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Developing a work-based degree in Clinical Leadership: the challenges of accessibility and supporting students in the workplace

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Title: Developing a work-based degree in Clinical Leadership: the challenges of accessibility and supporting students in the workplace


1
Developing a work-based degree in Clinical
Leadership the challenges of accessibility and
supporting students in the workplace
Drewe Phillips Associate Head - Care
Sciences Marianne Cowpe Divisional Head - Policy
Leadership and Clinical Governance Faculty of
Health Sport and Science FACE 2009
2
  • Workshop Outcomes
  • Discuss accessibility issues for professionals
    and joint working in design and delivery with
    employers and working in partnership with other
    providers of education.
  • Discuss the challenges of ensuring learner
    support, student attainment and progression.
  • Reflect /Consider implications for other subject
    areas.

3
  • Nursing academic levels in UK
  • Pre 1986
  • Pre 1992
  • Post 1992 (move to Higher Education)
  • UK Further Education and Higher Education System.
  • New University post 1992

4
  • Policy Drivers
  • The drive for highly developed leadership
    qualities amongst clinicians is a long term
    strategy for the NHS and the paper (DOH 2007b)
    sets out a ten year plan, in which health and
    social care staff are empowered to lead change.
  • In 2007 (DOH 2007a) identified key critical
    challenges that focus on ensuring a workforce
    well developed in clinical leadership.

5
  • A further report (DOH 2008) specifies that
    leadership qualities in clinicians must change.
  • In addition to NHS service reformation, there has
    been a drive to modernise career pathways amongst
    nurses (DOH 2006) where leadership is a key
    dimension.
  • The theme of leadership enhancement is evident
    throughout the four UK countries. Scottish
    Executive and NHS Education for Scotland (2007),
    Northern Ireland Government (2004 and 2008),
    Welsh Assembly Government (2005 and 2008).

6
  • On a broader policy platform, the Leitch Review
    (HM Treasury 2006) suggests that for the UK to
    become a world-class leader, it will require the
    attainment of skills, including leadership.
    Leitch advocates that efforts to achieve this
    must be doubled and responsibility shared between
    government, the employer and the individual.

7
  • Increased self awareness and how to effectively
    build teams. To be more analytical of day to day
    practice. Increased political awareness by
    constantly asking why? And how strategies help
    influence frontline staff delivering patient
    care.
  • Improved knowledge and confidence, networking,
    political awareness, wider picture, reflection
    re. Own practice and attitude, team building,
    leadership skills, credibility
  • Considerable wider reading, confidence deadlines 
  • Increased confidence to strive forward in my
    career. Reformed my ambition/career. Able to
    challenge more things, dont accept things so
    easily
  • Learnt who and how to contact in order to effect
    change management.
  • increased motivation to continue with further
    education. Changed my career pathway.
  • Thinking outside the box re awakes confidence
    and interests that I could act on

8
  • After qualifying as a traditional student from
    a nursing school many years ago I had no
    inclination of venturing into the world of
    academia. Doing the odd diploma modules at Uni
    Glam and various management courses for my
    professional development was my limitation or so
    I thought.  However after completing the RCN
    Clinical Leadership Course and shadowing various
    senior managers including the Chief Executive my
    confidence was riding high.
  • So as the opportunity presented to do the BSc
    Leadership course I told myself that at the age
    of 54 it was now or never. I now take great
    pleasure in telling the students when they come
    to the ward that I am also doing a degree and
    despite the fact that I have felt stretched with
    the assignments and presentation, I have really
    enjoyed learning at that level and I am
    definitely more resourceful. I would like to
    thank the lecturers for their support and
    encouragement and for believing in me when I
    didnt.

9
Award Structure
  • BSc Clinical Leadership
  • 3 20 Credit Modules-
  • Leadership and Managing Self
  • Effective Relationships Clinical Leadership
  • Political Awareness in Clinical Leadership
  • BSc (Hons)
  • Using Research Evidence to Improve Quality at
    Work (20 credits)
  • Project Module (40 credits) OR Project Module (60
    credits)

10
  • Background
  • Nursing background - work based leaning /credit
    rated
  • Programme themes informed by qualitative
    research (Cunningham et al 2002)
  • learning to manage self team building,
  • developing managing effective relationships,
  • focusing on the patient (client)
  • internal and external networking
  • political awareness
  • Clinical Leadership Programme - Royal College
    Nursing (RCN CLP multi-disciplinary)
  • Programme model adopts a practical approach i.e.
    Work- based focused i.e. client- focused and
    needs-led transformational leadership and
    life-long learning.
  • Programme facilitated via action learning
    (McGill and Brock bank 2004).
  • Tri Partite RCN/HEI/ NHS Trust

