwork results to the final classification. The reviewers are not confident in the effectiveness of practice learning assessment for measuring fairly the achievement of student learning outcomes in practice placements. Therefore, despite the degree classification statistics, and given the importance of the practice element, the reviewers are significantly concerned about the extent of student achievement of the intended learning outcomes in relation to meeting the expectations of the HPC standards of proficiency, the Subject benchmark statement and the FHEQ.
24 First-destination statistics for new graduate occupational therapists indicate a highly satisfactory level of employment (Table 2a). Completion rates from both the pre-registration and postgraduate programmes are high (Table 1a). The majority of MSc Health Through Occupation students secure jobs immediately following graduation, thereby demonstrating fitness to practise. They also progress quickly in their careers. Key strengths of the master's graduates identified by employers are their level of confidence and good knowledge of the real world working situation. Graduates from the BSc (Hons) Occupational Therapy (Crawley College) are also valued by employers in the workplace, this pathway enables therapy assistants to progress to become registered occupational therapists.
25 Employers expressed a very positive view about graduates' preparedness for practice, and the BSc (Hons) Occupational Therapy programme is valued as a pathway to enable therapy assistants to progress to become registered occupational therapists. Graduates are reported as having high levels of commitment to working within the local health community. Employers value post-registration master's courses and the professional doctorate programme, although it was stated that the number of staff that can be supported to attend full master's programmes is low due to service pressures.
Table 1a: Completion and achievement statistics for all award-bearing programmes in occupational therapy
| Programme | Cohort (entry year) | Diploma programmes Pass |
Diploma programmes Fail |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| MSc Health through Occupation (accelerated) | |||||||||||||||||
| MSc Graduated (Next exam board is 15/12/04) | 2004 | ||||||||||||||||
| PgDip Graduated | 2004 | ||||||||||||||||
| MSc Graduated | 2003 | 27 | 100 | ||||||||||||||
| PgDip Graduated | 2003 | 6 | 100 | ||||||||||||||
| MSc Graduated | 2002 | 31 | 100 | ||||||||||||||
| PgDip Graduated | 2002 | 2 | 100 | ||||||||||||||
| BSc (Hons) Occupational Therapy (Crawley College) | 2000 | 1 | 7 | 5 | 36 | 3 | 21 | 2 | 14 | 0 | 0 | ||||||
| 1999 | 1 | 10 | 4 | 40 | 4 | 40 | 0 | 0 | 1 | 10 | |||||||
| 1998 | 2 | 14 | 10 | 71 | 2 | 14 | 0 | 0 | 0 | ||||||||
Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes
| Programme | Further study | Local employers | Employers elsewhere | Unemployed | Other unknown | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| MSc Health Through Occupation | ||||||||||
| Graduated 2004 | 8 | 22 | 10 | 28 | 18 | 50 | ||||
| Graduated 2003 | 7 | 20 | 6 | 18 | 21 | 62 | ||||
| Graduated 2002 | 8 | 24 | 8 | 24 | 17 | 52 | ||||
| BSc (Hons) Occupational Therapy (Crawley College) | ||||||||||
| 2000 | 10 | 71 | 1 | 7 | 3 | 21 | ||||
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, with the exception of the BSc (Hons) Occupational Therapy (Crawley College) programme, at the University of Brighton in partnership with the Surrey and Sussex Strategic Health Authority.
Strengths
- The PBL philosophy of the MSc Health Through Occupation extends through learning outcomes, curriculum design and assessment (paragraph 7).
- Learning outcomes are well articulated in occupational therapy course documentation, module handbooks and practice placement documentation. They are effectively communicated to students, clinical staff and the academic staff, and well understood by them (paragraph 9).
- The majority of MSc Health Through Occupation graduates secure jobs immediately following graduation, thereby demonstrating fitness to practise. Key strengths identified by employers are their level of confidence and good knowledge of the real world working situation (paragraph 24).
Good practice
- The Professional Doctorate (Occupational Therapy) programme is innovative, responsive to service development needs and provides an example of good practice for the development of similar programmes in other HEIs (paragraph 8).
Overall, the reviewers have no confidence in the academic and practitioner standards achieved in the programme in BSc (Hons) Occupational Therapy (Crawley College) at the University of Brighton in partnership with the Surrey and Sussex Strategic Health Authority.
Weaknesses
- The rigour and validity of the assessment of the clinical placement component of the programme is compromised because of the omission of important elements in relation to the safe and ethical practice of occupational therapy in a patient-contact situation (paragraph 19).
- There is significant concern that marks awarded to clinical placement elements on the BSc (Hons) Occupational Therapy programme are consistently too high (paragraph 20).
- Both external examiners state that they do not consider that award classifications reflect accurately the true ability of all students. This concern has not been adequately addressed (paragraph 23).
Strength
- Graduates from the BSc (Hons) Occupational Therapy (Crawley College) are valued by employers in the workplace (paragraph 24).
B2 Physiotherapy
Intended learning outcomes
26 The intended learning outcomes for all programmes align with, and support, the overall aims of the provision. For the pre-registration BSc (Hons) Physiotherapy and MSc Rehabilitation Science the outcomes are mapped in detail against, and accurately reflect, the Subject benchmark statement published by QAA, and HPC standards of proficiency for physiotherapy. Pre-registration outcomes also take appropriate account of the accreditation requirements of the Chartered Society of Physiotherapy. Pre and post-registration programmes are validated/approved by the HPC and the accrediting professional body, as appropriate, to determine fitness for practice. The SHA, employers and service users are also involved in programme development, validation and revalidation.
27 Learning outcomes for post-qualifying and postgraduate courses are accurately matched to the levels defined in the FHEQ. Outcomes for post-qualifying programmes also clearly articulate with relevant professional reference points. For example, the MSc Manipulative Physiotherapy reflects standards set by the International Federation of Orthopaedic Manipulative Therapists and the Manipulative Association of Chartered Physiotherapists.
