MSc Advanced Clinical Practice. Facilitator and Role Champion Handbook

Transcription

1 MSc Advanced Clinical Practice Facilitator and Role Champion Handbook

2 CONTENTS Introduction 3 Aims of the Programme 4 The Role of the Clinical Facilitator 6 The Role Champion 8 The Personal Tutor 8 Assessment Strategies 9 Practice based Assessment 9 Progression flow chart 11 Clinical Practice Environment 13 Student Progression 13 Learning resources & Quality Enhancement 13 Programme Module table 14 Appendix 1 Summary Facilitator role 16 Appendix 2 Learning Environment Pre-course Assessment Tool 17 2

3 INTRODUCTION Thank you for agreeing to be a Facilitator/ Role Champion for a student enrolled on the MSc Advanced Clinical Practice programme. We appreciate your commitment to the process of enabling student learning and look forward to working with you. This document seeks to be brief but to set out the main features of the provision. You are invited to contact the student s Personal Tutor [PT] at any point to discuss queries or concerns that you may have. The University of Cumbria values learning in practice as evident in the following definitions Work-based learning is regarded as learning that is integral to a higher education programme and is usually achieved and demonstrated through engagement with a workplace environment, the assessment of reflective practice and the designation of appropriate learning outcomes. Institutions can draw upon and make use of personal development planning and/or accreditation of prior experiential learning (APEL). Work- based learning is often accredited, ranging from a single module within a programme to an entire programme that includes, at its core, activities and learning outcomes designed around the individual s occupation, whether paid or unpaid. Placement learning is regarded, for the purpose of this publication, as the learning achieved during an agreed and negotiated period of learning that takes place outside the institution at which the full or part tome student is enrolled or engaged in learning. As with work-based learning, the learning outcomes are intended as integral parts of a programme of study. It is important that each student is supported by the institution throughout his/her placement experience, to ensure that specific learning related to the programme can be achieved. Your student will provide you with contact details of their PT. In addition, you are also welcome to contact the Programme Leader at any time. Kathy Haigh Programme Leader MSc Advanced Clinical Practice kathryn.haigh@cumbria.ac.uk Tel ext Mobile:

4 THE AIMS OF THE PROGRAMME MSc Advanced Clinical Practice programme has been designed to meet the needs of changing health care provision and students who wish to develop their practice to enhance services and patient care. It enables the personal and professional development of practitioners who are fit for purpose, fit for practice and fit for role. It signals the responsiveness of the provision to meet the needs of service whilst enabling students to develop the skills and knowledge required to practice at an advanced level. Display mastery of a complex and specialised area of knowledge and a critical awareness of issues at the forefront of the area of study. Employ advanced subject-specific and cognitive skills to enable decision- making in complex and unpredictable situations. Generate new ideas and support the achievement of desired outcomes. Accept accountability for decision making including the use of supervision. Analyse complex concepts and professional situations by means of synthesis of personal and workplace reflection and data drawn from scholarship and research in the field. Students registered on the MSc Advanced Clinical Practice will experience a challenging, evidence-based and flexible learning environment at postgraduate level. The expectation is that students will adopt a critical and independent approach to their learning. It is a requirement that the student has opportunities to apply new ways of thinking and working to the practice setting. The roles of both Clinical Facilitator and Role Champion are critical to its success. The first year of the programme consists of 3 theoretical modules and part of the Qualificatory Practice Unit (QPU) designed to prepare students to undertake a range of clinical examinations, make clinical and treatment decisions and deliver care either autonomously or as part of a multidisciplinary team. The clinical learning component of the QPU contain advisory time commitments, guided systems examinations and a range of variable learning opportunities to meet the scope, level of practice and associated competence of practitioners working at an advanced level. Please refer to the Work Place Learning for Advanced Clinical Practice Handbook (WPL Handbook). 4

