PLS SIG Conference Wednesday 29th March 2006 - PowerPoint PPT Presentation


PPT – PLS SIG Conference Wednesday 29th March 2006 PowerPoint presentation | free to view - id: 120b05-Y2RlO


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation

PLS SIG Conference Wednesday 29th March 2006


Wednesday 29th March 2006. Reflections on clinical practice assessment. 9/27 ... Clinical assessor (experienced mentor) is supernumerary on the day of the triad ... – PowerPoint PPT presentation

Number of Views:42
Avg rating:3.0/5.0
Slides: 32
Provided by: csv22


Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: PLS SIG Conference Wednesday 29th March 2006

PLS SIG Conference Wednesday 29th March 2006
  • Reflections on clinical practice assessment

Unseen Triads the light is on
  • Elinor Clarke

  • In the dark?
  • Lights On
  • Triads Illuminated.
  • 40, 60 or 100w?
  • Conclusion

In the dark?
  • What is an triad?
  • A triad is
  • a method of assessment of student midwives in
    clinical practice. A summative assessment of
    theory in practice.
  • Levels 1,2 and Level 3 (Competent)
  • Based on Fit to practice at the point of

Unseen Triads the light is on!
  • Triads Illuminated
  • What are unseen triads?
  • Roles Responsibilities.
  • 40w, 60 w or 100w?
  • Evaluation
  • Partnership
  • Liberated or empowered?

Triads Illuminated
  • Roles Responsibilities.
  • Assessment criteria
  • Conduct of the Triad
  • Logistics
  • Marking
  • Domestic arrangements
  • Equity.

Triads Illuminated
  • Triads were developed planned (1998), utilised
    in the curriculum since May 2001
  • Triads are a summative assessment of clinical
    education modules.
  • There are 3 triads. Only one is unseen (Level
  • The Unseen triad is used to assess ALL student
    midwives (long 3yr shortened course78 weeks)
  • Triads are an assessment tool which mark or grade
    clinical practice.
  • Triads are weighted to value midwifery care in
  • The first unseen triads were conducted on 12th
    January 2004

Unseen Triad
  • An Unseen triad is a level 3 triad
  • The assessment provides the opportunity for the
    student to demonstrate autonomy the ability to
    undertake the role and responsibilities of a
    midwife at the point of registration.
  • The student is required to assess, plan implement
    and evaluate an episode of care for a woman/ or
    baby previously unknown to them, who has been
    selected by the clinical assessor.

Unseen triad
  • The unseen part of the triad relates to
  • The clinical assessor is NOT the students mentor,
    she does not work with the student on a regular
  • The woman/baby to whom the student provides care
    has not met the student before.
  • The care required may be antenatal or postnatal.

Clinical assessor/Experienced mentor
  • Definition an experienced midwife who is an
    established mentor with record of participation
    in Triad assessments.
  • Criteria for selection
  • willingness to participate in an unseen Triad
  • Understands process of Triads
  • Confident competent in assessment of students
  • Participated in specific updating/workshop for
    preparation to assess unseen Triads.
  • Has not regularly worked with the student

Role responsibilities of Clinical Assessor
  • The Clinical assessor (experienced mentor) is
    supernumerary on the day of the triad
    (unrostered/ but on duty)
  • To identify and choose a suitable woman / or
    baby to receive care the day before the
    assessment takes place.
  • To prepare the woman and her family for the
    students assessment and establish willingness to
    participate and gain consent.
  • To inform the student and Link tutor of time and
    venue for the assessment.
  • To participate in the awarding of marks.

Role responsibilities of Link Tutor
  • To provide copies of the assessment criteria
  • To confirm assessment may be conducted.
  • To provide written evidence of student
  • To confirm attendance at Triad when informed by
    clinical assessor.
  • To thank the student for the reflection and thank
    the assessor for her contribution time.
  • To update and inform clinical assessors of
    developments to student assessments.

Role Responsibilities of Student Midwife
  • To attend the Triad on the date and time
    specified by the Clinical assessor.
  • To confirm his/her intention to present for
  • To have prepared for the assessment
  • To bring with them the documentation for the
  • To attend the assessment be responsible for
    keeping to time participate in the agreement of

Assessment Criteria
  • All assessment criteria remain the same as
    introduced (NMC 2004 Competencies)
  • All students have a copy of the criteria in their
    handbooks at the start of the course.
  • Students requested (CCC) clarification of the
    numerical award system in an attempt to improve
    inter assessor reliability.
  • An additional grid has been produced and passed
    subject quality group (SQG) process

Conduct Unseen Triad (Level 3)
  • The assessments will take place on the
    antenatal/postnatal wards
  • Students will not (should not) have the
    opportunity to meet with the woman or view the
    notes prior to the triad
  • The assessment is expected to last 40-60 minutes.
  • 20-30 minutes for the student to provide care and
    20 minutes for the presentation.
  • The presentation must not exceed 20 minutes and
    will be a reflection.
  • Each member of the triad will have a copy of the
    marking sheet with the criteria listed.
  • Each member should identify their mark and
    agreement will be made on the final mark

  • Proposed Unseen Triads are clearly identified.
  • Annual leave, sufficient experience
  • University staff have been organised into Triad
  • Level 3 TRIAD Team members meet regularly to
    facilitate the process.