28 The Professional Doctorate (Physiotherapy) programme is innovative, responsive to NHS service modernisation and staff development needs and offers an example of good practice for the development of similar programmes in other HEIs.
29 The level of involvement of clinical colleagues and other key stakeholders in the development and ongoing review of courses is laudable and consistent with the School's aim 'to work collaboratively with the Strategic Health Authority, Trusts and other stakeholders'.
30 Learning outcomes are clearly articulated in programme documentation, module handbooks and practice placement documentation. These are effectively communicated to students, clinical staff and the academic staff, and well understood by them.
Curricula
31 The School's programmes offer breadth from level 1 to doctorate, with Foundation Degrees planned. The range of programmes helps to open entry into physiotherapy from different academic routes. The extensive range of post-registration programmes ensures that the continuing professional development needs of practising physiotherapists are addressed. These programmes demonstrate a commitment to working with colleagues to ensure that educational opportunities are 'needs led', while also being financially viable. Ongoing developments in post-registration courses have learning outcomes that ensure professional currency.
32 The physiotherapy curriculum has been developed using the Subject benchmark statement for physiotherapy and PSRB guidelines, and also conforms to the University's Academic Framework and General Examination and Assessment Regulations. Programme validation has demonstrated the success in meeting the multiple needs of these agencies. Learning outcomes are consistent with the Subject benchmark statement for physiotherapy, the HPC standards of proficiency and the Chartered Society of Physiotherapy professional requirements. The SHA, employers and service users have been involved in curriculum development. Competency and safety to practise are assessed in the School and in practice placements. Pre-registration and postgraduate programmes provide appropriate opportunities to enable students to effectively achieve IPL outcomes.
33 PBL in the MSc Rehabilitation Science programme has been developed following its success in the occupational therapy programme. The case-study exercises, based on patient case-studies, have been written with clinicians. Students were enthusiastic about PBL because it enhanced their self-directed learning skills, teamwork and clinical understanding. Clinical educators have recognised the students' strong clinical knowledge base.
34 For the pre-registration physiotherapy programmes, links between theory and practice are enhanced through PBL, by the teaching and learning philosophy of theoretical and practical preparation prior to placement, visiting lecturers and a lecturer practitioner. Students are considered by external examiners to be fit for practice and fit for purpose, with good clinical reasoning skills.
35 IPL for post-registration programmes is a positive feature of the multidisciplinary modules. For the pre-registration programmes the opportunity exists in a number of shared modules. Students are able to engage in interprofessional work in the clinical setting and increase their understanding of the role of other healthcare professionals.
Assessment
36 Assessment on the undergraduate and postgraduate programmes in physiotherapy conforms to the University's Assessment Policy, and follows the Code of practice guidelines, published by QAA. The courses also comply with more detailed and locally-developed guidelines on assessment operated at school level.
37 Overall, the physiotherapy assessments are well designed, carefully targeted to specific learning outcomes and carefully executed. The assessment process is thorough and robust throughout. The format, outcomes and process of each assessment are available in good time to students who are given clear information on the expectations related to each one. External examiners report that marking is fair and equitable, and that robust systems exist to ensure standardisation between markers.
38 The assessment of students working in clinical areas is undertaken comprehensively and rigorously and receives commendation from external examiners. Students are fully aware of the assessment criteria for placement learning and receive substantial formative feedback from clinicians. There are extensive safeguards in place to secure reliability of these assessments, including the provision of detailed assessment guidelines, visits to all placements by academic staff from the School, and extensive provision of training for educators. This includes study days, road shows out to Trusts, accreditation of clinical educators through the Chartered Society of Physiotherapy 'ACE' (Accreditation of Clinical Educators) scheme, and the provision of master's-level modules and a PgCert in Clinical Education. A clinician who had undertaken this latter programme spoke strongly of the positive impact that it had had upon her clinical practice as an educator.
39 The MSc Rehabilitation Science (Physiotherapy) (accelerated) degree is grounded in a PBL model. This is reflected in the assessment tools used. These are designed to ensure practical and clinical relevance. An example of good practice is module HEM 42 Neurology 2, where students are required to complete specific, clinically-relevant tasks, such as the production of a patient information leaflet for Parkinson's disease, or a service development report for a spinal cord injury service.
40 A standard clinical assessment form is used by the BSc (Hons) Physiotherapy and MSc Rehabilitation Science degrees. The same form is used by a total of nine education providers in order to reduce an otherwise confusing variety of documentation for clinical educators. Physiotherapy managers and clinicians welcome the use of a common form.
41 The assessment tool for Module PP109 Introduction to Health Psychology and Communication is particularly laudable and innovative. A series of clinical scenarios is presented to students in which patient-practitioner communications go badly wrong. Students have to remake the videos, demonstrating how to handle those situations properly. A textbook specifically designed to enhance health professional communication and written by the module team supports the module. This is particularly innovative and well applied to future professional practice, involving interaction with patients and clients.
Student achievement
42 Students demonstrate good levels of achievement of the intended learning outcomes and an ability to integrate academic and practice-based learning successfully. This judgement, derived from the reviewers' scrutiny of assessed student work, adds to the confidence expressed in the reports of external examiners, and the evaluations of employers and recent graduates, that students are well prepared by the courses to achieve fitness for practice, purpose and award.
43 Final degree classifications for the BSc (Hons) Physiotherapy are consistent with similar UK programmes, with the majority of students gaining an Upper Second class honours award or above (Table 1b). First-destination statistics for new graduate physiotherapists indicate a highly satisfactory level of employment (Table 2b). Completion rates from pre-registration and postgraduate programmes are consistently high.
