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, nursing and physiotherapy at the University of Birmingham in partnership with Birmingham and the Black Country Strategic Health Authority and Shropshire and Staffordshire 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 (ClinPsyD; full-time)****.
Nursing
Pre-registration programmes
- Bachelor of Nursing (BNurs) (Hons) (full-time, four-year programme; entrants for current programme in 2001and 2002 only)**
- BNurs (Hons) (full-time, three-year programme; first entrants 2003)**
- Diploma of Higher Education (DipHE) in Nursing (full-time; first entrants 2005)**.
Post-registration programmes
- MSc Health Sciences (Nursing Practice) (full and part-time )** leading to a specialist practitioner qualification in adult*/child*/mental health nursing
- MSc Health Sciences (Neonatal) (full and part-time)** leading to a specialist practitioner qualification.
Physiotherapy
Pre-registration programmes
- BSc (Hons) Physiotherapy (full-time)***
- BSc (Hons) Physiotherapy Flexible Route*** (first entrants 2003)
- MSc Physiotherapy (full-time; first entrants January 2005)***.
* These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the major review of healthcare programmes.
** Approved by the NMC.
*** Approved by the Health Professions Council.
**** Approved by the British Psychological Society.
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in clinical psychology, nursing and physiotherapy at the University of Birmingham in partnership with Birmingham and the Black Country Strategic Health Authority and Shropshire and Staffordshire Strategic Health Authority.
Strengths
- There is a strong partnership between the University and the NHS stakeholders, demonstrated by the involvement of practitioners and service users in the planning and delivery of the ClinPsyD curriculum (paragraph 11).
- Clinical supervisors are also involved in the academic and research components of the ClinPsyD programme. This facilitates the development of these aspects of the curriculum and promotes the integration of theory and practice (paragraph 11).
- Close attention is paid in clinical psychology to the development of core skills which are fostered through innovative pieces of assessed coursework (paragraph 14).
- Service users are also involved in the development of intended learning outcomes for some nursing programmes, notably in mental health (paragraph 24).
- Integration of theory is enhanced on the BNurs programme by practice placements which closely reflect the theoretical input in each module (paragraph 30).
- A significant element of flexibility and student choice is built into the nursing programmes (paragraph 31).
- The SHS has a well-developed strategy for interprofessional learning (IPL), which is reflected in the BNurs curriculum (paragraph 33).
- There are strong links between the University and physiotherapy practice placement providers and this ensures that practice intended learning outcomes are appropriate and clearly understood by clinical educators (paragraph 45).
- The physiotherapy programmes have been designed in consultation with clinical partners to give the greatest possible access to quality clinical placements throughout the three years of study and good integration of theory and practice (paragraph 49).
- The option modules at level 3 on the BSc Physiotherapy cover a valuable range of specific professional areas, for example, preparation for on-call duties (paragraph 51).
- IPL is well established in the BSc Physiotherapy curriculum (paragraph 53).
- There are regular visits by University tutors to physiotherapy placement sites to support student achievement (paragraph 60).
Weaknesses
- Some nursing mentors are unsure of the relationship between practice learning outcomes and the overarching intended learning outcomes of the programme and would welcome more direct contact from the University to clarify the situation (paragraph 26).
- The involvement of clinicians in ongoing curriculum development teams in nursing is variable (paragraph 28).
- The SHS has a policy for anonymous marking, double-marking and moderation. However, the nursing students' work scrutinised by the reviewers indicated that the policy is not consistently interpreted and there was variable evidence of moderation (paragraph 36).
- Although it is policy that all nursing students receive feedback from their module leaders on their CAP documents, this was inconsistently applied in the sample provided for the reviewers (paragraph 38).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strengths
- There are some excellent examples of the application of WebCT in physiotherapy, including video analysis, and formative and summative assessment (paragraph 67).
- In each professional group, practice educators/mentors/clinical supervisors utilise peer support, often with more experienced staff supporting those new to the role (paragraph 70).
- There is clear evidence of partnership working to provide adequate numbers and range of placements (paragraph 73).
Student progression
The quality of student progression in clinical psychology, physiotherapy and MSc Health Sciences (Nursing Practice) and the MSc Health Sciences (Neonatal) is commendable.
Strengths
- When students with disabilities are on placement, provided that the student has agreed to disclosure, the disability support unit and personal tutor, where necessary, contact the clinical educator/mentor prior to the placement and during placement to ensure that the specific needs of the student are met (paragraph 77).
- Nursing students share their experiences of practice with physiotherapy students who are about to go on placement (paragraph 84).
Good practice
- Clinical psychology trainees are able to access support for personal issues through a register of qualified clinical psychologists within the region (paragraph 81).
The quality of student progression in pre-registration nursing on the BNurs and DipHE programmes is approved.
Strengths
- When students with disabilities are on placement, provided that the student has agreed to disclosure, the disability support unit and personal tutor, where necessary, contact the clinical educator/mentor prior to the placement and during placement to ensure that the specific needs of the student are met (paragraph 77).
- Nursing students share their experiences of practice with physiotherapy students who are about to go on placement (paragraph 84).
Weaknesses
- On the pre-registration nursing programmes, there is only limited evidence that module leaders follow the SHS policy of visiting placements (paragraph 85).
- Some pre-registration nursing programme mentors would welcome more direct contact with the University (paragraph 86).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strength
- The ample wireless areas on a number of sites for students to use their own laptops are a particularly valuable resource (paragraph 91).
Maintenance and enhancement of standards and quality
Weaknesses
- Clinical staff in nursing receive very little feedback from students' evaluations of their experience on practice placement (paragraph 97).
- There are few examples evident from the provision under review of sharing good practice within the SHS or across the schools (paragraph 101).
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, nursing and physiotherapy at the University of Birmingham (the University) in partnership with Birmingham and the Black Country Strategic Health Authority (BBCSHA) and Shropshire and Staffordshire SHA. The review was completed during the academic year 2005-06.
2 The University was founded in 1900 by the citizens of Birmingham to teach the major scientific and engineering disciplines. It was the first university in the UK to establish a faculty of commerce and incorporate a medical school. Currently, the University has a staff of 6,000 and a student body of around 26,000 originating from 150 countries, of which 30 per cent are postgraduate students. The University is situated within the large West Midlands conurbation whose population, demography and facilities offer a breadth of challenging and cosmopolitan experiences and opportunities for its academic communities. Healthcare provision is also delivered at the neighbouring Universities of Aston, Central England and Wolverhampton.
3 The BBCSHA commissions education and training on behalf of the stakeholders for the region. This includes cross-commissioning for Staffordshire and Shropshire SHA. The commissions are based on information that is gathered locally by the Trusts, using their workforce plans and future projections for healthcare commissions to meet the needs of the populations they serve. The BBCSHA covers a large geographical area serving Birmingham, Dudley, Sandwell, Solihull, Walsall and Wolverhampton. The stakeholders of the SHA work in partnership through a tripartite framework which enables them to monitor the quality of provision by using formal mechanisms. This partnership extends to a strategic level through the quality framework between the SHA, the local Trusts and the University. In respect of this, the BBCSHA's annual monitoring procedure for the School of Health Sciences (SHS) has consistently confirmed the quality of provision.
4 The SHS was created in August 1995 by combining the academic groups of nursing and physiotherapy, and moved to a dedicated location in September 2003. Subsequent integration of previously disciplinary-specific quality processes and committee structures has been challenging, and progress continues in this respect. The integration of the two disciplines has provided enhanced opportunities for inter-professional learning, teaching and research. SHS has a thriving research infrastructure designed to enhance the quality of research. Nursing aspects of provision were awarded a 3b in the last Research Assessment Exercise (RAE), while physiotherapy will be entered for the first time in the 2008 RAE. The student numbers in health sciences have increased significantly from a combined intake of 92 in 1995 to 275 as a result of government health policy, healthcare workforce targets and BBCSHA commissions.
