Major review of healthcare programmes
The Department of Health, in partnership with the Nursing and Midwifery Council, the Health Professions Council and the Strategic Health Authorities have contracted with the Quality Assurance Agency for Higher Education (QAA) to carry out reviews of all NHS-funded healthcare programmes in England during the period 2003-06.
QAA helps to provide public assurance that the quality and standards of higher education are being safeguarded and enhanced by conducting academic reviews of higher education provision.
Major review
Major review is a peer review process. It starts when higher education institutions in partnership with their commissioning Strategic Health Authorities evaluate their provision in a self-evaluation document. This document is submitted to QAA for use by a team of academic and practitioner reviewers who gather evidence to enable them to report their judgements on the academic and practitioner standards and the quality of learning opportunities. Review activities include meeting academic and clinical staff and students, scrutinising students' assessed work, visiting practice learning environments, reading relevant documents, and examining learning resources.
Full details of the process of major review can be found in the Handbook for major review of healthcare programmes, 2003.
Judgements
The range of judgements that reviewers may utilise when they have completed a major review are summarised below.
Academic and practitioner standards
Reviewers make one of the following judgements on standards:
- confidence, which may be expressed as
- limited confidence, or
- no confidence.
To reach this judgement, reviewers look at:
- learning outcomes
- the curriculum
- student assessment
- student achievement.
Confidence in academic and practitioner standards: a judgement that is made if reviewers are satisfied with current standards and with the prospect of those standards being maintained into the future. A judgement of limited confidence is made if standards are being achieved but the reviewers have doubts about the ability of the HEI and partner placement providers to maintain them into the future.
No confidence in academic and practitioner standards: a judgement that is made if arrangements are inadequate to enable standards to be achieved or demonstrated. If a failure to achieve standards has occurred in specific programme/s and/or mode/s and/or level/s only, and there is confidence in standards at other levels, the failing programme/s mode/s level/s will be identified separately.
Quality of learning opportunities
Reviewers make one of the following judgements for each of three elements of learning opportunities:
- commendable
- approved
- failing.
The three elements of quality of learning opportunities are:
- learning and teaching
- student progression
- learning resources and their effective utilisation.
Maintenance and enhancement of standards and quality
Reviewers also report the degree of confidence they have in the providers' ability to maintain and enhance quality and standards in the healthcare programmes under review.
Commendable - the provision contributes substantially to the achievement of the intended outcomes, with most elements demonstrating good practice.
Approved - the provision enables the intended outcomes to be achieved, but improvement is needed to overcome weaknesses. The summary report will normally include a statement containing the phrase 'approved, but...', which will set out the areas where improvement is needed.
Failing - the provision makes a less than adequate contribution to the achievement of the intended outcomes; significant improvement is required urgently if the provision is to become at least adequate.
Summary of the main review outcomes
Subject provision and overall aims
Programmes in Health Visiting, Midwifery and Nursing at the University of Wolverhampton in partnership with Birmingham and the Black Country Strategic Health Authority (SHA) and the Shropshire and Staffordshire Strategic Health Authority Workforce Development Directorate were reviewed in the academic year 2004-05. Judgements were made about the academic and practitioner standards achieved and the quality of the learning opportunities provided.
The review covered the following programmes:
Health Visiting is currently offered in the following programmes:
Pre-registration
- BSc (Hons) Primary Healthcare Practice (Health Visiting) **
- Postgraduate Diploma/MSc in Primary Health Care with Professional Specialist Practice (Health Visiting) **.
* Programmes comprising the sample for annual review by the Nursing and Midwifery Council (NMC).
** Programmes that are conjointly validated by the NMC.
Midwifery is currently offered in the following programmes:
Pre-registration
- Registered Midwife, BSc (Hons) * / **
- Registered Midwife, BSc (Hons) Shortened programme * / **
Post-registration
- Return to Midwifery Practice (Professional Award) * / **
- BSc (Hons) Clinical Practice
- MSc Midwifery Studies
Nursing is currently offered in the following programmes:
Pre-registration
- Registered Nurse, Diploma of Higher Education (adult, mental health, child, learning disability) **
- Registered Nurse, BSc (Hons) Nursing Studies (adult, mental health, child, learning disability) **
Post-registration
- Return to Practice (Professional Award) **
- BSc (Hons) Clinical Practice
- BSc (Hons) Child Protection
- BSc (Hons) Learning Disability
- BSc (Hons) Mental Health Practice
- Bachelor of Nursing (Hons)
- DipHE/BSc (Hons) Palliative Care
- BSc (Hons) Cancer Care
- BSc (Hons) Professional Studies in Healthcare (Generic pathway)
- BSc (Hons) Professional Studies in Healthcare (Work Based Learning)
- BSc (Hons) Primary Healthcare Practice (Nursing in the Home, District Nursing; General Practice Nursing; Occupational Health Nursing; Public Health Nursing, School Nursing) **
- Postgraduate Diploma/MSc in Primary Health Care with Professional Specialist Practice (Non-Health Visiting) **
- MSc Nursing Studies
- MSc Ageing and Mental Health
- MSc/MA Professional Studies in Healthcare (Work Based Learning)
- MSc Advancing Clinical Practice **
- Supplementary/Extended Nurse Prescribing **
Academic and practitioner standards
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Health Visiting, Midwifery and Nursing at the University of Wolverhampton in partnership with Birmingham and the Black Country SHA and the Shropshire and Staffordshire SHAWDD.
Strengths
- Support for health visiting students from clinical practice teachers during the process of negotiating learning outcomes is excellent (paragraph 7).
- Communication of health visiting intended learning outcomes to students commences prior to initial induction during an interview with the course leader (paragraph 8).
- A particular strength of the health visiting programmes is in the breadth of the curriculum where some of the modules are organised and delivered by academic staff from other schools (paragraph 15).
- The quality of feedback on assignments for health visiting is excellent (paragraph 17).
- Midwifery students use their portfolios effectively and are very positive regarding their skills in reflection on practice (paragraph 37).
- If there is a problem with a midwifery student's performance, then a tripartite meeting is arranged with the student, mentor and link teacher to develop and agree an action plan (paragraph 39).
- A local, independent, charitable organisation has a collaborative and effective arrangement with the School to provide modules in palliative care and oncology at post-registration level (paragraph 45).
- Child, mental health and learning disability branch pre-registration nursing students state that feedback from assessments is excellent (paragraph 56).
Weaknesses
- Within the pre-registration nursing programmes, opportunities for interprofessional learning are limited in theory sessions (paragraph 47).
- Pre-registration nursing students stated that the practice proficiencies within the practice documentation are repetitive and difficult to comprehend (paragraph 52).
Quality of learning opportunities
Learning and teaching
The quality of learning and teaching is commendable.
Strengths
- Teaching is effective both on-campus and in the placement environment (paragraph 61).
- Dedicated information and communication technology staff have been employed to support academics in developing materials on the University's on-line learning framework, and these are well utilised by students (paragraph 64).
- In some clinical areas, the mentor preparation programme is an essential criterion for clinical staff applying for F and G Grade clinical posts (paragraph 66).
- Interprofessional learning occurs effectively within the health visiting programmes where students are involved in collaborative teamwork with their primary care colleagues (paragraph 69).
Weaknesses
- In the past, some mentors have not regularly attended preparation or updating sessions and the register has not always been current (paragraph 66).
- Pre-registration nursing students report varying availability and learning support from mentors (paragraph 66).
- Although staff can articulate its positive impact, there is no clear strategy for the dissemination of good practice from peer observation of teaching (paragraph 70).
Student progression
The quality of student progression is commendable with the exception of Registered Nurse Diploma of Higher Education, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programme.
Strength
- The Birmingham and the Black Country Strategic Health Authority demonstrates a commitment to lifelong learning with the induction and preceptorship programme for newly-qualified staff (paragraph 85).
- The quality of student progression in Registered Nurse Diploma of Higher Education, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programme is approved.
Weaknesses
- The attrition rates for the last three completed cohorts in the Registered Nurse Diploma, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programmes are above the national averages for these professional groups (paragraph 80).
- The high attrition rates were not recognised immediately, until preparation for major review, because of problems with the School's systems for analysing statistical data (paragraph 84).
Learning resources and their effective utilisation
The quality of learning resources and their effective utilisation is commendable.
Strengths
- New, state-of-the-art clinical skills laboratories and a multisensory 'Snoozlem' are well used and valued by students (paragraph 86).
- Support for students with additional learning needs is encouraged and positively evaluated by students (paragraph 86).
- The University's on-line learning framework is rated highly by students as a computer-based learning resource (paragraph 88).
- Students state that practice placement managers/clinical placement facilitators and link lecturers offer very good support in clinical practice and commend this system (paragraph 92).
Weakness
- Some pre-registration nursing adult branch students perceive that the School's definition of supernumerary status is not being adhered to because of staffing shortages (paragraph 91).
Maintenance and enhancement of standards and quality
Strength
- A tripartite agreement with the University, which incorporates the quality framework for monitoring contract quality and the Quality Group, ensures that all stakeholders are successfully engaged in reviewing the student journey (paragraph 99).
Weakness
- The student feedback loop resulting from the evaluation of module and placement learning is not always completed (paragraph 100).
Introduction
1 This report presents the findings of a review of the academic and practitioner standards achieved, and the quality of learning opportunities provided, in Health Visiting, Midwifery and Nursing at the University of Wolverhampton (the University) in partnership with Birmingham and the Black Country Strategic Health Authority (BBCSHA) and the Shropshire and Staffordshire Strategic Health Authority Workforce Development directorate (SASHA). The review was completed during the academic year 2004-05.
2 The University is a teaching-intensive university that recruits a diverse student population largely from its own region. The School of Health, one of the University's 10 academic schools, was created in 2001 from a merger of the School of Nursing and Midwifery and part of the School of Health Sciences. There are 3,025 undergraduate and 241 postgraduate students in the School. The School is structured into three divisions, Nursing and Midwifery, Continuing Development and Community Health. Academic provision is based at four sites, two in Wolverhampton and one each in Walsall and Burton upon Trent.
3 The BBCSHA covers the geographical patches of Wolverhampton, Walsall, Dudley, Birmingham and Sandwell. This represents five Acute Trusts, one Mental Health and Social Care Trust and nine Primary Care Trusts. Commissions for student placements are collated by BBCSHA and in collaboration with SASHA through the process of local workforce delivery planning. Commissioned numbers for education are determined by local demand and future population needs. The commissioning group, a tripartite partnership of the SHA, the University and representatives of local Trusts, monitors and manages the commissioning process. This group reports to the Black Country Nursing Network Group through the partnership quality group. Through the contract, BBCSHA funds the following posts to support the education of students in practice: 16.9 full-time equivalent practice placement managers (PPMs), five hours a week of administrative and clerical support for each PPM, and four clinical skills facilitators.
