Clinical Immersion 2
|Module title||Clinical Immersion 2|
Ms Alison Marchbank (Convenor)
|Number students taking module (anticipated)|
Description - summary of the module content
In this module you further develop your clinical practice to demonstrate achievement of specified NMC (2018) Standards of proficiency for registered nurses and adherence to the Code (NMC, 2015). Your clinical immersion this year is split into three parts. Your clinical immersion this year will incorporate a short exposure to a primary care setting and a short exposure to a mental health setting, as well as experience of services for children, pregnant women and people with learning disabilities.
During the clinical immersion you will participate in the usual working pattern for the service in which you are based, including shifts, weekends and nights.
Practice supervisors and practice assessors will support, assess and provide feedback and feed forward, recording your progress in your Practice Assessment Document (PAD) and Ongoing Achievement Record (OAR). All areas will meet educational learning audit requirements through the shared quality assurance framework - Educational Audit Process. Mandatory year two standards of proficiency are specified in your PAD and OAR.
Module aims - intentions of the module
The main objective of the module is that you will demonstrate increasing proficiency in planning, organising and delivering safe and effective nursing care.
- You will demonstrate achievement of a selection of the Standards of proficiency for registered nurses, including annexes A & B, as required by the Nursing and Midwifery Council (2018).
You will incorporate public health priorities, health improvement, health promotion and health protection into your clinical practice.
You will demonstrate development of management and leadership skills in the provision of care in a range of clinical settings.
You will integrate and synthesise Exeter’s six pillars of nursing into your daily practice.
Fundamental essentials of nursing care: as an Exeter nurse you will understand co-morbidities and the demands of meeting people’s holistic needs when planning and prioritising care. This will include co-ordination of processes involved in the planning and management of safe discharge or transfer of patients between health and social care settings. You will build on your year one knowledge of risk management, health promotion and health improvement. Excellence in the fundamentals of care remains central to your practice as you develop skills in care planning and evaluation of interventions. F
Patient and public involvement: as an Exeter nurse you will consistently demonstrate the principle of ‘nothing about us without us’ in all your interactions with patients, carers and members of the public. You will understand the importance of making decisions with patients based on their wishes, rather than your own. It is vital that you demonstrate the knowledge, communication and relationship management skills required to provide people with accurate information. You will help and support people to make informed decisions and use health promotion opportunities to discuss the impact of lifestyle choices including smoking, substance misuse, sexual behaviours, and diet and exercise on mental, physical, cognitive and behavioural health. PPI
Evidence for practice: as an Exeter nurse you will develop your critical analysis skills and will use appropriate evidence to support and challenge practice. You will use evidence gathered from the development, testing, implementation and evaluation of complex nursing interventions to explain the impact of the care delivered. You will learn about epidemiology, pathogenesis, and immunology for immunisation, vaccination and herd immunity to promote population health. E
No health without mental health: this pillar enables you to recognise clinical and psychosocial variation in relation to mental distress, emotional vulnerability and physical symptoms and will equip you with the skills to take appropriate action to reduce harm. You will understand case management and be able to locate resources which are evidence-based to support self-management of common mental health problems. You will demonstrate the knowledge and skills required to support people with mental health, behavioural, cognitive and learning challenges alongside long term physical conditions, within an overarching recovery framework. You will demonstrate knowledge and skills to support people with symptoms associated with anxiety, confusion and pain. MH
Leadership and management: as an Exeter nurse you will exhibit leadership potential as your practice experience progresses. This will involve developing the skills necessary to manage, support and motivate other members of the healthcare team. You will use your leadership skills to promote up-to-date approaches to behaviour change to enable individual, families and populations to make informed choices when managing their own health. L&M
Global health: this includes an elective placement that will enable you to provide and promote non-discriminatory care reflecting on patients’ diverse backgrounds and cultural characteristics making any necessary reasonable adjustments. GH
Exeter’s pillars are mapped to the ILOs below.
Intended Learning Outcomes (ILOs)
ILO: Module-specific skills
On successfully completing the module you will be able to...