5 The School of Psychology (the School) is one of the largest and most active psychology departments in Britain, gaining a grade of 5* in the 2001 RAE. The School's student population consists of 450 undergraduates, 70 postgraduates engaged in PhD research, 50 postgraduates studying forensic psychology, 40 MRes students and 81 ClinPsyD trainees. Staff research and teaching interests cover all areas of contemporary psychology. The School is housed in two adjacent buildings at the centre of the campus, Frankland (which houses the clinical psychology team) and Hills.
A Subject provision and overall aims
Clinical psychology, nursing and physiotherapy are currently offered on the following programmes:
Clinical psychology
- Doctorate in Clinical Psychology (ClinPsyD; full-time)****.
Nursing
Pre-registration programmes
- Bachelor of Nursing (BNurs) (Hons) (full-time, four-year programme; entrants for current programme in 2001 and 2002 only)**
- BNurs (Hons) (full-time, three-year programme; first entrants 2003)**
- Diploma of Higher Education (DipHE) in Nursing (full-time; first entrants 2005)**.
Nursing
Post-registration programmes
- MSc Health Sciences (Nursing Practice) (full and part-time )** leading to a specialist practitioner qualification in adult*/child*/mental health nursing
- MSc Health Sciences (Neonatal) (full and part-time)** leading to a specialist practitioner qualification.
Physiotherapy
Pre-registration programmes
- BSc (Hons) Physiotherapy (full-time)***
- BSc (Hons) Physiotherapy Flexible Route*** (first entrants 2003)
- MSc Physiotherapy (full-time; first entrants January 2005)***.
* These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the major review of healthcare programmes.
** Approved by the NMC.
*** Approved by the Health Professions Council (HPC).
**** Approved by the British Psychological Society (BPS).
6 The overall aim of the provision is to deliver research, teaching and scholarship of the highest standard in nursing, physiotherapy and health sciences to enhance healthcare provision.
School of Health Sciences
SHS's mission and specific objectives are identified in the SHS's Strategic Plan 2002-2007; they are organised under four broad headings: research, learning and teaching, outreach and infrastructure. The learning and teaching objectives of the provision are:
- to maintain a high quality of learning and teaching
- to provide a supportive, stimulating and demanding educational environment that ensures continuity of learning between theory and practice and fosters a spirit of enquiry and culture of lifelong learning
- to deliver innovative and accessible programmes that meet the needs of full and part-time students
- to expand the provision of undergraduate, postgraduate and outreach activity consistent with the changing needs of contemporary healthcare
- to increase the degree of flexibility in the range of programme provision, for example, coordinating the overall pattern of delivery to facilitate progression through different pathways dependent upon student need
- to maximise the use and range of learning and teaching strategies as appropriate, but particularly in e-learning
- to increase the diversity of the student body in line with widening participation initiatives in higher education, and policy objectives in the NHS Plan (DoH 2000)
- to maintain and expand the opportunities for students to benefit from learning in multiprofessional groups and settings
- to enrich the quality of the student's learning experience through effective collaboration with colleagues within the University, other institutions, and partners in the clinical setting
- to enhance the existing culture of scholarly debate and innovation on learning and teaching issues.
School of Psychology
The overall aim of the School is to provide teaching of excellence to students of high calibre from a wide range of backgrounds, while maintaining the School's position as one of research excellence.
The specific aim of the ClinPsyD is to provide professional doctorate level training, commensurate with the requirements of the BPS, that fits those qualifying for work as clinical psychologists in the NHS and related settings, and meets the requirements for registration as a Chartered Psychologist (Clinical).
The doctoral programme aims to provide those qualifying with sufficient knowledge, skills and experience to:
- draw effectively, creatively and appropriately on the evidence base for psychological processes in clinical practice
- undertake psychological assessment, formulation, intervention, evaluation and communication with individuals, carers and services
- work effectively with clients from a diverse range of backgrounds
- work effectively with systems relevant to clients
- work in a range of indirect ways to improve psychological aspects of health and healthcare
- conduct research that develops the knowledge base of clinical psychology and allows the effectiveness of working practices to be monitored and improved
- maintain an attitude of critical open-mindedness to a range of psychological approaches and theories
- manage their own learning and self-care, critical reflection and self-awareness such that they can transfer knowledge and skills to new settings and problems.
B Academic and practitioner standards
B1 Clinical psychology
Intended learning outcomes
7 The intended learning outcomes (ILOs) for the ClinPsyD are comprehensive and clearly stated in the programme's specifications. They are available to students, tutors, supervisors and other stakeholders through the programme handbook and the School's website. Trainees and supervisors indicate that the handbook is easily available and accessible and confirmed that the stated ILOs are clear and sufficient, although some supervisors reported having encountered problems in accessing the ILOs from the web. The ILOs fully support the aim of the programme to train psychology graduates to qualify as clinical psychologists and are supportive of trainees in becoming fit for practice, purpose and award.
8 The programme's ILOs have recently been revised in an extensive and wide-reaching consultative process as part of the move toward a competency-based framework. The new ILOs are based on the criteria for the Accreditation of Postgraduate Training Courses in Clinical Psychology, published by the BPS. They are entirely consistent with the Subject benchmark statement for clinical psychology and The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), published by QAA. There has been extensive discussion of the ILOs with regional clinicians, managers and supervisors, and there are mechanisms in place, including representative committee structures, to ensure that ILOs are monitored and developed to meet the changing needs of stakeholders.
9 The move toward a nationwide competency-based learning framework in clinical psychology necessitates that programmes revisit and redevelop their ILOs, particularly in relation to practice-based learning. At Birmingham, the ClinPsyD programme has worked in partnership with local placement providers to ensure the appropriateness and feasibility of any agreed placement learning objectives, and has developed new placement assessment forms in support of the revised ILOs. The level of ownership and commitment to delivering the ILOs across a broad range of stakeholders is impressive.
Curriculum
10 The curriculum of the ClinPsyD programme clearly meets the requirements of the BPS and is consistent with the Subject benchmark statement for clinical psychology. It enables students to achieve the ILOs. The curriculum encourages the development of skills required for practice in the NHS. These are developed specifically by clinical placements offered to trainees in core clinical settings which, additionally, offer the opportunity to trainees to develop their areas of specific clinical and research interests.
11 There is a strong partnership between the University and the NHS stakeholders, demonstrated by the involvement of practitioners and service users in the planning and delivery of the ClinPsyD curriculum. Employers and clinical supervisors recognise the value of the curriculum in fostering specific clinical and transferable skills, and consider it produces graduates who are fit for practice. Clinical supervisors are also involved in the academic and research components of the ClinPsyD programme. This facilitates the development of these aspects of the curriculum and promotes the integration of theory and practice.
12 To ensure that the curriculum reflects the continual changes in the NHS, the design and delivery are monitored by meetings of the programme management committee and changes are introduced as necessary to reflect developments by NHS placement providers and employers. Current trainees confirmed that the design and organisation of the curriculum promote their professional and academic competency and reflect the changes in the NHS. The current trainees value the placement experiences in the varied clinical settings and are able to develop competencies under well-structured supervision with qualified clinical NHS staff. The placements are appropriately managed and reflect the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), Section 9: Placement learning, published by QAA.
13 The curriculum provides an integrative approach to practice which embraces the BPS core competencies of assessment, formulation, intervention, evaluation and communication with individuals, carers and services. The academic, research and practice aspects of the programme are closely integrated, with a strong and coherent emphasis on reflective and ethical practice and with good involvement of service users in all aspects of the curriculum. The curriculum emphasises reflective practice in order to produce practitioners able to work effectively with a wide range of clients and other professionals in a changing NHS environment. Skills relating to reflective practice are fostered throughout each of the placements and through specific teaching and related coursework.
