The future of nursing graduates is changing.  With a greater focus on public health, health improvement and wellbeing, and a greater balance across physical and mental health, the Nursing & Midwifery Council (NMC) has recently set in place new standards to prepare graduates for future practice.  The profession currently faces many challenges, with a growing ageing population across the UK, there is greater demand for more graduate nurses and better patient care. 

Set against the backdrop of new 2018 NMC Standards and the challenges facing the profession, the need to support student nurses and midwives, and prepare them for professional practice is greater than ever.  

Edinburgh Napier University (ENU) School of Nursing, Midwifery and Social Care is the largest provider of nursing and midwifery education in Scotland.  With over 1,500 student nurses on placement in hospital and community settings across the Lothian and Borders area, providing the right level of support to ensure students’ progress and qualify in line with the new NMC standards is a top priority. 

What were the challenges?

Prior to working with MyKnowledgeMap, ENU had a paper-based system for assessing student nurses in practice, with student nurses carrying the same practice assessment documentation with them for the three-year duration of their course.  Although the risk of loss or damage to the assessment documentation was moderate during their programme, the assessment book contained personal information in relation to the student and their mentor, the loss of which posed a higher risk and potential to breach GDPR. 

Other challenges a paper-based Practice Assessment Document posed were:

• Paper documentation meant that it was difficult to easily view student progress or performance against competencies and skills in practice. It was therefore difficult to provide students with the right level of support, facilitate early intervention and improve failure to fail students appropriately.
• Paper documentation did not align with the NHS Education for Scotland (NES) quality benchmark or allow for effective implementation of the new NMC standards.
• There was considerable workload on administrative and academic staff at the end of each trimester when documents are submitted for marking and then returned to the student. A conservative estimate of the cost for the academic and administrative man hours to process these assessments over three years suggests that Edinburgh Napier currently spend between £14,000 and £20,000 to facilitate the process.
• Printing costs of paper-based documents were approx. just under £25,000, alongside the fact that use of paper is not environmentally friendly.
• The new NMC standards in Scotland introduce three new roles involved in supporting the student on placement including Student Mentor, Personal Development Tutor and Liaison Lecturer. Clear communication between these roles in the support of the student is required under the new standards. This process is something that paper documentation could not facilitate, especially with the student being remote on placement.

Developing the curriculum and establishing electronic Practice Assessment 

In February 2015, the ENU School of Nursing, Midwifery and Social Care commenced an integrated approach to curriculum development.  The initial phase of this identified a number of short-life working groups to take forward specific focus areas with the overall aim of achieving a strategic process for all key stakeholders.  The Electronic Professional Development Portfolio (ePDP) Working Group’s role was to explore opportunities for electronic assessment for practice, and to investigate options for delivery of ePDP within the context for the new curriculum development and NMC standards.

Following the review of various system providers, the group recommended Myprogress, a mobile practice assessment tool and ePortfolio developed by MyKnowledgeMap. With over 20 years’ experience working with medical and healthcare institutions, including some of the UK’s top nursing schools, Myprogress is specifically designed to support the assessment and feedback for students in clinical settings.

ENU chose Myprogress due to this proven experience and expertise alongside the platform’s ability to:

• Reduce overall processing time, including collation, receipt and handling of paper-based assessment materials, adhering to GDPR and eliminating the risk of lost documentation / assessment decisions
• Meet the quality benchmark statements for practice learning developed by NHS Education for Scotland (NES)
• Align with the student assessment processes with the School’s strategy and direction for enhancement of practice learning, as well as with those developed by NES to monitor and evaluate student achievement of the programme learning outcomes in practice
• Be cost-effective in comparison to the existing processes used for practice assessment
• Facilitate and enable the Student Mentor, Personal Development Tutor and Liaison Lecturer to monitor student progress when on placement, helping to address issues in real-time, create an action plan and ensure the student successfully meets the NMC / Programme learning outcomes for practice
• Facilitate an ePortfolio of evidence for ENU students whilst allowing integration of the student assessment data with the ENU new placement software system, InPlace.

The project at ENU not only aligned with the School’s strategy and direction to enhance assessment and feedback in practice, but also aligned with national goals set out by the NMC, Scottish Context of Health and Social Care Delivery Plan, the Nursing 2030 Vision and the CNO Commission on Widening Participation in Nursing and Midwifery Education and Careers. 

From May to August 2018, ENU ran a comprehensive pilot involving a group of students, mentors and academic staff.  Full on site and online training and support were given to all stakeholders involved with critical support provided by MyKnowledgeMap.  After a successful pilot, in September 2018 a staged rollout commenced across multiple nursing programmes and years. Since this rollout all nursing programmes are now using Myprogress in practice and the roll-out for midwifery programmes is the next stage of implementation.

Creating higher quality assessment, feedback and placement support

Since using Myprogress, a survey was carried out with students and mentors and there has been positive feedback from all users of the system.  It is highly recommended by students and mentors who have found the system to be quick and easy to use after training.  Students and mentors choose to use Myprogress to carry out assessments “off the floor” but have found that this provides dedicated mentorship time and overall higher quality assessment, feedback and placement support.

In terms of impact, within the survey, Academics report that Myprogress has been very effective and efficient in enabling them to monitor student progress in practice and verify the student’s achievement of NMC competencies.  Overall, students feel better supported on placement and Edinburgh Napier is able to easily demonstrate compliance with NMC standards and meet NES benchmarks.  Academics also report that there is a considerable reduction in their administrative time in verifying student practice documentation from the practice mentors, freeing valuable time to enhance student experience within practice and the programme overall. 

The introduction of electronic based assessment systems for student nurses is new to ENU within the School of Health and Social Care, but also new to the rest of the university.  When updates on the projects progress have been given to the Senior Leadership team within the university, there has been extremely positive feedback and the university is now considering the application of Myprogress across other groups of students who undertake practice learning experiences and require competency-based assessment i.e. Engineering and Allied Health.

Within the project there were a number of fundamental requirements that had to be met to ensure the projects success. From a compliance perspective, the solution had to align with NHS Education for Scotland processes and benchmarks, easily comply with the 2018 NMC standards and support the new roles set in place by these standards i.e. Student Mentor, Personal Development Tutor and Liaison Lecturer.  From a practical perspective, the solution had to be able to integrate with the School’s placement management system, InPlace.  After considerable research by the ePDP working group, Myprogress was found to the only system which was able to meet these requirements