MENTOR HANDBOOK · 9.3 The Practice Portfolio 27 ... Mentor Handbook 2018-2019 Practice assessment is designed to test the ability of ... practice. The teaching and learning

Pre Registration Midwifery Mentor Handbook 2017-2018 1

Faculty of Health and Human Sciences School of Nursing and Midwifery

BSc (Hons) Pre-Registration Midwifery

MENTOR HANDBOOK 2013 Curriculum

(For September and February cohorts)

Academic Year 2018-2019

Pre-Registration Midwifery 2 Mentor Handbook 2018-2019


If you require any part of this publication in larger print, or an alternative format, please contact Programme Administration at:- Faculty of Health and Human Sciences Plymouth University Floor 4, Rolle Building Drake Circus Plymouth PL4 8AA School of Nursing and Midwifery Professional Services team: 01752 586964 / 586959 / 586963/ 586954/ 586990 Faculty Student Reception: 01752 585335/ 585332/ 586999 Faculty of Health and Human Sciences School of Nursing and Midwifery Plymouth University Knowledge Spa, Royal Cornwall Hospital Truro TR1 3HD Student Reception: 01872 256450

Faculty of Health and Human Sciences

University of Plymouth.

WESC Foundation, Topsham Road. Countess Wear, Exeter, EX2 6HA

Student Reception: 01752 585858

tel:+441752585858


Information Regarding Students with Special Needs If students have a disability The University is very supportive of students with disabilities, and year–on-year we are making adjustments to assist students with special needs. It may be that we have already put in place changes which will assist them – but unless we know what their needs might be, we cannot guarantee that that will be the case. If we can identify their needs sufficiently far in advance of when they intend to start a course at the University, we are better able to put in place appropriate arrangements – or, if there is a health and safety issue or an issue about the expectations of students on the course, to advise them on alternative options. However, we may not be able to do so if we do not know in advance. If they have not told us about their disability Please do encourage the student to contact the University’s Disability Assist Services on Plymouth 01752 587676 to discuss their needs if they raise these with you. While we are making reasonable adjustments to our provision, we may not be able to meet their individual needs if we do not have the opportunity to assess them in advance, and that could impact negatively on their experience on the course or even their ability to take up their place. If they have told us about their disability Students may be asked for additional information or invited to attend an interview with Disability Assist Services. This is in order that we can properly assess their individual needs and ensure that we have the best possible chance of meeting them. Students are asked to provide any information requested and come in to see staff if asked to do so, since otherwise they – and we - could find ourselves in a position in which it is difficult or even unsafe for them to take up their place. If you require further information please see the website for more information: http://www.plymouth.ac.uk/disability

http://www.plymouth.ac.uk/disability


Disclaimer Plymouth University is proud of its teaching and research and it undertakes all reasonable steps to provide educational services in the manner set out in this handbook and in any documents referred to within it. It does not, however, guarantee the provision of such services. Should industrial action or circumstances beyond the control of the University interfere with its ability to provide educational services, the University undertakes to use all reasonable steps to minimise the resultant disruption to those services. All the information in this handbook is correct at the time of printing. Courses are regularly reviewed and updated so details may change. Occasionally, a module listed in the handbook may be replaced or withdrawn.

Copyright of this Mentor Handbook is held by the Plymouth University Midwifery Team


CONTENTS

Faculty of Health and Human Sciences contact details 2

Information regarding students with special needs 3

Disclaimer 4

Introduction

7

1 What is the purpose of the mentor handbook?

8

2 Who is available to support me in my role as mentor? 8

2.1 The Midwifery Team 8

2.2 Practice Quality Development Division (PQDD), POPPI and ARC

10

2.3 Placement Development Teams (PDT) 10

3 What do I need to know about the placements? 11

3.1 Provision of Placements 11

3.2 Placement Learning 11

4 What is expected of students when on placement? 12

4.1 Adhering to Trust Policies 12

4.2 Guidelines for the Management of the Practice Experience 12

4.3 Professional Responsibilities in Relation to Conflicts of Interest

14

4.4 Programme Attendance and the Responsibilities of Students 15

4.5 Health and Good Character 16

4.6 Fitness to Practice Procedures 16

4.7 Social Networking Sites 16

4.8 Travel Insurance, 17

4.9 Ambulance Escorts 17

4.10 Uniform Policy 17

4.11 Infection Control and Handwashing 18

4.12 Countersignatures in Records 18

4.13 Statement re Employment Law 19

4.14 Plymouth University Pregnancy Policy 19

5 What happens if a student is involved in or witnesses a clinical incident?

20

5.1 Incidents in the Clinical Area 20

5.2 Guidelines for dealing with Unsafe Practice/Inappropriate Professional Behaviour

20

5.3 Accidents in the Clinical Area 21

6 How are mentors selected? 22

7 What is a sign-off mentor? 22

7.1 Definition 22

7.2 Criteria for Sign Off 23

7.3 Triennial Review 23

8 What are my responsibilities as a sign-off mentor? 24

8.1 Summary of the responsibilities of the sign off mentor 24

8.2 Support and Feedback 26

8.3 Maintaining your sign off mentor status 26


9 As a sign-off mentor, what do I need to know about the assessment of practice?

26

9.1 The importance of practice assessment 26

9.2 What is assessed? 26

9.3 The Practice Portfolio 27

9.4 Formative Assessment 28

9.5 Summative Assessment and the Tripartite meeting 29

9.6 Protected Time 31

9.7 The Students’ Responsibilities 31

10 What does the curriculum cover? 32

10.1 General Principles 32

10.2 Overview of the curriculum 33

11 Student Midwife Caseloading 33

12 References 33

12 Appendices

36

1 Glossary of Terms

37

2 Portfolio of Activities to meet Nursing and Midwifery Council Criteria for ‘Sign off Mentor’

42

3 PRACTICE ASSESSMENT PROCESS includes: Practice portfolio components, MAP criteria, Guidelines for use of assessment document, Guidelines for grading of practice and criteria for awarding grades Example of completed MAP criterion, Final sign-off mentor statement of proficiency

43

4 Placement Record

51

5 Examples of practice Tripartite form and Unsatisfactory Progress Learning Contract

56

6 Curriculum overview: BSc (Hons) Pre-Registration Midwifery (2013 curriculum)

58

7 Example of completed timesheet and instructions

64

8 Student Midwife Caseloading documentation

• Introduction to Student Midwife Caseloading

• What is the difference between Student Midwife Caseloading and caseloading for midwives?

• The process of Student Midwife Caseloading

• Caseloading flowchart

66


INTRODUCTION Plymouth University currently offers the BSc (Hons) Pre- Registration Midwifery Programme 2013 curriculum. The programme is based in the School of Nursing and Midwifery within the Faculty of Health and Human Sciences and leads to registration as a qualified midwife with the Nursing and Midwifery Council (NMC). All midwifery theory is delivered on the Plymouth campus Drake Circus Campus. Students undertake clinical placements throughout the South West Peninsula. It is normal practice for students to remain with their “host” Trust for the duration of the programme. The principle that governs the assessment of practice is the achievement of the Nursing and Midwifery Council (NMC, 2009) Standards for pre registration midwifery education requirements and which also incorporate European Union Directive 2005/36/EU. In addition, the NMC now requires the five Essential Skills Clusters for Midwifery to be explicitly incorporated into both theory and practice components of the curriculum (NMC 2007b, NMC 2009). It also requires practice to be graded. The NMC (2006, 2008a) “Standards to support learning and assessment in practice” have had a major impact on mentorship in Nursing and Midwifery which will be explained in this handbook. Sets of data on all programmes in all universities nationally are now available

on the UNISTATS website (Key Information Sets (KIS)) and ‘widgets’ are

accessible on the University Portal course pages. This comprises information

regarding the ‘student experience’ obtained from a variety of sources including

the National Student Survey, University databases and programme-level

detail provided by programme teams.

We thank you for your continued support of midwifery students as they undertake the clinical elements of their programme. Alison James and the Midwifery Team 15/07/18


1. What is the purpose of the mentor handbook?

The Mentor Handbook for the Pre-Registration Midwifery programme attempts to answer some of the questions that are asked about the role of the mentor in supporting students and assessing their practice. The programme currently delivered in the Faculty of Health and Human Sciences is outlined, along with information in relation to expectations of midwifery students.

A glossary of relevant terms is provided in Appendix 1.

If you have any queries about the content of this handbook, please feel free to contact the student’s personal tutor or a member of the midwifery team in the Faculty of Health and Human Sciences.

2. Who is available to support me in my role as a mentor?

2.1 The Midwifery Team

Contact details for Midwifery lecturers can be seen on the next page. Staff are based at the Drake Circus campus, Plymouth (see full addresses on page 2):

Each clinical area has a midwifery link lecturer who is available to support and advise staff and students (identified in the table below). They are responsible for overseeing the students’ placement allocations and experience in the area, and liaising with clinical managers and staff. They also have a remit to monitor quality of the placement and support the maintenance of the live mentor register which is held by the Trust.

Each student has a designated personal tutor throughout their programme. Usually this is the link lecturer or a midwifery colleague also linked to the area. The personal tutor provides academic, pastoral and clinical support to the student, acts as ‘moderator’ in tripartite discussions at summative points in the programme and is the first point of contact if any concerns are identified.


Midwifery Lecturers Name Link area

Academic role e-mail Telephone and office base

Margaret Fisher Yeovil and Torbay

Associate Professor (Senior Lecturer) in Midwifery MSc Programme Lead

[email protected]

01752 587588 or 07815527989 Room 213, 8 Portland Villas Drake Circus, Plymouth

Dr Sarah Fitzpatrick Plymouth

Lecturer, Midwifery Admissions Tutor

sarah.fitzpatrick @plymouth.ac.uk

01752 587594 Room 212, 8 Portland Villas Drake Circus, Plymouth

Heather Hopper Taunton

Academic Lead, Midwifery; Lead Midwife for Education (LME)

[email protected]


Dr Alison James Cornwall

Associate Professor (Senior Lecturer) in Midwifery Pre-Registration Midwifery Programme Lead

[email protected]


Rebecca Lawes Plymouth

Lecturer, Midwifery

[email protected]


Rachel Stanyer Exeter

Lecturer, Midwifery [email protected]


Andrea Stebbings Barnstaple



Angela Thompson Exeter



Leeshia Walton Cornwall



mailto:[email protected]










2.2 The Placement Team, POPPI and ARC

The Placement Team provides strategic direction for the management of practice based learning across the Faculty of Health and Human Sciences. The Division works in partnership with other Higher Education Institutions, placement providers and healthcare commissioners to assure the provision of quality practice learning. Information key to mentoring students can be found on the POPPI website at https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi .This is freely accessible via the internet and comprises information including current mentor/ programme handbooks, Plymouth University policies of relevance to clinical placements/ professional issues and links to the mentor update resource and workbook. There is also a password-protected area on this site called ARC, which houses details of the students’ allocations and placement profiles. Key clinical staff and academics have access to ARC.

2.3 The Placement Development Team (PDT)

Placement Development Teams are led by a regional Academic Lead from Plymouth University and a Practice Lead in each Trust. All midwifery lecturers belong to a PDT and are part of the overarching team whose remit is to support placement learning. Mentors and students have access to the PDT Academic and/or Practice Leads in addition to the personal tutor/link lecturer, should this support be needed. Contact details for PDT leads in your locality can be found on the POPPI website at https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi Figure 1: Support systems for sign-off mentors

Practice Quality Development Division

(PQDD)

Placement Development Team – Academic and Practice Leads

Practice Education/

Development Midwife

Personal Tutor Link Lecturer

Module Teacher Module Leader

Programme Lead SIGN-OFF

MENTOR

Placement/ practice area

Managers

Trust Education Co-ordinator

Buddy/ co-mentors Professional bodies

https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi





Peer support

3. WHAT DO I NEED TO KNOW ABOUT PLACEMENTS?

3.1 Provision of Placements

Professional programmes require students to successfully complete periods of clinical/professional placement as a condition of progression and graduation. These placements are provided by external agencies such as health service providers. The University will take every care in ensuring that providers are advised of requirements in advance and in securing placements for all students at the requisite time. However, students need to be aware that circumstances beyond the reasonable control of the University may occur in which, as a result of changes within the Health Service or other external factors, it is not possible for providers to meet placement requirements. In such circumstances, while the University will make every effort to make alternative arrangements for students to meet the requirements of their programme, including identifying suitable alternative placements wherever possible, students should be made aware that it is possible that the completion of their programme may be unavoidably delayed and/or that the alternative arrangements put in place may cause some inconvenience. It is therefore essential that, as a mentor, you advise Plymouth University through the Link Lecturer or Academic Lead of the Placement Development Team if problems arise in supporting students.

3.2 Placement Learning

The purpose of practice experience within the Pre-Registration Midwifery programme is to facilitate individual skill development within an inter-disciplinary arena, to introduce students to the world of health care delivery and to develop an awareness and understanding of the relevance of theoretical concepts to the practice of midwifery. Placement experience provides the opportunity to integrate academic, practical and interpersonal aspects of midwifery and develop problem- solving skills and reflection abilities. The aim is to produce both a safe and proficient practitioner at the point of registration to become a midwife, who meets the requirements of the NMC and the programme. The clinical education placements are essential and are integrated components of students’ education and development as a midwife. Placements in both community and hospital settings are supported by designated clinical midwives who take on the formal role of sign-off mentor, having been prepared for the role and updated annually. All midwifery mentors are required to be sign-off mentors (NMC, 2008a – see Section 7 for further details).

Practice experience is distributed throughout the midwifery programme with a 45:55 theory / practice ratio. Students can therefore take full advantage of all the learning opportunities during a placement to achieve their learning objectives and assessment of their practice. All midwifery students will be exposed to both hospital and community based maternity


settings at some stage in their programme. Placements may vary such as integrated teams or opportunities to be placed in a midwife led unit, depending on the maternity care pattern in the student’s host Trust. Students will also have some experience in selected non maternity areas including gynaecology wards, intensive care units and emergency departments. Students are expected to experience student caseloading as part of their programme (NMC 2009) – please see Section 11/ Appendix 8 for further details.