A Subject provision and overall aims
4 Health Visiting is currently offered in the following programmes:
Pre-registration
- BSc (Hons) Primary Healthcare Practice (Health Visiting) **
- Postgraduate Diploma (PgDip)/MSc in Primary Health Care with Professional Specialist Practice (Health Visiting) **.
* Programmes comprising the sample for annual review by the Nursing and Midwifery Council (NMC).
** Programmes that are conjointly validated by the NMC.
Midwifery is currently offered in the following programmes:
Pre-registration
- Registered Midwife, BSc (Hons) * / **
- Registered Midwife, BSc (Hons) Shortened programme * / **
Post-registration
- Return to Midwifery Practice (Professional Award) * / **
- BSc (Hons) Clinical Practice
- MSc Midwifery Studies
Nursing is currently offered in the following programmes:
Pre-registration
- Registered Nurse, Diploma of Higher Education (DipHE) (adult, mental health, child, learning disability) **
- Registered Nurse, BSc (Hons) Nursing Studies (adult, mental health, child, learning disability) **
Post-registration
- Return to Practice (Professional Award) **
- BSc (Hons) Clinical Practice
- BSc (Hons) Child Protection
- BSc (Hons) Learning Disability
- BSc (Hons) Mental Health Practice
- Bachelor of Nursing (Hons)
- DipHE/BSc (Hons) Palliative Care
- BSc (Hons) Cancer Care
- BSc (Hons) Professional Studies in Healthcare (Generic pathway)
- BSc (Hons) Professional Studies in Healthcare (Work Based Learning)
- BSc (Hons) Primary Healthcare Practice (Nursing in the Home, District Nursing; General Practice Nursing; Occupational Health Nursing; Public Health Nursing, School Nursing) **
- PgDip/MSc in Primary Health Care with Professional Specialist Practice (Non-Health Visiting) **
- MSc Nursing Studies
- MSc Ageing and Mental Health
- MSc/MA Professional Studies in Healthcare (Work Based Learning)
- MSc Advancing Clinical Practice **
- Supplementary/Extended Nurse Prescribing **
5 The three disciplines aim to provide a range of programmes that:
- are flexible and developed in partnership with users and key stakeholders
- produce practitioners who are fit for purpose and who are responsive to, and able to challenge contemporary practice
- promote lifelong learning and the development of transferable skills
- widen student access and embrace diversity
- promote evidence-based practice
- meet Professional and Statutory Regulatory Body requirements and are responsive to health and social care economies
- are subject to rigorous processes of quality assurance and enhancement.
B Academic and practitioner standards
B1 Health Visiting
Intended learning outcomes
6 Health visiting programmes form part of the BSc (Hons) and PgDip/MSc Primary Health Care Practice Awards, which are carefully designed to meet NMC professional and regulatory requirements. The intended learning outcomes (ILOs) are linked to the Subject benchmark statement for health visiting, published by QAA, are consistent with The framework for higher education qualifications in England, Wales and Northern Ireland (FHEQ) and are developed collaboratively through a full scoping exercise, to reflect the interests of external stakeholders, including community practice teachers (CPTs)/educators from NHS Trusts. During approval in 2004, the degree of collaboration was noted as an example of good practice. External examiners confirm that ILOs meet professional benchmarks and are consistent with the needs of the profession.
7 Programmes make provision for a significant degree of flexibility, which allows students to negotiate their own ILOs. Support for the health visiting students from CPTs during the process of negotiating learning outcomes is excellent. Practice staff involvement in development reviews and subject and award boards ensures that clinical perspectives also influence the development of the ILOs. Consequently, programmes support the achievement of knowledge and skills and achieve integration of theoretical and practice components which are in line with workforce needs.
8 Communication of the health visiting ILOs to students begins prior to initial induction during an interview with the course leader. A variety of relevant approaches is subsequently used to communicate the ILOs to students commencing the programme, external examiners and academic and clinical staff. An initial induction during the summer, the involvement of previous students and the use of pathway guides, programme specification templates and course handbooks ensure that effective communication is achieved. Students and clinical staff confirm their understanding of the ILOs, which are clearly stated, meet both student and service expectations and prepare students effectively for future practice. Variations to the ILOs are communicated effectively to CPTs/educators in practice through cascaded briefing sessions.
Curricula
9 The health visiting programme is offered as one of the routes within the Primary Health Care pathway that also includes District Nursing, School Nursing, Practice Nursing and Occupational Health Nursing which replaced the Specialist Practice Awards in 2004. Health visiting can be undertaken on a full or part-time basis, and is offered at academic levels ranging from degree to postgraduate diploma and master's, and information on this is made available to students.
10 Students are confident that the curricula are contemporary and prepare them adequately for practice. Students have commented that some modules are cutting edge and have benefited from research undertaken by staff feeding into the curricula. There is evidence of the inclusion of government policies and strategies, such as the National Institute for Clinical Excellence guidelines and National Service Frameworks in curricular development. Currency is enhanced by the use of staff who have joint clinical/academic appointments and visiting lecturers who make a valuable contribution to the programme. Students expressed satisfaction with the curricula and found that it had exceeded their expectations.
11 The health visiting programmes are designed to achieve the appropriate NMC proficiencies and students and the external examiner expressed confidence in the ability of the curriculum to facilitate the achievement of these proficiencies; where problems may prevent their achievement, there are opportunities for students to negotiate additional experiences.
12 The requirement is made explicit to the students that the health visiting programmes within the pathway that lead to entry to the NMC's Professional Register are 50 per cent practice-based. Students and CPTs are confident that that there are sufficient learning opportunities for these requirements to be met.
13 A variety of methods is employed to ensure that students and practitioners are made aware of the curricula, and these include discussions with the course leader and previous students, induction sessions and regular meetings between the CPTs and academic staff. Students expressed satisfaction with their level of awareness of the curricula, and students and practitioners are able to influence the curricula by providing feedback to academic staff.
14 The structure of the curricula provides opportunities for shared learning for health visiting students with students undertaking district nursing, school nursing, occupational health nursing, social work programmes and with physicians. While in the practice setting, health visiting students work with a range of other professionals, including the police.
15 A particular strength of the health visiting programmes is in the breadth of the curricula where some of the modules are organised and delivered by academic staff from other schools. Examples of this include 'The Scientific Basis of Disease' and 'Advanced Pharmacological' modules, which are run by staff from the School of Applied Sciences.
Assessment
16 The University's processes for assessment and examination are sound and fairly conducted. There are clear regulations governing assessment methods which are in line with the Code of practice. The standards set by the University are appropriate to the subject and professional requirements. The assessment tasks are well thought out and reflect the ILOs of each module. Students demonstrate skills in reflection through assessment.
17 External examiners testify to the effectiveness of the assessment methods and associated tutorial support. A full range of skills is assessed throughout the programme. There is consistency of marking and moderation and the quality of feedback on assignments for health visiting is excellent.
18 The assessment of health visiting practice is undertaken by qualified CPTs. Health visiting students testify to the excellent academic and CPT support and feedback that they receive with assessment of both theory and practice. Students also evaluate the role of the link lecturer and the PPM/CPF as extremely effective in supporting their clinical practice placement experience and the process of assessment.
19 Students confirm that a range of assessment methodologies is used and they feel that they know what is expected of them from assignments. Students commented that the one-year degree programme and the assessment schedule are very intense. However, as a result of student evaluations, the assessment strategy had been revised by the programme team to reduce pressure on students at certain critical points in the year.
Student achievement
20 Students' assessed work is consistent with NMC requirements, the Subject benchmark statement for health visiting, and the intended academic level. External examiners' reports confirm that students achieve the programme ILOs and relevant standards which are comparable with similar awards in other UK institutions.
21 Programme completion rates are high, with all students recruited to the programme achieving degrees. Degree classification data in Table 1a show a favourable profile, with all degrees achieved being at Second class honours level or above. The 2001 October cohort is particularly impressive, with eight out of 11 candidates achieving a First or Upper Second class degree.
22 Former students feel that, on graduation from their programme, they were well prepared for their roles in modern-day healthcare practice. External examiners' reports also confirm student readiness for practice and their role as health visitors. Clinical staff are confident that students are well prepared and competent to practise. All health visiting students are employed by their sponsoring Trust.
Table 1a: Completion and achievement statistics for all award-bearing programmes
| Programme | Cohort | Diploma programmes |
Diploma programmes |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| PgDip Specialist Practice (Health Visiting) | 2001 | 11 | 100 | 0 | 0 | ||||||||||||
| 2002 | 13 | 93 | 1 | 7 | |||||||||||||
| 2003 | 6 | 100 | 0 | 0 | |||||||||||||
| BSc (Hons) Specialist Practice (Health Visiting) | 2001 | 1 | 9 | 7 | 64 | 3 | 27 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
| 2002 | 1 | 5 | 7 | 37 | 11 | 58 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
| 2003 | 0 | 0 | 9 | 45 | 11 | 55 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
Summary of academic and practitioner standards for Health Visiting
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Health Visiting at the University of Wolverhampton in partnership with Birmingham and the Black Country Strategic Health Authority and the Shropshire and Staffordshire Strategic Health Authority.
Strengths
- Support for health visiting students from clinical practice teachers during the process of negotiating learning outcomes is excellent (paragraph 44).
- Communication of health visiting intended learning outcomes to students commences prior to initial induction during an interview with the course leader (paragraph 45).
- A particular strength of the health visiting programmes is in the breadth of the curricula where some of the modules are organised and delivered by academic staff from other schools (paragraph 52).
- The quality of feedback on assignments for health visiting is excellent (paragraph 54).
B2 Midwifery
Intended learning outcomes
23 Pre-registration midwifery programmes are designed to reflect NMC standards and proficiencies. ILOs are linked to the Subject benchmark statement for midwifery, published by QAA, are in line with the standards set out in the FHEQ and are developed collaboratively to reflect the interests of external stakeholders, including clinicians from NHS Trusts. External examiners confirm that ILOs meet all external reference points pertinent to midwifery education.
24 Midwifery programmes include flexible additional ILOs, which ensure congruence with current trends in health and social care policy developments. Practice staff involvement in development reviews and subject and award boards also ensure that clinical perspectives influence the development of ILOs. Consequently, programmes support the achievement of acceptable levels of knowledge and skill and the integration of theoretical and practice components. ILOs also reflect the individual's developmental needs and achieve consistency with the student's area of practice.
25 A variety of relevant approaches is used to communicate the ILOs appropriately to students, external examiners and academic and clinical staff. Programme induction processes, the involvement of previous students and the use of pathway guides, programme specification templates, course handbooks and clinical assessment of practice documents are all used to ensure effective communication. Students and clinical staff confirm their understanding of the ILOs which are clearly stated, meet both student and service expectations and prepare for future practice. Changes to ILOs are communicated effectively to mentors in practice through mentor update sessions and also through briefing sessions delivered by PPMs/ and link teachers.
