Course guide for Return to Practice (Nursing) NH2332 Welcome On behalf of the Course Management Team we should like to extend to you a very warm welcome and to take this opportunity to wish you every success in your studies and trust that your time at the University of Wolverhampton will prove to be enjoyable, stimulating and rewarding. There are many awards run within the School of Health and Wellbeing, which has established an excellent reputation for the quality of its courses, for an innovative approach to teaching and learning, and for the friendliness of its staff. We believe it is important that you are encouraged to make your own contribution to the effective operation and development of your chosen course. We are, therefore, keen to hear your views and would welcome any suggestions that you may have about ways of improving any aspect of your course and/or the student experience here at the University. In practice, you will have the opportunity to do this through our student voice processes. Remember that the outcome of your studies could affect the whole of your future career and therefore study should certainly be your first priority. In resolving to work hard however, do not forget to have time for recreation and social activities. Do take full advantage of the University facilities at your disposal. Ann Saxon, Principal Lecturer Megan Tanner, Principal Lecturer 1 About the Course Having been a previously Registered Nurse on any part of the current or former Nursing & Midwifery Council (NMC) or UKCC Register, this is the course that can enable you to re-register and return to nursing practice. It does not matter how long you have been out of practice, you are welcome to apply for this course. There is no upper age limit. This guide gives details about the content, structure and delivery of the course. Nursing is an exciting and developing profession that you have previously enjoyed, and this course will provide a broad-based update on essential subjects that will, on successful completion, enable you to re-register with the NMC and continue your career. The course enables previously registered practitioners who have been out of practice for a period of three years or more to fulfill current Nursing and Midwifery Council requirements prior to returning to practice. Alternatively, you may already be registered to practice with a Registering Body in another European country, and been advised by the NMC to undertake this course to gain NMC Registration in the United Kingdom. If you have been out of nursing practice for a period of 3 years or more, then you are eligible to undertake the Return to Practice course offered by the School of Health & Wellbeing, University of Wolverhampton. Also if you currently have a live PIN number with the NMC and wish to refresh your nursing knowledge & clinical skills you can apply for this course. Before applying for a place on the course, it is recommended that you consider the following advice: Applicants from countries where English is not the first language must provide evidence of the International English Language Test (IELTS) score 7.0 or above 2 Funding for the course is now the responsibility of the Primary Care Trust (PCT) local to where you currently live. You should contact them to find out if they are willing to fund your course. Funding from PCTs will cover the University fees, and in some cases a bursary or training allowance may be paid to you in addition to the fees. If you cannot get funding from your local PCT, then you may pay for the course yourself. The cost of the course for academic year 09/10 is £1284. Additional to this cost is the occupational health clearance as well as the Criminal Record Bureau charges. You may approach various charities that are related to your area of nursing for funding. In addition to this, if you are currently out of work you may approach the Department for Work & Pensions for possible funding. The Nursing & Midwifery Council (NMC) requirements for returning to practice are available on their website. It is suggested that you visit the website and read the information available. http://www.nmc-uk.org/ If you are a qualified nurse from within the European Union you must contact the NMC before applying for the return to practice course. They will decide which course is most appropriate for you to apply for. The letter from the NMC must be sent with your application form. After completing an application form, short-listing of applicants will occur. If you are short-listed you will then receive a date for interview. There will be literacy and a numeracy test prior to the interview. You will be required to undergo a Criminal Record Check via the Criminal Records Bureau (CRB). Evidence that this has been done is required before your acceptance on the course can be considered. 