4. WHAT IS EXPECTED OF STUDENTS WHEN ON PLACEMENT? 4.1 Adhering to Trust Policies

When in practice, students must adhere to the Policies and Procedures of the local Trust, for example Administration of Drugs and Venepuncture. They may also be expected to undertake local Trust Induction – most Trusts requiring this before the students engage in any clinical practice.

4.2 Guidelines for the Management of Practice Experience

a. Students have supernumerary status throughout their Pre-Registration Midwifery programme. This means that throughout the programme they are part of the care team but extra to the staff allocated complement.

b. Students must work under the direct or indirect supervision of a registered health professional at all times. If working with a non-registered colleague such as an MSW or MCA, the midwife or nurse indirectly supervising the student’s practice (and that of the non-registered member of staff) must be clarified before the student engages in any clinical practice.

c. Students should work the same shifts, or part of, as their named sign-off

mentor/s. The NMC requires a minimum of 40% of the students time to be spent working directly/indirectly with their sign-off mentor/s. This would normally equate to at least two shifts per week. In addition, one protected hour per week needs to be identified for the sign off mentor and the student to meet to monitor their progress and review assessment documentation (NMC, 2008a).

d. Students would not normally be expected to work more than 37.5 hours per week. However, individual weeks (e.g. night duty) may exceed this and should be taken into account so that an overall average of 37.5 hours in practice is maintained. It is the responsibility of the student and sign-off mentor to ensure these hours are being met. Meal breaks are not included in this calculation unless service needs require the student to work over them.

e. Students are expected to work shifts, and in order to experience the 24 hour care provision, must attend the hand over meetings at the beginning of the shifts. This will include start times of 07:00 hours on some


occasions. Weekend shifts and night duty are part of the 24 hour care provision and they are required to work these shifts as reasonable. For some experiences, on call arrangements may be appropriate.

f. Students are expected to work Bank Holidays unless the placement area is closed or has been timetabled in as a private study day by the programme.

g. Normally, students should work no more than two weekends in any four week period during the course.

e. Students are responsible for notifying their clinical placement and their

Faculty of Health and Human Sciences base that they are unable to attend due to sickness. Each site is staffed from 0830-1700 and there is an answer-phone for hours outside this time. If a student is absent without notifying the clinical placement area, the sign-off mentor should inform their line manager and/or the student’s personal tutor (see contacts on p9) or Plymouth University Programme Administration (see contact details on p2). Please also see item 4.3 below.

f. Submission of monthly timesheets. Students are required to submit timesheets on a monthly basis to the appropriate Programme Administration office. Timesheets are required to ensure students meet the Nursing and Midwifery Council requirements for registration, and are reviewed regularly. A new electronic timesheet is currently being piloted is some areas. A small number of students will be using these.

All clinical shifts must be initialed by the supervising midwife / nurse. Designated sign-off mentors sign these timesheets as additional confirmation that a student has worked the shifts identified. All staff signing timesheets are required to provide an example of their signature and initial in the student’s OAR. Please note that as a sign-off mentor you may refuse to sign the timesheet if these are not available for cross-reference. Personal tutors may also undertake spot-checks. Absence for any reason must be recorded on the student’s timesheet, as must any additional time worked. The information contained in the student’s records provides essential data for the NMC. Students will not be able to register as a midwife until all practice and theory hours have been completed. An example of a timesheet is shown in Appendix 7. If students have not submitted their timesheets for three consecutive months they may be withdrawn from their practice placement until these have been received. Please do not pre-fill timesheets as errors can easily occur. Both students and staff recording entries are accountable for what they document. Any amendments must be initialed and dated by the person making these alterations and deleted with a single line. Students are ultimately accountable for ensuring timesheets submitted are accurate. When in practice students must ensure the timesheet is initialed on a daily basis. If more than one period of practice is undertaken on a day, each must be initialed separately by the staff member directly or


indirectly supervising this period of practice; use a diagonal line to enable this. The Sign-off Mentor Declaration must be signed by the sign-off mentor (or the designated buddy mentor if the sign-off mentor is unavailable) at the end of the month. A specimen of all initials/signatures must be available in the student’s OAR document to enable the mentor to verify these. The sign-off mentor must also write the total number of hours they are verifying in the box provided.

g. Student Caseloading forms part of the Midwifery programme, as an NMC

requirement (NMC, 2009). Please see Section 11 and Appendix 8 for further information. A staff handbook is available in the ‘Mentor Centre’ on POPPI https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/nursing-and-midwifery

4.3 Professional Responsibilities in Relation to Conflicts of Interest

a. Students must not have a mentor/practice assessor to whom they are related or are close friends or well-known to them or their family. If this occurs they must inform the practice area and their Personal Tutor.

b. If students are placed in a GP or community practice, where they or their family is being treated they should make this known to their Personal Tutor and the staff in the clinical area.

c. Students must not work as an HCA / phlebotomist etc. in any area where they are currently also being placed as a student. If their paid work is within the same Trust they must be in different departments and 'geographically' separate. This is because there may be a perceived blurring of the role being undertaken by a student.

d. Paid employment can take many forms but students who do work in the role of care assistance must recognise that this role is inherently different to that of a student midwife. As this is a professional course, working in the capacity of anything other than a supervised student midwife may compromise their ability to appreciate the professional boundaries and integrity of the role.

e. The Pre-Registration Midwifery curriculum is made up of practice hours and theory hours (classroom and directed study hours). These hours are essential to meet the learning outcomes of the programme; therefore paid employment that impinges upon this is likely to affect a student’s learning and professional development.

f. If students do choose to undertake paid employment, it is advisable that they do not undertake more than 15 paid hour’s employment per week whilst undertaking theory and that any additional employment does not conflict with their programme. Because of the professional implications and long working hours we recommend that students do not undertake

https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/nursing-and-midwifery




additional part-time employment whilst in practice. Students should also be aware of European Directives regarding working hours.

g. In any form of paid employment the following activities will be considered serious and may require disciplinary action, which may result in discontinuation from the programme:

• Students who have not attended programmed sessions within the University because they have or are undertaking paid employment.

• Students who work consecutive shifts (within the same 24 hour period) as this may lead to excessive tiredness, which may endanger patients and the students themselves. This includes working before or after a study day at the University.

• Students who alter their practice shifts to undertake paid work elsewhere.

• Students who are identified on the duty roster in their practice placement and who take sick leave or absence in order to work as agency or bank staff in any healthcare environment or in other employment.

4.4 Programme Attendance and Responsibilities of Students

The Faculty of Health and Human Sciences has a policy for managing both negotiated and unforeseen student absences from the programme. This is to ensure compliance with the statutory attendance requirements of the Nursing and Midwifery Council (NMC) and the need to demonstrate responsible financial management of public funds. Failure to meet these requirements could constitute fraud and will be followed up through the Faculty Fitness to Practise procedure.

It is an expectation of Plymouth University and an NMC and programme requirement, that students attend their practice placements on a regular and punctual basis. As evidence of meeting this requirement students are responsible for completing a monthly timesheet of placement information which is then logged onto their training record, which the sign-off mentor must sign (see section above – 4.2h – and Appendix 7). There is also an expectation that students attend all study sessions and signing in for each session is required. This record will be used for monitoring any inconsistencies. If students are sick/ absent from the clinical placement, they are responsible for informing their placement, in addition to the Faculty of Health and Human Sciences.

The Faculty of Health and Human Sciences has a responsibility to monitor patterns of attendance and absence. This monitoring forms part of a quality assurance process. It is also undertaken to ensure that individual students are not placed at any unnecessary risk to their health or well being. Repeated patterns of absence can indicate the need to resolve underlying personal issues or matters related to placements or programme


design for that individual. It is always more constructive for students to raise matters likely to affect their attendance or studies with the Faculty of Health and Human Sciences before they become serious issues. This enables appropriate solutions to be identified/ negotiated at an early stage. It cannot be over-emphasised that the Faculty of Health and Human Sciences operates this policy with the aim of achieving supportive solutions to what may be experienced as complex and distressing personal circumstances.

Prolonged and repeated periods of absence in either theory or practice threaten the educational viability and continuity of a programme of study and can be disruptive to fellow students. Whilst learning outcomes can be met in a variety of ways, absence may nullify the benefits to be gained from learning activities such as seminar presentations, debates and group work. All practice hours must be made up prior to completion of the programme. Students will not be able to register as a midwife until all their practice and theory hours have been completed - please note that the programme is validated as 156 weeks, and students will not be able to complete prior to this date. Please note that extended periods of absence for whatever reason may impact on a student’s ability to attend graduation with their cohort.

Students are made aware that inconsistencies in timesheets or repeated absences will be followed up formally and may result in a Fitness to Practise investigation and/ or be included in any future job references.

4.5 Health and Good Character

In accordance with Nursing and Midwifery Council guidance, after an initial enhanced Disclosure and Barring Service (DSB) check and Occupational Health check prior to commencement of the programme, students are required to sign a self declaration in respect to these at the start of each academic year.

4.6 Fitness to Practise Procedures

Guidance for Nursing and Midwifery students on professional conduct may be found on the NMC website. The University also has a Fitness to Practise procedure for students. This may be found on the POPPI website at https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/policies-procedures-and-guidelines .

4.7 Social Networking Sites

Used properly, social networking sites such as Facebook are a great way to find old friends, join interest groups and share information. However, nurses and midwives should remember that anything posted on a social networking site is in the public domain. What may be considered to be letting off steam about a situation at work can potentially be read by someone who may take offence at the content of a posting. Nurses and

https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/policies-procedures-and-guidelines




midwives could be putting their registration at risk if posting inappropriate comments about colleagues or patients or posting any material that could be considered explicit. This includes messages relating to your own or others’ personal lives. Several complaints have been received by the Faculty from Trusts about this issue and remarks made about wards, placements, mentors and patients on Facebook by students. The Faculty takes this issue extremely seriously; the consequence has been that several students have been taken through the Fitness to Practise process. The three key areas are:

• Treat people as individuals and respect their dignity-whether it’s a colleague or a patients, never post a comment that could cause serious offence to that individual or anyone else

• Respect people’s right to confidentiality- this applies to wards, placement areas, patients and colleagues as well as personal lives

• Uphold the reputation of your profession at all times The NMC offers 5 tips for staying fit to practise online 1. Do learn how to adjust your security or privacy settings 2. Do treat online conversations as if you were talking to people in a public space where you can be seen and over heard 3. Don’t post or tweet under the influence of alcohol 4. Don’t reveal personal information about yourself that could put you at risk 5. Don’t post explicit material or break the law. Please see the NMC website www.nmc-uk.org for further information, as well as the Faculty policy on POPPI https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/policies-procedures-and-guidelines .

4.8 Travel Insurance

Students need to ensure that, when they undertake community placements using their own cars, such as during their caseloading practice, their current car insurance must provide business cover. In addition, any equipment carried in their cars needs to be covered by insurance, and they need to inform their insurers if they are carrying flammable gases.

4.9 Ambulance Escort

Students may only accompany a client in an ambulance in the presence of a registered midwife/ nurse; if the ambulance staff have agreed that they are happy for this additional person to be in the vehicle and a seat is available for them. Because the reason for transfer of a childbearing woman or baby is by implication a potentially high risk situation, midwifery students must be under direct supervision of a midwife at all times.

4.10 Uniform Policy

http://www.nmc-uk.org/





When in practice, students must adhere to the Uniform Policy of the local Trust. They must also adhere to the following guidelines which have been designed for their safety as well as that of the patients/ clients:

(a) hair must be kept off the face and above the collar line, (b) only one plain gold stud in each ear may be worn, (c) only a wedding ring may be worn, (d) only low-heeled plain nursing shoes may be worn, unless otherwise

specified.

If students are not required to wear protective clothing or uniform but their own clothes, it is expected that the points made above will be respected.

Uniform is designed to be worn while students are in a practice placement. It should not be worn outside the working environment.

Identity badges should be worn whenever students are on Faculty of Health and Human Sciences business. This includes both the photographic student cards and name badges.

4.11 Infection control and hand washing:

All students are reminded that there is a need to wash or cleanse their hands following infection control principles and using the five handwashing moments when providing midwifery care. It is important that women see that students have washed or cleansed their hands prior to and after providing care.

Students should ensure they are adequately protected against seasonal influenza/ H1N1 virus. Midwifery students are classed as front-line workers with a vulnerable group including pregnant women and babies. Students are advised to obtain their flu vaccinations in a timely manner via their Trust or GP. The policy relating to ‘Seasonal Flu Vaccines’ is on POPPI; students are advised to take this with them if they are having difficulties obtaining the vaccination.

If students have experienced symptoms of diarrhoea or vomiting they must contact the clinical area to confirm how long they will need to be away; they may require 24-48 hours without symptoms in line with their Trust’s guidelines.

4.12 Countersignatures in records

All entries made by a student in clinical records must be countersigned by the registered midwife (or nurse) supervising their practice. If they undertake care under indirect supervision and the midwife (or nurse) overseeing their practice is unable to countersign their documentation as not physically present, the student must write "under indirect supervision by..." and identify the registered midwife (or nurse) concerned so that lines of responsibility and accountability are clear. It is also very important that students clearly document any care


they have undertaken and a plan of action so that continuity of care can be provided to the woman/ client.

It is essential that students have a named midwife identified for them on every shift. This includes when they are working with another non-registered member of the team such as a Maternity Support Worker (MSW) or Maternity Care Assistant (MCA). The midwife remains accountable for the student’s actions and omissions. In students’ non-maternity placements a registered nurse must be similarly identified.

4.13 Statement re Employment Law.

Having taken advice from the Legal Department of the University and the Nursing and Midwifery Council the following statement has been prepared in response to a query raised by a pre-registration nursing student. The following statement however is pertinent to all students from the Faculty.