Assessment
14 The assessment of the ClinPsyD is clearly structured to test achievement of the ILOs. A wide range of assessment methods is used. They effectively measure progression in the acquisition of academic, clinical and research skills through the three years of the programme. Close attention is paid in clinical psychology to the development of core skills which are fostered through innovative pieces of assessed coursework. In particular, the clinical practice report, which trainees formulate from the perspective of two different psychological models (an exercise known as the models CPR), and the reflective diary encourage the development of formulation and reflective skills.
15 The assessment procedures for clinical psychology are consistent with the Code of practice, Section 6: Assessment of students. They have appropriate, built-in checks to ensure reliability and validity. The reviewers saw evidence of moderation of marks in the sample of trainee work they scrutinised. For the current cohort of trainees, double-marking of a random selection of work has been introduced. The models CPR is marked by two individual markers, an exponent of each of the models used. This results in two completely different, and sometimes conflicting, views of the quality of the work, reflecting the student's variable grasp of the two different models. This caused a certain amount of initial confusion for some students.
16 Overall, the quality of feedback to trainees on written work scrutinised by the reviewers was of a high quality and conducive to learning. Feedback is facilitated by the use of marking grids which are very helpful in communicating categories of feedback alongside individually-tailored summaries. These grids are valued by the current trainees and generally work well. However, their role in the assessment of the reflective diary would benefit from further thought, as a greater degree of narrative, personalised feedback might be appropriate for this type of exercise. Formative assessment is also provided to trainees through planned meetings with appraisal tutors. Trainees are informed of their development through each placement by meetings with their placement supervisors and placement visits by their appraisal tutor. Feedback formally takes place through the end-of-placement forms completed by the clinical supervisor and the trainee.
17 Careful consideration is given to the assessment of clinical competency. Training is provided for clinical supervisors and their involvement in the assessment process is supported by the programme team. The commitment to offering mutual observation of clinical work during the placements plays a valuable formative role. Academic staff and NHS stakeholders cooperate closely in ongoing developmental work to guarantee consistency in the grading of trainees across supervisors and placements.
18 There is appropriate involvement of external examiners in the assessment process, with a selection of work being sent to the external examiner for moderation. The external examiners have commended the introduction of imaginative new forms of assessment, for example, the models CPR and the reflective diary.
Student achievement
19 Tables 1a and 2a show the pass rates for graduates of the programme as well as their employment destinations. Overall, these results demonstrate the quality of the programme's systems of support as well as the quality of its academic and practice placement provision.
20 The programme has a very high success rate and is producing trainees who are fit for practice, purpose and for award. External examiners' reports are complimentary about the standard of trainee achievement. There have been no failures in any cohort in the past three years; almost all of these have taken up employment, about four-fifths with local employers. Graduates of the programme are being recruited to a wide variety of specialities, including adult mental health, child and family, and older people's services, as well as specialist services in health and forensics. Feedback from employers and former trainees confirms the quality and employability of graduates of the programme and their fitness for practice.
21 The reviewers scrutinised more than 30 pieces of assessed work, including clinical practice reports, literature reviews, essays, theses and reflective diaries, and were satisfied that this work demonstrated achievement of ILOs. The reviewers found that the level of student achievement was commensurate with the award of the doctorate, and that the best academic work showed evidence of sophisticated and critical analysis and reflection. In essays, reflective diaries and practice reports, clinical practice was considered in relation to an impressive variety of theoretical approaches. Across all types of assessment there was evidence of work of the very highest quality. The reviewers also noted the large number of third-year research theses published in refereed journals.
22 The reviewers visited a variety of placement settings within the region and met with graduates of the programme, clinical supervisors and employers. Recent graduates reported that the programme had provided them with the knowledge and skills necessary to undertake their first appointment as clinical psychologists. Clinical supervisors across a range of specialities commented on the quality of graduates from the Birmingham programme and complimented them on the high standard of their clinical skills, while employers expressed satisfaction with the way in which the competencies and skills of those who had completed the programme met their service requirements.
Table 1a: Completion and achievement statistics for all award-bearing programmes in clinical psychology
| Programme | Cohort |
Doctorate | Doctorate | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| ClinPsyD | 2000-01 | 25 | 100 | ||||||||||||||
| 2001-02 | 24 | 961 | |||||||||||||||
| 2002-03 | 20 | 832 | |||||||||||||||
1 One student due to complete September 2006.
2 Four students due to complete in 2005-06 for reasons of illness or maternity leave during the programme.
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 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Year of entry | No | % | No | % | No | % | No | % | No | % |
| 2000-01 | 0 | 22 | 88 | 3 | 12 | 0 | 0 | 0 | ||
| 2001-02 | 0 | 20 | 80 | 4 | 16 | 0 | 1* | 4 | ||
| 2002-03 | 0 | 20 | 83 | 3 | 13 | 0 | 1* | 4 | ||
*Yet to complete but have posts.
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 Birmingham in partnership with Birmingham and the Black Country Strategic Health Authority and Shropshire and Staffordshire Strategic Health Authority.
Strengths
- There is a strong partnership between the University and the NHS stakeholders, demonstrated by the involvement of practitioners and service users in the planning and delivery of the ClinPsyD curriculum (paragraph 11).
- Clinical supervisors are also involved in the academic and research components of the ClinPsyD programme. This facilitates the development of these aspects of the curriculum and promotes the integration of theory and practice (paragraph 11).
- Close attention is paid in clinical psychology to the development of core skills which are fostered through innovative pieces of assessed coursework (paragraph 14).
B2 Nursing
Intended learning outcomes
23 ILOs for all nursing programmes have been developed to reflect the Subject benchmark statement for nursing and the FHEQ. They are mapped against NMC standards of proficiency and accurately reflect the professional body requirements. The National Service Frameworks (NSF) are incorporated where applicable.
24 Development of ILOs is by the Triplet group which involves academics, clinical managers and students. Service users are also involved in the development of ILOs for some nursing programmes, notably in mental health. Service-user involvement in nurse education is the particular research interest of a member of staff and a number of relevant projects have been funded. It is the policy of the SHS to move forward, building on the results of this research, in a way that avoids tokenism and ensures that user involvement is embedded in the organisation. ILOs are reviewed annually by the SHA and this review process involves placement-provider representatives.
25 Pre-registration ILOs relate theory to practice and prepare students for the contemporary healthcare environment. There is ongoing monitoring to ensure that ILOs are appropriate. ILOs for the post-registration MSc Health Sciences programmes are consistent with educational and clinical practice requirements, trends and role developments. They are grounded in and reflective of the individual student's clinical environment. Consequently, they allow for individually tailored learning experiences and negotiated learning outcomes.
26 The ILOs are clearly stated and communicated to staff, students and external examiners through student handbooks. Module learning outcomes are included in module proposals and guides. The practice placement managers (PPMs) hold the key documentation on ILOs and are able to advise mentors. The mentor preparation programme communicates practice learning outcomes to mentors, and they are also explicit in the continuous assessment of practice (CAP) documents. Mentors met by the reviewers were aware of practice ILOs and considered them to be clearly stated in the CAP document. Some nursing mentors are unsure of the relationship between practice learning outcomes and the overarching ILOs of the programme and would welcome more direct contact from the University to clarify the situation.
Curricula
27 The pre-registration DipHE in Nursing has been subject to recent approval and had its first intake of students in January 2005. The BNurs (Hons) four-year programme is the more established, with the current programme having been approved in 2001. This has now been replaced by a three-year programme, with first entrants in 2003. The post-registration specialist practitioner programme, the MSc Health Sciences, has adult, child, mental health and neonatal pathways, although the child pathway does not have any students at present.
28 The involvement of clinicians in ongoing curriculum development teams in nursing is variable. In the MSc programmes there is strong involvement, but in pre-registration programmes there is much less evidence of participation by clinicians. However, the annual review of programmes does include the involvement of clinicians.
29 The design and content of pre-registration programmes enable standards of proficiency and safe practice to be progressively developed. These programmes meet the requirements of the NMC. The patient is at the centre of the curriculum. The Care Approaches module introduces the concept of family-centred care, with the emphasis on partnership working with children and their families.
