School of Nursing, Midwifery & Social Work SNMSW Clinical... · UQ Undergraduate Nursing and Midwifery Model 6 In 2004 the UQ School of Nursing & Midwifery commenced implementation

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School of Nursing, Midwifery &

Social Work

Undergraduate Nursing and Midwifery Programs

Information

Booklet for

Clinical

Preceptors

2016

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Author Ms Denita Ward 2016 Parts of the Information for this booklet has also originated from previous ‘UQ School of Nursing and Midwifery Clinical Placement Booklets’, ‘Master of Nursing Studies Information Booklet for Clinical Mentors and Preceptors’ and ‘Preceptor Information - University of Queensland Final Year Nursing, Midwifery & Dual degree Students’. Credit to the following authors from previous booklets Dr Marion Tower Dr Jacqui Young A/Prof Fiona Bogossian Ms Jenny McIntosh Dr Victoria Kain Ms Catherine Carmody

Copyright materials contained herein have been reproduced under the provisions of the Copyright Act

1968, as amended, or with the permission of the copyright owner.

This material may not be reproduced in any manner whatsoever except with the approval of the School

of Nursing, Midwifery & Social Work. University Provider Number 00025B

© The University of Queensland 2010.

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Contents

Contents………………………………………………………………………………………………………………………………………………….3

Welcome to the School of Nursing, Midwifery & Social Work……………………………………………………….………..4

Introduction………………………………………………………………………………………………………………………………..………….5

UQ undergraduate Nursing & Midwifery Model……………………………………………………………………..………………6

Clinical Supervision…………………………………………………………………………………………………………………..…………….7

Bachelor of Nursing program overview………………………………………………………………………………….……………….8

Bachelor of Midwifery program overview……………………………………………………………………………………..………11

Dual Degree program overview………………………………………………………………………………………………………..…..14

Problem based learning………………………………………………………………………………………………………………………..15

Student assessment & feedback……………………………………………………………………………………………………….…..16

Student expectations & standards…………………………………………………………………………………………………………17

Clinical experience for first year students………………………………………………………………………………………..……18

Semester one nursing skills session guide…………………………………………………………………………………..19

Semester two nursing skills session guide……………………………………………………………………………..……20

Semester one midwifery skills session guide………………………………………………………………………………21

Semester two midwifery skills session guide………………………………………………………………………………22

Clinical experience for second year students…………………………………………………………………………………………23

Semester one nursing skills session guide…………………………………………………………………………………..24

Semester two nursing skills session guide……………………………………………………………………………..……25

Semester one midwifery skills session guide………………………………………………………………………………26

Semester two midwifery skills session guide………………………………………………………………………………27

Mental health clinical practice for second year students………………………………………………………..….28

Clinical experience for final year students……………………………………………………………………………………………..29

Electronic clinical practice performance portfolio………………………………………………………………………………...30

References…………………………………………………………………………………………………………………………………….………36

Welcome To The School of Nursing, Midwifery & Social Work

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Welcome to the clinical preceptorship program with the University of Queensland. Your clinical

expertise will be a valuable resource for the students whilst they undertake a Bachelor of Nursing

or Midwifery or Dual degree program. The undergraduate nursing and midwifery programs are

underpinned by the principle of partnership in all aspects of their development, implementation

and evaluation.

One of the most critical partnerships in this program is the clinical partnership between students,

nursing and midwifery clinicians. The expertise that clinicians have to bring to teaching and

learning is highly valued and makes a significant difference to students as they strive to integrate

diverse knowledge and skills in the real world of practice. In their own words our undergraduate

students consistently illustrate just how much they are guided and taught by clinical staff who:

▪ understand the position we are in

▪ explain new things, allowing us to try our skills

▪ lead by example, preventing us from picking up bad habits

▪ provide feedback on ways we can improve

▪ value students as part of the team

▪ make time to answer questions

▪ encourage me to think independently

▪ give me an example to work towards

▪ are kind, caring, patient, tolerant, understanding

We at the UQ School of Nursing, Midwifery & Social Work welcome the opportunity to work

together with you across the education and health sectors as we prepare new graduates for our

future nursing and midwifery workforce.

Introduction

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The University of Queensland (UQ), School of Nursing, Midwifery & Social Work recognises the

vital role clinicians play in the preparation of the next generation of nurses and midwives. This

occurs in many ways, such as, through formalised teaching and learning roles or through informal

teaching and learning opportunities.

