West Midlands’ Public Health Practitioner Development Scheme

Applicant In-Depth Training Day Wednesday 7th November 2012

Vicki Taylor, Director, The Roundhouse Consultancy MK Ltd.

1. Review of standardsWhat is evidence? Types of evidence

Technical competence

Underpinning skills & knowledge

Application of PH competence

Professional & ethical practice

The Public Health Practitioner Standards

Four key areas 12 standards

Each standard described by indicators of effective practice – 42 altogether (plus 7 sub-indicators)Standards cover knowledge, understanding & practice

• Standards 1-4: professional and ethical practice– Recognising and addressing ethical dilemmas and issues– Acting within limits of own competence, seeking advice– Acting in ways that promote equality and diversity etc– Developing and improving own and others’ practice

• Standards 5-8: Technical competencies in public health practice– Health and well-being and reduction of health inequalities– Dealing appropriately with data and information– Assessing evidence of effectiveness– Identifying risks to health and wellbeing

Summary of the 12 standards

Standard 9: Application of the technical competencies◦ Working collaboratively on programmes to improve health

and wellbeing outcomes that demonstrate the technical competencies

◦ See notes - need not be work you have personally led – but demonstrate understanding of how programme developed

Standards 10-12: Underpinning skills and knowledge◦ Public health policies and strategies◦ Working in teams, relationships, partnership working◦ Note difference between standard 9 and standard 11◦ Effective communications

Summary of standards contd.

◦ Framework and Guidance document◦ Main document – how the scheme works – for applicants, assessors and

verifiers◦ Standards and processes

◦ Supporting Information document◦ Standards - Examples and explanatory notes◦ Glossary – indication of expected knowledge – standards 5 – 8 especially◦ Assessment log◦ Observation proformas– Application forms for verification and registration– Guidance on testimonials and references

The UKPHR guidance documents

• Look at standard 5 • Think about what evidence you have for

this standard – remember to look at all the indicators

• Share and discuss in your group• What would be important to include in

your commentary about this evidence?

What evidence do you have?Group work

2. The assessment processThe assessment log, clarifications,

resubmissions & verification, relationship with assessor and

mentor

Do not have to submit all evidence to Assessor at the same time

• Recommend ‘formal’ agreement between practitioner and assessor on communication– Estimated number of commentaries + evidence– Dates for submission of commentaries– Turnaround time for assessor feedback– Preferred contact method(s) etc.

Relationship with assessor

Assessor• Agrees assessment

contract• Assesses evidence• Completes assessment

log• Feeds back outcome

Should not provide guidance and input to draft commentaries

Assessor and Mentor boundaryMentor Facilitates process of

self directed learning Gives advice on self

assessment against standardsIs not carrying out an assessment

• An important open document between applicant and assessor and provides full audit trail

• You, the applicant, must list the title(s) of your evidence against each sub-section of the standard

• Adequate, clarification, resubmission and assessor comment on why evidence meets the standard

Assessment log

Clarification ◦ Assessor believes there is evidence to meet standard but more detail/

clarity needed◦ Usually submitted within one/two months of request*

Resubmission◦ Assessor believes evidence is inadequate & new evidence needed◦ Usually submitted within 3/6 months of request*

*= Decided locally

If resubmission/clarifications needed for more than half of evidence, applicant may need further training

Clarifications and resubmissions

• Different types of evidence– Written reports from work setting; write-up of case

studies or observation of colleagues– Videos, DVDs with accompanying commentary– Observation possible for standards 11 and 12

(observation proformas provided)– Detailed testimonials with accompanying

commentary– Could be from other settings, e.g. voluntary work

• Knowledge and understanding and application of knowledge in evidence

Types of evidence

• Minimum of 3 discrete piece of “shows” work, supported by knowledge statements

• At least 2 pieces of work across areas 5-8 (PH technical areas)

• Half of the evidence should be from past 3 years (at time of applic. for Registration)

• 1 box file of evidence, or electronic equivalent• Data confidentiality

Amount and currency of evidence

• Nearly always, assessor will be confident that all the standards have been met and that applicant implements the ethical framework

• Very occasionally– Assessor may still have concerns which the applicant

accepts. ‘Bank’ competencies and resubmit entire portfolio at a later date. Further learning and development

– Assessor may still have concerns which applicant does not accept. Go to verification stage.