30 Clinical modules are designed to maximise the integration of theory and practice, enhanced by the development of reflective practice skills and the completion of a portfolio of learning. Integration of theory is enhanced on the BNurs programme by practice placements which closely reflect the theoretical input in each module.
31 A significant element of flexibility and student choice is built into the nursing programmes. The MSc Health Sciences programmes provides students with the ILOs in advance of the commencement of the programme to enable students to choose the modules most appropriate to their professional needs. Students on the BNurs are not required to select their branch of study until 12 months into the programme. This deferred choice is not formally available to students on the DipHE, but there is evidence that students have been able to change branch during their foundation year.
32 The curriculum enables students to achieve the ILOs in terms of knowledge and understanding, cognitive skills, subject and branch-specific skills, practice and professional skills and to progress to registration. Curricular content and design are informed by current research and scholarship. The range of modules develops students' skill and knowledge in evidenced-based practice and reflects the appropriate NSF changes in the organisation of specialist services and the changing needs of clients. Appropriate and intellectual progression is reflected in the pre-registration curriculum. In year one, students have the opportunity to explore different concepts of health, then to use this knowledge in years two and three to assess health needs and deliver care.
33 The SHS has a well-developed strategy for interprofessional learning (IPL), which is reflected in the BNurs curriculum. Currently, there are four shared learning modules between the BNurs and the BSc Physiotherapy. The year two with the professional development module is a good example of IPL. Interprofessional action learning sets with the use of problem-based learning (PBL) examine a range of ethical and managerial topics. Participation in IPL is emphasised in the module Acute Care 2. Clinical tutorials are held with physiotherapy students. MSc Health Sciences students have shared evidence-based practice and shared learning with physiotherapists, and the possibility of shared learning with sociologists is currently being explored. IPL for the DipHE students occurs in practice. Although there is a desire to involve students on this programme in joint modules, there is a difficulty because the programme begins in January, unlike other programmes which begin in September.
34 Clinical placements offer a range of opportunities for attaining branch-specific ILOs, including community placements, acute Trusts and placements involving clients across the age span. Curricular delivery in placement areas is supported by a group of clinical placement staff posts: mentors, clinical support facilitators and PPMs.
Assessment
35 The assessment strategy and individual assignments across nursing programmes enable the students to demonstrate their achievement of the ILOs. The assessment strategy is coherent and well organised, making it possible for students to develop their knowledge and skills. There is a good range of assignments pitched at appropriate levels. Electronic methods of assessment are also being developed as part of the SHS's strategy.
36 Policies in relation to assessment reflect the Code of practice, published by QAA. SHS has a policy for anonymous-marking, double-marking and moderation. However, the nursing students' work scrutinised by the reviewers indicated that the policy is not consistently interpreted and there was variable evidence of moderation.
37 Assessment guidance is differentiated for degree and diploma programmes and between levels. In the main, guidance is clear and focused, and students understand what is required of them in assignments. Although a school-wide policy applies to all, there was, in the past, some inconsistency in the information on penalties for late submission provided for students.
38 Feedback on theory assignments is given in a timely way. The quality of the feedback varies, with some that is excellent, clear and instructive, and other feedback that is somewhat brief and lacking in clarity. Although it is policy that all nursing students receive feedback from their module leaders on their CAP documents, this was inconsistently applied in the sample provided for the reviewers.
39 External examiners confirm that the marking schemes are appropriate and consistently applied and that the marks awarded are a fair reflection of student achievement. From the sample of student work they scrutinised, the reviewers agree with that view. Staff have recognised that there have been some problems with consistency of marking and have taken steps to address it through staff training and the introduction of a marking grid. External examiners welcome the improvements which have resulted. However, students reported to the reviewers that they still felt that occasional disparities occurred.
40 Communication between the SHS and practitioners about assessments and their development takes place, in the main, through the PPMs. Practitioners would welcome the opportunity to make a more direct contribution through contact with the module leaders. Mentor training and update events are used to support the practice assessment process.
Student achievement
41 The reviewers scrutinised a range of student work from the BNurs, DipHE in Nursing and MSc Health Sciences programmes. A variety of assessment methods is used to allow students to demonstrate achievement of ILOs, including examinations, workbooks, essays and practical assessments. The work demonstrates that students are achieving the ILOs at an appropriate level on these programmes. Student work also confirms progression in terms of achievement at different levels. External examiners' reports confirm that the appropriate standards are being met, and that standards achieved are similar to those at other universities. Students on the BNurs and DipHE are well prepared for their future professional roles and their work demonstrates that they are fit for practice, purpose and award. MSc students identify that undertaking these programmes enhances career progression and prepares them to take on new roles.
42 Visits made to practice by the reviewers provided further evidence that students are well prepared for their professional role, and that placement providers and the University work together to promote achievement on practice placements. Students nearing the end of the four-year BNurs programme also confirmed that they felt well equipped for their future career.
43 Table 1b shows that students on the BNurs programme are achieving a good standard at final award, with over 70 per cent of graduates being awarded an Upper Second class honours degree or better. Students on the MSc programmes are achieving success at the final award or are achieving exit awards of Postgraduate Diploma or Certificate. Failure is exceptional. At the time of the review there were no employment statistics yet available for the students of BNurs.
Table 1b: Completion and achievement statistics for all award-bearing programmes in nursing
| Programme | Cohort |
PgCert/Dip/MSc programmes |
PgCert/Dip/MSc programmes |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| BNurs - four-year | 2001 | 3 | 6 | 32 | 67 | 13 | 27 | ||||||||||
| MSc Health Sciences (Nursing Practice) part-time |
2001 | 13 | 100 | ||||||||||||||
| 2002 | 16* | 100 | |||||||||||||||
| 2003 | 6 | 100 | |||||||||||||||
| MSc/PgDip Health Sciences (Nursing Practice) full-time |
2002 | 6 | 86 | 1*** | 14 | ||||||||||||
| 2003 | 1 | 100 | |||||||||||||||
| 2004 | 2** | 100 | |||||||||||||||
| MSc Health Sciences part-time (Neonatal Pathway) |
2001 | 1 | 100 | ||||||||||||||
| 2002 | N/A | ||||||||||||||||
| 2003 | N/A | ||||||||||||||||
| MSc Health Sciences full-time (Neonatal Pathway) |
2001 | 4 | 100 | ||||||||||||||
| 2002 | N/A | ||||||||||||||||
| 2003 | 7 | 100 | |||||||||||||||
| 2004 | 3 | 100 | |||||||||||||||
* includes students who registered on the MSc Health Sciences Nursing Practice part-time but elect to exit prior to completion of programme with a lower award (PgCert/PgDip): four x PgDip and one x PgCert.
** includes one x MSc and one x PgDip Health Sciences Nursing Practice full-time as per registration at start of programme.
*** failed first submission dissertation, but did not attempt resubmission due to military duties; alternative award conferred (PgDip).
Summary of academic and practitioner standards for nursing
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Nursing at the University of Birmingham in partnership with Birmingham and the Black Country Strategic Health Authority and Shropshire and Staffordshire Strategic Health Authority.
Strengths
- Service users are also involved in the development of intended learning outcomes for some nursing programmes, notably in mental health (paragraph 24).
- Integration of theory is enhanced on the BNurs programme by practice placements which closely reflect the theoretical input in each module (paragraph 30).
- A significant element of flexibility and student choice is built into the nursing programmes (paragraph 31).
- The SHS has a well-developed strategy for interprofessional learning, which is reflected in the BNurs curriculum (paragraph 33).
Weaknesses
- Some nursing mentors are unsure of the relationship between practice learning outcomes and the overarching intended learning outcomes of the programme and would welcome more direct contact from the University to clarify the situation (paragraph 26).
- The involvement of clinicians in ongoing curriculum development teams in nursing is variable (paragraph 28).
