Frequently Asked Questions

Can we sign students off if we are not competent in the skills ourselves?

Yes, you are signing off a skill using testimony from others and evidence collected by the student, therefore, if you are satisfied that the student has shown and provided adequate evidence to be assessed in the Knowledge, Skills, Attitudes and Values for the proficiency you can sign off the skill.

Does a student have to demonstrate the skills on a patient to show sufficient evidence for sign off by Practice Assessor?

The Future nurse: Standards of proficiency for registered nurses document (NMC, 2018) specifies ‘the nursing procedures that registered nurses must demonstrate that they are able to perform safely’, further explaining ‘the annexes provide a description of what registered nurses should be able to demonstrate they can do at the point of registration to provide safe nursing care’. However, this does not specify that practice must be on a patient. This of course would be a natural route to support skill development and acquisition, providing that this could be done under supervision of a person competent in carrying out the skill. But it is accepted that this may not be possible in all settings due to staff skill mix, lack of need for a skill to be performed in a particular area, or other factors.

Does this mean that on qualification and entry onto the register, a newly qualified nurse can practise all these skills independently?

No, it will remain for individual Trusts to decide what form of preceptorship is deemed necessary and appropriate for all new nurses, according to role, location, skill requirements etc so this will be determined at a local level. Many Trusts will still require the completion of competency-based packages or training prior to independent practice of many skills. However, the completion of the proficiencies will support the process, in terms of readiness to practice.

My student is struggling to gather evidence in relation to a particular proficiency. How else can I help a student gather relevant evidence?

For helpful tips and ideas for encouraging students to 'think outside the box', and suggestions of other sources of evidence, please visit our Thinking Outside the Box page!

What happens when a student comes to an interview without any of the  evidence discussed here that they need for sign off?

Providing evidence is the students responsibility, therefore if you feel that there is inadequate evidence for you to sign off don't.  Its a really good idea to get your student thinking about sign off in your initial interview. Its important to point out to them that all educators are looking for evidence , discuss what that evidence may be, remind them  its vital to sign off, and therefore their responsibility. It is also good to remind students that there is time pressure,  there isn't room to keep re booking the final interview if the reason is the evidence has not been uploaded and completed.

Can we use evidence a student provides from previous placements, even if they were within a different trust or practice area?

Absolutely, students are encouraged to get testimony from others whenever they are involved in a skill in any way, be that a supportive role or practical role. This evidence can build up over time and will help you to assess increasing knowledge skill and confidence. 

The student has gathered evidence for all of their proficiencies but I am concerned that their overall knowledge of our particular area is lacking, I am concerned that they have picked an easy option to reflect on, and there is little depth to it, can I ask them to expand?

Absolutely, students are expected to meet the assessment criteria, (see Suitable Preparation Reminder for a reminder of the assessment criteria for each part) to do this, they need to give the PA evidence in the shape of a reflection, this reflection should expand the proficiency and show how their knowledge and skill has grown in over the period of their placement, how they have applied their knowledge in the placement area, and how law and policy underpin this. if you feel that you still require further reflection you can use question and answer to ascertain their knowledge or what they would do in hypothetical situations.

My student has a large amount of evidence for their proficiency sign off,  they passed their medicines management and Episode/Episodes of care, but I have concerns around their professional values. Can they still pass the placement?

No, a student cannot pass a placement if they fail any part of their professional values. Professional values are assessed throughout the placement, and formally at the mid point and final interview. It may be that the student passed at the mid point and was given some feedback to support them to improve, however there is evidence from a number of Practice Supervisors that this has not been taken on board. The student must be given the opportunity to make good, therefore an action plan should be created with the support of the students Academic Assessor/Link Lecturer (dependant on individual HEI policies). If an action plan was not put in place and the student has got to the point of their final interview, the student should be failed on their professional values, however they will be given an opportunity to make good as the agreed process was not followed.

My student is on placement for make up hours, they do not need to have any proficiencies or EOC or medicines management completed only professional values. I have a number of concerns around this, can a student fail make up hours on professional values alone?

Yes, in order to be recommended to the register, on completion of their course students must demonstrate that they have maintained not only their proficiencies, but also more importantly, their values and professionalism consistently throughout their make up hours. If you have any concerns, you should follow the concerns policy as with any other placement, you should contact the university and follow the action plan procedures as normal. The student should be given an opportunity to make good, if improvement is not evidenced then they are in a refer position, as they would be with any placement.  

My student has excellent knowledge and skill around the task based proficiencies, however their interactions with the individual whilst delivering these tasks is not person centred, holistic or even acknowledged, and are defensive when given feedback and struggle to reflect, Can I say that they have not met the required level for assessment of this skill?

Yes. Students must show professional values in addition to knowledge and skill for every task based proficiency, an example here would be the taking of a persons blood pressure. The student may be able to explain the procedure excellently, they may have in depth knowledge of the science behind the procedure, execute the task excellently gaining an expected measurement. But at no time during the procedure did the student complete one or all of the following (these are examples, this is not an exhaustive list),  acknowledge the individual, introduce themselves, gain consent, understand capacity, explain the procedure, make reasonable adjustments, support the individual throughout the full procedure, etc. The student should be given appropriate feedback, verbal and written in the form of a testimony which should be uploaded to the MYEPAD and the chance to repeat the assessment. If the concerns around the students values and interactions with individuals are the same, again the student should not be assessed as meeting the required level for assessment and this should be documented in the MYEPAD. This should be discussed with the students Practice Assessor, in addition to the proficiency, thoughts should also be discussed around assessment of the students professional values as this evidence would be important to that assessment.