Outcomes of assessment

• Verifiers are registered public health specialists (GMC, GDC, UKPHR) with at least 3 years at consultant level

• Check that the assessment has been carried out appropriately – independent scrutiny (QA role)

• Verification is not a second assessment

• Verifiers meet as the Surrey Sussex Verification Panel• The Panel may interview applicants and assessors• Verification Panel decision is final (apart from

moderation processes and formal appeals)

Verification process

• After meeting of verification panel, applicant must apply within 3 months to UKPHR for registration

• See section 5 of main guidance document• Application form is in Supporting Information

document; plus CV, testimonial, reference• Fee £20 admin fee + £75 subscription fee• Application considered by UKPHR Registration Panel• Registration valid for 5 years• CPD the basis of demonstrating fitness to practice

Registration procedure

Outline of the processAssessorApplicant

UKPHR

Assessment Log

Verification Panel

Registration Panel

Verifier

Scheme Co-ordinator

1

2

3

4

5

6

7

Admitted to register

• Assessors need not be registered public health professionals but will have sound knowledge of public health

• Will be appointed by NHS Midlands and East following successful completion of UKPHR training

• Will be allocated to practitioners by Scheme Co-ordinator• Relationship with the applicant – agreement on

communication• Assessor-mentor boundary – Guidance doc Annex 4

Assessors

3. Reflective writing, writing a commentary and putting a portfolio together

What is a portfolio?

• Provides evidence of your competence against 12 standards

• All portfolios are unique• Explicit and systematic presentation of evidence in a

commentary• Will include some reflective writing demonstrating

practical application of theory and learning from this

• Signpost the assessor to the supporting evidence• Set out context and role of applicant• How knowledge acquired• Understanding and application of knowledge• How the evidence demonstrates the particular

standard, relating directly to the wording in each sub-section of the standard

• A reflection on learning from the work

Commentaries

Commentaries‘Evidence for each standard needs to be accompanied by a commentary to give background information and help the assessor to make sound judgements on your evidence. A commentary might contain information on:

• The context for the work• Your own role in the work• How you acquired the knowledge to support the work• Your understanding of the issues, gained from your learning• How you have applied that knowledge in this piece of work• Precisely how you believe the evidence demonstrates the particular standard,

relating directly to the wording in each sub-section of the standard• A reflection on your learning from this work, what went well, what you would do

differently’

Writing a commentaryGroup exercise

• think about what you would need to include in a commentary

• prepare a flipchart with key headings once you have agreed these

Writing a commentarySome suggestions for key areas to cover:• Title - basic description of subject of summary• Competencies/standards claimed • Context• Methodology/approach• The project/what you did, why, how, what went

well less well etc.• Outcomes &Impact• Reflection• List of supporting evidence

Reflective writing

• Should help to demonstrate what was learnt from doing the work, your role, and what you might do differently if you were to do a similar piece of work in the future

• Should demonstrate critical analysis of your own practice

• Look at how the work could be improved, what you would do differently and why, what was learnt, and how you have applied this subsequently

Why reflection?• There is an expectation that practitioners reflect

on what is currently being done and why and improves/changes practice as a result.

• Relates theory to practice - reflection is one of the most important factors in achieving this synthesis. Unless this link is made then knowledge is of little practical value.

Some models

• Kolb and Fry - experiential learning cycle• Gibbs - reflective cycle• Johns - reflective practice• Boud, Keogh & Walker - model of reflection

Reflective writing

• What did I do?• What lessons have I learnt?• What challenges did I face and how did I address

these?• What would I do differently in the future, and why?• How have I applied my learning from this

experience?• Where am I now and what do I need to do next?

Reflective learning• is a process of internally examining and exploring

an issue of concern,• triggered by an experience, which creates and

clarifies meaning in terms of self, and whichresults in a changed conceptual perspective.

Reflection on action requires:• Thinking about current practice• Questioning whether it is the best method of

handling the problem• Enquiring whether other practitioners use similar

approaches

Some useful references• Boud, Keogh and Walker (2000) Reflection: Turning

Learning into Experience Kogan Page, London.• Bulman, C. and Schutz, S. (Eds) (2004) Reflective

Practice in Nursing, third edition, Blackwell Publishing, Oxford.

• Gibbs G. (1988) Learning by Doing: A guide to teachig and learning methods, Further Education Unit, University of Oxford, Oxford.

• Holm and S. Stephenson. ‘Reflection-A Student's Perspective’ in Palmer A, Burns S, Bulman C (1994) Reflective Practice in Nursing: The Growth of the Reflective Practitioner, Blackwell Scientific, London.

• Johns, C. (2005) Transforming Nursing Through Reflective Practice, second edition, Blackwell Publishing, Oxford.

• Knowles, M (1980) The Modern Practice of Adult Education, Englewood Cliffs, NJ Cambridge Adult Education.

• Kolb, D.A. and Fry, R. (1975) 'Towards an applied theory of experiential learning' in Cooper, C.L (ed) Theories of Group Processes, London, John Wiley, pp. 33-57

• Schon, D. (1983) The reflective practitioner: how professionals think in action, Basic Books, University of Michigan.