- The SHS has a policy for anonymous marking, double-marking and moderation. However, the nursing students' work scrutinised by the reviewers indicated that the policy is not consistently interpreted and there was variable evidence of moderation (paragraph 36).
- Although it is policy that all nursing students receive feedback from their module leaders on their CAP documents, this was inconsistently applied in the sample provided for the reviewers (paragraph 38).
B3 Physiotherapy
Intended learning outcomes
44 The ILOs for the pre-registration BSc and MSc Physiotherapy programmes are mapped against the Chartered Society of Physiotherapists (CSP) curriculum framework and comply with the HPC standards for education and training. They are aligned with the Subject benchmark statement for physiotherapy and are consistent with the FHEQ. ILOs are developed in consultation with managers and practitioners of associated Trusts and are approved by HPC, CSP and the University. ILOs are set at an appropriate level and relate clearly to the development of contemporary physiotherapy practice. There is currently very little service-user involvement in any of the programmes reviewed, as physiotherapy intends to proceed by utilising the experience gained in nursing.
45 The University works closely with partner placement providers, both managers and clinical educators, and the SHA to ensure that practice environments are conducive to effective learning. There are strong links between the University and physiotherapy practice placement providers and this ensures that practice ILOs are appropriate and clearly understood by clinical educators.
46 ILOs are communicated effectively to staff, students and external examiners by a variety of means. Programme, module and practice outcomes are clearly stated in programme handbooks and the clinical assessment documents. Every module has a very clear and unambiguous module guide to ensure that ILOs are understood by students. Outcomes are appropriate to both modules and level of study. The clinical educators' induction includes briefing on ILOs, and there are regular updates at clinical educator meetings. Students and clinical educators met by the reviewers were aware of ILOs both for the programmes as a whole and the placement.
47 Individual student learning contracts provide further clarification of the ILOs. The SHS acknowledges that unplanned outcomes do occur and this is viewed positively. They are highlighted in the learning contracts.
Curricula
48 The design and content of the pre-registration BSc (Hons) and MSc programmes enable standards of proficiency and safe practice to be progressively developed and the requirements of the CSP to be met. The curriculum is appropriate for the training of competent physiotherapists. Content reflects the HPC framework and the Subject benchmark statement for physiotherapy, and is mapped against the ILOs. Students are aware of CSP and HPC requirements and are confident that the programme enables them to be met.
49 The physiotherapy programmes have been designed in consultation with clinical partners to give the greatest possible access to quality clinical placements throughout the three years of study and good integration of theory and practice. Practitioners are fully aware of the curricular content of the physiotherapy programmes. Consequently, they have a good understanding of the students' overall learning and stage of development when they arrive on placement. Clinical educators are involved in the preparation of students prior to placements. The programmes are reviewed annually with participation by students and clinicians.
50 The physiotherapy programmes provide opportunities for access to a wide range of students. The accelerated MSc programme gives graduates of other disciplines an opportunity to enter the profession. The BSc (Hons) Physiotherapy Flexible Route offers students the opportunity to achieve the ILOs with some degree of choice in their mode of progression by varying the number of credits they take each year.
51 The curricula aim to develop students professionally during their programme so as to encourage lifelong learning and prepare them for employment as a registered practitioner. The students show progressive development from the beginning of the programme to registered practitioner with a good knowledge base, and progressive development of clinical skills. The option modules at level 3 on the BSc Physiotherapy cover a valuable range of specific professional areas, for example, preparation for on-call duties.
52 The curriculum design, content and organisation of the pre-registration programmes include six modules of clinical education which are designed to develop safe practice, profession-specific and generic skills within a practice context, and promote critical thinking and problem-solving. There is a range of placement areas, which support the students in developing the clinical skills to be safe and competent practitioners. This enables students to achieve ILOs in subject-specific, practice and professional skills.
53 IPL is well established in the BSc Physiotherapy curriculum. There are four significant shared learning modules with nursing. There are also joint tutorials with third and fourth-year medical students. The MSc programme is exploring links with social work.
Assessment
54 The assessment strategy for physiotherapy is coherent and well organised. Individual assignments for the physiotherapy pre-registration BSc and MSc programmes enable the students to demonstrate progressive development of knowledge and acquisition of skills. There is a good range of assessment methods employed, including electronic assessment. Assessment is mapped against the ILOs and enables students to demonstrate that they have achieved fitness for practice. The significance of placement learning is acknowledged by the grading of the clinical practice modules which contributes to the final award.
55 The process for assessing theoretical and practical work is consistent with School and University policies and the Code of practice. External examiners express their confidence in the equity and security of the assessment process. However, in the sample of student work scrutinised by the reviewers, there was some inconsistency in the application of the SHS's policy relating to moderation and double-marking.
56 Students are given clear and focused guidance on assignments and the requirements at different levels. Assessment criteria and expected levels of performance are clearly identified within student handbooks and module guidelines.
57 Feedback on student work is appropriate and supportive to student learning. Students confirm that they are happy with the feedback given. A schedule detailing assessments, submission dates and dates for return of feedback is published. Feedback is given within six weeks. Problems over delays with feedback have been addressed and are now resolved.
58 Good communication between the University and practitioners facilitates the process of assessment in practice. Practitioners also have opportunities to contribute to changes in assessment through discussion with University lecturers who visit the practice areas.
Student achievement
59 The reviewers examined a range of student work from the BSc (Hons) Physiotherapy programme. The range of assessment methods used on the programme enables students to demonstrate achievement of ILOs across the programme levels. The variety of assessed work scrutinised by the reviewers included written assignments, skills logbooks, practical examinations, portfolios, unseen examinations and practice-placement reports. The work demonstrated that students are achieving the ILOs for the programmes, with clear relationships between the assignments and the ILOs. External examiners' reports confirm that the appropriate standards are being met and that the level of achievement on this programme is similar to that of equivalent programmes elsewhere.
60 Through visits to practice placements, the reviewers were able to see the extent to which the University and the placement providers work together to promote students' achievement. There are regular visits by University tutors to physiotherapy placement sites to support student achievement. The University provides support to clinical educators in the case of students needing more help to achieve. Students and clinical practitioners are confident of the students' fitness for practice on successful completion of the programme.
61 Students on the BSc Physiotherapy programme show a high level of achievement at final award. Table 1c shows that all but a small number of students achieve a First or Second class honours award, with over 60 per cent of students in the 2000-02 entry cohorts achieving at least an Upper Second class degree. Table 2b shows employment statistics for the BSc (Hons) Physiotherapy which reflect the national picture for employment for newly-graduating physiotherapists. Students feel well prepared for their future professional roles. The University Careers Service is used to support students in achieving appropriate employment. Many graduates are employed locally and placement providers have indicated that they seek to employ graduates from this programme.
Table 1c: Completion and achievement statistics for all award-bearing programmes in physiotherapy
| Programme | Cohort |
Diploma | Diploma | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc Physiotherapy | 2000 | 3 | 6 | 37 | 68 | 14 | 26 | ||||||||||
| 2001 | 5 | 6 | 47 | 59 | 26 | 33 | 2 | 2 | |||||||||
| 2002 | 8 | 10 | 50 | 60 | 23 | 28 | 2 | 2 | |||||||||
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 | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Year of entry | No | % | No | % | No | % | No | % | No | % |
| BSc Physiotherapy | ||||||||||
| 2000-01 | 0 | 0 | 27 | 61 | 15 | 34 | 0 | 0 | 2 | 5 |
| 2001-02 | 0 | 0 | 19 | 37 | 26 | 51 | 0 | 0 | 6 | 12 |
| 2002-03 | 0 | 0 | 26 | 33 | 36 | 46 | 0 | 0 | 16 | 21 |
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 Birmingham in partnership with Birmingham and the Black Country Strategic Health Authority and Shropshire and Staffordshire Strategic Health Authority.
Strengths
- There are strong links between the University and physiotherapy practice placement providers and this ensures that practice ILOs are appropriate and clearly understood by clinical educators (paragraph 45).
