Innovation
Grading of professional practice experience
What prompted innovation?
In nursing the grading of practice placement performance has been traditionally on a pass/fail basis linked to the achievement of competencies prescribed by the professional body (NMC). This system could be viewed as undervaluing the practice element of the programme when 50% of the programme hours relate to practice activity. Further under this system it is possible for highly academically able students who ‘scrape by’ in practice, to nonetheless exit the programme with a first class honours degree. Similarly students that excel in practice, under the pass/fail system, would not have their achievements reflected in the overall marks for the programme. Therefore in reviewing the curriculum in 2005, a practice assessment tool (PAT) was developed that graded practice performance against the NMC competencies. Following evaluation the system has undergone several reviews since it was introduced.
What makes innovation different?
This was innovative because many practice assessment tools that claim to grade practice, actually grade reflections on practice, and as are essentially an assessment of academic writing about practice. The longitudinal evaluation of the introduction of the innovation throughout the 3 years of the programme from the perspective of students, mentors and academics, adds validity to claims of impact of the approach.
Changes in practice
The biggest change was cultural; prior to the grading of practice, assumptions were made in the university and practice that mentors would not want to grade practice and indeed were ill-prepared to do so. The evaluation and subsequent feedback on an annual basis does not support this. The effect of this has been a movement (although there is a way to go) to seeing the programme as a joint enterprise – ‘our programme’ (University/practice).
Both students and mentors have started to develop skills in justifying grades (each competency). This is not without tensions but draws on skills required for accountability and so is no bad thing.
The role of academics have also changed from being markers of reflections to more of a quality assurance role, reviewing individual students PATs but also in the moderation process where PATs are reviewed across the cohort. This latter process increases reliability of the tool and feedbacks into the mentor update programme content.
Impact
The initial system was recognised as innovative by the NMC/Mott McDonald periodic review but now is embedded.
The system has been taken up by neighbouring universities who wishes to introduce grading into their new programmes (eg University of Plymouth).
The process has been refined, notably the marking bands as a result of student and mentor feedback, indicating a good working dialogue with all partners. A new version is being introduced with the new curriculum commencing in Sept 13.
Dissemination
- HEASLIP, V., SCAMMELL, J.M.E., (2012) Failing underperforming students: The role of grading in practice assessment, Nurse Education in Practice, 12, 95-100.
- WILSON, K AND SCAMMELL, J. (2011). Chapter 6: Opportunities and Challenges of Grading Performance in Practice. In: Helme, M. and Reid, C. Assessment in Health Care Programmes: Occasional Paper. London: Higher Education Academy, Health Science and Practice Network.
- Scammell, J, Heaslip, V., Phillips, J. & Cooper, K. 2009. Assessment of practice in pre-registration undergraduate nursing programmes: Phase 2 survey. Bournemouth: Bournemouth University.
- Scammell, J, Halliwell, D & Partlow, C 2007. Assessment of practice in pre-registration undergraduate nursing programmes: An evaluation tool to grade student performance in practice. Bournemouth: Bournemouth University. ISBN: 978-1-85899-243-3