University of Newcastle upon Tyne
Northumberland, Tyne and Wear Strategic Health Authority

December 2005

RG235 12/05

Major review of healthcare programmes

The Department of Health, in partnership with the Nursing and Midwifery Council, the Health Professions Council and the Strategic Health Authorities have contracted with the Quality Assurance Agency for Higher Education (QAA) to carry out reviews of all NHS-funded healthcare programmes in England during the period 2003-06.

QAA helps to provide public assurance that the quality and standards of higher education are being safeguarded and enhanced by conducting academic reviews of higher education provision.

Major review

Major review is a peer review process. It starts when higher education institutions in partnership with their commissioning Strategic Health Authorities evaluate their provision in a self-evaluation document. This document is submitted to QAA for use by a team of academic and practitioner reviewers who gather evidence to enable them to report their judgements on the academic and practitioner standards and the quality of learning opportunities. Review activities include meeting academic and clinical staff and students, scrutinising students' assessed work, visiting practice learning environments, reading relevant documents, and examining learning resources.

Full details of the process of major review can be found in the Handbook for major review of healthcare programmes, 2003.

Judgements

The range of judgements that reviewers may utilise when they have completed a major review are summarised below.

Academic and practitioner standards

Reviewers make one of the following judgements on standards:

confidence, which may be expressed as
limited confidence, or
no confidence.

To reach this judgement, reviewers look at:

learning outcomes
the curriculum
student assessment
student achievement.

Confidence in academic and practitioner standards: a judgement that is made if reviewers are satisfied with current standards and with the prospect of those standards being maintained into the future. A judgement of limited confidence is made if standards are being achieved but the reviewers have doubts about the ability of the HEI and partner placement providers to maintain them into the future.

No confidence in academic and practitioner standards: a judgement that is made if arrangements are inadequate to enable standards to be achieved or demonstrated. If a failure to achieve standards has occurred in specific programme/s and/or mode/s and/or level/s only, and there is confidence in standards at other levels, the failing programme/s mode/s level/s will be identified separately.

Quality of learning opportunities

Reviewers make one of the following judgements for each of three elements of learning opportunities:

commendable
approved
failing.

The three elements of quality of learning opportunities are:

learning and teaching
student progression
learning resources and their effective utilisation.

Maintenance and enhancement of standards and quality

Reviewers also report the degree of confidence they have in the providers' ability to maintain and enhance quality and standards in the healthcare programmes under review.

Commendable - the provision contributes substantially to the achievement of the intended outcomes, with most elements demonstrating good practice.

Approved - the provision enables the intended outcomes to be achieved, but improvement is needed to overcome weaknesses. The summary report will normally include a statement containing the phrase 'approved, but...', which will set out the areas where improvement is needed.

Failing - the provision makes a less than adequate contribution to the achievement of the intended outcomes; significant improvement is required urgently if the provision is to become at least adequate.

Summary of the main review outcomes

Subject provision and overall aims

Clinical Psychology and Speech and Language Therapy programmes at the University of Newcastle upon Tyne, in partnership with Northumberland, Tyne and Wear Strategic Health Authority were reviewed in the academic year 2005-06. Judgements were made about the academic and practitioner standards achieved and the quality of the learning opportunities provided.

The review covered the following programmes:

Doctorate in Clinical Psychology*
BSc (Hons) Speech and Language Sciences**
MSc Language Pathology**.

* Approved by the British Psychological Society

** Approved by the Health Professions Council

Academic and practitioner standards

Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Clinical Psychology and Speech and Language Therapy at the University of Newcastle upon Tyne, in partnership with Northumberland, Tyne and Wear Strategic Health Authority.

Strengths

There is systematic collaboration between supervisors and the University through Special Interest Groups, the Liaison Committee and the Curriculum Coordinating Committee in the development and monitoring of the clinical psychology programme (paragraph 8).
The introduction of mini oral examinations to replace some written examinations in clinical psychology has been particularly appreciated by trainees for its role in preparing them for professional life and is also seen by supervisors as a more appropriate method of assessment (paragraph 16).
Trainees' assessed work in clinical psychology is clearly related to the intended learning outcomes for the programme and demonstrates a high level of achievement (paragraph 26).
Mechanisms for developing and reviewing the speech and language therapy curriculum are robust and exceptionally collaborative, involving placement partners in the Board of Studies, Curriculum Coordination Committee and Speech Practical Experience Committee to ensure that placement needs and feedback are taken into account when planning changes (paragraph 38).
Case presentations in speech and language therapy are excellent examples of a rigorous process to check students' understanding of clinical work and the theoretical underpinnings of therapy (paragraph 43).
The Rough Guides to Clinical Education in speech and language therapy give clear descriptions of the various forms of clinical assessment, and guidance on how to prepare for the various assessments, including a description of the problem-based approach to learning, sample forms and marking criteria (paragraph 46).
Case-based problem solving is a core focus of the speech and language therapy programme. This framework is effective in enabling students to achieve a high level of clinical and problem-solving skills (paragraph 50).

Good practice

The graded curriculum for placement learning in speech and language therapy is very effective in equipping students with basic generic competencies and in ensuring parity in student progression in a coherent manner (paragraph 42).

Weakness

Sampling of work by the reviewers suggested that marking criteria in speech and language therapy are not always explicit across the programmes (paragraph 45).

Quality of learning opportunities

Learning and teaching

The quality of learning and teaching is commendable.

Strength

There is clear and effective collaboration between the University and placement providers in the articulation and implementation of learning and teaching strategies. For example, the Director of Clinical Education in speech and language therapy and the NHS-based placement managers in clinical psychology have played key parts in facilitating the relationship between campus and placement learning (paragraph 55).

Student progression

The quality of student progression is commendable.

Strength

Effective working between the University, the Strategic Health Authority and placement providers contributes considerably to the ability of academic staff and clinicians to provide effective student support and to promote successful progression (paragraph 71).

Learning resources and their effective utilisation

The quality of learning resources and their effective utilisation is commendable.

Strength

The Strategic Health Authority has made significant investment in resources, for example, through the funding of placement manager posts in clinical psychology and its support for workshops (paragraph 73).