- The physiotherapy programmes have been designed in consultation with clinical partners to give the greatest possible access to quality clinical placements throughout the three years of study and good integration of theory and practice (paragraph 49).
- The option modules at level 3 on the BSc Physiotherapy cover a valuable range of specific professional areas, for example, preparation for on-call duties (paragraph 51).
- IPL is well established in the BSc Physiotherapy curriculum (paragraph 53).
- There are regular visits by University tutors to physiotherapy placement sites to support student achievement (paragraph 60).
C Quality of learning opportunities
Learning and teaching
62 Learning, teaching and assessment (LTA) strategies for individual programmes are articulated in the programme handbooks. Developments in learning and teaching, particularly in the use of web-based resources and PBL are in line with the SHS overall LTA strategy. Students value the range of learning opportunities which exists both within the University and on practice placement.
63 The importance of patient and public involvement in learning and teaching is acknowledged across the provision, and the client/patient is central to practice placement learning. Clinical psychology, physiotherapy and mental health nursing programmes have some involvement of users and carers in programme delivery and are exploring other ways of gaining greater involvement, for example, through links with expert patient programmes.
64 The integration of research into learning and teaching, occurs in all programmes. ClinPsyD staff present individual research interests to trainees and integrate their own interests into programme delivery. Much of the research done within the clinical psychology group is developed in response to local need and this research informs the delivery of the programme. Trainees are encouraged to publish the findings of their research. Physiotherapy and nursing staff incorporate their own research interests into teaching delivery, and there are research themes in these programmes. The use of visiting lecturers and joint contracts with Trusts allow staff to incorporate professional and practice activity into teaching.
65 There is a generally good range and breadth of placement experiences. In nursing, the Joint Practice-based Learning Committee meets termly to address placement issues. University clinical tutors are used to promote and support placement learning in physiotherapy. Practice placements in nursing and physiotherapy are secured through partnerships with local placement providers and in collaboration with local higher education institutions. In ClinPsyD, placement allocation takes some account of student preference and prior experience.
66 SHS has an established strategy for the development of IPL. The BNurs and BSc Physiotherapy programmes share four modules and students on placement have the opportunity for joint tutorials with other student health professionals. In the ClinPsyD programme, IPL occurs with psychiatrists and other mental health staff. IPL for the DipHE Nursing and MSc Physiotherapy students has proved more difficult to organise due to the January start for these programmes. However, possible IPL opportunities are being actively pursued for these groups.
67 WebCT is used across all programmes to support learning and teaching. Students have commented that this provides a valuable resource and link to teaching materials. There are some excellent examples of the application of WebCT in physiotherapy, including video analysis, and formative and summative assessment. Other programmes also exploit WebCT in a variety of ways: learning communities, quizzes, access to lecture notes, library links and links to other external resources, and there are yet further opportunities for its development.
68 PBL as an approach is widely used on the BNurs, DipHE in Nursing and BSc Physiotherapy programmes. Staff are aware of the reservations of some students about this approach and use a variety of methods to support learning further, including practical classes, lectures and tutorials. Staff who are new to PBL as a teaching approach are trained before taking on the role of facilitator.
69 New staff are supported through mentorship and are encouraged to undertake appropriate further qualifications in learning and teaching. Visiting lecturers provide significant elements of delivery, particularly in the ClinPsyD. Visiting lecturers in clinical psychology have the opportunity to undertake training with the University Staff Development Unit. On other programmes, module leaders take responsibility for providing assistance and guidance for visiting lecturers.
70 The quality of learning and teaching on practice placements is ensured by provision of initial training and regular updates for practice staff. Nursing placements are audited in collaboration with mentors, PPMs and the Clinical Placement Support Unit. The regular visits to placements by University physiotherapy staff to support both students and clinical educators are particularly valued. Weekly supervision meetings and the use of placement assessment forms allow further monitoring of the placement experience in ClinPsyD. In each professional group, practice educators/mentors/clinical supervisors utilise peer support, often with more experienced staff supporting those new to the role. Teaching and learning in practice placements provide varied learning opportunities, including theatre visits, study days and IPL opportunities.
71 Planning of workloads is facilitated by students having access to timetables through WebCT and through assessment schedules in programme handbooks. Students appreciate the spreading of the assessment load across the year.
72 Health and safety information is provided on WebCT and in programme handbooks. Staff who are personal safety trainers run sessions with students, there is notice-board information about safety and the police provide drop-in sessions. ClinPsyD students are made aware of lone working and home visit policies.
73 There is clear evidence of partnership working to provide adequate numbers and range of placements. Where difficulties have arisen in sourcing sufficient placements for the MSc Physiotherapy programme, the SHA is working with the University to address the problem. The different programmes each have their own approaches to managing placements, but all have developed in collaboration with practice and the SHA. SHS has developed strategic objectives for its placement strategy. In clinical psychology, there are close links with placement providers. All supervisors are honorary tutors, and any placement problems are discussed at the Clinical Issues Subcommittee.
The quality of learning and teaching is commendable.
Strengths
- There are some excellent examples of the application of WebCT in physiotherapy, including video analysis, and formative and summative assessment (paragraph 67).
- In each professional group, practice educators/mentors/clinical supervisors utilise peer support, often with more experienced staff supporting those new to the role (paragraph 70).
- There is clear evidence of partnership working to provide adequate numbers and range of placements (paragraph 73).
Student progression
74 The University has a comprehensive admissions procedure supported by easy-to-use prospectuses, available in a variety of forms, which detail specific entry requirements. There are rigorous selection procedures. In SHS these include interviews involving academic staff, managers and clinical staff.
75 The University has a successful outreach strategy to widen access. The access programme has facilitated the admission of a greater diversity of undergraduates to SHS programmes. The SHS is also active in visiting schools to foster positive views of nursing and physiotherapy careers. There are opportunities in physiotherapy for a flexible route to registration, and the MSc programme presents an opportunity for students with an existing degree to undertake an accelerated course.
76 The effective campus-based induction is incorporated into freshers' week. This includes a task-based library induction and a three-week support scheme from existing students. DipHE Nursing students and MSc Physiotherapy students begin their programmes in January. Arrangements are in place so that these students receive an appropriate induction, including specific induction to M-level working for the MSc students. ClinPsyD students are inducted using a 'buddy' system of trainees from the year ahead. Practice-based induction, well supported by documentation, takes place for all programmes.
77 There is an overall strategy for campus and practice-based support. There are robust and effective arrangements in place, both on-campus and on practice placement, for students with disabilities and dyslexia. Disability Enabling Education for Practice is a group set up to enable education for disabled students in practice and involves both University and placement providers. The disability coordinator and dyslexia and dyspraxia support service assist students to achieve independence. An assessment of needs is made; if the student agrees to disclosure of their disability the School is contacted and bespoke arrangements put in place to provide assistance. Students with dyslexia are assisted to complete documentation to apply for benefits from the NHS pensions agency and equipment is available from the University until they receive these benefits. Clinical educators have been given general training in assisting students with disabilities. When students with disabilities are on placement, provided that the student has agreed to disclosure, the disability support unit and personal tutor, where necessary, contact the clinical educator/mentor prior to the placement and during placement to ensure that the specific needs of the student are met. These arrangements are shown to work very well.
78 There are other mechanisms in place, detailed in the prospectus and programme handbooks, to support and advise students; these include help with financial problems, childcare, counselling and pastoral support. All major religions have chaplaincy representatives in the University. All handbooks give guidance on students' rights and responsibilities, which places the range of support services available into an appropriate context for adult learning.
79 The University has clear arrangements for a personal tutor system for all students; this includes guidance on minimum contact. The system is fully described in the programme handbooks, is generally working well and students consider that tutors are approachable and helpful.
80 In physiotherapy and nursing there is an effective mechanism to identify students with difficulties meeting the standards. Support is then offered by personal, subject and welfare tutors. There is a variety of styles of teaching and assessment which enables the needs of all to be met.