Curricula
26 The development of curricula is on a partnership basis, with practitioners being involved at all stages. Programmes at both pre and post-registration levels meet the University's standards. Practitioners and mentors are made aware of the curricula and any changes that may be occurring by a variety of mechanisms, for example, through link teachers.
27 The two pre-registration midwifery programmes are structured in such a way that there is shared learning, with the students on the 18-month programme joining the three-year programme students for the latter half of the programme. Students on the three-year programme are able to gain experience in the caring skills that are associated with nursing, for example, critical care, medical and surgical nursing skills, in both theory and practice, and this element of shared learning is valued by students and practitioners alike.
28 Within the post-registration provision, a range of modules is offered and most of these are popular with students. The only exceptions are the modules at master's level, which have had such a poor level of uptake that the programme is being discontinued. Students attending programmes at post-registration level do so on a part-time basis and are able to achieve a balance between meeting employer/work commitments and academic requirements, as most local employers are supportive of continuing professional development (CPD).
29 The pre-registration programmes adequately meet the NMC requirements. Students are made aware of the need to meet NMC and EU proficiencies and the curriculum is structured so that they can achieve them and provide evidence of this achievement. The programmes are contemporary and pertinent for practice, and external examiner scrutiny has demonstrated that the midwifery programmes address and meet the relevant statutory and academic benchmark. A range of CPD modules is provided, including specialist clinical modules.
30 Student midwives have more opportunities for interprofessional learning while in practice than in university-based sessions, for example, the sessions on domestic violence taken with students from other disciplines. In addition, a number of teaching sessions, for example, a session on anaesthetics, occur in practice placements and these are attended by a range of professionals.
Assessment
31 Professional body standards and benchmarks are met through the assessment strategy which is commended by external examiners. The processes for assessment are in line with the Code of practice for the assurance of academic quality and standards in higher education (Code of practice) and are sound and fairly conducted. The assessment tasks are well thought out and reflect the ILOs of each module. Assessments have a strong practice focus and there is clear integration of theory and practice, evidenced through samples of clinical assessment documentation and the practice portfolio.
32 The assessment policies are clearly articulated to the students through the pathway guides, and there is clear information regarding the internal moderation process. Evidence from module assignments and external examiners' comments demonstrates the effective use of internal moderation. Students feel that the assessment strategy is appropriate, with the same strategy being utilised for both the pre-registration three-year and shortened programmes. However, students commented that, on occasion, there was difficulty with consistency in marking if an assignment was failed and the re-submission was marked by another tutor.
33 There is a variety of assessments within the programmes. The use of the same assessment task at different academic levels is an innovative approach to assessment that is evidenced in student portfolios and that has been commended by the external examiner. Specific performance criteria are written at levels 1, 2, and 3 and have been developed from the midwifery competencies. The criteria are applied in practice settings to make judgements about students' clinical competence.
34 Midwifery students on both programmes comment that, because a number of assignments are due to be submitted at the same time, they are subjected to added pressure. However, the students reported that changes to the timing of assessments have now been instigated, following student evaluation.
35 Practice assessment is continuous, which is perceived as positive by the students. Mentors are satisfied with the practice assessment processes for the programmes and are able to work with them effectively. Students and mentors understand the practice assessment documentation the completion of which is moderated by the students' personal tutors.
36 External examiners consider that feedback to students is constructive, fair and consistent. However, perusal of student work indicates that feedback to students tends to be quite generalised, with little specific commentary relating directly to individual assignments. Overall, students find the feedback on performance to be useful. Constructive feedback is given to students regarding academic style, including the need to use evidence and skills in reflection on practice.
Student achievement
37 External examiners report that student performance in the BSc (Hons) Midwifery programme, both the three-year and the shortened programmes, Return to Midwifery Practice, the BSc Clinical Studies (Midwifery) and MSc Midwifery is comparable with that of students on similar programmes in other UK institutions. Scrutiny of students' work and the external examiners' comments demonstrate that students who complete midwifery programmes are fit for purpose, practice and award. There is clear evidence that practice proficiencies have been achieved, with cross-reference made between the assessment of practice documentation and the practice portfolio. Midwifery students use their portfolios effectively and are very positive regarding their skills in reflection on practice.
38 Student work reviewed across all programmes in midwifery showed that students are achieving marks in line with the expected standards. Table 1b shows that the BSc (Hons) Midwifery classifications form a normal distribution, with no obvious difference in achievement between the three-year and the shortened programme. BSc Midwifery uptake with local employers for the most recent cohort to complete is 96 per cent and, for the shortened course, is 75 per cent (Table 2b). Data for the previous cohort are incomplete, with a relatively high percentage of unknowns. Employers within the local Trusts emphasise the outstanding quality of Wolverhampton diplomates and graduates.
39 Some students appear to struggle with academic style at level 3, with errors in referencing and grammar, but there is evidence of student support and academic advice that has resulted in improved student performance. If there is a problem with a midwifery student's performance, then a tripartite meeting is arranged with the student, mentor and link teacher to develop and agree an action plan.
Summary of academic and practitioner standards for Midwifery
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Midwifery at the University of Wolverhampton in partnership with Birmingham and the Black Country Strategic Health Authority and the Shropshire and Staffordshire Strategic Health Authority.
Strengths
- Midwifery students use their portfolios effectively and are very positive regarding their skills in reflection on practice (paragraph 40).
- If there is a problem with a midwifery student's performance, then a tripartite meeting is arranged with the student, mentor and link teacher to develop and agree an action plan (paragraph 42).
Table 1b: Completion and achievement statistics for all award-bearing programmes
| Programme | Cohort | Diploma programmes |
Diploma programmes |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| BSc (Hons) Midwifery | 1999 | 2 | 10 | 7 | 33 | 9 | 43 | 3 | 14 | 0 | 0 | 0 | 0 | ||||
| 2000 | 1 | 7 | 0 | 0 | 3 | 21 | 9 | 64 | 1 | 7 | 0 | 0 | 0 | 0 | |||
| 2001 | 1 | 4 | 3 | 13 | 10 | 43 | 8 | 34 | 1 | 4 | 0 | 0 | 0 | 0 | |||
| BSc (Hons) Midwifery Shortened | Oct 2001 | 0 | 0 | 3 | 27 | 4 | 36 | 4 | 36 | 0 | 0 | 0 | 0 | ||||
| April 2002 | 1 | 13 | 2 | 25 | 4 | 50 | 1 | 13 | 0 | 0 | 0 | 0 | |||||
| Feb 2003 | 1 | 12 | 1 | 12 | 2 | 25 | 3 | 38 | 1 | 12 | 0 | 0 | 0 | 0 | |||
| BSc (Hons) Clinical Practice (midwifery) | 2003 | 0 | 0 | 0 | 0 | 1 | 100 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
| 2004 completers |
1 | 25 | 3 | 75 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
Table 2b: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes
| Programme (Award bearing only) | Further study | Local employers | Employers elsewhere | Unemployed | Other* | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| BSc (Hons) Midwifery | ||||||||||
| 1999 | 0 | 0 | 19 | 90 | 1 | 5 | 0 | 0 | 1 | 5 |
| 2000 | 0 | 0 | 7 | 50 | 0 | 0 | 0 | 0 | 7 | 50 |
| 2001 | 0 | 0 | 22 | 96 | 1 | 4 | 0 | 0 | 0 | 0 |
| BSc (Hons) Midwifery Shortened | ||||||||||
| Oct 2001 | 0 | 0 | 8 | 73 | 1 | 9 | 0 | 0 | 2 | 18 |
| April 2002 | 0 | 0 | 6 | 75 | 2 | 25 | 0 | 0 | 0 | 0 |
| Feb 2003 | 0 | 0 | 6 | 75 | 1 | 13 | 0 | 0 | 1 | 12 |
Other includes 'not known' and incomplete questionnaires
B3 Nursing
Intended learning outcomes
40 The programmes that prepare for the professional register are effectively designed to achieve the NMC standards of proficiency. ILOs are appropriately linked to the Subject benchmark statement for nursing, reflect the requirements of the FHEQ, both published by QAA. They are developed collaboratively to reflect the interests of external stakeholders, including clinicians from NHS Trusts, who are members of curricular development groups and proposing teams for the approval of awards. The School uses strategies to ensure non-NHS providers are engaged in the process of ILO development. Nursing programmes include valid ILOs that are congruent with contemporary health and social care policy developments. External examiners' feedback confirms that ILOs meet professional benchmarks.
41 Nursing programme ILOs support the achievement of acceptable levels of knowledge and skills, and achieve integration of theoretical and practice components. Within the post-registration provision, the School uses a flexible work-based learning approach to enable students successfully to negotiate their own ILOs, in line with service and workforce needs through a tripartite arrangement involving clinical managers, academic staff and the student.
42 An appropriate range of strategies is used to communicate the ILOs to students, external examiners and academic and clinical staff. These include pathway guides, programme specification templates, module guides, practice learning handbook and clinical assessment of practice documents. In the main, students and clinical staff confirm their understanding of the ILOs, which are clearly stated. Changes to ILOs are effectively communicated to mentors in practice through cascaded briefing sessions delivered by PPMs/clinical practice facilitators (CPFs) and link teachers and through mentor update sessions.
Curricula
43 The development of curricula is a joint venture between the School and the SHAs, featuring practitioners from the different NHS Trusts and specialities. For example, before the revalidation of the pre-registration nursing programmes, a mapping and scoping exercise was undertaken with academics and practitioners, and some practitioners serve as members of curricular development groups for other programmes.
44 A range of nursing programmes is offered within the School, which are coherently structured around modules that are core, that must be studied to achieve the award, core optional (chosen from a predefined group) or elective. There is a large pool of modules for post-registration students to choose from, and sufficient information is provided to allow students to make an informed choice. Programmes are offered at diploma, degree and master's level, and the levels are congruent with the FHEQ and the Subject benchmark statement. The University uses a variety of approaches to ensure that students and practitioners are informed of curricula and of any changes that may be taking place. These approaches include the mentor update programme, link lecturers and module handbooks.
45 A local, independent, charitable organisation has a collaborative and effective arrangement with the School to provide modules in palliative care and oncology at post-registration level. These modules are validated and reviewed efficiently using the same mechanisms as with other modules and programmes. In addition to these modules, the organisation offers a very valuable and popular placement for student nurses and its staff provide input on palliative care to other students in the School.