Good practice

Campus-based clinics in speech and language therapy provide an excellent transition point for students preparing for their first NHS-based placements and becoming familiar with the case-based problem-solving approach to learning (paragraph 82).

Weakness

In both SLT and clinical psychology, visits of the reviewers to practice revealed concerns recurring across the provision about the standard and adequacy of the space available to students and trainees for study and placement learning purposes (paragraph 84).

Maintenance and enhancement of standards and quality

Strength

Both programme areas have effective mechanisms through which practice staff are able to feed back on the quality and standards of programmes (paragraph 86).

Introduction

1 This report presents the findings of a review of the academic and practitioner standards achieved, and the quality of the learning opportunities provided, in Clinical Psychology and Speech and Language Therapy (SLT) programmes at the University of Newcastle upon Tyne in partnership with Northumberland, Tyne and Wear Strategic Health Authority (NTWSHA). The review was completed during the academic year 2005-06.

2 The University can trace its origins to a School of Medicine and Surgery (later the College of Medicine), established in Newcastle in 1834, and to Armstrong College, which was founded in the city in 1871 for the teaching of physical sciences. These two colleges formed one division of the federal University of Durham, the Durham Colleges forming the other division. The Newcastle Colleges merged to form King's College in 1937 and, in 1963, when the federal University was dissolved, King's College became the University of Newcastle upon Tyne. Clinical psychology is based in the School of Neurology, Neurobiology and Psychiatry within the Faculty of Medical Sciences, and SLT is located in the School of Education, Communication and Language Sciences within the Faculty of Humanities and Social Sciences. NTWSHA covers an area from the Scottish border in the North, down to Houghton le Spring in the South, and across to the Cumbrian border in the West. It serves a population of about 1.4 million and is co-terminous with local authority boundaries (encompassing two city councils, three borough councils and one county council with six district councils). NTW SHA covers five Acute Trusts, six Primary Care Trusts, two Mental Health Trusts and one Ambulance Trust.

A Subject provision and overall aims

3 Clinical psychology and SLT are currently offered in the following programmes:

Doctorate in Clinical Psychology*
BSc (Hons) Speech and Language Sciences**
MSc Language Pathology**.

* Approved by the British Psychological Society (BPS)

** Approved by the Health Professions Council (HPC)

As a result of the Doctorate in Clinical Psychology programme, students are enabled to:

work as competent and capable clinical psychologists, with a range of clients in a range of NHS settings, to meet local healthcare needs
understand and embrace the core purpose and philosophy of the profession
be committed to reducing psychological distress and enhancing and promoting psychological wellbeing, through the systematic application of knowledge derived from psychological theory and evidence
demonstrate the fundamental acknowledgement that all people have the same human value and the right to be treated as unique individuals
demonstrate the ability to work as a reflective 'scientist practitioner' drawing on and developing the knowledge base, through the production and utilisation of research findings
demonstrate that they can manager their own personal professional development, including the capacity to learn from experience.

The overarching aims of the SLT provision are to:

educate students to a standard commensurate with fitness for practice and purpose as newly qualified speech and language therapists
ensure that students meet the academic standards appropriate for the degrees which are awarded
develop in students a reflective and evidence-based approach to practice and to the evaluation of its effectiveness
equip students with the competencies which will ensure continued development and growth of SLT provision to meet the evolving needs of clients, employers and the changing contexts of healthcare
develop skills in problem-solving, critical evaluation and research which will enable students to continue to develop as professionals and individuals after graduation.

B Academic and practitioner standards

B1 Clinical psychology

Intended learning outcomes

4 Intended learning outcomes (ILOs) have undergone appropriate development recently to meet new BPS professional requirements based on a core competency framework of training. As well as meeting BPS requirements, the programme conforms to The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ), published by QAA. The programme specification is the clear and appropriately detailed, and the ILOs are in line with the Subject benchmark statement for clinical psychology, published by QAA. There is some reflection of interprofessional learning (IPL) in the ILOs.

5 The ILOs are well understood by trainees and supervisors, with both academic and practice elements of the programme clearly stated in programme and placement handbooks. The dissemination of the ILOs to stakeholders is effective, with all trainees, supervisors and external examiners receiving documentation and regular updates as required. Placement contracts make it clear what the ILOs need to be achieved if the required competencies are to be acquired in practice.

6 External examiners are appropriately consulted and informed about the ILOs and confirm that they are appropriate to doctoral level requirements. An in-depth and systematic consultation (known as the Delphi procedure) took place that involved placement providers and supervisors. Clinicians have been actively involved in the development of learning outcomes, for example, in relation to health psychology.

7 In discussions with the reviewers, placement providers and supervisors reported wide involvement and consultation in the development of the new learning outcomes based on the new competency framework. There has been good attendance at supervisor workshops to learn about this framework and the assessment of learning outcomes for trainees on placement.

Curricula

8 There is systematic collaboration between supervisors and the University through Special Interest Groups (SIGs), the Liaison Committee and the Curriculum Coordinating Committee (CCC) in the development and monitoring of the programme. A major redevelopment of the curriculum between 2000 and 2003 was undertaken effectively in collaboration with practitioners and the SHA using the Delphi procedure. Service users are members of the CCC. These consultative processes have resulted in a balanced and well thought through programme that appropriately reflects three main theoretical models: cognitive behavioural therapy, psychodynamic and systemic. The new curriculum has also led to more efficient use of placement time so that there is no longer any overlapping in clinical placements.

9 Curricular approval is consistent with university procedures and the Code of practice for the assurance of academic quality and standards in higher education (Code of practice), Section 7: Programme approval, monitoring and review, published by QAA. The content reflects the requirements of the BPS, confirming that the curriculum produces graduates who are fit for practice. The new competency framework has also been developed appropriately within the curriculum. The accreditation report of the BPS in

2003 comments on the strength of the relationship between the University and the confederation (later renamed the SHA), and this is confirmed by the reviewers' meetings with stakeholders.

10 External examiners note that the curriculum enables students to attain the ILOs of the programme and the claim in the self-evaluation document (SED) that the curriculum is well structured, producing well-prepared clinical psychologists, was confirmed by managers and supervisors met by the reviewers.