44 Graduates are rated highly as employees and employers viewed positively new graduates' preparedness for clinical practice. They expressed confidence in graduates' fitness for practice across all core areas of physiotherapy, with strengths identified in reflective practice and lifelong self-critical learning. Employers consider the standards of practice of graduates from the University's programme to be at least as good as graduates from other UK programmes and generally better. Collectively these findings provide strong evidence of achievement of the learning outcomes specified in the Subject benchmark statement and standards of proficiency.
45 Postgraduates are successful in progressing in their professional careers as physiotherapists. Master's-level courses and the professional doctorate programme are valued by employers, although it was stated that the number of staff that can be supported to attend full master's programmes is low due to service pressures.
Table 1b: Completion and achievement statistics for all award-bearing programmes in physiotherapy
| Programme | Cohort (entry year) | Diploma programmes Pass |
Diploma programmes Fail |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| BSc (Hons) Physiotherapy | |||||||||||||||||
| Graduated | 2004 | 1 | 1 | 47 | 71 | 18 | 28 | ||||||||||
| Graduated | 2003 | 5 | 6 | 49 | 63 | 24 | 31 | ||||||||||
| Graduated | 2002 | 5 | 7 | 46 | 67 | 18 | 26 | ||||||||||
Table 2b: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes
| Programme | Further study | Local employers | Employers elsewhere | Unemployed | Other unknown | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| BSc (Hons) Physiotherapy | ||||||||||
| Graduated 2003 | 21 | 33 | 47 | 36 | 51 | 1 | 1 | 12 | 1 | |
| Graduated 2002 | 30 | 49 | 29 | 48 | 2 | 3 | ||||
| Graduated 2001 | 11 | 25 | 35 | 36 | 50 | 4 | 6 | 7 | 10 | |
Data collected centrally soon after graduation.
Data for full cohort not always returned by graduates.
1 part-time
2 voluntary work
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 Brighton in partnership with the Surrey and Sussex Strategic Health Authority.
Strengths
- The range of programmes that helps to open entry into physiotherapy from different academic routes, ensures that the continuing professional development needs of practising physiotherapists are addressed, and demonstrates a commitment to ensure that educational opportunities are 'needs led' (paragraph 31).
- The assessment tool in physiotherapy for Module PP109 Introduction to Health Psychology and Communication is particularly laudable and innovative (paragraph 41).
- Employers identified physiotherapy graduates' particular strengths in reflective practice and lifelong self-critical learning (paragraph 44).
Good practice
- The Professional Doctorate (Physiotherapy) programme that is innovative, responsive to NHS service modernisation and staff development needs and offers an example of good practice for the development of similar programmes in other HEIs (paragraph 28).
- A standard clinical assessment form, used by a total of nine education providers, is used by the BSc (Hons) Physiotherapy and MSc Rehabilitation Science degrees, in order to reduce an otherwise confusing variety of documentation for clinical educators (paragraph 40).
B3 Podiatry
Intended learning outcomes
46 The intended learning outcomes for all programmes align with and support the overall aims of the provision. The learning outcomes for the pre-registration BSc (Hons) Podiatry are mapped in detail against, and accurately reflect, the Subject benchmark statement. The learning outcomes also reflect the HPC standards of proficiency for podiatry, even though no direct mapping against these has been undertaken.
47 There is an appropriate emphasis on the development of clinical learning outcomes to meet PSRB expectations. This is provided through closely supervised clinical practice in the Leaf Clinic that allows for the close integration of course and module learning outcomes in podiatric practice.
48 Learning outcomes for post-qualifying and postgraduate courses are accurately matched to the levels defined in the FHEQ. Outcomes for post-qualifying programmes also clearly articulate with relevant professional reference points. For example the PgCert in Podiatric Theory is designed to satisfy curriculum requirements of the Society of Chiropodists and Podiatrists Faculty of Surgery for entry to Part A examinations leading to Surgical Fellowship.
49 The Professional Doctorate (Podiatry) programme is innovative, responsive to service development needs and provides an example of good practice for the development of similar programmes in other HEIs.
50 Learning outcomes are well articulated in programme documentation, module handbooks and practice placement documentation. These are well understood by students, clinical staff and the academic staff through effective communication in the programme handbooks.
Curricula
51 The School demonstrates a strong ongoing commitment to providing a breadth of programmes from level 1 to professional doctorate. The post-registration programmes have been developed to meet the continuing professional needs of podiatrists and demonstrate a commitment to working with clinical colleagues.
52 The programmes for podiatry satisfy the recommendations of the Subject benchmark statement for podiatry and the HPC's standards of proficiency. Programme development involves the SHA, and heads of services from neighbouring Trusts who are members of the course board. The curricula conform to the University's Common Academic Framework and the General Examination and Assessment Regulations. The podiatry programmes are subject to validation and a decision regarding fitness for award, pre-registration programmes are validated/accredited respectively by the HPC and PSRBs.
53 Pre-registration and postgraduate programmes provide appropriate opportunities to enable students to achieve IPL outcomes effectively. The IPL developments between podiatry and pharmacy students in the Leaf Clinic are an example of how IPL might usefully be extended. Students from both professions collaborate in the assessment and management of patients. Research at the Leaf Clinic has been undertaken to evaluate this initiative and has demonstrated an increase in students' understanding of pharmacy issues and an increase in their confidence working with pharmacists. Pre-registration podiatry students reported less opportunity to work with other allied health professionals in the school-based modules. IPL is seen as a successful feature of the post-registration programmes.
54 Practice experience ensures that students demonstrate their safety and competence to practice in a range of settings. These include the Leaf Clinic and external NHS placements that form part of a day-release programme and two block placements. Students value their practice experience highly. The learning outcomes for these placements are written in collaboration with NHS clinicians and students appreciate their clarity. The SHA and employers consider that these NHS placement experiences ensure that podiatry students demonstrate their fitness for purpose. Since these external NHS placement experiences have been implemented, the SHA and employers consider that podiatry students are well prepared for practice.
