The nurses role in practice based education: Innovation in academic assessment and the influence on practice development

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The nurses role in practice based education
Innovation in academic assessment and the
influence on practice development

• Joanne Garside
• Dr Barbara Wood

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Aims

• Overview of the implementation of contemporary
  practice based, academic assessments
• Understand choice of assessment methods
• Insight into post registration students opinions
  and impact of a variety of assessment methods on
  their academic development
• Student and their managers view of assessment and
  there influence on practice development

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Your assessment

• Debate the influences that inform a current
  health care
• policy, provision and practice.
• What assessment method would you choose to
  answer the question?

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Academic assessment

• Essay?
• Presentation?
• Exam?
• Simulated exam?
• Why Choose??

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Assessment

• ..the facilitation of collection, review,
  monitoring and ultimately judgement of student
  learning. (Lambert and Lines, 2000)
• A measure of the quality of education received
  and in nurse education signal that the student
  has acquired the necessary skills and knowledge
  for registration and professional practice.
  (Wellard et al, 2007)
• No single assessment can hope to assess a
  students learning or practice development needs
  fully

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Background to the project

• New curriculum
• Innovative approach to assessment
• Module Evaluations
• Over dependence essay/exam
• High volume of assessment
• Cowan (2006) Race et al (2005)
• Suggests choice improves overall standard of
  assessment
• No published evidence found demonstrating
  efficacy of choice
• Learning styles and assessment preference

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Implementation 2007/8

• Pre registration
• 2007/8 - Second year adult branch cohort
  Nursing care of the person with a physiological
  disturbance (2007/08 289 intermediate level
  students )
• CPD modules
• 2007/8 Acute Illness course (62 Honours level
  students)
• 2008/9 Cardiology (24 Masters students)
• The student achieve the learning outcomes of this
• module in negotiation with the module leader. The
• outcome of these negotiations will be documented
  in
• the form of a learning contract.

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Pre Registration

• AP, disease and nursing care
• Part 1 OSCE 50
• Part 2 Exam, Presentation or Essay 50
• Knowledge and Understanding Outcomes
• 1. Distinguish between normal physiology and
  pathological processes
• 2. Describe the relevant, evidence based, nursing
  and therapeutic interventions, required by the
  person with a physiological disturbance in
  medical, surgical, intermediate and primary care
  settings
• 3. Identify how pathological processes affect the
  psychosocial wellbeing of the person, family and
  significant others
• Ability Outcomes
• 4. Make sound judgements about the
  appropriateness of nursing care to a person with
  a given physiological disturbance

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CPD students

• Acute Illness professional cert/BSc route
  Honours level
• Cardiology MSc level
• 4000 word equivalent their choice
• Professional Principles underpinning Acute
  Clinical Practice
• Knowledge and Understanding Outcomes
• 1. Debate the influences that inform current
  health care policy, provision and practice.
• 2. Critically appraise the role of the
  practitioner within integrated service provision
  in the context of multi-agency and disciplinary
  working practices.
• 3. Critically analyse care provision
  demonstrating an awareness of current political
  and moral philosophy, agendas, financial
  implications and constraints and social
  expectations.
• Ability Outcomes
• 4. Critically apply professional principles and
  legal and ethical theories within acute clinical
  practice.

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Methods chosen Pre registration
Sept Groups 2006 cohort 2007 cohort Total Students 172 Jan Groups 2006 cohort 2007 cohort Total Students 117
Essay 86 (93.5) 69 (86.25) 50 (76.9) 35 (67.3)
Exam 2 (2.2) 5 (6.25) 9 (13.6) 13 (25)
Presentation 4 (4.3) 6 (7.5) 6 (9.1) 4 (7.7)
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Negotiated assessment method (N62) 

• 4000 word Essay - 23
• 15 minute Presentation and 2000 word supporting
  essay - 32
• Poster and 2000 word supporting paper - 2
• Teaching Pack 43

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The evaluation

• After module completed/before assessment
  submitted results
• Questionnaire
• Biographical details
• Open ended questions
• Interviews
• CPD students
• Ethical approval
• Consent
• Data Analysis
• Thematic technique