11 Currency and coherence of the curriculum are maintained through systematic collaboration with partners through the SIGs, the Liaison Committee, and the CCC. There are also NHS-funded away-days where practitioners represent clinical interests. Some SIGs play a significant role in contributing to programme design; for example the health psychology module was added in response to clinicians' advice in one such group. Other SIGs are less effective in influencing the curriculum. The committee structure was revised in response to a University requirement.

12 Trainees are able to feed back on the curriculum and influence its development through robust mechanisms such as the staff-student subcommittee where, for example, the initial three-month block was changed to include more skills-based practical work. Trainees report some issues round the timing and sequence of some curricular components, but requests for change are responded to where appropriate.

13 Practice and campus staff demonstrate scholarly and research strength, with recent contributions to national policy developments, professional conferences and published research findings, all of which have informed and enriched curriculum development. Revisions to the organisation of research activities have led to a greater involvement of practitioners in research panels.

14 The small-scale research project introduces trainees to the rigours of design while remaining service-based. A concern was expressed by trainees that the time-scale for this project means that it can overlap the large-scale research project, leading to additional pressure on them. Staff explained that, in order to maintain the service orientation and ensure that all trainees have the opportunity to find a relevant project, it is important to keep open the option of trainees being able to undertake it on their very last placement. The programme has addressed the issue of potential overload by instituting measures to ensure that trainees engage with the research process as early as possible, in order that they can better manage the demands of the small and large-scale research projects. Some trainees also expressed the view that the small-scale research project is becoming more like the large-scale study and less service based. It was explained by staff that changes in research governance have meant that the project has become more rigorous, but that it retains the service orientation, which differentiates it from the large-scale research project. A feature of the provision is the way that the small-scale research projects feeds into placement learning and entails collaborative support from placement providers. The appointment of the Senior Research Tutor has clearly strengthened the research component of the programme.

Assessment

15 The philosophy and rationale underlying the assessment process is clearly described in the programme handbook. Based on a thoughtful review of current educational practice and practice within clinical psychology nationally, there is a clear commitment to using a range of assessment methods appropriate to the learning outcomes to be achieved and to move away from traditional, time-constrained examination formats. The Code of practice has been used appropriately to inform these developments. Trainees reported that changes in the assessment process are carefully monitored by the University and managed in a collaborative way.

16 Assessment methods include a range of essays, a critical review, a research protocol, and small and large-scale research projects. There are also presentations and case-studies. The methods of assessment enable the ILOs to be assessed appropriately and effectively. The introduction of mini oral examinations to replace some written examinations has been particularly appreciated by trainees for its role in preparing them for professional life and is also seen by supervisors as a more appropriate method of assessment.

17 A problem-based learning (PBL) portfolio was introduced for the 2004 cohort as a method of assessing the year one Foundation Module, following changes to the curriculum in this module. These changes were a response to trainee requests to make this module more practice-based, and have been well received by trainees.

18 The central role of the research base of clinical psychology is reflected in assessments through the research protocol, presentations and the small and large-scale research projects. The BPS commented positively on the development of this aspect of the programme but did reflect a view from the trainees that there may be less opportunity to develop and demonstrate skills in qualitative research methods. However, evidence was provided during the review that a significant proportion of trainees are able to gain experience of qualitative methods in both their small and large-scale research projects. This was further corroborated by the samples of student work seen by the reviewers.

19 An external examiner has drawn attention to the way in which delays in getting approval through ethics committees is causing some problems for trainees in being able complete research projects satisfactorily. This problem is recognised by the programme team and is being addressed through direct dialogue with the ethical committees and improvements in coordination and arrangements for resubmission. There have also been changes in the programme to promote earlier engagement of trainees with the research process and closer monitoring of progress.

20 The programme handbook contains clear marking criteria and a feedback grid for written assignments, together with the assessment schedule. Samples of work seen by the reviewers demonstrated that these grids are consistently used. Clear information is given about the arrangements for getting feedback, and trainees are apprised of the arrangements for ensuring that work is marked blind. The reviewers confirm the view of trainees who reported that feedback is timely and effective.

21 The various policies on the submission of late work, fabrication and plagiarism are clearly set out and described. Work is moderated on a sample basis in line with university policy and wherever there are referrals. The arrangements for the assessment of practice-based learning are equally well described.

22 The trainee is assessed in relation to a placement contract, which is negotiated with the supervisor at the beginning of each placement. This assessment is structured through the use of a number of instruments, which, in addition to a trainee's competence checklist (TCC), includes a placement record form, a supervisor feedback form and a trainee feedback form. Examples of these and guidance on how they are filled in and used are given in the placement handbook. This process is considered to be clear and transparent by both trainees and supervisors.

23 The tripartite assessment meetings between trainee, clinical tutor and clinical supervisor that occur at the mid-placement stage are well understood and valued by trainees and supervisors. Due to recent pressures on staffing, the routine presence of the clinical tutor at the final assessment meeting has ceased. This is regretted by some supervisors and trainees. The senior clinical tutor is aware of the issue and clear criteria have been established and disseminated for when the tutor's presence at a final three-way meeting can be requested. Whether this final three-way meeting should be reinstated is still under discussion in the CCC.

24 The TCC plays a central role in ensuring continuity and balance between placements and in identifying and addressing gaps in the trainee's experience. Some trainees commented that having a continuity of clinical tutor between placements would further enhance this process. The programme is sympathetic to this view and tries to achieve this wherever possible, but is constrained by the logistics of staffing.

25 Supervisors are able to influence the assessment strategy in a variety of ways, through their involvement in teaching on the programme, the three-way placement assessment meetings, the various training workshops run by the University, the SIGs, which are supported by the University, and the programme committee structure. They are also increasingly involved in campus-based assessment through the mini oral examinations.

Student achievement

26 Trainees' assessed work is clearly related to the ILOs for the programme and demonstrates a high level of achievement. The reviewers found that trainees' work displayed sharp critical analysis, good integration of theory and practice and the use of a range of appropriate theoretical models. This was also reflected in the comments of external examiners, which confirmed that trainees were reaching appropriate standards in their written work.

27 The strong relationship between the University and the placement providers ensures that trainees are well prepared for employment, practice and academic award. The close involvement of practitioners in the delivery of the programme ensures that trainees are able to achieve the required standards in practice throughout the degree. These links with the profession ensure that students are professionally competent and able to join the workforce with a range of skills. The foundations for professional development through lifelong learning are soundly laid.

