Maintaining Homeostasis in the Perioperative Patient

SCHOOL OF HEALTH

BSc in Operating Department Practice Clinical Assessment Document

Year Two

Trimester Trimester 1

Module Name Principles of Post Anaesthetic Care (M2B721429)

Student’s name...... …………......

Matriculation number………………………………

Mentor...... ………......

Placement...... ………......

Module leader ……Agnes Lafferty……………….

Group...... YEAR …………………..

Placement commencement date ………………….

Assessment Submission Date...... ………......

1 Table of Contents

TABLE OF CONTENTS...... 2

INFORMATION FOR MENTORS...... 3

STRATEGY FOR ASSESSING PRACTICE...... 3

SUPERVISION OF PRACTICE AND FACILITATION OF LEARNING...... 3

PRELIMINARY INTERVIEW...... 4

PROVIDING APPROPRIATE LEARNING EXPERIENCES...... 4

INTERIM PERFORMANCE REPORT DISCUSSIONS...... 4

FINAL WRITTEN REPORT...... 4

THE PROCESS OF ASSESSMENT...... 5

ORIENTATION PROGRAMME...... 5

CRITERIA FOR THE ASSESSMENT OF ASPECTS OF PERFORMANCE...... 6

LEARNING OUTCOMES...... 7

INTERIM PERFORMANCE REPORTS...... 9

FINAL WRITTEN REPORT...... 10

2 Information for Mentors

Strategy for Assessing Practice

Assessing a student may involve indirect methods such as reflective diaries or critical incident analysis. Arguably the most valuable indicator of ability comes from the direct observation of practice by you, the mentor. This assessment tool is designed to help you do this. Because you cannot (and would not want to) assess every minute of the student’s placement, your judgement is based on a sample of the student’s total performance. Learning outcomes have been identified and should be assessed independently at progressively higher levels as the student progresses in the course. Criteria by which you should judge how well a student performs are specified in the table on page 6. Please ensure that you have a working knowledge of these criteria to use when planning learning experiences and giving feedback to students.

Prior to making a ‘performance’ assessment, the learning outcomes should be assessed. Indicate whether they have been achieved or not by initialling the appropriate box.

It should be noted that failure to demonstrate an acceptable standard of professional conduct will normally result in a failed assessment and possibly the student’s subsequent removal from the programme, in accordance with programme regulations. You should be confident that maintaining professional standards is a crucial part of the mentor’s role, and that the academic advisor will advise and support you in these decisions. Further information is provided on page 6.

Supervision of Practice and Facilitation of Learning

This document has been developed in compliance with Quality Assurance Agency and NHS Education for Scotland national standards for placement learning. The details below outline how you can support the student in accordance with these standards.

The student must be assigned to a mentor prior to the placement and be welcomed and orientated at the beginning of the placement experience. A learning contract should be negotiated within the first 48 hours of the placement. If no mentor is available or the mentor becomes unavailable and cannot be replaced by a suitable co-mentor, then the module leader must be informed. As a mentor you should be in a position to facilitate the student’s learning and provide supervision and support on a regular basis, amounting to at

3 least 50% of total practice time. If you share the role with others, collaboration in completing learning contracts and assessment documentation is expected. On the first day of the placement the student must be orientated to the area and be provided with the necessary information relating to emergency procedures and Health & Safety policies. You should advise the student of the location of applicable policy and procedure manuals and allow time for these to be studied. Please confirm that this has been done on page 5.

Preliminary Interview

Preferably you (or someone acting on your behalf) should meet with the student within two days of commencing the placement. This discussion ought to establish the following:  The student’s previous practice achievements in order to identify current learning needs.  The performance level and competencies that need to be achieved during this placement.  The available learning opportunities.  An initial action plan.

Providing Appropriate Learning Experiences

It is anticipated that placements selected for students should provide sufficiently varied experiences to enable the student to achieve the outcomes or competencies, and to develop their performance. However, situations have been known to change at short notice. Should you anticipate any difficulty, you must inform the university to negotiate a satisfactory resolution to the problem. Writing ‘N/A’ against any of the student’s learning outcomes or competencies means that the student has been disadvantaged through not achieving essential learning at the appropriate time.

