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Education

Standard 7: practice placements, learning environment and competence assessment

The following is the standard for practice based learning and competence asssessments required by the Nursing and Midwifery Board of Ireland (NMBI) for approval of Higher Education Institutions (HEIs), associated health care providers (AHCPs) and educational programmes leading to registration by NMBI.

Criterion

Practice-based learning forms a mandatory and essential component of the professional nursing education to enable students to develop the domains of competence to become safe, caring, competent decision-makers who are willing to accept personal and professional accountability for evidence-based nursing care.

Standard

Clinical Placement Coordinators are appropriately qualified and adequately prepared for and supported in the role of guidance, support, facilitation and monitoring of practice-based learning among undergraduate nursing and midwifery students.

Preceptors and assessors of nursing students’ practice-based learning are appropriately qualified and adequately prepared for and supported in the role of student supervision and assessment of proficiency towards competence in nursing practice.

Indicators

  1. Clearly written up-to-date learning outcomes / objectives (The learning outcomes / objectives are reviewed and revised as necessary) appropriate to the practice placement environment are available and accessible to ensure optimal use of valuable practice placement experience.
  2. Learning outcomes that are explicit to the practice setting are used for each year of the programme to guide student practice-based learning.
  3. Nursing students and all those involved (Clinical Placement Co-ordinators, Preceptors, Nurse Practice Development Coordinators, Clinical Nurse Managers, Link Academic Staff and others involved in supervision or assessment of nursing students) in meeting their learning needs are fully acquainted with the expected learning outcomes relating to that practice placement setting.
  4. At all times, there are sufficient registered practitioners to facilitate the supervision and support of student nurses  to achieve the expected learning outcomes of the programme.
  5. Practice based learning is supported by adequate numbers of appropriately qualified and prepared practitioners with experience of the relevant division of nursing to act as preceptors.
  6. Practice based learning is supported by adequate numbers of appropriately qualified and prepared Clinical Placement Coordinators (CPCs) who are supported by a Nurse Practice Development Coordinator. A minimum ratio of one clinical placement coordinator to every 30 nursing students is in place with due regard to the geographical location and array of practice settings. This relates to acute services; the CPCs for primary care and community settings require a CPC-student ratio that reflects the geographical location and travel considerations for such settings.  (Department of Health 2004, 41).
  7. Preceptorship arrangements are in place to support student placements in community and primary care settings.
  8. Nursing students are assigned a named primary preceptor, who is a registered nurse, during practice placement to provide support and supervision and assist them to develop the knowledge, know how, skills and competence to become proficient practitioners of nursing.
  9. Preceptors/registered nurses, who support students, have completed a teaching and assessing course approved by the NMBI to enable them support, guide and assess students’ learning and competence development.
  10. Protected time policy / arrangements are in place for preceptor supervision and examining of undergraduate students.
  11. Preceptor initial preparation is supported by refresher courses and support from HEI in relation to student supervision and competence assessment.
  12. Assessment of the achievement of practice learning and competence development is undertaken in a fair, effective and transparent manner in accordance with the assessment strategy and NMBI standards and requirements.
  13. Practice-based assessment of learning and attainment of competence is based on an explicit model or framework for progressive achievement of proficiency.
  14. Mechanisms for preceptorship evaluation are in place.
  15. The supernumerary status of the student is explicit for preceptors and nursing students.
  16. Specified internship practice placements provide experience of the 24 hour cycle of the person accessing health services.
  17. Specific periods of protected time are allocated for reflection during supernumerary placements and the final internship clinical placement .The time allocated for reflective practice during supernumerary placements and the structures in place for the implementation of effective reflective protected time during the period of internship should be "agreed formally between third-level institutions and health service providers and included in the memorandum of understanding."
  18. The time allocated for protected reflective practice during supernumerary placements and the structures in place for the implementation of protected reflective time during the period of internship should be agreed formally between the HEIs and the associated health care providers and included in the memorandum of understanding.
  19. Reflective time of a minimum of one hour per week should be an integral component of any supernumerary nursing and specialist placement.
  20. Reflective time equivalent to a minimum of 4 hours per week forms an integral component of the internship period of clinical allocation to enhance the consolidation of theory to practice (HSE HR Circular 030/2009).
  21. Reflection is developed through the maintenance during the internship period by the nursing student of a personal professional portfolio of learning related to competence development.
  22. Students are supported and supervised during the final placement of 36 weeks internship to consolidate the completed theoretical learning and to support the achievement of clinical competence on graduation and registration.
  23. The HEI and AHCPs operate an effective fitness to practise mechanism for the protection of the public and safety of the vulnerable person receiving health care.
  24. The HEI and AHCPs operate robust processes for managing undergraduate health problems.

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