81 Each ClinPsyD trainee is allocated an appraisal tutor from among the programme team and a personal tutor who is a clinical psychologist from practice. The appraisal tutor works with the trainee to monitor progress and identify problems in all aspects of the programme, and meets the trainees twice a year for formal appraisal meetings. The personal tutor deals with pastoral matters. Clinical psychology trainees are able to access support for personal issues through a register of qualified clinical psychologists within the region. This is a valuable additional support mechanism which is provided free of charge to trainees.
82 All students receive comprehensive advice on plagiarism, how to avoid it and what to do if suspected of it. Appropriate briefing and monitoring arrangements are in place to ensure that case-study working does not breach the NHS code of practice on confidentiality.
83 Physiotherapy students are confronted with a particular problem because of the current shortage of posts for newly-qualified staff. Students are kept informed of the job situation and are given assistance with strategies for seeking employment.
84 Students are well prepared for practice in a variety of ways. Information about practice learning is available from the programme handbooks and through WebCT. Students are aware of the requirements for practice placements through preparation for practice sessions in the University prior to undertaking placements. Physiotherapy students undertake a specific preparation for practice module. In nursing, PPMs run sessions prior to placements. BNurs students go out on placement at an earlier stage in their programme than the BSc Physiotherapy students. On return to the University, nursing students share their experiences of practice with physiotherapy students who are about to go on placement. This gives a valuable extra student-led dimension to the preparation for practice. ClinPsyD trainees have access to placement description information on notice-boards, and formulate a supervision contract as part of their preparation. They undergo placement preparation days and NHS induction.
85 SHS's declared policy is that the module tutor for nursing and the clinical tutor in physiotherapy visit students on placement. This system works well in physiotherapy, with ample evidence being provided to the reviewers that regular and productive visits take place. However, on the pre-registration nursing programmes, there is only limited evidence that module leaders follow the SHS policy of visiting placements. Students of nursing also expressed reluctance to contact the University for support during placement. The clear and positive exception to the variable contact between the University and practice placements in nursing relates to public health, where the module leader makes frequent visits to placements and maintains excellent communication with PPMs and mentors.
86 Pre-registration nursing students are supported by mentors who are trained jointly at the University of Central England in Birmingham (UCE) by staff from UCE and the University of Birmingham. Mentors subsequently supplement this initial training with updates by University of Birmingham link tutors. After the two-day course, mentors are supported by a Mentor Toolkit. Unqualified mentors and newly-trained mentors are supported by a 'buddy' system, whereby an untrained mentor doubles up with a trained mentor prior to undertaking the course. PPMs are responsible for supporting both mentors and students, and assist with mentor training. On the whole, arrangements are in place to ensure that students are supervised effectively and are well supported by mentors and PPMs. However, some pre-registration nursing programme mentors would welcome more direct contact with the University of Birmingham. At present, contact between the University and practice for the pre-registration programmes is principally through the PPMs. Nursing students on the post-registration MSc Health Sciences programmes are well supported both by a clinical supervisor, who is a professional peer, and a specialist preceptor who is of consultant grade. University staff from the MSc team visit both students and supervisors on placement and provide appropriate support and guidance.
87 Physiotherapy clinical educators attend an induction and have the opportunity for regular updates. There are opportunities for clinical educators to undertake the Accredited Clinical Educator training and several are taking them up. Clinical educators consider there are good links with the University and students feel well supported.
88 ClinPsyD trainees are prepared for placement by the clinical tutors, and placement visits are carried out by the appraisal tutor who also monitors progress. While on practice placement, each trainee has a clinical supervisor whose role it is to plan the clinical experience with the trainee in respect of competencies to be achieved, provide a minimum of an hour's supervision a week, and review and evaluate the trainee's performance. Trainees met by the reviewers on visits to practice placement felt well supported. Supervisors state that communication with the University has improved, but those at a greater distance from the University would welcome still further contact.
89 Table 3 shows student progression rates. On the ClinPsyD, only one trainee over the most recent three cohorts was discontinued due to academic failure. No trainees withdrew. In physiotherapy the attrition rate is also consistently low, averaging under 5 per cent for the most recent three cohorts to complete the BSc. On the BNurs, only one cohort has completed the current four-year programme and none has yet completed the three-year programme. In the one year for which figures are available, there was a high level of attrition; 18 per cent of students withdrew and a further 6 per cent were discontinued for academic failure or unsuitability. The SHS investigated the reasons behind this high attrition rate and identified a range of personal and financial factors. This has resulted in changes to the recruitment process. The overall rate has now dropped to 8 per cent for students currently on the programmes. The attrition rates on the MSc Health Sciences programmes are low, although some students fail to complete within the usual period, generally for personal reasons.
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 | % | ||
| ClinPsyD | |||||||||
| 2000-01 | 25 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2001-02 | 25 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002-03 | 25 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 4 |
| BNurs (four year) | |||||||||
| 2001 | 67 | 12 | 18 | 3 | 4 | 4 | 6 | ||
| MSc Health Sciences (Nursing Practice) part-time | |||||||||
| 2001 | 14 | 1 | 7 | ||||||
| 2002 | 20 | 2* | 10 | 2 | 10 | ||||
| 2003 | 8 | 2* | 25 | ||||||
| MSc/PgDip Health Sciences (Nursing Practice) full-time | |||||||||
| 2002 | 8 | ||||||||
| 2003 | 1 | 1* | 13 | ||||||
| 2004 | 3** | 1* | 33 | ||||||
| MSc Health Sciences Neonatal part-time | |||||||||
| 2001 | 1 | ||||||||
| 2002 | 0 | ||||||||
| 2003 | 0 | 1* | 100 | ||||||
| MSc Health Sciences full-time (Neonatal) | |||||||||
| 2001 | 4 | ||||||||
| 2002 | 0 | ||||||||
| 2003 | 8 | 1 | 13 | ||||||
| 2004 | 6 | 3* | 50 | ||||||
| BSc Physiotherapy | |||||||||
| 2000 | 59 | 3 | 5 | 1 | 2 | 1 | 2 | 1 | 2 |
| 2001 | 83 | 1 | 1 | 2 | 2 | ||||
| 2002 | 89 | 5 | 6 | 4 | 5 | 5 | 6 | ||
* Students yet to complete.
** Includes PgDip full-time.
The quality of student progression in clinical psychology, physiotherapy and post-registration Nursing programmes is commendable.
Strengths
- When students with disabilities are on placement, provided that the student has agreed to disclosure, the disability support unit and personal tutor, where necessary, contact the clinical educator/mentor prior to the placement and during placement to ensure that the specific needs of the student are met (paragraph 77).
- Nursing students share their experiences of practice with physiotherapy students who are about to go on placement (paragraph 84).
Good practice
- Clinical psychology trainees are able to access support for personal issues through a register of qualified clinical psychologists within the region (paragraph 81).
The quality of student progression in pre-registration Nursing on the BNurs (Hons) and DipHE in Nursing is approved.
Strengths
- When students with disabilities are on placement, provided that the student has agreed to disclosure, the disability support unit and personal tutor, where necessary, contact the clinical educator/mentor prior to the placement and during placement to ensure that the specific needs of the student are met (paragraph 77).
- Nursing students share their experiences of practice with physiotherapy students who are about to go on placement (paragraph 84).
Weaknesses
- On the pre-registration nursing programmes, there is only limited evidence that module leaders follow the SHS policy of visiting placements (paragraph 85).
- Some pre-registration nursing programme mentors would welcome more direct contact with the University (paragraph 86).
