What do we do about assessment in
practice?
Sophie Pullen
Objectives of a course in HE
The broad aims of the Foundation Degree in Veterinary Nursing are to:
• Produce a safe, competent and reflective Veterinary Nurse
who is eligible for admission to the RCVS Veterinary Nurse
Register
• Produce a critical thinking practitioner with extensive
knowledge, who can contribute to the standing of the
Veterinary Nursing profession through subject specific
preparation
• Produce Veterinary Nurses with a wider range of skills,
enabling them to work in a variety of roles within Veterinary
practice
(RVC, 2009)
Portfolio system
• Shopping trolley
• Toast rack
• Spinal column
• Cake mix
(Timmins et al, 2008)
Backwash: the effect of assessment on
learning
• Backwash: when the assessment rather than
the curriculum, determines learning.
• It implies that what the students learn and
how they learn depends very much on what
they think they will be assessed on .
(Biggs 1995 cited in Tiwari and Tang, 2003)
The NPL Nursing Progress Log
• We know that this is to be introduced
• We understand it will be supported by a
‘clinical coach’
Benner: novice to expert
• Novice
• Advanced
• Competent
• Proficient
• Expert
Theory-practice divide
• ‘A major dilemma of curriculum development
in nurse education is whether is should focus
on ‘nursing as it is’ or on ‘nursing as it should
be’
(Mead, 1999)
The move into HE suggesting the second is
endorsed: theory – practice gap?
What could we do?
Add an element of reflection?
Sayer (1990) – described reflective thinking as ‘...the
artistry of combining a professional repertoire with
current clinical problems to invent unique responses’
Characteristics of reflective
practitioners (Schon)
The effective reflective practitioner has the...
– ability to engage in self assessment
– ability to criticise the existing state of affairs
– ability to promote change and adapt to change
– ability to act as an autonomous individual
– ability to recognise and explore confusing or
unique events
How do we do this?
‘A portfolio in which there is a reflective
component, may provide a tangible
bridge between theory and practice.’
(Severinsson, 1998)
Reflective Journals/diaries
• Journals provide a very useful tool from which
to explore beliefs and values in terms of your
own experience’
• They can also provide a valuable teaching tool
when used during individual tutorials or
group discussions
(Hinchliff, 2004)
Marland and McSherry 1997
A diary had the following positive effects:
• It enhanced time management between student and
preceptor
• It promoted reflective learning
• It facilitated the transferability of insights gained in one
situation or placement to others
• It allowed students to see how they were progressing
• They concluded that the use of a reflective diary
provided a ‘framework for analysis and discussion’
and formed a link between theory and practice.
Critical incident analysis
• Benner (1984) stated that a critical incident could
be:
An incident...
–
–
–
–
–
–
In which the nurses intervention made a difference
that went unusually well
where there was a breakdown
that was typical or ordinary
that captured the essence of nursing
that was particularly demanding
Discussion boards?
• Reed and Proctor (1993) found that ‘sharing
experiences has a positive effect on learning’
• In order to learn from critical incidents
students in one study were encouraged to
share their reflections in small peer groups.
Guided reflection
Discussion boards?
• Glen and Hight (1992) describe the tutor as a
‘resource’ for the student in reflecting on
experiences and subsequent development.
(Cited in Harris et al, 2000)
Student comment
‘I felt exhausted both mentally and physically. I
felt frustrated. I could not give the patients my
full attention’
Reflective comment..
What constraints are present in your workplace
which prevent you from giving the care you
would like to give to each patient?
(Adapted from Taylor, 2000)
Communication is essential
Student
Mentor/coach
University
The use of models
Should we use one?
‘Students may be reluctant to share personal information
with their peers and tutors’
(Harris et al, 2001)
Remember....
Models are there to provide guidance .
They are not meant to be ‘rules’ for reflection.
Veterinary nurses should be encouraged to ...
‘develop a flexible approach to their use, giving
some thought to which parts of the model are
most useful...’