5 On successful completion of their studies on the MSc Advanced Clinical Practice programme students will be able to: 1. Develop a comprehensive and systematic knowledge and practical understanding of how techniques of rigorous enquiry enable the critical appraisal, interpretation and application of evidence and the critical evaluation of the implementation of research and evidence based practice as it concerns the field of advanced clinical practice. 2. Critically evaluate modes of decision making in the arena of advanced clinical practice and the impact and interaction of judgement and decision making in complex and unpredictable situations. 3. Critically appraise different models of leadership and management and apply them appropriately to enable advanced clinical practice service development, demonstrating originality of thought and the development of strategic thinking in response to a changing and dynamic practice environment and to health and social policy. 4. Critically appraise a range of theoretical concepts, research and frameworks for collaborative working and therapeutic relationships (embracing equality and diversity), demonstrating mastery in their application and innovative approaches to multi agency working in the arena of advanced clinical practice, including user/carer engagement and team working. 5. Critically review the complex nature of sociocultural, economic, political, technological, legal, professional and ethical concepts as they apply to the field of advanced clinical practice. The theoretical and clinical components together support the achievement of the nationally agreed standards for advanced clinical practice outlined in the HEE (2017) position statement. The recent Health Education England (2017) review defines advanced clinical practice as, delivered by experienced, registered health care practitioners. It is a level of practice characterised by a high level of autonomy and complex decision making. This is underpinned by a master s level award or equivalent that encompasses the four pillars of clinical practice, leadership and management, education and research, with demonstration of core capabilities and area specific clinical competence. Advanced clinical practice embodies the ability to manage clinical care in partnership with individuals, families and carers. It includes the analysis and synthesis of complex problems across a range of settings, enabling innovative solutions to enhance people s experience and improve outcomes.. HEE (2017, p8) 5

6 The Work Place Learning for Advanced Clinical Practice Handbook incorporates: Capability Assessment document (compulsory) Demonstration of Practice (DOP) informed by the physical examination proformas (compulsory). Mini-Clinical Evaluation of Practice (CEP) (compulsory) Practice review summary records (compulsory) Patient Questionnaire (compulsory) Log of minimum 500 practice hours (compulsory) Learning contracts (optional) Learning in Practice Log (optional) Students may exit the programme at the end of year 2 with a Postgraduate Diploma in Advanced Clinical Practice having met the minimum required standards, or proceed with the full MSc programme. Year 2 consists of 3 modules which may include Non-Medical Prescribing (NMP), and year 3 consists of a Work based project with the equivalent credit of 2 single modules. There is scope to undertake at least 1 further optional module (see programme handbook) and further scope if NMP is not undertaken as part of the programme. It is expected that facilitators support the students throughout the programme of study, however in years 1 and 2 the requirements for supervision and assessment in practice are prescribed by the programme, whereas the support and supervision required in year 3 is more flexible and is determined at least in part by the work based project and the requirements of the role following qualification. In addition to meeting the standards within the HEE (2017) Multi professional framework for Advanced Practice, the programme is also accredited by the Royal College of Nursing, and nursing students can apply for credentialing by the RCN on completion. The Role of the Clinical Facilitator We require students to have an appropriately qualified clinical facilitator to guide them in the practice setting. The role of the facilitator is to help the student develop their competence and confidence. The clinical facilitator may be a medical practitioner or a Masters qualified advanced clinical practitioner. Approximately 1.5 hours per week should be committed to the role. Although this requirement is not compulsory it is recommended in order to teach, monitor and assess the student. Other members of the health care team can be involved in the process but the named clinical facilitator must take overall responsibility for interim and final assessments. It is advised that the student should access a minimum of 5 hours practice time per week (both facilitated and supervised) and this time should be recorded in the learning log. 6

