Midwifery Sign-off mentor update

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Midwifery Sign-off mentor update

• June 2014

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• Thank you for completing the
• Mentor Evaluation Form.

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• On line information
• To support this presentation please access the
  link below for the information and guidance
  included in this presentation
• www.anglia.ac.uk/mentors

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Embracing the NHS Values within mentoring

• Positive role modelling
• The NHS Constitution Values
• The 6 Cs
• The Essential Skills Clusters.

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Mentorship of Student Midwives

• Student midwives must have a named sign-off
  mentor to support them through each of their
  midwifery placements.
• Students must work with their sign-off mentor for
  40 of their placement minimum of 2 shifts a
  week or 15 hours.

• All midwifery mentors have to be a sign-off
  mentor or working towards becoming a sign-off
  mentor.
• Midwifery mentors working towards becoming a
  sign-off mentor must be supervised by a sign-off
  mentor when mentoring students.

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Entering and Remaining Live on the mentor
register

1. NMC approved mentor preparation programme.
2. Been supervised mentoring students on 3 occasions
   ( or done 2 simulations and 1 supervised
   sign-off).
3. Have completed the Midwifery Sign-off
   Verification Document to enter the register.
4. Annual mentor update (within 12 months of last
   update)
5. Triennial review (within 3 years of last
   triennial review.)
6. Supported and summatively assessed two students
   within the three year cycle.

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Triennial Review

• Three yearly cycle of reflection of mentor
  practice against NMC standards.
• The process is a self assessment of your skills
  as a mentor.
• Complete Triennial Review for Mentors document
  available on the Mentor Portal or Trust
  equivalent
• This provides evidence of your on-going updating
  of your mentoring skills
• Meet with your line manager or appropriate other
  to review your evidence.
• The Mentor Register is then updated.

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Quality assurance

• The HEI and Placement Providers work together to
  assure the quality of the student practice
  learning experience through the process of
• Audits
• Practice Education Committees
• Student/Mentor Evaluations
• Moderation of Practice Assessment
• External reviews from CQC, Monitor, PQAF,
  Professional Body, NHSLA

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New Curriculum Sept 2014

• The September 2014 cohort will commence a new
  curriculum.
• New curriculum will have a new Practice
  Assessment Document.
• New curriculum has a new Grading in Practice
  Tool.
• September 2012 and 2013 cohorts will remain on
  the old curriculum, but will use the new
  curriculums Grading of Practice Tool.

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Content of New Curriculum
  Year One (Level 4)   Year One (Level 4)   Year One (Level 4)   PROGRESSION POINT (NMC) Year Two (Level 5) Year Two (Level 5) PROGRESSION POINT Year Three (Level 6) Year Three (Level 6) Year Three (Level 6) PROGRESSION POINT (NMC)
Trimester One Fundamentals of Midwifery Practice 1 (30 credits, Standard Module)   Small Group Presentation(Fine graded) 1800 word reflective account(pass/fail) Fundamentals of Midwifery Practice 1 (30 credits, Standard Module)   Small Group Presentation(Fine graded) 1800 word reflective account(pass/fail) Knowledge, research and evidence in midwifery practice (30 credits, Standard Module)     4800 word critique of research paper (Fine graded)   PROGRESSION POINT (NMC) Midwifery Care for the woman and infant with complex needs (30 credits, Standard Module)   2 hr Multiple choice exam (pass/fail) 3 hr written exam (Fine graded) Promoting Health Wellbeing in Midwifery Care (30 credits, Standard Module)   5000 word essay(Fine graded) PROGRESSION POINT Undergraduate Major Project (30 credits, Project Module)   10,000 word major project (Fine graded) Newborn Infant Physical Examination (30 credits, Theory/Practice Module)   NIPE practice document Pass/fail OSCE (Fine graded) Newborn Infant Physical Examination (30 credits, Theory/Practice Module)   NIPE practice document Pass/fail OSCE (Fine graded) PROGRESSION POINT (NMC)
Trimester Two Fundamentals of Midwifery Practice 2 (30 credits, Standard Module)   Breastfeeding OSCE(Fine graded) MCQ paper (including AP/ Breastfeeding Fine graded)   Fundamental Midwifery Skills (30 credits, Placement Module)   Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded) Safe Medicate 80 pass  Start case-load     Knowledge, research and evidence in midwifery practice (30 credits, Standard Module)     4800 word critique of research paper (Fine graded)   PROGRESSION POINT (NMC) Emergency Midwifery Skills (30 credits, Standard Module) OSCE NLS Pass/fail Random OSCE (Fine graded)   Developing professional midwifery skills (30 credits, Placement Module)   Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded)   PROGRESSION POINT Undergraduate Major Project (30 credits, Project Module)   10,000 word major project (Fine graded) Collaborative professional working (30 credits, Standard module)   Annotated PowerPoint (Fine graded) Advancing Midwifery Practice (30 credits, (Placement Module)   Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded) Safe Medicate 100 pass   PROGRESSION POINT (NMC)
Trimester Three Fundamentals of Midwifery Practice 2 (30 credits, Standard Module)   Breastfeeding OSCE(Fine graded) MCQ paper (including AP/ Breastfeeding Fine graded)   Fundamental Midwifery Skills (30 credits, Placement Module)   Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded) Safe Medicate 80 pass  Start case-load       PROGRESSION POINT (NMC)   Developing professional midwifery skills (30 credits, Placement Module)   Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded)   PROGRESSION POINT   Collaborative professional working (30 credits, Standard module)   Annotated PowerPoint (Fine graded) Advancing Midwifery Practice (30 credits, (Placement Module)   Practice Competencies (Pass/ Fail) Placement Assessment ( Fine Graded) Safe Medicate 100 pass   PROGRESSION POINT (NMC)
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Placements

