applying the evidence: portfolio assessment in midwifery margaret fisher senior lecturer in...
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APPLYING THE EVIDENCE:PORTFOLIO ASSESSMENT IN
MIDWIFERY
Margaret FisherSenior Lecturer in Midwifery/ Ceppl Activity Lead,
University of Plymouth
Alison StoneMidwife, Torbay Hospital/ Ceppl Team member
www.placementlearning.org
Email: [email protected]
9th Annual Interdisciplinary Research Conference, Dublin, 7/11/08
Background: Triggers for change
• Ceppl research: “Assessment of Practice”
• Literature evidence
• Anecdotal feedback
• Professional body requirements
• Re-validation of Midwifery curriculum
Evidence from the literature
•Assessment of practice is crucial in determining whether or not a student meets the criteria required of their profession, thus ensuring safety of the public
UKCC 1999, Watkins 2000, Cowburn et al 2000
•Defining competence has long been a challenge Cowan et al 2005
•Efforts to ‘measure’ competence and professional abilities have resulted in a wide variety of methods of assessment
Baume and Yorke 2002, McMullan et al 2003
•The student may also be required to fulfil set criteria or outcomes and practice may be graded Caraccio and Englander 2004, Slater and Boulet
2001
•Unless outcomes are clear, the result may be that the student focuses too heavily on completing the portfolio [or other tool] rather than learning from the experience itself
Scholes et al 2004
•Reflections on practice may form part of portfolio assessments, and this process may also contribute to the student’s learning
Mountford and Rogers 1996
Ceppl project: Assessment of Practice
• Longitudinal case studies
• Staff focus groups
• Literature search
• Trawl of websites
• Conference networking
Aim
To establish an evidence-based set of key principles and
resources to guide
Assessment of Practice,
relevant across professional boundaries.
Research Questions
1. What are perceptions of validity and reliability of the practice assessment methods used?
2. What are perceptions of the impact of the practice assessment process on the student learning experience?
Methodology
• 14 participants from Midwifery, Social Work and Emergency Care programmes (nurses and paramedics)
• Semi-structured interviews at the end of each year
• Longitudinal case study approach• Single-case and cross-case analysis
and synthesis of findings – “Framework technique”
Ritchie and Spencer 1984
Methods used
1. Portfolios *
2. Reflections
3. Tripartites/ 3-way meetings *
4. Criterion referenced assessments *
5. Conversations
6. Observations
7. OSCEs
Portfolios
Provide focusEvidence of
capability/ achievement
Encourage student as see their progress
Self-directedMotivate learning
×Prescriptive/ restrictive (“tick boxes”)×Weighting of marks
unbalanced/ difficult to assess×Potential to “cheat
the system”×Bulk (paper format)×Heavy workload
Tripartites/ 3-way meetings Useful checkpoint Opportunity to reflect
on progress and learning
Opportunity to get feedback from mentor and tutor
Enable clarification of issues
Student-centred Reliable if student and
mentor have worked closely together
× Difficult to arrange× May be challenging to
express conflicting opinions
× Likened to a “parent’s evening”
× Some students though mentor and tutor should also have private discussion
Criterion referenced assessment
Focused learning
Best if continuous assessment
Mostly valid, reliable and achievable
× Criteria not always relevant to placement
× Some criteria ambiguous/ overly complex/ unclear
× Dependent on professional judgement and experience of mentor
Key themes
People
GUIDANCE
Consistency
Becoming a
professional Doing the job
PURPOSE
PROCESS
Timing Clarity Placements
Paperwork
Application to Midwifery: A new curriculumIncorporating new NMC requirements:
• All graduate• Grading of practice• Sign-off mentor throughout programme• Ongoing Achievement Record• Case-loading and focus on normality• Essential Skills Clusters (ESC’s) for
Midwifery – theory and practice
And a new Portfolio
Portfolio work-party
Decision to develop part-paper (summative)
and part-electronic (formative/ evidence learning)
portfolio
Key changes to the portfolio• Ongoing Achievement Record (OAR) –
paper component
• Electronic portfolio
• Assessment tool: MAP (Mentor Assessment of Proficiencies) based on Essential Skills Clusters and Midwifery Proficiencies and graded annually during tripartite meeting
• Entire portfolio summative at end of programme – pass/ fail
Ongoing Achievement Record(paper component)
Comprises all documents needing signature by sign-off mentor or others:
1.Signature record
2.Mandatory sessions
3.EU Midwifery record
4.Placement record
5.Learning contract
6.MAP
MAP CRITERIA
Communication and Confidentiality *
Evidence Based Practice and Health Education/Promotion
Personal and Professional Growth
Risk Assessment and Management Skills
Initial Consultation between the Woman and the Midwife *
Ongoing Antenatal Care
Normal Labour and Birth *
Postnatal and Neonatal Care
Initiation and Continuation of Breastfeeding *
High Risk Care across the Childbirth Continuum
Emergency Procedures
Medicines Management *
Electronic PortfolioEvidence of student’s practice
learning:
Learning through SWOT analysis and reflection
How Midwifery Proficiencies, Essential Skills Clusters and learning outcomes achieved
Evidence of case-loading and other core clinical experiences (eg: non-maternity placements, skills packs) Demonstration
Pilot of Portfolio: Methodology
• 12 students and mentors (students with a range of IT abilities and learning styles)
• 7 lecturers
• 6-week trial including tripartite
• Questionnaire follow-up
Pilot of portfolio: Key findings
Guidelines: very positive
Hyperlinks: • logical system
• tricky to begin with but became easier with use
• particularly useful when making external links (eg: to national guidelines)
Feedback facility: valuable
Varied IT skills/ learning styles: coped
Summary
→
Clear understanding of
PURPOSE
Safe, competent
PRACTITIONERS
who have achieved
PERSONAL and
PROFESSIONAL
GROWTH
Clear, consistent and timely
PREPARATION
Optimise the
PROCESS
People Placement Paperwork
Copyright statement:
Copyright for this portfolio belongs to Margaret Fisher in collaboration with the University of Plymouth Midwifery,
Ceppl and Emily teams