7 At first we suggest that the facilitator demonstrates history taking/ physical examination techniques, and gradually the student should become the history taker and take the lead in physical examinations. Constructive feedback to the student from the facilitator and other team members is vital in order to facilitate the development of competence and confidence. It is necessary to highlight areas that need development and to identify aspects of good practice. Over time students should be able to carry out unsupervised consultations, asking for help or advice as needed, but the level of supervision required should always be determined as part of an agreed strategy between the student and the clinical facilitator. Some learning may require the student to seek different placements where the facilitator may not be directly involved in the supervision. It is acceptable and usual that clinical facilitation is from time to time undertaken by a deputy. However, it remains the responsibility of the formal clinical facilitator to ensure that the deputy and student are working to a satisfactory level. Progression in competence can be agreed and signed off with any clinical supervisor but it remains the responsibility of the main facilitator to undertake final sign offs of competencies at the end of the QPU and ensure that the student is ready to undertake their OSCE. As can be seen from the capability profile documentation (WPL Handbook), many of the standards within the domains are broad and generic. This means that you need to discuss and interpret the statements with your student, developing evidence of attainment and concurrently acquiring in depth theoretical knowledge and awareness of the wider scope of advanced clinical practice. It is anticipated that as the programme progresses, your student is able to show that they are capable of working independently and as part of an interdisciplinary environment at an advanced level as described within all 4 domains of advanced practice. At various stages throughout years 1 and 2 the facilitator supports the student to make the transitions required to establish a specific training pathway to meet the outcomes of the envisaged role. Discussion is needed to agree a way forward, and this should include the role champion and/or service managers. It is an opportunity to establish clear agreement within and between stakeholders about the original vision of the training post and clarify any new objectives within the role specification. The student needs to consider how they will consolidate their generic skills and incorporate new knowledge and skills. There is an expectation that advanced practitioners will take a lead in the development of new services or new ways of working. Innovative models of practice should have demonstrable outcomes which meet at least one of the above criteria. Current examples include practitioner led clinics and new services, developing existing services using advanced level clinical skills, taking part in the medical rota in clinics, surgery and wards. There is also an expectation that students use their academic skills to participate in evidence based decision making and in the production of clinical data to inform practice. It is anticipated that advanced practitioners, following their training and a period of 7

8 consolidation will become clinical experts within their specialist field. This requires not just clinical competence but also an ability to assimilate and present evidence, to participate in debate and to act as a resource for others. Clinical supervision is frequently a combination of monitoring and supporting progression of existing competencies and supporting the student to become adept in their specialist role as outlined in the original vision. We recognise that the role of the facilitator requires the commitment of time and sustained enthusiasm. In view of the high level of autonomous practice associated with advanced clinical practice, this is necessary to ensure the highest standards are met. The Role Champion We recommend that students have a role champion as they progress through their programme of study. Alongside their facilitator, the role champion will be central to the process of student support. However there are differences in the two roles. In brief the role champion has to act in the role of critical friend and advocate. Therefore it is important that the role champion is someone who will listen to the student and support the sometimes difficult process of making the transitions required in practice. They need to be able and willing to provide support and encouragement. The role champion must be someone who can give honest, constructive feedback. The role champion does not necessarily have to work in the same setting as the student, but it is important that they have the time to commit to supporting them as they progress through the programme. It is suggested that the student meets with the role champion at least once a month. Unlike the facilitator, the role champion is not involved in the assessment of competence, unless the role champion and facilitator are one and the same. It is usual for the role champion to be someone who can influence decisions and speak for the student as and when the future role is being discussed, and to focus on the transitions required to the role of advanced practitioner after qualification. For many reasons, the original vision for the role can become diluted over the course of the programme of study, and the role champion can help to keep the student and the rest of the clinical team focused on the envisaged future role. The Personal Tutor [PT] The student s PT will be a member of the programme team and will be a source of support and guidance for the student, the facilitator and the role champion. Members of the programme team are committed to ensuring that facilitators are supported in their roles to the best of our ability. A PT will be allocated to your student at the outset of the programme and will undertake practice reviews at key points in the programme (see flow chart Appendix 1) Facilitators are welcome to discuss the progress of their student at any point. If there are issues or concerns, we ask that facilitators get in touch as soon as possible. 8