46 Curricula are contemporary and acknowledge a range of government policies, strategies and initiatives. Both students and practitioners have confidence in the ability of the programmes to prepare them for future practice. The currency of curricula is evident through the incorporation of local and national research, and by the involvement of relevant staff in curricular development and implementation. All the pre-registration nursing curricula and, where relevant, some of the post-registration nursing modules, for example Nurse Prescribing, meet the statutory requirements. Sufficient learning opportunities in theory and practice are available for students to meet both the NMC requirements and EU directives.
47 Within the pre-registration nursing programmes, opportunities for interprofessional learning are limited in theory sessions, although there are more opportunities in practice. In some modules, students share teaching and learning with students on other branches of nursing, which also helps to meet the requirements of the NMC 2004 Standards of Proficiency for pre-registration nursing on the nature and content of Common Foundation Programmes. In practice, students have the opportunity to work with a range of other professionals, including paramedics, social workers, dieticians and physiotherapists. In addition, students are able to undertake placements, 'selective electives', in other branches of nursing, which affords them the opportunity to learn and work with other professionals.
48 The involvement of users in the planning and delivery of nursing curricula is variable, although it is evident in the mental health branch. In this branch, individuals and local organisations make a contribution to the teaching of students, although a need for a greater input has been identified. A school-wide strategy for increasing user involvement in curricula has been developed but the extent of its effectiveness is yet to be evident.
Assessment
49 The University's processes for assessment and examination are sound and fairly conducted and congruent with the Code of practice, Section 6: Assessment of students, published by QAA. There are clear guidelines for theoretical and clinical assessment described within the programme pathways guides. Examples of assessed student work demonstrate the appropriateness of assessment to the ILOs, the curricular content, academic level and current healthcare provision. The assessment of theory supports developing professional knowledge by using a variety and diverse range of assessments, including seminars, oral examinations, objective structured clinical examinations and portfolios.
50 The assessment strategy demonstrates a balance between theory and practice with a suitable range of challenging assessments. This includes completion of a summative portfolio each year with specific outcomes that require the application of theory to practice, module assessments that utilise scenarios from practice and clinical assessments by practice mentors. Specialist practitioner students comment that they found the portfolio, which includes clinical competencies that were graded as a Pass or Fail, to be very helpful. The portfolio for nurse prescribing is very well organised and focused.
51 The NMC visitor report in 2004 identified that regulatory requirements are met in mental health and learning disability branches, with assessment procedures being thorough and valid. Positive relationships exist with mental health and learning disability external examiners who have taken the opportunity to meet the students in clinical practice and to examine practice assessment documentation.
52 Pre-registration nursing students stated that the practice proficiencies within the practice documentation are repetitive and difficult to comprehend. Mentors also report that it was initially difficult to understand the assessment of practice documentation. However, the documentation has been revised to demonstrate the achievement of professional proficiencies and to show that practice outcomes are met.
53 Practice mentors have a key role in supporting and assessing students in clinical practice. External examiners and the NMC confirm the efficacy of mentors' judgments about students' standards and performance in practice. Mentors are clear about their role in the assessment of students and are aware that information is available to them on mentorship through the University's website. A mentor support group has been established, which is being positively evaluated.
54 Clinical staff comment that occasional poor student attendance in practice can have a subsequent effect on completion of clinical assessment documentation. However, they cite examples of problems with students that have been addressed promptly by the University. If mentors have any issue with a particular student or if a student is failing, mentors contact the link tutor or the PPM/CPF. Mentor updates include a session on failing students, which is found to be very helpful.
55 Effective second-marking and internal moderation take place, but there is some evidence of confusion of terminology between moderation and second-marking roles. Management of intersite marker reliability within the adult branch is effectively managed through module teams. External examiners receive a sample of 10 per cent of assignments but not fewer than six scripts for moderation, with samples from across sites.
56 External examiners report that the quality of written feedback to the students is comprehensive, although reviewers found that the quality and quantity of feedback can vary depending on individual members of academic staff. Adult branch students reported that assessment feedback is variable but they are able to contact academic staff for more detailed feedback if required. Child, mental health and learning disability branch pre-registration nursing students state that feedback from assessments is excellent. Post-registration/postgraduate students report that feedback from assignments is legible and constructive, although they feel that receipt of feedback takes a long time, between six to eight weeks.
Student achievement
57 The work sample scrutinised by the reviewers demonstrated that students are achieving appropriate levels of knowledge and skills. Examples of student longitudinal work demonstrate students' skills in reflection and knowledge of research methodologies. Achievement in the master's programmes demonstrates that students are performing at an appropriate level. External examiners confirm that, on qualification, students are fit for award, purpose and practice and that students' performance is comparable with similar awards in other UK institutions. They also confirm that NMC requirements are met for pre-registration nursing and the specialist practitioner programme.
58 Statistics relating to all forms of summative assessment, shown in Table 1c, demonstrate successful student achievement. A satisfactory overall 97 per cent of students who present for final assessment achieve the pre-registration Diploma in Nursing. Around half of the degrees in BSc (Hons) Nursing Studies are consistently at or above Upper Second classification. The remainder are Lower Second class degrees with very few Thirds or Fails. A similar picture pertains across post-registration diploma and degrees, with the pattern of results generally conforming to a normal distribution.
59 Table 2c demonstrates satisfactory post-qualifying employment rates, although a substantial proportion of the destinations for earlier cohorts is unknown. However, information held at subject level shows that employment levels within local Trusts are much higher than indicated by the centrally generated destination statistics. In its most recent contract review, the SHA endorsed the value and employability of diplomates and graduates. Former students across pre and post-registration programmes agree that their achievements are appropriate for their current employment. Post-registration programmes are meeting the students' aspirations for career progression, particularly in primary care settings.
Summary of academic and practitioner standards for Nursing
Overall, the reviewers have confidence in the academic and practitioner standards achieved by the programmes in Nursing at the University of Wolverhampton, in partnership with Birmingham and the Black Country Strategic Health Authority, and the Shropshire and Staffordshire Strategic Health Authority.
Strengths
- A local, independent, charitable organisation has a collaborative and effective arrangement with the School to provide modules in palliative care and oncology at post-registration level (paragraph 11).
- Child, mental health and learning disability branch pre-registration nursing students state that feedback from assessments is excellent (paragraph 22).
Weaknesses
- Within the pre-registration nursing programmes, opportunities for interprofessional learning are limited in theory sessions (paragraph 13).
- Pre-registration nursing students stated that the practice proficiencies within the practice documentation are repetitive and difficult to comprehend (paragraph 18).
Table 1c: Completion and achievement statistics for all award-bearing programmes
| Programme | Cohort | Diploma programmes |
Diploma programmes |
Degree classification | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Pass | Fail | 1 | 2i | 2ii | 3 | P | F | ||||||||||
| No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | No. | % | ||
| Registered Nurse: DipHE | Oct 2000 | 193 | 97 | 5 | 3 | ||||||||||||
| Apr 2001 | 227 | 97 | 6 | 3 | |||||||||||||
| Oct 2001 | 225 | 98 | 5 | 2 | |||||||||||||
| BSc (Hons) Registered Nurse | 1999 | 1 | 7 | 7 | 47 | 5 | 33 | 2 | 13 | 0 | 0 | 0 | 0 | ||||
| 2000 | 2 | 10 | 3 | 35 | 8 | 40 | 3 | 15 | 0 | 0 | 0 | 0 | |||||
| 2001 | 1 | 3 | 15 | 50 | 10 | 33 | 2 | 7 | 0 | 0 | 2 | 7 | |||||
| BSc (Hons) Specialist Practice (non-health visiting) | 2001 | 0 | 0 | 32 | 50 | 30 | 47 | 2 | 3 | 0 | 0 | 0 | 0 | ||||
| 2002 | 1 | 2 | 29 | 50 | 25 | 43 | 3 | 5 | 0 | 0 | 0 | 0 | |||||
| 2003 | 2 | 5 | 13 | 31 | 26 | 62 | 1 | 2 | 0 | 0 | 0 | 0 | |||||
| PGD Specialist Practice (Non-Health Visiting) | 2001 | 7 | 100 | 0 | 0 | ||||||||||||
| 2002 | 4 | 100 | 0 | 0 | |||||||||||||
| 2003 | 3 | 75 | 1 | 25 | |||||||||||||
| DipHE Palliative Care | 2002 | 2 | 100 | 0 | 0 | ||||||||||||
| 2003 | 6 | 100 | 0 | 0 | |||||||||||||
| 2004 completers |
2 | 100 | 0 | 0 | |||||||||||||
| BSc (Hons) Palliative Care | 2002 | 0 | 0 | 2 | 50 | 1 | 25 | 0 | 0 | 1 | 25 | 0 | 0 | ||||
| 2003 | 1 | 33 | 2 | 67 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
| 2004 completers |
0 | 0 | 5 | 71 | 2 | 29 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
| DipHE Professional Studies (Nursing) | 2002 | 67 | 100 | 0 | 0 | ||||||||||||
| 2003 | 34 | 100 | 0 | 0 | |||||||||||||
| 2004 | 28 | 100 | 0 | 0 | |||||||||||||
| BSc (Hons) Professional Studies (Nursing) | 2002 | 3 | 25 | 5 | 42 | 4 | 33 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
| 2003 | 0 | 0 | 7 | 47 | 5 | 33 | 1 | 7 | 2 | 13 | 0 | 0 | |||||
| 2004 completers |
0 | 0 | 6 | 55 | 4 | 36 | 0 | 0 | 1 | 9 | 0 | 0 | |||||
| Bachelor of Nursing (Hons) | 2002 | 0 | 0 | 2 | 13 | 6 | 40 | 0 | 0 | 7 | 47 | 0 | 0 | ||||
| 2003 | 0 | 0 | 2 | 20 | 4 | 40 | 0 | 0 | 4 | 40 | 0 | 0 | |||||
| 2004 completers |
0 | 0 | 1 | 20 | 2 | 40 | 1 | 20 | 1 | 20 | 0 | 0 | |||||
| BSc (Hons) Child Protection | 2002 | 0 | 0 | 0 | 0 | 1 | 100 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
| 2003 | 0 | 0 | 2 | 50 | 2 | 50 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
| 2004 completers |
0 | 0 | 2 | 50 | 1 | 25 | 1 | 25 | 0 | 0 | 0 | 0 | |||||
| BSc (Hons) Clinical Practice (Nursing) | 2002 | 1 | 50 | 1 | 50 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | ||||
| 2003 | 3 | 18 | 6 | 35 | 7 | 41 | 1 | 6 | 0 | 0 | 0 | 0 | |||||
| 2004 completers |
3 | 13 | 13 | 57 | 7 | 30 | 0 | 0 | 0 | 0 | 0 | 0 | |||||
| MSc Professional Studies | 2002 | 1 | 100 | 0 | 0 | ||||||||||||
| 2003 | 2 | 100 | 0 | 0 | |||||||||||||
| 2004 completers |
4 | 100 | 0 | 0 | |||||||||||||
| MSc Advancing Clinical Practice | 2002 | 3 | 100 | 0 | 0 | ||||||||||||
| 2003 | 5 | 100 | 0 | 0 | |||||||||||||
| 2004 completers |
7 | 100 | 0 | 0 | |||||||||||||
Table 2a: Employment statistics for all pre-registration programmes and exception reporting only for post-qualification programmes
| Programme (Award bearing only) | Further study | Local employers | Employers elsewhere | Unemployed | Other* | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % | No. | % | No. | % | No. | % | |
| Registered Nurse, Diploma in Higher Education | ||||||||||
| Oct 2000 | 0 | 0 | 92 | 48 | 15 | 8 | 0 | 0 | 86 | 45 |
| April 2001 | 0 | 0 | 130 | 57 | 18 | 8 | 0 | 0 | 79 | 35 |
| Oct 2001 | 0 | 0 | 152 | 68 | 28 | 12 | 19 | 8 | 26 | 12 |
| BSc (Hons) Registered Nurse | ||||||||||
| Oct 2001 | 0 | 0 | 10 | 34 | 0 | 0 | 1 | 3 | 18 | 62 |
Other includes 'not known' and incomplete questionnaires
C Quality of learning opportunities
Learning and teaching
60 The School's learning and teaching strategy reflects that of the University and provides a framework for learning and teaching within the healthcare programmes. Students on all programmes are provided with a guide to their learning and teaching schedules to enable them to plan their studies.
