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 dietetics, health visiting, midwifery and nursing at the University of Chester, in partnership with Cheshire and Merseyside 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:
Dietetics
- BSc (Hons) Nutrition and Dietetics***
- MSc/PgDip Nutrition and Dietetics***
Health visiting
Pre-registration
- BSc (Hons)/MSc Specialist Practice Community - Health Visiting**
- Return to Practice: Health Visiting**
Midwifery
Pre-registration
- BSc (Hons)/DipHE Midwifery** (*)
- DipHE Midwifery (shortened programme) ** (*)
- Return to Practice: Midwifery
Post-registration
- BSc (Hons) Professional Practice (Midwifery)
- MEd Professional Education (Practice Education)**
Nursing
Pre-registration
- BSc (Hons)/ DipHE Nursing** (pathways include Audit, Child Health, Learning Disabilities (*) and Mental Health; modes include shortened programmes (for second registrations) and Enrolled Nurse (conversion)
- Return to Practice Nursing**
Post-registration
- BSc (Hons) Specialist Practice**
- BSc (Hons) Specialist Practice Community** (General Practice Nursing, Learning Disability Nursing (*), Nursing in the Home/ District Nursing, Mental Health Nursing, Occupational Health, Children's Nursing and School Nursing, Public Health Nursing/ Health Visiting)
- Non-Medical Prescribing**
- BSc (Hons) Reproductive and Sexual Health**
- BSc (Hons) Professional Practice
- MSc/PgDip Professional Practice
- MSc/PgDip Specialist Practice Community (several pathways)**
- MSc/PgDip Health Promotion
- MEd Professional Education (Practice Education).**
(*) These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the major review of healthcare programmes.
** NMC approved programmes.
*** Health Professions Council approved programmes.
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved in the programmes in dietetics, health visiting, midwifery and nursing at the University of Chester, in partnership with Cheshire and Merseyside Strategic Health Authority.
Strengths
- The Placement Fair for dietetics provides the opportunity for emphasis to be given to intended learning outcomes as well as guidance for particular practice placements (paragraph 9).
- In dietetics, comprehensive workbooks are provided for each module during the practice placements, with especially good examples being seen at Aintree and Royal Liverpool/Broadgreen (paragraph 12).
- In dietetics, the theoretical underpinning allows excellent preparation for students before they go to practice placements, and is valued by service and students (paragraph 13).
- The development of the objective structured clinical examination (OSCE), which comprises four stations, has been effectively used in the assessment of postgraduate and undergraduate dietetics students (paragraph 19).
- A strength of the assessment strategy in health visiting is the oral examination, which allows students to present the contents of their reflective portfolio (paragraph 38).
- Positive and collaborative teamworking between the different universities and practice staff in health visiting is effective (paragraph 40).
- Currency of the programmes in midwifery is maintained by proactive staff engagement in practice development and research, and frequent visits by midwifery lecturers to maternity modules (paragraph 55).
- In midwifery, students receive detailed feedback on written assignments which is clearly used as a tutorial opportunity (paragraph 59).
- The University has worked closely with other higher education institutions on a collaborative post-qualifying framework for nurses to facilitate the student transfer of credits between them (paragraph 72).
- Learning disability students follow the patient's journey, which involves a multidisciplinary approach (paragraph 74).
Weaknesses
- Developments in dietetics placement learning take place mainly within each individual Trust and there is a lack of consultation between the university and placement staff and little monitoring of equity of training pack materials (paragraph 12).
- In dietetics, the currency of some content is not always successfully communicated to the practice providers (paragraph 14).
- There are no student members on the midwifery programme committee (paragraph 46).
- The assessment strategy, designed to test student proficiency in a wide range of midwifery competencies, fails to consider the ongoing capability of the students to 'manage and prioritise competing demands' in midwifery practice (paragraph 51).
- External examiners and the reviewers note that students on some pre-registration nursing programmes demonstrate little evidence of using interprofessional learning (IPL) reflective skills in practice systematically (paragraph 87).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strengths
- The Learning and Teaching Institute works collaboratively with each School to complement their learning and teaching provision (paragraph 96).
- The Practice Allocation Unit at Bache Hall is highly effective in coordinating, planning and managing placements for each of the nursing and midwifery programmes (paragraph 98).
- Practice placement staff are highly committed and enthusiastic in their efforts to support students in their learning (paragraph 101).
- The School has established seven practice development and research units in partnership with NHS Trusts to further practice development, research and staff development (paragraph 105).
- The internet-based information system (IBIS) provides an efficient and effective method of communication to students (paragraph 106).
Weakness
- While the schools and their partners have worked on formalising the interprofessional learning within the workplace, less emphasis has been placed on facilitating student groups into formal interprofessional groups for learning within a School (paragraph 102).
Student progression
The quality of student progression is commendable.
Strengths
- The University has a well-developed strategy and structure for academic placement and pastoral support, and students spoke highly of the support they receive (paragraph 110).
- In dietetics, students appreciate the five-day 'catch-up' biochemistry course offered by the University before begining their postgraduate programme (paragraph 110).
- Many students receive detailed support by link teachers, mentors and practice facilitators (paragraph 114).
- Funding has been increased to extend the role of clinical facilitators as a multiprofessional focus to help students develop confidence in practice (paragraph 115).
Weakness
- Assessor/mentor preparation is work-based and regular updates are provided; details are kept on a database, although there is no tracking of update requirements (paragraph 118).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strengths
- Considerable investment in both resources and staff provides a comprehensive range of learning resources accessible to students both on and off campus (paragraph 123).
- Considerable investment in the building of new facilities and refurbishment of existing premises has resulted in on-site education centres with clinical skills laboratories (paragraph 134).
- Mentorship training and updates are provided monthly, are well attended and supported collaboratively by universities in the area (paragraph 142).
Good practice
- For most students, the facility afforded by the IBIS enables excellent access on-campus and all the sites visited to programme materials and discussion boards, as well as the University's pastoral services (paragraph 131).
Weaknesses
- Across all of the programmes some excellent opportunities are afforded in practice placements for IPL. However, these are often informal and not managed systematically (paragraph 136).
- Placement audit documentation is not always up to date and, at times, is incomplete (paragraph 139).
Maintenance and enhancement of standards and quality
Strengths
- There is a clear structure in place for the support and monitoring of quality, and stakeholders are actively involved in the monitoring and enhancement of quality through formal meetings and processes (paragraph 145).
- Programme planning committees include academic staff, practice assessors, students and other stakeholders, and provide a mechanism by which they can influence the programme and aid the review of quality (paragraph 149).
Weakness
- The nursing programme specifications contain several major errors (paragraph 146).
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 dietetics, health visiting, midwifery and nursing programmes at the University of Chester (the University) in partnership with Cheshire and Merseyside Strategic Health Authority (SHA). The review was completed during the academic year 2005-06.
2 The University gained university status in 2005 and has more than 10,000 higher education students. The University is organised into seven schools which are responsible for ensuring that quality assurance procedures are followed. Programmes that are part of this review are based in two schools. Dietetics is located in the School of Applied and Health Sciences and has 146 students in the programmes under review. Health visiting, midwifery and nursing are located in the School of Health and Social Care and have 2,819 students taking modules related to the programmes in this review. The School of Health and Social Care is multi-sited, with education centres at the Chester main campus, Bache Hall, adjacent to the Countess of Chester Hospital, Leighton Hospital at Crewe, the University campus at Warrington and Arrowe Park Hospital in Wirral.