9 If students feel they are receiving insufficient support from their workplace or from their supervision, in the first instance they are encouraged to discuss the problem with their facilitator. If problems persist they will need to inform their personal tutor. Assessment Strategies Assessment strategies for the modules are set out in a handbook which accompanies each module. It is important to know that the pass mark for all modules is 50% and that every module has to be passed. Fails within a module on programme cannot be condoned. A range of assessment strategies is employed to reflect the focus of the modules and their learning outcomes. It may be the case that your student wishes to talk through their ideas for modular assignments with you, however, students should always be advised to refer to their module handbook and the module co-ordinator to ensure that the piece of work envisaged meets the requirements. Practice Based Assessment The programme team appreciates that facilitators assessing students in practice will require support and guidance. Further detail in respect of this is provided in the Work Place Learning for Advanced Clinical Practice Handbook. The Qualificatory Practice Units (QPUs) must be passed. The QPUs serve to frame student learning in practice and demonstrate progress and the achievement of competence. In order to complete the QPUs, students must submit a fully completed Learning in Practice Profile which will include the following, Capability Assessment document Demonstration of Practice (DOP) informed by the physical examination proformas. Mini-CEP Practice review summary records Patient Questionnaire Log of minimum 500 practice hours and may include the optional documents Learning contracts Learning in Practice Log You will need to look at the WPL Handbook with your student in order to support their role development in practice. 9

10 At the outset of the programme students are required to assess themselves against the capability statements, noting where they believe they currently sit and how they interpret their competencies using examples from their previous experiences and skills. This is a starting point and an important basis for their subsequent learning needs. It helps to demonstrate progression over the entire assessment period. It helps you to guide their learning opportunities and supervision requirements when venturing into new situations. Six reviews of progress (Practice Reviews) take place during the first 2 years of the programme. These should be informed by your observations and assessments as outlined in the flow chart (page 11) as well as the less formal impressions gained during the time spent with the student in clinical supervision. In other words, there is a process of continual assessment, with key stages designed to monitor achievement and progression and help to identify learning needs in a developmental manner. Evidence of achievement may be gained from either your observations or your discussions with the student, when their knowledge and skills can be tested. Evidence of meeting a competence should be noted. The capability profile (see WPL handbook) is formative until the end of the QPU, by which time all competencies must be signed off as evidence of achievement. Your assessment will thus consist of a combination of observed skills and discussions relating to some of the more widely defined capabilities which may be evidenced through a variety of methods and situations in practice. The student may use their developing capability profile to generate discussion or to demonstrate their competence, but it is also essential that you observe them in a range of practical situations. In many cases once you are confident that direct supervision is not required students are free to log whatever hours are relevant to their learning, subject to your approval. Different levels of supervision will be required at different stages of learning new skills, and it is your responsibility to ensure that students receive the supervision appropriate to their skill level at different points of time during their training. There is an expectation that you (or a designated deputy) are able to offer the student 1.5 hours of direct support per week, but this is likely to vary from time to time from direct teaching, observation, supervision, discussion and signposting towards alternative learning environments where appropriate. The practice reviews are undertaken at the end of each stage following discussion between the student and their personal tutor. This document should be signed off by you if you are in agreement with the content. If you do not agree with the statements in the practice review it needs to be brought to the attention of the personal tutor or programme leader. 10

11 Midpoint QPU: end Year 1 Initial Practice review: year1 Learning Environment in Precourse Assessment Tool Facilitator Student Personal Academic Tutor Student: Undertakes self-assessment of capability document Identifies learning needs Begin Log of Hours Student and Facilitator: Sign off completed self-assessment in Capability Profile Begin Physical Exam Practice Conduct Time 1 Practice Review Summary Student and PT: Conduct 1st Practice Review Summary Facilitator, student and PT conduct 2 nd practice review Student working with capability profile completes: Logging practice hours Patient questionnaires (6 in total by this point) 2 mini-ceps by this point Facilitator: Invited to contact student PT regarding student s At midpoint the Student and Facilitator: Conduct 3rd Practice Review Summary Mid-point Capability Assessment Continue with Physical Assessment Practice DOPs forms At end Yr 1 Mid-point review the Student and PT: Conduct 3rd Practice Review Summary 11

12 End Review Year 2 Student, facilitator and PT will undertake: Practice review 4 in Year 2 Practice review 5 in Year 2 Student completes: Logging Practice Hours achieving minimum 500 hrs Patient questionnaires (further 9 by this point) Final 2 Mini-CEPs by this point Facilitator: Invited to contact student s PT regarding student s progress By end of this 6th Semester the Student and Facilitator: Complete capability assessment Complete QPU DOPs and Mini-CEP Completed all patient questionnaires Conduct Time 6 Final Practice Review Summary Logged a minimum of 500 hours Facilitator communicates with student s PT to: Confirm all capabilities achieved Anticipated readiness for OSCE 12