• Curriculum is 50 theory and 50 practice.
• During placements students will work 30 hours a
  week clinically. 7.5 hours will be for guided
  reflection, skills or theory sessions.
• Students will have the following placements
  through the course.

YEAR WEEKS OF PLACEMENT   PLACEMENT AREAS
ONE   21 weeks Midwifery placements  
TWO 30 weeks Midwifery placements 2 weeks Gynae/acute care placement 2 weeks neonatal unit placement 2 weeks non- midwifery placements 3 weeks elective placement.  
THREE 24 weeks Midwifery placements.  
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Practice Assessment Document

• Students will have a separate Practice Assessment
  Document for each year of their course.
• They are designed to enable the student to
  demonstrate achievement of the Standards for
  Pre-Registration Midwifery Education (NMC 2007)
  and the Essential Skills Clusters (NMC 2009)
  which will allow them entry onto the midwifery
  part of the NMC register.
• The Practice Assessment Document will be bound
  and should remain with the student at all times.

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Progression Points

• The NMC requires that there are progression
  points within midwifery course, where students
  have to pass all academic and practice
  assessments up to that point before they can
  proceed onto the next part of the course, or
  qualify as a midwife.
• The NMC state that the proficiency in practice
  needed to pass a progression point must to be
  assessed by a sign-off mentor in practice.

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Progression Point 1 2

• The sign-off mentor on the students last
  midwifery placement in the first year and second
  year needs to make a judgement of whether the
  student has achieved the level of proficiency for
  that year.
• They will do this through reviewing the students
  Practice Assessment Document and through their
  own observations of the student.
• The sign-off mentor will need to sign the
  Progression Point completion form to verify
  successful completion of the practice element of
  the progression point.

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Final progression point

• The student will be allocated a final sign-off
  mentor in the third year.
• The final sign-off mentor must work a placement
  with the student in their 3rd year and must meet
  with the student for at least 1 hour per week in
  their final placement.
• The final sign-off mentor is responsible and
  accountable for assessing the student against the
  NMC Final Progression Point Standards.
• The final sign-off mentor will need to sign the
  declaration to verify that the student has met
  the standards in order for the student to enter
  onto the midwifery register.

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Practice skills

• Each year the students will have a set of
  practice skills in which they need to be able to
  demonstrate proficiency.
• These skills can be signed off by any midwife who
  the student works with and who observes their
  proficiency in the skill.

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Essential Skills Clusters

• The Essential Skills clusters (ESCs) are a set
  of broad, woman-focused, midwifery skill
  statements introduced by the NMC (2009). The
  ESCs cover five areas of midwifery practice
• Communication
• Initial antenatal assessment
• Normal labour and birth
• Breastfeeding
• Medicine management.
• ESC outcomes are assessed at 2 points at the end
  of the first year and at the end of the third
  year. The Essential skills clusters must be
  signed off by the students sign-off mentor.

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NIPE assessments

• 1st year
• Students must complete 10 formative top to toe
  Examinations of the Newborn, which include
  examination of the TESTES (part of the NIPE
  check). A sign off- mentor can assess these
  examinations.
• At the end of the year students MUST also
  undertake a summative assessment of a top to toe
  Examination of the Newborn. The summative
  assessment must be observed by a sign-off mentor
  who has done at least 3 of the students
  formative assessments.