3 The programmes in health visiting, midwifery and nursing are commissioned by Cheshire and Merseyside SHA. Dietetics is commissioned by Cheshire and Merseyside SHA on behalf of the North West SHAs (inclusive of Cumbria and Lancashire and Greater Manchester). The SHA works in partnership with the University to ensure that workforce needs are met. Placements cover a diverse area, including the rural communities of Cheshire to the more sparsely populated communities in Cumbria, together with the multicultural cities of Liverpool, Manchester and Chester. The SHA and the University participated in the Ongoing Quality, Monitoring and Enhancement (OQME) prototype in 2005.
A Subject provision and overall aims
4 Dietetics, health visiting, midwifery and nursing are currently offered in the following programmes:
Dietetics
- BSc (Hons) Nutrition and Dietetics***
- MSc/PgDip Nutrition and Dietetics***
Health visiting
Pre-registration
- BSc (Hons)/MSc Specialist Practice Community - Health Visiting**
- Return to Practice: Health Visiting**
Midwifery
Pre-registration
- BSc (Hons)/DipHE Midwifery** (*)
- DipHE Midwifery (shortened programme) ** (*)
- Return to Practice: Midwifery
Post-registration
- BSc (Hons) Professional Practice (Midwifery)
- MEd Professional Education (Practice Education)**
Nursing
Pre-registration
- BSc (Hons)/DipHE Nursing** (pathways include Adult, Child Health, Learning Disabilities (*) and Mental Health; modes include shortened programmes (for second registrations) and Enrolled Nurse (conversion)
- Return to Practice Nursing**
Post-registration
- BSc (Hons) Specialist Practice**
- BSc (Hons) Specialist Practice Community** (General Practice Nursing, Learning Disability Nursing (*), Nursing in the Home/ District Nursing, Mental Health Nursing, Occupational Health, Children's Nursing and School Nursing, Public Health Nursing/ Health Visiting)
- Non-Medical Prescribing**
- BSc (Hons) Reproductive and Sexual Health**
- BSc (Hons) Professional Practice
- MSc/PgDip Professional Practice
- MSc/PgDip Specialist Practice Community (several pathways)**
- MSc/PgDip Health Promotion
- MEd Professional Education (Practice Education).**
(*) These programmes underwent Nursing and Midwifery Council (NMC) annual monitoring as part of the major review of healthcare programmes.
** NMC-approved programmes.
*** Health Professions Council (HPC) approved programmes.
5 Each school's provision is designed to contribute towards the values identified in the overall mission statement of the University 'to offer undergraduate and postgraduate programmes of study that promote academic, vocational and personal development and professional training, preparing students for a wide range of careers within the community and offering students a sense of corporate membership'. The mission of the SHA complements the mission and values of the University in seeking to commission professional education and training that supports delivery of key service objectives.
6 The principal aim of the provision is to produce practitioners who are fit for award, practice and purpose and who will meet professional and local health economy needs and aspirations. The major outcome of the learning experience of students is to influence positively the quality of the workforce to meet service needs and sustain and improve delivery of healthcare. Educational aims of the programmes are set out in the programme specifications and are guided by the University's Learning and Teaching Strategy. More specific aims are included in the handbooks for each programme.
B Academic and practitioner standards
B1 Dietetics
Intended learning outcomes
7 Intended learning outcomes (ILOs) for both the BSc (Hons) Nutrition and Dietetics and the MSc/PgDip Nutrition and Dietetics reflect the Subject benchmark statement for dietetics and meet The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), both published by QAA, and HPC requirements. Programmes are approved by the HPC and the aim is to equip students with the knowledge, skills and attitudes required for registration as registered dieticians. The postgraduate programme meets the standards required for an MSc programme.
8 The ILOs are suitably and clearly communicated through the University's Internet-based information system (IBIS), student handbooks, module guides and the training and induction which the supervisory skills supervisors receive. Meetings with students, practice and academic staff confirmed that this information is readily available and that all parties have a thorough understanding of the ILOs throughout the programme. The ILOs are noted at the beginning of each module.
9 The Placement Fair for dietetics provides the opportunity for emphasis to be given to the ILOs as well as guidance for particular practice placements. This formal event brings together students, academic staff and dietetics practice placement educators, informs students about placements and assists them in selecting potential placements. Furthermore, this event includes opportunities to explore the expectations of students and practice educators during the placement experience. Students were confident that the practice staff were familiar with the learning outcomes and as such had confidence in their practice placements.
Curricula
10 Two routes leading to registration to work as a dietician have been approved by the HPC. The undergraduate BSc (Hons) route is a four-year programme and the PgDip/MSc in Nutrition and Dietetics is a two-year, full-time programme. Students may exit with a PgDip, eligibility for registration with the HPC and membership of the British Dietetic Association. Master's programme students have the option of completing their dissertation either full or part-time.
11 Networking arrangements with other university providers and local stakeholder partnerships, including users, ensure the currency of the curriculum and the preparation of students who are fit for practice and purpose. The encouragement to become independent learners early on in the curriculum gives confidence for practice placements.
12 Study and placement learning opportunities are flexible to meet student needs and preferences as much as possible. Information about the curriculum is communicated effectively to the placements that span a wide geographical area. In dietetics, comprehensive workbooks are provided for each module during the practice placements, with especially good examples being seen at Aintree and Royal Liverpool/Broadgreen. Developments in dietetics placement learning take place mainly within each individual Trust and there is a lack of consultation between the university and placement staff and little monitoring of equity of training pack materials. Dieticians in practice areas have an expectation that the recent appointment of clinical placement facilitators should enhance the sharing of good practices and resource materials. One placement follows up students six months into their first post to find out how well the placement had prepared them for practice. The feedback from these evaluations is then discussed locally and programme materials adapted as appropriate.
13 The curriculum is designed to ensure that students demonstrate the level of learning required to meet FHEQ guidelines for the level of the awards. In dietetics, the theoretical underpinning allows excellent preparation for students before they go to practice placements and is valued by service and students.
14 Students find the currency of the curriculum is underpinned by the latest research and up-to-date information. Staff expertise is drawn upon in relation to international perspectives in dietetics. In dietetics, the currency of some content is not always successfully communicated to the practice providers.
15 There are many informal opportunities for students to engage in interprofessional learning (IPL) when on practice placements. However, there is only one formal module covering this in the undergraduate curriculum, but developments to incorporate more of these modules are in preparation.
Assessment
16 The development of assessment procedures is underpinned by the Department of Biological Sciences assessment procedures working within the University's regulations and requirements. The procedures reflect the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), Section 6: Assessment of students, published by QAA. Assessment procedures take account of the requirements for registration with the HPC as the regulatory body. Regular assessment workshops are open to all staff. External examiners receive a suitable range of students' work for scrutiny before each assessment board. The external examiners have reported positively on the quality of the feedback given to students on both diploma and degree programmes.
17 The assessments used for both undergraduate and postgraduate dietetics programmes enable students to demonstrate achievement of the ILOs relating to professional and regulatory requirements. The programmes utilise a variety of innovative assessment methods and students are examined across a broad range of skills. Students reported on the clarity of the assessment and marking criteria before assignments are given to them, as well as the responsive and timely manner in which feedback is given.
18 There is an extensive range of assessments which include posters, group discussions, case studies, presentations, assignments and examinations. In addition, emphasis is given to among other areas the traditional preparation and planning of food for a variety of settings and the design of basic diet prescriptions, which is fundamental to all dietetics practitioners. Professional development seminars that run through the programmes are an effective initiative in preparing students for their practice placements and provide a forum to discuss the professional attributes required for a registered dietician.
19 The development of the objective structured clinical examination (OSCE), which comprises four stations, has been effectively used in the assessment of postgraduate and undergraduate dietetics students. This is a practical-based simulation examination in which students rotate throughout four 'stations'. They are assessed at each station and there is evidence of moderation. Students comment favourably on the ways in which the practical method of assessment links theory to practice in preparing them for practice placement.