Learning resources and their effective utilisation
90 The University's Information Services is founded upon a commitment to the delivery of a fully-integrated computing, library and media academic support service for students. There are several different libraries on the campus, of which the Barnes Medical Library, the Main Library and the Education Library are the most used by the students from SHS and the School. There are good lines of communication between the libraries and the schools. Library staff are kept informed of changes to the curricula to ensure that appropriate reading material is available. Meetings between the reviewers and campus library staff showed a commitment to supporting student learning with flexible access to resources. Library Services Direct is a valuable service which enables students to access a range of library services from any location, by telephone or internet. The telephone service is available seven days a week in term time, a 12-hour day Monday to Thursday, with slightly shorter opening other days of the week. Opening hours for the Main and Barnes libraries are even more extensive. Students confirmed the valuable help they had received on an individual basis from library staff. There is induction to the library service when students first enrol, although some found the information difficult to absorb at this early stage. Some clinical psychology trainees were critical of the library facilities, describing them as the weakest aspect of otherwise strong provision. They found the electronic journal resources good, book holdings less so. Trainees confirmed that they had been encouraged to put forward book titles for library acquisition but had not responded as actively as they should to this initiative.
91 There are extensive information technology (IT) facilities across the Edgbaston Campus. In addition to central University facilities in the learning centre and main library, there is localised access to two clusters of computers in the Frankland Building that are reserved for ClinPsyD trainees and a cluster in 52 Prichatts Road for SHS students. The comprehensive support available to students is detailed in programme handbooks. The ample wireless areas on a number of sites for students to use their own laptops are a particularly valuable resource. Electronic learning is integrated into all the programmes under review, with WebCT used in conjunction with lecture delivery and for self-directed learning and problem-solving. SHS has a wide range of well-equipped practical skills rooms for the learning and teaching of clinical proficiencies.
92 Over 50 per cent of lecturing staff in SHS are new in post. Effective methods are in place for supporting probationary staff. The programme leader for the MSc Health Sciences has recently left and a new programme leader is in the process of being appointed. Otherwise there are sufficient appropriately-qualified staff to deliver the programmes in nursing and physiotherapy. The clinical psychology team has recently been restructured to enhance the delivery of the ClinPsyD programme and has appropriate staff in post.
93 Learning experiences in clinical areas across the programmes are generally good and matched to the students' and trainees' learning needs. Students normally have access to good resources while on placement. Placement visits confirm that locations are well resourced to enhance practice learning. Facilities include computers, well-equipped clinical skills laboratories and gymnasia. Clinical psychology students consider the libraries in NHS Trusts particularly useful. Concern was raised in one clinical psychology placement area in respect of the availability of office space, although other locations visited provided adequate office, IT and secretarial support.
94 Details of placements for physiotherapy and nursing are available to students through WebCT. There is a Joint Practice-based Learning Committee with UCE which ensures consistency of practice experience for nursing students in SHS. There are clear lines of responsibility for securing clinical placements, with the SHA having joint responsibility for all healthcare programmes. Birmingham works closely with the universities of Coventry and Warwick to organise placements for clinical psychology trainees in year three.
95 There are opportunities available for continuing professional development for clinical staff. PPMs employed by the SHA are key appointments, providing support on placement to mentors, clinical educators and students. Clinical psychology supervisors have access to a two-day residential course and may also joint third-year workshops.
The quality of learning resources and their effective utilisation is commendable.
Strength
- The ample wireless areas on a number of sites for students to use their own laptops are a particularly valuable resource (paragraph 91).
D Maintenance and enhancement of standards and quality
96 The self-evaluation document is evaluative and does attempt to assess both strengths and the areas in which the provision needs to improve, for example, the need to provide feedback to practitioners in nursing. It also identifies where new developments are beginning to take place, for example, IPL between mental health students and clinical psychology students, and where improvements have taken place as a result of external comment, such as steps to improve consistency in marking. However, information is limited with respect to learning and teaching in nursing and the extent to which there is sharing of good practice across professions.
97 There is evidence of effective partnership working between the University and the staff in the practice area. Good examples include the collaboration between academic and clinical staff in clinical psychology over the development and delivery of the curriculum, and the extent of feedback given by the University to practitioners in physiotherapy clinical areas. Partnership between academic and practice staff in nursing exists principally at strategic and management level. Placement providers are represented on committees, for example, the curriculum development committee for the new nursing programme. However, the University is aware that clinical staff in nursing receive very little feedback from students' evaluations of their experience on practice placement. This deprives the clinicians of the opportunity to utilise these comments to enhance the student experience in practice. The University is taking steps to address the problem by using WebCT as a tool to disseminate the information. However, visits by the reviewers to practice only provided limited evidence of progress in this area to date.
98 There is evidence that the University is responsive to student opinion, and both staff and students were able to cite several examples of action taken as the result of student criticism. Student participation in quality management takes place through module and placement evaluation and representation on the Staff-Student Committee (SSC). Student feedback is routinely collected on both university and practice-based learning. Evaluations may be of a specific placement, module or individual session. Staff-student forums such as the SSC provide a platform for programme representatives to feed issues into programme teams. Programme representatives use email to report back to the student body. Meeting minutes are also available through WebCT. However, the University has recognised that feedback to students on how their concerns have been addressed could be more systematic, and is working with the Guild of Students through the Student Representation System Advisory Board to improve the situation.
99 Procedures relating to external examining are consistent with the Code of practice. External examiners play a full and appropriate role in the assessment process. They confirm that action is taken as a result of their comments, for example, by revisions to marking strategies and assessment guidelines.
100 There are appropriate quality management processes in place at university and school level. The committee structure for the ClinPsyD is particularly effective in identifying and addressing matters of concern or for development. Annual monitoring ensures that the quality of the provision is secure and confirmed by all stakeholders.
101 There have been challenges in bringing together discipline-specific processes, documents and committees. The development of the interprofessional clinical audit tool is a good example of a cross-SHS quality assurance initiative. Otherwise, there are few examples evident from the provision under review of sharing of good practice within SHS or across the schools. Although there were some instances where this had taken place, there was little evidence of systematic mechanisms or committees in place for sharing good practice in programme delivery and assessment, for example, with respect to the student handbooks, a consistent approach to feedback to placements or placement visits.
Weaknesses
- Clinical staff in nursing receive very little feedback from students' evaluations of their experience on practice placement (paragraph 97).
- There are few examples evident from the provision under review of sharing of good practice within SHS or across the schools (paragraph 101).
Action plan
MARCH 2006
University of Birmingham
Birmingham and the Black Country Strategic Health Authority
We have discussed and agreed the following action plan:
Title of organisation (Lead SHA/WDC): Birmingham and the Black Country Strategic Health Authority
Name: Professor S Field
Position: Head of Workforce Development/Dean
Title of organisation (HEI): University of Birmingham
Name: Professor A Hughes
Position: Pro Vice-Chancellor (Academic Quality and Students)
Title of organisation (Lead SHA/WDC): Shropshire and Staffordshire Strategic Health Authority
Name: Mr N McKellar
Position: Director of Workforce
| 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 | ||||||
|
To review the membership of the Curriculum and Assessment Sub Committee (CASC) and the Course Partnership and Quality Forum (CPQF) to ensure all areas are represented in curriculum planning and quality assurance. | May 2007 for review to agree changes as required | Competing demands on Supervisors and Course staff | Membership of committees will remain broad but may not be fully representative | Chairs of CPQF and CASC | Minutes of Curriculum Group and CPQF and module descriptions | |
|
To provide an annual opportunity for clinical psychology NHS staff in the Birmingham and Black County to formulate feasible Clin Psy D research projects in conjunction with members of the university team to present to trainees. | Feb-07 | Effectiveness of mechanisms used to ensure as full participation as possible | Exclusion of some supervisors who may wish to participate | Research Director and tutors, ClinPsyD | Broad participation in research participation by Supervisors Trainee feedback Register of presentations | |
|
Review and (if necessary) modify the guidelines, learning objectives and format of each academic assessment to ensure close correspondence with the competency model. | May 2007 for review, to agree a programme of development | Competing demands on Course staff | Risk of Course not assessing the full range of competencies | Academic Director and Assessment Tutor, ClinPsyD | ||