This booklet has been prepared to assist clinicians who are involved with the undergraduate

students, either as clinical educators, mentors or preceptors. The aim of this booklet is to provide

clinicians with information relating to the theoretical and clinical preparation of students, and

the expectations during the various stages of their development. You will also find contact details

for the Clinical Supervisors who are responsible for the students allocated to your area.

Thank you for your contribution to the education of the University of Queensland Nursing and

Midwifery students. If you have any questions, concerns or feedback regarding the program

please contact:

Dr. Marion Tower Director, Undergraduate Nursing, Midwifery & Pre-registration Programs University of Queensland St Lucia Campus, Chamberlain Building (35) QLD 4072 M: 0420 310 264 Email: [email protected]

mailto:[email protected]

UQ Undergraduate Nursing and Midwifery Model

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In 2004 the UQ School of Nursing & Midwifery commenced implementation of an innovative

Bachelor of Nursing (BN) program. Special features of the program included a problem based

learning approach and a clinical partnership model of teaching. However it wasn’t until 2007 when

the School introduced and accepted the first students into the Bachelor of Midwifery program,

followed by the introduction of the Bachelor of Nursing and Bachelor of Midwifery dual degree in

2008.

The UQ model was established in response to the Senate report―National review of nursing

education 2002‖(Turner, Davis, Beattie, Vickerstaff & Wilkinson, 2006). The report made 36

recommendations that focused on three areas: Building a sustainable workforce through

Partnership; Maximising health outcomes through Quality Education; and Capacity Building. The

curriculum model emerged from a strategically planned partnership between the University of

Queensland and health care providers committed to improving graduate outcomes and transition

into professional practice (Turner, et al 2006).

The UQ model is a preceptor model, where the student’s work alongside a clinical preceptor and are

exposed to the clinical area’s early in the program, attend clinical shifts each week where they can

immediately implement skills learned in university. Students place great value on early exposure to

the clinical setting, and the personalised engagement from their clinical preceptors. UQ nursing and

midwifery supervisors are responsible for liaising and consulting regularly with students, unit staff

and preceptors in the clinical facility to provide on-going support to ensure students meet the

relevant learning objectives, and to respond promptly to any concerns and needs of the students.

The overarching aim of the undergraduate Bachelor of Nursing and Bachelor of Midwifery programs

is to develop a cohort of graduates who have developed a lifelong commitment to continuing

education and the ability to contribute to the continuing evolution of nursing and midwifery

knowledge.

Clinical Supervision

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We are pleased to introduce you to the UQ Clinical Supervisor’s working at your facility. Over the

coming weeks they will be seeking feedback regarding progression of student(s) in your clinical

area. The Clinical Supervisor’s regularly visit students when on clinical placement, so they would

be happy to discuss a student’s progress in person, or if more convenient via phone or email.

A student’s learning opportunity is magnified with constructive criticism and positive feedback

and students are encouraged by UQ to seek such feedback from clinical staff. We welcome and

support clinical staff in providing timely and ongoing feedback for students.

If you have any questions, concerns or other general feedback regarding students clinical

placement please do not hesitate to contact the Clinical Supervisors on the pager numbers,

telephone numbers or emails below:

Clinical Supervisors Nursing: Contact via pager number:-

Clinical Supervisors Midwifery: Contact via pager number:-

Bachelor of Nursing Program Overview

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The BN degree is a three year (6 semesters) curriculum with clinical practice and problem-based

learning integrated throughout the program. The curriculum integrates content from a variety of

disciplines and applies this to nursing practice. As well as the theoretical focus, students undertake

clinical practice units, which prepare students for beginning practice in a range of metropolitan

hospital and community settings. Students have early and regular exposure to the clinical setting.

In first semester the theoretical focus is on human development throughout the lifespan. In second

and third semester Australia’s national health priority areas with the themes of promoting healthy

lifestyles and managing complex health problems drive the content. In the fourth semester the

focus shifts to major international health priority areas, which also happen to be Australian

priorities.

During the fifth and sixth semesters of the degree the third year students undertake two semesters

of intensive clinical practice. In the fifth semester students select an area of specialty practice and

a corresponding theoretical course. In the final semester students undertake intensive clinical

practice in a ward setting in their designated base teaching hospital in preparation for transition

to the role of a Registered Nurse. Students are required to demonstrate their competence by

completing a comprehensive Clinical Practice Performance Electronic Portfolio.

