Guidelines to support students

1. MSc Nursing
(pre-registration)September 15
PUP 4095
Developing competence in inter-professional practice
Reflective Essay – 3000 words
3/20/2017Dr Juliet Thomas and David Rootes

2. LEARNING OUTCOMES
On successful completion of the module you will be able to:
 Demonstrates professionalism and integrity in collaborative practice
(Professional Values)
 Critically analyse professional ethical and legal frameworks for
safe practice (Professional Values)
 Apply key transferrable skills such as communication, respect, privacy, dignity,
compassion, therapeutic relationships (Communication & interpersonal skills)
 Apply evidence based practice for safe compassionate person centred nursing
practice that meets service user/ carer needs across a range of inter-professional
practice settings (Nursing Practice and decision making)
 Critically reflect and appraise own knowledge and skills towards
developing competence in inter-professional practice (Leadership,
Management and Team Working)
 Demonstrate an appreciation of the mechanisms for safe collaborative practice
through reflection (Leadership Management and Team Working)

3. Reflective Essay
 Identify two practice competencies in Practice Assessment
Record One (PAR 1) and critically reflect on the knowledge
and skills you acquired to achieve them
 3,000 notional words
 This must meet Learning Outcomes 2 and 5
 This assessment represents 100% of the graded mark and
The pass mark is 40%
 In order to pass the module, both parts of the assessment
strategy must be passed (PAR1 practice is already
achieved
 SMILE………..

4. Learning outcomes 2 &5
 (2) Demonstrates a critical appreciation of recognised
professional, ethical and legal frameworks for safe practice
: Professional Values (P)
 (5) Critically reflect and appraise own knowledge and skills
towards developing competence in inter-professional
practice:
Leadership Management and Team Working (L)

5. Indicative competencies
 The domains are further subdivided into indicative
competencies – (see slide 10 onwards) and your
assignment should reflect these
 It is important that you choose one competency to
discuss from domain 1(e.g.P1, P2, P3, P4, P5) AND
one competency from domain 4 (e.g. L1, L2, L3, L4,
L5, L6)

6. Reflective Framework –as this is a critically reflective
assignment, you may write in the first person
 You should introduce the reflective framework you will use
and provide a rationale for your choice – e.g.Driscoll, Johns
or Gibbs for example….
 You may wish to critically reflect on both competencies
rather than introduce them separately e.g. If you choose P2
and L5 you may wish to reflect on both & critically analyse
how the legal professional & ethical frameworks may impact
on your practice
 OR if you choose P1 and L3 you may wish to reflect on
both and critically analyse how you are able to recognise and
work within knowledge, skills and professional boundaries
understanding that you are responsible for your own actions
and must acknowledge your own level of competence

7. Critical Thinking
 Is when you adopt a questioning approach and thoughtful
attitude to what you read, see or hear, rather than accepting
things at face value. It relates to both academic work and
professional practice.
 Critical thinking involves a critical appraisal of the
information available to you.
 Critical appraisal is when you consider the strengths &
limitations of the evidence you see and hear, depending on
the type of evidence you have.
 The types of questions you need to ask yourself are:

8. Types of questions
 WHERE does this information come from?
 WHAT is being said?
 HOW did they write this?
 WHO is telling this?
 WHEN was this written?
 WHY has this been written?
 This means making a judgement about the facts and the
quality of evidence on which these facts are based. Critical
appraisal involves Critical Analysis

9. Critical Analysis
 Is when you break down or explore in depth all the
information available relating to an issue or question.
 It usually involves exploring what is happening and the
reasons why….. You may need to consider and access
alternative perspectives, including theory
 Unpack things…..