Essentially a student who is on placement may not be considered as an employee and does not have the same rights, pursuant to employment legislation as if they were to be treated as an employee. Therefore in so far as an employee might have the right to request flexible working in order to deal with post-pregnancy issues, that right does not apply to persons who are on placement.

From a Nursing and Midwifery Council perspective they advise that flexibility can only be achieved if it is available at a local level and indeed it may result in a student needing to lengthen their programme in order to achieve the requisite number of hours prior to registration.

We as a Faculty, abide by Section 22 of the Sex Discrimination Act 1975 recognising that is unlawful for the ‘responsible body’ of an educational establishment to discriminate on grounds of sex. Furthermore we cannot and indeed do not discriminate in the terms on which it offers to admit a student, or by refusing or deliberately omitting to accept an application, or the terms upon which a student, once admitted, is given access to facilities.

We will as a Faculty always do our best to be flexible and accommodate students’ requests, however due to the limits placed on us by the placement process, it may not always be possible to do so.

4.14 Plymouth University Pregnancy Policy

The University’s policy on supporting pregnant students and students with very young children can be found on the student’s programme’s MOODLE page.


5. WHAT HAPPENS IF THE STUDENT IS INVOLVED IN / WITNESSES A CLINICAL INCIDENT? 5.1 Incidents in the Clinical Area

Students may witness an incident while in clinical practice as an observer or a participant. Potentially this may involve them as a witness and they may be asked to write a statement of events. This is not something to be worried about but students should seek the advice of their personal tutor. He / she will advise them on how to manage such situations and accompany them to any necessary meetings which are arranged as a result of the incident.

Please do not let the student write any statement before seeking support from someone at the University, even if this is only through a telephone call.

It is very important that students promptly raise any cause of concern in the clinical area or university setting. Matters can then be addressed at an appropriate level of urgency. Students need to be supported to feel safe to do this. We have a duty of care to the public to ensure the care environment is safe.

5.2 Guidelines for Dealing with Unsafe Practice/ Inappropriate Professional Behaviour and Escalation of Concerns

The Midwifery team is mindful of the strategic vision for nursing, midwifery and care staff: ‘Compassion in Practice’ (NHS Commissioning 2012) as well as the outcomes of the ‘NMC Review of University Hospitals of Morecambe Bay NHS Foundation Trust’ (NMC 2012) and the more recently published ‘Francis Report’ (DH 2013). These documents highlight the importance of escalating concerns and demonstrating compassion in practice. As a result, the team will fully support any student identifying areas of concern, and follow up verbal or written concerns relating to students, in adherence with the NMC (2010) Guidance on raising and escalating concerns. The Faculty policy for Escalation of Concerns can be seen on the POPPI website.

The Nursing and Midwifery Council (2015) The Code: Standards of conduct, performance and ethics for nurses and midwives state that:

“The people in your care must be able to trust you with their health and wellbeing. To justify that trust, you must:

• Make the care of people your first concern, treating them as individuals and respecting their dignity


• Work with others to protect and promote the health and wellbeing of those in your care, their families and carers, and the wider community

• Provide a high standard of practice and care at all times

• Be open and honest, act with integrity and uphold the reputation of your profession”,

Specifically, “You must:

• Act as an advocate for those in your care, helping them to access relevant health and social care, information and support

• Disclose information if you believe someone may be at risk of harm, in line with the law of the country in which you are practising”.

Teachers of Nursing and Midwifery are covered by NMC guidance on accountable practice. Therefore, where practice which apparently compromises the safety of others is reported verbally, in writing or within assignments, they are bound to act in a manner that protects those at risk.

All cases of practice that compromise the safety of others revealed through reporting, reflection or in writing will be acted upon:

• Practice that compromises the safety of others will be discussed in a non disciplinary/supportive way with the appropriate line manager.

• In order to encourage student responsibility they may if they wish, be involved in discussions with the appropriate party.

• The appropriate party shall be deemed to be the designated Senior Manager in the practice placement.

• It is the responsibility of the placement provider to investigate and act upon the information received from the teacher, to ensure the maintenance of quality care and safe practice for patients, clients and others, to keep appropriate records and to report action taken to the teacher and student concerned.”

5.3 Accidents in the Clinical Area If a student is involved in an accident on Trust premises or at any other placement premises, an Accident Form will normally be provided by

staff at that location, and they will retain the completed form. It is important that the Faculty of Health and Human Sciences is aware of the accident, so that any particular circumstances or injuries can be taken into account when the student returns to the Faculty of Health and Human Sciences premises. It is in the student’s own interest that copies of all records of accidents are retained on their Faculty file so that full information is available if there are long-term consequences of injury which were not


immediately apparent at the time of the accident. Therefore, if an accident does arise away from Plymouth University / Faculty of Health and Human Sciences premises, the student should ask for a copy of the completed Accident Form to be forwarded to the Faculty of Health and Human Sciences (Programme Administration) or alternatively, if in doubt, should ask the Faculty of Health and Human Sciences for an Accident Form for completion. If students are injured in any way while on Trust premises, they will be treated in the first instance by the Trust Occupational Health or Accident and Emergency Department. At a later date they will be seen by Exeter Occupational Health and Safety Service.

Please see further guidance/ policies on the POPPI website https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/policies-procedures-and-guidelines

6. HOW ARE MENTORS SELECTED?

Each Midwifery student requires at least one named midwifery sign-off mentor for every placement. Explanation of this term may be seen in Section 7. In addition, the student may be supported by buddy/ co-mentors who are not fully qualified/ experienced as sign-off mentors but may contribute to the body of evidence of the student’s practice in the progress reports and in the MAP (Mentor Assessment of Proficiencies/ Practice) practice document. This evidence will help to inform the sign-off mentor in assessing the student’s practice. Only the sign-off mentor may indicate whether or not the student has achieved the practice statements and MAP criteria and award a grade.

Selection of appropriate midwifery sign-off and buddy mentors is

usually by the clinical manager/ practice education/ development midwife in conjunction with the link lecturer. It is important that you highlight your need to be allocated a student if you are approaching the time of your triennial review (see Section 7.3) and have not mentored at least two students in the past three years.

Nursing mentors should be identified for midwifery students when

on allocation in non-maternity areas. These mentors should supervise and facilitate the student’s learning, but not sign summative practice assessment documentation. Their formative evidence may also inform the midwifery sign-off mentor in making decisions about assessment of the student’s practice.

7. WHAT IS A SIGN-OFF MENTOR? 7.1 Definition

“The term ‘mentor’ is used to denote the role of the nurse, midwife or health visitor who facilitates learning and supervises and assesses students in the practice setting. The Nursing and Midwifery Council, as an





outcome of the review of Fitness for Practice, now requires all midwives designated as mentors for student midwives to be ‘sign-off mentors’ (NMC 2008a: “Standards to support learning and assessment in practice”).

7.2 Criteria for a Sign-off Mentor

A sign-off mentor must:

• Be identified on the local register as a sign-off mentor or practice teacher

• Be registered on the same part of the NMC register

• Be working in the same field of practice as that in which the student intends to qualify

• Have clinical currency and capability in the field in which the student is being assessed

• Have a working knowledge of current programme requirements, practice assessment strategies and relevant changes in education and practice for the student they are assessing

• Have an understanding of the NMC registration requirements and the contribution they make to the achievement of these requirements

• Have an in-depth understanding of their accountability to the NMC for the decision they must make to pass or fail a student when assessing proficiency requirements at the end of a programme

• Have been supervised on at least three occasions for signing off proficiency by an existing sign-off mentor (at progression points or at the end of the final placement) or have undertaken the Faculty-approved Portfolio of Activities to meet Nursing and Midwifery Council Criteria for ‘Sign off Mentor’ (please see Appendix 2 for further information about this process which is based on NMC Circular 05/2010)

• Have completed an NMC approved mentorship preparation programme and/or undertaken APEL (Accreditation of Prior Learning) of existing qualifications and in some cases further study, as required by the local Trust).

All sign-off mentors must be annotated as such on the live mentor register held by each Trust. All sign off mentors will need to undertake a triennial review to ensure that they have met the criteria to continue to be a sign-off mentor (see point 7.3 below).

7.3 The Triennial Review

All sign-off mentors and buddy/co-mentors will need to attend a triennial review (NMC 2008a: “Standards to support learning and assessment in practice”). The format of this meeting will be agreed locally, but will entail a review of your experience over the last three years. Evidence supporting your eligibility to become/ remain annotated as a sign-off mentor on the Trust mentor register will be reviewed. It is important that you keep a record of the following evidence:


• Sign-off mentor or buddy/ co-mentor of at least two students in the past three years

• Participation in annual mentor update – to include exploring assessment and supervision issues with other mentors/sign-off mentors

• Exploration as a group activity of the validity and reliability of judgements made when assessing practice in challenging situations

• Mapping of ongoing development in sign-off mentor role against current NMC standards

• Met all requirements needed to be maintained/newly annotated on the local register as a sign-off mentor

8. WHAT ARE MY RESPONSIBILITIES AS A SIGN-OFF MENTOR? 8.1 Summary of the Responsibilities of a Sign-off Mentor

Your role as a sign-off mentor plays an essential part in facilitating the student midwife’s learning as s/he gains the knowledge and skills necessary for registration with the Nursing and Midwifery Council. The table on the following page summarises your key responsibilities. Further details regarding the process of assessment of practice in midwifery can be seen in Section 9 and Appendix 3.


Responsibilities of a Sign-off Mentor

You are identified as the sign-off mentor for a midwifery student by your line manager/ practice education midwife/ link lecturer when the University notifies the placement of student allocations via the Link Lecturer or ARC.

If you require a briefing session/ annual mentor update to familiarise yourself with the relevant assessment of practice process and documentation, you need to make the necessary arrangements. This information may also be found on the POPPI website.

The student should contact you in advance of the placement, when you agree their off-duty rota and discuss key learning objectives/ other issues relating to the placement or assessment of practice.

Orientate the student to the placement setting on the first shift, and explain local health and safety and emergency procedures. Guide the student to any local induction requirements as applicable. Negotiate a learning contract based on module/ programme learning outcomes, self-assessment by the student and available placement opportunities. This should occur within two weeks of the start of the placement. Timing of formative and summative assessments are agreed in line with programme requirements. Other contact time, including the hour per week protected time required by the NMC, is also agreed. Note that the NMC requires you to work with your student a minimum of 40% of the time (2 days per week).

Formative review of the student’s progress is undertaken midpoint in the placement at a minimum. It is important that documentation of the student’s progress in the Placement Record and MAP is maintained throughout the placement and not left until the summative point. Please also refer to the student’s e-portfolio for further evidence. Learning contract updated. Any continuing problems are referred to the student’s personal tutor/ link lecturer/ practice educator/ Academic or Practice Lead of the Placement Development Team as appropriate, and a tripartite may be requested.

Summative assessment is undertaken towards the end of the placement, after the student has had the required amount of experience and has undertaken a formative review. The assessment must be completed by the specified submission date. You should use evidence from other health professionals/ buddy or co-mentors to contribute to your assessment as appropriate, counter-signing any of their entries in the MAP. Only the midwifery sign-off mentor may identify whether or not the student has


achieved the required statements and award grades for each MAP criterion (see Appendix 3). A tripartite meeting between the student, personal tutor and mentor is mandatory if it is a programme summative point. Grades will be moderated at this meeting and each must be signed by the sign-off mentor, student and attending lecturer. Failure to do so will result in referral.

The student is responsible for checking and submitting the practice assessment documentation.

8.2 Support and Feedback

It is recommended that you seek support from the key people identified in Section 2 as well as from your peers, as required. It is important that you obtain feedback on your role as a sign-off mentor as part of your continuous professional development from students, practice colleagues and academic staff. A form is available for students to use – please encourage them to provide this feedback at the end of their placement with you. Feedback should also be given during your triennial review with your line manager.

8.3 Maintaining your Sign-off Mentor Status You are required to ensure that you keep yourself up-to-date with mentorship and programme issues, and support a minimum of two Midwifery students in a three-year period. Please see specific NMC requirements in Section 7.2, including evidence required for your triennial review.

9. AS A SIGN-OFF MENTOR, WHAT DO I NEED TO KNOW ABOUT

THE ASSESSMENT OF PRACTICE? 9.1 The Importance of Practice Assessment

It is a Nursing and Midwifery Council requirement that students undertake a minimum of 50 per cent practice throughout their programme. Students must successfully achieve both theory and practice outcomes in order to obtain the award of BSc (Hons) Pre-Registration Midwifery leading to eligibility to apply for registration as a midwife. In those modules that have both a theory component and a practice requirement, both elements must be passed for successful completion of the module.

Assessments demonstrating the progression towards the academic award and competence in practice are submitted to the appropriate Award Assessment Board at the end of each programme year.

9.2 What is Assessed?


Practice assessment is designed to test the ability of the student to apply theory to practice, and to use practice experiences to verify or challenge theory and practice. As a sign-off mentor, you will continually be assessing your student’s performance and informing them of their progress. A tripartite meeting between yourself, your student and their personal tutor/link lecturer at summative assessment points provides the mechanism to review progress and performance and agree grades, as appropriate. It is also an opportunity for you to clarify any queries and receive support and feedback for your own development.

In order to comply with European Union directives for Midwifery registration, students will have to demonstrate that they have achieved the learning outcomes as identified in European Union Directive 2005/36/EU and the Standards for pre-registration midwifery education (NMC 2009). In addition, students are required to be taught and assessed in both theory and practice elements the Essential Skills Clusters for Midwifery and their practice must be graded (NMC 2009). All of the above are incorporated into the student’s practice portfolio and achieved during clinical placement learning, including caseloading.

9.3 The Practice Portfolio

The practice portfolio provides a comprehensive record of the student’s practice learning and achievements, and is central to the assessment of practice in the pre-registration midwifery programme. Students are expected to take responsibility for their own learning and completion of the practice assessment documentation by the required submission dates. Regular updating of the portfolio ensures that evidence is collected to support the Pre-Registration Midwifery programme and meet the requirements for registration with the Nursing and Midwifery Council. The Practice Portfolio forms an Ongoing Achievement Record (OAR) as required by the Nursing and Midwifery Council (NMC, 2009).

