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Learning Enhancement and Development

Julie Attenborough - SHS - Education Enhancement Grant

Julie Attenborough - School of Health Sciences

The funding was used to employ an independent research assistant through Unitemps to carry out semi-structured interviews for the project outlined below, this was crucial as there was a considerable risk of both a perception of coercion, and bias. We also used the funding to transcribe the interviews. This enabled us to access some very rich data, which along with the survey yielded the following results.

Revalidation project: Impact on students and lecturers

When revalidation was introduced by the Nursing and Midwifery Council (NMC) in April 2016 the emphasis was on nurses and midwives employed in clinical practice (Falla et al, 2016; Beach and Oates, 2015). Revalidation replaced the system of post-registration education and practice (PREP), and aimed to promote safe and effective practice. The process involves demonstrating competence and adherence to the Code (NMC 2015), currency, reflection and engagement with professional networks within a defined area of practice. The NMC reported 2% of registrants revalidating in the first year of the process as working in higher education (NMC 2017).
The university provided some resource to implement the initial revalidation of registrants, including the provision of workshops, and individual coaching. However, as a new process and concept, some challenges emerged in implementing revalidation; the most common was academic staff anxiety about professional identity in relation to clinical credibility.

During a pre-registration nursing and midwifery course, students develop understanding about their profession, its scope and boundaries through interaction with their lecturers and exposure to clinical practice. The influence of lecturers’ professional identity on this is not well understood; unlike lecturers in medical schools, lecturers of nursing and midwifery and are not required to undertake clinical practice.

The overall aim of this study is to establish the impact of the NMC revalidation process on the professional identity of academic staff at City, University of London. This study also investigates student perceptions of their lecturers as registrants, and student identity. It is anticipated that the results of the study will inform further development of nursing and midwifery as clinical academic subjects.

Objectives


*To explore staff experiences of revalidation and its impact on their identity
*To explore student understanding of the NMC revalidation process and gain understanding of student learning in relation to the clinical credibility of academic staff.
*To establish the nature of the relationship between NMC revalidation and academic staff perception of themselves as registrants.
*To identify any technical and implementation issues to inform implementation
*To investigate staff’s perceived value of NMC revalidation in relation to other professional recognition, such as the Higher Education Academy (HEA) fellowship scheme.

Methods

The project adopted a mixed methods approach, examining the experiences and feelings of students and staff via an on-line survey questionnaire and semi-structured interview. The focus of the survey was developed from themes discussed at the interactive workshops preparing staff for revalidation, and included anxiety about revalidation, professional identity and the perception of the university's commitment to the employment of registrants in academic roles. The focus of staff interviews was expectations, experiences and reflections on revalidation, especially in relation to their identity as nurses, midwives and School, Community and Public Health Nurses (SCPHN) employed in an academic role. The focus of student interviews was experiences and understanding of lecturers as registrants and the perceived importance of revalidation and the Code of Conduct for Nurses and Midwives in promoting professional identity.
Interview transcripts were analysed systematically for themes, with a deliberate search for divergent cases.

How will this enhance student learning?

The results of this study clearly illustrated the importance of lecturers having a clinical background to students, but not that they are up-to-date- students didn’t expect that and although lecturers may be aware of it, it does help to inform how lecturers prepare to meet students’ needs. This will be shared with academic staff. There were some important lessons about the disruption of networks whilst in placement and I will be speaking to the Student Union to discuss how we can help to bridge this gap.
There were some important lessons about the theory-practice gap which I will be sharing with lecturers and discussing with students.
Overall identity of lecturers as nurses, midwives and health visitors appears to be very important to those individuals- there are some important lessons from the literature about how this may be a constraining factor for advancement of nursing and midwifery as academic subjects in universities (a global phenomenon), which in turn must impact of students’ experience. With new moves to limit the amount of connection between clinically based healthcare students and higher education this is a concern, and one which I will be highlighting at the Council of Deans for Health and the NMC as regulator of these programmes, as there is no evidence that this is what students want.
A paper based on this study will be submitted shortly to Nurse Education Today. I think the paper will add to the body of knowledge about healthcare students in universities and may shape and influence further developments in curricula and support for these subjects in higher education.