20 Dietetics practice educators utilise common assessment tools. This allows for parity, equity and fairness across the range of placement areas which adapt them to suit local needs. A variety of assessment mechanisms including tutors' visits to placements, external examiners' reports and the training of the clinical placement facilitators further assures quality. A clinical supervisory skills programme is provided for supervisors and junior staff in practice, which they are encouraged to attend.
21 Regular assessment workshops are open to all staff. Peer assessment for lecturers takes place within a specified two weeks in the academic year. Visiting lecturers are supported by workshops and peer assessment. These developments result in an effective and robust assessment in both practice and academic settings.
Student achievement
22 The reviewers sampled a range of assessed work which demonstrated evidence of progressive achievement to an appropriate level. The ILOs are achieved in both programmes. Comments on the written work are detailed and indicate how the work could be improved.
23 Students are well prepared, fit for purpose and award. The ILOs are achieved sequentially and incrementally, and Table 1a shows 100 per cent pass rates for the last three cohorts. The undergraduate degree has yet to have any students graduate.
24 External examiners note the good range of performance and the reviewers found that some provision demonstrates a particularly high level of work which includes both critical and analytical perspectives. In the meetings students confirmed that they feel confident to practise and this view was reinforced by employers.
25 Independent learning is evident in the assessments, and the skills developed are consistent with the philosophy of lifelong learning. Students confirmed that they are encouraged to read around subjects and to explore and analyse the material. This is reflected in the use made of the portfolios, where some interesting approaches were used and some students developed a critical approach to their specific projects.
26 Table 2a provides statistics on the destination data for cohorts that graduated in 2003 and 2004, and these show that a significant percentage find employment with local employers. This is supported by other local arrangements whereby additional support is provided for the new graduates in the workplace.
Table 1a Completion and achievement statistics for all award-bearing programmes in dietetics
| Programme | Academic Year | Programmes Pass |
Programmes Fail |
||
|---|---|---|---|---|---|
| No. | % | No. | % | ||
| PgDip Nutrition and Dietetics | Sept 2002 | 12 | 100 | ||
| Sept 2003 | 17 | 100 | |||
| MSc Nutrition and Dietetics | Sept 2002 | 1 | 100 | ||
Where provision is delivered on a cohort basis, these figures detail the three most recent completions. Students on the BSc (honours) provision have yet to complete.
Table 2a Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes for dietetics
| Programme | Final Cohort | Further study | Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | ||
| PgDip/MSc Nutrition and Dietetics | Sept 2002 | 9 | 45 | 7 | 35 | 1 | 5 | 3 | 15 | ||
| Sept 2003 | 1 | 4 | 16 | 55 | 7 | 24 | 1 | 3 | 4 | 14 | |
These detail the employment of those students who successfully completed the programme. Local employers include all employers in the Cheshire Merseyside area. 'Other' includes those students about whom no information is available.
Summary of academic and practitioner standards in Dietetics
Overall the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Dietetics at the University of Chester in partnership with Cheshire and Merseyside Strategic Health Authority.
Strengths
- The Placement Fair for dietetics provides the opportunity for emphasis to be given to intended learning outcomes as well as guidance for particular practice placements (paragraph 9).
- In dietetics, comprehensive workbooks are provided for each module during the practice placements, with especially good examples being seen at Aintree and Royal Liverpool/Broadgreen (paragraph 12).
- In dietetics, the theoretical underpinning allows excellent preparation for students before they go to practice placements and is valued by service and students (paragraph 13).
- The development of the objective structured clinical examination (OSCE) which comprises four stations has been effectively used in the assessment of postgraduate and undergraduate dietetics students (paragraph 19).
Weaknesses
- Developments in dietetics placement learning take place mainly within each individual Trust and there is a lack of consultation between the university and placement staff and little monitoring of equity of training pack materials (paragraph 12).
- In dietetics, the currency of some content is not always successfully communicated to the practice providers. (paragraph 14).
B2 Health visiting
Intended learning outcomes
27 The programme is designed jointly with Liverpool John Moores University and approved by the NMC, and prepares nurses for Specialist Practice Community Nursing. Health visiting is one of eight programmes in the degree and students are recruited to follow a specific pathway. Both the BSc (Hons)/MSc Specialist Practice Community - health visiting programme and return to practice programmes are aligned with the Subject benchmark statement for health visiting, the FHEQ and the NMC Specialist Practice Community Standards.
28 There are references to the National Service Frameworks, the Knowledge and Skills Framework and the national occupational standards where these are appropriate. The ILOs are designed to be achieved in both theoretical and practice components of the programme. Mapping against the draft functional map for practice of Public Health (Skills for Health 2003) was an example of the forward thinking of the programme planners. This structure encourages students to acquire the knowledge, skills and attitudes required for fitness for purpose, practice and award.
29 The ILOs are communicated enthusiastically through lecturers, practice teachers, IBIS, student handbooks, module guides and in the training of mentors. Students, practice and academic staff all confirmed that this information is readily available and demonstrated that all parties have a thorough understanding of the ILOs throughout the programme. Students were confident that the staff in practice placements did understand the ILOs and were prepared for them when they undertook placements.
30 There is clear evidence of partnership working throughout the programmes. Students, users and carers actively contribute to the development, monitoring and evaluation of the ILOs. There are a number of committees where the information and programme preparation is developed jointly with stakeholders.
31 Interprofessional education takes place within clinical practice and is particularly strong in the Specialist Practice routes. Opportunities exist but the structure for IPL is yet to be realised in the programmes.
Curricula
32 The Specialist Practice Community - Health Visiting programme is offered at bachelor and master's degree levels. There have been joint meetings with Liverpool John Moores University to develop a curriculum in partnership and to share best practices. Service providers and the SHA participated in the programme design. Although the programme has approval to run until 2007, university and stakeholder partners are working together in preparation for approval of a Specialist Community Public Health Nursing Programme in 2006-07.
33 The programmes have been mapped against the NMC Specialist Practitioner Qualification (SPQ) competencies and Health Visiting Domains, as well as the Code of practice and subject benchmark statement, both published by QAA, and are designed to incorporate local and national agendas of relevance. A stakeholder event attracted private sector user involvement and users contribute to programme delivery and evaluation.
34 The health visiting route is one of eight Community Specialist Practice pathways where 50 per cent of the academic curriculum is common learning. Health visiting students share intraprofessional learning in the university setting, whereas IPL is more likely to take place in the practice placements. Innovative IPL strategies are under consideration in some practice areas but have not yet been formalised. There is an intention to provide specific opportunities for shared learning with other professions when the programme is re-approved.
35 Currency of the curricula is achieved by the scholarly activity of academic staff, their research and clinical practice. The programmes are designed to equip students to be fit for purpose and practice.
Assessment
36 The development of assessment procedures is underpinned by the School's Learning, Teaching and Assessment (SLTAC) for quality assurance and enhancement purposes. The procedures reflect the Code of practice, Section 6: Assessment of students, published by QAA, and those for the NMC as the regulatory body. Regular assessment workshops are open to all staff. External examiners receive a suitable range of students' work for scrutiny before each assessment board. The external examiners have reported positively on the quality of the feedback given to students.
37 The planned introduction of the Specialist Community Public Health Nursing (52-week programme) is supported by both academic and practice staff, and is regarded as beneficial to students in developing skills across the continuum in public health.
38 A range of assessment methods enables students to demonstrate achievement of the ILOs in both campus and practice settings, such as assignments, learning profile, research technique, seminar presentation, examinations and a patient case study portfolio. Students value the support in the learning and practical environment. A strength of the assessment strategy in health visiting is the oral examination, which allows students to present the contents of their reflective portfolio. Moderation is based on the recording of this activity. Students are well prepared by receiving criteria for assessment before the oral examinations and are assessed by two assessors.