61 Discussion with students, student evaluations and external examiners' reports indicate that teaching is effective both on-campus and in the placement environment in helping students fully to achieve the ILOs. For example, health visiting students comment on the exceptional quality of the teaching, guidance and support they receive from academic and practice staff. The adult branch is the only pre-registration nursing programme that is delivered at four different sites, and sufficient measures are in place to ensure parity and consistency in the teaching sessions and students' experience.
62 Teaching and learning opportunities are designed to enable students to achieve the ILOs, and to develop transferable skills relevant to their professional practice. They are organised through a modular framework that provides theoretical and practical experiences with practice as the focus of student learning. The variety of approaches, including formal lectures, problem-based learning and on-line learning, engages students in their learning. The range of teaching methods is considered to be appropriate by external examiners. Students report that large group sizes on-campus can hinder learning opportunities. The School is aware of this and is looking at ways to encourage small-group work.
63 Testimonies from students, mentors and external examiners confirm that learning opportunities are effective in enabling students to meet the aims and ILOs of their programmes. The School involves clinicians in delivery to enhance the learning experience, for example, the involvement of a modern matron in the teaching of managing aggression. Within the DipHE/BSc (Hons) Palliative Care, the team has created a safe, sensitive and supportive learning environment for small cohorts of students in the subject area. Students are taught by subject experts who maintain clinical currency, for example, within the Cedars Study Centre at Compton Hospice.
64 Students have access to the university and school information and communication technology (ICT) facilities. They are prepared effectively for the use of these facilities and utilise ICT skills within their modules. Technology-supported learning is increasing within the School. Dedicated ICT staff have been employed to support academics in developing materials on the University's on-line learning framework, and these are well utilised by students. The School is increasingly using clinical skills teaching in purpose-built clinical skills laboratories, and students value these learning opportunities.
65 A suitable range of practice-learning opportunities is available for health visiting and midwifery programmes, although there are still some challenges for pre-registration nursing which the partnership is currently addressing. In health visiting, the focus of learning and teaching enables students to relate module content and assessment tasks to professional practice. This is facilitated and supported through negotiation between CPTs, academic staff and students.
66 The School requires that mentors are allocated to all students on clinical placements. A 'live' register of mentors allows the School to monitor numbers of staff available to assess students. Practice mentors are expected to undertake an initial mentor preparation workshop and then annual updates. In some clinical areas, the mentor preparation programme is an essential criterion for clinical staff applying for F and G Grade clinical posts. However, the availability of mentors can be variable. In the past, some mentors have not regularly attended preparation or updating sessions and the register has not always been current. This has been recognised by the partnership and is currently featured in the clinical learning environment group's action plan. While students on the health visiting and midwifery programmes report effective mentorship, pre-registration nursing students report varying availability and learning support from mentors. A new, two-day mentor preparation course has just been instigated to address the lack of mentor capacity.
67 In each of the nursing pre-registration programmes, PPMs/CPFs are available to support students in achieving integration of theory and practice. Students report positively on the support they receive from PPMs/CPFs. PPMs/CPFs also support mentors in the clinical areas and are able to demonstrate their knowledge of practice placements. Link teachers from the School provide additional support in the clinical areas. They assist in developing and maintaining the learning environment in order that students can achieve their ILOs.
68 The School recognises the importance of patient and public involvement in learning and teaching. A school-wide strategy for increasing user and carer involvement in learning and teaching is in place, but the extent of its effectiveness is yet to be evident.
69 Interprofessional learning occurs effectively within the health visiting programmes where students are involved in collaborative teamwork with their primary care colleagues. The School has made limited progress towards this in pre-registration programmes by using opportunities for shared learning in practice and by the involvement of other subject disciplines and professionals in curriculum delivery. The School acknowledges the early stage of development.
70 Staff without a recognised teaching qualification or relevant teaching experience take a postgraduate certificate in Learning and Teaching in Higher Education. Staff recognise the benefits of the recently introduced peer observation of teaching scheme in enhancing the quality of the student experience. However, although staff can articulate its positive impact, there is no clear strategy for the dissemination of good practice from peer observation of teaching.
71 A strategic forum exists for coordinating research activity and strengthening the School's research capacity. At present, the results of ongoing research are feeding primarily into learning and teaching within post-registration curricula. There are plans to develop input into pre-registration programmes as the School's research capacity matures.
72 The quality of learning and teaching is monitored through module evaluation forms and verbal feedback. The staff-student committees formally discuss and record programme-related issues to ensure that students' concerns are heard. This is further monitored by the School's Quality Committee. Student involvement in the evaluation of learning and teaching takes place in a number of ways. Feedback comes from Student Council meetings, staff-student liaison meetings, placement evaluation and student satisfaction surveys. Students evaluate the quality of their placement experience both formally and informally. These evaluations are conducted in partnership with PPMs and academic staff. Issues arising are reported back to the practice area and link teacher.
73 The health and safety of students is given due consideration. There are procedures for ensuring that students are prepared before their placements and that they receive instruction in basic skills prior to practice. Campus health and safety issues are managed through the School's health and safety subcommittee. Health and safety issues for placement learning are addressed in both University and trust-specific pre-placement briefings and through clearly identified policies and procedures. All pre-registration students are trained in moving and handling, and registers of attendance are kept for these sessions.
74 As the School is located in an area with a high cultural mix, the School has made progress in its efforts to ensure that students develop an appreciation of the unique and diverse healthcare needs of the local population. This is achieved by a school-wide strategy to promote cultural sensitivity, and is evidenced in some of the assignments that students have produced.
The quality of learning and teaching is commendable.
Strengths
- Teaching is effective both on-campus and in the placement environment (paragraph 61).
- Dedicated information and communication technology staff have been employed to support academics in developing materials on the University's on-line learning framework, and these are well utilised by students (paragraph 64).
- In some clinical areas, the mentor preparation programme is an essential criterion for clinical staff applying for F and G Grade clinical posts (paragraph 66).
- Interprofessional learning occurs effectively within the health visiting programmes where students are involved in collaborative teamwork with their primary care colleagues (paragraph 69).
Weaknesses
- In the past, some mentors have not regularly attended preparation or updating sessions and the register has not always been current (paragraph 66).
- Pre-registration nursing students report varying availability and learning support from mentors (paragraph 66).
- Although staff can articulate its positive impact, there is no clear strategy for the dissemination of good practice from peer observation of teaching (paragraph 70).
Student progression
75 Recruitment and selection principles are identified within the University's and School's admission strategies. A comprehensive range of recruitment materials and strategies is available, including the University's prospectus, website, open days and a secondment arrangement with the Trusts. Current midwifery staff and students participate in recruitment activities, for example, in open days. Students are successfully recruited from a variety of academic backgrounds, including school and college leavers, nurse 'cadets', sponsored healthcare assistants and mature entrants with experience of working in other settings. The University's equal opportunities policy supports the admissions process. Applications are managed by the central university services and application rates to the pre-registration programmes reflect the national downward trend; stakeholders are involved in recruitment of students. A significant number of students are recruited from diverse ethnic backgrounds.
76 Fast-tracking is available within the programmes through accreditation of prior learning (APL) and prior experiential learning (APEL). The NMC has commended the use of APEL specifically in mental health and learning disability. There is evidence of good tutorial management within work-based learning. As yet, there are no published benchmarks for work-based learning, but the University's standards are comparable with national codes.
77 All new pre-registration students are inducted into their programmes and all students have inductions to placements at university and local level, as illustrated by the welcome packs issued by clinical areas such as that of the Respiratory Unit, Russells Hall Hospital. Post-registration students are normally already employed in clinical practice and they undertake part-time programmes. They receive induction as appropriate to their academic work. Students on post-registration programmes are funded through the Workforce Development Directorate/employer to which most appear to have easy access. However, a recent validation report highlighted the difficulties that some students were experiencing in securing funding for the second year of their programme.
78 The School places great importance on collaboration with practice partners in the preparation and support of students. Collaborative links are established with Primary Care Trusts, which are maintained by link lecturers visiting students in practice and liaising with mentors and PPMs/CPFs. The two consistent approaches identified for dealing with any issue are to rely upon either the link lecturer or PPM/CPF, whichever was available. PPMs/CPFs also facilitate a robust support network for students in placement. The students understood what they were expected to do if they were having difficulties meeting the ILOs. A comprehensive series of procedures and protocols for addressing practice placement issues provides clear guidance for students. All students undertaking NMC-approved programmes are required to be assigned to appropriately prepared mentors for the practice elements of their programmes. The mentor is expected to provide immediate access to academic and pastoral care. In most cases, students felt that the HEI and placement providers worked very hard to maintain support for students.
79 The School has a well-developed structure for pastoral and academic support for students following the University's guidelines. The NMC has confirmed effectiveness of the personal tutor system. Most students report that academic support received from the university team is excellent. However, a few students who had failed in theory felt that it was difficult to access academic staff. Support is available for students who have English as a second language. This includes additional support for study skills, individual tutorial support and the recent appointment of a multilingual librarian.
80 Recruitment and attrition statistics for the last three years indicate a 20 per cent attrition rate across all pre-registration nursing diploma branches (Table 3). The attrition rates for the same three years for the BSc (Hons) Nursing rise from around 25 to 35 per cent. Figures for the BSc (Hons) Midwifery show attrition to be around 20 per cent with a peak of 50 per cent in the 2000 cohort. On average, the attrition rates for the shortened midwifery programme are around 20 per cent. The attrition rates for the last three completed cohorts in the Registered Nurse Diploma, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programmes are above the national averages for these professional groups.