Interim Performance Report Discussions

You should hold these at least every second week, to discuss the student’s progress. From these sessions, the initial action plan should be updated. Comments on performance should be recorded on the interim performance report sheet then signed and dated by you and the student. This is especially important if you anticipate the possibility of the student not achieving the required level of performance, or become concerned about the student’s professional behaviour, in which case the university must be informed at once.

Final Written Report

This must normally be completed during the last few days of the placement. In anticipation of this, you should review the student’s progress, identifying evidence upon which you can make a professional judgement. This should involve discussion with other appropriately qualified staff who have supported the

4 student in your absence. Analyse the criteria in the table on page 6. In the event of the student not achieving the competencies or learning outcomes, or demonstrating an unsatisfactory level of performance, you must forewarn a member of university academic staff. This allows a lecturer to be present when the assessment is discussed with the student.

The Process of Assessment

It is important to understand that there are two elements to this assessment. The student’s ability to carry out specific activities, as well as their overall performance must be assessed. That is,  each of the specified learning outcomes need to be achieved & the appropriate box signed/initialled.  the student’s performance needs to satisfy the criteria in the table on Page 6. Criteria are in relation to professional standard and quality of performance. The level of support you require to give the student is another useful indicator of their level of performance.

The consequence is that it may in fact be possible for a student to achieve every learning outcome, assessed in isolation, but if in day-to-day activities the student’s efficiency and effectiveness and amount of assistance required are such that their performance has not reached the appropriate level for the placement, the student has failed the assessment.

The methods you use to assess the student will vary from situation to situation. Direct observation, reports from colleagues, reflection on practice and analysis of written work should, taken together, indicate a level of performance and the achievement of competencies. Probing underpinning theory and decision making processes, perhaps through posing hypothetical questions relating to clinical situations should reveal breadth and depth of knowledge and understanding. This may supplement other, more direct methods of assessment, especially as the student should be developing initiative and require less ‘direct supervision’ as the programme progresses.

There is opportunity to comment on the student’s professional standard, quality of performance, level of support and evidence in support of your judgement in the ‘Final Written Report’ (page 10).

Orientation Programme Please indicate that you have advised the student of:  Location of Policy and Procedure Manuals  Layout of Area  Emergency Procedures  Health & Safety Policies

Signed Mentor…………………………………….. Student ……………………… Date…….

