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1 UNIVERSITY CAMPUS SUFFOLK FACULTY OF HEALTH, WELLBEING & SCIENCE SCHOOL OF INTERPROFESSIONAL STUDIES AND MIDWIFERY BSc (Hons) MIDWIFERY STUDENT RECORD OF ACHEIVEMENT Student Name Cohort Base Site
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BSc (Hons) MIDWIFERY STUDENT RECORD OF ACHEIVEMENT

Feb 21, 2022

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Page 1: BSc (Hons) MIDWIFERY STUDENT RECORD OF ACHEIVEMENT

1

UNIVERSITY CAMPUS SUFFOLK

FACULTY OF HEALTH, WELLBEING & SCIENCE

SCHOOL OF INTERPROFESSIONAL STUDIES AND MIDWIFERY

BSc (Hons) MIDWIFERY

STUDENT RECORD OF ACHEIVEMENT

Student Name Cohort Base Site

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CONTENTS PAGE

Introduction to the passport 04

Manual Handling Training form 05

Resuscitation Training form 06

Year one – Certificate Level

Responsibilities in placement forms

…….Practice Placement Meetings

Long practice placement forms

Short practice placement forms

Midwifery Practice 1 –Learning Outcomes

Action Plans

Tripartite meetings

………………………Practice Grading

Year Two – Intermediate Level

Responsibilities in placement forms

…….Practice Placement Meetings

Long practice placement forms

07

08 - 13

14

15 - 34

35 – 37

38

39 and 47

40 - 41 and 48 - 49

42 – 46 and 50 – 54

55

56 – 65

66

67 – 74

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Short practice placement forms

Midwifery Practice 2 –Learning Outcomes

Action Plans

Tripartite meetings

………………………Practice Grading

75 – 81

82

83 and 91

84 – 85 and 92 - 93

86 – 90 and 94 – 98

Year three – Honours level

Responsibilities in placement forms

…….Practice Placement Meetings

Long practice placement forms

Short practice placement forms

Midwifery Practice 3 –Learning Outcomes

Action Plans

Tripartite meetings

………………………Practice Grading

99

100 - 107

108

109 – 128

129

130

131 and 139

132 -133 and 140 – 141

134 – 138 and 142 -146

Overall summary of placements 147

Specimen Signature sheet 148

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Introduction

What is a student record of achievement? All students who commence courses from September 2007 will be required to keep an up-to-date Student Midwife Passport (Record of Achievement) This document is an overall record of the student’s practice assessment and will be taken from one placement to the next, so sign off mentors have an opportunity to see how the student has progressed through the course. • Students are expected to keep a record of their learning experiences, identifying evidence to support achievement of NMC outcomes and competencies and

where further support and supervision is required. This record should be made available to their sign off mentor at the beginning of a new experience to enable discussion of strengths and areas for improvement

• The final assessment of proficiency draws on evidence of assessment over a sustained period of time. The sign-off mentor may use the student record of achievement and other evidence to assess proficiency at the point of registration.

• The sign-off mentor will review all of the sheets at the end of the course, check all proficiencies have been achieved and will sign a “Statement of proficiency at the Point of Registration” confirming that the student has successfully completed all practice requirements

• Students must submit a copy of the “Statement of Proficiency at the Point of Registration” to their University in order that their registration with the NMC can be processed

This document contains all the information that you require to maintain a record of your achievement in practice throughout the course. This document must not be dismantled under any circumstances and to do so may result in your practice being referred.

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Record of Mandatory Training: Manual Handling. Student Name:……………………. Student ID: ……………………… Manual Handling. Initial training takes place BEFORE THE FIRST PLACEMENT IN YEAR ONE, followed by an annual update in SEMESTER 3 and 5. This record is to be signed each year by the senior trainer on completion. Failure to complete each stage will result in withdrawal from placement. I certify that the student named above has completed the training to the required stage: Year One: ……………………….. Date:………………………………. Year Two: ………………………. Date:………………………………. Year Three: ……………………….. Date:………………………………. To be signed as fully completed by the Personal Tutor on completion of SEMESTER 6 Personal Tutor Name: …………………….. Signature: ………………………… Date:………………………

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Record of Mandatory Training: Resuscitation Training. Student Name:……………………. Student ID: ……………………… Resuscitation Training. Training in the recognition of collapse and life support techniques takes place during the first year and all students must attend a refresher during each subsequent year. This will be as timetabled by your course leader. The record must be signed each year on completion. Year One: ……………………….. Date:………………………………. Year Two: ………………………. Date:………………………………. Year Three: ……………………….. Date:………………………………. To be signed as fully completed by the Personal Tutor on completion of SEMESTER 6. Personal Tutor Name: …………………….. Signature: ………………………… Date:………………………

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Certificate Level

Forms Required for Year One

The forms in this section must be completed for all placements in year one. Included within is the documentation for

• Student accepting responsibility for their own actions

• Long placement records (duration four weeks or greater)

• Short placement records (duration three weeks or less)

• Action Plans

• Tripartite meeting documentation forms

• Practice Grading

For each placement that the student attends the form below MUST be completed

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For each placement that the student attends the form below MUST be completed Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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For each placement that the student attends the form below MUST be completed Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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For each placement that the student attends the form below MUST be completed Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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For each placement that the student attends the form below MUST be completed Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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For each placement that the student attends the form below MUST be completed Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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For each placement that the student attends the form below MUST be completed Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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PRACTICE PLACEMENT MEETINGS

– 4 weeks duration or longer.

For each placement of 4 weeks duration or longer you must meet with your mentor at least three occasions as detailed below. The record of these meetings must be completed. INFORMATION:

Initial meeting To familiarise the learner with the practice setting; Discuss learning needs and learning opportunities in the placement; Agree roles, responsibilities and teaching, learning and assessment strategy

Mid-point meeting Update on progress with Practice Assessment Document; Ensure documentation is on target; Provide a mid-point mentor report, with action plan if necessary

End-point meeting Provide a final mentor report with recommendations for assessment of the practice component of the module. In conjunction with the student and the Practice Assessment Document, consider the focus for future learning.

PRACTICE PLACEMENT MEETINGS

- Short placements

For each placement of 1-3 week’s duration you must meet with your mentor to discuss learning opportunities. You are not required to complete other interviews.

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Long placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

?

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SHORT PLACEMENT MEETINGS Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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MIDWIFERY PRACTICE 1

ACTION PLANS

TRIPARTITE MEETINGS

PRACTICE GRADING

The following are records of tripartite meetings held between the student and their personal tutor and mentor. These meetings will normally take place during assessment week towards the end of each semester. It is the student’s responsibility to arrange these meetings.

At the outset of the semester the student is required to complete an action plan of learning for the semester. This learning should be agreed with the mentor.