39 Learning outcomes are assessed formatively and summatively by practice teachers and collated through the development of a practice portfolio. The portfolio provides a clear insight into the student's competence in practice.
40 Positive and collaborative teamworking between the different universities and practice staff in health visiting is effective, and this is a strength. Practice staff noted particularly the support from the University. Students commented on the enthusiastic and approachable nature of both academic and practice staff. Timely and constructive feedback is consistent and helpful in encouraging the students to further develop their abilities.
41 Considerable commitment of the SHA, service and University is demonstrable in the preparation of mentors and assessors through continuing professional development (CPD) opportunities and mentorship updates. Substantial investment has been made in the employment of link tutors, lecturer practitioners, clinical facilitators and practice coordinators to identify and develop new modes of assessment. The School is continuing to update the current modules on Learning and Assessment in Practice to further the work of OQME.
Student achievement
42 Students are fit for purpose and practice, and the level of work seen is commensurate with the award. Portfolios offer clear evidence of integration of theory and practice and demonstrate that students are provided with the skills to develop as self-critical, lifelong learners.
43 For the last cohort, 23 per cent of students achieved a First class honours degree, 31 per cent an Upper Second, 31 per cent a Lower Second and 15 per cent a Third; 77 per cent of students find employment locally on completion of their programme, and 23 per cent are employed outside of the region.
Table 1b Completion and achievement statistics for all award-bearing programmes in health visiting
| Programme | Year | Degree classification | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | 2i | 2ii | 3 | P | F | ||||||||
| No | % | No | % | No | % | No | % | No | % | No | % | ||
| BSc Specialist Practice Community Health Visiting | 2003-04 | 3 | 23 | 4 | 31 | 4 | 31 | 2 | 15 | ||||
There have been no postgraduate completions as the programme only began in 2004.
Table 2b Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes in health visiting
| Programme | Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Year of entry | No. | % | No. | % | No. | % | No. | % | No. | % |
| September 2004 | 10 | 77 | 3 | 23 | ||||||
These detail the employment of those students who successfully completed the programme. Local employers include all employers in the Cheshire Merseyside area.
Summary of academic and practitioner standards in Health Visiting
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programme in Health Visiting at the University of Chester, in partnership with Cheshire and Merseyside Strategic Health Authority.
Strengths
- A strength of the assessment strategy in health visiting is the oral examination which allows students to present the contents of their reflective portfolio (paragraph 38).
- Positive and collaborative teamworking between the different universities and practice staff in health visiting is effective (paragraph 40).
B3 Midwifery
Intended learning outcomes
44 The ILOs have been developed in collaboration with key partners. They are consistent with the FHEQ guidelines and have been mapped against the Subject benchmark statement for midwifery and the NMC competencies, and reflect the requirements of the EC Midwifery Directives 80/154/EEC and 80/155/EEC (as amended by 89/594/EEC). ILOs for the BSc (Hons)/DipHE Pre-Registration Midwifery, DipHE Midwifery (shortened programme) and Return to Practice: Midwifery programmes are consistent with the requirements for pre-qualifying programmes leading to registration on the midwives part of the register. The programmes enable students to acquire knowledge, skills, competencies and attitudes required for fitness for practice, purpose and award.
45 The ILOs are clearly expressed in the programme specifications. They are communicated to students and staff through IBIS, student handbooks and module guides, and form part of the preparation of mentors. In addition, an abridged version of the programme specifications is supplied to practice areas. This information is readily available and all parties said that they have a thorough understanding of the ILOs. Students were confident that the practice staff did understand the ILOs and that this facilitated the learning within the placement area.
Curricula
46 There are three pre-registration midwifery programmes, a three-year and shortened diploma route and a three-year honours degree route. They were approved by the NMC in April 2003 for a period of five years. The programmes were designed in partnership with clinical staff, including supervisors of midwives and managers. There are no student members on the midwifery programme committee but the teaching team is in the process of rectifying this deficiency. User involvement in curriculum design has been through tutor representatives on the Maternity Services Liaison Committees feeding back to the programme committee.
47 The Return to Midwifery Practice programme was re-approved in 2005 and is offered at diploma and degree levels. It has been designed in accordance with the NMC Post-Registration Education and Practice requirements (2002) and individual student needs are taken into account when timetabling lectures, tutorials and practice placements.
48 Qualified midwives can access a post-registration programme leading to a BSc (Hons) Professional Practice (Midwifery) or master's programme. Core modules are shared, mainly, with nurses and half the programme comprises a selection from the midwifery list of modules. Pre-registration programmes are designed to enable students to be fit for practice and award.
49 In response to employers' concerns that not all new qualifiers were competent to administer medicines, more attention has now been paid to numeracy and medicine administration in the curriculum. Students are aware that their views about curriculum design are taken into account.
50 Curricular design integrates theory and practice. The pre-registration programme team has included honours level credits in the diploma route programmes. This facilitates students who initially exit with a DipHE and professional registration, completing an honours degree part-time while working as a midwife. Modules on the pre-registration honours programme are also available to students studying on the BSc (Hons) Reproductive and Sexual Health and Professional Practice pathways.
51 Preparation for practice is introduced early on through the development of caring and midwifery skills in simulation, followed by practice and comprehensive assessment in the clinical setting. The scheduling of the numerous practice skills assessments (referred to by the University as OSCEs) does not always match sufficient exposure in practice placements for all students. This assessment strategy, designed to test student proficiency in a wide range of midwifery competencies, fails to consider the ongoing capability of the students to 'manage and prioritise competing demands' in midwifery practice.
52 As students are allocated to one of five very different practice locations, they have the opportunity to visit a site that has a different model of midwifery practice from their own. Students have opportunities to experience low and high interventions in childbearing. The programme puts the woman at the centre of care.
53 IPL is not evident in the university-delivered curriculum but, in practice, is opportunistic rather than programmed for all students. Some mentors actively encourage students to engage with other professions in discussing client care and sharing good practices.
54 In response to the re-approval of the pre-registration programmes report (NMC validation 2003), the academic team has identified the modules where non-discriminatory practice and diversity issues have now been incorporated, but current students felt ill-equipped to practise in culturally diverse contexts.
55 Currency of the programmes in midwifery is maintained by proactive staff engagement in practice development and research and frequent visits by midwifery lecturers to maternity modules. There was little evidence of University staff actively engaging in midwifery practice, but communication and collaboration between university and practice placement staff is effective. The Practice Development and Research Unit (PDRU) established at Arrowe Park Hospital is an example of good partnership between the University and the NHS to promote staff development and improvements in the maternity services. There was, however, a lack of student knowledge about this initiative, although the leader of the unit has now contributed to the pre-registration programmes.
Assessment
56 The development of assessment procedures is underpinned by the SLTAC for quality assurance and enhancement purposes. The procedures reflect the Code of practice published by QAA and those of the NMC as the regulatory body. Regular assessment workshops are open to all staff. External examiners receive a suitable range of students' work for scrutiny before each assessment board. The external examiners have reported positively on the quality of the feedback given to students both on diploma and degree programmes.
57 There is a clear strategy for assessing learning outcomes in the midwifery programmes. Assessment methods for written work are appropriate for the achievement of the ILOs relating to regulatory and professional requirements. Assessment criteria are clearly outlined in the module handbooks and through IBIS, and are understood by students.
58 The OSCEs are a major feature of the modules. They assess practice and, although they work well for the majority of students, it is difficult to see the difference and make comparisons between the strong and weak students. Much emphasis is placed on these OSCEs but there is limited evidence to suggest that assessors make written comments on the forms that are submitted to the University or that external examiners comment on them.