- 1. Provide safe, person-centred, evidence-based care in an increasingly confident manner, within an appropriate timeframe in partnership with the person receiving care/family and the multidisciplinary team. (F;E;PPI) (4PEC 4.4, 4PEC 4.5, A2.1, B1.1.1 1.1.5, B1.2.1, B1.2.2)
- 2. Identify and use appropriate opportunities and effective communication skills to explore the importance of healthy lifestyle choices in relation to the mental and physical health and wellbeing of the persons receiving care. (G;F;E:PPI;MH) (2PHPIH 2.1, 2PHPIH 2.6, 2PHPIH 2.7)
- 3. Demonstrate that you can undertake a whole person assessment and effectively contribute to the decision-making process and provision of safe, person-centred, evidence-based care. (E;F;L&M;MH) (3ANPC 3.2, 3ANPC 3.3, B2.7)
- 4. Demonstrate that you can co-ordinate the nursing care of a small group of people/person with complex care needs, demonstrating understanding of risk assessment and management and can access appropriate support and resources as required. (L&M;F;E;MH) (7CC 7.5, 5LMNCWIT 5.5, 6ISQC 6.5)
- 5. Demonstrate understanding of the contribution of social influences, health literacy, behaviours and lifestyle choices to the mental health and physical health outcomes in people, families and communities. (MH;E:G) (2PHPIH 2.7)
- 6. Demonstrate relevant knowledge in the prioritisation of care and be able to identify changes in a persons condition and respond appropriately. (F;E;L&M) (4PEC 4.10, 5LMNCWIT 5.5)
- 7. Accurately undertake risk assessments demonstrating understanding of risk management and health improvement strategies. (E;F;L&M;PPI) (6ISQC 6.4, 6ISQC 6.5, 6ISQC 6.6)
- 8. Apply knowledge of pharmacology, how medicines act and interact in the systems of the body, and their therapeutic action. (F;E) (4PEC4.14, 4.15)
- 9. Carry out an initial and continued assessment of people receiving care and their ability to self-administer their own medications. (F;E;PPI) (B11.1)
- 10. Prepare medications where necessary, safely and effectively administer these via common routes, maintain accurate records and be aware of the laws, policies, regulations and guidance which underpin medicines management. (E:F) (B11.2)
- 11. Safely and accurately perform medicines calculations for a range of medications. (E;F) (1BAP 1.15, B11.4)
- 12. Coordinate the process and procedures involved in managing the safe discharge, move or transfer between care settings of the person. (F;PPI;L&M;MH) (4PEC 4.18)
- 13. Maintain safety and safeguard the patient from harm, including non-compliance, demonstrating understanding of the Mental Capacity Act (DH 2007) The Mental Health Act (DH 2007), where appropriate. (MH;F;E) (6ISQC 6.1)
- 14. Demonstrate and apply knowledge of a range of mental health and physical health conditions in the assessment, planning, implementation and evaluation of person-centred, evidence-based care. (F;E;MH;L&M;PPI) (3ANPC 3.1, 3ANPC 3.3, 3ANPC 3.5, B1.1.1 1.1.5, B1.2.1, B1.2.2)
- 15. Interact and engage confidently with families/ carers and members of the multidisciplinary team in coordinating care for a small group of people (or in caring for an individual with complex care needs). (L&M;PPI) (4PEC 4.3, 5LMNCWIT 5.4, A2,1, A2.2)
ILO: Discipline-specific skills
On successfully completing the module you will be able to...
- 16. Demonstrate the ability to consistently provide safe and effective care underpinned by the evidence base in order to meet the Nursing and Midwifery Council Standards of Proficiency for Registered Nurses (2018) and the Code (2015). L&M
ILO: Personal and key skills
On successfully completing the module you will be able to...
- 17. Demonstrate your potential to work more independently, making the most of opportunities to extend knowledge, skills and practice. L&M
- 18. Demonstrate appropriate communication skills for clinical practice, in increasingly complex contexts. F
- 19. Develop numeracy, literacy and digital literacy skills to support and enhance clinical practice. F
Whilst the module’s precise content may vary from year to year, an example of an overall structure is as follows:
This module is based in the clinical setting and is made up of a series of clinical learning immersions. These clinical immersions are integrated with your theory module and together they form the second year of your MSci Nursing.
In your clinical immersions you will practice under supervision and in collaboration with nurses, students and healthcare colleagues to develop your nursing skills including assessing, planning, implementing and evaluating nursing care. The indicative content for each pillar is listed below; the required Standards of proficiency (NMC, 2018) are clearly set out in your PAD.