3 Following a successful interview the form for CRB will be sent to you. Please note, having a criminal record does not necessarily prevent you from returning to nursing. You will pay for the CRB clearance separately. Medical clearance is required to ensure that you are fit for work. Following a successful interview the occupational health form will be sent to you. You will be invoiced for this separately. An interview with the module leader and another member of the University staff or practice staff will be arranged and the date, time and venue notified to you. The interview is an opportunity for you to ask questions about the course and for the University staff to advise if necessary on a suitable clinical placement for you. Five days of full time study will be delivered over a 2-month period at Walsall Campus (WP Building, Gorway Road, Walsall WS1 3BD). The dates and timetables for these days will be notified to you following acceptance of a place. If you have not studied for some time, the University has systems in place to support your academic work. The assessment requirements of the course will be explained to you at interview and you will be given time to ask questions. Placements - you are strongly advised to try to secure your own placement prior to commencing the course. All placement areas must have had an educational audit undertaken and have a ‘sign off’ mentor to support you. The University will require this evidence prior to commencing the placement. For further advice contact Mary Drozd, Course Leader (see details below). Your clinical placement is where you will complete the clinical part of the course. The NMC require that returners spend a minimum of 75 4 hours, and a maximum of 150 in supervised clinical practice before returning to the Register. We strongly advise that you should spread these hours over 4 to 6 months, and if necessary complete more than 150 hours if you feel you need more time to be competent and confident in practice. If you are currently working, please consider very carefully how you would incorporate your clinical hours into your current job. It is not permissible to try to complete the clinical hours working weekends only. You need to spread your hours over weekdays and weekends in order to gain useful and varied experience. You may work one or two nights if you wish, but the majority of your clinical time will be on day duty covering mornings, afternoons and evenings. The supervised clinical practice hours can be completed however you wish. You must work with your sign off mentor for at least 40% of the time. It is suggested that you spread the hours into shifts of a minimum of 4-6 hours, to cover some mornings, afternoons and evenings. We advise you to work at least one shift per week and be present for at least some handovers. Course Structure The course is offered twice yearly in September and February, based at the Walsall Campus, Gorway Road. Students complete a minimum of 5 full study days in school 9 – 4 pm, followed by a period in supervised clinical practice as detailed below in “course management” To encourage the development of confidence, the course has taught, negotiated and practice assessment components and is designed to enable the returning students to fulfill their commitment to lifelong learning as required by the Post Registration Education & Practice standards. 5 Course Description This is a stand-alone module that awards 15 academic credits at level 2 (diploma) on successful completion. These academic credits can be used to contribute towards a number of undergraduate awards offered by the School of Health & Wellbeing- See the Continuing Professional Development Prospectus for further details. Course Management Procedure for Admission to Return to Nursing Programme Application Pack obtained from: Chris Banton – Admissions Tutor, SHaW 01902 518800 Tina Bate – SHaW 01902 518615 Khaleda Miah – SHaW 01902 518807 Completed Application Forms and references to be returned to Admissions who will photocopy & send to Course Leader. Short listing takes place 3 months prior to commencement of the course. Successful applicant invited for interview and to bring PIN/PRN, photograph, ID, e.g. passport, driving licence. Literacy and numeracy tests to be undertaken at interview from September 2009. Course Leader checks PIN via NMC Caller Code System. PRN for European nurses is checked via telephone call to the NMC Letter sent to successful applicant offering a conditional place on the course. Admissions send successful applicant Criminal Review Bureau/Occupational Health forms to be processed. 6 Once completed paperwork received and unconditional offer made the applicant is invited to: Induction day Commencement of Course Following the 5 study days in school, students commence a pre-arranged placement in a clinical area. Students are encouraged to secure a clinical placement prior to commencing the course. Placements must be arranged where there are suitably qualified and prepared mentors- that is, a ‘Sign Off’ Mentor- available to support you. Placements are in areas that currently take student nurses from the University of Wolverhampton or another university. Whilst completing the required clinical placement, students are advised to keep in touch with their personal tutor / course leader and report any concerns or problems without delay. Dates for portfolio building and reflective writing workshops alongside action learning sets and individual tutorials will be given on the timetable issued at the start of the course. Students can also arrange additional tutorials with the personal tutor. Staff Involved with the Course Mary Drozd - Course Leader & Senior Lecturer- Adult Walsall Campus: Tel 01902 518927 email: M.Drozd@wlv.ac.uk Val Woodward, Senior Lecturer- Adult Walsall Campus Tel 01902 518839 Email V.J.Woodward@wlv.ac.uk Mary Rayner, Senior Lecturer- Adult Mary Seacole Building, 7 Wolverhampton Tel 01902 518692 Email M.A.Rayner@wlv.ac.uk Carol France Professional Development Manager Manor Hospital Walsall Email carol.france@walsallhospitals.nhs.uk Lorna Southan Practice Placement Manager Royal Wolverhampton Hospital Email lorna.southan@wlv.ac.uk lynn Edwards Senior Lecturer Mental Health Mary Seacole Building Wolverhampton Tel 01902 518668 Email L.E.Edwards@wlv.ac.uk Lynne Westwood Senior Lecturer Learning Disabilities Boundary House, Walsall Campus Tel 01902 518848 Email