Bachelor of Nursing Program Overview (cont)

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Semester One:

Foundations of Nursing Practice:

Human Development throughout the Lifespan

▪ Embryology, neonate and child

▪ Adolescence and young adults

▪ Adults and older persons

▪ Systematic Preparation for Clinical Practice: Clinical Practice 1 (120 hours clinical placement)

Semester Two:


National Health Priorities

▪ Cardiovascular Health

▪ Respiratory Health

▪ Musculoskeletal Health


Semester Three:

National Health Priorities

▪ Nutritional and Metabolic Health

▪ Immunological Health

▪ Mental Health


Semester Four: National Health Priorities

▪ Neuro-Endocrine Health

▪ Injury prevention

▪ Healthy Aging


Bachelor of Nursing Program Overview (cont)

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Semester Five:


Speciality Clinical Elective

▪ Acute Care

▪ Aged Care

▪ Community Care

▪ Indigenous Health

▪ Mental Health

▪ Rural and Remote Health

▪ Paediatric


Semester Six:



Bachelor of Midwifery Program Overview

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The BM degree is a three year (6 semesters) curriculum with clinical practice and problem-based

learning integrated throughout the program. The curriculum integrates content from a variety of

disciplines and applies this to midwifery practice. As well as the theoretical focus, students

undertake clinical practice units, which prepare students for beginning practice in a range of

metropolitan hospital and community settings. Students have early and regular exposure to the

clinical setting.

In first semester the theoretical focus is on human development throughout the lifespan. In second

semester the emphasis is on normal fertility patterns and conception, the midwives role in

promoting health in pregnancy during the antenatal period, and preparing women for birth and

parenting. Third semester focuses on preparing women for the experience of normal birth and

the post-natal care as well as managing mental health issues that may arise. In the fourth semester

the emphasis shifts to managing complex health problems and acute trauma in the pregnant

woman as well as management of multiple pregnancy and preterm birth.

During the fifth and sixth semesters of the degree the third year students undertake two semesters

of intensive clinical practice. In the fifth semester students select an area of specialty practice and

a corresponding theoretical course. In the final semester students undertake intensive clinical

practice in a ward setting in their designated base teaching hospital in preparation for transition

to the role of a Registered Midwife. Students are required to demonstrate their competence by

completing a comprehensive Clinical Practice Performance Electronic Portfolio.

Bachelor of Midwifery Program Overview (cont)

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Semester One:

Foundations of Midwifery Practice:

Human Development throughout the Lifespan

▪ Embryology, neonate and child

▪ Adolescence and young adults

▪ Adults and older persons


Semester Two:


▪ Preconception and pregnancy planning

▪ The midwife and healthy pregnancy

▪ Preparing for birth and parenting


Semester Three:


▪ Promoting normal birth

▪ Birth and immediate post-natal care

▪ Mental health in pregnancy


Semester Four:


▪ The midwife and high-risk pregnancy

▪ The midwife and acute trauma management

▪ Caring for the vulnerable newborn


Bachelor of Midwifery Program Overview (cont)

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Semester Five:


Speciality Clinical Elective


Semester Six:



Dual Degree Program Overview

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The Bachelor of Nursing/Midwifery Dual degree is a four year (8 semesters) curriculum with clinical

practice and problem-based learning integrated throughout the program. The curriculum

combines theoretical content from the bachelor of Nursing and the Bachelor of Midwifery degrees

(outlined previously). As well as the theoretical focus, students undertake clinical practice units,

which prepare students for beginning practice in a range of metropolitan hospital and community

settings. Students have early and regular exposure to the clinical setting.

Problem Based Learning

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Problem based learning (PBL) is an educational format that is centred on the discussion and

learning that develops from the analysis of a clinically based problem. It is a method that

encourages independent thinking, challenging of previously accepted norms and strategic learning

and gives students practice in tackling puzzling situations that can arise in the clinical practice

situation.

Students begin by defining their own gaps in understanding of components of relevant clinical

problems and then explore the underpinnings of this issue with the most current research and

evidence based practice. This basis in real-life scenarios promotes a contextual nature to the

course and makes it more likely that students will be able to recall the material later in the clinical

setting.

It is a way of learning, which encourages a deeper understanding of the foundations of practice

rather than superficial review. This depth of understanding allows students to develop skills, which

will equip them to stay at the forefront of the ever changing world of information within the

healthcare environment.

The small group setting used in PBL encourages an inquisitive, exploratory and detailed look at all

issues, concepts and principles related to the problem. The time spent outside of the classroom

setting facilitates the development of skills such as literature retrieval, critical appraisal of available

information and the seeking of opinions of peers and specialists. PBL encourages students to

become responsible for, and more involved in, their own learning. Many students have reported

that this is a highly enjoyable and effective way to learn.

