The Nursing and Midwifery Council has published new standards on nurse and midwifery proficiency and education. This article outlines what will change in terms of student nurse supervision and assessment
We are on the cusp of a new era: in May 2018, the Nursing and Midwifery Council published its long-awaited new standards of proficiency for registered nurses and standards for the education and training of student nurses. From January 2019 onwards, these will gradually replace the 2008 Standards to Support Learning and Assessment in Practice. While the new standards also apply to midwifery students, this article focuses on student nurses. It looks at how mentoring will change in light of these new standards and focuses on how students will be supervised and assessed in practice. It also describes the new standards and their implications for registered practitioners.
Citation: Hoy G, George S (2018) New standards on the supervision and assessment of students in practice. Nursing Times [online]; 114: 12, 27-29.
Authors: Georgina Hoy is senior lecturer in nursing, Anglia Ruskin University; Sharon George is clinical educator and placements lead, Cambridgeshire Community Services Trust.
Nursing practice is evolving. Health professionals are caring for a growing ageing population with increasingly complex, and often multiple, health and social care needs. The vision of the Nursing and Midwifery Council is to regulate for future needs in a dynamic way that anticipates and responds to changing demands (NMC, 2015). Looking ahead to 2030 and beyond, the regulator has reviewed its standards for the education and training of nurses to ensure that members of the workforce are suitably prepared for their future roles. This article explains what will be changing in relation to student mentoring and assessment.
In May 2018, the NMC published its long-awaited Standards of Proficiency for Registered Nurses (NMC, 2018a), which identifies the main aspects of registered nurses’ roles, responsibilities and accountabilities. The required proficiencies are structured around seven areas (Box 1). Alongside the new standards of proficiency, the NMC also published Realising Professionalism: Standards for Education and Training, which comprises three key documents:
- Part 1: Standards Framework for Nursing and Midwifery Education (NMC, 2018b);
- Part 2: Standards for Student Supervision and Assessment (NMC, 2018c);
- Part 3: Standards for Pre-registration Nursing Programmes (NMC, 2018d).
Box 1. Areas of registered nurses’ proficiencies
The new proficiencies outlined by the Nursing and Midwifery Council cover seven areas:
- Being an accountable professional
- Promoting good health and preventing ill health
- Assessing needs and planning care
- Providing and evaluating care
- Leading and managing nursing care and working in teams
- Improving safety and quality of care
- Coordinating care
Source: Nursing and Midwifery Council (2018a)
The new set of standards will replace the Standards for Competence for Registered Nurses (NMC, 2014), Standards for Pre-registration Nursing Education (NMC, 2010) and the Standards to Support Learning and Assessment in Practice (SLAiP) (NMC, 2008). Box 2 outlines the timeframe for the new standards to come into effect.
This article focuses on Realising Professionalism: Standards for Education and Training – Part 2: Standards for Student Supervision and Assessment. This details how the supervision and assessment of all students on NMC-approved programmes will change.
Box 2. When will the new standards come into effect?
At the time of writing, the Nursing and Midwifery Council’s website states:
- From 28 January 2019, all approvals will be made against the new standards
- After 1 September 2020, only programmes approved against these new standards will be able to accept new students and meet requirements for award and registration
Currently, how students are mentored and assessed in practice is governed by the SLAiP (Shaw-Flach and Hoy, 2016). In particular, these standards set out the requirement for students on assessed placements to be directly or indirectly supported in practice by a live mentor or practice teacher for 40% of the time. A live mentor is a registered practitioner who has undertaken an approved mentorship course and goes through annual mentor updates and triennial reviews.
Although this area within the profession is still governed by the SLAiP, at the time of writing, the NMC was developing more-detailed information (NMC supporting information on standards for student supervision and assessment) relating to:
- Practice assessment;
- Academic assessment;
- The practice learning environment;
- Student empowerment.
It is imperative that nurses work together to promote high-quality practice learning to safeguard the public, students and practitioners. The NMC emphasises the importance of safe and effective learning environments to make sure that those who are learning receive the training and education they need to be able to deliver safe and effective practice; it has developed a new quality assurance framework in this regard (NMC, 2017e).
What is changing?
The NMC’s (2018c) Standards for Student Supervision and Assessment explains the regulator’s expectations for student learning, support and supervision in the practice environment. It also describes how students will be assessed in both theory and in practice.
A key change is in the language: under the new standards, there will no longer be mentors. The new mentoring roles are described in the section on supervision of students later in this article.
The requirement for triennial review has been removed, as this is now a requirement for all NMC registrants in the form of revalidation. The NMC (2018f) stipulates the importance of students continuing to practise in accordance with its code of practice, prioritising the safety of the public at all times.
The NMC’s (2018c) Standards for Student Supervision and Assessment is organised in three sections:
- Effective practice learning;
- Supervision of students;
- Assessment of students and confirmation of proficiency.
Effective practice learning
The quality of practice learning environments is integral to providing safe and inclusive places in which students can experience, and learn, healthcare. Partnership working between educational institutions and placement providers is fundamental to make sure that appropriate opportunities exist within placements for students to fulfil the proficiencies and outcomes that are relevant to the programme they are studying.
A team approach to supporting students remains key, with recognition that students benefit by learning from a range of relevant individuals within practice, including:
- Service users;
- Registered and non-registered practitioners.
The overall aim is for students to learn safely, and achieve both proficiency and autonomy in their chosen role.
Supervision of students
The NMC (2018c) states that all registered nurses and midwives are capable of:
- Role-modelling safe and effective practice;
- Supervising students.