55 A range of staff activities, such as research, professional body activity, the University academic quality committees, conference publications, academic writing and clinical practice, ensures the relevance, evidence base and currency of the curricula. From 2003-04, the SHA has also funded a lecturer practitioner post. The benefits include research links and the better integration of theory and practice. The lecturer practitioner also helps to ensure that fitness for purpose is achieved.
Assessment
56 Assessment of the undergraduate and postgraduate programmes in podiatry conforms to the University's Assessment Policy. The assessment processes also reflect the guidance given in the Code of practice, published by QAA. The courses also comply with more detailed and locally-developed guidelines on assessment, operated at school level. Assessment of students at postgraduate and undergraduate level is sound. There are planned changes to the clinical assessment portfolio to ensure that summative credit is awarded for work conducted whilst on placement.
57 The teaching team is both responsive and proactive in developing new assessments to meet the needs of current podiatry practice. A good range of formative and summative assessments is used, properly reflecting learning outcomes and national standards appropriate to the level of the three awards in podiatry. External examiner comment on the podiatric provision is favourable, and the good standard of student work and rigour of the assessment process receive commendation. The assessment tool for the Introduction to Health Psychology and Communication module is particularly laudable and innovative. A series of clinical scenarios is presented to students in which patient-practitioner communications go badly wrong. Students have to remake the videos, demonstrating how to handle those situations properly. A textbook specifically designed to enhance health professional communication, and written by the module team, supports the module. This is particularly innovative and well applied to future professional practice, involving interaction with patients and clients.
58 The evolution of the use of Clinical Evidence Files, as both a formative learning tool and a summative assessment method, has been an area of development on the BSc (Hons) Podiatry course. The file also acts as a framework for recording clinical reflection. It is anticipated that students will carry these files into their professional careers as a starting point of their professional portfolios, demonstrating the School's commitment to develop lifelong learning. The assessment of reflection in the podiatry programme is underpinned by pedagogical research in this area by the staff teaching team.
59 Clinical examination assessment is conducted at the excellent facility of the Leaf Hospital's 24-chair clinical unit, using a team of trained examiners in the presence of the external examiner. This is a current professional body requirement, facilitated in this case by the easy access to the Leaf Clinic.
60 Although easy access to the Leaf Clinic offers substantial advantages, there is also the disadvantage that it is somewhat distanced from the more usual NHS practice setting for podiatry. Recently, a new module has been introduced, Practice Based Studies, in consultation with local Primary Care Trusts (PCTs) that assists in ameliorating this shortcoming. The assessment for this module was designed in association with NHS clinicians and is focused on personal development planning. It will contribute to the BSc (Hons) Podiatry degree classification.
Student achievement
61 Students demonstrate good levels of achievement of the intended learning outcomes and an ability to apply successfully theoretical and practical learning in professional practice. This judgement, based on the reviewers' scrutiny of assessed student work, confirms the view expressed in the reports of external examiners that students are well prepared for practice by the programmes. In their meetings with current students, the reviewers were impressed by students' positive evaluation of the quality of support and feedback they received while achieving their learning outcomes.
62 Final degree classifications for the BSc (Hons) Podiatry reveal that the majority of students gain a Second class honours degree, with a significant number also achieving First and Third class honours awards (Table 1c). This profile is consistent with equivalent UK pre-registration podiatry programmes. First-destination statistics indicate a highly satisfactory level of employment (Table 2c). Completion rates have varied between cohorts but, overall, these are within the expected range and are being closely monitored. Collectively, these statistics provide good evidence of achievement of the learning outcomes in line with the Subject benchmark statement and the HPC standards of proficiency.
63 Employers feel very positive about recent new graduates' preparedness for clinical practice. In particular, they welcomed the recent development of external NHS placements, that is placements in NHS Trusts that provide students with opportunities to gain supervised practice experience outside the Leaf Clinic. Employers and academic staff have indicated a wish to develop further the number of NHS external placements through engaging a greater number of PCTs to enhance new graduates' fitness for practice.
64 Postgraduates are successful in progressing in their professional careers in podiatry. Master's-level courses and the professional doctorate programme are valued by employers, although it was stated that the number of staff that can be supported to attend full master's programmes is low due to service pressures.
Table 1c: Completion and achievement statistics for all award-bearing programmes in podiatry
| Programme | Cohort (entry year) | Diploma programmes Pass |
Diploma programmes Fail |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| BSc (Hons) Podiatry | |||||||||||||||||
| Graduated | 2004 | 4 | 26 | 6 | 41 | 3 | 20 | 2 | 13 | 0 | 0 | ||||||
| Graduated | 2003 | 3 | 10 | 8 | 28 | 9 | 31 | 9 | 31 | 0 | 0 | ||||||
| Graduated | 2002 | 4 | 13 | 6 | 19 | 15 | 47 | 7 | 21 | 0 | 0 | ||||||
Table 2c: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes
| Programme | Further study | Local employers | Employers elsewhere | Unemployed | Other unknown | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| BSc (Hons) Podiatry | ||||||||||
| Graduated 2003 | 11 | 12 | 86 | 2 | 14 | |||||
| Graduated 2002 | 31 | 6 | 43 | 8 | 57 | |||||
| Graduated 2001 | 24 | 70 | 8 | 24 | 2 | 6 | ||||
1 part-time
Summary of academic and practitioner standards for podiatry
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Podiatry at the University of Brighton in partnership with Surrey and Sussex Strategic Health Authority.
Strengths
- Podiatry students value their practice experience highly. The learning outcomes for placements are written in collaboration with NHS clinicians and students appreciate their clarity (paragraph 54).
- The assessment tool for the module Introduction to Health Psychology and Communication is particularly laudable and innovative (paragraph 57).
Good practice
- The Professional Doctorate (Podiatry) programme is innovative, responsive to service development needs and provides an example of good practice for the development of similar programmes in other HEIs (paragraph 49).
- The assessment of reflection in the podiatry course is underpinned by pedagogical research in this area by the staff teaching team (paragraph 58).