28 Trainees display a high academic calibre on entry and their achievement on the programme reflects this. As shown in Table 1a, there is low attrition and it is rare for students to fail. As a result of some disquiet among one trainee cohort, following early failure of a peer from the programme, more support has been put in place to ensure that trainees are clear about the criteria for competent performance.

29 Documentation that clearly delineates the achievement goals for placements is excellent and is commended by clinicians and trainees for being accessible and informative. This facilitates high achievement in the practice setting and ensures that the skills needed to gain BPS registration are attained. Trainees receive detailed formative feedback on the clinical and academic work they complete and are clear about their achievement at each stage of the programme. The mid-placement, three-way visit is valued by all parties and enables students to be clear about their level of professional competence and further development needs.

30 There are clearly defined and understood support mechanisms for all trainees, and procedures to help those who are failing to meet the necessary standards. Family-friendly policies are in place. Trainees are aware of these and are able to take advantage of them when necessary.

31 The majority of graduates take up posts in the NHS within three months of graduating (Table 2a), and career progression is monitored by local employers. Employers met by the reviewers attested to the professional knowledge and insights of graduates they employed from the programme.

Table 1a: Completion and achievement statistics for all award bearing programmes in clinical psychology

Programme	Cohort	Award
		Distinction		Pass		Fail
		No.	%	No.	%	No.	%
Doctorate in Clinical Psychology	September 2003	2	12	14	82	1	6
	September 2004	3	15	17	85	0	0
	September 2005	2	12	14*	82	1	6

* plus three students who have not yet completed as they had extensions for their large-scale research projects

Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-registration/post-qualification programmes

Programme	Further study		Local employers		Employers elsewhere		Unemployed		Other*
	No.	%	No.	%	No.	%	No.	%	No.	%
Doctorate in Clinical Psychology
September 2003	0	0	9	56	4	25			3	19
September 2004	0	0	16	80	3	15			1	5
September 2005	0	0	13	68	2	11			4	21

* Other = travelling/working abroad or not known

Summary of academic and practitioner standards for clinical psychology

Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programme in Clinical Psychology at the University of Newcastle upon Tyne, in partnership with Northumberland, Tyne and Wear Strategic Health Authority.

Strengths

There is systematic collaboration between supervisors and the University through Special Interest Groups, the Liaison Committee and the Curriculum Coordinating Committee in the development and monitoring of the programme (paragraph 8).
The introduction of mini oral examinations to replace some written examinations has been particularly appreciated by trainees for its role in preparing them for professional life and is also seen by supervisors as a more appropriate method of assessment (paragraph 16).
Trainees' assessed work is clearly related to the intended learning outcomes for the programme and demonstrates a high level of achievement (paragraph 26).

B2 Speech and language therapy

Intended learning outcomes

32 The ILOs for SLT were developed with reference to an appropriate range of external reference points. They reflect the HPC Standards of Proficiency, meet the curricular guidelines of the Royal College of Speech and Language Therapists (RCSLT) and reflect the Subject benchmark statement for speech and language therapy, published by QAA. These standards, linked to the curricula, are clearly set out in the programme specifications. The ILOs conform to the requirements of the FHEQ.

33 Service partners were actively involved in the development of the ILOs through their membership of the committee that prepared for the full review of the curricula towards the end of the 1990s. There is also service representation on the Board of Studies. Updating of the ILOs has been appropriately driven by changes in the professional requirements in practice, for example, working in multiprofessional groups, dysphagia and multi-agency working, in particular with the education sector. The ILOs for all modules involving placement learning are competency-based, with the clinical competencies determined by a panel consisting of university staff, NHS service managers and clinical educators. These are in line with the RCSLT clinical education practice standards (CEPS).

34 The ILOs are clearly articulated in programme documentation, and both students and clinical educators reported satisfaction with the clarity of these documents. Clinical educators are well supported by university staff and attend training workshops. This enables them to be kept fully informed on relevant aspects concerning practice placements and in facilitating learning opportunities that enable students to achieve the ILOs.

35 With the exception of initial, in-house placements, individual ILOs for practice are negotiated by students in discussion with their clinical educator to reflect both the module requirements and individual learning and professional needs. The MSc programme has ILOs in common with the undergraduate programme. However, this is appropriate, given that MSc students do not have previous learning to build upon in this area, though there is scope for individual professional development needs to be met.

Curricula

36 The curricula of the two programmes clearly reflect the Subject benchmark statement and the HPC Standards of Proficiency and RCSLT guidelines. The programmes require similar competencies, ensuring that students demonstrate fitness for award, practice and purpose, although the curriculum is geared effectively to a faster pace for students following the MSc programme.

37 The curricula enable students to attain the ILOs of the programme. The reviewers endorse the view of the external examiner that the curricula are carefully designed to address key content and skills in an integrated framework with constant attention to detail. The emphases on research and building an evidence base for practice, are themes that run throughout the programmes.

38 Mechanisms for developing and reviewing the curriculum are robust and exceptionally collaborative, involving placement partners in the Board of Studies, the CCC and Speech Practical Experience Committee (SPEC) to ensure that placement needs and feedback are taken into account when planning changes. Clinical educators are involved in teaching on the programme in the University and this offers opportunities to influence the curricula. One example of this is the development of a new approach to the teaching of the dysphagia component of the curricula. Further examples include the identification of changes needed in learning disability and the role of the clinical educators in implementing this in the Exceptional Development module. This need was also identified in the Professional Accreditation report 2001. Client-specific workshops are set up to establish guidelines for placements and the programme is very quick to respond to clinicians, with ideas for specific workshops going to the CCC for consideration.

39 The staff are research-active and their expertise clearly influence the curricula. Case-based problem-solving (CBPS) is an innovative and effective design for the SLT curricula. Reflective practice is deemed to be a positive feature of the programme by the external examiner, and the reviewers agree with this. The integration of theory and practice is evident through a process of active learning. Students report that they feel that lecturers have professional credibility and that their research means that they are knowledgeable and up to date in their field.

