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Standardised literacy and numeracy testing on horizon for student nurses in London


Student nurses in London could in the future see their numeracy and literacy skills assessed under standardised tests, as part of city-wide plans to make it easier for them to get jobs.

Currently universities and employers both carry out their own set of different tests. But it has been suggested that this model wastes time and that upon graduation nurses should be ready to practise if their skills have already been checked while studying.

In addition, there have previously been concerns about the wide variation in skills among new nurses, which the introduction of standardised testing could help to tackle because universities and employers would have to agree on an assessment to the level required, according to those behind the proposals.

Plans are now afoot to ensure student nurses are only tested while in their final year of university, through an online numeracy test, and also via the “episode of care” assessment, which already features in programmes and it is thought could be extended to incorporate literacy checks.

The proposals have been drawn up under the Capital Nurse programme, which was set up jointly in 2015 by Health Education England, trust nursing directors, unions and universities to try and encourage more locally-trained nurses to remain in London after they qualify.

As previously reported by Nursing Times, one of the main aims of the programme is to ensure that, from this coming academic year, all city-trained graduates are guaranteed a job in the capital.

In theory, the introduction of standardised testing would help to achieve this aim, because graduates would not have to complete multiple assessments with different NHS trusts, making it simpler to apply for a job.

“There has been a concern about a duplication – why are trusts doing testing when those assessments are done within universities?”

Tim Bryson

Consultant Tim Bryson, a mental health nurse by background who has been helping to develop the plans, said the intention was to make the process of testing “more nurse friendly”.

“There have been shared concerns about testing,” he said. “Quite a lot of NHS trusts over the last few years have developed literacy, numeracy and assessment centre approaches to testing.”

“It’s been very variable across London but it’s arisen out of concern about the numeracy and literacy of newly-qualified nurses,” he told a group of nurses, students and educators at the Capital Nurse conference in London last week.

He added: “Variable pass rates have been experienced but they have been improving. And from a university perspective, there has been a concern about a duplication – so why are trusts doing testing when those assessments are done within universities?”

In addition, he noted that, for nurses, this meant possibly having to complete multiple tests with several employers.

“This may feel as though it is yet another barrier or hurdle to complete to get a job,” said Mr Bryson, who is also a former director of nursing.

“[Completing multiple tests] may feel as though it is yet another barrier or hurdle to complete to get a job”

Tim Bryson

NHS trusts and universities want to work together to “make sure recruitment is as smooth and effective as possible” for the 4,000 nurses trained annually in London at 10 universities, he told delegates.

Following pilots at the end of last year at Buckinghamshire New University, London South Bank University, Middlesex University and City, University of London, it is hoped that all pre-registration nursing courses starting this autumn will use the same numeracy test – provided by online training provider Snap Assessment and Education.

Meanwhile, the extended “episode of care” assessment – to include literacy testing – is still being trialled, at mental health provider Central and North West London NHS Foundation Trust.

It is anticipated that the new approach will replace the clinical literacy assessments used by many universities and trusts, which involve scrutinising care plans.

In contrast, the model being trialled will see final-year student nurses presenting an episode of care that has actually taken place to a group of assessors, and also providing a written reflection and patient records – so their record-keeping and handwriting skills can also be checked.

“We felt the OSCE guidance could be used to strengthen our current assessment for clinical literacy… focussing on clinical skills as opposed to…spelling and grammar”

Rebecca Butler

The assessement method being trialled also includes elements of objective structured clinical examinations (OSCEs), already favoured by some universities.

Central and North West London NHS Foundation Trust’s practice educator Rebecca Butler, who is leading the work, said: “We felt the OSCE guidance could be used to strengthen our current assessment for clinical literacy.

“The guidance focusses on clinical skills, as opposed to some of our previous testing which was very much based on spelling and grammar,” she said.

If the pilot is sucessful, it is hoped the standardised literacy assessment will also be introduced in the coming academic year.


Readers' comments (2)

  • The tests and H&S standards be along the lines of that developed recently by the Thames Tideway Scheme.
    All tests are done pre employment and all personnel must be fluent not only in written work but in verbal. They must be able to understand the accents & dialects that they may come into contact with.
    It is a scheme all companies should follow

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  • Obviously, I'm not With The Beat here.

    Shouldn't it be the case that student applicants should be able to demonstrate adequate numeracy and literacy skills, in order to start to train and be educated at a University; afterall University education follows Primary & Secondary (&/or Further education)? it's not the other way around.

    University, I thought, was about developing one's critical analytical skills, following GCSEs (or equivalent) A levels, or (equiv.)

    Oh, wait a minute...for University: see School. For entrance criterion see: Warm and Breathing.

    Checking if someone can read, write and do simple arithmetic, during their final year presumes that they shouldn't need to be able to read, write, add up, subtract, times and divide, in their first, second (or sometimes) third year; and to suggest that clinical ability need not include literacy and numeracy is, to me nonsensical.

    All this begs questions about the quality and expectations of Primary & Secondary Education in Britain; what, basically, to expect from an immigrant workforce; the now further lowered expectations surrounding Nursing; and the raison d'etre of Universities.

    I think that there is a mismatch here between what is School and what is University..and the matter is being fudged! It will not end well.

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