C Quality of learning opportunities
Learning and teaching
65 The University's Learning and Teaching Strategy has been successfully implemented in the School and influences appropriately the delivery of its programmes. Of particular note is the successful use of PBL as the principal method of learning and teaching for both MSc pre-registration programmes. There is extensive evidence of pedagogical research undertaken by subject staff related to this mode of delivery. Students are consistently enthusiastic about the use of PBL, recognising that this approach equips them with the ability to enquire, to solve problems and proactively develop their lifelong learning skills. The School enjoys the benefit of the professional expertise in PBL of the Head of Division of Occupational Therapy. Furthermore, a bid to the Higher Education Funding Council for England to become a 'Centre of Excellence in Learning and Teaching' for PBL has been successful at the first phase.
66 Students experience a variety of teaching and learning methods, including action learning sets, practical workshops, creative skills classes, student-led group work, learning contracts on practice placement, practical examinations and shared IPL with pharmacy and podiatry students. IPL is well recognised by pre-registration students in occupational therapy as a feature of their placement experience. Opportunities arise within their clinical work to observe and work alongside other healthcare professionals. In the BSc (Hons) Occupational Therapy course at Crawley, the students are required, as part of some of their modules, to meet with other health professional students and qualified staff. This is a formal requirement but it is the student's responsibility to arrange the liaisons. Students need to be proactive in identifying and arranging experience with other healthcare professionals. For the MSc Health Through Occupation, IPL consists of one shared case-study exercise in PBL, with limited scope for occupational therapy in this trigger. The School is currently addressing IPL-working through research. In contrast, the pre-registration occupational therapy students at Crawley College have relatively few formal opportunities for IPL. These students are also in employment and, consequently, they report that they do have contact with other professionals.
67 Post-registration MSc and professional doctorate students confirm that they engage in IPL on a regular basis. They particularly value the use of interprofessional action learning sets as a method of learning. Pre-registration MSc students have a number of shared elements in their campus-based modules with all the assessments being uniprofessional. School staff acknowledge the importance of IPL but, equally, recognise the need for students to form a clear understanding of the theory and practice underpinning their own profession.
68 The pre-registration podiatry course includes the innovative student placement passport as a method of student reflection and self-critical appraisal. Students are complimentary about the quality of teaching at all levels across all programmes. The high quality of teaching is further endorsed by the regular nomination of School staff members for University teaching excellence awards. Two have won this award in the last three years. Teaching of a high quality is further supported by the strong research underpinning that influences the work of most staff.
69 New staff members are supported with an informative and current staff development and induction pack. A voluntary scheme of peer review of staff teaching is in place. This scheme has recently been reviewed in order to increase staff participation.
70 Students generally reported positive experiences in practice-based learning. The School's practice placement handbook is comprehensive and up to date. Clinical educators are making particular use of the module information in order to promote the link between theory and practice and to assist students in achieving the relevant learning outcomes. They expressed satisfaction with the regular visits made by School staff halfway through the placement and reported ready access to staff at other times by telephone or with further visits. Student feedback is received by the School and consistently communicated to the practice placement coordinators. However, there is variability in the effectiveness of the practice placement coordinators providing this feedback to the clinical educators. Clinical educators value the feedback and use it to provide evidence for the effectiveness of their own practice. Most clinical educators in the School's local area have undertaken the School's own practice placement training and are aware of the PBL structure of the pre-registration master's programmes. This knowledge enhanced their own preparedness for the placement, enabling them to structure learning and teaching in the workplace from a PBL approach. Occupational therapy clinical educators who have undertaken practice educator training in other institutions, rather than at the University, are not always sufficiently aware of how to incorporate PBL into the placement. Those without PBL knowledge confirmed that they relied on the student to explain the characteristics of PBL and, using their own skill and initiative, structured the placement to promote PBL.
71 The reviewers identified a variety of models of student supervision being adopted to support students on placements. For example, in physiotherapy both students and clinical educators are aware of the student to staff ratio of 2:1 model of practice supervision for physiotherapy, which the School is keen to promote and extend. Students who have experienced it are unanimously positive, citing the benefits of peer support and increased confidence in trying new experiences and testing out learning with each other. A newsletter has been sent by the School to practice educators to offer information about how to structure this model. An increasing number of occupational therapy and physiotherapy clinical educators are offering this type of placement supervision.
The quality of learning and teaching is commendable.
Strengths
- Students are consistently enthusiastic about the use of PBL recognising that this approach equips them with the ability to enquire, to solve problems and proactively to develop their lifelong learning skills (paragraph 65).
- Students are complimentary about the quality of teaching at all levels across all programmes (paragraph 68).
Good practice
- Students who have experienced it are unanimously positive about the student to staff ratio of 2:1 model of supervision for physiotherapy, which the School is keen to promote and extend. They cite the benefits of peer support and increased confidence in trying new experiences and testing out learning with each other (paragraph 71).
Weaknesses
- The pre-registration occupational therapy students at Crawley College have relatively few formal opportunities for IPL (paragraph 66).
- In occupational therapy, clinical educators who have undertaken practice educator training in other institutions are not always sufficiently aware of how to incorporate PBL into the placement (paragraph 70).
Student progression
72 The University has clear admissions requirements and selection procedures for all programmes. All prospective students for health profession programmes are interviewed before any offer of a place on a programme is made.
73 The University has modified the admissions process to take account of the requirements of the Disability Discrimination Act (Part 4) and the widening participation agenda. Relatively few students have registered special educational needs, while those that have are predominantly registering dyslexia. There is evidence that the School provides support for students who identify special educational needs prior to admission to their programme. The University provides policies and procedures that permit variations to assessment methods to accommodate students with special educational needs and disabilities.
74 The School provides information about its programmes to potential students in a range of formats, including open days and taster days. It makes provision for telephone interviews for postgraduate courses and for overseas students. The reviewers were able to confirm that arrangements for the selection and admission of students are robust.