40 The Voice, Laryngectomy and Dysfluency Intensive modules in year three and the Dysphagia module in year four currently stand outside the CBPS approach, but are being reviewed to ensure that they are brought more into line with the delivery of other curricular components. The reviewers endorse this as a more appropriate and consistent approach.

41 The IPL is developing within the curricula alongside clinical psychology but is still 'work in progress'. It has been administratively complex but is warmly received by students. The IPL common learning scheme, although constrained by logistics, is supported by some Trusts and is rolling out in adult placements with a commitment to move to paediatrics. Some placements have very effective links for students to experience IPL. Managing and enhancing placement learning is well evidenced, with the CEPS being used as a means of audit.

42 The graded curriculum for placement learning is very effective in equipping students with basic generic competencies and in ensuring parity in student progression in a coherent manner. Handbooks clearly support the integration of theory and practice and the adoption of a reflective and evidence-based approach to practice. Projects carried out on the Professional Context Module and the Extended Case Study involve effective collaboration between the University and placements.

Assessment

43 Assessment processes have been devised and developed in accordance with university practices and regulations which reflect due consideration of the Code of practice. The programme makes use of a wide range of assessment methods. These comprise essays, practical tests, observational studies, learning logs, seminar presentations and group projects, case reports and studies and clinical portfolios. These methods are clearly described in the programme handbooks, together with clear schedules of assessment and the various policies associated with the assessment process. These include explicit guidelines for the submission of assignments and the rules governing extensions and the consequences of late submission of work. Case presentations are excellent examples of a rigorous process to check students' understanding of clinical work and the theoretical underpinnings of therapy.

44 The revised programme handbooks for 2005-06 contain useful summaries of the areas of learning and levels of expertise expected at each stage of the undergraduate programme and within each year of the master's programme. These level descriptors and associated assessment criteria not only help to differentiate the two programmes but also define progression within each programme. In an ongoing piece of work, these level descriptors are being used to develop module-specific assessment criteria, which will replace the generic criteria used formerly. Initially, this is being piloted on a small number of modules and monitored through the CRC. Training is planned to ensure that staff are familiar with the new structures and students' attention is drawn to the changes through the student handbooks, module leaders and staff-student committees.

45 The reviewers endorse the views expressed in the reports of the external examiners that the methods of assessment are appropriate to the ILOs, and discriminate adequately between levels. Coursework is carefully marked and discrepancies taken seriously and resolved through multiple marking. However, sampling of work by the reviewers suggested that marking criteria are not always explicit across the programmes. These observations reflect a comment by one of the external examiners. This is an issue that is being addressed by the current revision of marking criteria. Students reported that feedback is timely.

46 The assessment of clinical practice is competency-based and uses a combination of case presentations and reports, observation of clinical work, a clinical oral examination and clinical evaluation reports which are completed by the clinical educators. The Rough Guides to Clinical Education give clear descriptions of the various forms of clinical assessment, and guidance on how to prepare for the various assessments, including a description of the problem-based approach to learning, sample forms and marking criteria.

47 The effectiveness of the Rough Guides and the other assessment briefings received by students is reflected in their comments that they feel well prepared for the clinical assessment process and that they understand the structure and process of the assessment. They particularly value the mid-placement assessment during the first placement.

48 Clinical educators clearly feel themselves to be valued partners in the design and review of the assessment process and the various assessment instruments, which they consider to be highly appropriate to practice. This process is helped by the fact that many of them also teach on programme modules. The roles of the CCC and SPEC have also been central in this regard, and comments were made about how the work of the CCC has become more focused in the last few years.

49 Practitioners feel well supported by the University through the clinical educators' workshops, which are mandatory. When practitioners first take on the role of clinical educator, they have a graduated entry into the role during which they are supported by more experienced staff and carry out joint assessments. Clinical tutors do not routinely attend assessment meetings in the practice setting but clinical educators felt that there are good mechanisms in place for addressing problems in relation to assessment and that programme tutors are very responsive when there is a problem.

Student achievement

50 CBPS is a core focus of the programme. This framework is effective in enabling students to achieve a high level of clinical and problem-solving skills. The reviewers confirm the views of students, and academic and practice staff, that it is having a positive effect on outcomes in SLT practice by facilitating an increasing autonomy in clinical decision-making. The approach is reported to suit some students better than others but support for students is in place to develop the CBPS skills.

51 It is rare for students to fail and there is low attrition in both programmes, with 100 per cent of the last two cohorts of MSc students progressing and a very small proportion of undergraduates withdrawing. These withdrawals are usually for personal reasons.

52 Graduates are considered by employers to be fit for purpose, professional practice and award. Exit awards are commendable, with SLT BSc students having a very high proportion of First and Upper Second class degrees, and MSc students with high proportions of Distinction and Merit awards. External examiners confirm that standards of achievement are high and the work seen by the reviewers reflects these standards.

53 There is good support for all students and procedures to help those who are failing to meet the necessary standards. Documentation is exceptionally clear and accessible, and there are well-established procedures that enable student achievement to be monitored effectively.

54 There is a strong partnership between clinical educators and the University that promotes high achievement. There are opportunities for clinician involvement in research, university lecturing, and student assessment and for university staff to have a strong clinical grounding through practice-based research, thus supporting students in both academic, clinical and research achievement. Innovative clinical educators' workshops have taken place to enhance placement provision and consequently student achievement, especially in areas of need such as dysphagia. There are no clearly identified step off/on opportunities. With small cohorts, however, individualised support is put into place if this becomes necessary.

Table 1b: Completion and achievement statistics for all award-bearing programmes in speech and language therapy

Programme	Cohort	Distinction		Merit		Degree classification
						1		2i		2ii		3		P		F
		No.	%	No.	%	No.	%	No.	%	No.	%	No.	%	No.	%	No.	%
BSc (Hons) Speech and Language Sciences	2005					7	33	13	62	1	5
	2004					8	35	15	65
	2003					9	41	12	55	1	4
MSc Language Pathology 2005-04**	2005	3	23	10	77
MSc Language Pathology 2005-04**	2004**	5	50	5*	50

*Including one overseas student **Figures do not include two non-NHS funded students who graduated without eligibility for registration as a practitioner

Table 2b: Employment statistics for all pre-registration/post-qualification programmes and exception reporting only for post-registration/post-qualification programmes in speech and language therapy

Programme	Further study		Local employers		Employers elsewhere		Unemployed		Other
	No.	%	No.	%	No.	%	No.	%	No.	%
BSc (Hons) Speech and Language Sciences
2005			14	67					8*	33
2004			21	91					2**	9
2003
MSc Language Pathology
2005			11	79					3***	21
2004			9	90					1****	10

NB: The table has not differentiated between local/elsewhere employers as we do not track that information

* Two students are travelling, five students unknown, and one student still to graduate.