10. Domain 1 – Professional
values
P1 Practices honestly and with integrity applying the
principles of the code: standards of conduct, performance
and ethics for nurses and midwives (2008) and the
guidance of professional conduct for nursing and midwifery
students (2010)
 Works within limitations of the role & recognises own level of
competence
 Displays appropriate interest and enthusiasm

11. Domain 1 – Professional
values
P2 Displays a professional image in behaviour and
appearance
 Adheres to local policy and National guidelines on dress code
for prevention and control of infection, including; footwear,
hair, piercing and nails
 Adheres to practice provider and University sickness and
absence policies
 Displays a responsible approach to time management
including punctuality and reliability

12. Domain 1 – Professional
values
 P3 Acts in a manner that is attentive, kind, sensitive,
compassionate and non-discriminatory, that values diversity
and acts within professional boundaries
 Engages with people in a way that ensures dignity is
maintained whilst adopting an appropriate attitude
 Demonstrates an understanding of the impact, culture,
religion, spiritual beliefs, gender and sexuality have on health,
illness and disability

13. Domain 1 – Professional
values
 P4 Displays respect for an individual’s rights and choices

14. Domain 1 – Professional
values
 P5 Displays an awareness of how one’s own values,
beliefs, emotions, health and well –being impact on practice

15. Domain 4: Leadership,
management & Team working
 L1 Seeks help and shares information with colleagues
where people’s needs are not being met or they are at risk
 Under supervision assesses risk within current sphere of
knowledge and competence
 Understands the context of multi-professional/agency/cross-
boundary teams

16. Domain 4: Leadership,
management & Team working
 L2 Demonstrates an understanding of how to work within
legal and professional frameworks

17. Domain 4: Leadership,
management & Team working
 L3 Is able to recognise and work within, knowledge, skills and
professional boundaries, understanding that they are
responsible for their own actions
 Uses support systems to recognise, manage and deal with
own emotions
 Understands and applies the importance of rest for effective
practice
 Accepts delegated activities within limitations of own role,
knowledge and skill

18. Domain 4: Leadership, management &
Team working
 L4 Maintains professional boundaries, and acts in a way that values the
roles and responsibilities of others including service users and carers
and interacts appropriately
 Respects and responds appropriately to constructive feedback
 Effectively communicates people’s stated needs and wishes to
other professionals
 Appreciates the ways in which own interactions affects
relationships to ensure that they do not impact inappropriately
on others

19. Domain 4: Leadership,
management & Team working
 L5 Demonstrates the ability to work within local policies to
safeguard and protect people, particularly children, young
people, older people and vulnerable adults
 Demonstrates an understanding of the central role in
preventing maltreatment
 Identifies and understands how to refer those at risk of
experiencing harm
 Demonstrates an awareness of the role of relevant agencies
and professionals

20. Domain 4: Leadership,
management & Team working
 L6 Effectively uses reflection and appropriate supervision
mechanisms for working safely and effectively
 Demonstrates self-awareness through their own professional
development whilst learning from practice
 Seeks feedback on own practice, reflects and adapts practice
appropriately

21. A good outline of an essay’s
intention…..
 This assignment will address the attainment of competencies P.2 and
L.6 from Practice Assessment Record 1 (see Appendix 1). To achieve
these competencies, students need to develop self-awareness and
ability to think critically, honestly, and reflectively, about their
practice (Page & Meerabeau, 2000, Atkins & Murphy, 1993, Wilson,
1996). It is the intention of this essay to critically reflect on the
knowledge and skills I acquired to achieve these competencies.
Competence is complex (Higgins, et al. 2010) and requires a
combination of knowledge, skills and values; essentially a holistic
approach (Gonczi, 2013). We must recognise our abilities, and work
only within our levels of competency (Jasper, 2006). Advancement of
these competencies will contribute to evidence based person-centred
care (Driscoll, 2007, McSherry & Smith, 2012, Dugdill, et al. 2009,
Rolfe, 2011, Maree & Van Rensburg, 2013).

22. Later on, the second competency
(P2) is introduced..
 Student nurses are educated in the need for infection
prevention and control procedures and protection
equipment (Department of Health (DH), 2007, Edge Hill
University (EHU), 2012). Wearing correct and clean uniform
promotes professional identity (EHU, 2012, DH, 2006,
Brennan & Timmins, 2012) and inspires confidence (DH,
2007). Despite there being no conclusive evidence that
uniforms transmit infections (DH, 2007, Loveday, et al.
2007), it remains good practice not to wear uniform outside
of the workplace, in order to protect the professional image
of nursing portrayed to the public (DH, 2007, EHU, 2012).