The action plan will be reviewed at the tripartite meeting. Comments at tripartite should be used to inform the next action plan.

Midwifery Practice 1 Learning Outcomes

On completion of the module the student will be able to:

1. Demonstrate a woman centred approach to a care based on partnerships that are both ethical and non discriminatory

2. Demonstrate a range of communication and interpersonal skills with women and other professionals in a range of practice settings

3. Identify theoretical concepts and begin to apply these to practice

4. Demonstrate ability to reflect on practice

5. Develop the required level of competency in achieving the skills to enable progression to intermediate level

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Year 1 - Semester 1 – Student Action Plan What do you want to achieve?

By when? Who can offer support? What activities will you undertake?

How will you evidence achievement

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INTERVIEW WITH PERSONAL TUTOR AND MENTOR (TRIPARTITE MEETING) To be completed by the Personal Tutor Name of Personal Tutor: Name of Interviewer (if different to Personal Tutor): Date of Interview: Placement: Year of course :1 Semester :1 Has the student completed their Action Plan? Yes No Has the student brought their Practice Assessment Document with them? Yes No Has the student brought their Clinical Record Book with them Yes No If the answer to above is No, the interview will be halted and a new interview date arranged (NB, please sign this form as a record of this decision).

Total number of essential skills completed to date: Total number of desirable skills completed to date: Evidence of progression through clinical record book

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Is there a completed: Initial Interview? Yes No Mid Point Interview? Yes No Final Interview? Yes No Form for each placement: Yes No

Comments by student on their overall progression – to be used to identify / inform future learning needs.

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Year 1 Semester 1 Formative Practice Grading Midwifery Practice 1 Learning Outcomes On completion of the module the student will be able to:

1. Demonstrate a woman centred approach to a care based on partnerships that are both ethical and non discriminatory

2. Demonstrate a range of communication and interpersonal skills with women and other professionals in a range of practice settings

3. Identify theoretical concepts and begin to apply these to practice

4. Demonstrate ability to reflect on practice

5. Develop the required level of competency in achieving the skills to enable progression to intermediate level

Practice Grading can only be completed once all skills within the Practice Assessment Document have been achieved at the level of Internalisation Confirmed by Student:………………………………………………………………………..Date:…………………………….. Confirmed by Mentor…………………………………………………………………………Date:……………………………..

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Effective Midwifery Practice Excellent links made

between knowledge and practice

Very good links made between knowledge and practice

Good links made between knowledge and practice

Limited links made between knowledge and practice

Excellent understanding of the midwife’s role

Very good understanding of the midwife’s role

Good understanding of the midwife’s role

Limited understanding of the midwife’s role

Consistently adapts language to ensure effective

communication with women/families and the multidisciplinary team

In most circumstances adapts language

appropriately. Occasional prompting required to ensure

effective communication

In some circumstances able to adapt language

appropriately. Needs prompting to ensure effective

communication

Frequent prompting required to adapt language to ensure effective communication

Excellent ability to assess the woman’s needs and plan and

participate in care appropriately

Very good ability to assess the woman’s needs and plan

and participate in care appropriately

Good ability to assess the woman’s needs and plan and

participate in care appropriately

Frequently requires support to assess the woman’s

needs and plan and participate in care

appropriately

Consistently demonstrates a women-centred approach to care based on partnership

On most occasions demonstrates a women-centred approach to care

based on

Sometimes demonstrates a women-centred approach to care based on partnership

Requires ongoing support to demonstrate a women-

centred approach to care based on partnership

Dexterity demonstrated in skill development expected

at level 1

Good skill development at level 1 though scope for

refinement in some areas

Skill development satisfactory for level 1

student

Some skills would benefit from further refinement for a

level 1 student

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Professional and Ethical Practice Excellent ability to express

personal feelings and identify learning from experience

Very good ability to express personal feelings and identify

learning from experience

Good ability to express personal feelings and identify

learning from experience

Support required to express feelings and identify learning

from experience

Consistently displays an understanding of the

concepts of professionalism

Frequently displays an understanding of the

concepts of professionalism

On some occasions demonstrates an understanding of professionalism

Understanding of professionalism requires

development in some areas

Consistently promotes ethical and non discriminatory

practices

Typically practices in accordance with ethical and

non-discriminatory frameworks

Demonstrates an understanding of practice

within ethical and non-discriminatory frameworks

Has understanding but demonstrates some

hesitancy in attending to the individual rights, interests,

beliefs and cultures of women

Consistently creates an environment of care to

promote the health, safety and wellbeing of women

Frequently able to create an environment of care to

promote the health, safety and wellbeing of women

Is able in some circumstances to creates an

environment of care to promote the health, safety and wellbeing of women

Attempts to create an environment of care to

promote the health, safety and wellbeing of women

Performs effectively within a multidisciplinary team

Usually works well within a multidisciplinary team

Aware of own contribution to multidisciplinary team

working

Some hesitancy of involvement within

multidisciplinary team

Demonstrates understanding and application of relevant

legislation to practice commensurate with level 1

Understands relevant legislation to practice

commensurate with level 1

Is able to identify some areas of relevant legislation

commensurate with level 1

Needs support to identify legislative framework for

practice commensurate with level 1

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Developing the Individual Midwife and Others

Proactively identifies and engages in learning

opportunities within the practice environment for a

level 1 student

Actively engaged in learning within the practice

environment for a level 1 student

Seeks out learning opportunities with some

encouragement for a level 1 student

Requires support to identify appropriate learning

opportunities for a level 1 student

Well motivated within the practice arena

Shows enthusiasm in most practice areas

In some circumstances willing to engage in practice

Encouragement needed to engage in practice

Consistently displays a mature attitude to receiving constructive criticism and

adapts performance accordingly

Able to accept and use constructive criticism to improve performance

Accepts constructive criticism and makes efforts to improve

performance

Requires support to interpret constructive criticism

Consistently displays confidence appropriate for

level 1

On most occasions shows confidence in practice appropriate for level 1

Confident in some situations appropriate for level 1

Level of confidence may adversely inhibit performance

appropriate for level 1

Consistently displays an empathetic approach to care

In most circumstances demonstrates an empathetic

approach to care

In some circumstances demonstrates an empathetic

approach to care

Needs help to demonstrate empathetic responses to

care

Makes good use of assertiveness skills to

effectively care for women,

Frequently uses assertiveness skills to

effectively care for women,

In some situations demonstrates assertiveness skills to effectively care for

women

Care for women would be enhanced if assertiveness

skills were developed

Comments

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46

Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Achieving Quality Care Through Evaluation and Research Explains methods used to monitor and evaluate care

and performance

Identifies methods to monitor and evaluate

care and performance

Needs encouragement to recognise methods used to monitor and

evaluate care and performance

Limited ability to recognise methods used to monitor and

evaluate care and performance

Frequently draws on evidence to support care

decisions

Sometimes draws on evidence to support

care decisions

Needs some encouragement to consider evidence to practice

Limited recall on evidence to support practice

Comments

TOTAL OF AGREED MARKS AWARDED

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Year 1 - Semester 2 – Student Action Plan What do you want to achieve?

