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Quality Assurance of Clinical Placement Learning

Quality Assurance of Clinical Placement Learning (Health-Relationd Programmes)

THE QUALITY ASSURANCE OF CLINICAL PLACEMENT LEARNING

1.         INTRODUCTION

 "Placement Learning is a planned period of learning, normally outside the institution at which the student is enrolled, where the learning outcomes are an intended part of the programme of study.  It includes those circumstances where students have arranged their own learning opportunity with a placement provider, with the approval of the institution".  [QAA Code of Practice — Placement Learning]

The majority of University of Wales College of Medicine taught provision at degree and sub-degree level and a number of taught higher degree schemes include a substantial element of clinical placement learning.

2.         GENERAL REQUIREMENTS

Schools/departments are required to consider the role of clinical placement learning in the design of new schemes of study and in the Annual Scheme Monitoring and Periodic Review of Schemes processes.

It is a requirement for all schemes of study that, as a minimum, the following information be made available to students in Student Handbooks or similar documentation:

  • the aims and learning outcomes of clinical placements;
  • the contribution of clinical placements to the achievement of the overall aims and learning outcomes for the scheme;
  • the contribution of the assessment of clinical placement learning to the overall assessment of the scheme;
  • the strategy adopted for the assessment of learning outcomes provided for clinical placements.

The role of clinical placement learning should also be articulated in programme specifications for all taught schemes of study.  Scheme documentation should describe, where appropriate, how requirements of the Professional and Statutory Bodies for the granting of license to practice and the relevant Subject Benchmarking Statements are embedded in scheme design.  Such documentation must be made available to students and also to all teaching staff, including clinical teaching staff (or fieldwork educators as appropriate) in hospital and community settings.

Students are required to complete their clinical placements in order to progress through their scheme of study as laid down in scheme regulations.

UWCM is responsible for ensuring that each clinical placement is fit for purpose.  The criteria for the selection of a clinical placement provider shall be the:

  • appropriateness of the experience offered in meeting the prescribed aims and learning outcomes for the clinical placement;
  • qualifications and general opinion of the ability of clinical teaching staff to deliver the teaching required to enable students to meet the learning outcomes of the placement;
  • training and development opportunities available for clinical teaching staff;
  • facilities available to support student learning and the provision of sufficient resources which may include, for example, the availability of library and information technology support and whether it meets the minimum requirements prescribed by UWCM and where available, residential accommodation;
  • arrangements for the pastoral support of students including those with physical or learning disabilities;
  • whether the arrangements for the health and safety of students satisfy the legal requirement that the student’s work environment would be as safe as it would be were that student studying on campus;
  • any other issues that may be a requirement of the appropriate Professional and Statutory Body.

The Dean of School is ultimately responsible for ensuring the appropriateness of a clinical placement provider.  In respect of clinical placements involving student attachments of at least 2 weeks in duration, prior to the approval of a clinical placement provider, the Dean or Head of Department shall be responsible for ensuring that a staff visit to the potential clinical placement provider is undertaken.  The purpose of the visit is to provide an educational audit to assess the ability of the clinical placement provider to meet the criteria for approval of the placement. 

A written report should be provided of the educational audit visit to each potential clinical placement provider.  The clinical placement provider should be informed of any issues to be addressed prior to the commencement of the placement and a written record should be kept of the responses of the clinical placement provider to any concerns raised.

Once a clinical placement provider has been approved schools/departments are responsible for ensuring that the continued suitability of the placement is subject to regular review to ensure that it continues to meet the selection criteria.  Students may be withdrawn from the placement provider if the clinical placement arrangements become unsatisfactory.

In cases whereby a UWCM school collaborates with another Higher Education Institution in the provision of a placement opportunity the placement must meet all of the UWCM criteria for its approval as a placement setting.

It is recommended that wherever possible formal agreements should be signed by UWCM and the clinical placement provider in order to define the responsibilities of each party to the agreement.