** one student travelling, one student unknown.

*** one student unknown, one student not employed, one student still to graduate

**** one student not working

Summary of academic and practitioner standards for speech and language therapy

Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Speech and Language Therapy at the University of Newcastle upon Tyne in partnership with Northumberland, Tyne and Wear Strategic Health Authority.

Strengths

Mechanisms for developing and reviewing the curricula are robust and exceptionally collaborative, involving placement partners in the Board of Studies, Curriculum Coordination Committee and Speech Practical Experience Committee to ensure that placement needs and feedback are taken into account when planning changes (paragraph 38).
Case presentations are excellent examples of a rigorous process to check students' understanding of clinical work and the theoretical underpinnings of therapy (paragraph 43).
The Rough Guides to Clinical Education give clear descriptions of the various forms of clinical assessment, and guidance on how to prepare for the various assessments, including a description of the problem-based approach to learning, sample forms and marking criteria (paragraph 46).
Case-based problem solving is a core focus of the programme. This framework is effective in enabling students to achieve a high level of clinical and problem-solving skills (paragraph 50).

Good practice

The graded curricula for placement learning are very effective in equipping students with basic generic competencies and in ensuring parity in student progression in a coherent manner (paragraph 42).

Weakness

Sampling of work by the reviewers suggested that marking criteria are not always explicit across the programmes (paragraph 45).

C Quality of learning opportunities

Learning and teaching

55 There is clear and effective collaboration between the University and placement providers in the articulation and implementation of learning and teaching strategies. For example, the Director of Clinical Education in SLT and the NHS-based placement managers in clinical psychology have played key roles in facilitating the relationship between campus and placement learning. The head of one SLT department has developed a special computer programme for the delivery of the 'Voice' component that is being rolled out to other clinical educators through the SIG.

56 There is a wide variety of teaching and learning strategies and methods across both clinical psychology and SLT that effectively promotes learning. In SLT, the external examiner cites the excellent quality of programme materials for some modules. Clinical psychology students have gained considerable learning benefits from Balint (experiential discussion) groups, as well as peer case-discussion groups.

57 PBL and CBPS have been used respectively in clinical psychology and SLT to successfully encourage reflective practice and to enhance independent learning. CBPS is reported by SLT students as being hard initially, but extremely effective as the programme progresses, enabling them to develop a framework to build on for each client group. It enables them to use a structure to work with clients even if they have not covered all the relevant theory in class. Placement staff confirm that this approach to speech pathology learning has led to improvements in students on placement. CBPS produces students who are better able to integrate knowledge, and clinical educators feel it better reflects the reality of professional work. Staff report that students have better problem-solving skills, are more able to use underlying principles and do not compartmentalise their knowledge and skills.

58 Staff in clinical psychology placements reported problems in working out appropriate levels of support to students following the PBL framework in first placements to ensure safe and ethical practice, but noted that these were resolved through an effective reporting process. PBL has helped trainees to be more confident on placement and require less guidance.

59 The SHA has taken an active part in the Department of Health funded Common Learning Project which features IPL as part of its core element. Local universities, including Newcastle, have engaged with the NHS-funded students to introduce and evaluate interdisciplinary learning sets. This has moved on to the participation of the SHA and NHS partners with the universities to be part of a Centre for Excellence in Teaching and Learning for Health, and IPL is a feature of that stream of work. Some successful placement modules promoting IPL are being piloted by SLT. Clinical psychology and SLT staff have experienced some success in combining modules. In addition, clinical psychologist trainees work in multidisciplinary teams on placement where they gain experience of planning care programmes with other professionals.

60 Practice-based learning in both clinical psychology and SLT is plainly a central focus of the programmes and has been increasingly so in SLT over the last five years. Students feel that placements meet their needs and they often have a choice of setting. Clinical psychology trainees reported some variation in the learning experience in placements but, on the whole, were satisfied with this.

61 Students and trainees report that clients are at the heart of their learning experience. In SLT, clients attend lectures and are part of the teaching group, which students value. Systems for informing students and staff about learning and teaching on placement are explicit. Introductory and advanced workshops for SLT and clinical psychology practice staff are well attended, address very important issues and are highly valued. Students report that staff in the University and on placement are up to date in their knowledge.

62 In the Professional Context placement, SLT students have an opportunity to conduct a service-orientated project which is reported as excellent. Clinicians also value opportunities to be involved in research. In clinical psychology, the appointment of a senior tutor for research has been welcomed, as structured teaching for research needed strengthening and the lack of a dedicated tutor for projects had been noticeable. Systems for informing students and staff about learning and teaching on placement are explicit.

63 There is clear and effective collaboration between the University and the SHA in the promotion of placement learning through investment in key posts. For example, the role of the Director of Clinical Education in SLT has been instrumental in effectively enhancing learning opportunities. In clinical psychology, there is evidence of the successful use of placement managers across all but one of the placement areas, indicating that clear and well thought through coordination for placements in an area is an effective strategy for managing and enhancing learning. Both professional areas have taken account of the Code of practice, Section 9: Placement learning, published by QAA.

64 The partnership between the University and SHA has led to stable funding for the aphasia centre in SLT in order to facilitate student learning. This has increased learning opportunities and enabled the University to establish students as clinically confident before they go out onto NHS placements. It has also enabled the Aphasia Centre to become accepted as a valid element of a client's care pathway and places clients at the heart of the students' learning. As a result, the Centre receives referrals from NHS colleagues, and clinicians also work within the centre. When clients are discharged back to the NHS, a large amount of materials and resources is sent with them to enable their care to be continued and to facilitate the dissemination of good practice.

The quality of learning and teaching is commendable.