Student Assessment and Feedback

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Assessment is a fundamental and considered activity that is an integral part of the teaching and

learning process, is grounded in sound curriculum design, development and implementation, and

makes a significant contribution to learning outcomes.

Within the Bachelor of Nursing and Bachelor of Midwifery programs, assessment of student

performance is varied. In each theoretical course students may be required to give an oral

presentation about a critical issue or submit a written assignment on a contemporary topic and

undertake an examination. In addition to this, students may also be required to complete

structured self-directed learning activities.

In each clinical course, the students are required to undertake a formative clinical assessment,

which provides feedback on progress, and a summative assessment, which determines whether

objectives have been met at the end of the period of placement. These assessments are framed

on the Nursing and Midwifery Board of Australia (NMBA) competency guidelines. For both

formative and summative clinical assessment the responsibility to provide evidence of

achievement rests with the student and this is assessed by their Clinical Lecturer.

Throughout the program, students complete an extensive electronic Clinical Practice Performance

Portfolio (e-CPPP) (refer to page 30 for more detail) in which they provide evidence of achievement

of the NMBA competencies and the University of Queensland graduate attributes. Only during

the final year of the student’s program will the clinical preceptors be required to make comments

in the e-CPPP.

As a clinician involved with the BN, BM and DD students whether in the role of mentor or preceptor

you will not be required to formally assess a student, this is the role of the Clinical Lecturer or

Supervisor. However, your input into the assessment process is critical in terms of providing

feedback and guidance directly to the student and, indirectly, about your perceptions of the

individual student‘s strengths and areas requiring improvement.

Student Expectations and Standards

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Expectations of students while on clinical Prac

▪ Students are expected to look up and follow the protocols and procedures of the clinical

unit they are practicing on.

▪ Students are expected to practice safely within their professional scope of practice.

▪ Students are expected to seek assistance if they are unsure.

▪ Students are expected to be punctual to all clinical placements and to remain until the

completion of their shift.

▪ Students are expected to advise the clinical unit in advance directly in the event of

absence from a scheduled shift.

▪ Students are expected to use ‘down time’ in the clinical unit constructively.

▪ Students are expected to conduct themselves in a professional manner as they are

representing the School of Nursing, Midwifery & Social Work of The University of

Queensland.

▪ Students are expected to adhere to the School of Nursing, Midwifery & Social Work

uniform and to ensure that their attire and appearance is professional at all times:-.

o Purple UQ polo shirt

o Black long trousers, shorts, culottes or skirt

o Black Vest - Cardigans may not be worn during patient contact

o Black closed shoes

o Hair should be tied back neatly if it touches the collar

o Nails should be kept short, clean and free of nail polish

o No jewellery (including piercings) should be worn except for a plain wedding ring

and ear studs

o Wristwatches should not be worn during patient contact

o Student/ Clinical unit ID should be worn at all times while in the clinical unit

Clinical Experience for First Year Students

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During the first year of practice students become familiar with the principles and foundation of

nursing and midwifery practice. The learning curve is steep and students may struggle with

balancing the new environment, the new level of responsibility and the technicalities of new skills

and equipment.

A supportive environment for students in this phase of learning is essential in order to build

confidence in the student and rapport between students and staff. The nursing and midwifery

culture transforms abnormal situations into what they consider normal (for example most people

normally shower without assistance and often in hospital people rely on assistance with this basic

function) so after a while, exposure to managing intimate cares for a patient/client becomes

second nature to the student. It is important to remember that beginning students are not yet

initiated into this culture and may experience some difficulty adjusting.

By the end of the first semester, students will be able to safely manage the care of a patient/client

and meet their basic care needs. While students have differing levels of skill and confidence, it is

anticipated that they will seek learning opportunities and support from staff in order to improve

and develop their clinical practice. Students must seek assistance for procedures they are

unfamiliar with. Students are expected to work within their scope of practice.

Students undertake weekly clinical skills sessions at university that prepares them for clinical

practice. Each week the students learn new skills with which they can then incorporate into their

scope of practice and begin to perform while on clinical placement. Students are permitted to

administer medications following their classroom sessions, in second semester (excluding insulin

administration and S8 medications which they will learn in 2nd year), this must be under direct

supervision of their clinical preceptor at all times. All medications and documentation must be

counter-signed and checked by a RN/RM. Students need to be aware that they are accountable

for their practice and thus are expected to be aware of actions, interactions and side effects of ALL

medications they administer.

