MSc Advanced Healthcare Practice

A GUIDE TO COMPETENCY ASSESSMENT

The assessment strategy for this module includes completion of a competency package for all students. These competencies will be assessed at the point of care delivery i.e. in the students own practice area with you as their practice assessor assessing them.

This step-by-step guide uses examples from this module and is designed to familiarise mentors with the competency assessment process:

On day 1 of the module, students will be provided with the appropriate competency packages and guidance notes on how they should be completed
Each student will be allocated a Personal Tutor ( a member of the UCS Lecturing team) who will be available to support the student and their mentor during this module
Students will be required to overview the competency package and undertake a self assessment at the beginning of the programme in order to begin planning for their work towards competency achievement
Initial Meeting – Students will be required to arrange to meet with their practice assessor early in the module to discuss their self-assessment and formulate a plan for achievement of the competencies during the course of the programme
During the course of the programme, it is envisaged that the practice assessor will provide ongoing support and review of their allocated student with the support of the personal tutor
Mid-Point Meeting – Students are required to meet with their practice assessor at the mid-point of the programme to review progress with competency package to date.
Final Meeting – Students are required to meet with their practice assessor at the end of the programme/semester to review the competency package. The final confirmation that the competency package is complete should be made at this meeting

Completion of Competency Package

Each competency must be substantiated by appropriate and robust evidence which demonstrates that the RCN Standards have been clearly met.

The completed competency package will be handed in during the Work Based Learning module in year two and will form part of the assessment for that module. Whilst each module throughout the course is designed to support the students to work towards competencies, the Work Based Learning module will provide the students with a vehicle to complete and submit the portfolio, ensuring that it is robust in its' presentation, and is truly entrenched in the student's own area of practice.

A well constructed portfolio will provide a systematic collection of evidence from a wide range of sources which is logically constructed, clearly meets the competency and shows evidence of learning throughout the portfolio building exercise.

Each competency will be signed and dated by the students' own clinical supervisor and a clear cross referencing system will be developed by the student.

The student should use a wide range of evidence to support their competencies but will need to be creative in how these pieces of evidence are utilised to support and demonstrate the wide range of clinical competency required to meet the RCN domains and competencies for Advanced Practice.

Possible sources of evidence to support competency are:

Critical incident reflections

Writing up a critical incident means that an incident or case, either positive or negative is considered, and time is taken to think about the incident and how it went. In reality, many of the competencies will be met in this way. Questions the student should ask themselves;

What happened?
How did you feel about the incident?
What led you to manage the situation in the way that you did?
What were the implications for your management decisions?
Could it have been managed in a different way?
How?
What difference would it have made?
What could have been improved?
How would you handle this situation again in the future?

Direct observation of practice

The clinical supervisor could observe practice, perhaps a particular practice skill in order to discuss with the student how this observation can be used as evidence of competence. It is an idea for the supervisor to make notes during the observation in order to ensure that the discussion afterwards is valuable and appropriate.

The supervisor should encourage detailed discussion about how the time was spent, what was well done and what aspects could be improved upon. The supervisor will then need to write up a summary of the observation, including information about what competencies have been covered and how.

Clinical supervision

In a case where clinical supervision is underway, and this may not be by the actual named supervisor but may be with a range of colleagues perhaps working together on a project, it is acceptable for there to be a testimony from other colleagues. This testimony however, should be further substantiated by information from the supervisor about how these discussions support the competencies for advanced practice.

360 degree feedback

When undergoing a group venture, it may be useful to collect feedback from a number of individuals perhaps to include colleagues, stakeholders, patients etc. This information can be collected as evaluations in the form of questionnaires, feedback sheets, testimonials or discussions. Again, it will be useful to gain the opinion of the supervisor to assess clearly which competencies will have been covered through this process

Contributions to the workplace

When involved in, or leading a change in practice, this can be documented in a variety of forms and utilised to support the competencies. Audits, changes in practice, production of protocols etc can all be used within the portfolio as supporting evidence. Remember here to include any evidence of dissemination of good practice.

OSCEs

Some of the modules carry structured clinical assessments as the means of assessment for the module. It is possible to use these assessments in themselves to show competency, for example, patient assessment. In this case, the competency may be 'signed off' by the academic who is conducting the assessments.

Other types of evidence

Reflections on practice or incidents
Teaching evaluations and plans
Meetings
Audits
Revisiting of protocols and procedures
Reports
Letters

Each piece of evidence should be supported by a narrative which discusses how that piece of evidence was collected, how it relates to the competencies and what learning has taken place as a result of the process.

It is important to remember though, that the evidence in the portfolio is more about quality than quantity so a balance must be struck between ensuring the competency is met clearly within the portfolio and not putting in evidence which does not support specific competency just for the sake of it.

Clinical Supervision

Support for each student during the undertaking of the competency package and ultimately, the work based learning module is provided by an academic member of staff and an appropriate Practice Assessor/Practice Teacher. The roles of these staff are outlined below.

The role of the designated member of academic staff

Advise and guide the student in the creation of a robust and relevant learning agreement.
Provide the equivalence of three one hour tutorials.
Facilitate links with sources of information and expertise.
Be prepared to participate in the Portfolio Marking & Moderating Panel.

The role of the Practice Assessor

Students undertaking this course are required to have a designated Practice Assessor. The student and line manager/senior clinician need to identify, and secure the agreement of, this person. The selection of suitable Practice Assessor will need to be agreed with the Course Leader.

Key responsibilities:

In partnership with the student and designated member of academic staff facilitate access to appropriate learning experiences;
Provide feedback on progress (formative assessment);
Complete a final (summative) assessment of advanced practice competencies;
Liaise with the designated academic member of staff, module or course leader as appropriate;
Be prepared to represent Practice Assessor's at the Portfolio Marking and Moderating Panel.

To be included in the portfolio

A record of an initial meeting with your practice assessor showing discussion has taken place around your plans for the course, your understanding of the portfolio construction, and your strengths and weaknesses in relation to the domains and competencies.
Record of a self- assessment of your learning needs following initial discussion with your supervisor
An action plan for learning which is agreed and signed by both yourself and your supervisor
A mapping grid which clearly defines the evidence which supports each competency and any cross referencing
A record of a final interview with your practice assessor supporting your claims to have shown competence in every domain.

PRACTICE HOURS LOG (500 HOURS OF RELEVANT PRACTICE TO BE DOCUMENTED)

In order to demonstrate achievement of the RCN standards, you must document a total of 500 relevant clinical hours by the end of Professional Role Development: Advanced Healthcare Practice module. These hours should consist of time spent in your clinical area that has been devoted to working with your supervisor or alongside another appropriate healthcare professional.

Example Competency

DOMAIN 1 : ASSESSMENT AND MANAGEMENT OF PATIENT* HEALTH/ILLNESS STATUS

NHS KSF Dimension

Evidence

Location

Assessor

Signature/ date

Health promotion/health protection and disease prevention