81 Other figures in Table 3 indicate that the BSc Specialist Practice Health Visiting attrition rates are low, with only one student withdrawing from each of the 2003 and 2001 cohorts. A low rate of attrition is also evident in the non-health visiting routes through the BSc/PgDip Specialist Practice programme and also in Nurse Prescribing. Figures for the Return to Practice (midwifery) are difficult to interpret because of the low numbers involved. The external examiner reports that standards of student progression for BSc (Hons) Clinical Practice (Midwifery) and MSc Midwifery Studies are comparable with those of other institutions.
82 Anecdotal evidence and evidence obtained from exit interviews with midwifery students suggest that students leave programmes for a variety of reasons rather than failing to meet academic standards. These often tend to relate to students' personal circumstances, which can include financial and childcare difficulties, which are exacerbated by recruiting increasingly large numbers of local students from an area known to have problems with poverty. Unrealistic expectations of the profession are also a feature.
83 The School has prioritised efforts to minimise attrition in the School Plan for 2004-05. The actions include conducting exit interviews, offering pre-programme 'taster days' where there is the opportunity to talk with current students, reviewing selection criteria, identifying high-risk students earlier and offering appropriate support, improving the placement experience, offering a one-week, pre-programme placement, reducing workload and construction of a web link to detail student experiences of the programme.
84 The high attrition rates were not recognised immediately, until preparation for major review, because of problems with the School's systems for analysing statistical data. A new member of staff has been appointed who is responsible for providing monthly statistics according to a new formula. This will allow the School to monitor attrition rates closely. Initial figures suggest that attrition is decreasing for midwifery and nursing, with the current pre-registration nursing rates running at 13 and 7 per cent for the April and October 2004 cohorts respectively. The BBCSHA is satisfied with these arrangements, suggesting the monthly reporting as evidence of good practice to its other partner higher education institutions.
85 The BBCSHA demonstrates a commitment to lifelong learning with the induction and preceptorship programme for newly qualified staff. This includes a nurse development programme package to support transition from practising under direct supervision to the application of skills, knowledge and personal values in the role of a qualified nurse.
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. | % | ||
| Registered Nurse, DipHE | |||||||||
| Oct 2000 | 293 | 67 | 23 | 14 | 5 | 19 | 6 | 5 | 2 |
| April 2001 | 312 | 82 | 26 | 62 | 20 | 32 | 10 | 6 | 2 |
| Oct 2001 | 366 | 76 | 21 | 37 | 10 | 49 | 13 | 5 | 1 |
| BSc (Hons) Registered Nurse | |||||||||
| 1999 | 22 | 6 | 27 | 1 | 5 | 1 | 5 | 0 | 0 |
| 2000 | 32 | 12 | 37 | 4 | 13 | 3 | 9 | 0 | 0 |
| 2001 | 61 | 23 | 38 | 4 | 7 | 3 | 5 | 2 | 3 |
| BSc (Hons) Specialist Practice Nursing (non Health Visiting) | |||||||||
| 2001 | 67 | 1 | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002 | 65 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2003 | 72 | 4 | 6 | 0 | 0 | 0 | 0 | 1 | 1 |
| PGD Specialist Practice Nursing (non Health Visiting) | |||||||||
| 2001 | 9 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002 | 6 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2003 | 8 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Supplementary/ extended Nurse Prescribing | |||||||||
| Sept 2003 | 26 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Feb 2004 | 15 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Jun 2004 | 20 | 1 | 5 | 0 | 0 | 0 | 0 | 1 | 5 |
| BSc (Hons) Midwifery | |||||||||
| 1999 | 27 | 6 | 19 | 22 | 15 | 2 | 7 | 2 | 7 |
| 2000 | 30 | 14 | 47 | 1 | 3 | 1 | 3 | 1 | 3 |
| 2001 | 32 | 6 | 19 | 3 | 9 | 0 | 0 | 1 | 3 |
| BSc (Hons) Midwifery Shortened | |||||||||
| Oct 2001 | 14 | 2 | 14 | 0 | 0 | 1 | 7 | 0 | 0 |
| April 2002 | 11 | 4 | 36 | 1 | 9 | 0 | 0 | 0 | 0 |
| Feb 2002 | 12 | 2 | 17 | 0 | 0 | 0 | 0 | 0 | 0 |
| Return to Practice (Midwifery) | |||||||||
| April 2002 | 5 | 1 | 20 | 0 | 0 | 0 | 0 | 0 | 0 |
| Jan 2003 | 2 | 1 | 50 | 0 | 0 | 0 | 0 | 0 | 0 |
| April 2003 | 2 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| BSc (Hons) Specialist Practice Nursing (Health Visiting) | |||||||||
| 2001 | 12 | 1 | 8 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002 | 19 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2003 | 22 | 1 | 4 | 0 | 0 | 0 | 0 | 0 | 0 |
| PgDip Specialist Practice Nursing (Health Visiting) | |||||||||
| 2001 | 11 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| 2002 | 14 | 0 | 0 | 0 | 0 | 0 | 0 | 1 | 7 |
| 2003 | 7 | 1 | 14 | 0 | 0 | 0 | 0 | 0 | 0 |
The quality of student progression is commendable, with the exception of Registered Nurse Diploma of Higher Education, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programme.
Strength
- The Birmingham and the Black Country Strategic Health Authority demonstrates a commitment to lifelong learning with the induction and preceptorship programme for newly-qualified staff (paragraph 85).
The quality of student progression in Registered Nurse Diploma of Higher Education, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programme is approved.
Weaknesses
- The attrition rates for the last three completed cohorts in the Registered Nurse Diploma, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programmes are above the national averages for these professional groups (paragraph 80).
- The high attrition rates were not recognised immediately, until preparation for major review, because of problems with the School's systems for analysing statistical data (paragraph 84).
Learning resources and their effective utilisation
86 The University's and School's strategic plans influence the allocation of resources, and systems are in place to ensure that resources support the ILOs. The Wolverhampton Campus accommodation and learning centres were modernised in April 2004 following extensive investment. New, state-of-the-art clinical skills laboratories and a multisensory 'Snoozlem' are well used and valued by students. The skills laboratories are staffed by eight facilitators. The Harrison Learning Centre has a new and well-furnished Adaptive Technology Centre for supporting students with special needs. Support for students with additional learning needs is encouraged and positively evaluated by students.
87 Students on both hospital and community placements report good access to both university and trust libraries and rate the facilities highly. A new email prompt system has reduced the number of overdue books. Some students report that the security measures on campus deter reasonable access to classrooms and other facilities and report feeling excluded. To ameliorate this, the number of swipe cards to access the buildings is being increased. In addition, pre-registration students report that classrooms are sometimes overcrowded.
88 The University's on-line learning framework is rated highly by students as a computer-based learning resource. There is good access to computers on campus facilitated by a booking system for computers in the learning centres, although not all students use this facility. There is variable access to computer facilities on placement and Trust policies do not allow students to have individual passwords.
89 Academic staff, including visiting lecturers, are appropriately prepared to deliver the programmes and are all on a professional register. New staff report that they are well supported with a comprehensive induction package and ongoing training package, evidenced by a high uptake of further academic study. The School provides dedicated time for scholarly activity.
90 There is evidence of a strong and effective partnership between the University, placement providers (in both the NHS and independent sector), and the two SHAs. Resources and responsibilities of partner placement providers are set out in a partnership placement agreement, formulated as part of the School's contract negotiation with BBCSHA in 2004. Monitoring of this takes place through the Quality Group, membership of which includes all collaborative partners. The reviewers confirm that the partners are pursuing a range of strategies in order to maintain and enhance the quality of placements for students. Placement-learning environments are audited annually to confirm availability of learning opportunities. Completion of annual educational audits of placement-learning environments has improved considerably in the last six months, despite reconfiguration of some hospital services.
91 Student numbers are agreed annually between stakeholders, and practice placements are coordinated well by the PPMs/CPFs who also effectively support mentors and students in practice. While placement capacity is reported as adequate overall, some pre-registration nursing adult branch students perceive that the School's definition of supernumerary status is not being adhered to because of staffing shortages.
92 Link-lecturer support is reported by students as variable and the Quality Group is making progress towards ensuring equitable support for students on placement; all placements now have an allocated lecturer. In areas where support is rated highly, link lecturers visit weekly and are accessible. Students state that practice-placement managers/clinical-placement facilitators and link lecturers offer very good support in clinical practice and commend this system. Students appreciate placement information and learning packs. In some areas this information is available in advance.
93 The Quality Group has recently undertaken a comprehensive audit of placement provision. Progress is being made with the resulting BBCSHA Action Plan for Clinical Placements and the School Clinical Learning Environment Project. The plans aim to reduce the disparity in the effectiveness of support and to enhance quality in the clinical environments.
The quality of learning resources and their effective utilisation is commendable.
Strengths
- New, state-of-the-art clinical skills laboratories and a multi-sensory Snoozlem are well used and valued by students (paragraph 86).
- Support for students with additional learning needs is encouraged and positively evaluated by students (paragraph 86).
- The University's on-line learning framework is rated highly by students as a computer-based learning resource (paragraph 88).
- Students state that practice placement managers/clinical placement facilitators and link lecturers offer very good support in clinical practice and commend this system (paragraph 92).
Weakness
- Some pre-registration nursing adult branch students perceive that the School's definition of supernumerary status is not being adhered to because of staffing shortages (paragraph 91).
D Maintenance and enhancement of standards and quality
94 The University has robust and clearly documented quality management policies, processes and procedures in place. The current arrangements for quality and standards management and enhancement were approved by institutional audit, which indicated that procedures were comprehensive and broadly effective.
95 At school level, quality and enhancement have been designed congruent with the University's expectations. The systems within the School are of an acceptable standard, with an effective audit cycle being firmly in place. Awards and subject areas undertake an annual review of activities as part of the annual monitoring procedure set out in the University's School Quality Committee Handbook. Course committee meetings are routinely held and are attended by academic and practice staff and students. Module evaluations are routinely formally conducted and the quantitative and qualitative analysis is presented at subject boards and fed into the annual monitoring reports.
96 Placement capacity is proactively managed. Effective relationships are in place between the School, link tutors and PPMs/CPFs. The results from clinical placement audits, completed by the clinical staff, PPMs/CPFs and link tutors, are fed directly to the placement areas which respond appropriately. Action plans are detailed in course committee meetings and there is evidence of these being followed through. The results of evaluation of placements are addressed with placement providers.