(Heath, 1998)
Rolfe’s Reflective model (2001)
based on Borton’s model (1970)
What?
This is the description and
self awareness level and
all questions start with
the word what
So What?
This is the level of
analysis and evaluation
when we look deeper at
what was behind the
experience.
Now what?
This is the level of synthesis.
Here we build on the
previous levels these
questions to enable us to
consider alternative courses
of action and choose what
we are going to do next.
Examples
What happened?
What did I do?
What did other do?
What was I trying to
achieve?
What was good or bad
about the experiences
Examples
So what is the importance
of this?
So what more do I need
to know about this?
So what have I learnt
about this
Examples
Now what could I do?
Now what do I need to do?
Now what might I do?
Now what might be the
consequences of this action?
Gibbs Reflective Cycle (1988)
Description
Action plan
Feelings
Evaluation
Conclusion
Analysis
Interestingly…
• ‘Students who report negative experiences were
more likely to outline their feelings’
• ‘Students in the more senior years were more
likely to use a cycle and move beyond the first
phase of reflection, whereas the junior students,
particularly the first years were more likely to
confine reflection to the first phase of Gibb’s’
(Timmins et al, 2008)
What do we do with this
information?
Do we mark it?
How do we mark this?
Summative or formative?
• There are issues of validity and honesty of written
accounts, particularly when summative
assessment requires the assignment of a grade.’
(Timmins et al, 2008)
Adopt a portfolio marking criteria?
Investigate those used within human nursing?
Whatever we do the following
points need to be considered …...
Considerations……
• Clear guidelines needs to be provided
• A suitable mentor/coach is essential
• Students should to continue being supported by
College/University staff
• A suitable placement environment is required –
belongingness.
• There is a potential to identify legal and ethical issues
occurring in practice.
• Issues of confidentiality
References - portfolio
• Gannon, F. T., Draper, P. R., Watson, R., Proctor, S. and
Norman, I. J., 2001. Putting portfolios in their place.
Nurse Education Today 21, 534 – 540.
• Harris, S., Dolan, G. and Fairbairn, G., 2001. Reflecting
on student portfolios. Nurse Education Today. 21, 278286.
• McCready, T., 2005. Portfolios and the assessment of
competence in nursing: A literature review.
International journal of nursing studies 44, 143-151.
References - portfolio
• McMullan, M., 2008. Using portfolios for clinical practice learning
and assessment: The pre-registration nursing student’s perspective.
Nurse Education Today 28, 873 – 879.
• Storey, L. and Haigh, C., 2002. Portfolios in professional practice.
Nurse Education in Practice 2, 44-48.
• Timmins, F. and Dunne, P. J., 2009. An exploration of the current use
and benefit of nursing student portfolios. Nurse Education Today
29, 330-341.
• Tiwari, A. and Tang, C., 2003. From process to outcome: the effect
of portfolio assessment on student learning. Nurse Education Today.
23, 269 – 277.
References - reflection
• Burns, S and Bulman, C., 2000. Reflective Practice in
Nursing: the growth of the professional practitioner 2nd
edn. Oxford: Blackwell Science.
• Duffy, A., 2008. Guiding students through reflective practice
– the preceptors experiences. A qualitative descriptive
study. Nurse education in practice.
• Heath, H., 1998. Keeping a reflective practice diary: a
practical guide. Nurse Education Today 18, 592-598.
• Hinchliff, S., 2004. The practitioner as teacher 3rd edn
London: Elsevier.
References - reflection
• Taylor, B. J., 2000. Reflective Practice: a guide for
Nurses and Midwives, Milton Keynes: Open
University Press.
• Teekman, B., 2000. Exploring reflective thinking in
nursing practice. Journal of Advanced Nursing
31(5), 1125 – 1135.
• Quinn, F. M., 2000. The Principles and Practice of
Nurse Education, U.K.: Stanley Thornes
(Publishers) Ltd.