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Published on January 15, 2008

Author: Hillary

Source: authorstream.com

PLS SIG Conference Wednesday 29th March 2006:  PLS SIG Conference Wednesday 29th March 2006 Reflections on clinical practice assessment Unseen Triads – the light is on:  Unseen Triads – the light is on Elinor Clarke Welcome :  Welcome In the dark? Lights On: Triads Illuminated. 40, 60 or 100w? Conclusion In the dark?:  In the dark? What is an triad? A triad is: a method of assessment of student midwives in clinical practice. A summative assessment of theory in practice. Levels 1,2 and Level 3 (Competent) Based on “Fit to practice” at the point of registration. Unseen Triads – the light is on!:  Unseen Triads – the light is on! Triads Illuminated What are unseen triads? Roles & Responsibilities. 40w, 60 w or 100w? Evaluation Partnership Liberated or empowered? Triads Illuminated:  Triads Illuminated Roles & Responsibilities. Assessment criteria Conduct of the Triad Logistics Marking Domestic arrangements Equity. Triads Illuminated:  Triads Illuminated Triads were developed & planned (1998), utilised in the curriculum since May 2001 Triads are a summative assessment of clinical education modules. There are 3 triads. Only one is “unseen” (Level 3) The Unseen triad is used to assess ALL student midwives (long 3yr & shortened course78 weeks) Triads are an assessment tool which mark or grade clinical practice. Triads are weighted to value midwifery care in practice. The first unseen triads were conducted on 12th January 2004 Unseen Triad :  Unseen Triad An Unseen triad is a level 3 triad The assessment provides the opportunity for the student to demonstrate autonomy & the ability to undertake the role and responsibilities of a midwife at the point of registration. The student is required to assess, plan implement and evaluate an episode of care for a woman/ or baby previously unknown to them, who has been selected by the clinical assessor. Unseen triad:  Unseen triad The “unseen” part of the triad relates to The clinical assessor is NOT the students mentor, she does not work with the student on a regular basis. The woman/baby to whom the student provides care has not met the student before. The care required may be antenatal or postnatal. Clinical assessor/Experienced mentor:  Clinical assessor/Experienced mentor Definition – an experienced midwife who is an established mentor with record of participation in Triad assessments. Criteria for selection: willingness to participate in an unseen Triad Understands process of Triads Confident & competent in assessment of students Participated in specific updating/workshop for preparation to assess unseen Triads. Has not regularly worked with the student (unbiased) Role & responsibilities of Clinical Assessor:  Role & responsibilities of Clinical Assessor The Clinical assessor (experienced mentor) is supernumerary on the day of the triad (unrostered/ but on duty) To identify and choose a suitable woman / + or baby to receive care the day before the assessment takes place. To prepare the woman and her family for the students assessment and establish willingness to participate and gain consent. To inform the student and Link tutor of time and venue for the assessment. To participate in the awarding of marks. Role & responsibilities of Link Tutor:  Role & responsibilities of Link Tutor To provide copies of the assessment criteria To confirm assessment may be conducted. To provide written evidence of student assessment. To confirm attendance at Triad when informed by clinical assessor. To thank the student for the reflection and thank the assessor for her contribution & time. To update and inform clinical assessors of developments to student assessments. Role & Responsibilities of Student Midwife:  Role & Responsibilities of Student Midwife To attend the Triad on the date and time specified by the Clinical assessor. To confirm his/her intention to present for assessment To have prepared for the assessment To bring with them the documentation for the assessment To attend the assessment be responsible for keeping to time & participate in the agreement of marks. Assessment Criteria:  Assessment Criteria All assessment criteria remain the same as introduced (NMC 2004 Competencies) All students have a copy of the criteria in their handbooks at the start of the course. Students requested (CCC) clarification of the numerical award system in an attempt to improve inter assessor reliability. An additional grid has been produced and passed subject quality group (SQG) process Conduct Unseen Triad (Level 3):  Conduct Unseen Triad (Level 3) The assessments will take place on the antenatal/postnatal wards Students will not (should not) have the opportunity to meet with the woman or view the notes prior to the triad The assessment is expected to last 40-60 minutes. 