By when? Who can offer support? What activities will you undertake?

How will you evidence achievement

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INTERVIEW WITH PERSONAL TUTOR AND MENTOR (TRIPARTITE MEETING) To be completed by the Personal Tutor Name of Personal Tutor: Name of Interviewer (if different to Personal Tutor): Date of Interview: Placement: Year of course :1 Semester :2 Has the student completed their Action Plan? Yes No Has the student brought their Practice Assessment Document with them? Yes No Has the student brought their Clinical Record Book with them Yes No If the answer to above is No, the interview will be halted and a new interview date arranged (NB, please sign this form as a record of this decision).

Total number of essential skills completed to date: Total number of desirable skills completed to date: Evidence of progression through clinical record book

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Is there a completed: Initial Interview? Yes No Mid Point Interview? Yes No Final Interview? Yes No Form for each placement: Yes No

Comments by student on their overall progression – to be used to identify / inform future learning needs.

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End of Year 1 Practice Grading Midwifery Practice 1 Learning Outcomes On completion of the module the student will be able to:

1. Demonstrate a woman centred approach to a care based on partnerships that are both ethical and non discriminatory

2. Demonstrate a range of communication and interpersonal skills with women and other professionals in a range of practice settings

3. Identify theoretical concepts and begin to apply these to practice

4. Demonstrate ability to reflect on practice

5. Develop the required level of competency in achieving the skills to enable progression to intermediate level

Practice Grading can only be completed once all skills within the Practice Assessment Document have been achieved at the level of Internalisation Confirmed by Student:………………………………………………………………………..Date:…………………………….. Confirmed by Mentor…………………………………………………………………………Date:……………………………..

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Effective Midwifery Practice Excellent links made

between knowledge and practice

Very good links made between knowledge and practice

Good links made between knowledge and practice

Limited links made between knowledge and practice

Excellent understanding of the midwife’s role

Very good understanding of the midwife’s role

Good understanding of the midwife’s role

Limited understanding of the midwife’s role

Consistently adapts language to ensure effective

communication with women/families and the multidisciplinary team

In most circumstances adapts language

appropriately. Occasional prompting required to ensure

effective communication

In some circumstances able to adapt language

appropriately. Needs prompting to ensure effective

communication

Frequent prompting required to adapt language to ensure effective communication

Excellent ability to assess the woman’s needs and plan and

participate in care appropriately

Very good ability to assess the woman’s needs and plan

and participate in care appropriately

Good ability to assess the woman’s needs and plan and

participate in care appropriately

Frequently requires support to assess the woman’s

needs and plan and participate in care

appropriately

Consistently demonstrates a women-centred approach to care based on partnership

On most occasions demonstrates a women-centred approach to care

based on

Sometimes demonstrates a women-centred approach to care based on partnership

Requires ongoing support to demonstrate a women-

centred approach to care based on partnership

Dexterity demonstrated in skill development expected

at level 1

Good skill development at level 1 though scope for

refinement in some areas

Skill development satisfactory for level 1

student

Some skills would benefit from further refinement for a

level 1 student

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Professional and Ethical Practice Excellent ability to express

personal feelings and identify learning from experience

Very good ability to express personal feelings and identify

learning from experience

Good ability to express personal feelings and identify

learning from experience

Support required to express feelings and identify learning

from experience

Consistently displays an understanding of the

concepts of professionalism

Frequently displays an understanding of the

concepts of professionalism

On some occasions demonstrates an understanding of professionalism

Understanding of professionalism requires

development in some areas

Consistently promotes ethical and non discriminatory

practices

Typically practices in accordance with ethical and

non-discriminatory frameworks

Demonstrates an understanding of practice

within ethical and non-discriminatory frameworks

Has understanding but demonstrates some

hesitancy in attending to the individual rights, interests,

beliefs and cultures of women

Consistently creates an environment of care to

promote the health, safety and wellbeing of women

Frequently able to create an environment of care to

promote the health, safety and wellbeing of women

Is able in some circumstances to creates an

environment of care to promote the health, safety and wellbeing of women

Attempts to create an environment of care to

promote the health, safety and wellbeing of women

Performs effectively within a multidisciplinary team

Usually works well within a multidisciplinary team

Aware of own contribution to multidisciplinary team

working

Some hesitancy of involvement within

multidisciplinary team

Demonstrates understanding and application of relevant

legislation to practice commensurate with level 1

Understands relevant legislation to practice

commensurate with level 1

Is able to identify some areas of relevant legislation

commensurate with level 1

Needs support to identify legislative framework for

practice commensurate with level 1

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Developing the Individual Midwife and Others

Proactively identifies and engages in learning

opportunities within the practice environment for a

level 1 student

Actively engaged in learning within the practice

environment for a level 1 student

Seeks out learning opportunities with some

encouragement for a level 1 student

Requires support to identify appropriate learning

opportunities for a level 1 student

Well motivated within the practice arena

Shows enthusiasm in most practice areas

In some circumstances willing to engage in practice

Encouragement needed to engage in practice

Consistently displays a mature attitude to receiving constructive criticism and

adapts performance accordingly

Able to accept and use constructive criticism to improve performance

Accepts constructive criticism and makes efforts to improve

performance

Requires support to interpret constructive criticism

Consistently displays confidence appropriate for

level 1

On most occasions shows confidence in practice appropriate for level 1

Confident in some situations appropriate for level 1

Level of confidence may adversely inhibit performance

appropriate for level 1

Consistently displays an empathetic approach to care

In most circumstances demonstrates an empathetic

approach to care

In some circumstances demonstrates an empathetic

approach to care

Needs help to demonstrate empathetic responses to

care

Makes good use of assertiveness skills to

effectively care for women,

Frequently uses assertiveness skills to

effectively care for women,

In some situations demonstrates assertiveness skills to effectively care for

women

Care for women would be enhanced if assertiveness

skills were developed

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Achieving Quality Care Through Evaluation and Research Explains methods used to monitor and evaluate care

and performance

Identifies methods to monitor and evaluate care and

performance

Needs encouragement to recognise methods used to monitor and evaluate care

and performance

Limited ability to recognise methods used to monitor and

evaluate care and performance

Frequently draws on evidence to support care

decisions

Sometimes draws on evidence to support care

decisions

Needs some encouragement to consider

evidence to practice

Limited recall on evidence to support practice

Comments

TOTAL OF AGREED MARKS AWARDED

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Intermediate Level

Forms Required for Year Two

The forms in this section must be completed for all placements in year two. Included within is the documentation for

o Student accepting responsibility for own actions

o Long placement records (duration four weeks or greater)

o Short placement records (duration three weeks or less)

o Action Plans

o Tripartite meeting documentation

o Practice Grading

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

• Number of days sick/absent during the placement

Days: Occasions:

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PRACTICE PLACEMENT MEETINGS

– 4 weeks duration or longer.

