Setting The Direction For Nursing & Midwifery Education in Scotland

Strategic Aim 4

Enhance the quality of the practice learning environment for staff and students

The quality of the practice learning environment is crucial for pre-registration students' development as practitioners and professionals and throughout nursing and midwifery careers. Education and placement providers work together to continuously improve the quality of the learning environment to meet the standards for Nursing and Midwifery Council approved programmes and through a number of national initiatives, to reduce variation and duplication of effort. Mentors play a key role in supporting learning and development, acting as role models and in public protection terms, as assessors of competence and gate keepers to the profession for pre-registration students. The learning environment is challenged to provide the types of placements and experience that prepare students and staff to practice within a changing health and care context. This includes access to new types of placements in the community and with third sector and social care providers.

How we are doing this now

Pre-registration education

• Consistent approaches - The Recruitment & Retention Delivery Group established a National Strategic Group for Practice Learning to promote consistency and coordination. The group's work includes a National Approach to Practice Assessment,^[27] pilot of the Quality Management of the Practice Learning Environment online system and the commissioning of literature reviews and evaluation to expand the evidence base.
• Enhancing mentorship - NHS Education for Scotland, in partnership with the universities and service providers, established The National Approach to Mentor Preparation^[28] and the Practice Education Facilitator (PEF) and Care Home Education Facilitator (CHEF) roles. These support those mentoring pre-registration students and enhance the practice learning environment using the Quality Standards for Practice Placements (QSPP).^[29] Although this infrastructure is embedded across the country the quality of mentorship and student experience continues to vary. This raises questions as to whether mentor and assessor is a role for all registered nurses and midwives.
• Placement allocation - The National Strategic Group for Practice Learning, has supported innovative demonstration projects. The evaluation of models,^[30] e.g. 'Hub & Spoke' has shown benefits to students and best use of scarce placements such as those in the community. Shared practice placement arrangements and Memoranda of Agreement are opening up more national approaches and overcoming some of the complexity and inefficiency associated with local allocation models. They have been effective in allocating pre-registration midwifery and learning disability nursing students to dispersed placements now that programmes are concentrated at fewer universities.

Post-registration programmes

Practice learning is already a core component of many continuing professional development, post-registration and postgraduate programmes. However, there is an increasing demand for approaches which maximise the work base as a learning environment and enable staff to combine development of skills and competence within their own practice environment with flexible and innovative educational technology and other methods of delivery.

Improving what we do

4.1 Develop and maintain a national tool to capture placement quality data, share student and mentor feedback and audit the quality of the learning environment for all students

4.2 Build on the existing PEF and CHEF structures to ensure improvement and innovation in practice learning and review practice learning support roles, titles, infrastructure and reward systems

4.3 Introduce methods to select and recruit mentors with the appropriate skills and aptitude for the role and ensure their role is valued

4.4 Implement approaches to enable pre-registration students to spend more time learning in community settings

4.5 Develop efficient and equitable models and processes for allocating placements across Scotland

4.6 Ensure the practice learning environment develops to accommodate the learning needs of an increasing range and number of staff

4.7 Collaborate across practice learning environments to achieve a consistent approach to placement assessment documentation for pre-registration students

Collaborating for the future

4.8 Introduce inter-professional and cross-institutional monitoring of the quality of the practice learning environment and its relationship with care quality

4.9 Extend PEF and CHEF structures beyond NHS and care home practice learning settings

4.10 Work collaboratively to develop a model to manage placement allocation across professions and institutions

4.11 Continue to strengthen the relationship between education and practice placement providers to enhance access to learning opportunities, standards of care and welcoming cultures in the learning environment

4.12 Disseminate good practice to ensure practice learning is evidence informed and impact assessed

4.13 Standardise Memoranda of Agreement and practice placement arrangements between service and education providers

4.14 Promote and facilitate access to remote and rural learning experiences for students