75 The School ensures that students for occupational therapy and physiotherapy courses are interviewed by panels comprising University staff and NHS service staff. However, it has been unable to involve NHS service colleagues in interviews for podiatry undergraduate students due to the sporadic nature of student applications for this programme. Podiatry service managers would like to be more involved in the recruitment and selection of students.
76 For those students who have been out of education for more than five years, the School offers a system to identify and give good-quality support to those who may find difficulty bridging the gap between undergraduate and postgraduate study. This involves access to a level 3 module, Advanced Learning Studies. Some students who have taken this module have progressed well in their master's programmes.
77 Application rates for physiotherapy and occupational therapy undergraduate programmes are buoyant, with numbers of applications far outweighing the number of available, commissioned places. However, application rates for podiatry are lower, with an applicant to place ratio of 1:1. This reflects the national picture for podiatry application rates. The School is working to increase enquiries and support applications to the podiatry programme by, for example, offering work experience placements and visit days to the Leaf Clinic.
78 All students are provided with an induction to their courses and programmes. For undergraduate programmes this takes place over a one-week period at the commencement of the programme, with scheduled University and School briefings and events. For postgraduate programmes, induction is a one-day event. All students receive an induction pack that is also available on Studentcentral, the University's virtual learning environment. Additional study skills sessions are provided for those students who have specific needs. Students view the induction process as supportive.
79 All students have access to a wide range of personal and academic support, including designated personal tutors. Students are encouraged to meet their personal tutor at least once each semester. The University provides comprehensive guidance for the role of personal tutors. Students regard the support provided from tutors as comprehensive.
80 Support for post-registration students is structured in a variety of ways. For some programmes the course leader acts as personal tutor to all students, while others have specified personal tutors. The dissertation supervisor is often a key source of support for these students. Postgraduate students express satisfaction with the levels of support provided to enable them to progress through their programmes of study. The University provides a wide range of services that is well used by students including careers, chaplaincy, accommodation services, medical services, nursery, services for international students, counselling, sport and recreation, travel, study support and welfare.
81 Students are supported on placement by members of University staff undertaking site visits at least once during each period of placement. Students consider that their preparation prior to placement is effective, as is the support they receive while on placement. Most clinical educators are provided with comprehensive guidelines and support for their role in supporting, training and assessing students, and feel well prepared to support students during their placement experience.
82 A systematic approach to the evaluation of placement education is in place. This consists of student feedback on placement, visits from School staff to placement sites, and feedback from clinical educators. There is evidence that such feedback is used to enhance the quality of clinical education, for example through annual update meetings for clinical educators.
83 Completion rates for pre-registration courses in, occupational therapy, physiotherapy and podiatry are good and demonstrate effective student progression through the programmes of study (Table 3). Attrition rates are generally below 10 per cent for the 2001, 2002 and 2003 entries to pre-registration health profession programmes. These rates are in line with figures reported nationally for attrition from pre-registration health profession programmes. Recruitment targets for all programmes are realistic and are, in most cases, achieved or exceeded. The School has good mechanisms in place to support students in progressing through their programmes of study. This is evidenced by a very low discontinuation rate. Discontinuation is less than 5 per cent for all programmes, with most experiencing a zero rate.
Table 3: Recruitment and attrition statistics for pre-registration and recordable qualifications
| Award title (entry by date) | Recruited | Withdrawal | Transfer in | Transfer out | Discontinuation | ||||
|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | ||
| Occupational Therapy | |||||||||
| MSc Health through occupation (Occupational Therapy) (accelerated) | |||||||||
| 2003 entry | 4 | 1 | 25 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002 entry | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2001 entry | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| BSc (Hons) Occupational Therapy (Crawley College) | |||||||||
| 2002 entry | 21 (30) | 3 | 14 | 2 | 9 | 0 | 0 | 1 | 5 |
| 2001 entry | 27 (30) | 3 | 11 | 3 | 11 | 2 | 7 | 0 | 0 |
| 2000 entry | 18 (30) | 3 | 17 | 0 | 0 | 2 | 11 | 0 | 0 |
| Physiotherapy | |||||||||
| BSc (Hons) Physiotherapy | |||||||||
| 2003 entry | 82 (80) | 5 | 6 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002 entry | 82 (80) | 4 | 5 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2001 entry | 80 (80) | 6 | 7 | 0 | 0 | 1 | 1 | 0 | 0 |
| MSc/PGDip Rehabilitation Science | |||||||||
| 2003 entry (March, first cohort) | 21 | 0 | 0 | 0 | 0 | 1 | 5 | 0 | 0 |
| Podiatry | |||||||||
| BSc (Hons) Podiatry | |||||||||
| 2003 entry | 47 (40) | 6 | 13 | 0 | 0 | 1 | 2 | 1 | 2 |
| 2002 entry | 38 (40) | 3 | 8 | 2 | 5 | 0 | 0 | 0 | 0 |
| 2001 entry | 30 (40) | 0 | 0 | 1 | 3 | 2 | 6 | 0 | 0 |
Numbers in brackets indicate recruitment target
Intermittence occurs and can impact on figures repeating year 1
Strengths
- For those students who have been out of education for more than five years, the School offers a system to identify and give good-quality support to those who may find difficulty bridging the gap between undergraduate and postgraduate study (paragraph 76).
- Clinical educators are provided with comprehensive guidelines and support for their role in supporting, training and assessing students, and feel well prepared to support students during their placement experience (paragraph 81).
- The attrition rates are generally below 10 per cent for 2001, 2002 and 2003 entries to all pre-registration health profession programmes (paragraph 83).
The quality of student progression is commendable.