For each placement of 4 weeks duration or longer you must meet with your mentor at least three occasions as detailed below. The record of these meetings must be completed. INFORMATION:

Initial meeting To familiarise the learner with the practice setting; Discuss learning needs and learning opportunities in the placement; Agree roles, responsibilities and teaching, learning and assessment strategy

Mid-point meeting Update on progress with Practice Assessment Document; Ensure documentation is on target; Provide a mid-point mentor report, with action plan if necessary

End-point meeting Provide a final mentor report with recommendations for assessment of the practice component of the module. In conjunction with the student and the Practice Assessment Document, consider the focus for future learning.

PRACTICE PLACEMENT MEETINGS

- Short placements

For each placement of 1-3 week’s duration you must meet with your mentor to discuss learning opportunities. You are not required to complete other interviews

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to

Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date

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MIDWIFERY PRACTICE 2

ACTION PLANS

TRIPARTITE MEETINGS

PRACTICE GRADING

The following are records of tripartite meetings held between the student and their personal tutor and mentor. These meetings will normally take place during assessment week towards the end of each semester. It is the student’s responsibility to arrange these meetings.

At the outset of the semester the student is required to complete an action plan of learning for the semester. This learning should be agreed with the mentor.

The action plan will be reviewed at the tripartite meeting. Comments at tripartite should be used to inform the next action plan.

Midwifery Practice 2 Learning Outcomes

On completion of the module the student will be able to: 1. Refer women who would benefit from the skills and knowledge of other professionals 2. Demonstrate effective working across professional boundaries and develop professional networks 3. Participate in the care of women and babies with specific health and social care needs 4. Continue to make appropriate links between theory and practice and base practice on the best available evidence. 5. Recognise emergency situations and take appropriate action to assist in meet the health needs of women and babies

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Year 2 - Semester 1 – Student Action Plan What do you want to achieve?

By when? Who can offer support? What activities will you undertake?

How will you evidence achievement

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INTERVIEW WITH PERSONAL TUTOR AND MENTOR (TRIPARTITE MEETING) To be completed by the Personal Tutor Name of Personal Tutor: Name of Interviewer (if different to Personal Tutor): Date of Interview: Placement: Year of course : 2 Semester : 1 Has the student completed their Action Plan? Yes No Has the student brought their Practice Assessment Document with them? Yes No Has the student brought their Clinical Record Book with them Yes No If the answer to above is No, the interview will be halted and a new interview date arranged (NB, please sign this form as a record of this decision).

Total number of essential skills completed to date: Total number of desirable skills completed to date: Evidence of progression through clinical record book

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Is there a completed: Initial Interview? Yes No Mid Point Interview? Yes No Final Interview? Yes No Form for each placement: Yes No

Comments by student on their overall progression – to be used to identify / inform future learning needs.

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Year 2 Semester 2 Formative Practice Grading Midwifery Practice 2 Learning Outcomes On completion of the module the student will be able to:

1. Refer women who would benefit from the skills and knowledge of other professionals

2. Demonstrate effective working across professional boundaries and develop professional networks

3. Participate in the care of women and babies with specific health and social care needs

4. Continue to make appropriate links between theory and practice and base practice on the best available evidence.

5. Recognise emergency situations and take appropriate action to assist in meet the health needs of women and babies Practice Grading can only be completed once all skills within the Practice Assessment Document have been achieved at the level of Internalisation

Confirmed by Student:………………………………………………………………………..Date:…………………………….. Confirmed by Mentor…………………………………………………………………………Date:……………………………..

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Effective Midwifery Practice Consistently able to apply appropriate links between knowledge and practice

On most occasions applies appropriate knowledge and understanding to practice

Sometimes applies appropriate knowledge to

practice

Application of knowledge to practice needs to be

developed to enhance care

Consistently able to demonstrate the role of the

midwife

On most occasions demonstrates the role of the

midwife

Occasional prompting required to demonstrate the

role of the midwife

Frequent prompting required to demonstrate the role of the

midwife

Consistently adapts language to ensure effective

communication with women/families and the multidisciplinary team

In most circumstances adapts language

appropriately. Occasional prompting required to ensure

effective communication

In some circumstances able to adapt language

appropriately. Needs prompting to ensure effective

communication

Frequent prompting required to adapt language to ensure effective communication

Consistently demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

On most occasions demonstrates ability to

assess, determine and plan programmes of care for

women based on needs from preconception to the

postnatal period.

Sometimes demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

Frequently requires support to assess, determine and

plan programmes of care for women based on needs from

preconception to the postnatal period.

Consistently demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

On most occasions demonstrates a women-centred approach to care

based on partnership which respects the individuality of

women

Sometimes demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

Requires ongoing support to demonstrate a women-

centred approach to care based on partnership which respects the individuality of

women

Dexterity demonstrated in skill development expected

at level 2

Good skill development at level 2 though scope for

refinement in some areas

Skill development satisfactory for level 2

student

Some skills would benefit from further refinement for a

level 2 student

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0

Student Mentor Award

Professional and Ethical Practice Uses structured reflection on

practice to enhance care delivery

Frequently uses structured reflection to consider how

care can be improved

Occasionally uses structured reflection to consider how

care can be improved

Support required to engage in reflection on practice

Consistently displays an understanding of the

concepts of professionalism for a level 1 student

Frequently displays an understanding of the

concepts of professionalism for a level 1 student

On some occasions demonstrates an understanding of

professionalism for a level 1 student

Understanding of professionalism requires

development in some areas for a level 1 student

Consistently promotes ethical and non discriminatory

practices for a level 1 student

Typically practices in accordance with ethical and

non-discriminatory frameworks for a level 1

student

Demonstrates an understanding of practice

within ethical and non-discriminatory frameworks for

a level 1 student

Has understanding but demonstrates some

hesitancy in attending to the individual rights, interests,

beliefs and cultures of women for a level 1 student

Usually creates an environment of care to

promote the health, safety and wellbeing of women for a

level 1 student

Frequently able to create an environment of care to

promote the health, safety and wellbeing of women for a

level 1 student

Is able in some circumstances to creates an

environment of care to promote the health, safety

and wellbeing of women for a level 1 student

Attempts to create an environment of care to

promote the health, safety and wellbeing of women for a

level 1 student

Consistently works well within the team

Usually works well within the team

Aware of own contribution to working within the team

Some hesitancy of involvement within the team

Demonstrates understanding and application of relevant

legislation to practice

Understands relevant legislation to practice

Is able to identify some areas of relevant legislation

Needs support to identify legislative framework for

practice

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Developing the Individual Midwife and Others