This practice portfolio is both paper based to enable formative and summative assessment and electronic to demonstrate the student’s wider learning.

The Essential Skills Clusters for Midwifery and Midwifery Standards (NMC 2009) form the basis of the assessed components within the Mentor Assessment of Proficiencies/ Practice (MAP) section in the Ongoing Achievement Record (paper component). Practice is graded by the sign-off mentor, fulfilling the NMC requirements (NMC 2009).

The paper component (Ongoing Achievement Record - OAR) comprises:

• Signature record (all staff singing time sheets and anyone contributing to entries in the OAR must provide specimen signatures).

• Mandatory sessions

• EU Midwifery record (European Union)

• Placement record


• Learning contract

• MAP document (Mentor Assessment of Proficiencies / Practice)

The electronic component (e-portfolio) provides the opportunity for students to record learning and development through e.g.:

• Learning objectives (including SWOT/ SCOB analysis)

• Key experiences

• Wider reading or attendance at extra-curricular study days

• Reflections

as well as recording evidence of student midwife caseloading practice

The student needs to make the Ongoing Achievement Record available to the sign-off mentor and all others contributing to their supervision/ assessment on request, so that evidence and signatures may be obtained. The sign-off mentor does not need to complete anything in the e-portfolio, but may request that the student makes sections available to inform their monitoring of the student’s progress and assessment of practice. If the student declines to make any of these documents available, please contact their personal tutor/link lecturer.

There are three summative points for practice in the programme (towards the end of each academic year). Please see Appendix 3 for further details regarding the assessment document (MAP) and other components of this curriculum’s practice portfolio.

The Ceppl Assessment of Practice Team (2011) Top Tips For Students: Your journey through Practice Assessment. Plymouth: University of Plymouth Faculty of Health. Available on: https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/policies-procedures-and-guidelines.

9.4 Formative Assessment

The aim of planned formative assessments is to review with the student their strengths and weaknesses. Plans can then be agreed on how to maintain their strengths and improve on their weaknesses. This type of assessment therefore contributes to their learning, and guides the student towards achievement of the module/ programme learning outcomes. It is important that you, as the sign off mentor, regularly document progress in the practice portfolio to avoid overload at the summative assessment point. Other midwives working regularly with the student may – with your agreement – also contribute to the evidence in the MAP, but you will need to counter-sign all entries and only the sign-off mentor may identify whether the student has achieved the criteria and award grades. Other staff working with the student, including those





from other professions, as well as service-users may write evidence in the ‘Reports from others’ in the Placement Record in the OAR. Formative assessments can occur at any point during a placement at an agreed time. However, at a minimum, this should take place mid-point in the placement. The learning contract should be reviewed at this point, and the assessment document completed as appropriate (see Appendix 4). The student, sign-off mentor and ideally any buddy/ co-mentors should be present at this meeting. A student’s progress should be incremental. If you, as the sign-off mentor, or the student are concerned about their progress, the personal tutor/link lecturer/ another member of the midwifery academic team (or PDT Lead in their absence) must be contacted without delay. The tutor will discuss the situation, and be available for support and advice. A tripartite meeting may be requested if appropriate (see point 9.5 below). An ‘Unsatisfactory Progress Learning Contract’ will be completed to enable the student to focus on key learning needs, see Appendix 5. Similarly, the personal tutor/link lecturer should be contacted if there are aspects of a student’s attitude, performance or behaviour that do not easily fit within the learning outcomes of a module or cause concern in any way with regards to safety in practice, behaviour or attitude. We value your support in helping us to address these issues.

9.5 Summative Assessment and the Tripartite Meeting

Summative assessment is the process by which the sign-off mentor, using their professional judgment, decides whether or not the student has achieved the practice learning outcomes for that progression point. This is done through reviewing the evidence to support each performance criterion or capability. This may include feedback from other professionals who have worked with the student, service-users or peers. The NMC requires this evidence to be documented by the sign-off mentor, providing an audit trail leading to their decisions (NMC 2009). Therefore any entries in the MAP made by staff other than the sign-off mentor by prior agreement must be counter-signed by the sign-off mentor at this point. Only the sign-off mentor may indicate whether or not the student has achieved each criterion and award a grade. A student who is weak in any performance criterion/capability should not be summatively assessed until the required submission date. This ensures maximum time for the student to develop the skills, gather the required evidence of proficiency and achieve their potential.

Summative assessment in the form of the tripartite will normally take place in the fortnight before the assessment submission date. It is the student’s responsibility to arrange this meeting. The tripartite forms an essential part of the assessment process, and must be attended by the student, the sign-off mentor and the student’s personal tutor/link lecturer (or, on occasion, another member of the midwifery academic team). If other buddy/co-mentors have been helping to support the student, their


attendance is beneficial. The lecturer acts as the moderator in all cases. Where there is disagreement between a student and sign-off mentor, the personal tutor/link lecturer may call on other midwives who have worked with the student to establish their assessment of the student. If interim grades have been awarded by previous sign off mentors, grades may only be reduced if prior discussion has taken place between the summative and previous sign-off mentors. It is important that the sign-off mentor remembers that it is the student’s performance which is being assessed – not them as a person. It is also important to assess the student’s performance against the criteria for that stage of the programme, not your own expectations. The full range of grades should be used as appropriate. It is essential that the sign-off mentor’s signature and evidence is documented on all statements throughout each criterion. The ‘cues’ in each statement may, however, be initialed and dated by the designated buddy mentor if the sign-off mentor is in agreement. All grades will be moderated at the tripartite and all criteria must be signed by the sign-off mentor, student and attending midwifery lecturer, or the student will be referred in practice. It is the student’s responsibility to ensure all documentation is correctly completed, signed and dated before submission. Absence of any of these will result in referral in the module. Attention to detail is a vitally important part of midwifery practice and record-keeping. Students should receive verbal and written comments about their performance. This is achieved through the sign-off mentor’s and others’ comments on progress and achievement during that placement (see Appendix 4) as well as the tripartite review form, completed by the personal tutor/ lecturer (see Appendix 5). Excellence should be acknowledged, but the student also needs to be made aware of weaker areas of practice and where improvements can be made. Sign-off mentors are requested to document feed-forward in the ‘comments’ section of the MAP criteria, guiding students as to how they can improve on their performance and grade.

The results of summative assessment of practice are presented at the Subject Assessment Panel and Award Assessment Board for progression and completion, where the decision of the summative sign-off mentor is subject to ratification, but is normally considered final. Any appeals will be considered under Plymouth University regulations. The student normally has only two attempts at practice for each module, unless they have valid extenuating circumstances when a further attempt may be permitted by the Award Assessment Board. The pass mark is 40%.

9.6 Protected Time

Assessing practice during a practice placement demands time and commitment by the sign-off mentor. The NMC therefore requires that, in addition to the minimum 40% of the time spent directly or indirectly supervising the student’s practice, the sign-off mentor and student should


also have an hour per week of protected time to enable effective discussion of progress and achievement, and completion of relevant practice documentation (NMC, 2008). This time should be recorded so that monitoring can take place. Regular documentation of the student’s progress will avoid overload at the summative point and contribute to the body of evidence required by whoever is the sign-off mentor at this point.

If the sign-off mentor experiences difficulty in achieving protected time with the student, this should be discussed in the first instance with their line manager, and if the problems persist, the Academic or Practice Lead of the Placement Development Team.

9.7 The Student’s Responsibilities

The student should:

• contact the sign-off mentor prior to the placement, to discuss off-duties, placement requirements and learning opportunities

• ensure that a formal discussion takes place with the sign-off mentor within the first two weeks of the placement to establish a learning contract

• ensure ongoing discussion with the sign-off mentor throughout the placement

• provide the sign-off mentor with the Practice Portfolio on request so that progress can be monitored and formative discussions facilitated and documented

• present the Practice Portfolio to the personal tutor/link lecturer/module teacher as requested for review of progress

• arrange a tripartite meeting with the personal tutor/link lecturer and sign-off mentor at the summative point (and formative point, on request) to discuss and document progress, making the Practice Portfolio available

• check all practice documentation carefully and ensure that all MAP criteria have been initialed, evidence written and signed by the sign-off mentor and graded and signed by their sign-off mentor, themselves and the attending lecturer at the tripartite or they will be referred in practice

• submit the Practice Portfolio at summative points

• All students undertaking programmes delivered by the Faculty of Health and Human Sciences are reminded that any alteration to University documentation, including Practice Portfolios, involving forgery/falsification of a sign-off mentor’s/others comments or


signatures/ initialing will be investigated. This investigation could lead to a Fitness to Practise investigation, which may lead to a student being unable to achieve professional registration.

10. WHAT DOES THE CURRICULUM COVER? 10.1 General Principles

1. The BSc (Hons) Pre-Registration Midwifery programme comprises 156 weeks including annual leave.

2. The programme is modular and incorporates the principles of

proficiency-based assessment to achieve the practice learning outcomes.

3. The theoretical content of the modules of the programme is intended to

provide the student with the underpinning knowledge associated with practice. The teaching and learning strategies will:

• place practice centre stage

• facilitate the integration of theory and practice

• be based on the notion of students accepting responsibility for their own learning

• be based on students’ active involvement in their own learning, such as enquiry based and problem based learning

• establish the principle of lifelong learning

• include interactive, collaborative/shared learning, involving other professions, disciplines and agencies when appropriate

• facilitate student achievement of the learning outcomes and proficiencies/ standards.

4. Each module of the programme focuses on a particular area of theory

and/or practice. The student’s knowledge and proficiency in the learning outcomes will be summatively assessed. Students are required to pass all the theory assessments and pass the relevant progression statements in the Practice Portfolio assessment document (MAP – see Appendix 3).

5. Clinical practice is organised so that the student placements within their host Trusts support the modules of study at that time.


6. During each placement, the students will have ‘supernumerary status’. This means that the students are part of the care team but extra to the allocated staff complement. The student is therefore able to take full advantage of all the learning opportunities.

7. By the end of the pre-registration midwifery programme, all

requirements will have been achieved in accordance with the NMC (2009) “Standards for pre-registration midwifery education”. In addition students will have complied with European Union Directive 2005/36/EU for registration as a midwife with the Nursing and Midwifery Council.

10.2 Overview of the Curriculum

Information concerning the module aims, the assessed learning outcomes and indicative syllabus content for each module is recorded on the definitive module record (DMR) in the student’s programme handbook. Copies of these are freely available electronically on the POPPI website https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi . Details of the modules and specific programme features may be found in Appendix 6

11. STUDENT MIDWIFE CASELOADING

Caseloading experience is required in midwifery programmes validated by the Nursing and Midwifery Council from 2008 onwards (NMC 2009). This has therefore been incorporated into the curriculum and is undertaken by final year students. Information regarding student midwife caseloading can be found in Appendix 8.

12. REFERENCES / RELATED READING Department of Health (2010) Midwifery 2020: Delivering Expectations. Cambridge: Midwifery 2020

Department of Health (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry (Francis Report). London: The Stationery Office Limited. http://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf [accessed 25/8/13] Equality Act 2010 (Amendment) Order 2012. London: The Stationery Office

European Union Directive 2005/36/EU (2005) from Directive 2005/53/36EC of the European Parliament and of the Council



http://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf

http://www.midstaffspublicinquiry.com/sites/default/files/report/Executive%20summary.pdf


Fry J, Rawnson S and Lewis P (2011) Problems and practicalities in student caseload holding. British Journal of Midwifery 19 (10) pp659-664

National Health Service Commissioning Board (2012) Compassion in Practice: Nursing, Midwifery and Care Staff – Our Vision and Strategy. Nursing and Midwifery Council (2008a) Standards to support learning and assessment in practice. London: Nursing and Midwifery Council. http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learning-assessment.pdf Nursing and Midwifery Council (2015) The Code: Standards of conduct ,performance and ethics for nurses and midwives. London: Nursing and Midwifery Council http://www.nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf Nursing and Midwifery Council (2009) Standards for pre registration midwifery education. London: Nursing and Midwifery Council http://www.nmc-uk.org/Documents/NMC-Publications/nmcStandardsforPre_RegistrationMidwiferyEducation.pdf Nursing and Midwifery Council (2010) Sign Off Mentor Criteria - NMC Circular 05/2010 (www.nmc-uk.org )

Nursing and Midwifery Council (2011) Guidance on professional conduct for nursing and midwifery students. London: Nursing and Midwifery Council http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Guidance-on-professional-conduct.pdf Nursing and Midwifery Council (2012) Nursing and Midwifery Council of University Hospitals of Morecambe Bay NHS Foundation Trust, London, Nursing and Midwifery Council http://www.nmc-uk.org/Documents/MidwiferyExtraordinaryReviewReports/Final%20Morecambe%20Bay%20extra%20ordinary%20report%2020120907.pdf Nursing and Midwifery Council (2010) Raising and escalating concerns: Guidance for nurses and midwives. London: Nursing and Midwifery Council http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Raising-and-escalating-concerns.pdf Nursing and Midwifery Council (2012) Midwives rules and standards 2012. London: Nursing and Midwifery Council http://www.nmc-uk.org/Documents/NMC-Publications/Midwives%20Rules%20and%20Standards%20(Plain)%20FINAL.pdf Steinaker N & Bell MR (1979) The experiential taxonomy: a new approach to teaching and learning. Educational Psychology New York: Academic Press University of Nottingham in Collaboration with the Universities of Kingston/St Georges, Glamorgan, Robert Gordon and Plymouth (2010) The MINT Project, Midwives in Teaching: Evaluation of Whether Midwife Teachers Bring a Unique Contribution Particularly in the Context of Outcomes for Women and their Families. Final Report to the Nursing and Midwifery Council.

http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learning-assessment.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learning-assessment.pdf

http://www.nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf

http://www.nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/nmcStandardsforPre_RegistrationMidwiferyEducation.pdf




http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Guidance-on-professional-conduct.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Guidance-on-professional-conduct.pdf

http://www.nmc-uk.org/Documents/MidwiferyExtraordinaryReviewReports/Final%20Morecambe%20Bay%20extra%20ordinary%20report%2020120907.pdf



http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Raising-and-escalating-concerns.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Raising-and-escalating-concerns.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/Midwives%20Rules%20and%20Standards%20(Plain)%20FINAL.pdf

http://www.nmc-uk.org/Documents/NMC-Publications/Midwives%20Rules%20and%20Standards%20(Plain)%20FINAL.pdf



13. Appendices

Appendices

1 Glossary of Terms

37

2 Portfolio of Activities to meet Nursing and Midwifery Council Criteria for ‘Sign off Mentor’

42

3 PRACTICE ASSESSMENT PROCESS FOR ALL CURRICULA includes: Practice portfolio components, MAP criteria, Guidelines for use of assessment document, Guidelines for grading of practice and criteria for awarding grades Example of completed MAP criterion, Final sign-off mentor statement of proficiency

43

4 Placement Record

51

5 Examples of practice Tripartite form and Unsatisfactory Progress Learning Contract

56

6 Curriculum overview: BSc (Hons) Pre-Registration Midwifery

58

7 Example of completed timesheet and instructions

64

8 Student Midwife Caseloading documentation

• Introduction to Student Midwife Caseloading

• What is the difference between Student Midwife Caseloading and caseloading for midwives?