Learning resources and their effective utilisation
84 The University's estate, including teaching accommodation, is managed through the Department of Estates and Facilities Management. The work of this Department is informed and monitored by the Estates Committee, a subcommittee of the Academic Development Committee (ADC). Similarly, library and electronic learning resources are managed by the Department of Information Services, monitored and informed by the Information Strategy Committee and Learning Resources Committee, both subcommittees of ADC. This process ensures that learning resource investment meets programme needs. The provision of new temporary clinical skills facilities, which will be replaced by the longer-term investment in expansion of current permanent facilities, provides a recent example. Review of the learning environment is at present ongoing to inform the Surrey and Sussex Health and Education Strategic Partnership, and Kent and Medway Workforce Development Partnership Forum, of the current management and future direction for Libraries and Knowledge Services.
85 The library facilities have recently been refurbished and are well regarded by staff and, on the whole, by students. Students and staff have 24-hour, seven days a week access to a range of electronic resources through the internet when off campus. The library staff received particular mention from students for their effective support. Most areas of the library are equipped with information technology (IT) and students noted that they used traditional study-only space without IT equipment much less. Students reported insufficient provision of IT facilities in the library at peak times. The issue of the limited opening times for physical access to University library facilities, to support the well-regarded shortened pathways to professional registration and for student access at evenings and weekends during placement periods, has been explored at length by the University but continues to be a source of negative student comment. The University Information Services Strategy contains a number of potential developments, such as the introduction of self-issue which may enable the facilities to be made available for longer hours in a cost-effective manner. Students evaluate positively the access they have to library facilities off-campus at the local hospitals and in community placement areas.
86 IT facilities are accessible and available to students on campus in the library and other computer laboratories. However, negative comments about access times were again received from students. Students and placement staff identified difficulty with IT access and facilities in placements. While problems experienced are often related to physical access to equipment, they are also about system permissions and passwords. Students and placement staff identified this as an issue. Students agree that the on-line library catalogue and the facility to reserve and renew books is of particular benefit when they are away from campus on placement. Students have access to a wide range of electronic resources through Studentcentral which is well regarded by them. However, the variable quality of access to IT on placement does not give consistent support to students there. The SHA has commissioned a learning environment review that should provide the first steps in addressing this issue. There is effective and adequate support available from within the University for students whose IT skills are limited.
87 Students on all courses are provided with handbooks of creditable quality for both campus and practice-based learning. These provide module descriptions and information, and are very well regarded both by students and practice placement staff. Students also have access to Studentcentral, the School's virtual learning environment, which provides a range of electronic resources and provides a platform for e-based learning opportunities. Studentcentral is integral to the School's learning and teaching provision. Students confirm that they make regular use of it to enhance learning, both when they are on campus and while out on practice placements. Studentcentral also provides students with valuable discussion fora and programme and module information including timetable changes.
88 The number and expertise of academic and clinical staff are a strength and fully support the programmes. Academic staff are well qualified. Many are currently undertaking postgraduate qualifications and there is a well-developed research, development and publication culture within the School. The School's Clinical Research Centre is instrumental in the development of this research culture. Staff are supported through a process of individual performance review that includes identification of development needs. Staff workload is managed effectively through this process. However, there is a difficult balance to achieve when the School's highly motivated staff also engage in important external professional activities. Staff from practice are used as visiting lecturers on the programmes. This is well regarded both by students and staff.
89 The recent lack of a programme leader at Crawley College has contributed towards a number of programme management problems for the BSc (Hons) Occupational Therapy, and problems of communication with both students and University staff. These should be addressed satisfactorily now that a University staff member has been seconded to the College until both remaining cohorts of students have completed their degrees.
90 The Darley Road Campus provides well-maintained general teaching rooms, well equipped with a range of modern teaching aids. The clinical skills facilities on the campus are adequate. The high quality and comprehensive range of equipment in the human movement laboratory is creditable and contributes significantly to the quality of student learning.
91 The SHA and University engage with the Physiotherapy Placement Information and Management System (PPIMS) that involves a number of other universities and SHAs. This system brings a range of benefits to placement quality and is well regarded by practice staff. The occupational therapy placement management is facilitated by the development of the East Sussex Occupational Therapy Practice Education Network. However, the need to place students outside these local frameworks in order to gain essential clinical experience provides a challenge to the School to ensure that placements are of equivalent quality and that placement staff are adequately prepared. The SHA's lack of clarity in defining placement circuits in terms of 'commissioning areas' further complicates this difficult area. Podiatry placements are mainly provided at the Leaf Clinic. This provides a high-quality learning environment. The Podiatry Division has made moves to increase the number of external practice-based placements. This is well regarded by NHS managers and has addressed past concerns regarding fitness for practice. Plans to further increase the number of external placements in order to optimise fitness for practice is welcomed and anticipated by service managers.
92 For physiotherapy, a new practice placement education audit form has been produced for use by those universities involved in PPIMS. In addition, a comprehensive student practice-placement evaluation form is in place. Practice placement complaints can be dealt with either informally or formally through the School's established procedure that reflects the Code of practice, published by QAA. Students and practice educators consider the monitoring of practice placements to be satisfactory. Overall, placements are adequate in range and number, and are of high quality. There are sufficient practice placement staff to provide student placements. Any problems arising during placements are addressed quickly by linking with the relevant School staff who also undertake visits to each placement. The preparation of practice placement staff local to the University is commendable but the preparation of staff at distant placements is more challenging to achieve.
Strengths
- Handbooks of creditable quality on all courses, for both campus and practice-based learning, are very well regarded by both students and practice placement staff (paragraph 87).
- The number and expertise of academic and clinical staff fully support the programmes (paragraph 88).
- The high quality and comprehensive range of equipment in the human movement laboratory contribute significantly to the quality of student learning (paragraph 90).
- Placements are of high quality, with problems addressed quickly by linking with the relevant School staff who also undertake visits to each placement (paragraph 92).
Good practice
- Studentcentral, the School's virtual learning environment, is integral to the School's learning and teaching provision; students confirm that they make regular use of it to enhance learning, and it provides them with valuable discussion fora and programme and module information (paragraph 87).