4.         THE MANAGEMENT OF CLINICAL PLACEMENT ACTIVITY

Consideration will, in due course, be afforded to exploring the potential for the Student Information System (SIS) to manage, on a School and College wide basis, clinical placement activity in all its aspects. The management of this activity through the SIS will be undertaken in conjunction with Schools/Departments and where appropriate the UWCM/NHS Liaison Unit.  The SIS will maintain and report on:

  • Criteria for the selection and review of clinical placements to ensure that they are fit for purpose
  • Details on the roles and responsibilities of named contacts or link tutors for all placements to ensure that the placement provider and students on placement are matched appropriately.

Rules will be built in the SIS to ensure that students are provided with sufficient placement opportunities to achieve the learning outcomes of the scheme in accordance with the allocation scheme devised by the School/Department.  The SIS will support the monitoring and evaluation of clinical placements by reporting on information required for analysis in the Annual Scheme Monitoring and Periodic Review processes and other review mechanisms.  It will also match student records with evaluation forms to facilitate the on-line completion of student feedback on placements.

 

Most students will be placed within the NHS and for these placements it should only be necessary for schools/departments to ensure that the Trust Hospital is complying with current Welsh Risk Management Standards, which by implication would demonstrate broadly that the Trust is complying with existing health and safety legislation.

For students taking up placements outside the NHS such as in Nursing, Residential Homes and Local Authorities, Schools/Departments should develop specific health and safety related guidance in this regard as appropriate to the nature of the delivery of their schemes of study.

 (Further guidance in this area should be sought in the UWCM Policy on Safety Requirements for Placement of Students with Employers).

Placement Providers are responsible for informing students who is responsible for ensuring their safety during the placement.

In addition to health and safety requirements students should receive initial manual handling training prior to the commencement of their initial clinical placement and this should be updated during their scheme.  All students will receive a health-screening programme which will include establishing immunity against Hepatitis B followed with a subsequent immunisation programme.  It will also include recommendations and procedures regarding meningitis vaccination in accordance with current national guidelines.  Schools/Departments may also wish to consider providing students with CVR and aggression training prior to their undertaking their initial clinical placement.

6.         SECURING PLACEMENTS FOR STUDENTS

Schools/departments are responsible for ensuring that students are provided with sufficient placement opportunities to achieve the learning outcomes of the scheme of study in accordance with an allocation scheme devised by the school/department.  This responsibility extends to those instances where students may be responsible for organising one or more of their own clinical placements such as elective placements.

In the allocation of clinical placement locations schools/departments should, where possible, be sensitive to student’s access to transport, family commitments and any health related problems.  Students with particular difficulties in this regard are requested to contact their school office.

Schools/departments should, in accordance with the UWCM Welsh Language Policy, make every effort to place Welsh speaking students who wish to communicate through the medium of Welsh in clinical settings where there will be a high exposure to Welsh speaking staff and patients.

Schools/departments should continue to work with placement providers to ensure that the identified needs of students with disabilities are met and that students with disabilities are not the subject of any form of discrimination.

Schools/departments are responsible for ensuring that in the unlikely event of a student being unable to secure a clinical placement that contributes towards the final award an opportunity would be provided for the student to be able to undertake the placement at an appropriate time during the scheme.  Similar provision shall be made in respect of any student who is unable to complete a clinical placement through reasons beyond their control.  In the event of the clinical placement in question being the final placement during the scheme of study, a student shall not be admitted to their degree until the placement is successfully completed.

Schools/departments should submit to the clinical placement provider in advance of the commencement of the placement the names of the students who will be attending the placement.

7.         RESPONSIBILITIES OF SCHOOLS

Schools/departments are responsible for providing through a named contact or link tutor at each clinical placement setting with the following information:

  • scheme documentation containing the aims and learning outcomes of the clinical placement;
  • the strategy adopted for the assessment of the learning outcomes prescribed for that clinical placement and the role of clinical teaching staff at the placement setting in the assessment process;
  • pastoral support for students;
  • health and safety issues.

It is also recommended that, wherever possible, schools/departments should submit to clinical placement providers background information on the skills and capabilities of the student cohort who will be pursuing the clinical placement.

At each clinical placement setting there should be a named Contact/Link Tutor/Honorary Senior Lecturer who shall, as a minimum, be responsible for:

  • ensuring the distribution of all relevant scheme and other documentation to all clinical teaching staff;
  • liaison with the UWCM school/department concerned;
  • co-ordinating pastoral arrangements for students during the placement;
  • other duties as agreed with the school/department concerned.