L.R.Westwood@wlv.ac.uk Learning, Teaching and Assessment Teaching A wide variety of teaching methods are used. Structured discussion, demonstrations, skills practice, question and answer sessions and the use of information technology are all included in the course. All students are supported by academic staff and Study Skills Advisors. Students are actively encouraged to make use of the Study Skills Advisors and the facilities available in the Learning Centres throughout their course. A well-equipped Learning Centre is available at the Walsall campus, and once registered and enrolled, students have access to all of the University’s 8 Learning Centres on all sites. A member of the Learning Centre staff will present an introduction to the Learning Centres facilities at the beginning of the course. Learning University education is based on an adult learning approach. This may be a new concept to some students. You are actively encouraged to question what you read, see and experience in practice and in the classroom. You are expected to take responsibility for your own learning by negotiating some practice outcomes with your mentor during your placement. You are also expected to lead the assessment process by preparing evidence to support your practice performance, and negotiate with your mentor a suitable time for assessment. All of this will be fully explained during the time in school. Assessment The module is assessed by the completion of 15 clinical practice outcomes. These are set out in a Clinical Assessment Practice Document (CAD) issued to you at the start of the course. Within this document, there are 15 outcomes that have to be successfully achieved in practice in order to pass the course. In addition to successful performance of each outcome, assessed by the Sign off mentor, students are required to produce written evidence of underpinning knowledge. This can be in a variety of forms and will be fully explained during the time in school Students are also required to produce a 2000 word reflective essay about their journey returning to professional nursing practice. The completed CPD, with accompanying portfolio of evidence and reflective essay is submitted for marking on the date set at the start the course. 9 Health and Safety Issues The Health and Safety at Work Act 1974, charges all employers to ensure, so far as is reasonably practicable, that the health, safety and welfare at work of all its employees is safeguarded. The School recognises its responsibilities under this Act and a policy to this effect is provided. You have a legal responsibility to abide by the safety practices and codes prepared by the area in which you are based and have an equal responsibility with management for maintaining safe working practices for employment for your own health and safety whilst in School Clinical Placement areas. The School contact for Health and Safety is: Bashyr Aziz Senior Lecturer Mary Seacole Building City Campus 01902 518632 or email bashyr@wlv.ac.uk Employability & Your Personal Development Portfolio (PDP) Employability & Your Personal Development Portfolio (PDP) What is ‘Employability’? ‘Employability’ is concerned with the development of skills aimed at enhancing your employment prospects throughout your time here at the University of Wolverhampton. Developing specialist subject and academic knowledge is important for employers but they also want to employ individuals who are able to: Communicate effectively, Work in a team and have good interpersonal skills. Solve problems Work on their own using their own initiative and are able to adapt to changing situations Be self-confident 10 How Will You Develop Your Employment Skills? At the School we aim to provide you with the opportunity to develop these through the module you will be studying. The assessments you do for your modules are designed to help you develop Subject specific skills through the research you undertake for the assignments. In addition, they are also designed to help you develop other key skills such as your written communication skills. Where you have formal presentations, this will build your self-confidence in addition to helping you develop your skills of verbal communication. Working as part of a team will develop vital group-work skills. Attending your classes regularly will further ensure that you have the opportunity to develop other skills. Throughout your time at the University, you will develop and be able to demonstrate a number of skills, some of which are listed below: Working as part of a group Demonstrating teamwork skills and leadership skills Effective communication Written Oral Problem-solving IT skills Time management Attending classes on time Handing in your assignments by the deadline date 11 Career Opportunities and Future Study Academic Regulations This course adheres to the University’s academic regulations for students undertaking an undergraduate study, commencing after October 2002. A full version of these regulations can be found on the University web site: www.wlv.ac.uk. These regulations govern your course and will be binding on you. It is, therefore, important that you read and become familiar with them. However the School has gained exceptions from some regulations as identified below: Additional Information specific to your course Frequently asked questions. Q: What are the needs of the returner? A: They are varied. To overcome this, the Return to Practice Student needs to be able to discuss his/her individual needs with the sign off Mentor One of the most difficult issues is that of the Return to Practice Student saying “I don’t know what my strengths and development needs are because I’ve just returned and have no idea what I need to achieve”. Returners have transferable skills, for example, most will have good organisational skills from their time out of the profession, but they might not recognise they have these. The mentor can assist the student by helping them apply these in practice. 