Semester One Nursing Clinical Skills Sessions Guide

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The following is a guide to the weekly skill sessions in Year 1, semester 1.

Semester 1 clinical skills sessions

Week 1 Hand Hygiene

Infection control

PPE

Week 2 Vital signs

Week 3 Professional communication

Week 4 Nutrition

Assisting patients with eating

Making a hospital bed

Patient hygiene cares

Pressure area care

Week 5 Blood Glucose Monitoring

Week 6 Documentation

Handover

Week 7 Patient health assessment

Falls risk

Week 8 Patient mental health assessment

Week 9 Continence management – care of IDC

Fluid balance charts

Specimen collection - urinalysis

Week 10 Mini-OSCE - Vital signs assessment


Week 12 Summative assessment

PLEASE NOTE:-

Students should not use the pulse oximeter or dynamap for pulse and blood pressure

measurement. A student needs to be able to detect pulse abnormalities, describe pulse quality

and take blood pressures manually. These are vital and examinable skills so manual pulse and

blood pressure measurement practice is essential for these students.

Semester Two Nursing Clinical Skills Sessions Guide

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The following is a general guide to the weekly skill sessions in Year 1, semester 2.


Week 1 Chest pain management ECG measurement

Week 2 Oral medication administration

Medication documentation

Week 3 Topical medication administration

Enema and suppository administration

Ear, nose and eye medication administration

Week 4 Parenteral medication administration

Week 5 Respiratory assessment

Oxygenation

Week 6 Lung function tests - spirometry

Week 7 Aseptic technique

Week 8 Simple wound management Removal of sutures and clips

Removal of IVC

Week 9 Traction, splints and bandaging

POP care

Week 10 Mini OSCE - parenteral administration



Semester One Midwifery Clinical Skills Sessions Guide

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Week 1 Hand hygiene

Infection control PPE

Week 2 Vital signs

Week 3 Professional communication

Week 4 Making a hospital bed

Hygiene cares for women – bathing a baby

Support actions for breastfeeding mother

Week 5 Health assessment of mother and neo-nate (newborn examination, neo-natal screening

Blood glucose monitoring

Week 6 Ante-natal health assessment

Week 7 Intra-partum assessment

Week 8 Mental health assessment

Week 9 Continence assessment

Specimen collection

Week 10 Mini OSCE - Vital signs assessment



PLEASE NOTE: -

Students should not use the pulse oximeter or dynamap for pulse and blood pressure

measurement. A student needs to be able to detect pulse abnormalities, describe pulse quality

and take blood pressures manually. These are vital and examinable skills so manual pulse and

blood pressure measurement practice is essential for these students.

Semester Two Midwifery Clinical Skills Sessions Guide

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Week 1 Cardiac assessment - ECG

Auscultation fetal heart rate

Week 2 Oral medication administration

Medication documentation

Week 3 Topical medication administration

Enema and suppository administration

Ear, nose and eye medication administration

Week 4 Parenteral medication administration

Week 5 Respiratory assessment mothers and neonates

Oxygenation Lung function tests - spirometry

Week 6 Neo-natal screening test Serum bilirubin collection

Week 7 Aseptic technique

Simple wound management Removal of sutures and clips

Removal of IVC

Week 8 Simple wound management – caesarean section

Perineum care Cord care

Week 9 Musculo-skeletal assessment Von-rosen splints, talipes, POP care Symphysis pubis dysfunction




Clinical Experience for Second Year Students

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During the second year of practice students are consolidating the foundation skills learned in the

previous year and adding new more advanced level skills to their repertoire. While students have

differing levels of skill and confidence, it is anticipated that they will seek learning opportunities

and support from staff in order to improve and develop their clinical practice. By the end of the

second year students will be able to safely manage the nursing care of at least two patients

independently. This includes giving and receiving handover.

Students again undertake weekly clinical skills sessions at university that prepares them for clinical

practice in their 2nd year. Each week the students learn new skills with which they can then

incorporate into their scope of practice and begin to perform while on clinical placement. Students

are permitted to administer S8 medications and insulin following their classroom sessions in 1st

semester, all medication administration must be checked by a registered nurse/midwife and

always under their direct supervision. Students are unable to countersign the Dangerous Drug

book as second signatory as they are not yet registered. All other documentation must be counter-

signed by a registered nurse/midwife.