  • The triad mark forms 60 of the total module
  • The student must get a minimum of 40 of the
    possible triad mark in order to pass this
  • All items must reach at least a score of 2

Domestic arrangements
  • The Clinical assessor should inform the student
    and the Link tutor the time and venue for the
  • All students have 10 minutes to view the woman's
    records prior to the assessment should also
    receive a verbal report from the midwife
    responsible for the womans care.
  • The Link tutor will provide copies of the
    assessment criteria for those who forget to bring
  • The student will declare him/herself fit well
    to undertake the assessment.
  • The student is responsible for time management of
    her care and the presentation

Guidelines to promote equity
  • Students will not receive any prompts /questions
    by either Link tutor or clinical assessor during
    the presentation.
  • Each member of the tripartite assessment should
    identify their mark on the assessment sheet. Each
    should identify their mark and agreement made on
    the final mark. Where no agreement can be reached
    then the mark awarded will be that of the two
    closest agreed marks e.g. 4,5 and 4 the mark of 4
    will be awarded.

  • Triads are a method of assessment for student
  • Unseen triads are assessed at level 3
  • The student, the clinical assessor and the link
    tutor all participate in marking
  • The student must pass this assessment to qualify
    as a midwife!

Evaluation 40w 60w or 100w!
  • What do we perceive from reflecting on this
    method of assessment?
  • Hearsay time consuming, stressful
  • Evidence co-operation, results
  • Are Triads a good method of clinical assessment?

  • Is there any evidence that Unseen triads liberate
    student midwives?
  • Is it possible to empower students when they have
    to demonstrate skills?
  • Can student assessment empower participants?
  • What does partnership mean in the provision of
    health care and education?
  • Do triads liberate clinical assessment?
  • How does partnership working impact upon clinical
  • Creativity ?

Liberation in clinical assessment
  • Engaging students in critical thinking in
    midwifery is complex
  • Problem solving potentially re-enforces medical
    model of care.
  • Partnership with women alienates husbands,
    partners and obstetricians
  • Professionals have historically taken the lead.
  • Reflection on incidents exposes staff to
    challenges to their delivery of care.
  • Potential to generate creative power

  • Not new to midwives work in partnership with
    pregnant women and their families.
  • Based on DoH (1993) Changing Childbirth
    (choice,continuity and control) for childbearing
  • Bsc (Hons) Midwifery programme is based on
    partnership with local NHS Trusts.
  • Learning contracts partnership with mentors.
  • Adult learners

Action Plan ??
  • Continue to use Unseen Triads for the assessment
    of clinical practice
  • Promote the benefits to the NHS TRUST
  • Share and disseminate our experiences.
  • Place Unseen Triads in Learning Repository
  • Publish our experiences.

Thank You
  • For
  • attending the workshop
  • being willing to discuss Unseen Triads
  • Considering some of the issues surrounding
    clinical assessments in midwifery

  • Coventry University (2002) Curriculum
  • Coventry University (2002) Criteria for Marking
    Triad Assessment Level 3 Competent. School of
    health Social Sciences. Competence Log Book
  • Freire P (1996) Pedagogy of the oppressed.
  • UKCC (2000) Requirements for pre-registration
    Midwifery programmes. London. UKCC
  • Nursing Midwifery Council (2004) Standards of
    proficiency for per-registration midwifery
    education. NMC.London.

Workshop Evaluation
  • Please complete the evaluation in order that I am
    able to monitor, develop and improve this

Aims and Objectives
  • Aim to reflect upon the unseen triad.
  • Objectives are that by the end of the workshop
    participants will
  • Understand the process of unseen triad
  • Recognise the roles contributions of all
  • Identify how the Unseen Triad may empower the
    student and clinical assessor.
  • Consider the practicalities of this assessment.
  • Share examples of good practice which emerged
    from Unseen triads.

Plan of workshop
  • 11.05 Welcome and introduction
  • 11.04 PP Presentation in the dark?
  • 11.10 Handout re Triads
  • 11.15
  • 11.25 Questions
  • 11.30 Finish

Historical Landmarks
  • 1988 Introduction of Triads into the Midwifery
  • 2001 Unseen triads validated for Level three
  • 2003 Clarification of numerical award system (to
    improve inter assessor reliability)
  • 2003 Introduction of Triad assessment grids
  • 2004 Unseen triads used for the first time