• The process of Student Midwife Caseloading

• Caseload flowchart

66


Appendix 1

GLOSSARY OF TERMS APEL: Accreditation of Prior (Experiential) Learning. This is the

process by which previous academic qualifications and/ or experience can be mapped against current modules and credit gained. Further work may be required to achieve the full number of credits for the current module.

Buddy/Co-mentor: A mentor who is not fully qualified and/or has not gained the

required experience to be a sign-off mentor, who helps to facilitate learning and supervise students in the practice setting. However, they are not able to summatively assess the student’s progress without supervision of a sign-off mentor.

Essential Skills Clusters:

A set of five key midwifery skills which needs to be achieved by students at their first progression point and point of entry to the register. They are explicitly taught and assessed in both theory and practice in the curriculum and form the basis of the MAP document.

Extenuating circumstances: Students may experience a variety of situations in either their personal, academic or practice spheres which could potentially have a negative impact on their progress and/ or achievement (eg: sickness, bereavement, relationship breakdown, legal issues, lack of continuity of mentorship, inadequate exposure to specific practice experiences). If the student experiences these, they may be advised by their personal tutor to complete an ‘extenuating circumstance form’ which needs to be submitted to a screening panel prior to the Subject Assessment Board, together with corroborative evidence from a third party. If the panel deems the extenuating circumstances to be valid, the Board may allow the student a further attempt at their summative assessment, which may include being viewed as a “first attempt”. In some situations, the student or personal tutor may approach the sign-off mentor with a request for corroborative evidence, if the sign-off mentor is prepared to provide this. Extenuating circumstances may only be submitted for non / late submission.

Fail: The student does not reach the required standard,

normally at the third attempt in theory or second attempt in practice, and is discontinued from the programme.

Faculty: The pre-registration midwifery programmes are based in the

School of Nursing and Midwifery within the Faculty of Health and Human Sciences at Plymouth University .


Formative assessment:

The aim of the formative assessment is to review the student’s progress towards successfully achieving the practice learning outcomes for the module and inform development. Strengths and weaknesses are identified and the learning contract is updated accordingly..

Learning contract: A written agreement between the student and sign-off mentor

that identifies the learner’s individual learning objectives and how they are to be achieved. Student progress is reviewed and the objectives are updated at regular intervals. The learning contract may also stipulate other criteria for the placement, to which the sign-off mentor and student sign agreement.

Learning outcomes: Learning outcomes are detailed in the programme specification

and identify what learners should have achieved as a result of the learning process.

Link lecturer: A midwifery lecturer who is linked to a maternity unit and

associated community areas, who has responsibility for overseeing the students’ placement allocations in that area, and liaising with clinical managers and staff. They assist in quality monitoring of the learning environment and provide relevant information and support to sign-off and buddy mentors, assisting in the maintenance of the Trust live register of mentors.

MAP: Mentor Assessment of Proficiencies / Practice. This forms part of

the Practice Portfolio and is the tool for practice assessment in all current Pre-Registration Midwifery curricula. It is based on the NMC Essential Skills Clusters for Midwifery and Midwifery Standards.

Module: The pre-registration midwifery programme comprises a number

of modules. Each module has specified learning outcomes which are mapped against quality, educational and professional indicators. Academic credits are accrued at levels 4, 5 and 6 (formerly levels 1, 2 and 3) as the students achieve the required assessments. Each module has a code and title (eg: HEAA311 Literature Review and Research Proposal, MID114 Preparation for Professional Practice).

NHS KSF: National Health Service Knowledge and Skills Framework.

Module learning outcomes are mapped against these criteria, mirroring Agenda for Change.

NMC: Nursing and Midwifery Council – the professional regulatory

body for nurses and midwives in the UK.


Ongoing Achievement Record (OAR):

The paper component of the Practice Portfolio in the Pre- Registration Midwifery curriculum. This is a record of evidence which is carried by the student from placement to placement, and is a requirement of the NMC.

OSCE: Objective Structured Clinical Examination. This method of

academic assessment mirrors practice as far as possible, and is used in a range of modules in the Midwifery programmes.

PDT: Placement Development Team. A model of placement

support provided in all the Trusts in the South West since November 2007. The team comprises a practice and academic lead, a range of practice staff and identified academics from the Faculty of Health and Human Sciences. Their remit is to support learners and ‘mentors’ from all health professions throughout the Trust, monitor quality of the placement settings and ensure that contractual obligations are met by all parties. At least one Midwifery lecturer is linked to each PDT where Midwifery students are placed and is the first point of contact in issues relating to students.

Personal tutor: Each midwifery student has a designated personal tutor

who is one of the academic staff in the midwifery team – usually the link lecturer for the maternity unit in which the student is based, or a colleague also linked to the area. The personal tutor provides academic, pastoral and clinical support to the student, acts as ‘moderator’ in tripartite discussions at summative points in the programme and is usually the first point of contact if any concerns are identified.

Practice Education Development Midwife or Practice Educator:

This is a member of the midwifery clinical team who is responsible for educational matters in the maternity unit. Most have their main remit as post-qualified or staff education, but some are able to contribute to the support of midwifery students in placement. Usually this is the person responsible for maintaining the local register of mentors/ sign-off mentors.

Practice Portfolio: This is documentary evidence of the student’s learning in

practice and of their achievement of practice outcomes. It is essential to the assessment of practice in the midwifery programme.


Proficiency: The term proficiency means to “describe the skills and ability to practice safely without the need for direct supervision”. The NMC stipulates a set of proficiencies/standards which students have to achieve before they can be entered onto the register as a midwife.

Protected time: The NMC stipulates that sign-off mentors and their students

should have the equivalent of one hour per week protected time to spend together discussing the student’s practice progress and achievement, and documenting evidence.

PQDD: Practice Quality Development Division. This division

provides strategic direction for the management of practice based learning across the Faculty of Health and Human Sciences.

Refer: If a student fails to achieve one or more assessment

criteria in either theory or practice, they are referred in the module. They will be able to re-take the assessment as a second attempt. Unless the student has extenuating circumstances, a student who is referred at second attempt in practice (or third in theory) is usually deemed to have failed, and they are discontinued from the programme. A referral without extenuating circumstances will usually result in whatever grade the student has achieved for that module being capped at 40%.

Sign-off mentor: A registered nurse or midwife, who facilitates learning,

supervises and assesses students in the practice setting, and has met strict mentor qualification and experience criteria set by the NMC. Such individuals must be annotated on the Trust live register of mentors as sign-off mentors, and must maintain this status by fulfilling certain criteria which are reviewed every three years. Only a midwifery sign-off mentor may assess practice proficiency of midwifery students at each progression point and at point of entry to the register.

Summative assessment:

This is the process by which the sign-off mentor, using their professional judgement, decides whether or not the student has achieved the practice learning outcomes for that progression point. This is done through review of the evidence to support each performance criterion or capability. Grading of practice is required at this point in all current Pre-Registration Midwifery curricula.

SWOT/SCOB analysis

Self assessment undertaken by students at specific points on the programme where they identify their Strengths and Weaknesses (or Challenges), Opportunities and Threats (or Barriers) in order to set learning objectives.


Triennial review: A formal review of a buddy/co-mentor/sign-off mentor’s experience and updating of qualifications which takes place every three years. Evidence must be provided to support the sign-off mentor’s eligibility to become/ remain annotated as such on the Trust live mentor register.

Tripartite: This is a mandatory meeting which takes place between

the student, sign-off mentor and personal tutor/link lecturer to discuss the student’s progress and moderate practice assessment at summative points. A tripartite may also be requested by any of the above parties in order to discuss progress as a process of formative assessment or if problems have been identified. It is the student’s responsibility to arrange these meetings.

Pre Registration Midwifery 43 Mentor Handbook 2017-2018

Appendix 2 Portfolio of Activities to meet Nursing and Midwifery Council Criteria for ‘Sign off Mentor’ - Supporting Mentors to achieve sign off mentor Criteria Activity Responsibility

Stage 1 Preparation workshop

Introduction to role and responsibilities

Introduction to portfolio

Achievement of criteria

Support/assessment

Program specific update

Use of OARS and assessment documentation

Mandatory Scenario work

Delivery

Placement Development Team Academic / Practice Lead and or

Designated academics from wider PDT

Stage 3

Support and Assess minimum of 1 final placement student or a midwifery student at

any progression point

Complete portfolio

Supervised

By designated sign off mentor /practice teacher.

Allocation of appropriate pre-registration/ overseas/ return to practice learners

Allocations team in collaboration with PDT Practice

/ Academic Lead

Annotated on Trust live register of mentors as a sign off mentor

Completion

By PDT / keeper of the Trust Live Register of Mentors.

Stage 2 Undertake one of the following

• PDT lead session exploring case studies/

scenarios

• Peer review of undertaking Summative

assessment of a year 2 or 3 nursing

student or a midwifery student at any

progression point

• Access the on line mentor resource and

complete quiz at

http://public.tulip.plymouth.ac.uk/Module/

HEAB370%20AYAU%2009/Mentorship2

010/ evidence certificate of

completion.

•

Delivery /Support in workplace

PDT and Designated academics from wider PDT

https://webmail.plymouth.ac.uk/OWA/redir.aspx?C=9b7f30c1c2074991abf1feef8a1c7a57&URL=http%3a%2f%2fpublic.tulip.plymouth.ac.uk%2fModule%2fHEAB370%2520AYAU%252009%2fMentorship2010%2f



BSc (Hons) Pre Registration Midwifery 44 Ongoing Achievement Record 2017-2018

Appendix 3

PRACTICE ASSESSMENT PROCESS IN THE PRE-REGISTRATION MIDWIFERY

CURRICULUM The following are the tools/ processes used in the assessment of practice of the BSc (Hons) Pre-Registration Midwifery Programme. 1. Ongoing Achievement Record (paper component) This part of the portfolio comprises all documents requiring signatures of the sign-off mentor, student, personal tutor and others. This is the main summative element of the practice portfolio, and the grades awarded by the sign-off mentor for the MAP criteria contribute to the student’s overall degree classification as they are associated with practice modules. The pass mark is 40%. Further detail regarding the assessment process and MAP document can be seen on pages 45-51 of this appendix. Documents in the OAR include:

• Signature record

• Mandatory sessions

• EU Midwifery record (European Union Directive 2005/36/EU)

• Placement record and learning contract (see Appendix 4)

• MAP document (Mentor Assessment of Proficiencies/ Practice) 2. E-portfolio (electronic component) This part of the portfolio demonstrates evidence of the student’s learning and development towards achievement of the practice learning outcomes. It also includes completion of work packs, caseloading documentation etc. Entries do not need to be signed by anyone, but form an important contribution to the evidence used by the sign-off mentor in making their decisions about the student’s achievement in practice, and it is therefore recommended that students share this with their sign-off mentor. The e-portfolio forms part of the summative assessment in the final practice module in conjunction with the Ongoing Achievement Record, being awarded a pass/ refer by the module teachers according to set marking criteria. Students may include evidence relating to:

• Learning objectives (including SWOT/ SCOB analysis) i.e. self assessment of the student’s strengths, weaknesses (or challenges), opportunities and threats (or barriers).

• Key experiences

• Wider reading/ attendance at extra-curricular study days

• Reflections

• Other evidence of their choice


Mentor Assessment of Practice (MAP) Criteria

Based on the Standards for pre registration midwifery education (NMC 2009)

NOTE THAT THE LEVEL EXPECTED IN YEAR ONE IS

‘REFLECTION AND KNOWLEDGE UNDER DIRECT SUPERVISION’

THE LEVEL EXPECTED IN YEAR TWO IS

‘INTERNALISATION OF KNOWLEDGE AND SKILLS UNDER MINIMAL SUPERVISION’

THE LEVEL EXPECTED IN YEAR THREE IS

‘PROFICIENT AND COMPETENT, ACCURATE PERFORMANCE UNDER INDIRECT SUPERVISION’

CRITERION Page No.

1 Initial Consultation between the Woman and the

Midwife *

2 Ongoing Antenatal Care

3 Normal Labour and Birth *

4 Postnatal and Neonatal Care

5 Initiation and Continuance of Breastfeeding *

6 Medical Products Management*

7 Personal and Professional Growth

8 Risk Assessment and Management Skills


9 Communication*

*Indicates linked to Essential Skills Clusters

GUIDELINES FOR USE OF ASSESSMENT DOCUMENT

PRACTICE ASSESSMENT PROCESS: 1. Assessment of practice in the Pre-Registration Midwifery programmes is through

continuous monitoring of progress, based on Steinaker and Bell (1979). The student gradually moves towards a point of practising at a level of proficiency, competence and accuracy under indirect supervision. Summative assessment by the sign-off mentor/s must be documented at set points in the programme.