In order to give S8 medication students must be knowledgeable about the medication and its side

effects and should be able to safely manage a patient following narcotic administration. Students

need to be aware that they are accountable for their practice.

Students are expected to be aware of actions, interactions and side effects of ALL medications they

administer. Students should be able to articulate a strategy for the assessment and management

of toxicity/anaphylaxis. Students must seek assistance for procedures they are unfamiliar with and

are always expected to work within their scope of practice.

Semester One Nursing Clinical Skills Session Guide

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Week 1 Revision – Aseptic Technique, suture and clip removal, parenteral medication

Week 2 IV therapy administration

Week 3 IV Medication administration

Week 4 Mini OSCE – IV therapy

Week 5 Insulin administration

Week 6 Pain assessment S8 administration

PCA & epidurals

Week 7 Oncology PPE & spill kit

Surgical scrubbing, gowning and gloving

Week 8 Surgical wounds and drains

Week 9 Introduction to mental health

MSE

Week 10 Depression

Week 11 Psychosis

Week 12 Substance misuse Suicidal Thoughts

Semester Two Nursing Clinical Skills Session Guide

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Week 1 Neurological assessment

Week 2 IDC insertion

Week 3 NGT insertion and management

Week 4 Care of the unconscious & dying patient

Week 5 CVAD & dressing

Week 6 Chest drain management

Week 7 Blood administration

Week 8 Tracheostomy care

Week 9 Arrhythmias

Week 10 ABG

Week 11 Stoma care

Week 12 OSCE

Semester One Midwifery Clinical Skills Session Guide

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Week 1 Revision

Week 2 IV therapy and drug administration

Week 3 S8 administration

Week 4 Epidural anaesthesia

Insulin administration

Week 5 Surgical scrubbing, gowning and gloving

Post caesarian care woman/baby

Week 6 Pain assessment and management

Pain strategies in labour

Week 7 Normal vaginal birth

Vaginal exam

Abdominal assessment

Week 8 Assessment of women throughout labour and delivery

Week 9 Antenatal/Postnatal depression

Puerperal psychosis

Week 10 Advanced communication skills

Week 11 Mental health assessment

Week 12 Risk assessment Care of patient at risk of self harm

Semester Two Midwifery Clinical Skills Session Guide

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Week 1 Neurological assessment

Week 2 IDC insertion

Week 3 NGT insertion and management – adult and baby

Week 4 ARM

Membrane sweep

Week 5 Fetal scalp electrode

Week 6 Venipuncture

Blood administration

Week 7 Antepartum/postpartum haemorrhage

Week 8 Management and care of the woman and family experiencing grief and loss

Week 9 Thermoregulation and phototherapy in the neonate

Week 10 IV cannulation

Week 11 Neonatal resuscitation

Week 12 OSCE

Mental Health Clinical Practice For Second Year Students

M

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During the second year of the program in addition to their usual clinical practice students have the

opportunity to attend a mental health placement. Mental health often encompasses a holistic

approach to client care and the psychological, social, cultural and spiritual dimensions of the

person are all key points of consideration in the care of mental health clients. Students are

expected to explore this holistic approach with a view to developing and understanding of nursing

beyond the task oriented ‘doing‘. While the student activity role in these placements may be

limited, it is important for students to be attentive observers to the processes and interactions

between staff and clients. Students are expected to look deeply into the underpinnings of

psychological issues and draw upon the expertise of the nurses in this area to develop their own

knowledge base. Students may find their personal and professional boundaries challenged during

this placement and should be aware of appropriate channels of communication and supports.

Students are expected to be aware of issues regarding personal safety and adhere to

unit/placement policies.

Specific focus - Exploration of the challenges of Mental Health Nursing

In the weeks allocated for Mental Health placement, students are expected to continue with their

professional development and expansion of their knowledge base. They will:

▪ Develop a basic knowledge about mental health and the manifestations of illness.

▪ Explore the impact of mental illness on the person as an individual and their significant

others.

▪ Observe and commence an introduction into mental health/illness assessment. This should

include medications, provisional diagnoses, health history, impacting psychosocial factors

and plan of management.

▪ Explore the stigmas toward mental illness with a view to challenging negative and harmful

approaches to mentally ill clients.

▪ Reflect on practice and identify areas of strength and areas for improvement.

▪ Discuss personal and professional boundaries with mentor and implement strategies to

maintain personal & professional integrity.