20-30 minutes for the student to provide care and 20 minutes for the presentation. The presentation must not exceed 20 minutes and will be a reflection. Each member of the triad will have a copy of the marking sheet with the criteria listed. Each member should identify their mark and agreement will be made on the final mark Logistics:  Logistics Proposed Unseen Triads are clearly identified. Annual leave, sufficient experience University staff have been organised into Triad Teams. Level 3 TRIAD Team members meet regularly to facilitate the process. Marking:  Marking The triad mark forms 60% of the total module mark. The student must get a minimum of 40% of the possible triad mark in order to pass this assessment All * items must reach at least a score of 2 Domestic arrangements:  Domestic arrangements The Clinical assessor should inform the student and the Link tutor the time and venue for the assessment. All students have 10 minutes to view the woman's records prior to the assessment & should also receive a verbal report from the midwife responsible for the woman’s care. The Link tutor will provide copies of the assessment criteria for those who forget to bring theirs. The student will declare him/herself fit & well to undertake the assessment. The student is responsible for time management of her care and the presentation Guidelines to promote equity:  Guidelines to promote equity Students will not receive any prompts /questions by either Link tutor or clinical assessor during the presentation. Each member of the tripartite assessment should identify their mark on the assessment sheet. Each should identify their mark and agreement made on the final mark. Where no agreement can be reached then the mark awarded will be that of the two closest agreed marks e.g. 4,5 and 4 the mark of 4 will be awarded. Recap/Summary:  Recap/Summary Triads are a method of assessment for student midwives. Unseen triads are assessed at level 3 The student, the clinical assessor and the link tutor all participate in marking The student must pass this assessment to qualify as a midwife! Evaluation 40w 60w or 100w!:  Evaluation 40w 60w or 100w! What do we perceive from reflecting on this method of assessment? Hearsay – time consuming, stressful Evidence – co-operation, results Are Triads a good method of clinical assessment? Analysis:  Analysis Is there any evidence that Unseen triads liberate student midwives? Is it possible to empower students when they have to demonstrate skills? Can student assessment empower participants? What does partnership mean in the provision of health care and education? Do triads liberate clinical assessment? How does partnership working impact upon clinical assessment? Creativity ? Liberation in clinical assessment:  Liberation in clinical assessment Engaging students in “critical thinking” in midwifery is complex Problem solving potentially re-enforces medical model of care. Partnership with women alienates husbands, partners and obstetricians Professionals have historically taken the lead. Reflection on incidents exposes staff to challenges to their delivery of care. Potential to generate creative power Partnership:  Partnership Not new to midwives – work in partnership with pregnant women and their families. Based on DoH (1993) Changing Childbirth (choice,continuity and control) for childbearing women Bsc (Hons) Midwifery programme is based on partnership with local NHS Trusts. Learning contracts – partnership with mentors. Adult learners Action Plan ??:  Action Plan ?? Continue to use Unseen Triads for the assessment of clinical practice Promote the benefits to the NHS TRUST Share and disseminate our experiences. Place Unseen Triads in Learning Repository Publish our experiences. Thank You:  Thank You For attending the workshop being willing to discuss Unseen Triads Considering some of the issues surrounding clinical assessments in midwifery References:  References Coventry University (2002) Curriculum Coventry University (2002) Criteria for Marking Triad Assessment – Level 3 Competent. School of health & Social Sciences. Competence Log Book Freire P (1996) Pedagogy of the oppressed. Penguin. UKCC (2000) Requirements for pre-registration Midwifery programmes. London. UKCC Nursing & Midwifery Council (2004) Standards of proficiency for per-registration midwifery education. NMC.London. Workshop Evaluation:  Workshop Evaluation Please complete the evaluation in order that I am able to monitor, develop and improve this workshop. Aims and Objectives:  Aims and Objectives Aim to reflect upon the unseen triad. Objectives are that by the end of the workshop participants will: Understand the process of unseen triad assessments Recognise the roles & contributions of all participants Identify how the Unseen Triad may empower the student and clinical assessor. Consider the practicalities of this assessment. Share examples of good practice which emerged from Unseen triads. Plan of workshop:  Plan of workshop 11.05 Welcome and introduction 11.04 PP Presentation in the dark? 11.10 Handout re Triads 11.15 11.25 Questions 11.30 Finish Historical Landmarks:  Historical Landmarks 1988 Introduction of Triads into the Midwifery curriculum 2001 Unseen triads validated for Level three 2003 Clarification of numerical award system (to improve inter assessor reliability) 2003 Introduction of Triad assessment grids 2004 Unseen triads used for the first time

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