12 Q: How does the Return to Practice Student feel about returning to the profession? A: The majority of returners feel under-confident due to the changes which have taken place in the NHS. The most common causes of concern are the changes in paperwork, technology and the speed of client turnover, and what is expected of them. Q: What can Return to Practice Students do/not do? A: Return to Practice Students may undertake a full range of activities under the supervision of their mentor. It may be that the Return to Practice Student may want to observe initially. The mentor takes professional responsibility for them in the same way as they do for other students. The important issue is that the Return to Practice student is achieving their proficiencies and that supernumerary status is respected. Q: Can Return to Nursing Practice Students administer drugs and injections or put I.V.I.s? A: Return to Practice Nursing Students should not be expected to take responsibility for administration of medicines. However they may administer medicines under supervision. Return to Practice nursing students cannot undertake expanded roles. Q: What hours and shifts do Return to Practice Students Work? A: A Minimum of 75 clinical hours are necessary to complete the Return to Practice course in addition to approximately 8 study days. 13 If the student is not achieving proficiencies they must, by negotiation, spend further time in practice. Students are advised to undertake their placement practice in small, manageable chunks. For the sake of continuity these should be close proximity to each other and the student should work with their mentor wherever possible (at least 40% of the time) Q: Who can the Return to Practice Student work with? A: Ideally the Return to Practice student will work as many hours as possible with the designated sign off Mentor (at least 40%). If for any reason this is not possible, an associate mentor should be identified to supervise and assess the student on a continuous basis. Completion of the document is the responsibility of the designated sign off mentor in liaison with the associate mentor. Q: When should the proficiencies be assess and verified? A: The Return to Practice Student should be assessed on a continuous basis. When the clinical proficiency has been achieved, and sufficient evidence has been documented, the mentor should verify the achievement of competence at this point. Q: How much evidence does a student need to produce to show that they have achieved the stated proficiency? A: Ensuring validity and reliability requires that the Sign Off Mentor utilises a variety of assessment methods. The student is 14 required to provide a variety of evidence; the broader the range, the more likely it will be that the student is able to demonstrate proficiency. Q: Who do I contact if I need help and advice? A: Return to Practice students are expected to reflect upon how they feel they are progressing throughout the placement. If at any point during the placement the mentor is concerned about any aspects of the Return to Practice Programme/ student progress, the course leader should be consulted. A tripartite meeting will be initiated. Section 2: School Specific Information In order to help you achieve your objectives with us we will provide Stimulating and well-planned learning opportunities Up-to-date learning resources, including books and computers Well-defined and appropriate programme of study State of the art clinical skills centres Opportunities to plan and review progress Access to learning support Access to confidential counselling, careers advice and financial advice A welcoming environment with quiet places to study and well equipped social learning space Qualified, experienced clinical staff and academic lecturers Friendly, helpful staff Clinical learning environments that provide you with opportunities to achieve your learning outcomes. We will ensure that Written and verbal feedback is provided on all assessments within 4 working weeks of submission You are provided with different types of support during your study for example, a module leader (who deals with module issues), a personal tutor (dealing with progression and pastoral issues), a link 15 tutor (dealing with practice-related issues). It is likely that these roles are undertaken by more than one person who will be identified to you. Your tutor’s availability will be clearly advertised in pathways guide and module guides. There are opportunities for you to comment on and influence your University and School experience, e.g. via student forums, other student-staff meetings, module and course questionnaires and student representation on School committees You have access to information you need to progress on the course, e.g. through module guides, and award/pathway guide and during tutorials All staff treat you with courtesy and respect Equal opportunities is promoted and evidence of discrimination is acted upon promptly You review your progress via SITS We deal promptly/fairly with issues of concern raised by you Your evaluation of learning, in practice and theory, is acted upon appropriately. We expect you to: Attend all learning sessions, including tutorials, clinical practice punctually and act