97 The School is receptive to external examiners' comments which are considered by subject and award boards. Responses to comments, including any actions required, are communicated back to the external examiner. There was consistent praise from external examiners for the support that students receive when either academic or clinical weaknesses are identified.
98 The reviewers found strong local partnership arrangements exist with the NHS Trusts and SHAs. The strength of the partnership is reflected in the involvement of all stakeholders in the production of the self-evaluation document, which was highly evaluative and open about challenges.
99 The BBCSHA, the SASHA and NHS Trusts work together productively to ensure commissions reflect workforce needs. A tripartite agreement with the University, which incorporates the quality framework for monitoring contract quality and the Quality Group, ensures that all stakeholders are successfully engaged in reviewing the student journey. The partnership arrangements also ensure that standards related to the student journey are continually enhanced. The school and divisional plans ensure that the School is responsive to health and social care policy development and the requirements of the regulatory and professional bodies.
100 The reviewers witnessed appropriate feedback arrangements between students and the University, with significant opportunities for students to raise issues and have them resolved. Students' views are actively sought and they are represented on award management subcommittee meetings. Feedback mechanisms are in place to enable students to evaluate the quality of teaching and practice mentorship through module and practice placement evaluation processes. The student feedback loop resulting from the evaluation of module and placement learning is not always completed. Students report that some students were unaware of actions that had been taken as a result of their evaluations.
101 The quality assurance procedures in place give the reviewers' confidence in the ability of the School and the University to maintain and enhance academic standards in the subject areas of Health Visiting, Midwifery and Nursing. The School's strong links with the BBCSHA, SASHA/WDD and the University are recognised as key factors in further developing the provision.
Strength
- A tripartite agreement with the University, which incorporates the quality framework for monitoring contract quality and the Quality Group, ensures that all stakeholders are successfully engaged in reviewing the student journey (paragraph 99).
Weakness
- The student feedback loop resulting from the evaluation of module and placement learning is not always completed (paragraph 100).
Action plan
Major Review of healthcare programmes
JUNE 2005
University of Wolverhampton
Birmingham and the Black Country Strategic Health Authority
Shropshire and Staffordshire Strategic Health Authority Workforce Development
We have discussed and agreed the following action plan:
Title of organisation (Lead SHA/WDC): Birmingham and the Black Country Strategic Health Authority
Name: Mr Andrew Snowden
Position: Director of Workforce Development and Strategic Human Resources
Title of organisation (SHA/WDC): Shropshire and Staffordshire Strategic Health Authority
Name: Mr Neil McKellar
Position: Director of Workforce Development
Title of organisation (HEI): University of Wolverhampton
Name: Professor Geoff Hurd
Position: Acting Vice-Chancellor
| Component | Strengths/Weaknesses | Actions to be taken | Target completion date/s | Constraints preventing delivering the action required | Impact of not delivering the action required | Lead responsibility (organisation/s and person/s)Name and title of organisation | Evidence of quality enhancement |
|---|---|---|---|---|---|---|---|
Academic and practitioner standards Nursing |
Strengths A local, independent, charitable organisation has a collaborative and effective arrangement with the School to provide modules in palliative care and oncology at post-registration level (paragraph 45). |
Annual review of Memorandum of Co-operation. | Annually from 2005 | None. | Ineffective collaborative working. | Associate Dean, Postgraduate Studies (Taught) (University). | Updated Memorandum of Co-operation in place. |
| Continue to include staff from Compton Hospice in membership of relevant decision-making fora within the School. | September 2005 and annually thereafter | Head of Education and Training (Compton Hospice) and Dean (University). | Greater participation of Compton Hospice staff in relevant School decision-making processes. | ||||
| Child, mental health and learning disability branch pre-registration nursing students state that feedback from assessments is excellent (paragraph 56). | Ensure maintenance of identified excellence and disseminate good practice across the School through: | Continued positive evaluation by students. | |||||
| Staff development workshops. | Once per academic year | Competing priorities for staff development activity | Reduction in standard of feedback to students and/or a failure to develop and enhance practice in other subject areas within the School. | School Learning and Teaching Co-ordinator (University) | Consistent approach across the School to providing feedback to students. | ||
| Incorporation of guidance in School Assessment Handbook. | June 2006 | None | Associate Dean, Quality & Standards (University). | ||||
| Standardisation of assessment feedback forms. | June 2006 | Associate Dean, Quality & Standards (University). | |||||
| Consideration of feedback as part of internal moderation. | January 2006 and subsequent moderation cycles | Associate Dean, Quality & Standards (University). | Positive reporting by External Examiners across the School regarding feedback to students. | ||||
| Midwifery | Midwifery students use their portfolios effectively and are very positive regarding their skills in reflection on practice (paragraph 37). | Review the curriculum annually to ensure portfolio outcomes continue to reflect academic and practitioner standards. | January 2006 and annually thereafter | None | The effectiveness of portfolios to aid development of practice would be limited. | Education Lead for Midwifery (University) in liaison with Supervisors of Midwives (NHS Trusts). | Continued effective portfolio use in Midwifery. |
| Roll out good practice in portfolio use across other subject areas. | September 2006 | Learning and Teaching Co-ordinator (University) in collaboration with Education Lead for Midwifery (University). | Good practice in portfolio use evident in all relevant areas. | ||||
| If there is a problem with a midwifery student's performance, then a tripartite meeting is arranged with the student, mentor and link teacher to develop and agree an action plan (paragraph 39). | Enhance effective partnership working between placement and HEI staff by: | ||||||
| Continuing to monitor the effectiveness of the link teacher role in supporting students through the assessment processes in all subject areas. | January 2006 and annual review thereafter. | None | Inconsistent approach to supporting failing students across all subject areas | Practice and Innovation Co-ordinator (University) and Lead Midwife for Education (University). | Positive student evaluation of support in clinical placements. | ||
| Further developing written guidelines for practice mentors a) to support failing students and b) to share good practice across the School. | January 2006 | Practice and Innovation Co-ordinator (University). | Positive feedback following visits to placement areas by external examiners. | ||||
| Maintaining clinical representation on Subject and Award Management Committee. | Annual review. | Chair of Subject and Award Management Subcommittee (University). | High levels of clinical participation maintained. | ||||
| Support for health visiting students from clinical practice teachers during the process of negotiating learning outcomes is excellent (paragraph 7). | Build on good practice of health visiting students negotiating learning outcomes and roll out across subject areas. | September 2006. | None | Inconsistency of practices across subject areas | Subject Leader/Co-ordinator for Health Visiting (University) and Practice Teachers (NHS Trusts). | Students positively evaluate the process of negotiating their learning outcomes. | |
| Communication of health visiting intended learning outcomes to students commences prior to initial induction during an interview with the course leader (paragraph 8). | Disseminate good practice across the School by enhancing information on learning outcomes within pre-course information. | February 2006. | None | Candidates unaware of the learning outcomes for programmes. This lack of awareness may contribute to attrition | Subject Leader/Co-ordinator for Health Visiting (University) and other Subject Leaders (University). | Through evaluation, students report knowledge of intended learning outcomes they had before the course began. | |
| A particular strength of the health visiting programmes is in the breadth of the curricula where some of the modules are organised and delivered by academic staff from other schools (paragraph 15). | Build on good practice within health visiting and disseminate across all subject areas. | September 2006 and annually thereafter | None. | Under utilisation of cross- University expertise in the curricula. | Subject Leader/ Co-ordinator for Health Visiting (University). | Student evaluations reflect a greater use of cross-University expertise than previously. | |
| Review existing curricula to identify potential areas where other schools could contribute to the curriculum. | June 2006 | Heads of Division (University). | Annual monitoring reports demonstrate increased input from other Schools in the University. | ||||
| The quality of feedback on assignments for health visiting is excellent (paragraph 17). | Ensure maintenance of identified excellence and disseminate good practice across the School through: | Continued positive evaluation by students. | |||||
| Staff development workshops. | Once per academic year | Competing priorities for staff development activity | Reduction in standard of feedback to students and/or a failure to enhance practice in other subject areas within the School. | School Learning and Teaching Co-ordinator (University). | Consistent approach across the School to providing feedback to students. | ||
| Incorporation of guidance in School Assessment Handbook. | June 2006 | None | Associate Dean, Quality & Standards (University). | ||||
| Standardisation of assessment feedback forms. | June 2006 | Associate Dean, Quality & Standards (University). | |||||
| Consideration of feedback as part of internal moderation. | January 2006 and subsequent moderation cycles | Associate Dean, Quality & Standards (University). | Positive reporting by External Examiners across the School regarding feedback to students. | ||||
Weaknesses Within the pre-registration nursing programmes, opportunities for interprofessional learning are limited in theory sessions (paragraph 47). |
School Learning and Teaching Strategy to make explicit the need to maximise interprofessional learning opportunities with other Schools and institutions. | 2005/06 School Plan and annually thereafter. | None | Students will not benefit from shared and interprofessional learning opportunities. | School Learning and Teaching Co-ordinator (University). | Positive evaluation by students of interprofessional learning. | |
| Interprofessional learning will be included in annual staff development programmes. | 2005/06 and annually thereafter. | Further limitations on interprofessional learning. | School Learning and Teaching Co-ordinator (University) in liaison with Subject Leaders/Co-ordinators (University). | External examiner reports demonstrate relevant inclusion of interprofessional learning. | |||
| Pre-registration nursing students state that the practice proficiencies within the practice documentation are repetitive and difficult to comprehend (paragraph 52). | Amend the 2000 pre-registration nursing curricula documentation to reduce repetition and enhance comprehension. | November 05 | None | Students and practice mentors continue to have difficulty understanding practice proficiencies. | Head of Division for Pre-registration Nursing and Midwifery (University). | In future evaluations of learning, students and practice mentors report reduced repetition and better understanding. | |
Quality of learning opportunities Learning and teaching |
Strengths Teaching is effective both on-campus and in the placement environment (paragraph 61). |
Disseminate good practice identified by Peer Observation. | June 2006 and annually thereafter | None | Reduction in effectiveness of teaching on campus and in placements could compromise the standards of achievement. | Learning and Teaching Co-ordinator (University). | Learning and Teaching Strategy identifies the process for dissemination of good practice. |
| Continue to identify individual staff teaching development needs through the appraisal process. | June 2005 and annually thereafter | Competing priorities for staff development activity | Subject Leaders/Co-ordinators & Heads of Division (University). | Positive evaluation of the uptake and effectiveness of staff teaching development activities. | |||
| Work with the University Centre of Excellence in Learning and Teaching (CELT) to capture good practice and input into the School. | June 2006 and as necessary thereafter | None | Learning and Teaching Co-ordinator (University). | Learning and Teaching Strategy identifies University good practice for implementation in the School. | |||