Strength

There is clear and effective collaboration between the University and placement providers in the articulation and implementation of learning and teaching strategies. For example, the Director of Clinical Education in speech and language therapy and the NHS-based placement managers in clinical psychology have played key roles in facilitating the relationship between campus and placement learning (paragraph 55).

Student progression

65 Admission procedures for both disciplines are transparent. The standard academic criteria for entry to the SLT undergraduate programme are higher than the sector average, although there is some flexibility in respect of the standard GCE A-Level requirements. Entry requirements for the MSc SLT programme and for clinical psychology are in line with national norms.

66 Applications for all programmes are buoyant, with very high application rates, especially for the MSc SLT. Clinical psychology has responded to suggestions in the 2003 BPS accreditation and now has a clear protocol for involving NHS partners and service users in admissions through meetings, short-listing, and selection interviews. In addition, the University has taken action to ensure that all places are filled by having a reserve list of suitable candidates.

67 The selection procedure is seen to be welcoming by clinical psychology trainees. Prospective students who are unsuccessful can have a debrief, which has been formally constituted by the clinical psychology team. Both disciplines hold open days for prospective students. Interviewing in SLT is carried out to ensure students understand the nature of the programme, but only for non-traditional applicants to the BSc programme, who typically are mature. All applicants for the MSc are interviewed using a problem-based exercise with NHS and university staff being involved.

68 The SHA has carried out a survey of ethnicity in the region and has undertaken work to encourage individuals from ethnic minorities to enter the NHS workforce, but to date with limited success. The SHA employs a member of staff to advise and to consider the mix of student intake. It is currently content that students on the programmes do reflect the ethnic mix of the local area. Gender balance in both disciplines is heavily biased towards female students, reflecting the national pattern. Wider access for SLT relates predominantly to mature applicants. The clinical psychology team has audited intake, and it appears in line with other programmes in the UK in respect of the student profile.

69 Induction arrangements are commended by students of both disciplines for being well organised and well focused. Student support within the programmes and within the University is well established, well understood and available as required. A 'buddy' system in each discipline facilitates peer support, as does the support from staff.

70 All placements are supervised by appropriately qualified professionals. Student support by NHS staff is reported by students to be good, with additional email and telephone communication from the University at regular times for SLT students. There is a three-way, mid-placement visit to practitioners for clinical psychology trainees, which enables students to review their progress and reflect on their achievement to date and competencies still to be achieved. Clinical psychology trainees have requested greater clarity on the tutoring and support arrangements, which is being addressed through placement induction and documentation. Students generally report feeling well prepared to commence placement.

71 Effective working between the University, SHA and placement providers contributes considerably to the ability of academic staff and clinicians to provide effective student support and to promote successful progression. University support for placement providers is excellent, with effective partnership working, facilitated by the new practice placement manager posts in clinical psychology, and SPEC and CCC meetings in SLT. Continuing professional development opportunities are available, and there are workshops for both new and experienced placement providers, with required attendance for both disciplines. These workshops are jointly devised with university and placement staff. Practice colleagues in SLT uniformly commended the approach to offering experienced clinician workshops.

72 Attrition in both professional areas is very low, as seen in Table 3. Graduates are welcomed into the workforce and employment is buoyant, with graduates being employed within the North-East and across the UK.

Table 3: Recruitment and attrition statistics for pre-registration and NMC recordable qualifications

Award title	Recruited number	Withdrawal		Transfer in		Transfer out		Discontinuation
		No	%	No	%	No	%	No	%
Doctorate in Clinical Psychology
September 2003	17	1	6	1	6	0	0	1	6
September 2004	20	0	0	1	5	1	5	0	0
September 2005	20	0	0	1	5	1	5	1	5

NB:Transfer in/out refers to trainees who have not completed with their own cohort but have joined a later cohort and graduated with them.

Award title	Recruited number	Withdrawal		Transfer in		Transfer out		Discontinuation
		No	%	No	%	No	%	No	%
BSc (Hons) Speech and Language Sciences
2005 (2001-02 entry)	26	2	8	0	0	2	8	1	4
2004 (2000-01 entry)	27	1	4	0	0	3	12	1	4
2003 (1999-2000 entry)	23	0	0	0	0	1	4	0	0
MSc Language Pathology
2005 (2003-04 entry)	14*	0	0	0	0	0	0	0	0
2004 (2002-03 entry)	12**	0	0	0	0	2***	17	0	0

* one student still to graduate

** two overseas students.

*** one overseas student, one EU student.

The quality of student progression is commendable.

Strength

Effective working between the University, the SHA and placement providers contributes considerably to the ability of academic staff and clinicians to provide effective student support and to promote successful progression (paragraph 71).

Learning resources and their effective utilisation

73 It is clear that there is an overall strategy for learning resources generated jointly by the University and the SHA in both the academic and practice settings. There is good support for clinical psychology and SLT from within the University in terms of the provision of library, information technology (IT) and teaching resources. The SHA has made significant investment in resources, for example, through the funding of placement manager posts in clinical psychology and its support for workshops. Access to NHS library resources is good.

74 In the University, a liaison librarian structure ensures regular contact with subject staff. These liaison staff attend the relevant boards of studies. Core texts are placed on reserve and many books and journals are available on-line. Requests for book purchases are honoured. Students in SLT report no difficulties in acquiring the literature they require. Students have access to computer clusters across the campus, as well as some dedicated networked computers in departments. Students commented favourably on their access to written and electronic media.

75 In SLT, there is a good range of equipment with a loan system for students, and well-equipped specialist laboratories. In phonetics and linguistics, self-study materials making use of video, audio and internet-based resources are available. The School has a range of test materials. These resources were evaluated as an area of strength in the accreditation report. In clinical psychology, relevant clinical tests and other materials are available on campus and through NHS placements.

76 A virtual learning environment is available as a means of communicating with students, providing learning materials and other support. This is being developed in Speech and Language Sciences. It is not yet utilised in clinical psychology but there are plans to explore its use. Clinical psychology students reported that they had adequate opportunities to communicate through email. In SLT, project funding has been awarded by the University's Teaching Innovation Programme to develop an e-portfolio tool to support the reflective learning approach of the CBPS framework. In clinical psychology, two CD-ROM-based focus tasks have been developed for use in the long foundation block. Video, computer and slide projector facilities are available in all lecture rooms.