Proactively identifies and engages in learning

opportunities within the practice environment for a

level 2 student

Actively engaged in learning within the practice

environment for a level 2 student

Seeks out learning opportunities with some

encouragement for a level 2 student

Requires support to identify appropriate learning

opportunities for a level 2 student

Well motivated within the practice arena

Shows enthusiasm in most practice areas

In some circumstances willing to engage in practice

Encouragement needed to engage in practice

Consistently displays a mature attitude to receiving constructive criticism and

adapts performance accordingly

Able to accept and use constructive criticism to improve performance

Accepts constructive criticism and makes efforts to improve

performance

Requires support to interpret constructive criticism

Consistently displays confidence appropriate for

level 2

On most occasions shows confidence in practice appropriate for level 2

Confident in some situations appropriate for level 2

Level of confidence may adversely inhibit performance

appropriate for level 2

Consistently displays an empathetic approach

In most circumstances demonstrates an empathetic

approach to care

In some circumstances demonstrates an empathetic

approach to care

Needs help to demonstrate empathetic responses to

care

Consistently utilises assertiveness skills to

effectively care for women,

Frequently uses assertiveness skills to

effectively care for women,

In some situations demonstrates assertiveness skills to effectively care for

women

Care for women would be enhanced if assertiveness

skills were developed

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Achieving Quality Care Through Evaluation and Research Explains how monitoring can

enhance care and performance

Conversant with methods to monitor and evaluate care

and performance

Identify methods to monitor and evaluate care and

performance

Needs encouragement to recognise processes that

contribute to the monitoring and evaluation of care and

performance

Incorporates best available evidence into practice

Frequently draws on evidence to support care

decisions

Sometimes draws on evidence to support care

decisions

Needs encouragement to consider evidence for

practice

Comments

TOTAL OF AGREED MARKS AWARDED

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Year 2 - Semester 2 – Student Action Plan What do you want to achieve?

By when? Who can offer support? What activities will you undertake?

How will you evidence achievement

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INTERVIEW WITH PERSONAL TUTOR AND MENTOR (TRIPARTITE MEETING) To be completed by the Personal Tutor Name of Personal Tutor: Name of Interviewer (if different to Personal Tutor): Date of Interview: Placement: Year of course :2 Semester :2 Has the student completed their Action Plan? Yes No Has the student brought their Practice Assessment Document with them? Yes No Has the student brought their Clinical Record Book with them Yes No If the answer to above is No, the interview will be halted and a new interview date arranged (NB, please sign this form as a record of this decision).

Total number of essential skills completed to date: Total number of desirable skills completed to date: Evidence of progression through clinical record book

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Is there a completed: Initial Interview? Yes No Mid Point Interview? Yes No Final Interview? Yes No Form for each placement: Yes No

Comments by student on their overall progression – to be used to identify / inform future learning needs.

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End of Year 2 Practice Grading Midwifery Practice 2 Learning Outcomes On completion of the module the student will be able to:

1. Refer women who would benefit from the skills and knowledge of other professionals

2. Demonstrate effective working across professional boundaries and develop professional networks

3. Participate in the care of women and babies with specific health and social care needs

4. Continue to make appropriate links between theory and practice and base practice on the best available evidence.

5. Recognise emergency situations and take appropriate action to assist in meet the health needs of women and babies Practice Grading can only be completed once all skills within the Practice Assessment Document have been achieved at the level of Internalisation

Confirmed by Student:………………………………………………………………………..Date:…………………………….. Confirmed by Mentor…………………………………………………………………………Date:……………………………..

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Effective Midwifery Practice Consistently able to apply appropriate links between knowledge and practice

On most occasions applies appropriate knowledge and understanding to practice

Sometimes applies appropriate knowledge to

practice

Application of knowledge to practice needs to be

developed to enhance care

Consistently able to demonstrate the role of the

midwife

On most occasions demonstrates the role of the

midwife

Occasional prompting required to demonstrate the

role of the midwife

Frequent prompting required to demonstrate the role of the

midwife

Consistently adapts language to ensure effective

communication with women/families and the multidisciplinary team

In most circumstances adapts language

appropriately. Occasional prompting required to ensure

effective communication

In some circumstances able to adapt language

appropriately. Needs prompting to ensure effective

communication

Frequent prompting required to adapt language to ensure effective communication

Consistently demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

On most occasions demonstrates ability to

assess, determine and plan programmes of care for

women based on needs from preconception to the

postnatal period.

Sometimes demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

Frequently requires support to assess, determine and

plan programmes of care for women based on needs from

preconception to the postnatal period.

Consistently demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

On most occasions demonstrates a women-centred approach to care

based on partnership which respects the individuality of

women

Sometimes demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

Requires ongoing support to demonstrate a women-

centred approach to care based on partnership which respects the individuality of

women

Dexterity demonstrated in skill development expected

at level 2

Good skill development at level 2 though scope for

refinement in some areas

Skill development satisfactory for level 2

student

Some skills would benefit from further refinement for a

level 2 student

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0

Student Mentor Award

Professional and Ethical Practice Uses structured reflection on

practice to enhance care delivery

Frequently uses structured reflection to consider how

care can be improved

Occasionally uses structured reflection to consider how

care can be improved

Support required to engage in reflection on practice

Consistently displays an understanding of the

concepts of professionalism for a level 1 student

Frequently displays an understanding of the

concepts of professionalism for a level 1 student

On some occasions demonstrates an understanding of

professionalism for a level 1 student

Understanding of professionalism requires

development in some areas for a level 1 student

Consistently promotes ethical and non discriminatory

practices for a level 1 student

Typically practices in accordance with ethical and

non-discriminatory frameworks for a level 1

student

Demonstrates an understanding of practice

within ethical and non-discriminatory frameworks for

a level 1 student

Has understanding but demonstrates some

hesitancy in attending to the individual rights, interests,

beliefs and cultures of women for a level 1 student

Usually creates an environment of care to

promote the health, safety and wellbeing of women for a

level 1 student

Frequently able to create an environment of care to

promote the health, safety and wellbeing of women for a

level 1 student

Is able in some circumstances to creates an

environment of care to promote the health, safety

and wellbeing of women for a level 1 student

Attempts to create an environment of care to

promote the health, safety and wellbeing of women for a

level 1 student

Consistently works well within the team

Usually works well within the team

Aware of own contribution to working within the team

Some hesitancy of involvement within the team

Demonstrates understanding and application of relevant

legislation to practice

Understands relevant legislation to practice

Is able to identify some areas of relevant legislation

Needs support to identify legislative framework for

practice

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Developing the Individual Midwife and Others