13 Clinical Practice Environments Clinical practice environments vary widely as do the student s base profession and specific role requirements post qualification. The programme for all students starts with generic skills and progresses onto specific training to meet the requirements of the particular role. Thus students initially focus on similar clinical presentations with increasing differentiation over time in the specific training needs required for various advanced clinical roles. It is necessary for all students to develop their ability to confidently and competently undertake patient consultations, taking histories, doing physical examinations, moving on to problem solving, making clinical diagnoses and agreeing evidence based plans of action. We appreciate that in the practice setting full physical examinations are commonly adapted to fit the situation and/or the presenting condition. However, from a programme and best practice perspective we need to know that students are capable of demonstrating the full examination before they begin to adapt it. Assessment by Objective Structured Clinical Examination [OSCE] at the end of the Qualificatory Practice Units will require students to demonstrate some full patient consultations. Student Progression Practice reviews must take place within the relevant stages of study. The onus of responsibility to arrange these lies with the student. Failure to organise timely practice reviews will result in failure of the Qualificatory Practice Unit and may also result in the instigation of Student Progress Review and/ or Adjudication processes. As previously indicated, if at any point you are concerned about the progress of your student in practice, it is important that you contact the programme team. In the event that your student fails to meet the standard set when the QPU assessments takes place, we will work with you to devise remedial support strategies. If this fails to deliver the required improvements and all attempts at redemption have failed discontinuation will result. We recognise this is likely to be a difficult decision; however, it is vital that incompetence in practice is identified in the interests of public safety. Learning Resources and Quality Enhancement The University provides a range of services to support students with their studies, such as Library and IT support, counselling and support for students with learning needs and specific disabilities. There is a wealth of on-line resource within modules themselves and via a range of external networks. 13

14 The following table shows the range of modules students are expected to undertake in the three years of study. Some of these are core components, some qualificatory and there are also optional modules to take into consideration qualifications that students may already have achieved or to complete the required 180 credits for the MSc. Module Code Module Title Academic Credit Core, optional or qualificatory 1 st Academic year HPHA7006 HPHA7007 HPHA7008 HPHA9004 HPHA9005 The Clinical Consultation: Embedding Theory into Practice Clinical Decision Making: Improving Outcomes in Complex Patients Analysing Research and Evidence to Inform and Advance Clinical Practice Work Place Learning in Clinical Practice Work Place Learning for Advanced Clinical Practice (OSCE) 20 Core 20 Core 20 Core 0 Qualificatory 0 Qualificatory Students exiting programme with 60 credits at this stage leave with PGCert in Healthcare only 2 nd Academic Year HPHN 7311 HPHN 7313 NMLB 6244 NMLB 7117 HPHN 7115 HPHN7116 Non- Medical Prescribing (module codes dependent on profession) Optional (for students who do not already hold this qualification) Leadership for 20 Core HPHA7009 Improving Health Outcomes Work Place Learning in 0 Qualificatory HPHA9004 Clinical Practice Work Place Learning 0 Qualificatory HPHA9005 for Advanced Clinical Practice (OSCE) Students leaving the programme with 120 credits and successful completion of the

15 Qualificatory Units at this point are awarded the Post Graduate Diploma in Advanced Clinical Practice. Those with 120 credits and unsuccessful Qualificatory Units would receive a Post Graduate Diploma in Healthcare and will exit the programme. 3 rd Academic Year (includes options for year 2 replacing NMP) HPHA 7010 HPHA 7011 Option Developing Innovation in Advanced Clinical Practice Health Assessment in Common Childhood Conditions 40 Core 20 Optional HPHA 7012 Option Advanced Assessment of the Acutely Ill Child 20 Optional HLLG Option Negotiated Learning 20 Optional HPHG 7004 Option HPHG 7002 Option Advanced Pathophysiology and Disease in Practice Acute Care: Assessment and Management of the Acutely Ill Adult 20 Optional 20 Optional Students exiting at this point with 180 credits will receive an MSc Advanced Clinical Practice award as well as the RCN award. Nurses will be automatically registered on the RCN Credentialing database. Summary This programme of study is essentially clinical especially within the first two years of study. It seeks to provide students with the knowledge and skills to become safe, competent practitioners at an advanced level. The clinical facilitator has a pivotal role to play in enabling this outcome to be attained. It is a challenging and responsible role; it is also satisfying and rewarding. We thank you for your time and enthusiasm. 15