59 In midwifery, students receive detailed feedback on written assignments that is clearly used as a tutorial opportunity. Grading criteria for written assessments enable markers to identify student achievement and developmental needs. Tutors' comments on the work demonstrate to students how they can improve, as well as challenging the more able student. Students reported on timely and constructive feedback on their written work.
60 External examiner reports identify that the nature of the assessment tasks relate well to module aims and appropriate benchmarks. They did, however, suggest increasing diversity in relation to the assessment tasks, and assessments have been redesigned to address these concerns.
61 The geographical locations make specific demands on the lecturing staff to provide consistency in the marking arrangements. The commitment of the module leaders and lecturers to ensure that the marking is equitable is evident. The moderating procedures are rigorous and fair for university-marked assessments, but there is little evidence of moderation for assessment in practice.
Student achievement
62 External examiners report the level of work as commensurate with the award. The reviewers agree with this and agree that students achieve ILOs and are fit for purpose and practice. A small number of students in the pre-registration programme are identified as having problems with study skills, resulting in failure of the first assignment. The external examiners note that work is comparable with that at other institutions.
63 In the three-year DipHE, the average pass rate for the last three cohorts is 97 per cent and, for the shortened programme, the pass rate for the last two cohorts is 100 per cent. Student work examined by the reviewers demonstrated that, generally, good work is produced throughout the three-year programme. Some of the best work demonstrates significant progress over the course of the programme. In the practice visits, students, including those on the Return to Practice programme, confirmed that they are prepared as confident practitioners.
64 Most students (86 to 95 per cent) find employment locally and 5 to 14 per cent elsewhere. Leighton Hospital has a particularly good track record of employing student midwives at the end of their programme. All four students on the shortened midwifery programme were registered nurses seconded by the Trust and returned to their Trust employed as midwives.
Table 1c Completion and achievement statistics for all award-bearing programmes in midwifery
| Programme | Academic Year | Pass | Fail | ||
|---|---|---|---|---|---|
| No. | % | No. | % | ||
| DipHE Midwifery | Sep 2000 | 27 | 96 | 1 | 4 |
| Sep 2001 | 29 | 97 | 1 | 3 | |
| Sep 2002 | 21 | 100 | |||
| DipHE Midwifery (shortened programme) | Sep 2002 | 2 | 100 | ||
| Sep 2003 | 2 | 100 | |||
| Return to Practice: Midwifery | Sep 2002 | 8 | 100 | 0 | 0 |
| Sep 2003 | 4 | 80 | 1 | 20 | |
| Sep 2004 | 4 | 100 | |||
Where provision is delivered on a cohort basis, these figures detail the three most recent completions.
Table 2c Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes in midwifery
| Programme | Final Cohort |
Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | ||
| DipHE Midwifery* | Sep 2000 | 25 | 93 | 2 | 7 | ||||||
| Sep 2001 | 25 | 86 | 4 | 14 | |||||||
| Sep 2002 | 20 | 95 | 1 | 5 | |||||||
| Return to Practice: Midwifery | Sep 2002 | 8 | 100 | 0 | 0 | ||||||
| Sep 2003 | 3 | 75 | 1 | 25 | |||||||
| Sep 2004 | 4 | 100 | 0 | 0 | |||||||
These detail the employment of those students who successfully completed the programme. Local employers include all employers in the Cheshire Merseyside area.
* includes those on the shortened programme.
Summary of academic and practitioner standards in Midwifery
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Midwifery at the University of Chester, in partnership with Cheshire and Merseyside Strategic Health Authority.
Strengths
- Currency of the programmes in midwifery is maintained by proactive staff engagement in practice development and research and frequent visits by midwifery lecturers to maternity modules (paragraph 55).
- In midwifery, students receive detailed feedback on written assignments which is clearly used as a tutorial opportunity (paragraph 59).
Weaknesses
- There are no student members on the midwifery programme committee (paragraph 46).
- The assessment strategy, designed to test student proficiency in a wide range of midwifery competencies, fails to consider the ongoing capability of the students to 'manage and prioritise competing demands' in midwifery practice (paragraph 51).
B4 Nursing
Intended learning outcomes
65 The ILOs are developed in partnership with service providers through a collaborative approach to programme planning and validation. The ILOs for the BSc (Hons)/DipHE Nursing (adult, children, mental health and learning disabilities), including shortened programmes and enrolled nurse conversion and the return to practice nursing programmes, are consistent with the programme requirements for pre-qualifying programmes leading to registration on the nurses' part of the NMC register.
66 All ILOs for the BSc (Hons) Specialist Practice Community (general practice nursing, learning disability nursing, nursing in the home/district nursing, mental health nursing, occupational health nursing, children and school nursing) are consistent with the requirements for specialist practitioner status. There are references to the National Service Frameworks and the Knowledge and Skills Framework where these are appropriate. The ILOs for the range of other specialist nursing professional programmes address the relevant subject benchmark statements and have been accredited by the NMC, HPC and the Royal Pharmaceutical Society of Great Britain. Programmes allow students to acquire the knowledge, skills and attitudes required for fitness for purpose, practice and award.
67 In the pre-registration programmes, specific clinical learning outcomes have been developed to bring theory and practice together and to encourage evidence-based practical skills. Learning outcomes are communicated through IBIS, student handbooks and module guides, and the preparation of mentors now includes guidance and support for gaining access to the University intranet.
68 Meetings with the students, practice and academic staff confirmed that this information is readily available and that all parties have a thorough understanding of the ILOs across all the programmes. Students were confident that the practice staff did understand the ILOs and their application within practice placements.
69 There is clear evidence of partnership working at the strategic level, although partnerships need to be strengthened with all stakeholders. In all nursing programmes, insufficient attention is given to capitalising on the knowledge and skills of the students and service users and integrating them fully into the curriculum process.
Curricula
70 Pre-registration programmes are offered at diploma and degree level for all four branches. In addition there is a shortened route for those nurses seeking a second registration, a programme for enrolled nurses to convert to first-level nurses and a return to practice programme. A variety of bachelor and master's programmes is available for registered nurses, with pathways addressing specific areas of practice and providing specialist practice routes for those seeking a NMC-recordable qualification. The BSc (Hons) Professional Practice has a possible 10 routes, the BSc (Hons) Specialist Practice has six routes and the BSc (Hons) Specialist Practice Community and the MSc Specialist Practice Community have eight routes (including the health visiting route). The number of routes available at any stage depends on the number of students. For many of these programmes, students select from a menu of optional modules as well as taking the core modules for the award. There is also the BSc (Hons) Reproductive and Sexual Health programme and a number of programmes leading to master's degrees.
71 A large number and variety of modules at different academic levels are offered to health professionals to enable practitioners to plan a route relevant to their sphere of practice and which can lead to a bachelor or master's degree. A regional e-learning initiative involving nine HEIs is being developed. Internet-based exercises ensure that students can apply generic principles within their specific practice area. The generic Non-Medical Prescribing programme attracts no formal award but is accredited by the HPC, the NMC and the Royal Pharmaceutical Society of Great Britain.
72 The University has worked closely with other HEIs on a collaborative post-qualifying framework for nurses to facilitate the student transfer of credits between them. The School of Health and Social Care's Curriculum Planning and Review Committee is responsible for the planning and design of nursing curricula and maps programmes against key national benchmarks. Clinical partners and the SHA work closely with the University to ensure programmes address local needs. This includes a practice placement committee and stakeholder days, as well as the programme committees. In particular, programmes are designed to accommodate individual student differences following interruptions in studies and part-time access. There was evidence of user involvement in BSc (Hons) Professional Practice (Oncology Care), but little evidence of user involvement in the other branches.
