Demonstrating Safe and Effective Practice: Transitioning students from pre-registration competency attainment to post-registration Revalidation

Tennant, Julie (2017) Demonstrating Safe and Effective Practice: Transitioning students from pre-registration competency attainment to post-registration Revalidation. In: Royal College of Midwives Annual Conference, 31 October - 1 November 2017, Manchester.

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Abstract

The publication of ‘The Gathering Storm’ by the Royal College of Midwives (RCM) contextualises the current landscape in England’s maternity workforce and services as one in which demonstrating safety and effectiveness is compromised by rising levels of complexity in pregnancy, midwife shortages and financial constraints in the NHS (RCM, 2017). Despite these challenges, a Midwife in practice must demonstrate that they can practise safely and effectively and ‘live’ the standards set out within the Nursing and Midwifery Council (NMC) ‘Code’; demonstration of this being achieved via the process of Revalidation (NMC, 2016). Preparing student midwives to have a critical appreciation of the complexities of midwifery care or the ‘real’ world of midwifery is a goal of the undergraduate curriculum. Learning in practice is a fundamental part of this process and is complemented by learning opportunities facilitated by academic staff in University settings. The challenge in the University environment is to provide teaching and learning opportunities which are ‘real’ or ‘authentic’ in nature and can be achieved, for example, through the use of simulation or analysis of case based scenarios drawn from practice. Central to this approach is the use of authentic means of assessment that encourages deep learning and this can be achieved using methods such as observation and work-situated assessment. Preparing a new undergraduate curriculum afforded the opportunity to address innovative means of authentically assessing final year student midwives in preparation for their future role. Subsequently, a modified version of the NMC professional revalidation process was proposed as an assessment method for a module of study addressing the care of women and families. The module aims to support students to integrate knowledge and skills, provide women-centred care, and foster a collaborative role in leading and managing women’s journeys. In addition, students are required to evaluate their own skills and abilities and produce strategies for advancing day-to-day practice. The modified template of the NMC Revalidation process is used as a vehicle for recording and integrating module learning with reflective analysis of cases drawn from practice. The process culminates in the presentation of evidence of learning, practice hours, service user feedback, reflective accounts and developmental plans mirroring the ‘real world’ requirement of the safely practicing midwife. Where the modified template and process differs, is in the requirement for students to critically appraise the evidence and research and personal skills commensurate with module outcomes. There is recent evidence from the National Nursing Research Unit to suggest that although the research evidence base around continuing professional development (CPD) is relatively limited and weak, some conclusions can be drawn suggesting that CPD does not appear to be regarded as being part of development but rather maintenance of health professionals’ standards of practice (Rafferty, Xyrichis, Caldwell, 2015). Using the modified template for NMC Revalidation as ‘transitioning’ tool is hoped not only to prepare students to maintain competency but to continue to develop ‘safe and effective in practice’ skills, preparing them for the turbulence of contemporary midwifery practice.

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