16 Appendix 1: summary of Facilitator Role and Responsibilities Facilitator Roles and Responsibilities Medical Facilitator Member of the Royal College or its equivalent Actively engaged in clinical practice Nurse/Allied Healthcare Facilitator Graduate of a nurse practitioner programme or Advanced Practitioner programme Active registration with the NMC/HCPC Minimum of two years of experience as a Nurse Practitioner or Advanced Practitioner Paramedic Facilitator Graduate of an Advanced Paramedic Practitioner programme Active registration with the HCPC Two years experience at least as an advanced paramedic practitioner The Facilitator needs to: Be engaged in their own on-going professional development Be able and willing to offer approximately 1.5 hours/ week to the student in the form of a one-to- one tutorial, supervision or discussion (and provide a designated deputy for periods when this is not possible) Be willing to assess students against the criteria outlined in the programme Be committed to creating a learning environment for the student Work with the student to organize their practice time. Ensure that the student records their learning throughout the programme. Be committed to the advancement of the advanced clinical practitioner role, and can support the student in their efforts to make the transitions required. The domains of advanced practice : Clinical care Leadership and management Education Research The Advanced Clinical practitioner: The capabilities described in the HEE (2017) document are used to provide an appropriate framework for advanced practice students to determine their competence and is suitable regardless of their professional field, recognising that advanced practice is a level of practice and not merely a title or role. 16

17 Appendix Two Learning Environment Pre-course Assessment Tool 17

18 Department of Nursing, Health and Professional Practice MSc Advanced Clinical Practice LEARNING ENVIRONMENT PRE-COURSE ASSESSMENT TOOL IMPORTANT: If you have received this form electronically, please print it then complete and submit ONE hard copy Student Name Facilitator Role Champion Funded By: (please indicate) Self Employer S.H.A. C.E.V. Programme Leader Approved: (Signed)... 18

19 INFORMATION TO BE PROVIDED BY THE STUDENT: Student s Name: Home Address: Tel: Home Work Mobile Work Address: address: (must be a work-based address where possible) Name of Manager: Work Address of Manager: Contact Tel No: address: 19

20 INFORMATION TO BE PROVIDED BY THE FACILITATOR Facilitator s Name: Facilitator s Work Role: Address: Tel: Work Facilitator s Qualifications and Areas of Specialist Interest: Mobile address: Facilitator s prior experience of supporting learning in the workplace: What is the plan for how the student s learning will be enabled? Other Sources Of Learning And Development Please indicate the type of setting that this is: Hospital: A&E Ward Unit Clinic Other [please state] Primary Care: General Practice Walk In Centre Other [please state] Paramedic Practice: 20

21 Access to other clinical settings/ learning environments? Available resources? Computer Internet Access Library Books Journals Video Training Facilities Private Study Space Other: Other team members who can support the student s learning? Have you received and read the facilitator information that has been provided by the student? Y / N If not received, please Lisa Bailey at lisa.bailey@cumbria.ac.uk via your work address I am committed to facilitating this students learning for 3 hours per week SIGNED. Any other comments/ information: 21

22 INFORMATION TO BE PROVIDED BY THE ROLE CHAMPION Role Champion s Name: (if different from Facilitator) Role Champion s Work Role: Work Address: Role Champion s Qualifications and Areas of Specialist Interest: Tel: Work Mobile address: I have read the course documentation which explains the Role Champion role and I am committed to fulfilling it SIGNED. If you require further information on completing this form, please contact the Programme Leader Kathryn Haigh Kathryn.haigh@cumbria.ac.uk 22