2. The MAP (Mentor Assessment of Practice/ Proficiencies) document comprises the criteria against which students are assessed. These consist of the Essential Skills Clusters (ESC) as well as additional criteria necessary to achieve the Midwifery Standards (NMC 2009) and Quality Assurance Agency Midwifery Benchmark statements (2001).

3. Designated midwifery sign-off mentors, or buddy mentors with the sign-off mentor’s

agreement, will initial and date cues within statements as this experience is gained and demonstrated at the appropriate level. All entries must be signed/ counter-signed by the sign-off mentor. Only the sign-off mentor may write comments in the box indicating whether or not the student has achieved the statement as a whole. Students may not write anything in the MAP.

4. In some clinical areas the student may change placements and sign-off mentors during the

course of the year. If it is unlikely that the student will return to a placement before the summative point, and the sign-off mentor considers that the student has achieved all statements within a specific criterion, they may award an interim grade. This must be written in ink and the entry signed and dated by both the sign-off mentor and student on the “first attempt” section at the end of the relevant criterion. Please note that interim grades may be subject to amendment, however they may only be adjusted if prior discussion has taken place between the summative and previous sign-off mentors who awarded the interim grades.

5. Comments by other supervising practitioners may be included in the Placement Record in

Part One to supplement evidence and to guide the sign-off mentor in their decision regarding the student’s achievement/ non-achievement of criteria. Students are also reminded to share their e-portfolio with their sign-off mentor as this can also be referred to as evidence in the MAP.

6. Before the summative progression point the sign-off mentor must ensure that all cues

within statements have been initialled and dated, and counter-sign any made by a buddy mentor. The sign-off mentor must decide whether the student has achieved that statement and document comments in the box. Evidence supporting the sign-off mentor’s decisions must be recorded and signed by the sign-off mentor. The sign-off mentor then needs to award an appropriate grade for each criterion (see Guidelines for Grading of Practice) – the sign-off mentor may prefer to wait until the tripartite to award these grades, but they


need to have provisional grades in mind. In preparation for the summative tripartite, the sign-off mentor must have liaised with any other designated sign-off mentors if they disagree with an interim grade previously awarded for that year (see point 4 above). Liaison should also take place with other staff who have worked with the student so that triangulation of evidence is achieved.

7. A tripartite meeting must be arranged by the student prior to the summative

submission date. A detailed discussion regarding the student’s progress and the evidence for the grades will take place with a midwifery lecturer (usually the personal tutor) as moderator. The present sign-off mentor and the moderator will agree the final grades for all criteria. It is essential that all parties (sign-off mentor, student and midwifery lecturer attending) sign and date where indicated. Failure to do so will result in a referral for practice.

8. The sign-off mentor will also be required to sign a statement at each progression point to

confirm that the student’s practice has been safe and professional, and at the final assessment point of the programme that the student is fit for practice and eligible to apply for registration as a midwife, based on clinical performance. If the sign-off mentor’s signature does not appear on the ‘Proficiency’ statement at the final assessment point the student will be referred in practice and will not be able to be admitted to the NMC register until this has been achieved, together with all other NMC, EU and programme requirements.

GUIDELINES FOR GRADING OF PRACTICE: Grading may only be undertaken by the designated sign-off mentor.

a) For each criterion – ascertain whether student has achieved all statements i) If Yes:

• Initial/ countersign and date all those cues in the statements achieved

• Write comments in the ‘Evidence of achievement’ box and sign

• When all statements for a criterion have been achieved award a grade (see below).

ii) If No:

• Do not initial the cues in the statements which have not been achieved

• Write comments and sign in the relevant box ‘Comment if not achieved’ explaining why the student hasn’t achieved

• Identify a brief plan on how criteria can be achieved

b) Awarding a grade You need to take the following into consideration when deciding upon a grade:-

✓ Your evidence and observations from working with the student. ✓ Comments and reports from other practitioners, service users, etc. ✓ Using the grid at the end of this section, determine the appropriate grade for

each criterion. The column headed ‘Criteria’ may be a helpful starting point. Many sign off mentors find it appropriate to determine the grade band (i.e. 40’s, 50’s) before deciding on the specific mark. Only grades identified in the banding should be used (eg: 52% or 55% or 58%). To identify the specific mark it may


be helpful to consider the bands on either side to determine if the student falls within top, middle or bottom of the identified band.

✓ The band of 42% - 48% indicates that the student is meeting the minimum requirements of the criterion, and is practising safely

✓ A pass mark of 40% must be achieved in all statements, or the student will be referred in the module and will be unable to progress until all statements have achieved a pass grade (NMC 2009). Under University Regulations, the student is only allowed two attempts at practice.

c) Tripartites A tripartite meeting between student, sign-off mentor and a midwifery lecturer must take place before submission; it should be arranged in advance by the student. The following should take place at this meeting:

i) A process of moderation, this is where the evidence and proposed grades are reviewed, correlation between the comments and grade should be evident.

ii) A checking process to ensure the following are completed: ✓ Signature record completed ✓ European Union Midwifery Record completed ✓ Placement records completed ✓ Initials/signatures and dates inserted for all cues in the MAP ✓ Comments including evidence written by sign-off mentor for all

statements, having determined achievement/ non-achievement – signed and dated

✓ Grade agreed for each MAP criterion – signed and dated by sign-off mentor, midwifery lecturer and student

✓ Final year students - ‘Proficiency’ statement by sign-off mentor ✓ If interim grades are adjusted during this process, the original grade

should be crossed out and initialled by the sign off mentor; comments must be made if this is the case. An overall comment should also be documented by the sign-off mentor or midwifery lecturer if the student has been practising at an exceptionally high/ low level

iii) Failure to evidence all signatures and thereby the completed grading and moderation process will result in referral in the module.

If students or staff have any questions about understanding the assessment process or completing the documentation, or there are any concerns in practice please do not hesitate to contact a midwifery lecturer.

Criteria for awarding grades

Grade Description Criteria Faculty Guidelines

Below 29 Clear failure to achieve a pass

Frequently fails to meet expectations in performance

Limited and inappropriate links between theory and practice. Unsafe or ineffective practice demonstrated.

32/35/38 Failure to achieve a pass

Sometimes meets expectations in performance

Poor understanding of practice issues. Evidence of unsafe practice.

42/45/48 Satisfactory pass

Meets expectations in performance

Safe practice demonstrated with some reference to evidence-based underpinning.


52/55/58 Good Sometimes exceeds expectations in performance

Consistently safe practice demonstrated with some reference to evidence-based rationale.

62/65/68 Very good Frequently exceeds expectations in performance

Safe and evidence-based practice consistently demonstrated.

72/76/80/84 Excellent Sometimes excellent/ outstanding performance

Incorporates evidence of consistently safe and best standards of practice.

86/90/95/100 Outstanding Consistently outstanding performance

Incorporates evidence of consistently safe and highest standards of practice. Outstanding comprehension of contemporary issues. Excellent application of recent research to practice.

EXAMPLE OF COMPLETED MENTOR ASSESSMENT OF PRACTICE

(MAP) CRITERION

YEAR TWO

CRITERION 8 Risk Assessment and Management Skills

1:Follows Trust guidelines and policies to meet service needs

2:Can manage workload and make decisions

3:Demonstrates the ability to manage risk Initials Date

Appropriately utilises policies and guidelines in the delivery of care for both low and high-risk women and their fetuses/ babies

JB 7/6/14

Is able to prioritise and plan workload with minimal supervision when providing normal care, and under direct supervision when there are risk factors

PJ JB

19/5/14 7/6/14

Has attended one of the following and reflected upon the learning gained:

o Clinical audit meeting o Labour Ward case discussion meeting o Perinatal meeting o Other (please specify)

JB 10/5/14

Understands the clinical risk reporting system:

o Incident reporting o Risk assessment o Risk management

JB 2/4/14

Evidence of achievement

I have seen Emma access policies on induction of labour and Streptococcus B management. Other midwives have commented

that she always asks if a policy exists. Penny Jones (buddy mentor) commented on her ability to manage her workload on a

very busy day (see page 29 and above), when very little supervision was needed. Emma seems to be very conscious of the

importance of risk management and has attended some relevant meetings in this placement. She has been able to discuss key

issues highlighted. I have read a reflection written by Emma which clearly demonstrated her awareness of appropriate risk

assessment. All midwives she works with say she is very safe.

Sign-off Mentor………Julie Brown………… Date……..7/6/14…


Comment if not achieved Sign-off Mentor…………………………… Date………………..

TRIPARTITE

CRITERION 8 Risk Assessment and Management Skills

First attempt

Grade ……80…….…..%

Sign-off mentor signature …… Julie Brown ………..………… Date …10/6/14…….

Student signature ……………………Emma Black………………… Date ….. 10/6/14….… Lecturer signature ………………Annie Tutor……………………… Date …..10/6/14……

Comments: Emma has clearly demonstrated practice at a level well above that required in year 2. This has been consistent. Grade agreed at tripartite.

Second attempt Grade ………….…..%

Sign-off mentor signature ……………..…………….……………. Date ……….……………


Student’s signature …………………………………………..……. Date ……….…………… Lecturer signature …………………………………………………… Date ……………………

Comments:

Pre Registration Midwifery Programme 52 Mentor Handbook 2016-2017

FINAL SIGN-OFF MENTOR STATEMENT OF PROFICIENCY

COMPLETION OF PROGRAMME TO BE COMPLETED BY SIGN-OFF MENTOR 1:

I confirm that ........................................................................... (insert student name) has met the defined Nursing and Midwifery Council (2009) Standards for pre- registration midwifery education and is capable of safe and effective practice.

Sign-off Mentor Name

Sign-off Mentor Signature:

Mentorship Qualification

Date of last attendance at annual mentor update

Date of signing statement:

TO BE COMPLETED BY SIGN-OFF MENTOR 2 (IF APPLICABLE):

I confirm that ........................................................................... (insert student name) has met the defined Nursing and Midwifery Council (2009) Standards for pre- registration midwifery education and is capable of safe and effective practice.

Sign-off Mentor Name

Sign-off Mentor Signature:

Mentorship Qualification

Date of last attendance at annual mentor update

Date of signing statement:



Appendix 4

Placement:

• The following set of documentation (5 pages) should be completed for each placement. Please note that ‘Placement’ refers to a period of at least four weeks in one clinical area, and only refers to midwifery placements. This Ongoing Achievement Record must be sufficiently detailed to enable the midwife sign-off mentors to confirm that a student is proficient at designated points in the programme. Mentors should not keep their own separate student progress records (NMC 2009, p18).

• All other non-maternity allocations (eg: neonatal, gynaecology, accident and emergency, intensive care unit, medical ward/ outpatients department) should be recorded in the relevant resource workbook. Please note that these are not assessed ‘placements’ and the supervising nurse may not sign any of your MAP assessment documentation. However, please ask the nurse mentoring you in these non-maternity areas to write a brief statement on the ‘Reports from Others’ page in your associated midwifery placement documentation (eg: page 33). Experiences gained must be recorded as appropriate on European Union Midwifery Record numbers 8 – 10 (pages 22 – 24). Learning Contract:

• The ‘Learning Contract’ must be completed and signed by you and your sign-off mentor within the first week of the placement.

• The learning needs identified should be drawn from your Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis which is in your electronic portfolio (capability plan), and full learning objectives should be documented and reviewed in this. You may add to these learning needs during the course of the placement.

• Please give a photocopy of your learning contract to your sign-off mentor so that s/he is reminded of your identified learning needs and can help you to access the necessary resources. Progress Reports:

• The ‘Mid-point Report’ provides an opportunity for you and your sign-off mentor to record your progress during your placement period, as a means of formative assessment. Buddy mentors may also contribute. You may or not wish to invite your personal tutor/ midwifery lecturer to be present for this discussion. Depending on the stage of your programme, you and your sign-off mentor may also need to record your progress at the formative point in your MAP document (see Part Two of Ongoing Achievement Record).

• The ‘Reports from Others’ page provides an opportunity for other health professionals or service-users to comment on your progress. This is particularly useful if you have worked with someone other than your sign-off mentor for a period of time. This includes allocations to non-maternity areas (see above). This evidence may help inform your sign-off mentor’s decisions regarding your fitness to practise. Please ensure that all those contributing to this page also sign the ‘Signature Record’ (see page 7).

• The ‘End of Placement Report’ needs to be completed by you, your sign-off mentor/s and the midwifery lecturer (usually your personal tutor) attending for your tripartite discussion. It is essential that a tripartite is held when it is a summative point in your programme, and the MAP document requires completion and grading of your practice. If it is not a summative point, a tripartite is not compulsory, but is recommended.


LEARNING CONTRACT

Name of Placement: …………………………… Speciality …………………… Date of commencement of Placement: ………………………………………….…. Name of sign-off mentor/s…………………………................................................. ………………………………………………………………

The following are my identified learning needs for this placement, drawn from my SWOT/ SCOB analysis in my electronic portfolio:

I will liaise with my sign-off mentor/s and any other supervising practitioners to ensure that I do all that I can to achieve my learning objectives. This includes working a 24-hour pattern of care and ensuring that I work a minimum of two days per week with my designated sign-off mentor/s. I will liaise with my personal tutor if I have any concerns, and will arrange tripartites in a timely way. I will practise safely and professionally at all times. Student signature: …………………………………….. Date: …………………….. I will aim to work with the student a minimum of two days per week pro rata, and will liaise with all other practitioners supervising her/his practice when I am not available, to ensure that the student’s learning needs are being met and that I am able to monitor her/his progress. I have explained the health and safety issues and emergency procedures relevant to this placement to the student. Sign-off Mentor Signature (1): ………………………..…….. Date:………………….. Sign-off Mentor Signature (2):………………………………. Date: ………………….


MID-POINT REPORT

• For documentation of student progress during a longer placement

• Personal tutor/ midwifery lecturer may or not be requested to attend a tripartite

discussion at this point

Student’s self-assessment of progress to date: Student signature: ............................................................. Date :.............................