Clinical Experience For Final Year Students

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Students entering the final year of practice have completed all the required clinical skills and all

theoretical components of the program. They have been assessed throughout the program using

the NMBA Competency Standards and the UQ graduate attributes. Final year students have

undertaken on-campus briefing sessions at the commencement of the semester to prepare them

for their final year and are motivated to demonstrate a higher level of practice and to consolidate

their skills and knowledge and begin the transition from student to beginning level practice as a

RN/RM.

Final year students are usually preceptored by only one or two RN/RM’s in the clinical placement

area, so they can be mentored more closely and where students can further develop and refine

their clinical and time management skills, clinical reasoning, as well as their professional, ethical

and legal practice. Utelising the electronic Clinical Practice Performance Portfolio (eCPPP), clinical

preceptors can record their feedback of student’s progress throughout the year (see page 30).

By the end of the year, students should be taking on a patient load of 80-90 % and be directing

care for their patients under the supervision of the RN/RM. The role of the preceptor should

change throughout the final semester as the requirement for support and guidance diminishes

with increasing student competence. Students should be accountable for their actions and should

continue to seek assistance in areas where they are uncertain; however the focus is to develop a

realistic exposure to day-to-day nursing/midwifery.

Even though final year students have increased confidence and competence, ALL medication and IV

administration must be observed and checked by a registered nurse/midwife and always administered

under their direct supervision, otherwise the student will be working outside of their scope of practice.

Electronic Clinical Practice Performance Portfolio

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The electronic Clinical Practice Performance Portfolio (eCPPP) has been developed to assist

students to transition to become safe, competent RN/RMs. It provides students with the

opportunity to produce evidence to support their claims of competence, develop an archive of

achievements, demonstrate personal and professional growth over time, as well as develop skills

in self-assessment, critical reflection and identification of appropriate learning strategies.

As a clinician involved with the nursing or midwifery program you will be asked to provide feedback

regarding a student with respect to a specific competency and the student may use this as

evidence of their performance. In order to do this you will be given electronic access to the

students’ e-CPPP. The student will guide you in setting up a password which is protected to your

name only. Within sections of the e-CPPP a preceptor comment is required. As the student

successfully demonstrates an attribute of the RN/RM role, you will be asked to sign that you have

seen this demonstrated clinically. This enables the Clinical Lecturer to build a picture of the

student’s competence.


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The following information about the e-CPPP will offer some guidance for you as the preceptor. It

has been designed so that students may achieve competency in a number of Nursing and Midwifery

Board of Australia (NMBA) attributes, along with those competencies that are more facility/specialty

focussed and develop their personal philosophy of nursing or midwifery.

It is anticipated that the student will work with you to complete the portfolio in a timely manner.

However, the initiation and completion of this portfolio is entirely the responsibility of the student.

This portfolio represents two semesters work and as such is a vital part of their final year assessment.

It is intended to model for the students the value of maintaining a record of the competencies they

have achieved, a library of relevant literature and a journal of their clinical experiences.

By completing this portfolio, the student is acquiring the attributes of a novice registered nurse or

midwife. This is also an opportunity for them to appreciate the depth and scope of nursing or

midwifery practice, and to acknowledge the array of skills they have.

What is a portfolio?

“In education, a portfolio is usually a collection of information that informs the demonstration of

learning that has occurred for an individual in a specific course or programme of studies” (Andre &

Heartfield, 2011, p3-4). The portfolio is self-directed by the owner and can contain a collection of

work in the form of narratives, certificates, photos or other documents, that demonstrates

achievement. “An effective portfolio not only includes description of experiences and practice but

links to the relevant nursing or midwifery knowledge to produce an argument about the level of

competence or learning that has been achieved” (Andre & Heartfield, 2011, p4).


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Portfolio contents

This portfolio has been designed in three sections:

Section 1: Provide high quality nursing/midwifery care through the safe and effective

nursing/midwifery practice according to the NMBA competency standards:

These attributes/elements relate specifically to the Competency Standards for the respected

professions of Nursing and Midwifery. Each student will address each attribute/element of the

specific degree they are completing. For Bachelor of Nursing students, they will address the

Competency Standards for the Registered Nurse. For Bachelor of Midwifery students they will

address the Competency Standards for the Midwife. Students completing the Bachelor of

Nursing/Bachelor of Midwifery will complete attributes/elements across both Competency

Standards documents.

Section 2: Direct your own learning and apply clinical reasoning skills in your nursing/midwifery

practice, which will continue throughout your professional life.