Schools/departments are responsible for informing students of the name and contact details of the Co-ordinator/Link Tutor/Honorary Senior Lecturer prior to the commencement of the clinical placement.

Schools/departments are required to provide students with Professional Awareness Training at an early stage in the scheme of study and prior to the first clinical placement.   These sessions should provide students with an account of their responsibilities as representatives of UWCM and their responsibilities towards staff and patients at hospital and community settings.   Students should be provided with guidelines on ethics and professional conduct and any local protocols of, for example, a particular NHS Trust.

Students should be informed of the name and contact details of the member of staff within the UWCM school/department to report any issues that may effect the satisfactory completion of the placement.

Schools/departments should develop mechanisms to ensure that there is an opportunity for placement providers to receive feedback from students on the quality of the clinical placement learning.  Opportunities should also be provided for dialogue between the school/department and placement providers with a view to enhancing the student learning experience at the clinical placement setting and promulgating good practice.

8.         RESPONSIBILITIES OF STUDENTS

Students must not allow their views about a patient’s lifestyle, culture, race, colour, gender, sexuality, age, social status, or perceived economic worth to prejudice their approach or attitude towards any member of the public.  Students cannot refuse to undertake a clinical placement based on these grounds provided their safety is not compromised.

All students will have to have received a satisfactory criminal record check prior to admission to UWCM and also complete the UWCM Criminal Record Disclaimer form and the Criminal Records Bureau Disclosure process (at the enhanced level).

Students are required to observe any local guidance on conduct including standards of dress and hygiene on clinical placement.

9.         STUDENT SUPPORT AND INFORMATION

Students should in all cases be provided (usually in the form of a handbook or other curriculum documentation) with the following information:

  • the aims and learning outcomes of the clinical placement together with the strategy for assessing the achievement of the learning outcomes;
  • a list of contacts at the clinical placement setting and the name of the placement Co-ordinator/Link Tutor/Honorary Senior Lecturer;
  • a School/Departmental contact at UWCM in the event of problems being experienced during the clinical placement;
  • accommodation information where available;
  • uniform requirement (where applicable);
  • travel directions to the placement location;
  • procedures for the student evaluation of the placement.

Information relating to accommodation, uniform and travel directions may in certain instances be provided directly to students by the clinical placement provider.

Consideration will be afforded in due course to exploring the potential of the SIS to extract student data to provide schools/departments with the names of students from other UWCM schemes of study who are pursuing a clinical placement at the same setting and at the same time in order that this information may be passed to students.

Clinical placement providers should provide students with an induction to the placement setting (preferably in conjunction with the clinical placement organiser within the UWCM School/Department).  The induction should normally be provided by the placement Co-ordinator/Link Tutor/Honorary Senior Lecturer and include, inter alia, a consideration of the following:

  • health and safety issues;
  • professional standards;
  • the availability of staff and support for students;
  • the availability and quality of library and other support facilities;
  • accommodation arrangements;
  • catering arrangements;
  • transport arrangements;
  • other local arrangements.

In cases where students seek to secure an elective placement, it is the responsibility of schools/departments to formally endorse or otherwise the students choice of elective placement.  This should occur upon their submission of evidence to confirm their offer of a placement.  It is the responsibility of students to ensure that they arrange any necessary personal insurance cover for their placement.

During the course of their clinical placements students retain their rights of access to all support services based at UWCM.  Students should be provided with the telephone numbers and e-mail addresses of key contacts at UWCM whilst they are on placement.

10. CLINICAL ASSESSMENT

It is the responsibility of Schools to ensure that all clinical teaching staff (UWCM, NHS and other non-UWCM staff) involved with the assessment of students receive an appropriate level of training in their assessment role.  The training needs of staff should be subject to regular review to ensure that they keep pace with the development of curricula and assessment methods and a database should be held in each school of the names of all clinical assessment staff together with the date that they last received training in the assessment of students.  Schools should ensure that such training includes an account of the assessment of students with disabilities.  Schools should maintain a record of such training activity.

