A Handbook for Teaching and Learning in Higher Education Enhancing academic and Practice

454 ❘
Teaching in the disciplines
Case study 1: Portfolio of practice
Portfolios of practice were developed for assessing students’ practice. These
replaced practice-based assessment documents with learning outcomes and a
separate skills schedule. Thus all practice assessment requirements are
incorporated into one document and mentors document all feedback on a
student’s performance in a single place. Furthermore, students have only one
document to remember to take to their placements. However, it was not felt to be
practical to have one portfolio for the entire programme and so portfolios were
developed for each year. For nursing the first-year portfolio is common to all
branches but for years two and three they are branch-specific.
The portfolios were designed with practitioners and included all the activities
students needed to undertake to demonstrate achievement of the appropriate
proficiencies. Some action planning and reflection were included to enable the
portfolio to be graded. Using the portfolio over a period of a year has enabled
mentors to review a student’s performance elsewhere. Students can see their
progress more clearly.
(Pam Parker and Val Dimmock, St Bartholomew School of Nursing
and Midwifery, City University London)
Developing clinical reasoning
Theoretical perspectives, empirical knowledge and reflection all underpin the clinical
reasoning that leads to clinical decision-making. It is good practice to begin with a client
encounter (a real encounter, PBL trigger, case study or patient management scenario).
This capitalises on the intrinsic motivation to provide appropriate care to be found among
healthcare students. The learning trigger should be suited to students’ prior knowledge
and experience in order that an appropriate level of disjuncture is created. Disjuncture is
the gap between what you know and understand (consciously or unconsciously) and
what you feel you need to know and understand (see Jarvis (1987) for an elaborated
discussion). Moderate disjuncture creates a readiness to learn and thereby closes the gap;
excessive disjuncture leads to learners giving up – a ‘miseducative experience’ (Dewey,
1938).
Providing appropriate learning triggers is made more difficult by heterogeneous
groups, or poor knowledge about the learners for whom the trigger is intended. It
therefore follows that writing or selecting good triggers for interprofessional groups
presents special challenges. Experience in writing triggers is often key: it may be possible
to work with a more experienced colleague, or colleagues whose knowledge of the
student group or field of practice exceeds yours.