• Students will be completing the Newborn Infant
  Physical Examination module (NIPE) as part of
  their midwifery course.
• This will be taken as a module in Year 3.
• However, students must prepare for the module
  throughout their midwifery course and keep a
  practice document of their progress.

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NIPE assessments continued

• 2nd year
• Students must complete 10 formative top to toe
  Examination of the Newborn examinations, which
  include the HEART (part of the NIPE check). These
  must be assessed by a practitioner with the NIPE
  qualification to ensure accuracy of the Heart
  examination. A further 10 formative top to toe
  Examination of the Newborn examinations are
  required, but could exclude the heart if assessed
  by a practitioner without the NIPE qualification.
  
• At the end of the year students MUST also
  undertake a summative assessment of a top to toe
  Examination of the Newborn.
• The summative assessment must to be observed by a
  sign-off mentor who is a NIPE practitioner who
  has done at least 3 of the students formative
  assessments.

• 3rd year
• Students must complete the NIPE module. This
  includes-
• 10 formative Newborn Infant Physical
  Examination (NIPE) assessments with a NIPE
  qualified practitioner.
• An OSCE- summative assessment which is
  undertaken in the University.
• Producing a practice document with evidence of
  all assessments.

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Placement documents

• Mentor details
• Orientation to practice area
• Learning contract
• Mid-placement/interim review
• Grading in Practice Tool
• Feed forward

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Grading in Practice Tool

• The Traffic Light System
• Any mark that falls in
• The red is unsafe practice so the student will
  fail the assessment with an overall mark as 0
• In the amber column is satisfactory
• In the green column indicates good /excellent
  progress.

• Holistic assessment tool to be completed at the
  end of every midwifery placement of 4 weeks or
  more.
• Different grid for each year of the course.
• Marks contribute credits to the students degree.
• Follows a traffic light system.
• Pass mark for FGT is 40

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Failing the Grading in Practice Tool what
happens?

• Inform the students personal tutor/link lecturer
  immediately.
• A tripartite meeting will be set up between the
  student, sign-off mentor and personal tutor to
  develop an action plan for remedial action for
  further placements.
• The student will need to repeat and pass the
  placement in the first trimester of the next
  year.
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Feedback and feed forward

• Feedback is important to help the student know
  how they are performing.
• Feed forward gives specific suggestions to the
  student on how they could improve their
  performance.
• To be effective feedback and feed forward needs
  to be
• Early
• Specific
• Written feedback is crucial for
• Sign-off mentors decision at progression points
• Continuity and validity of summative assessment
• Student reflection
• Verbal feedback should be honest and caring
• Service users feedback is important
• Interpersonal skills
• Confidentiality

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The Old and the New

• New Curriculum
• Learning contract
• Mentor details Orientation to practice area
• Mid-placement/interim review
• Practice Skills
• Essential skills clusters
• Examination of the Newborn Skills formative
  summative assessments
• Grading of Practice Tool Feed forward.
• Interprofessional learning
• Management practice assessment
• Sign-off of 3 progression points

• Old Curriculum
• Learning contracts
• Preliminary practice reviews
• Interim practice reviews
• Midwifery practice skills
• Midwifery practice outcomes
• Observed practice assessments
• Fine grading tools
• Interprofessional Learning Opportunities
• Sign-off of 2 progression points.

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Case loading

• It is an NMC requirement that students hold a
  small caseload during their course (NMC 2009).
• Students will carry a caseload of a minimum of 5
  women over the 3 years of the course.
• Students can start to gather their caseload in
  the 3rd trimester of their 1st year.
• Students must gain consent from the woman and the
  woman can withdraw at any time.
• All care given must be fully supervised.

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Empathy for Students

• Make students feel welcome.
• Sensitive to students needs
• Respect student as you would a colleague
• Understand that student has deadlines
• Consider them as your future colleague
• Ensure they feel a valued member of the team
• Encourage students to discuss potential
  improvements to standards of care
• Maintain students confidentiality

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Mentoring is Key to Student Learning

• Professional gatekeeper
• Professional role model
• Positive mentoring is valued by the student
• You may be the most inspirational figure in the
  students career

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References.

• NMC (2008) Standards to Support Learning and
  Assessment in Practice London Nursing and
  Midwifery Council
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• NMC (2009) Standards for Pre-Registration
  Midwifery education London Nursing and Midwifery
  Council