73 For pre-registration students, practical skills are recognised as essential for fitness for practice, and hence progressive skills acquisition and reinforcement are prioritised. Placement allocation is allied to module content as much as possible, and the 'hub-and-spoke' model enables students to achieve their learning requirements. As yet there is no strategy for ensuring that IPL forms part of the University curriculum, as the emphasis has been on encouraging students to capitalise on IPL opportunities in the workplace.
74 Students are encouraged to record and reflect on IPL activities in practice. In particular, learning disability students follow the patient's journey, which involves a multidisciplinary approach, and mentors encourage students to see how other professions contribute to care.
75 Although non-discriminatory practice and cultural diversity are adequately addressed in the pre-registration nursing programmes, application and reinforcement of the theory in practice is not always evident. A tripartite survey of the views of students and university and clinical staff about the pre-registration curriculum is in progress.
76 Adult nursing students are aware that their feedback brings about curricular change. The clinical facilitators have a key role in identifying any common issues across a Trust and discussing these and, where necessary, taking the appropriate action.
77 The intention to integrate research and collaboration in practice has been facilitated through the formation of PDRUs in partnership with NHS Trusts. The first unit to be established was in surgical and anaesthetic nursing in 2000. The findings arising from the projects are incorporated into the curriculum as and when appropriate. Clinical facilitators have been proactive in developing learning in practice, and staff research studies have led practice developments.
Assessment
78 The development of assessment procedures is underpinned by the SLTAC for quality assurance and enhancement purposes. The procedures reflect the Code of practice, published by QAA and those of the NMC as the regulatory body. Regular assessment workshops are open to all staff. External examiners receive a suitable range of students' work for scrutiny before each assessment board. The external examiners have reported positively on the quality of the feedback given to students on both diploma and degree programmes.
79 Programme handbooks provide details of the assessment requirements. The variety of assessment, including assignments, practical assessments, OSCEs and examinations, is fully consistent with the achievement of the ILOs. Students acknowledge that they clearly understand the assessment criteria.
80 Grading criteria are clearly defined and the general assessment grids (GAGs) provide a clear structure for assessments in practice, providing helpful detail for students and internal and external markers. The statements documented in the GAGs provide the criteria that are assessed when students deliver care and interact with patients. Such criteria form part of the overall assessment of each placement and provide a continuous record of a student's development from placement to placement throughout the year and over the programme.
81 Processes for internal double-marking are in place and demonstrated in the work reviewed. Given the variety of approaches and the different geographical locations, sufficient attention is given to ensuring that marking and guidance are consistent. The commitment of the module leaders and lecturers to ensure that the marking is equitable is evident. The reviewers are reassured and conclude that the moderating procedures are rigorous and fair.
82 The detailed feedback on written work now provided is well received by students. Efforts to standardise and improve such feedback over the last few years have improved the clarity and quality of feedback to students. A new feedback form has been introduced which enables students to identify priorities in the way that they can improve their presentations.
83 There is a comprehensive and timely approach to dealing with failing students. Proactive advice and guidance are given over the first few weeks. There is an intermediate point in the general assessment where discussions are held between mentors, link tutors and students. At these meetings, additional support is given and further formative assessment and action plans agreed with the link tutor and clinical facilitator.
Student achievement
84 Standards achieved in both undergraduate and postgraduate programmes meet the expectations of the award against the FHEQ and NMC requirements. The level of work produced by students is comparable with work in other institutions; students achieve the appropriate ILOs and graduates from all programmes are fit for purpose, practice and award.
85 Students said that they discuss achievement with academic staff and described how they are encouraged to think about career pathways. There are opportunities for using credits to access subsequent programmes at different levels, with progression from diploma to degree and onto a master's degree.
86 Students indicated their confidence in practice and also identified good links between mentors and academic staff. Mentors are described by students as being up to date. In the Non-Medical Prescribing programme, the external examiners note the influence of clinical facilitators in the achievement of the ILOs. External examiners also comment that work needs to be done with mentors to ensure validity, equity and fairness in judgements about clinical competence. Mentor updates focus on how to support failing students.
87 A feature of nursing programmes is IPL, which is developed progressively from the early stages of all programmes. The level of student reflection in practice is variable and not always sufficient to support IPL. External examiners and the reviewers note that students on some pre-registration nursing programmes demonstrate little evidence of using IPL reflective skills in practice systematically.
88 Table 1d shows that the average pass rate for the DipHE is 92 per cent for the last three cohorts. For the BSc (Hons) Specialist Practice, Community, 12 per cent of students achieve a First class honours degree, 47 per cent an Upper Second, 35 per cent a Lower Second and 6 per cent a Third. The flexibility offered by the University enables students to complete their programme either by full or part-time study. Students on other degree, diploma and postgraduate programmes are successful and pass rates in many programmes are 100 per cent
89 In the last three cohorts of the DipHE, an average of 52 per cent of students found employment locally, mostly within Cheshire and Merseyside, 4 per cent found employment elsewhere, one student was unemployed and 42 per cent are identified in Table 2d as having not made their decision at the time of data collection (the sixth week of the trimester).
90 In the BSc (Hons) Specialist Practice Community and other pathways, 94 per cent were employed locally and 6 per cent elsewhere.
Table 1d Completion and achievement statistics for all award-bearing programmes in nursing
| Programme | Cohort |
Diploma | Diploma | Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No | % | No | % | No | % | No | % | No | % | No | % | ||
| DipHE nursing | Oct 01 | 126 | 91 | 13 | 9 | ||||||||||||
| Jan 02 | 157 | 93 | 11 | 7 | |||||||||||||
| Jun 02 | 77 | 93 | 6 | 7 | |||||||||||||
| BSc (Hons) Specialist Practice Community Other than Health visiting |
2004-05 | n/a | n/a | n/a | 2 | 12 | 8 | 47 | 6 | 35 | 1 | 6 | |||||
| BSc (Hons) Nursing | |||||||||||||||||
| Return to Practice | 2002-03 | 78 | 95 | 4 | 5 | ||||||||||||
| 2003-04 | 56 | 98 | 1 | 2 | |||||||||||||
| 2004-05 | 42 | 95 | 2 | 5 | |||||||||||||
| BSc (Hons) Reproductive and Sexual Health |
2002-03 | 1 | 50 | 1 | 50 | ||||||||||||
| 2003-04 | 1 | 100 | |||||||||||||||
| 2004-05 | 1 | 50 | 1 | 50 | |||||||||||||
| BSc (Hons) Professional Practice | 2002-03 | 9 | 29 | 4 | 13 | 11 | 35 | 6 | 19 | 1 | 3 | ||||||
| 2003-04 | 12 | 71 | 5 | 29 | |||||||||||||
| 2004-05 | 11 | 37 | 3 | 10 | 9 | 30 | 3 | 10 | 2 | 7 | 2 | 7 | |||||
| PGCR Professional Practice | 2002-03 | 1 | 100 | ||||||||||||||
| 2003-04 | 3 | 100 | |||||||||||||||
| MSc Professional practice | 2004-05 | 2 | 100 | ||||||||||||||
| MSc Health Promotion | 2002-03 | 2 | 100 | ||||||||||||||
| 2003-04 | 1 | 100 | |||||||||||||||
| 2004-05 | 2 | 100 | |||||||||||||||
| PgDip Professional Education | 2003-04 | 3 | 100 | ||||||||||||||
| 2004-05 | 3 | 100 | |||||||||||||||
| PgDip Health Promotion | 2002-03 | 3 | 100 | ||||||||||||||
| 2003-04 | 1 | 100 | |||||||||||||||
| PGC Health Promotion | 2002-03 | 1 | 100 | ||||||||||||||
| 2003-04 | |||||||||||||||||
| CAS Health promotion | 2004-05 | 2 | 100 | ||||||||||||||
Where provision is delivered on a cohort basis, these figures detail the three most recent completions.
