Completing a PAD

GUIDANCE ON COMPLETING A STUDENTS PRACTICE ASSESSMENT DOCUMENT (PAD)

The PAD is the record of practice achievement for all pre-registration Nursing and Midwifery students.

It is completed over the course of a year, rather than being specific to a particular term. For students following the 2004 curriculum (Intake groups up to and including the February 2009 cohort) there are three terms in each year each containing 7 weeks of practice learning. The student should aim to complete approximately one third of their learning outcomes in each term. Students following the 2009 curriculum (September 2009 and subsequent cohorts) undertake two semesters per year each containing 10 weeks of practice learning. They will be seeking to complete approximately one half of their learning outcomes in each semester.

Mentors and Students should use their preliminary interview to identify areas of activity from the PAD that are relevant and appropriate to the placement and set their learning goals accordingly. These should be reviewed at the mid-point interview. Each student will develop at a different rate according to the nature and depth of their experience to date and the PADs can easily reflect this. Also, the statements in the PAD can be interpreted to reflect a general expectation of the level of a students performance as they progress through their course.

At the front of the PAD (or for students starting their course after January 2008 - in the Students on-going record of acheivment) the report form (below) will be found. This is to be completed in each placement area.

 

Demonstrates ability to accept responsibility for their own actions YES NO COMMENTS
  • arriving on duty on time
     
  • wears uniform in line with trust policy
     
  • reports sickness/absence in line with UCS/Trust policy
     
  • responds appropriately to constructive feedback
     
  • Identification of fire points
     

This needs to be completed for each student, but interpretation will vary according to the point of development.

'arriving on duty on time' for instance. A major consideration for a first year student will be an awareness of expected patterns of attendance and the demonstration of punctuality. For a second year student to achieve a positive outcome in respect of this statement they will add consistent reliability to this essential punctuality. A third year student will need to demonstrate punctuality, reliability and an awareness of what their presence or absence means to the activities of their patients/clients and colleagues before their mentor considers this skill to have been demonstrated.

Similarly, for the 'identification of fire points' it is reasonable that a student at the start of their course may have a passive expectation that somebody will orient them to the environment and show them the fire exits, alarm points, extinguisher locations etc. whereas a student towards the end of the course would take the action expected of a Registered Practitioner who, finding themselves in an unfamiliar area, will seek out this information for themselves without the need for prompts or reminders from a senior.

The main body of the PAD lists the activities that the student can engage in and the skills that they will need to demonstrate in this engagement. Rather than a simple YES/NO or Achieved/Not achieved response students of Nursing are expected to perform at the level of the taxonomy relevant to their year target, while students of Midwifery are targeting 'Internalisation' of all skills in each year.

Progression for students of Nursing:

From 'Exposure' to 'Participation' -  year one

'Identification' -  year two

'Internalisation' -  year three

'Dissemination' - is a high order skill that might be warranted by a third year student.

This is a sample page from the year 1 PAD (Nursing). The skills statements are derived from the NMC outcomes for the Common Foundation Programme and the student must demonstrate these, by active 'participation', before they can enter their branch programme.

1. Skills - Professional and Ethical Practice Domain
  Experience 1 Experience 2 Experience 3
  Level Achieved Date & Signature Level Achieved Date & Signature Level Achieved Date & Signature
Demonstrates ability to recognise their own limitations and refers to the registered Nurse as appropriate            
Demonstrates respect for client confidentiality            
Demonstrates commitment and responsibility through their professional approach to client care            
Demonstrates commitment to team working and respect for others at all times            
Demonstrates fairness and sensitivity when responding to patients/clients from a range of circumstances            
Demonstrates ability to contribute to nursing care in a fair and anti-discriminatory way            
Demonstrates ability to recognise situations that require referral to the Registered Nurse            

Using column blocks 'Experience 1', 'Experience 2' or 'Experience 3' in sequence - a Registered Practitioner will assess the students performance according to the taxonomy and write in the level achieved, a date and signature is required to confirm and validate the entry (see footnote|).