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Overall comments

• I was surprised when I was first made awarebut
  I was relieved and happy that I could choose the
  assessment I felt most comfortable with
• people are comfortable with different types of
  assessment
• It helped us decide which method was appropriate
  to ourselves rather than being told what to do
• It is good that you can choose to be in your
  comfort zone
• it made me think through what each process
  involved and I dont think that any are easier
  than the other it is just what people feel more
  comfortable with.
• I though this was a brilliant idea

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Thoughts

• I thought it was great to have a choice..
• I was very happy that we had a choice because it
  is the
• first course I have done where this was
  possible.
• Mmmm at first it was like oh God what do I do! It
  did
• take a bit of thinking about, .which in itself
  is good, as
• it makes you think why am I here and what do I
  want to
• achieve, well weve never been asked before

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Achievement

• My grades were quite good for assignments
• I thought it was a good idea and would help me
  to be assessed on a personally stronger method of
  assessment.
• It was a good idea as not everyone is good at
  exams or essays. Students can now try to get
  better marks by choosing what is best for them as
  individuals
• Different people shine at different things
  being given a choice rather than feeling forced
  to do either AB or C should produce some good
  results as we have all chosen what we think we
  are good at.
• Gave us an opportunity to chose an area in
  which we perform best. A very good idea.

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Exam/Presentation pressure

• I dont enjoy exams as I get really anxious and
  then my mind goes blank
• Fantastic that I dont have to do an exam
• It was a relief I do not like presentations or
  exams
• Relieved! I do not find presentations beneficial
  to my learning and find I can examine subjects in
  more depth in essay format.
• I am not a confident public speaker therefore
  appreciate the option to express my ideas in
  essay format.

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Recruitment

• If I wasnt given the choice.. that had a
  bearing as to whether I would have done the
  course or not. Thats how much I hate doing
  presentations .. I never got used to it and it
  got to the point of being too stressed, I just
  cant, I look at doing courses and if that is
  the main assessment method, I wouldnt do the
  course.

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Decision making

• I dont like choice I cant make a decision to
  save my life. I want the simplest method so then
  I am notbecause I tie myself up in knots and
  make it more complicated.
• At first I thought I would have liked to have
  been offered a choice but then felt a little
  overwhelmed by having to make a decision, I would
  have preferred it to have been made for me
• Which do I choose?

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CPD practice based

• It was nice to be given the opportunity to
  choose an assessment method as an adult learner.
  I felt it made the course more applicable to my
  practice and I believe I have achieved something
  useful that will not just be filed in a drawer.

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• I thought this was a fantastic opportunity to
  relate my
• coursework to my current practice area and to
  share the
• knowledge I acquired with my colleagues
• I enjoyed having that choice and its good to have
  to do
• something different like the teaching and
  learning pack
• rather than having to do a 4000 word assignment.

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• I am glad that the ward got something out of it,
  like when I
• did the poster and that got taken back to the
  wardI
• thought that was really useful
• The actual presentation that I did is actually
  going to be
• used.thats quite useful and off the back of it
  weve got
• an unit study day where we have got about 5
  presentations
• being delivered in a day for our newly qualified
  staff so its
• come up trumps really

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• I did a teaching package on carotid
  endarterectomy patients because those were the
  ones who were extending their stay, traditionally
  we had them for half an hour and then they were
  back to the ward so then we were like oh what do
  we do after half an hour, so that was really good
  now most of the recovery staff are doing what we
  should be doing with these people so we are
  improving care which is fab.

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Summary/Discussion

• Well received
• Avoidance of high stress assessment methods
• Comfort zones
• Learning disabilities
• Professional role

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References Acknowledgements

• Cowan J. (2006) On becoming an innovative
  university teacher reflection in action Open
  University Press, Maidenhead.
• Garside J., Nhemachena JZZ., Williams J. and
  Topping A. (2009) Repositioning assessment
  Giving students the choice of assessment
  methods. Nurse Education in Practice 9, 141-148
• Lambert D. and Lines D. (2000). Understanding
  assessment. London Routledge-Falmer
• Race P., Brown S., Smith B. (2005) 500 Tips on
  Assessment 2nd Ed Routledge Falmer, London.
• Welland S.J. Bethune E. and Heggen K. (2007)
  Assessment of learning in contemporary nurse
  education Do we need standardised examination
  for nurse registration. Nurse Education Today
  27 68-72.
• Thanks to
• Julie Williams
• Dr Jean Nhemachena
• Dr Janet Hargreaves
• Dr Annie Topping

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Any Questions?

• Thank you for listening!