appropriately at all times Show courtesy and respect to staff, other students and patients / clients where this latter group applies to your course Understand the requirements of your programme of study Understand the requirements of each module you are studying (e.g. sessions to attend and procedures for assessment and examinations) Respect and abide by the University Regulations, e.g. Equal Opportunities Policy, ID Cards, quiet areas, no smoking, plagiarism, student conduct Bring all necessary equipment to classes/workshops/Clinical Skills Centres Wear required uniform in practice and in Clinical Skills Centres Hand in assessments on time in line with assessment procedures (or they will not be marked) Switch off mobile phones when in class, practice environments, and clinical skills centres Behave considerately in lectures / practice and participate fully in class activities Keep your personal tutor informed if you have personal problems that affect your work and practice learning. If any problem makes it necessary for you to seek an extension to the date on which your assessment should have been submitted, then do so before the deadline date 16 Use the advertised time (or make new appointment by e-mail or other means) to seek advice from your tutor/lecturer/practice mentor. Please meet and discuss with your tutor/lecturer/practice mentor your concerns at the earliest opportunity Seek approval for, record any change in your programme and submit the record to your tutor/lecturer within the deadlines Inform the Registry Administrator for the School if your address or other contact details change Notify your personal tutor/practice mentor for your placement area of any sickness or absence. Student Feedback The School values each student as an individual. We value your views and experiences during your study here with us. We welcome any feedback you may wish to give, whether you have an issue of concern, a complaint or if you feel something has been particularly good during your time with us. Please let us know about your learning experience – theory or practice-, good or not so good. This can be done through your Personal Tutor or directly to the Associate Dean responsible for your area of study. To help you know who your Associate Dean is, contact details and location are set out below. Phil Begg – Associate Dean, Primary Health Care (Specialist Practice), Mary Seacole Building, City Campus Ext. 8626 Jill Williams – Associate Dean, Undergraduate Pre-Registration Nursing and Midwifery, Boundary House, Walsall Campus Ext. 8820 If you should have any continuing concerns about your study, please contact: Alex Hopkins – Associate Dean, Quality and Standards, Boundary House, Walsall Campus Ext. 8819 Your Dean is Professor Linda Lang, PhD, Mary Seacole Building, City Campus Ext. 8624 17 Where to get help with your course Student Support If you encounter any issues (personal or academic) the following staff should be able to help you Academic and course related- Course Leader- Mary Drozd 01902 518927 & personal tutor Personal issues- personal tutor Study issues- study skills advisor- www.wlv.ac.uk/skills or book an appointment with reception on 01902 518800 Special needs- Pauline Lim 01902 518868 General advice 07971322157 and support- Student Advisor Laura Clode Complaints- any member of academic or administrative staff Accreditation of Prior Learning (APL) Accreditation of Prior learning is not applicable to the Return to Practice course. However your previous study, training and experience may count towards a diploma or degree after completion of the R2P course in the University of Wolverhampton, and there should be no need for you to repeat study that you have undertaken previously. APL can significantly reduce the length of a course of study. The APL process requires you to demonstrate that the learning you have previously acquired is the same as that required of students undertaking your selected programme of study, and achieving the identified learning outcomes. 18 All claims for APL must be supported by valid evidence. At diploma and degree levels, you can APL up to 50% of the total credits for the award as long as this meets the requirements of the award. Prior to Application Before applying for APL, it is helpful to have some idea of the award or programme for which you wish to register. Familiarise yourself with: 1. The prescribed pathway of the award. 2. Modules that you need to achieve, and their associated learning outcomes. 3. Any specific regulations regarding APL within the chosen programme. A portfolio of evidence is required to support any claim for APL. For further information, contact the Administrative Staff, Khaleda Miah, based at Walsall campus on 01902 518807. Learning, Teaching & Assessment: What Can You Expect? Learning & Teaching Resources There is a wide range of resources available for your learning, including on-line materials for each module (on WOLF), web-based information and, importantly, the online resources provided by the Learning Centres. Module information will direct you to specific information sources, but there is an expectation, particularly at diploma level and above, that you will research your own sources in order to enhance your achievement of the learning outcomes for the programme. 