77 The SLT accreditation report draws attention to the high standing of programme staff in research, with a good publication record. In clinical psychology, the BPS was impressed by the development of minimum standards for placements, the development of locality clinical tutor roles and the availability of supervisor training. The BPS highlighted the important role of the trainee competency checklist as an instrument for ensuring continuity and balance between placements. This was identified by both trainees and clinical supervisors as an important means by which continuity is achieved.

78 The BPS expressed concern about the capacity to increase placement provision as the numbers of trainees increase. Although there are no current plans to increase numbers further in clinical psychology, an important development in relation to clinical placements has been the creation of placement manager/coordinator roles funded by the NHS through collaboration between the University and the SHA. These posts are now established in four of the five placement areas. The placement managers sit on and report to the Clinical Liaison Committee, and play an important role in coordinating placement resources by bringing services together to manage resources more effectively. It is significant that in the one area that does not yet have a placement manager, the reviewers noted that staff were experiencing the most problems in managing the increased numbers of clinical trainees. The University and the SHA are both committed to developing a post in this area.

79 Placement capacity has been an area for discussion in both clinical psychology and SLT. For SLT, target student numbers will be reached across all years of the programme next year, and the teaching team and the SHA are confident that there will be no strain on the provision. The enthusiasm of the managers in finding placements is encouraging, and campus clinics provide a consistent first placement. In SLT, the manager of each Trust has responsibility for monitoring the placement provision and for designating placements to clinical educators. To date, there have been no major difficulties in placing all students and in providing placements in a range of specialisms. A member of academic staff has the role of Director of Clinical Education, with a remit to organise and monitor students on clinical placements, and has provided courses in clinical teaching for supervising clinicians.

80 The SLT programme has been experimenting with new strategies to increase the number of placements available. The use of satellite clinics has been piloted. These clinics were described to the reviewers as intensive, time-limited interventions, with an emphasis on student learning opportunities and a higher student: staff ratio than usual. They have attracted some additional funding from the NHS Trusts for materials, space and equipment.

81 Training days for clinical supervisors are used to facilitate consistency across placements, and clinical educators clearly felt well supported by this provision. With support from the SHA, it has been possible to increase provision of experienced clinical educators' workshops.

82 In SLT, there are two campus-based clinics within clinical suites. These are equipped with video and audio monitoring equipment to allow for non-intrusive observation and to support the clinical development of the trainees. One of these, the Aphasia Clinic, is identified by the accreditation panel as a means of ensuring that all students receive an adult placement. The Clinic is also a valuable resource for staff development and research. The campus-based clinics provide an excellent transition point for students preparing for their first NHS-based placements and becoming familiar with the CBPS approach to learning. The funding stream for the Aphasia Clinic was under threat at the time of the last accreditation visit, but has now been secured with the help of the SHA.

83 In SLT, there is a school technician to meet the technical needs of staff and students and to organise the loan system for video and audio equipment. The accreditation report for the programme comments that the level of support staffing is adequate. The level of technical and administrative support for clinical psychology was also reported to be adequate for their needs.

84 In both SLT and clinical psychology, visits of the reviewers to practice revealed concerns recurring across the provision about the standard and adequacy of the space available to students and trainees for study and placement learning purposes. It is clear, however, that in Newcastle there is a very close and fertile relationship between the training programmes and the SHA, which has led to a number of difficult issues being addressed in a constructive and productive way.

The quality of learning resources and their effective utilisation is commendable.

Strength

The SHA has made significant investment in resources, for example, through the funding of placement manager posts in clinical psychology and its support for workshops (paragraph 73).

Good practice

Campus-based clinics in speech and language therapy provide an excellent transition point for students preparing for their first NHS- based placements and becoming familiar with the case-based problem-solving approach to learning (paragraph 82).

Weakness

In both SLT and clinical psychology, visits of the reviewers to practice revealed concerns recurring across the provision about the standard and adequacy of the space available to students and trainees for study and placement learning purposes (paragraph 84).

D Maintenance and enhancement of standards and quality

85 Programmes in clinical psychology and SLT benefit from a number of effective quality assurance mechanisms. Internal quality assurance is operated in accordance with well-established and rigorous university systems and practices. These include annual and five-yearly internal review. The initial approval and subsequent revalidation and review of programmes are robust and conform to the expectations of the Code of practice, published by QAA. The Code of practice in all its relevant sections has been taken full account of by the programme providers in the development and refinement of policies and practices.

86 Both programme areas have effective mechanisms through which practice staff are able to feed back on the quality and standards of programmes. The CCC in clinical psychology and the CCC and SPEC in SLT offer significant opportunities to clinicians to influence the development and enhancement of programme quality, and for the providers jointly to address quality issues and enhance standards and quality.

87 Accreditation procedures conducted by the BPS and HPC are responded to effectively by programme staff and there is an appropriate response to the recommendations of internal review bodies. External examiners' reports are given serious and appropriate consideration and action taken, where required, to maintain and enhance standards.

88 Placement quality is soundly managed and monitored by programme staff and their practice colleagues, with regular review meetings and appropriate action planning to remedy any shortcoming or shortfall. Contract monitoring by the SHA is regular and effective in both programme areas and there is a clear commitment by the SHA to invest in the future of these professional areas. A strong and effective partnership exists between the University and SHA that is cemented by joint investment and development of key areas such as the SLT in-house clinic and the placement manager posts in clinical psychology.

89 Student evaluation is carried out effectively through a number of mechanisms. Central to these are the completion by students and trainees of module evaluation forms and their membership of boards of studies and liaison committees. Students and trainees gave examples of changes that had been brought about by their evaluation of programmes, such as the changes to the small-scale research project in clinical psychology.

90 The SED provided a good basis for major review. It was clearly written and had benefited from the constructive inputs of stakeholders and students/trainees. Though not always as self-critical as it could have been, it nonetheless reflected a sufficiently evaluative approach to assure the reviewers that the providers take the assurance, maintenance and enhancement of standards and quality seriously and have effective systems in place.

Strength

Both programme areas have effective mechanisms through which practice staff are able to feed back on the quality and standards of programmes (paragraph 86).

Action plan

Major Review of healthcare programmes

December 2005