Table 2d Employment statistics for all pre-registration and exception reporting only for post-registration/post-qualification programmes in nursing
| Programme | Final Cohort |
Further study |
Local employers |
Employers elsewhere |
Unemployed | Other | |||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | ||
| DipHE Nursing all branches | Oct 2001 | 94 | 56 | 10 | 6 | 65 | 39 | ||||
| Jan 2002 | 114 | 65 | 7 | 4 | 1 | 1 | 52 | 30 | |||
| Jun 2002 | 53 | 48 | 5 | 5 | 1 | 1 | 52 | 47 | |||
| Return to Practice Nursing | 2002-03 | 30 | 38 | 25 | 32 | 10 | 13 | 13 | 17 | ||
| 2003-04 | 18 | 32 | 13 | 23 | 5 | 9 | 20 | 36 | |||
| 2004-05 | 19 | 45 | 9 | 21 | 14 | 33 | |||||
| BSc Specialist Practice Community Other pathways | Sept 2004 |
16
|
94
|
1
|
6
|
||||||
These detail the employment of those students who successfully completed the programme. Local employers include all employers in the Cheshire Merseyside area.
The high number in the 'other' category is because the data were collected in the sixth week of the trimester, when students had not had the opportunity to take up a post.
Summary of academic and practitioner standards in Nursing
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Nursing at the University of Chester in partnership with Cheshire and Merseyside Strategic Health Authority.
Strengths
- The University has worked closely with other higher education institutions on a collaborative post-qualifying framework for nurses to facilitate the student transfer of credits between them (paragraph 72).
- Learning disability students follow the patient's journey, which involves a multidisciplinary approach (paragraph 74).
Weakness
- External examiners and the reviewers note that students on some pre-registration nursing programmes demonstrate little evidence of using IPL reflective skills in practice systematically (paragraph 87).
C Quality of learning opportunities
Learning and teaching
91 The learning, teaching and assessment strategy has been developed by the School of Health and Social Care and its partners and reflects the principles of the University strategy. It is based on four objectives: to develop successful learners, to design inclusive curricula, to promote excellence in teaching practice, and to build institutional capacity for change. These objectives are formalised as a learning paradigm in the delivery of the programmes on campus and in practice placements.
92 Learning and teaching approaches are evaluated through the monitoring processes of the programmes, student evaluations and assessments of competence and practice placement audits. Subject staff have appropriate academic qualifications and practice experience to deliver the specialist modules in the programmes. There is an established staff-development policy which includes peer observations for all probationary lecturers and an annual peer review for all academic staff.
93 Health and Social Care staff development activities include in-house staff development days plus a University annual staff-development day. Dietetics staff are afforded 10 days a year in practice. The University and the SHA provide for relevant and selected staff to undertake, within the MEd award, a professional education pathway which meets the NMC requirements for a recordable teaching qualification and membership of the Higher Education Academy. This pathway is available for all newly-appointed nurses and midwives in the School, as well as some practice educators. Visiting lecturers (VLs) and users are encouraged to contribute to all the programmes. The VLs are subject to evaluations from both students and core staff who are involved with the module.
94 A variety of learning and teaching methods is utilised in all programmes and intended to encourage students to take responsibility for their own learning. This is evidenced in the practice placement areas in nursing, where the hub-and-spoke model of learning is adopted. Using this approach, students can follow the patient's journey and be involved at all the appropriate stages of care. This method was particularly evident on the orthopaedic wards at the Countess of Chester Hospital.
95 The recent establishment of the Learning and Teaching Institute (LTI) has encouraged a review of the teaching activities and research into learning and teaching across the University. Within this framework, a number of staff within the Schools are currently engaged in extending staff development activities and stimulating further research and scholarship in learning and teaching. The Institute already has Learning Support Services for students and staff located within it and in future will house the Learning Technology Support Unit. Learning Support Services are available at the Chester and Warrington campuses and at each of the hospital sites.
96 The LTI staff work with the School's learning, teaching and assessment coordinators and e-learning coordinators, alongside the School learning, teaching and assessment representatives, to formulate the School's learning, teaching and assessment strategy. The LTI works collaboratively with each School to complement their learning and teaching provision.
97 The LTI has taken on the responsibility for the strategic development of e-learning and e-pedagogy, in conjunction with the Communication and Information Technology Services (CITS). In Non-Medical Prescribing modules there are a number of individual e-learning modules and also elements of e-learning within other developed modules. This mode of learning and delivery is not being fully exploited, but the establishment of the LTI and the development of the new e-learning coordinators' posts signals the University's commitment to the strategic development of e-learning and e-pedagogy.
98 At the core of the undergraduate and pre-registration provision is the practice element enabling students to achieve competent practitioner status. The Practice Allocation Unit at Bache Hall is highly effective in coordinating, planning and managing placements for each of the nursing and midwifery programmes and is a central point of contact for students. Dietetics placements are organised within the academic team, in conjunction with the service providers across a wide geographical area. Clinical placement facilitators in dietetics have been instrumental in ensuring that students experience parity and equality while in practice placements.
99 Practice coordinators are employed by the School of Health and Social Care to monitor practice placements, support the service and expand the range of placements. These posts are managerially responsible to the Head of Practice Learning. Clinical facilitators work very closely with the School and especially with the link lecturers, who are geographically linked to placement areas, to provide students with well-organised learning experiences and to identify new placement opportunities.
100 Students said that an appropriate range of placements was available to ensure that they experienced different types of clinical environments. So that they could maximise their learning experiences, students in adult nursing self-rostered their off-duty time to coincide with their mentor.
101 Practice placement staff are highly committed and enthusiastic in their efforts to support students in their learning. Of particular note were the opportunities for IPL provided at Prospect House Nursing Home and the Orthopaedics Unit at the Countess of Chester Hospital. Collectively, the SHA and Trusts work closely with the University to provide effective, well-managed learning support for students in care settings.
102 While the schools and their partners have worked on formalising the IPL within the workplace, less emphasis has been placed on facilitating student groups into formal interprofessional groups for learning within a School. Post-qualifying and postgraduate activity, along with CPD commissioning from partner Trusts, is developing, and a range of individual modules can be accessed by more than one professional group.
103 The development of the hub-and-spoke approach to IPL in many practice areas has enabled a structured approach to other professional departments with which the student could work during placements. Pre-registration nurses and midwives, as part of the learning profile, record evidence of working with other professions. The effectiveness of the initiative will be reviewed and reported at programme management meetings.
104 In nutrition and dietetics, the undergraduate programme includes a module dedicated to IPL at honours level. This covers learning about, from, and with other health professionals and provides opportunity for students to learn alongside others from different health backgrounds such as medical students. Plans for additional IPL opportunities are being developed and will include workshops with students from health and social care and occupational therapists. Plans for practice-based/workplace IPL are being developed for placement A, B and C. The supporting documentation and process for the allocation of dietetics placements is clear and comprehensive, and includes information about priority criteria and appeal. Postgraduate nutrition and dietetics students learn alongside public health nutrition students throughout their first year of studies.
105 The research and scholarship strategy of the School of Health and Social Care emphasises the importance of increasing the quantity and quality of its research output, of concentrating its research effort on applied research and knowledge transfer and of enhancing the capability of its staff to undertake research. The School has established seven practice development and research units in partnership with NHS Trusts to further practice development, research and staff development. A number of reports commissioned have been in collaboration between the SHA and the University.