Proactively identifies and engages in learning

opportunities within the practice environment for a

level 2 student

Actively engaged in learning within the practice

environment for a level 2 student

Seeks out learning opportunities with some

encouragement for a level 2 student

Requires support to identify appropriate learning

opportunities for a level 2 student

Well motivated within the practice arena

Shows enthusiasm in most practice areas

In some circumstances willing to engage in practice

Encouragement needed to engage in practice

Consistently displays a mature attitude to receiving constructive criticism and

adapts performance accordingly

Able to accept and use constructive criticism to improve performance

Accepts constructive criticism and makes efforts to improve

performance

Requires support to interpret constructive criticism

Consistently displays confidence appropriate for

level 2

On most occasions shows confidence in practice appropriate for level 2

Confident in some situations appropriate for level 2

Level of confidence may adversely inhibit performance

appropriate for level 2

Consistently displays an empathetic approach

In most circumstances demonstrates an empathetic

approach to care

In some circumstances demonstrates an empathetic

approach to care

Needs help to demonstrate empathetic responses to

care

Consistently utilises assertiveness skills to

effectively care for women,

Frequently uses assertiveness skills to

effectively care for women,

In some situations demonstrates assertiveness skills to effectively care for

women

Care for women would be enhanced if assertiveness

skills were developed

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Achieving Quality Care Through Evaluation and Research Explains how monitoring can

enhance care and performance

Conversant with methods to monitor and evaluate care

and performance

Identify methods to monitor and evaluate care and

performance

Needs encouragement to recognise processes that

contribute to the monitoring and evaluation of care and

performance

Incorporates best available evidence into practice

Frequently draws on evidence to support care

decisions

Sometimes draws on evidence to support care

decisions

Needs encouragement to consider evidence for

practice

Comments

TOTAL OF AGREED MARKS AWARDED

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Honours Level

Forms Required for Year Three

The forms in this section must be completed for all placements in year three. Included within is the documentation for

• Student accepting responsibility for their own actions

• Long placement records (duration four weeks or greater)

• Short placement records (duration three weeks or less)

• Action Plans

• Tripartite meeting documentation forms

• Practice Grading

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed to

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Name of Placement: Dates of placement: from The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

For each placement that the student attends the form below MUST be completed

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Name of Placement: Dates of placement: from to The MENTOR should tick whether the student has demonstrated the ability to accept RESPONSIBILITY for their own action in the areas identified, PROVIDE COMMENTS AND SIGN, DATE AND PRINT THEIR NAME YES NO COMMENTS SIGNATURE &

DATE PRINT NAME

Demonstrates ability to accept responsibility for their own actions

• Arriving on duty on time

• Wears uniform in line with trust policy

• Responds appropriately to constructive feedback

• Identification of fire points

• Reports sickness/absence in line with University Campus Suffolk/Trust policy

N/A

• Number of days sick/absent during the placement

Days: Occasions:

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PRACTICE PLACEMENT MEETINGS – 4 weeks duration or longer.

For each placement of 4 weeks duration or longer you must meet with your mentor at least three occasions as detailed below. The record of these meetings must be completed. INFORMATION:

Initial meeting To familiarise the learner with the practice setting; Discuss learning needs and learning opportunities in the placement; Agree roles, responsibilities and teaching, learning and assessment strategy

Mid-point meeting Update on progress with Practice Assessment Document; Ensure documentation is on target; Provide a mid-point mentor report, with action plan if necessary

End-point meeting Provide a final mentor report with recommendations for assessment of the practice component of the module. In conjunction with the student and the Practice Assessment Document, consider the focus for future learning.

PRACTICE PLACEMENT MEETINGS

- Short placements

For each placement of 1-3 week’s duration you must meet with your mentor to discuss learning opportunities. You are not required to complete other interviews.

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Long Placement Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Initial Report Objectives student wishes to achieve on this placement: Areas to work on identified from previous placement: Placement Area: Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. Mid-point Report Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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Recording of meetings It is helpful for these to be recorded as notes for the purposes of the overall learning plan for individual students. Please indicate significant future learning needs as part of this report. End-point Report

Strengths: Areas to work on:

1. Effective Midwifery Practice 2. Professional & ethical practice 3. Developing the individual midwife & others 4. Achieving quality care through evaluation & research

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Summary Report on student development during this placement: (overall comments) Overall this student is safe to practice YES/NO (Delete as applicable) Mentor Signature: Print Name: Date: Student Signature: Print Name: Date:

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SHORT PLACEMENT MEETINGS Date From to Section 1 To be completed by student What do I want to achieve during this placement? Section 2 To be completed by the Mentor Please comment: Placement area: Student Signature: Print Name: Date: Mentor Signature: Print Name: Date:

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MIDWIFERY PRACTICE 3

ACTION PLANS

TRIPARTITE MEETINGS

PRACTICE GRADING

The following are records of tripartite meetings held between the student and their personal tutor and mentor. These meetings will normally take place during assessment week towards the end of each semester. It is the student’s responsibility to arrange these meetings.

At the outset of the semester the student is required to complete an action plan of learning for the semester. This learning should be agreed with the mentor.

The action plan will be reviewed at the tripartite meeting. Comments at tripartite should be used to inform the next action plan.

Midwifery Practice 3 Learning Outcomes

On completion of the module the student will be able to:

1. Use critical reflection monitor and evaluate practice and its contribution to the improvement of outcomes for women, babies and their families

2. Recognise emergency situations and take appropriate action to meet the health needs of women and babies 3. Select, acquire and administer safely a range of permitted drugs consistent with legislation, applying knowledge and skills in context. 4. Manage a small caseload under indirect supervision and prioritise competing demands. 5. Demonstrate an understanding of the quality dimension of care contributing to effective care provision.

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Year 3 - Semester 1 – Student Action Plan What do you want to achieve?

By when? Who can offer support? What activities will you undertake?

How will you evidence achievement

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INTERVIEW WITH PERSONAL TUTOR AND MENTOR (TRIPARTITE MEETING) To be completed by the Personal Tutor Name of Personal Tutor: Name of Interviewer (if different to Personal Tutor): Date of Interview: Placement: Year of course :3 Semester :1 Has the student completed their Action Plan? Yes No Has the student brought their Practice Assessment Document with them? Yes No Has the student brought their Clinical Record Book with them Yes No If the answer to above is No, the interview will be halted and a new interview date arranged (NB, please sign this form as a record of this decision).

