An innovative practice assessment in nursing: exploring the contested relationship between assessment and learning in practice

This professional doctorate addresses a protracted challenge that is fundamental to ‘learning to nurse’, that of learning, and the assessment of that learning, in the practice environment. This project was inspired by the obligation to implement a Pan London practice assessment document for nursing students as mandated by the National Health Service (NHS) London office in 2013. As a member of the pan London practice learning group (PLPLG) I had a participatory role in its development. As ‘Head of Practice-based Learning’ within the School of Health and Education my ‘inward’ facing role in this project was to positively influence the practice learning curriculum development institutionally. Collaborating within my institutional community of practice to achieve their understanding and ownership of this externally produced assessment tool, and lay the foundations for their adoption and implementation of this tool across a variety of placements was key to this project.
A critical consideration for Middlesex University was the specific requirement pertaining to the our curriculum validated in 2011, being that the assessment of practice must be both graded and awarded credits and the timing of this implementation afforded me with the opportunities to explore views and perceptions related to this integral part of our learning and assessment strategy.
My approach to this inquiry reflects an action research methodology due to its critical and transformative nature and the integration of action and reflection. The action cycles adopted a range of activities including a critical discussion using an appreciative inquiry approach, focus groups involving academics, practice education staff and students as well as an analysis of the text provided by student assessment documentation.
A number of important insights have been developed along the journey of this project and significant learning gains for myself and participants. The challenges that students face, whether their practice is graded or not, are illuminated against a background of traditional and controlling assessment practices and complex environments influenced by historical and socio-political factors. The significance of these findings within the changing context of nurse education with the planned implementation of new Nursing and Midwifery Council standards for education in Sept 2019 will also be elucidated.
This project has led to the enhancement of a community of practice for practice learning within the school, involving both academic and practice colleagues; a fuller appreciation of the student experience with a decision not to grade practice in our new curriculum; actions that aim to empower students to engage more actively in their learning; and the promotion of an enhanced team based approach to learning in practice.