106 Generally, students expressed a high level of satisfaction with their learning experience. They commented favourably on the level of support in the learning environments from their mentors, clinical facilitators and link lecturers. The IBIS provides an efficient and effective method of communication to students.
The quality of learning and teaching is commendable.
Strengths
- The Learning and Teaching Institute works collaboratively with each School to complement their learning and teaching provision (paragraph 96).
- The Practice Allocation Unit at Bache Hall is highly effective in coordinating, planning and managing placements for each of the nursing and midwifery programmes (paragraph 98).
- Practice placement staff are highly committed and enthusiastic in their efforts to support students in their learning (paragraph 101).
- The School has established seven practice development and research units in partnership with NHS Trusts to further practice development, research and staff development (paragraph 105).
- The internet-based information system provides an efficient and effective method of communication to students (paragraph 106).
Weakness
- While the schools and their partners have worked on formalising the interprofessional learning within the workplace, less emphasis has been placed on facilitating student groups into formal interprofessional groups for learning within a School (paragraph 102).
Student progression
107 There are effective arrangements for admission and induction that are generally understood by staff and applicants. Detailed information is sent out prior to enrolment, outlining the programmes. Applicants are invited to attend the University and service staff are involved in the selection process. A corporate induction package is available, and health and safety requirements are included in the content. Each placement provides a welcome/induction pack. Students confirmed that they were well prepared for practice and described examples of current safe and ethical guidance in learning disability and in midwifery.
108 Taster events have been held for 14-year olds, where academic staff explain the programmes to enable potential applicants to exercise informed choice. In nutrition and dietetics, there have been more applicants than available places and the number of students on the PgDip shows an increase of 10 or 11 students in each cohort over the past two years. A workshop is run for applicants who are interested in dietetics and would like more information before submitting an application form.
109 Entrance to each programme is through varied routes and students can use professional experience as alternatives to qualifications. The procedures for the Accreditation of Prior (Experiential) Learning processes are clearly defined and advisers are available on each site to offer appropriate advice and guidance.
110 The University has a well-developed strategy and structure for academic placement and pastoral support, and students spoke highly of the support they receive. Good support has been found to be effective in improving recruitment to the learning disability programme. In dietetics, students appreciate the five-day 'catch-up' biochemistry course offered by the University prior to commencing their postgraduate programme.
111 Students encountering difficulties are interviewed to identify the problems. A flow chart enables the teaching team to manage underperforming students by following step-by-step action points to provide help for the individual. The introduction of the GAG for pre-registration students in health and social care offers a useful tool for guiding the interviews on areas that are required in dealing with clients. The reviewers' analysis of student work highlighted the help provided for developing study skills.
112 The University has a policy to widen access. Targets are monitored and planning is collaborative between service staff, the SHA and the University. As part of a national initiative for workforce targets, a robust analysis of retirement, service delivery requirements and new ways of working has been completed. Recruitment to the programmes is guided by a strategy based on frequent market analysis and consideration of the patterns of demand across the sector.
113 A range of activities is in place to enable students to complete their programme successfully. Regular progress meetings are held to strengthen the partnership arrangement. A position paper articulates the University's commitment to diversity and equality, providing examples such as policy making, employment practices and service delivery. Any student with special needs can self-refer; this is treated in confidence and a personal plan is put in place.
114 Most placements are well planned; service providers receive notification in advance and students receive such information some four weeks in advance. Many students receive comprehensive support from link teachers, mentors and practice facilitators. In a recent survey carried out with pre-registration students in the School of Health and Social Care, 90 per cent of students confirm that they are well supported and feel confident to practise. The exceptions to this related to the first placement and return to nursing practice students who considered that more support could have been available. In midwifery, students were supported by the practice development facilitator on a day-to-day basis and, where a shift is particularly stressful, a midwife is always available.
115 In some areas, a buddy system has been introduced, where a third-year student supports a first-year student. To gain confidence, students can opt to work an extra shift with their mentor. Funding has been increased to extend the role of clinical facilitators as a multi-professional focus to help students develop confidence in practice.
116 Academic staff operate an open-door policy for students, and they respond swiftly through email or telephone, although students reported that responses from Arrowe Park staff can be slower. In dietetics, the external examiner commented that students were thoroughly enjoying the practice component of their programmes.
117 Students' views are represented on the student/staff committees and issues are resolved quickly, as noted in the examples of workload and library opening times. Students are encouraged to work towards lifelong learning critical thinking and reflection in midwifery. Such developments are supported by the important information to be found on IBIS. There is a wide range of modules that can be used by professionals as step-on, step-off points to encourage flexibility.
118 Assessor/mentor preparation in the School of Health and Social Care is work-based and regular updates are provided; details are kept on a database, although there is no tracking of update requirements. Resource files are provided for reference for the mentors. E-learning is limited to information about where students are in their programme and to IBIS.
119 Although attrition is higher than the SHA target in the Return to Practice and pre-registration programmes, rates of completion compare favourably when mapped against published trends in most programmes. Primary reasons for attrition are said to be financial and personal. Academic staff have introduced a range of withdrawal monitoring procedures, including exit interviews.
120 Nomination of Trust secondees to all pre-registration branches has presented challenges of shortfall and this is particularly so in mental health. A focused recruitment event has been effective in increasing the number of male applicants to the mental health branch. Recruitment to the BSc Nursing has increased from 23 to 45 in the last two cohorts. Quarterly reviews and monthly returns are applied to monitor the numbers closely.
121 The SHA monitors shortfalls to targets to ensure commissions reflect Trust capabilities and needs. Students following programmes for health professionals have some flexibility, as they are able to complete their programme over seven years. They can step on and off the programme according to their particular career and personal circumstances. Given the flexible nature of these programmes, effective measures to track and support students are in place.
122 Mentors described the process they follow for underperforming students and were clear about whom to contact. Difficulties are often identified early on in the placement, when the link lecturer and placement facilitator work with the student on a personal development action plan.
Table 3: Recruitment and Attrition Statistics for pre-registration and NMC-recordable qualifications
| Award title | Recruited number | Withdrawal | Transfer in | Transfer out | Discontinuation | ||||
|---|---|---|---|---|---|---|---|---|---|
| No | % | No | % | No | % | No | % | ||
| DipHE in Nursing | |||||||||
| October 2001 | 204 | 30 | 15 | 1 | 1 | 36 | 18 | 13 | 6 |
| January 2002 | 206 | 41 | 20 | 25 | 12 | 22 | 11 | 11 | 5 |
| June 2002 | 93 | 30 | 32 | 26 | 28 | 6 | 6 | 6 | 6 |
| BSc (Hons) Nursing | |||||||||
| September 2003 | 23 | 6 | 26 | 1 | 4 | ||||
| September 2004 | 45 | 4 | 9 | 1 | 2 |
4
|
9
|
||
| Return to Practice Nursing | |||||||||
| 2002/03 | 86 | 8 | 9 | ||||||
| 2003/04 | 62 | 6 | 10 | ||||||
| 2004/05 | 54 | 12 | 22 | ||||||
| BSc (Hons) Specialist Practice Community other pathways | |||||||||
| September 2004 | 25 |
2
|
8
|
||||||
| BSc ( Hons) Specialist Practice Community Health Visiting | |||||||||
| Sept 2004 | 15 |
1
|
7
|
||||||
| PgDip Specialist Practice Community (Health Visiting) | 4 |
1
|
25
|
||||||
| PgDip Specialist Practice Community other pathways | |||||||||
| September 2004 | 4 |
2
|
50
|
||||||
| Non-Medical Prescribing | |||||||||
| April 2004 | 27 | ||||||||
| September 2004 | 24 |
1
|
4
|
||||||