23. Personal reflective element
regarding P2…..
 One of the constraints I found in the practice environment is
the difficulty fitting into the team. On placement I observed staff
approaching patients without gloves and/or aprons, and I
questioned my own understanding. I felt as though the staff
judged me as ‘too posh’ to just get stuck in without gloves,
which is ridiculous as PPE is there to protect the patient as
much as the professional (NICE, 2011, Folan & Baillie, 2009,
Paboteeah, 2007). Pollard (2009) notes that staff behaviour
sometimes contradicts that of formal learning, and students
most often gravitate towards the informal role models.
Retrospectively thinking, I should have taken time to reflect on
the ethics of what I observed, as patients are entitled to the
highest standard of evidence based care, and not participating
in infection control measures is in confrontation with these
ethical considerations (Quallington, 2012).

24. Further personal reflective
element regarding P2…..
 While on placement, a doctor asked me to chaperone an examination. I was
dressed according to the uniform policy (EHU, 2012) and so communicating
the message of neatness, cleanliness, and professionalism (Albert, et al.
2008, Rezaei-Adaryani, et al. 2012). The student nurse uniform is instantly
recognisable to patients, inciting confidence in their ability fulfil their role
(Loveday, et al. 2007), as patients ‘wish to know who is caring for them and
expect to use appearance to do this’ (DH, 2007:7).

 As the doctor began the examination, I was required to select items and
open them to preserve the sterile field. My lack of familiarity with the
examination area meant I found it a slow process, increasing my
embarrassment. I had not put on gloves, so when the doctor needed help
handling items I was of no use. This further extended the time spent on the
internal gynaecological examination, and discomfort experienced by the
patient. I had allowed myself to be influenced by what I observed the staff
doing, despite prior knowledge that it was wrong (Felstead, 2013). My
forgetfulness, or perhaps subconscious decision that gloves were not
needed, proceeded to influence the negativity of the experience.

25. References
Department of Health (2010) Uniforms and Workwear:
Guidance on Uniform and Workwear Policies for NHS
Employers. https://www.gov.uk/government/organisations
(Accessed 27 August 2013).
Driscoll, J (2007) Practising Clinical Supervision, a reflective
approach for healthcare professionals. 2nd Ed. London:
Elsevier Ltd.
Ghaye, T. & Lillyman, S. (2011) ‘Reflection on values: being a
professional’ Independent Nurse. 7 Feb. pp. 40-41.

26. References
Health and Safety Executive (2013) Personal Protective
Equipment at Work. A Brief Guide. www.hse.gov.uk (Accessed
27 August 2013).
Loveday, Wilson, J. P. Pratt, R. (2007) ‘Uniform: an evidence
review of the microbiological significance of uniforms and
uniform policy in the prevention and control of healthcare-
associated infections. Report to the Department of Health
(England)’. Journal of Hospital Infection. 66 (4)pp.301-307.
Price, S.L. (2009) ‘Becoming a nurse: a meta-study of early
professional socialization and career choice in nursing’ Journal
of Advanced Nursing. 65(1)pp.11–19.


27. References
Royal College of Nursing (2013) Guidance on Uniforms and
Work Wear. www.RCN.org.uk (Accessed 27 August 2013).
Webb, C. (1992) ‘The use of the first person in academic
writing: objectivity, language and gatekeeping’ Journal of
Advanced Nursing. 17 pp. 747-752.
Wocial, L. Albert, N.M. Fettes, S. Birch, S. Howey, K. Na, J.
Trochelman, K. (2010)’Impact of Paediatric Nurses Uniforms
on Perceptions of Nurses Professionalism’ Paediatric Nursing.
36 (6) pp.320-326.