Sign-off mentor’s assessment of student’s progress to date: Sign-off mentor signature: ……………………........................ Date: ...........................

Buddy mentor comments or personal tutor/midwifery lecturer, if attending: Buddy mentor/Lecturer signature: ....................................... Date: .............................


REPORTS FROM OTHERS DURING PLACEMENT

• Those midwives contributing to a significant part of the student’s supervision during the placement may like to record comments which will help inform the sign-off mentor of evidence of progress

• Others may also document comments on the student’s progress (eg: other medical/ nursing staff; student peers; service-users or their partners). Where these are not midwives, the sign-off mentor/ supervising midwife must countersign entries.

• All contributors must provide a specimen signature on the ‘Signature Record’

Name: .......................................... Position: ..................................... Date: ................





END OF PLACEMENT REPORT

• A report must please be written at the end of a placement.

• If this is a summative point, a tripartite must be arranged with the personal tutor/

midwifery lecturer , and all parties must record comments on the student’s

progress

• The midwifery sign-off mentor must be present at the tripartite, and preferably

any buddy mentors contributing to monitoring of the student’s progress.

Student’s self-assessment of progress during the placement:

Student signature: ............................................................. Date: .............................

Sign-off mentor’s comments on student’s progress during the placement:

I confirm that ……………………………………………………….. (insert student name)

behaved professionally and safely throughout this placement.

Sign-off mentor signature: .......................................................................................

Mentorship qualification: ………............................ Date: ............................

Buddy mentor comments or personal tutor/midwifery lecturer, if attending

Buddy mentor/Lecturer’s signature: .................................... Date: .............................


Appendix 5

Faculty of Health and Human Sciences Pre-registration Midwifery Programme

Practice Feedback Form (Sept 2008 / 2013 curriculum)

ONGOING ACHIEVEMENT RECORD/ TRIPARTITE Student to complete this section

Student Name Registration Number

Programme Cohort

Formative Summative Module Code Submission Deadline

Module Teacher Submission (please delete) 1st 2nd 3rd

Staff to complete this section

Section Are these up to date and signed and dated?

Yes No Comments

Signature Record

Mandatory Sessions

Placement Records

MAP Criterion Are the following criteria evidenced, achieved and graded?

Grade Comments

1. Initial

Consultation

2. Antenatal Care

3. Normal Labour

4. Postnatal Care

5. Breastfeeding

6. Medicines

7. Personal Growth

8. Risk Assessment

9. Communication

European Union

Midwifery Record

1 2 3 4 5 6 7 8 9 10

Positive comments

on progress

Areas needing

development

Name of Midwifery Lecturer

Signature Date Provisional Outcome* Pass Refer Fail

Provisional Mark #

Name of Sign-off Mentor

Second Marker

External Examiner


*Please circle the appropriate Provisional Outcome. #The Provisional Mark can only be entered after computerised aggregation. This is subject to confirmation/ modification by Subject Assessment Panel.


Faculty of Health and Human Sciences Pre-Registration Midwifery Programme

UNSATISFACTORY PROGRESS LEARNING CONTRACT

Student Name

Programme Cohort

Date of Initial Meeting

Sign-off Mentor Midwifery Lecturer

Reason for Development of Learning Contract

Area/s of Concern Learning Objective Target Date

Student’s Review Sign-off Mentor’s Review

Midwifery Lecturer’s Review

Achieved/ Not Achieved

Agreed Further Action at Review Meeting Print Name Signature Date

Student:

Sign-off Mentor:

Lecturer:


Appendix 6

CURRICULUM OVERVIEW: BSC (HONS) PRE-REGISTRATION MIDWIFERY

The following information provides guidance regarding the focus and expectations of the BSc (Hons) Pre-Registration Midwifery curriculum, including the underpinning changes to midwifery curricula required of the NMC from 2008. NMC Requirements of Midwifery Programmes from 2008 1. Essential Skills Clusters The Nursing and Midwifery Council (NMC 2007b, NMC 2009) Essential Skills Clusters are embedded within this programme in both the theoretical and practice elements. The Essential Skills Clusters (ESC) comprise:

• The initial consultation between the woman and the midwife

• Communication

• Normal Labour and Birth

• Initiation and continuance of breastfeeding

• Medical Products Management Where appropriate, modules have been developed to support the ESC. The assessment of the ESC largely takes place in clinical practice which has been built into the clinical assessment documents. The theory provides a framework for learning in clinical practice and enables students to have knowledge and understanding of midwifery practice, the evidence base, theory and understanding on which this practice is built. 2. Student Midwife Caseloading Caseloading is a feature of this programme as required by the Nursing and Midwifery Council (NMC 2007a). Preparation begins in year two and students are given a “Caseloading Workbook” to support this. Caseloading practice is undertaken in year 3. It enables students to develop many transferable skills and build on their professional and communication skills. It will also develop their decision making, organisational, leadership and management skills.


2013 CURRICULUM (Years 1,2 & 3) Programme structure - for February and September cohorts

TERM ONE

TERM TWO

Stage One, Level Four

MID 113 Applied Clinical Skills (20 credits)

MID 114 Preparation for Professional Practice (30 credits)

MID 115 Foundations of Biology (30 credits)

MID 116 Communication and Psychosocial Issues in Midwifery (20 credits)

MID 117 Health Promotion and Public Health in Midwifery Practice (20 credits)

Stage Two, Level Five

MID 224 Reproductive and Contemporary Biology to Inform Practice (20 credits)

NRS 204 Knowledge and Skills for Evidence-Informed Decision Making (1) (20 credits)

MID 225 Antenatal, Postnatal and Gynaecological Complications

(30 credits)

MID 226 Developing Midwifery Practice (30 credits)

MID 227 Medicine Management (20 credits)

Stage Three, Level Six

MID 323 Intrapartum Complications and Obstetric Emergencies (20 credits)

MID 324 Facilitating Learning in Midwifery Practice (20 credits)

MID 325 Neonatal Care and Assessment (20 credits)

MID 327 Professional Practice in Midwifery (30 credits)

NRS 304 Knowledge and Skills for Evidence-Informed Decision Making (2) (30 credits)


Stage One, Level Four The structure of the first year is aimed at providing students with a solid foundation in midwifery practice. All modules are midwifery-specific, which will enable students to become embedded in the profession. They will experience their first practice placement in the month leading up to the Christmas break which will enable them to apply the skills and knowledge they have gained to clinical practice. Students will then have a further theory block in term 2, when they will develop this knowledge further and apply what they have seen in practice to the theory. The majority of the rest of the year will be based in practice. A week of autonomous study at the end of the academic year will enable students to consolidate their learning and practice. MID 113 Applied Clinical Skills is a 20-credit module which will introduce students to the clinical skills underpinning normal midwifery practice. They will have the opportunity to rehearse these in the safety of a non-clinical environment before going into practice. They will have the opportunity to apply these skills in practice before they return to university at the end of term 1 and will be assessed through a practical examination called an OSCE (Objective Structured Clinical Examination). MID 114 Preparation for Professional Practice is a 30-credit module which runs alongside MID 113, and introduces students to the professional issues underpinning midwifery practice. They will also gain a foundation in study skills, literature retrieval and evidence-based practice. This module runs in both terms one and two, and students will be assessed through an essay which enables them to evaluate their academic and clinical progress at the end of term one, with their practice being assessed at the end of term two. MID 115 Foundations of Biology is a 20-credit module which provides students with the knowledge of human anatomy and physiology which they will need as a foundation for their midwifery practice. This will be assessed by a formal examination. MID 116 Communication and Applied Psychosocial Issues. This 20-credit module introduces students to the theoretical knowledge and an understanding of the social and psychological influences on the childbearing experience of women and their families. It will also develop communication skills. This is assessed through a reflective essay. MID 117 Health Promotion and Public Health in Midwifery Practice is the final 20-credit module of the year which also runs in term two, and introduces students to the principles of public health and health promotion within the context of childbearing. Students will be required to develop a health promotional resource as the assessment for this module. Stage Two, Level Five Students will primarily gain clinical experience in both hospital and community maternity settings. In addition they will gain experience in some selected nursing areas which will begin this year, specifically gynaecology and neonatal care. The pattern of placements and care will vary in different Trusts according to local service provision. Students will begin to plan towards their experience of student midwife caseloading which will begin after successful completion of all year two assessments. The academic demands increase at level five and the focus is on increasing the depth and range of students’ midwifery knowledge and understanding. They are encouraged to value research and scholarly activity in relation to the development of midwifery and maternity care. Students


will continue to undertake predominantly midwifery-specific modules, with the addition of one shared module, NRS 203. NRS 204 Knowledge and Skills for Evidence-Informed Decision Making (1) is a 20-credit module which is shared with nursing students in an exciting and innovative method of delivery called Team-Based Learning. Students will work in small groups, using resources provided by the module team, and will develop the foundations of research by applying this in an interactive way. They will also develop key team-working skills as they work together to reach decisions, and some of the assessment will reflect this group-work as well as their individual knowledge and abilities. MID 224 Reproductive and Contemporary Biology to Inform Practice is a 20-credit module which will build on the year one foundation module, in which students will apply deep biological knowledge and understanding to the care of childbearing women and the neonate. Assessment will be through a formal written examination. MID 225 Antenatal, Postnatal and Gynaecological Complications will run across the year and is worth 30 credits. This module will help students to develop a deeper understanding of pre-existing conditions women may present with, and those they may develop in pregnancy or the postnatal period. They will also develop knowledge of common gynaecological complications and procedures. Students’ first non-maternity placement will be in the gynaecology department, and they will write an essay about their experiences at the end of term one. In term two they will continue to explore complications in pregnancy and the postnatal period, and will write an examination. MID 227 Medicine Management is a 20-credit module which will equip students with the knowledge and skills related to medicines which they will require in order to be able to safely undertake this aspect of midwifery practice. They will be required to undertake a numeracy test for which they will need to gain 100%, and in addition they will present a critical analysis of a medicinal product to the group and the module assessors. MID 226 Developing Midwifery Practice is the practice-focused 30-credit module for year two and runs across terms one and two. Students will advance their knowledge and experience of skills to support normal midwifery practice in more complex situations. There will also be a strong focus on supporting breastfeeding in this module, and an OSCE will assess this area. Their practice will be assessed by their sign-off mentor, according to the criteria for year two in the MAP document. As in the first year, a week of autonomous study in the summer will enable students to consolidate their learning and practice, and they can seek out opportunities to extend their knowledge in areas such as medical clinics and mental health. Stage three level six MID 323 Intrapartum Complications and Obstetric Emergencies This 20 credit module critically examines the actions and accountability of the midwife in providing care to the mother, fetus and neonate when deviations from normal occur during the intrapartum period and during emergency situations. It is assessed by an Objective Structured Clinical Examination (OSCE). MID 324 Facilitating Learning in Midwifery Practice


This 20 credit module aims to prepare the student with the knowledge and skills required to facilitate learning and assessment in preparation for their future role as a midwifery sign-off mentor in the practice setting. MID 325 Neonatal Care and Assessment Students will build on existing theoretical knowledge of neonatal physiology and be introduced to skills required to undertake examination of the newborn during this module. Students will critically analyse the evidence base and professional issues relating to the assessment, examination and care of the neonate, to include support of feeding in more complex situations. MID 327 Professional Practice in Midwifery By the end of this 30 credit module students will be expected to critically evaluate the provision of women-centred care within the maternity services and debate the way in which contemporary issues may influence the provision of safe and effective care. Students will critically appraise the professional responsibility and accountability of the midwife within the regulatory framework of the NMC. The student’s practice will be assessed by their sign-off mentor, according to the criteria for year three in the MAP document. NRS 304 Knowledge and Skills for Evidence-Informed Decision Making This 3o credit module builds on research knowledge developed across the students’ programme, particularly NRS 204 Knowledge and Skills for Evidence Informed Decision Making (1). This module will enable students to search for and identify secondary sources of research evidence including systematic reviews and clinical guidelines; develop skills in the critical appraisal and synthesis of a body of evidence relating to the student’s field of professional practice; and identify and develop practice-focused research questions.


Appendix 7 Example of BSc (Hons) Pre-registration Midwifery Timesheet



BSc Pre-Registration Midwifery Timesheet (Back) Activity Codes To Use:

When in Theory: During Practice:

T = Theory (Attendance at University – Drakes or PAHC) P (+hrs) = Practice

PS = Private Study Day / Highly Directed Study (timetabled reading day or agreed in advance with personal tutor/ module teacher)

N (+hrs) = Night Duty

PMU (+hrs) = Practice Make Up Time

H = Annual Leave AS = Autonomous Study (counts as practice)

DO = Day Off DO = Day Off

When Missing Either Theory or Practice:

A = Absence (unauthorised/ not notified) C = Compassionate Leave – must be agreed by Personal Tutor

S = Sick SL = Special Leave – must be agreed by Personal Tutor

FA = Family Absence

TIMESHEET - Guidance Notes for Midwifery Students and Practice Staff

1 Do not pre-fill timesheets as errors can easily occur. Students and staff recording entries are accountable for what they document. Any amendments must be initialed and dated by the person making these alterations and deleted with a single line. Students are ultimately accountable for ensuring timesheets submitted are accurate.

2 When in practice the timesheet must be initialed on a daily basis. If more than one period of practice is undertaken on a day, each must be initialed separately by the staff member directly or indirectly supervising this period of practice; use a diagonal line to enable this.

3 The Sign-off Mentor Declaration must be signed by the sign-off mentor at the end of the month. A specimen of all initials/signatures must be provided in your OAR document to enable the mentor to verify these. The sign-off mentor must also write the total number of hours they are verifying in the box provided.

4 You are expected to work the equivalent of 37.5 hours per week or 75 hours per fortnight. It is the responsibility of yourself and your sign-off mentor to ensure these hours are being met. Where possible you should participate in the same shifts – or part of shifts – as your named sign-off mentor for at least 15 hours per week. You should work with your buddy mentors or named individuals for the remaining hours. Please inform your personal tutor/ link lecturer if you are not achieving these full hours.