- The PPIMS physiotherapy placement management system involves a number of other universities and SHAs, brings a range of benefits to placement quality and is well regarded by practice staff (paragraph 91).
Weaknesses
- The limited amount of time for physical access to University library facilities, particularly in evenings and at weekends during placement periods, has been explored at length by the University but continues to be a source of negative student comment (paragraph 85).
- Students and placement staff identified difficulty with IT access and facilities in the placement environment (paragraph 86).
The quality of learning resources and their effective utilisation is commendable.
D Maintenance and enhancement of standards and quality
93 The self-evaluation document is excellent and provided a sound basis for the review. The School is engaged with a considerable range of external and professional bodies, in addition to its own internal processes, to address quality maintenance and enhancement. It has thorough systems of programme review in line with its commitment to quality assurance for which the health programmes were previously commended in the recent QAA institutional audit (May 2004). Internal subject review (ISR) is an integral part of the University's quality system, where panels include representatives of the SHA. Through ISR, the University periodically reviews the subject area in some depth. External subject specialists are a key feature of the process. The report following the last ISR in May 2004 was positive, confirming that effective quality assurance systems were in place for health professions provision at the University. The system includes annual module reviews at subject level. These consider student feedback, statistical data, external examiners' reports, attendance records and curriculum organisation. Course reports are subsequently compiled using the module reports and further information gained from student achievement and progression data, external examiners' reports, PSRB reports and updates from previous recommendations. The course report is then considered for approval and to recommend actions. An action list includes staff responsibilities, but not a target time set for action completion. Students are informed of the results of reviews through their representatives, notice boards and electronically on Studentcentral. Students recognise the ways in which they are able to provide feedback and value the evidence they received of action taken. Clinical colleagues also value their involvement. However, service users are not consulted in this quality review process.
94 As part of the annual academic health process an Academic Health Report for the School is produced. The report for 2002-03 details many positive outcomes. For example, students rate the School highly, the external examiners deem the standard of all the provision good or very good and positive feedback was received informally and through quality review processes from clinical staff about the fitness for purpose of their students on the pre-registration courses. The action list details a number of items for action and subsequent review, some of which have been resolved, whilst a number are ongoing. The SHA undertakes annual quality reviews with the University. The Trusts and School complete a quality monitoring tool for the purpose of improvement and development. The most recent reports (autumn 2003) demonstrate the Trusts satisfaction with the quality of the education provision, with action planned where issues arose. Currently this 'Quality Monitoring Tool' is being replaced so that it can reflect the different needs of the different programmes.
95 Maintenance of the quality of provision in partner colleges has been thoroughly considered. The School's system to facilitate partnership working is reported as impressive by partner colleges. In particular, there is a link tutor and partner college coordinator for each partnership to facilitate two-way collaboration and sharing of good practice. Their role is to work with staff from each course and includes ensuring that partner colleges follow School and University policies; developing lines of communication between partner colleges and the School and Central Departments; staff training; sharing good practice; and providing advice and guidance on common issues or addressing issues of common concern.
96 The School recognises the complexity of maintaining the quality of provision in partner colleges. Staff at Crawley College feel well supported by the School. However, the pre-registration BSc (Hons) Occupational Therapy programme has been a matter of ongoing concern for all stakeholders, with various quality-related shortcomings. For example, repeated concerns raised by external examiners have not yet been fully resolved. Despite work to strengthen the staffing structure, staffing stability was not achieved and in 2003 the University and the College of Occupational Therapists requested that no new student be admitted that year. In summer 2004 Crawley College indicated that it no longer wished to provide a BSc (Hons) programme in occupational therapy. The provision will cease when the remaining two cohorts have completed their programme (2006). The School has implemented a number of mechanisms to try to secure the ongoing quality of provision for these remaining two cohorts. These include increased communication between staff, the part-time secondment of a programme leader, and an extensive schedule of planned activities to support the College staff and students and to address issues of quality assurance. An effort has been made to reassure students, although this was some time after they had heard rumours of closure. For legal reasons, communication to the students was limited, but this caused much anxiety for the remaining students.
Strengths
- The self-assessment document is excellent and provided a sound basis for the review (paragraph 93).
- The School has thorough systems of programme review in line with its commitment to quality assurance (paragraphs 93).
Weakness
- The quality of the pre-registration BSc (Hons) Occupational Therapy (Crawley College) programme has continued to be a matter of ongoing concern for all stakeholders (paragraph 96).
Disclaimer
The review report is the documented outcome of the major review process. The review team followed the agreed process outlined in the Handbook for major review of healthcare programmes. The judgements were made following due consideration of all the evidence.
The action plan that follows documents the responses identified and agreed by the University of Brighton and Surrey and Sussex Strategic Health Authority. The statements are the responsibility of the organisations named at the beginning of the action plan.
Action plan
Major Review of healthcare programmes
May 2005
University of Brighton Surrey and Sussex Strategic Health Authority
We have discussed and agreed the following action plan:
Title of organisation (Lead SHA/WDC): Surrey and Sussex Strategic Health Authority
Name: S Mckinley Position: Head of Workforce Development
Title of organisation (HEI): University of Brighton
Name: Professor S Laing Position: Pro-Vice-Chancellor (Academic Affairs)
| 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
|
The PBL philosophy will continue More staff development sessions to develop advanced tutoring skills Continue with annual PBL workshops for practice placement tutors Continue to influence the national and international PBL community through research and publications. |
Ongoing |
If the funding for this course is reduced, not all the actions may be achievable. |
PBL philosophy will potentially become weakened. |
Course Leader |
Student feedback OQME Annual review and report as appropriate to university and strategic health authority |
|
Learning outcomes will be reviewed annually and updated to include new requirements from PSBs, and occupational therapy theory and practice developments. All changes will be co |