Total number of essential skills completed to date: Total number of desirable skills completed to date: Evidence of progression through clinical record book

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Is there a completed: Initial Interview? Yes No Mid Point Interview? Yes No Final Interview? Yes No Form for each placement: Yes No

Comments by student on their overall progression – to be used to identify / inform future learning needs.

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Year 3 Semester 2 Formative Practice Grading Midwifery Practice 3 Learning Outcomes Upon completion of the module the student will be able to:

1. Using critical reflection monitor and evaluate practice and its contribution to the improvement of outcomes for women, babies and their

families

2. Recognise emergency situations and take appropriate action to meet the health needs of women and babies

3. Select, acquire and administer safely a range of permitted drugs consistent with legislation, applying knowledge and skills in context.

4. Manage a small caseload under indirect supervision and prioritise competing demands.

5. Demonstrate an understanding of the quality dimension of care contributing to effective care provision.

Practice Grading can only be completed once all skills within the Practice Assessment Document have been achieved at the level of Internalisation Confirmed by Student:………………………………………………………………………..Date:…………………………….. Confirmed by Mentor…………………………………………………………………………Date:……………………………..

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Effective Midwifery Practice Outstanding application of

theory to practice Very good application of

theory to practice On most occasions good application of theory to

practice

Sometimes applies appropriate knowledge to

practice

Excellent understanding of the midwife’s scope of

practice

Consistently demonstrates understanding of the

midwife’s scope of practice

On most occasions demonstrates the midwife’s

scope of practice

Occasional prompting required to demonstrate the midwife’s scope of practice

Excellent ability to adapt language to ensure effective

communication with women/families and the multidisciplinary team

Consistently adapts language to ensure effective

communication with women/families and the multidisciplinary team

In most circumstances adapts language

appropriately. Occasional prompting required to ensure

effective communication

In some circumstances able to adapt language

appropriately. Needs prompting to ensure effective

communication

Outstanding ability to assess, determine and plan

programmes of care for women based on needs from

preconception to the postnatal period

Consistently demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

On most occasions demonstrates ability to

assess, determine and plan programmes of care for

women based on needs from preconception to the

postnatal period.

Sometimes demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

Outstanding ability to provide a women-centred approach to care based on partnership

which respects the individuality of women

Consistently demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

On most occasions demonstrates a women-centred approach to care

based on partnership which respects the individuality of

women

Sometimes demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

Dexterity demonstrated in skill development expected

at level 3

Good skill development at level 3 though scope for

refinement in some areas

Skill development satisfactory for level 3

student

Some skills would benefit from further refinement for a

level 3 student

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Professional and Ethical Practice Consistently uses structured

reflection on practice to enhance care delivery

Uses structured reflection on practice to enhance care

delivery

Frequently uses structured reflection to consider how

care can be improved

Occasionally uses structured reflection to consider how

care can be improved

Consistently displays an understanding of the

concepts of professionalism

On most occasions displays an understanding of the concepts of professionalism

Frequently displays an understanding of the

concepts of professionalism

On some occasions demonstrates an understanding of professionalism

Always promotes ethical and non discriminatory practices

Consistently promotes ethical and non discriminatory

practices

Typically practices in accordance with ethical and

non-discriminatory frameworks

Demonstrates an understanding of practice

within ethical and non-discriminatory frameworks

Always creates an environment of care to

promote the health, safety and wellbeing of women

Consistently creates an environment of care to

promote the health, safety and wellbeing of women

Frequently able to create an environment of care to

promote the health, safety and wellbeing of women

Is able in some circumstances to creates an

environment of care to promote the health, safety and wellbeing of women

Performs effectively within a multidisciplinary team

and across professional boundaries

Usually works effectively within a multidisciplinary

team and across professional boundaries

Can work well within a multidisciplinary team

requires support to work across professional

boundaries

Aware of own contribution to multidisciplinary team working and requires

encouragement to work across professional

boundaries

Excellent understanding and application of relevant legislation to practice

Very good understanding and application of relevant

legislation to practice

Good understanding and application of relevant legislation to practice

Demonstrates understanding and application of relevant

legislation to practice

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Developing the Individual Midwife and Others

Proactively identifies and engages in learning

opportunities within the practice environment for a

level 3 student

Actively engaged in learning within the practice

environment for a level 3 student

Seeks out learning opportunities with some

encouragement for a level 3 student

Requires support to identify appropriate learning

opportunities for a level 3 student

Outstanding use of initiative and strongly motivated to

participate in all aspects of care

High level of initiative and well motivated to participate

in all aspects of care

Reasonable use of initiative and motivation to participate

in all aspects of care

Some encouragement and support required to

participate in all aspects of care

Consistently displays a mature attitude to receiving constructive criticism and

adapts performance accordingly

Able to accept and use constructive criticism to improve performance

Accepts constructive criticism and makes efforts to improve

performance

Requires support to interpret constructive criticism

Consistently displays confidence appropriate for

level 3

On most occasions shows confidence in practice appropriate for level 3

Confident in some situations appropriate for level 3

Level of confidence may adversely inhibit performance

Consistently demonstrates an empathetic approach to

care

In most circumstances demonstrates an empathetic

approach to care

In some circumstances demonstrates an empathetic

approach to care

Needs help to demonstrate empathetic responses to

care

Consistently utilises assertiveness skills to

effectively support women and colleagues

Frequently uses assertiveness skills to

effectively support women and colleagues

In some situations demonstrates assertiveness skills to effectively support

women and colleagues

Support for women and colleagues would be

enhanced if assertiveness skills were developed

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Achieving Quality Care Through Evaluation and Research Utilises methods of

monitoring and evaluation to enhance care and

performance

Explains how monitoring and evaluation can enhance care

and performance

Conversant with methods to monitor and evaluate care

and performance

Identifies methods to monitor and evaluate care and

performance

Consistently utilises best available evidence to inform

practice

Incorporates best available evidence into practice

Frequently draws on evidence to support care

decisions

Sometimes draws on evidence to support care

decisions

Comments

TOTAL OF AGREED MARKS AWARDED

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Year 3 - Semester 2 – Student Action Plan What do you want to achieve?

By when? Who can offer support? What activities will you undertake?

How will you evidence achievement

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INTERVIEW WITH PERSONAL TUTOR AND MENTOR (TRIPARTITE MEETING) To be completed by the Personal Tutor Name of Personal Tutor: Name of Interviewer (if different to Personal Tutor): Date of Interview: Placement: Year of course :3 Semester :2 Has the student completed their Action Plan? Yes No Has the student brought their Practice Assessment Document with them? Yes No Has the student brought their Clinical Record Book with them Yes No If the answer to above is No, the interview will be halted and a new interview date arranged (NB, please sign this form as a record of this decision).