5 Students are expected to work shifts, and in order to experience the 24 hour care provision, must attend the hand over meetings at the beginning of the shifts. This will include start times of 07:00 hours on some occasions. Weekend shifts and night duty are part of the 24 hour care provision and you are required to work these shifts as reasonable. For some experiences, on call arrangements may be appropriate.

6 Lunch Breaks or Breaks whilst out on practice are not included as practice hours and cannot be included as hours recorded on the Student Experience Record Sheet unless you have worked through them.

7 You are expected to work Bank Holidays unless the placement area is closed or has been timetabled in as a private study day by the programme. This should be recorded as a Day Off or the hours worked. You will need to work a full 37 ½ hour week.

8 Timesheets that have not been submitted for three consecutive months may result in you being withdrawn from practice placement until outstanding timesheets have been received.

Reporting Sickness/Absence

You are expected to inform your Programme Administration office if you are sick or absent from ANY part of the programme and, in addition, are responsible for notifying your placement area if you are unable to attend any shifts. Please note the default for recording a day of absence or sickness is 7.5 hours per day. It would be appreciated if practitioners could remind students to contact their relevant site if they are unable to attend their practice placement or notify the relevant site if a student fails to arrive when expected. Please contact the sites on:

Faculty Student Reception: Telephone: 01752 586964 / 585335 / 585332 /586999 E-mail [email protected]

Office Hours: Monday – Thursday 8.30am – 5pm Friday 9am – 4.30pm Answerphones are available after these times



Appendix 8

INTRODUCTION TO STUDENT MIDWIFE CASELOADING

In accordance with the Nursing and Midwifery Council requirements (NMC 2009) all students on the Plymouth University BSc (Hons) Pre Registration Midwifery programme will be involved in the care of a small group of women throughout their childbirth experience, including antenatal, intrapartum and postnatal care. The emphasis is on the learning to be gained from being involved in the woman’s childbearing journey and the continuity of care this offers. The midwife remains accountable for any delegation of care and the student must keep them informed of their actions at all times. The aims of caseloading are to:

• Follow individual women through the continuum of pregnancy, birth and motherhood, working collaboratively with others involved in the woman’s care

• Plan, deliver and evaluate a programme of midwifery care, exercising decision making skills

• Gain experience of autonomous practice in a carefully supervised setting prior to completion of the programme

In collaboration with their Caseload Co-ordinator and personal tutor, students will identify approximately two to five women in whose care they will be involved from initial consultation through to the postnatal period. They will be expected to undertake home or community visits, hospital appointments and birth where feasible. They will be expected to liaise with their current sign-off mentor as to when they will be needed by their caseloading women and negotiate release for this. In order to ensure that this learning experience is safe and effective, the following key points must be adhered to at all times:

1. Communication – between the student and the woman, the Caseload Co-ordinator and/or the lead midwife for the woman as well as others involved in her care.

2. Supervision - care will always be under the direct/indirect supervision of the Caseload Co-ordinator or the lead midwife for that woman. The level of supervision will vary depending on the student’s level of ability and the needs/ wishes of the woman. In higher risk situations it is expected that supervision will be direct.

3. Documentation – all care and communication must be documented, and the name of the

supervising midwife must always be recorded, with contemporaneous countersignatures where possible.

4. Audit – in situations where indirectly supervised practice has been agreed, it is expected

that the Caseload Co-ordinator or lead midwife will see the woman and sign the student’s records at a minimum after every three encounters. This enables the woman to confirm their satisfaction with the student’s care, their practice and record-keeping to be audited and the student to be reassured that they are providing safe and effective care (Fry et al 2011).

5. Follow policies – national and local policies should be adhered to at all times. Any

exceptions must be discussed and agreed with the student’s Caseload Co-ordinator/ lead midwife. This includes frequency, location and timing of visits.


1. WHAT IS THE DIFFERENCE BETWEEN STUDENT MIDWIFE CASELOADING AND CASELOADING FOR MIDWIVES?

MIDWIVES STUDENT MIDWIVES

The aim is to provide continuity of care and carer for the woman in order to improve their experience and outcomes.

The aim is for the student to gain experience of a woman’s journey through the continuum of childbearing, in order to develop their decision-making skills and promote autonomous practice – thus enhancing their future practice as a midwife.

Midwives generally hold a caseload of 30-60 women per year.

Students are encouraged to hold a caseload of 2-5 women in the final year of their programme. Experiences gained are in addition to their normal clinical and academic requirements, so it is important that burnout is avoided.

Either individual midwives or small teams of 2-3 provide all antenatal, intrapartum and postnatal care for their caseload.

Students are expected to undertake as much of the care of the woman as is feasible without compromising theoretical elements of the programme and within their own personal constraints. Individual availability will be discussed with the Caseload Co-ordinator/ midwife accountable for the woman’s care and the woman herself.

Midwives are expected to work their hours and undertake their practice in settings convenient to the women in their caseload.

Students are required to follow local Trust policies with regard to location/ timing/ frequency of visits, and need to discuss any proposed variations with the woman and the midwife accountable for her care.

Midwives are accountable for their own practice, although a ‘fresh eyes’ or partnership approach is deemed good practice.

Students remain under supervision of a registered midwife at all times, who is accountable for their actions and omissions. The level of supervision will vary, depending on the abilities of the student and the needs/ wishes of the woman. The midwife makes this judgement. It is expected that the midwife will provide ‘fresh eyes’ at a minimum of every three encounters by the student, to include audit of their records.

2. WHO ARE THE PEOPLE INVOLVED IN SUPPORTING THE STUDENT AND STAFF? Caseload Co-ordinator – the midwife responsible for overseeing the student’s caseloading experience. A Caseload Co-ordinator does not necessarily need to be a sign-off mentor as the role is very different, but it is useful if they are either the student’s sign-off or buddy mentor. Lead Midwife – the midwife who is lead carer for the woman (i.e.: part of their caseload) and who is the person to whom the student refers regarding her care. Supervising Midwife – the midwife temporarily supervising the student in the clinical setting when they are caring for their caseloading woman. This may be a community colleague (e.g.: when the Caseload Co-ordinator or lead midwife is away) or a hospital midwife.


Sign-off Mentor – the midwife who is designated to teach, supervise and assess the student’s practice in their usual placement setting. The sign-off mentor may or not also be the student’s Caseload Co-ordinator. Personal Tutor/ Link Lecturer – the university lecturer who is linked to the clinical area in which the student is practising.

3. THE PROCESS OF STUDENT MIDWIFE CASELOADING (a) Prerequisites: The following must be achieved/ undertaken prior to students commencing their caseloading experience:

• Students must pass all year two assessments, both theory and practice, before consenting women for caseloading.

• Prior to the start of caseloading students must hold a Caseload Planning Meeting with their Caseload Co-ordinator and personal tutor/link lecturer. This will form part of the coursework element for MID 220 Normal Midwifery Practice 2, and is an essential pre-requisite before the student is able to consent women.

• ‘Caseloading’ does not mean that the student necessarily needs to be undertaking indirectly supervised care – the caseloading period starts when the woman consents to be part of the student’s caseload.

• The Caseload Co-ordinator/ lead midwife must be satisfied with the student’s practice before they will be able to undertake indirectly supervised visits. Note that the timing of these ‘solo’ visits will vary, and in some cases directly supervised practice may be required throughout the woman’s care. Please do not feel pressurised into allowing students to undertake indirectly supervised practice until they are ready; however, it is beneficial to their professional development to undertake some indirectly supervised practice when you consider this is appropriate.

(b) General principles:

• Whilst undertaking caseloading, students must continue to attend all theory sessions in accordance with the midwifery programme. It is accepted that students will wish to care for their caseloading woman in labour. More flexibility in this situation may be approved by the module teacher, but the student will need to accept responsibility for making up any missed theory. Extenuating circumstances for missed academic work or deadlines cannot be submitted due to caseloading commitments.

• Plymouth University and local Trust policies must be adhered to at all times. The Faculty policies for lone working may be found on POPPI at https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-and-workbased-learning/poppi/poppi-health/policies-procedures-and-guidelines




Please note that although nurses are specifically referred to, this also applies to midwifery students. These guidelines must be used in conjunction with the relevant Trust policies. Other relevant University policies relating to practice may be found on the same site. Students are responsible for accessing and following relevant Trust policies. Please assist them to locate relevant documents.

Third year student midwives undertaking student midwife case loading may only undertake lone working (i.e work indirectly supervised) in the community setting during daytime working hours (i.e 0830 – 1730) Monday to Sunday inclusive. Outside these times, students are NOT permitted to undertake lone working. Please note, first and second year student midwives should NOT be working indirectly supervised in the community setting.

• If a woman or baby requires transfer in an ambulance students may only accompany them if a midwife is present in the ambulance and if it is deemed appropriate for an additional person to be in the vehicle.

• If at any time a client’s condition becomes complicated, the student must seek the guidance of her Caseload Co-ordinator or the lead/ supervising midwife. When, for whatever reason a woman’s risk factors change (physical, social or psychological), the midwife should take steps to monitor the situation closely and intervene if required. It may be appropriate for the student to observe while the midwife takes over the care directly. The midwife should remember that she remains professionally and legally accountable for the woman’s care.

• At no point should any student feel “out of their depth.” If a caseloading student asks for support, she needs to receive it in a constructive manner from which she can learn and develop.

1. The stress of carrying even a small caseload while a student should not be under

estimated. Student midwives undertaking caseloading are simultaneously balancing this with their other practice and academic requirements as well as their personal lives. Together with the added responsibility of carrying a supervised caseload for the first time, the pressure can be considerable. If you note any signs of stress or burn-out (e.g.: insomnia, irritability, and a lack of concentration, exhaustion, as well as physical symptoms of illness such as headaches, irritable bowel, continual anxiety or an inability to “switch off”), please discuss these with the student and seek a solution. However, if you remain concerned, please contact their personal tutor.

2. Student midwives are required to keep a personal log of their clinical hours. They should

ensure that they do not work more than their rostered hours. However, if they do accrue hours as a result of their clinical caseload, then arrangements must be negotiated for them to take the time owing within four weeks. After this period, time owing will be lost so it is essential that student midwives do not accrue a large number of hours. All time spent undertaking caseloading practice must be verified on the student’s timesheet by the midwife overseeing this period of care.

3. Caseloading students are not available seven days a week, twenty-four hours a day. They

may choose to be “on call” for their women from 37 weeks gestation onwards and this should be explained to those concerned. Individual students’ on call arrangements may vary and should be clearly discussed with the women concerned. On occasions, this may


mean that the student is unable to attend an appointment. This must be clearly communicated to the woman and midwife, and the student should follow up the outcome.

(c) Maintaining Professional Boundaries:

• If you feel that the student is having difficulty in establishing appropriate boundaries between a friendship and a professional relationship with a woman in their caseload, please discuss your concerns with the student in the first instance, and try to find a solution. You may need to talk directly to the woman to explore the issues and reach a more satisfactory resolution. This is not a friendship, and any activities such as adding the woman (or she adding the student) as a ‘Facebook friend’ or similar are not permitted. Please refer to the NMC guidance for further advice at www.nmc-uk.org/ or the guidance on the POPPI site. If you still have concerns, please contact the student’s personal tutor.

• It is important that the student, Caseload Co-ordinator and women are all aware that the student does not provide a 24-hour counselling service, and is not on-call except for the agreed period (usually 37-42 weeks). Appropriate arrangements for contacting the student, reflecting local policy, must be discussed at the Caseload Planning Meeting and clarified with the women.

(For further information please see the ‘Staff Information for Student Midwife Caseloading’

on POPPI https://www.plymouth.ac.uk/student-life/your-studies/academic-services/placements-

and-workbased-learning/poppi/poppi-health/nursing-and-midwifery )





CASELOAD FLOWCHART

YEAR ONE Students attend Caseloading Introduction session (clinicians are welcome to attend)

YEAR TWO

Students receive and download Caseloading Workbook

Preliminary Planning (Complete Part One of Caseloading Workbook). Discussions will also take place in timetabled theory sessions.

Caseload Co-ordinator will be identified through discussion between student’s personal tutor and

clinical area and will be based in the community.

Caseload Planning Meeting

Arrange caseload planning meeting with their Caseload Co-ordinator and personal tutor having first completed Part One of their Workbook in preparation (students)

Complete Part Two of the Caseloading Workbook (students)

Maintain Caseloading Workbook

electronically (students)

Upload copies of signed documents to your E-portfolio (students)

Once students have successfully completed all elements of assessment relating to year two of their

programme they may start booking women for their caseload. They MUST NOT start to consent women until they have passed all year two assessments and undertaken the Caseload Planning Meeting

YEAR THREE

Provision of caseload bag and equipment (early in the academic year). Students provide care for women, documenting this in the Caseload Activity Log. The Midpoint Review

meeting must be undertaken with their Caseload Co-ordinator and personal tutor (Part Three Caseloading Workbook)

Updated Caseload Workbook, records of meetings and ‘Records of Caseloading Practice’ completed to date must be included in student’s E-portfolio as part of their summative practice assessment (MID 316/ 326). They are also required to write a report on their planning towards caseloading in MID 220 (2008

curriculum) or a critical report of their caseloading experience as part of the module assessment for MID 326 (2013 curriculum). Written feedback from the women in their caseload forms an essential element of the evidence supporting their practice assessment, but permission must be obtained for use of women’s

names.

Undertake Final Review meeting (Part Four Caseloading Workbook) with their Caseload Co-ordinator when they have completed their caseloading experience. Their personal tutor is not required to attend

this meeting. Return of caseload bag and equipment

Hard copy of the Final Review Meeting form to be given to the student’s personal tutor at exit interview for filing in their student records. Caseload Activity Logs and Consent forms to be stored in the woman’s

hospital records, following local Trust policy.

Please note


All Students will be expected to work within the National Institute for Health and Clinical Excellence (NICE) guidelines and local Trust policies and procedures when planning and providing care.