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Innovation

Enabling revalidation for registrants working in an education setting

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An initiative was set up in a university to educate and support its nursing and midwifery educators through the process of revalidation

Abstract

This collaborative project at City, University of London, aimed to support the revalidation of nurses and midwives employed in a variety of roles. Defining their practice area as ‘education’, nurses and midwives employed by the university attended interactive workshops to support their revalidation submission. Working with the human resources department, registrants were identified. In total, 11 workshops were delivered to those intending to revalidate, one of which was for confirmers. Over 80% of registrants employed by the university attended a workshop. The project revealed the challenges and the potential of combining educational and professional identities in a university context, with revalidation having a positive effect on the identity of nurses and midwives working in an education setting.

Citation: Attenborough J (2017) Enabling revalidation for registrants working in an education setting. Nursing Times [online]; 113: 4, 34-35.

Author: Julie Attenborough is associate dean and director of undergraduate studies, School of Health Sciences, City, University of London. 

Introduction

When revalidation was introduced by the Nursing and Midwifery Council in April 2016, much of the guidance and information focused on nurses and midwives working in clinical practice. This article examines the issues and challenges of revalidation for staff in an education setting – namely, City, University of London. 

Revalidation replaced the previous system of post-registration education and practice (PREP), and was developed with the aim of promoting safe and effective practice by encouraging registrants to relate their practice closely to the recently revised code (NMC, 2015). This involves demonstrating competence and adherence to the code within their area of practice.

Much of the literature and guidance on revalidation focuses on nurses and midwives in clinical practice (Falla et al, 2016; Beach and Oates, 2015) and large employers such as NHS trusts have provided training and support to registrants. However, for many nurses and midwives employed by universities as lecturers and researchers their practice can be defined as education, research or education and research. 

Many universities also employ registrants in student health-centres, occupational health and counselling services, while a number of visiting lecturers are registrants. We were aware that we needed to provide some support and guidance for registrants working across the university to help them to revalidate (Box 1). 

Box 1. Implementation steps

  • Set up a recording system to identify all registrants in the university, and arranged for this to be updated by the human resources team for starters and leavers. Data collected included revalidation dates
  • Raised awareness of the code and its relationship to revalidation at an early stage of the process
  • Communicated about the revalidation process and explained its relationship to nurses’ role at the university through workshops, a human resources intranet page and revalidation leads
  • Identified revalidation leads within each discipline, acknowledged that registrants are employed in a variety of roles in a university
  • Integrated links to Nursing and Midwifery Council guidance in human resources intranet pages
  • Clearly identified to registrants that the university supports the revalidation process

Two universities were included in the NMC pilot for revalidation, so we contacted them for advice during the planning and early implementation stage of the project. Key findings from this pilot have been reported in the literature, although not in direct relation to education (Middleton et al, 2015).

Because this was a new process and concept, we faced a number of challenges in a short space of time – the most common was staff anxiety about identity. For example, some lecturers asked to be released from their teaching and research duties to undertake clinical work in a local NHS trust in order to meet the revalidation requirements. They did not realise that they could identify their area of practice as education and/or research and did not need to carry out clinical work specifically for revalidation. 

We also needed to identify registrants in other parts of the university, for example, in student counselling, occupational and student health. Despite the challenges, we recognised that the process of revalidation had the potential to raise the status of, and investment in, nursing and midwifery educators in a university context.  

Training and support

While we recognised that revalidation is fundamentally the responsibility of registrants, we wanted to support them in the university to revalidate. Critical to the success of providing such support was institutional buy-in by the university as an employer of registrants. By approaching human resources at an early stage we were able to access increased HR resources for the first year of the project. 

Our first step was to identify all registrants in the university and contact them to raise awareness about revalidation and the code; 72 were identified. We encouraged all of them to register online with the NMC and organised a series of workshops for confirmers and registrants, which covered the requirements, reflective account writing, feedback and documentation. We produced a folder for use by all registrants containing materials about revalidation, and also developed an online quiz to test knowledge about revalidation. The quiz was popular: 48 registrants completed it, and it has subsequently been adapted for use with second-registration students.   

We set up an intranet page through HR, which had links to the NMC guidance, provided details of workshops and sources of support, and identified revalidation leads across the university to support staff. We also identified people who were suggested confirmers for registrants; where possible, these were line managers. 

Crucial to the success of the project was the identification of revalidation leads across the nursing and midwifery disciplines. They attended an initial workshop and were able to advise and support staff preparing for revalidation.

Workshops

There were 11 workshops, one of which was specifically for confirmers, and all the workshops were well attended. In total, 63 registrants took part, which was 87% of those employed by the university. 

Seven registrants attended the workshop for confirmers, which explored the purpose of revalidation, the role of the confirmer, and provided guidance on examining evidence, acting honestly and in good faith, and information about the code. 

Addressing this in a supportive and collaborative way, using scenarios, enabled confirmers to explore their anxieties about the role and become familiar with the materials provided by the NMC. Registrants were universally positive in their evaluation: they thought the workshops demystified the process, and they left with a sense of “being able to do it”. Staff raised some issues about their identities as both nurses and midwives and educators – and there was a discussion about the positive role of revalidation in supporting their professional identities.  

We were encouraged that staff considered the process of revalidation had raised the profile of nursing and midwifery at the university, and that they planned to develop this further through special interest groups. This was reinforced by feedback from staff who went on to revalidate in April 2016; it was especially encouraging that they considered the university had ‘bought into’ supporting them to retain their registration and helped raise the profile of the code. 

One midwifery lecturer said: 

“…ultimately, this supports the embedding of the importance of public protection for this and future generations of nurses and midwives.”

This is, of course, part of the aim: 

“The Code will be central in the revalidation process as a focus for professional reflection. This will give the Code significance in your professional life, and raise its status and importance for employers” (NMC, 2015)

Future developments

Alignment with the university’s appraisal system was identified as an important area for development and this is being explored. Revalidation training is also now part of induction for new staff. We have also embedded teaching about the code and revalidation in the pre-registration curricula, with bespoke workshops for midwifery students undertaking the shortened course. 

Conclusion

Despite the anxieties and challenges, the introduction of NMC revalidation at City, University of London, has enabled registrants to feel pride in their identity as nurses and midwives. It has also raised the visibility and status of nursing and midwifery as part of the professional education profile of the university. The process of identifying registrants across the university and supporting them to revalidate has also contributed towards building a stronger professional community within City. 

Key points 

  • Nursing and midwifery educators may experience anxiety about revalidation related to their identity as registrants 
  • Registrants employed by universities are not confined solely to schools of health
  • Supporting registrants with human resources input from the outset contributes to the success of revalidation in the university setting 
  • Revalidation can have a positive effect on the professional identity of nurses and midwives working in higher education 
  • Workshops are beneficial in promoting the Nursing and Midwifery Council’s code of conduct, linking it to practice and supporting confirmers
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