If a student has been both 'exposed' to an activity and successfully 'participated' in it as part of the same experience then a single entry of 'Participation' may be made. A statement of 'exposure' will alert a subsequent mentor that the student has begun to acquire this skill, but has yet to demonstrate successful participation.

If a student in year one already has a record of successful participation from a previous experience this skill will not need to be assessed again. However, any Registered Practitioner supervising a students practice may feel that a student has gone on to perform that skill at a level higher than the target for the year. In this case it is an option to further grade the skill at that higher level. This will not change the students targets for their next year of study, nor will it give them an increased 'pass mark'. Other options for identifying an above target performance by a student are direct feedback or a comment entered into the final interview record.

As a practice experience develops, and after a student has had a number of 'experiences' that bear on a skill area this page in the PAD might look like this:-

1. Skills - Professional and Ethical Practice Domain
  Experience 1 Experience 2 Experience 3
  Level Achieved Date & Signature Level Achieved Date & Signature Level Achieved Date & Signature
Demonstrates ability to recognise their own limitations and refers to the registered Nurse as appropriate            
Demonstrates respect for client confidentiality Participation J. Smith 17/07/08        
Demonstrates commitment and responsibility through their professional approach to client care            
Demonstrates commitment to team working and respect for others at all times Exposure J. Smith 17/07/08 Participation P Wilson 02/08/08    
Demonstrates fairness and sensitivity when responding to patients/clients from a range of circumstances            
Demonstrates ability to contribute to nursing care in a fair and anti-discriminatory way Exposure P. Wilson 02/08/08        
Demonstrates ability to recognise situations that require referral to the Registered Nurse            

The opportunity for the student to participate in all the skills might not be available in all placements but the Mentor and Student together should aim to complete one third of the skills in each placement and all of the skills to the required level by the end of the year.

The student will take their PAD with them to subsequent placements where their Mentor and other Registered Practitioners in the care team will be able to see what the student has achieved to date and identify those areas in need of development. After further clinical experience this page of the students PAD might look like this.

1. Skills - Professional and Ethical Practice Domain
  Experience 1 Experience 2 Experience 3
  Level Achieved Date & Signature Level Achieved Date & Signature Level Achieved Date & Signature
Demonstrates ability to recognise their own limitations and refers to the registered Nurse as appropriate Exposure G Singh 09/10/08 (3) (4)      
Demonstrates respect for client confidentiality Participation J. Smith 17/07/08 (1)      
Demonstrates commitment and responsibility through their professional approach to client care Participation L. Willis 04/10/08        
Demonstrates commitment to team working and respect for others at all times Exposure J Smith 17/07/08 Participation P Wilson 02/08/08    
Demonstrates fairness and sensitivity when responding to patients/clients from a range of circumstances Exposure G Singh 18/09/08 (3) (4)      
Demonstrates ability to contribute to nursing care in a fair and anti-discriminatory way Exposure P Wilson 02/08/08 Participation M Brown 23/09/08 (2)  
Demonstrates ability to recognise situations that require referral to the Registered Nurse (4)          

(1) The skill that had already been achieved at 'participation' did not need to be re-assessed, (2) entries showing a students previous 'exposure' have been developed to 'participation' and (3) some new 'exposure' situations provided.

(4) The student and their Mentor will now know that during further practice they need to identify opportunities to confirm abilities in recognising personal limitations and acting accordingly and confirming the students fairness and sensitivity in relationships with clients - while, of course, maintaining their performance in all the other areas of activity. So that by the end of year one the student will have demonstrated successful 'Participation' in all of these skills of professional and ethical practice and will be ready to progress to the second year of their course.

During year two the target for students of nursing is to show 'Identification' skills. For a reminder of what this means see Grading Practice|

Final Note: While any Registered Practitioner may sign to confirm the performance of a skill at an appropriate level by a student, it is the students Mentor who must, at the final interview, review the students overall performance in the placement, approve and countersign entries by Associate Mentors and determine whether the student is 'safe in practice' and therefore ready to progress to their next clinical experience.

Back to Information for Nursing and Midwifery Mentors|