19 Assessment Types of assessment The tutor, as part of the introduction to the course, will outline the assessment tasks. A more detailed briefing for each assignment will be available via the WOLF topic that supports the course. There are both clinical (clinical assessment document) and academic assessments. Marking of Assessments The marking and grading of your written is a comprehensive exercise involving first-marking by tutors, moderation by the tutors in the module team and the submission of assessments to independent external examiners who monitor and advise, thereby ensuring quality and standards. The normal return period for feedback on your marked (summative) work is eight weeks after the date of submission. Results will be available on e vision and you will receive a grade achieved and comments on whether and how you have achieved the learning outcomes. The processing of grades is outlined in the Undergraduate Student Guide and the Postgraduate Student Guide available at www.graduateschool@wlv.ac.uk. Assessment grades follow the ‘Grade Point Scale’ format outlined in the Guide. Grades range from A16 (outstanding) to F0 (fail, no resit permitted). For the majority of modules the average achievement level will be in the C category which is ‘average-good’; grades above this are ‘above average-very good to outstanding’, and grades below are from ‘satisfactory’ down to ‘uncompensatable fail’. Thus, an ‘upper’ C grade (e.g. C10) is comfortably a ‘good’ grade within the A to F distribution. 20 Please note that the clinical assessment document is NOT graded. You are awarded a Pass/ Refer. What Should You Avoid? What Should You Seek to Achieve? Remember that you are writing for another reader or readers. Do not assume that the reader will fill the gaps in your work. Use the introduction to establish what you are doing in your assignment. Use examples to support your analysis. Be objective and aim for reasoned argument. Phrases such as ‘in my opinion’ or ‘in my view’ are of little value because they are subjective. Do not use them. You should aim to support your points with evidence and reasoned analysis. Always acknowledge the use of someone else’s work, using the appropriate system of referencing. Also, it is a very serious offence to use someone else’s work, especially wordfor-word or paraphrased contents of other’s work. This is called “plagiarism” and will be covered throughout the programme to ensure that you are aware of how to avoid it. Always keep copies of the sources or keep a note of each source as you use it, so that you can reference it in your reference list at the end of your assignment. Plan your work in advance so as to meet the hand-in (submission) date. Writing up your research is often more time-consuming than you expect. Get help from tutors and mentors if you are unsure. Above all, do not ‘suffer in silence’; the Course Leader, Student Advisor and tutors will be able to provide guidance so please use them. 21 What Feedback Can You Expect? What can you expect from your tutors whilst you are preparing your work? Normally tutors will advise you, as a group, on the assessment at or near the start of the module. Thereafter, you may consult your tutors by emailing or telephoning them. What should you not expect from your tutors? It is not the role of a tutor to read drafts of your work and correct them with a view for you to obtain a ‘good mark’. An assignment should reflect your effort and input, and the role of the tutor is to guide and advise. It is then your responsibility to assess this advice and guidance and use it accordingly. Tutors provide this in good faith, but its use - or lack of it - by you is not an automatic route to a good or a poor grade. Other factors, particularly those pertaining to your skills and efforts, will play a vital role in your achievement. After completion of the assignment The main feedback is through a copy (to you) of the assessment feedback sheet by email from tutors/administrative support staff. How You Can Comment on Learning & Teaching and Assessment We greatly value your feedback; students’ views are collectively influential in how we deliver L&T and are gathered through staffstudent meetings and via questionnaires, particularly the Module Evaluation Proformas (MEPs) that you are asked to complete 22 towards the end of a module. Such feedback is analysed for annual monitoring of modules, subjects and courses. Definitions of Academic Misconduct Cheating is defined as any attempt to gain unfair advantage in an assessment by dishonest means, and includes, e.g. all breaches of examination room rules, impersonating another candidate, falsifying data and obtaining an examination paper in advance of its authorised release. Plagiarism is the act of taking someone else’s work and passing it off as your own. This includes incorporating either unattributed direct quotation(s) or substantial paraphrasing from the work of another/others. It is important to cite all sources whose work has been drawn on and reference them fully in accordance with the referencing standard used in each academic school. Collusion is when two or more people combine to produce a piece of work for assessment that is passed off as the work of one student alone. The work may be so alike in content, wording and structure that the similarity goes beyond what might have been coincidence. For example – where one student has copied the work of another, or where a joint effort has taken place in producing what should have been an individual effort. Updated May 2009 Academic Regulations This course adheres to the University’s academic regulations for students undertaking an undergraduate course, commencing after October 2002. A full version of these regulations can be found on the University web site: www.wlv.ac.uk. These regulations govern your course and will be binding on you. It is, therefore, important that you read and become familiar with them.. 23 24