As a result, all registered nurses will be required to supervise or assess students in practice, while other registered health and social care professionals may also supervise them. All students on NMC-approved programmes must be supervised while they are learning in practice, with a level of supervision that has been tailored to their specific learning needs and training stage.
The NMC describes the specific role of practice supervisor. Practice supervisors will role model safe and effective practice in line with the NMC’s code of practice (NMC, 2018f). Their role will be to support learning in accordance with students’ scope of practice, empowering them to become independent and, ultimately, fulfil the proficiencies and outcomes of their programme of study. Feedback for students will be integral to this, enabling them to become reflective practitioners. Practice supervisors should be appropriately supported to get involved with educating learners in the practice environment.
In relation to assessment, practice supervisors will contribute to students’ achievement records by recording observations on conduct, proficiency and achievements. These observations will contribute to student assessments and, crucially, inform decisions about whether they are able to progress. Practice supervisors will need to understand individual students’ proficiencies and programme requirements. They will also need to be supported in raising concerns if needed.
Collating information and feedback from practice supervisors will enable practice assessors (whose role is described later in this article) to make a rounded and informed decision about a student’s progress and abilities.
The vision is that student nurses will be prepared for supervisory roles during their pre-registration training so that, when they qualify, they themselves are ready to take on the role of practice supervisor for new learners. This aligns with the NMC’s code of practice (NMC, 2015f), in which the requirement for supporting students’ and colleagues’ learning is integral to clinical practice and partnership working.
Assessment of students and confirmation of proficiency
In line with current practice, the NMC identifies that students’ assessments must be evidence-based, robust and objective. It describes two specific assessor roles:
- Practice assessor;
- Academic assessor.
Practice and academic assessors will need ongoing support to enable them to fulfil their roles.
All students undertaking a programme of study approved by the NMC will be assigned to a different academic assessor for each part of the programme. They will also be assigned to a practice assessor, either for a single placement or for a series of practice placements.
For student nurses, assessors must be registered nurses with appropriate equivalent experience for the student’s field of practice. This promotes flexibility, allowing practitioners to draw on their expertise without being constrained, as may currently be the case with the SLAiP. For student midwives, assessors must be registered midwives. All assessors must be empowered to raise any concerns in relation to a student’s conduct, achievements and competence.
For each student, a nominated practice assessor will work in partnership with a nominated academic assessor. Practice assessors will need to be given sufficient opportunities to observe the student in practice to ascertain their level of proficiency and suitability to progress. Partnership working between practice assessors and academic assessors will be key and must be scheduled at relevant progression points in the programme.
It is important to highlight that a student’s practice assessor cannot be their practice supervisor at the same time. However, a practice assessor could be practice supervisor for a different student.
The NMC no longer stipulates training requirements for supervisory and assessment roles, but it is in the process of developing guidelines on how to prepare for those roles. The guidelines for practice supervisors have already been published, while those for practice assessors and academic assessors are still in development (NMC supporting information on standards for student supervision and assessment).
The main changes to the supervision and assessment of nursing and midwifery students are outlined in Box 3. New supervision and assessment standards herald a new era in nurse education, equipping the profession for an increasingly demanding and complex healthcare environment. How we supervise and assess students in practice is crucial to ensure our future workforce is fit for purpose. By promoting a positive learning culture that allows honesty and openness, the nursing profession will continue to meet and surpass needs and expectations. While legal and regulatory requirements need to be upheld, there will be opportunities for innovation, wherein student nurses are empowered to harness diverse learning opportunities across a wide range of settings. In so doing, they will become able to practise effectively, safely and compassionately and, in turn, inspire a new generation of nurses.
Box 3. Changes to student supervision and assessment
- The language is changing – the term ‘mentor’ will be phased out when the new standards are implemented
- Nursing and midwifery students will be supervised in practice by practice supervisors
- Feedback from practice supervisors will inform the decisions that are made by practice assessors
- Practice assessors and academic assessors will liaise in respect of practice assessments
- Triennial review will be phased out when the new standards are implemented
- Due regard will be phased out when the new standards are implemented. Students will be assigned to practice and academic assessors, who have “appropriate equivalent experience for the student’s field of practice” (Nursing and Midwifery Council, 2018c)
- All registered nurses and midwives will be responsible for contributing to the supervision and support of student nurses in practice
- The Nursing and Midwifery Council (NMC) has published new education standards, including those on student learning and assessment in practice
- All registered nurses will be required to supervise or assess students in practice
- Practice supervisors will support students’ learning, helping them to achieve clinical independence
- For each student, a practice assessor will work in partnership with an academic assessor
- The NMC is developing documentation relating to the new standards
Nursing and Midwifery Council (2018a) Standards of Proficiency for Registered Nurses.
Nursing and Midwifery Council (2018b) Realising Professionalism: Standards for Education and Training – Part 1: Standards Framework for Nursing and Midwifery Education.
Nursing and Midwifery Council (2018c) Realising Professionalism: Standards for Education and Training – Part 2: Standards for Student Supervision and Assessment.
Nursing and Midwifery Council (2018d) Realising Professionalism: Standards for Education and Training – Part 3: Standards for Pre-registration Nursing Programmes.
Nursing and Midwifery Council (2018e) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates.
Nursing and Midwifery Council (2018f) Quality Assurance Framework for Nursing and Nursing Associate Education.
Nursing and Midwifery Council (2015) Strategy 2015-2020: Dynamic Regulation for a Changing World.
Nursing and Midwifery Council (2014) Standards for Competence for Registered Nurses.
Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education.
Nursing and Midwifery Council (2008) Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers.
Shaw-Flach A, Hoy G (2016) Supporting pre-registration nurses within health visiting and school nursing. Community Practitioner; 89: 12, 44-48.