| Continue to review module and award evaluations. | January 2006 and annually thereafter | Chair of Subject and Awards Management Sub-committee (University). | Annual monitoring of subjects and awards reflects positive evaluation of class and placement learning. | ||||
| Implement the clinical learning environment action plan. | January 2006 and annually thereafter. | Practice and Innovation Co-ordinator. | |||||
| Dedicated information and communication technology staff have been employed to support academics in developing materials on the University's on-line learning framework, and these are well utilised by students (paragraph 64). | Further develop materials in accordance with the E-Learning Strategy. | June 2006 | None | Missed opportunities for further development of e-learning materials. | Technology Supported Learning Co-ordinator. | Positive student and staff evaluation of the e-learning materials developed. | |
| In some clinical areas, the mentor preparation programme is an essential criterion for clinical staff applying for F and G Grade clinical posts (paragraph 66). | Work collaboratively with other clinical trusts to promote the level three mentorship module as a criterion for F and G grade clinical posts. | March 2006 | Competing demands on the time of clinical staff | Inadequate mentor preparation of senior clinical staff. | Knowledge and Skills Framework Lead (SHA) and Education and Training Leads (NHS Trusts). | An increased number of Trusts use mentorship preparation as a criterion for F and G grade clinical posts. | |
| Interprofessional learning occurs effectively within the health visiting programmes where students are involved in collaborative teamwork with their primary care colleagues (paragraph 69). | Build on good practice within health visiting and disseminate across all subject areas. | September 2007 | None | Under-utilisation of expertise in the curricula. | Subject Leader/Co-ordinator for Health Visiting (University). | Positive student evaluation of interprofessional learning opportunities. | |
| School Learning and Teaching Strategy to make explicit the need to maximise interprofessional learning opportunities with other Schools and institutions. | 2005/2006 School Plan and annually thereafter | Learning and Teaching Co-ordinator (University). | |||||
Weaknesses In the past, some mentors have not regularly attended preparation or updating sessions and the register has not always been current (paragraph 66). |
Develop a system of alerting mentors and link teachers to updating requirements. | December 2005 | Competing demands on mentors' time | Inconsistency in mentor training and assessment of students' performance. | Practice and Innovation Co-ordinator (University) in liaison with PPMs/CPFs (Trusts). | Increase in numbers of mentors practising and on 'live' register. | |
| Ensure mentor database is current and accurate. | December 2005 and monthly thereafter | Unreliable information about currency of practice mentor update. | |||||
| Pre-registration nursing students report varying availability and learning support from mentors (paragraph 66). | Continue with the practice of all placement areas having an identified link teacher with scheduled visits and agreed purposes. | August 2005 and annually thereafter | None | Students not fully supported and therefore not achieving their full potential. | Practice and Innovation Co-ordinator (University) in liaison with PPM / CPFs (NHS Trusts). | Improved consistency of link teacher activity evidenced by student evaluations. | |
| Review annually student and mentor resource folder in all areas. | November 2005 and annually thereafter | Link teachers (University). | Accurate and up-to-date student and mentor resource folders available in clinical areas. | ||||
| Reinforce supportive aspect of the role of a mentor in mentor preparation and update sessions. | Ongoing | Module leader for mentorship preparation (University). | Students report orally and in written evaluation more consistent mentor support in practice. | ||||
| Although staff can articulate its positive impact, there is no clear strategy for the dissemination of good practice from peer observation of teaching (paragraph 70). | School Learning and Teaching Strategy (2005-06 and annually) will incorporate dissemination of good practice from peer observation of teaching. | September 2005 and annually thereafter | None | Peer observation will not be embedded in the Learning and Teaching Strategy. Peer observation will not be valued or utilised effectively. |
Senior Associate Dean (University) and Learning and Teaching Co-ordinator (University). | Good practice incorporated as a standard item in staff development activities and the School newsletter. | |
| Student progression | Strength The Birmingham and the Black Country Strategic Health Authority demonstrates a commitment to lifelong learning with the induction and preceptorship programme for newly-qualified staff (paragraph 85). |
Adopt the programme across Birmingham and The Black Country for nursing staff in the first instance and widen out to AHPs later. | December 05 | Competing strategic priorities and demands | Disparity in induction and preparation of newly qualified staff. | Quality Lead (SHA)/Chair of Education Sub Group, aligned to Strategic Nurse Forum (Nursing Network). | Successful programme in place which evaluates positively. |
Weaknessess The attrition rates for the last three completed cohorts in the Registered Nurse Diploma, BSc (Hons) Nursing Studies, BSc (Hons) Midwifery and BSc (Hons) Midwifery Shortened programmes are above the national averages for these professional groups (paragraph 80). |
Identify and analyse the reasons why students have left their programme of study and develop a strategy to reduce the numbers who leave. | December 2005 and monthly thereafter | Students may decline to provide exit information | Insufficient number of trained staff to meet future workforce needs. | Associate Dean, Quality and Standards (University). | Monthly and internal annual monitoring statistics show attrition reduced to the national standard of 13% over a five year period. | |
| Identify early students who may wish to leave the course and implement appropriate and timely action. | December 2005 | None | Financial penalty to the HEI.1. Negative impact on cohort morale. |
Subject Leaders/Co-ordinators (University). | Timely action taken for students who are considering leaving. | ||
| Extend 'taster sessions' from Midwifery to Nursing using the School's clinical skills teaching facilities. | December 2005 | Some students continue to have unrealistic expectations of nursing and midwifery. | Subject Leaders/Co-ordinators (University). | A decrease in the number of students leaving due to unrealistic expectations of the programme. | |||
| Institute an annual bilateral meeting between senior representatives from lead SHA/WDD and the University to discuss impact of actions taken on student attrition as part of the annual monitoring process. | June 2006 and annually thereafter | Failure to share strategy and management of attrition between the University and SHA. | Dean (University), Associate Dean, Quality and Standards (University) and Chair of the Quality Group (BBCSHA). | The University's lead NHS commissioner of healthcare provision is involved in evaluating strategies for lowering attrition arising from annual monitoring. | |||
| Student progression | The high attrition rates were not recognised immediately, until preparation for major review, because of problems with the School's systems for analysing statistical data (paragraph 84). | Test the NHS students' electronic data collection system developed in the School from 2004 based on DOH methodology for pre-registration nursing (RNDipHE), BSc(Hons) and midwifery (BSc(Hons) 18 months; three years) to capture all relevant statistics. | March 2006 | None | An efficient electronic system would not be in place leading to data retrieval failure. | Administrator (Data), (University). | The development of a flexible and sensitive electronic system that captures relevant data of pre-registration nursing and midwifery students. |
| Collect, analyse and manage student attrition data. | March 2006 and monthly thereafter | Incomplete monitoring of student attrition. | Dean (University) and Administrator (Data), (University). | Detailed attrition data are understood by staff and specific measures are taken consistently to reduce attrition rate. | |||
| Learning resources and their effective utilisation | Strengths New, state-of-the-art clinical skills laboratories and a multi-sensory Snoozlem are well used and valued by students (paragraph 86). |
Build on positive experiences and disseminate good practice throughout the School and University. | September 2005 and annually thereafter | None | Sub optimal use of expensive facilities and clinical skills teaching staff. | Practice and Innovation Co-ordinator (University). | Positive feedback about the utilisation of skills centres from module evaluation. Interrogation of timetabling demonstrates increased uptake of facilities. |
| Participate in the SHA scoping exercise relating to clinical skills facilities. | June 2006 | Practice and Innovation Co-ordinator (University) and Curriculum Projects Manager (BBCSHA). | SHA's scoping exercise includes participation by the University. | ||||
| Support for students with additional learning needs is encouraged and positively evaluated by students (paragraph 86). | Continue to promote the full range of support mechanisms available and reinforce their availability. | September 2005 and annually at induction | None | Students will be unaware of the support available within the school and may be thereby disadvantaged. | Subject Leaders/Co-ordinators (University) | Students continue to give positive evaluation on level of support . | |
| The University's on-line learning framework is rated highly by students as a computer-based learning resource (paragraph 88). | Continue to develop high-quality accessible on-line learning resources to support and enhance the curricula. | July 2006 and review annually | None | Materials are not aligned with curriculum developments. | Learning and Teaching Co-ordinator (University) with Subject Leaders (University) and Multi-media Communications Officer (University). | Students report high levels of satisfaction with on-line learning materials. | |
| Students state that practice placement managers/clinical placement facilitators and link lecturers offer very good support in clinical practice and commend this system (paragraph 92). | Disseminate good practice across subject areas and placement areas in accordance with the Clinical Learning Environment Action Plan. | December 05 and annually thereafter | None. | Reduction in the quality of support for students and mentors. | Practice and Innovation Co-ordinator (University) and PPMs/CPFs (PHS Trusts). | Continuing positive student evaluation of support in clinical placements. Positive feedback following visits to placement areas by external examiners. |
|
Weakness Some pre-registration nursing adult branch students perceive that the School's definition of supernumerary status is not being adhered to because of staffing shortages (paragraph 91). |
Affirm definition of supernumerary status with students and mentors prior to each placement. | September 2005 and annually thereafter | None | Students and mentors may have differing interpretations of supernumerary status. | Practice and Innovation Co-ordinator (University). | Reduced incidence of students reporting occasions when supernumerary status has not been followed. | |
| Maintenance and enhancement of standards and quality | Strength A tripartite agreement with the University, which incorporates the quality framework for monitoring contract quality and the Quality Group, ensures that all stakeholders are successfully engaged in reviewing the student journey (paragraph 99). |
Build on the tripartite agreement to ensure that the Quality Group continues the implementation of mechanisms for the robust monitoring and enhancement of agreed quality standards. | 2004 (rolling) | None | A reduction in stakeholder involvement in the monitoring of quality. | Dean (University) and Chair of Quality Group (BBCSHA)/Quality Lead (BBCSHA). | Timescales adhered to on appropriate action plans; Quality Group meets and produces action minutes which are monitored and evaluated. High level of stakeholder satisfaction with their engagement in quality monitoring. |
Weakness The student feedback loop resulting from the evaluation of module and placement learning is not always completed (paragraph 100). |
Develop and publicise a web-based placement feedback mechanism accessible to all students incorporating both module and placement evaluations and subsequent action. | February 2006 | None | Ineffective use of student feedback to improve placement and classroom provision. | Multi-media Communications Officer (University) and Associate Dean, Quality and Standards (University). | All students access website and report that information is useful and appropriate. Student issues are coherently raised and disseminated to both staff groups and student fora. |
|
| Alert students to the existing module evaluation feedback mechanism including undergraduate student council, course committee, award management, and annual monitoring reports. | December 2005 | Heads of Division (University). | Clear audit trail in annual monitoring of how evaluations have been used to improve teaching in theory and practice sessions. |
ISBN 1 84482 413 6
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