5 Criteria for the Assessment of Aspects of Performance PERFORMANCE TO BE PROFESSIONAL STANDARD* QUALITY OF PERFORMANCE* LEVEL OF SUPPORT* LEVEL ACHIEVED BY Year 1 The student cannot safely perform clinical activities The student begins to build a fragile The mentor acting as motivator, explains Trimester 1 alone. Initial involvement with a new experience is confidence. Co-ordination and efficiency, the relevance of the experience, by looking and listening before participation. He or lacking initially, begin to improve. revealing what needs to be learned. 1 she demonstrates awareness of their own limitations The student begins to learn to respond Through frequent verbal support and and seeks help and advice. Positive attitudes towards appropriately to individual patients. demonstration, activities are explained. caring for people, and learning, are demonstrated. Year 1 The student is sufficiently self-motivated to explore The student’s performance is efficient in The mentor acts as a catalyst, engaging Trimester 2 & issues and practise in a number of activities in a safe part, but requires a prolonged timescale the student with experiences in a Trimester 3 and caring manner. Attention to detail is more and excessive effort. He or she does not controlled manner, explaining, 2 evident in performance. yet fully consider the needs of the whole demonstrating and encouraging safe patient. participation. Year 2 The student is safe and accurate in a growing The major goals of the student’s practised Through monitoring activities and giving Trimester 1 number of activities. His or her performance is activities can normally be achieved. He or feedback, the mentor moderates the typified by critical and systematic practice in the she frequently notices patients’ actions student’s perception of their 3 development of an understanding of guiding and responses, and attends to these performance. principles, and inherent values. Students begin to appropriately. Performance is becoming Explanations may be required, but the identify emotionally and intellectually with their efficient, co-ordinated, confident, and emphasis shifts from demonstrating and experiences in caring for others. completed within a reasonable time. giving direction, to giving the student support in the performance of activities. Year 2 The student consistently demonstrates safe, accurate The student can effectively meet the The student predominantly needs Trimester 2 and co-ordinated practice within assigned activities, majority of patients’ needs, and develops supportive cues and feedback, with little contributing to patient care. Caring attitudes and efficiency in rehearsed activities. He or direction. Under supervision, she or he empathy are characteristic of performance. She or he she demonstrates awareness of patients’ can be held increasingly accountable for 4 can support actions by reasoned discussion and can changing needs, and confidence in the delivery of interventions that have justify decisions, but this may be limited in depth providing appropriate interventions as previously been practised. and specific to context. situations unfold Year 2 The student can provide a sound rationale for peri- The student is aware of the effect of The student can act independently within Trimester 3 operative care, and effectively communicates interventions on the patient and adjusts supervised environments, and (Entry to Register) information and concepts. care to produce positive outcomes as opportunities should be provided to He or she is able to evaluate the contribution that situations unfold. The delivery of peri- extend the student’s abilities. Critical 5 peri-operative care makes within a wider context. operative care is informed, efficient, appraisal, debate, and challenge are now effective, integrated and confident. required in order that the student consolidates this level of performance. At the point of entry to the register, the student demonstrates competence, ie, “the skills and ability to practise safely and effectively without the need for direct supervision” † *Based on Bondy (1983), Steinaker and Bell (1979). † Definition of Competence, Peach (1999)

6 Principles of Post Anaesthetic Care

Each of the following learning outcomes must be achieved

Achieved? Please sign/initial relevant box Yes No  Demonstrate the ability to establish and maintain a safe environment for the reception and treatment of postoperative patients and, where appropriate, their carers in the post anaesthesia care unit.  Demonstrate the ability to apply the knowledge and skills of a post anaesthesia practitioner to the planning, implementation and evaluation of care to patients recovering from elective surgery and anaesthesia and apply pertinent national and local policies.  Demonstrate a broad knowledge of the anatomy, physiology and pathophysiology of the endocrine system and the associated surgical procedures, with particular reference to caring for the diabetic patient.  Demonstrate skills and knowledge in the recognition, assessment and treatment of patients suffering from commonly occurring post operative complications and conditions.  Demonstrate the ability to administer and monitor the effects of drugs.  Identify, analyse and reflect upon the cultural, ethical, moral and practical issues that affect communication with patients in the immediate postoperative period.  Understand and apply to practice the legal and professional issues surrounding inter-professional communication, discharge criteria and the documentation of care.

Student: Evidence in support of your achievement

Student’s signature…………………………… Date…………

7 Mentor: What level of performance (page 6) has the student reached?

NOT YET PERFORMANCE PERFORMANCE PERFORMANCE PERFORMANCE PERFORMANCE LEVEL 1 LEVEL LEVEL LEVEL LEVEL LEVEL 1 2 3 4 5

Please sign in the appropriate box. You may qualify your judgement on page 11.

Mentor’s Signature...... Date......

8 INTERIM PERFORMANCE REPORTS

Comments on performance and outcomes of interim interviews should be recorded and signed by both mentor and student. The frequency of meetings should be at least every two weeks. You may attach additional sheets to this document if necessary.

Date Comments Signatures

9 FINAL WRITTEN REPORT Please comment on achievement relative to expectations outlined on table, page 6, under each area below

Professional Standard

Quality of Performance

Level of Support

10 Student’s Strengths and Areas for Improvement

Mentor’s Comments in Support of Judgement

Student’s Comments in Relation to Level of Performance

Mentor’s Signature...... Date......

Student’s Signature...... Date......