Facility specific skill competencies:

The student is required to obtain evidence of competency in a minimum of three elective specific

skill competencies and five final placement skill competencies. The student should show learning

outcomes, learning strategies and performance indicators to their preceptor and reach agreement

with them.


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Section 3: Demonstrate the qualities, skills, knowledge and abilities expected of a University of

Queensland (UQ) graduate.

Summary of clinical development and skills

(a) In-depth knowledge of the field of nursing/midwifery:

(b) Effective Communication:

(c) Independence and Creativity:

(d) Critical Judgement:

(e) Ethical and Social Understanding:

For each of the competencies, we have identified learning strategies and performance indicators.

When learning outcomes have been achieved, evidence must be provided to explain how the

student used their knowledge and skills to attain competency.

There are also areas within this portfolio for the student to comment on critical incidents they

witnessed or were a part of. This section of the portfolio is designed for them to document the

incident, reflect on the actions of those involved, go to the literature to support the interventions

they are discussing and to gain comment from one of the RNs/RMs involved. This is not designed

to be a ‘whinge’ about something, rather it is intended that the student reflect on both positive

and negative incidents experienced whilst on clinical placement, with a view to seeking support

from the literature and to demonstrate personal and professional development.

Students are not limited in the number of comments that they include per section. This portfolio is

evidence of their learning and professional abilities and, as such will be a very valuable tool when

they are seeking employment as a novice registered nurse/midwife. Therefore, they are

encouraged to be pro-active in gathering as many testimonials as they deem necessary to

demonstrate their level of achievement. The student alone is responsible for its completion.


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It is strongly recommended that they take the opportunity to complete as many facility generated

competency packages relevant to their intended area and scope of practice.

It should be noted that the student is expected to find an appropriate balance between meeting the

requirements of this portfolio and spending time consolidating their skills and acquiring the new

skills/attributes the facility offers them.

Who is this portfolio for?

This portfolio is intended for the final year Bachelor of Nursing, Midwifery or Dual degree students

at the University of Queensland. It has been designed to be part of the assessment for

NURS3001/MIDW3001 Clinical Practice 5 and NURS3002/MIDW3002 Clinical Practice 6, as well as

complement the assessment for the Speciality Clinical Elective selected (i.e. MIDW3003, and

NURS3013).

Your role

You have an important role in helping students to achieve their goal of becoming a registered

nurse/midwife. Your role is as a facilitator of the student’s experiences, both theoretical and clinical.

The students will ask you to observe them as they perform new skills and demonstrate skills they

already possess. You will be called upon by the student to provide expert feedback to the student

that verifies the attribute/skill they are demonstrating is at a competent level.

The intention of this portfolio is that you are the student’s facilitator. You are not expected to assess

the students. Your role is to provide feedback on whether the student is demonstrating competency

in the skill/attribute and to offer any professional advice as to how to better demonstrate skills and

attributes they may not be competent in. It is anticipated that this take no more than 15 minutes

each shift.


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Once you have deemed the student competent in a skill, they do not need to demonstrate that skill

again for assessment purposes. However, please note that you, as the preceptor will be asked to

provide written feedback to the student once they have demonstrated the skill/attribute

competently. For the majority of attributes/skills, you will see a section entitled “Preceptor

comments”. If you feel the student is competent, you may write any comments you wish, sign and

date the entry.

Providing feedback to the student

One suggested statement is:

“I have witnessed (student name) performing this attribute/skill (number) and have provided

positive feedback.”

However if you the preceptor, feel that the student is not maintaining competency, you are within

your rights to seek further demonstration of the skill/attribute.

If, in your opinion, the student cannot demonstrate the skill/attribute adequately, and you cannot

provide positive feedback, do not make any written comments. Discuss your decision with the

student, and offer any guidance you deem appropriate.

References

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Andre, K., & Heartfield, M. (2011) Nursing and midwifery portfolios: evidence of continuing

competence. 2nd edn. Elsevier Australia:Chatswood.

Turner, C., Davies, E., Beattie, H., Vickerstaff, J,. Wilkinson, G. (2006). Developing an Innovative

Undergraduate Curriculum – responding to the 2002 National Review of Nursing Education

In Australia. Collegian. 13:2. pg. 7-14. doi:10.1016/S1322-7696(08)60518-1

Documents

School of Nursing, Midwifery & Social Work SNMSW Clinical... · UQ Undergraduate Nursing and Midwifery Model 6 In 2004 the UQ School of Nursing & Midwifery commenced implementation