For new clinical staff involved with the assessment of students schools/departments should devise a preparation programme to ensure that all such staff are competent to assess students prior to their undertaking an assessment role.

Schools/departments should develop mechanisms to ensure that the assessment of students’ clinical skills and competencies is valid and reliable.

The criteria for the assessment of student’s clinical skills should be clearly identifiable.  This information should be made available to students and the external examiner(s).

11.       STAFF TRAINING AND DEVELOPMENT

Schools/departments should ensure that the training and development needs of staff involved in the organisation of clinical placements is afforded a high degree of priority.

However, the majority of clinical teaching is undertaken by NHS and other non-UWCM teaching staff employed and based in hospital and community settings throughout Wales and beyond.  In order to ensure that the quality of the student learning experience is as high as possible in all disciplines consideration should be afforded by schools/departments to the following:

·        extending the use of the Honorary Contract system in order that NHS and other non-UWCM teaching staff awarded honorary titles at UWCM have satisfied the relevant Board of Studies of their commitment to learning and teaching and are provided with an agreed set of academic responsibilities;

  • establishing fora for regular meetings between UWCM teaching staff and NHS and other non-UWCM teaching staff in order to update them on the latest developments in the curriculum, assessment, support for students and other learning and teaching issues;
  • providing high quality documentation to support NHS and other non-UWCM teaching staff in their teaching role;
  • encouraging NHS and other non-UWCM teaching staff to attend the UWCM Even More Effective Teaching course;
  • including NHS and other non-UWCM teaching staff representatives on the School Committee Structure;
  • inviting NHS and other non-UWCM teaching staff to attend meetings of the UWCM Learning and Teaching Support Forum and access the Learning and Teaching Support pages on the UWCM web site;
  • encouraging NHS and other non-UWCM teaching staff to apply for the appropriate level of membership of the Institute for Learning and Teaching.

Additionally all NHS and other non-UWCM teaching staff shall be provided with a UWCM induction pack containing, inter alia, the following information:

  • general information on UWCM;
  • the organisational structure of UWCM;
  • a summary of the UWCM Strategic Plan;
  • a summary of the UWCM Strategy for Learning and Teaching;
  • a summary of the UWCM procedures for Assuring Academic Quality and Standards;
  • UWCM Fitness to Practice procedures.

Particular consideration should be afforded to the on-going training and development needs of Placement Co-ordinators/Honorary Senior Lecturers/Link Tutors.  Furthermore the teaching role of NHS staff should be considered as part of the NHS and other non-UWCM teaching staff or other organisations appraisal system.

12.       MONITORING AND EVALUATION

The Quality of Placement Learning shall be monitored internally by means of:

  • The Annual Scheme Monitoring process for all taught schemes of study.
  • The Periodic Review of Schemes.
  • The Student Evaluation of each placement.
  • Student/Staff Panels.
  • Feedback received from the Placement Provider.

The format of the Student Evaluation Questionnaires will vary according to the requirements of the scheme;  however, in general, all questionnaires should seek information from students in respect of:

  • the welcome received at the commencement of the placement;
  • the quality of teaching received on placement;
  • the range of clinical experience gained;
  • the opportunities provided to communicate with staff, patients and other service users;
  • whether the placement was successful in delivering its stated aims;
  • the feedback provided from staff;
  • the support received from teaching staff at the placement setting;
  • availability and access to library, IT and other support services.

Student evaluation questionnaires should normally be completed anonymously by students.

Wherever possible questionnaires should be designed to incorporate a number of specific questions whilst allowing students to provide some free text comments at the end of the form.

Schools are required to ensure that they have a mechanism to evaluate whether the needs of students with disabilities have been met by the placement provider.

The Quality of Placement Learning shall be monitored externally by means of:

  • Comments contained in reports submitted by External Examiners*.
  • Accreditation, Review and Revalidation visits conducted by Professional and Statutory Bodies.
  • QAA Subject Review visits.

*The UWCM External Examiner System also permits External Examiners to have access to information concerning the performance of students on clinical placement and (subject to the approval of the Examining Board) participate in the assessment of students at clinical placement locations where this is an integral element of the assessment process.

 

Adrian Novis

Senior Assistant Registrar

Registry