11
Delivery and Assessment
  • Academic Action Learning Sets
  • Action learning is a continuous process of
    learning and reflection, supported by colleagues,
    with the intention of getting things done
    (McGill and Brockbank 2004).
  • Assessment - summative
  • Work based competency
  • Reflective accounts/self analysis tool
  • Presentations
  • Analysis of context of care and development
  • of action plans for improvement
  • Analysis of impact of local or national policy

12
Holistic v Atomised Approaches (Hirsh 2006)
  • Atomised
  • BITE-SIZED MODULES
  • MATCHING MENUS
  • SELF-SERVICE
  • E-LEARNING
  • TECHNICAL OR GENERIC
  • LOOKS SYSTEMATIC
  • JUST-IN-TIME
  • BULK DELIVERY
  • LOW IMPACT?
  • Holistic
  • INTEGRATED PROGRAMMES
  • MENTORING COACHING
  • EXPERIENTIAL LEARNING
  • TEAM LEARNING
  • COMMUNITIES OF PRACTICE
  • SOCIAL CULTURAL
  • TRANSFER INTO JOB
  • HARD TO BULK DELIVER
  • HIGHER IMPACT?

13
  • Challenges
  • Flexible learning -
  • e - learning/Blackboard/action learning.
  • Learner support
  • Clinical facilitators/ mentors/coaching/employer
  • liaison support line manager support (Eraut
  • 2008)
  • Needs of work based learners
  • Professional issues

14
  • Challenges (cont)
  • Quality assurance
  • Recognised Teacher Status
  • Student attainment progression
  • Theory and practice competency assessment
  • Use of reflection - facilitating transformation
    (Kolb 1971, Schon 1983) used extensively
  • Portfolio (formative)

15
  • References
  • Benner, P (1984) From Novice to Expert
    Addison-Wesley Publishing Company, Sydney
  •  
  • Brockbank, A., McGill, I. Beech, N (2003)
    Reflective Learning What is it Exactly?
    Organisations and People. 10 (2) 28-36
  •  
  • Cunningham, G Large, S Kitson, A Allen, E
    Lister, S and Nash, S. (2002) Summary Evaluation
    Report for Phase 2 of the RCN Clinical Leadership
    Programme. London RCN
  •  
  • DOH (2006) Modernising Nursing Careers DOH London
  •  

16
  • DOH (2007a) Shaping health care for the next
    decade The NHS Next Stage Review DOH London
  •  
  • DOH (2007b) Our NHS our future NHS next stage
    review - interim report DOH London.
  • DOH (2008) Our NHS Our Future NHS Next Stage
    Review - Leading Local Change Modernising Nursing
    Careers (2006) DOH London.
  • Dreyfus, S.E. (1982) Formal Models vs Human
    Situational Understanding Inherent Limitations
    on the Modelling of Business Expertise. Office
    Technology and People, 1 p 133-135.
  •  
  • Eraut,M. (2008)The significance of Workplace
    Learning for Individuals, Groups and
    Organisations ESRC Centre on Skills, Knowledge
    and Organisational Performance
  • Govier, I. (2004). Advocating Excellence in
    Leadership. Nursing Management 10(9) 13-15.
  •  
  •  

17
  • HM Treasury (2006) Leitch Review of Skills,
    Prosperity for all in the global economy world
    class skills The Stationary Office Norwich
  • Hirsh, W. (2006) Improving performance through
    Appraisal Dialogues, London Corporate Research
    Forum
  •  
  • McGill, I. and Brockbank, A. (2004). The Action
    Learning Handbook. Routledge Falmer. London.
  • Kolb,D.A.,Rubin, and McIntyre , J. (1971)
    Organizational Psychology An Experiential
    approach, Englewood Cliffs NJ Prentice-Hall
  • Northern Ireland Government (2004) A Healthier
    Future, a twenty year vision for health and
    wellbeing in Northern Ireland 2005 2025
    Department of Health Social Services and Public
    Safety Belfast
  • Northern Ireland Government (2008) Northern
    Ireland Health and Social Care Reform
    Consultation Department of Health Social Services
    and Public Safety Belfast

18
  •  
  • Schon,D. (1983) The Reflective Practitioner How
    Professionals Think in Action, New York Basic
    Books
  • Scottish Executive and NHS Education for Scotland
    (2007) The Modernising Nursing Careers Scottish
    Projects Advanced Practice and Early Clinical
    Career Fellowships NHS Education for Scotland
    Edinburgh
  •  
  • Walsh A (2008) What is distinctive about
    work-based knowledge and learning?. The Higher
    Education Academy workforce development
  • Welsh Assembly Government (2008) Designed to
    Realise our Potential WAG Cardiff
  • Welsh Assembly Government 2005 Designed for Life
    A World Class Health Service for Wales WAG
    Cardiff
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