Total number of essential skills completed to date: Total number of desirable skills completed to date: Evidence of progression through clinical record book

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Is there a completed: Initial Interview? Yes No Mid Point Interview? Yes No Final Interview? Yes No Form for each placement: Yes No

Comments by student on their overall progression – to be used to identify / inform future learning needs.

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End of Year 3 Practice Grading Midwifery Practice 3 Learning Outcomes Upon completion of the module the student will be able to:

1. Using critical reflection monitor and evaluate practice and its contribution to the improvement of outcomes for women, babies and their

families

2. Recognise emergency situations and take appropriate action to meet the health needs of women and babies

3. Select, acquire and administer safely a range of permitted drugs consistent with legislation, applying knowledge and skills in context.

4. Manage a small caseload under indirect supervision and prioritise competing demands.

5. Demonstrate an understanding of the quality dimension of care contributing to effective care provision.

Practice Grading can only be completed once all skills within the Practice Assessment Document have been achieved at the level of Internalisation Confirmed by Student:………………………………………………………………………..Date:…………………………….. Confirmed by Mentor…………………………………………………………………………Date:……………………………..

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Effective Midwifery Practice Outstanding application of

theory to practice Very good application of

theory to practice On most occasions good application of theory to

practice

Sometimes applies appropriate knowledge to

practice

Excellent understanding of the midwife’s scope of

practice

Consistently demonstrates understanding of the

midwife’s scope of practice

On most occasions demonstrates the midwife’s

scope of practice

Occasional prompting required to demonstrate the midwife’s scope of practice

Excellent ability to adapt language to ensure effective

communication with women/families and the multidisciplinary team

Consistently adapts language to ensure effective

communication with women/families and the multidisciplinary team

In most circumstances adapts language

appropriately. Occasional prompting required to ensure

effective communication

In some circumstances able to adapt language

appropriately. Needs prompting to ensure effective

communication

Outstanding ability to assess, determine and plan

programmes of care for women based on needs from

preconception to the postnatal period

Consistently demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

On most occasions demonstrates ability to

assess, determine and plan programmes of care for

women based on needs from preconception to the

postnatal period.

Sometimes demonstrates ability to assess, determine

and plan programmes of care for women based on needs from preconception to the

postnatal period.

Outstanding ability to provide a women-centred approach to care based on partnership

which respects the individuality of women

Consistently demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

On most occasions demonstrates a women-centred approach to care

based on partnership which respects the individuality of

women

Sometimes demonstrates a women-centred approach to care based on partnership

which respects the individuality of women

Dexterity demonstrated in skill development expected

at level 3

Good skill development at level 3 though scope for

refinement in some areas

Skill development satisfactory for level 3

student

Some skills would benefit from further refinement for a

level 3 student

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Professional and Ethical Practice Consistently uses structured

reflection on practice to enhance care delivery

Uses structured reflection on practice to enhance care

delivery

Frequently uses structured reflection to consider how

care can be improved

Occasionally uses structured reflection to consider how

care can be improved

Consistently displays an understanding of the

concepts of professionalism

On most occasions displays an understanding of the concepts of professionalism

Frequently displays an understanding of the

concepts of professionalism

On some occasions demonstrates an understanding of professionalism

Always promotes ethical and non discriminatory practices

Consistently promotes ethical and non discriminatory

practices

Typically practices in accordance with ethical and

non-discriminatory frameworks

Demonstrates an understanding of practice

within ethical and non-discriminatory frameworks

Always creates an environment of care to

promote the health, safety and wellbeing of women

Consistently creates an environment of care to

promote the health, safety and wellbeing of women

Frequently able to create an environment of care to

promote the health, safety and wellbeing of women

Is able in some circumstances to creates an

environment of care to promote the health, safety and wellbeing of women

Performs effectively within a multidisciplinary team

and across professional boundaries

Usually works effectively within a multidisciplinary

team and across professional boundaries

Can work well within a multidisciplinary team

requires support to work across professional

boundaries

Aware of own contribution to multidisciplinary team working and requires

encouragement to work across professional

boundaries

Excellent understanding and application of relevant legislation to practice

Very good understanding and application of relevant

legislation to practice

Good understanding and application of relevant legislation to practice

Demonstrates understanding and application of relevant

legislation to practice

Comments

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Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Developing the Individual Midwife and Others

Proactively identifies and engages in learning

opportunities within the practice environment for a

level 3 student

Actively engaged in learning within the practice

environment for a level 3 student

Seeks out learning opportunities with some

encouragement for a level 3 student

Requires support to identify appropriate learning

opportunities for a level 3 student

Outstanding use of initiative and strongly motivated to

participate in all aspects of care

High level of initiative and well motivated to participate

in all aspects of care

Reasonable use of initiative and motivation to participate

in all aspects of care

Some encouragement and support required to

participate in all aspects of care

Consistently displays a mature attitude to receiving constructive criticism and

adapts performance accordingly

Able to accept and use constructive criticism to improve performance

Accepts constructive criticism and makes efforts to improve

performance

Requires support to interpret constructive criticism

Consistently displays confidence appropriate for

level 3

On most occasions shows confidence in practice appropriate for level 3

Confident in some situations appropriate for level 3

Level of confidence may adversely inhibit performance

Consistently demonstrates an empathetic approach to

care

In most circumstances demonstrates an empathetic

approach to care

In some circumstances demonstrates an empathetic

approach to care

Needs help to demonstrate empathetic responses to

care

Consistently utilises assertiveness skills to

effectively support women and colleagues

Frequently uses assertiveness skills to

effectively support women and colleagues

In some situations demonstrates assertiveness skills to effectively support

women and colleagues

Support for women and colleagues would be

enhanced if assertiveness skills were developed

Comments

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146

Mark Awarded by 20 - 16 15 - 11 10 - 6 5 -0 Student Mentor Agreed

Achieving Quality Care Through Evaluation and Research Utilises methods of

monitoring and evaluation to enhance care and

performance

Explains how monitoring and evaluation can enhance care

and performance

Conversant with methods to monitor and evaluate care

and performance

Identifies methods to monitor and evaluate care and

performance

Consistently utilises best available evidence to inform

practice

Incorporates best available evidence into practice

Frequently draws on evidence to support care

decisions

Sometimes draws on evidence to support care

decisions

Comments

TOTAL OF AGREED MARKS AWARDED

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Overall Summary of placements

Year Semester Placement area Dates from and to

Long / short placement

No of sick days

Paperwork complete

Relative Page in passport

Tripartite meeting dates

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Specimen signature sheet Please ensure that any person who signs an entry within the clinical record book has provided a specimen signature on this page.

Name

Signature Initials Designation Place of work

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