Fundamental essentials of nursing care
Physical and holistic nursing assessment, monitoring, recognising and acting upon deteriorating health and wellbeing, pharmacology, genetics, medication management, non-judgemental attitudes, co-morbidities and their impact on people and complex care needs, planning and prioritising care from the person’s perspective, clinical skills, infection control.
Public and patient involvement
Enhancing communication, relationship management, medication support, partnership planning and goal setting, reviewing outcomes together, working with and supporting vulnerable people, negotiation and advocacy.
No health without mental health
Recognising common mental health problems and wellbeing issues, recognising signs of deterioration, and acting to reduce harm, supporting people with mental health, behavioural, cognitive and learning needs alongside long-term physical conditions and symptoms associated with anxiety, confusion and pain.
Evidence for practice
Appraising, applying and implementing appropriate research evidence for complex interventions in nursing, behaviour change, and health promotion taking into account the social and economic context of the people being cared for, risk assessment, applying the philosophy of public involvement.
Leadership and Management
Undertaking risk assessments, leadership, coaching and supporting others, increasing management and leadership of patient care and others including your management of safe discharge and transfers between care settings.
Immunisation and population health, global health care systems, cultural competence, non-discriminatory care including identification and provision of reasonable adjustments for people with disabilities.
The hours contribute to the NMC and EU Directive of 2,300 practice learning hours across the whole programme. Your clinical immersion module equates to 835 hrs.
Learning and teaching
Learning activities and teaching methods (given in hours of study time)
|Scheduled Learning and Teaching Activities||Guided independent study||Placement / study abroad|
Details of learning activities and teaching methods
|Category||Hours of study time||Description|
|Clinical Practice Immersion||835||Practice based learning supported by a practice supervisor and practice assessor.|
|Form of assessment||Size of the assessment (eg length / duration)||ILOs assessed||Feedback method|
|Mid-point assessment of progress as part of the Practice Assessment Document (PAD).||Formative assessment of achievement of proficiencies will happen at the mid-point of each part of the immersion.||1-19||Direct verbal feedback and feed forward and written feedback and feed forward within PAD.|
Summative assessment (% of credit)
|Coursework||Written exams||Practical exams|
Details of summative assessment
|Form of assessment||% of credit||Size of the assessment (eg length / duration)||ILOs assessed||Feedback method|
|Practice Assessment Document (PAD) and Ongoing Achievement Record (OAR) successful completion of these documents provides evidence of your achievement in practice. (Pass/Fail)||100||Professional values and specified proficiencies are assessed continuously throughout the clinical immersion- these must be completed by the end of the clinical immersion. You have a single attempt at the Episode of Care and Medicines Management assessments, which are observed assessments, with a pass/ fail outcome. These will be undertaken at a time agreed by you and your practice assessor, usually towards the end of the final part of your clinical immersion.||1-19||Direct verbal feedback and feed forward and written feedback and feed forward within PAD.|
Details of re-assessment (where required by referral or deferral)
|Original form of assessment||Form of re-assessment||ILOs re-assessed||Timescale for re-assessment|
|Practice Assessment Document (PAD) and OAR. (Pass/Fail) (100%)||Practice Assessment Document (PAD) and Ongoing Achievement Record (OAR) successful completion of these documents provides evidence of your achievement in practice. (Pass/Fail) (Professional values and specified proficiencies are assessed continuously throughout the clinical immersion- these must be completed by the end of the clinical immersion.||1-19||A three week consolidation period is also available at the end of the academic year to make up learning hours missed due to illness etc. and to allow for reassessment including a second attempt of the Episode of Care and Medicines Management assessment if required.|
To progress into year three you must demonstrate that you have met the modular learning outcomes by demonstrating the professional values and agreed proficiencies specified in the PAD, in line with the NMC Standards of proficiency for registered nurses (2018). Furthermore, you must pass both ‘Episode of Care’ assessments and the ‘Medicines Management’ assessment, as detailed in the PAD. The final practice assessor will confirm that the specified professional values and agreed skills have been achieved and will ensure that relevant proficiencies have been signed for. They will also undertake the summative ‘Episode of Care’ assessments and the ‘Medicines Management’ assessment. Progression is supported and confirmed by the academic assessor for each year of the programme.
The Practice Assessment Document is assessed as either pass or fail. Within the year two clinical immersion, proficiencies can be carried over from one part of the immersion to the next. However, they must be achieved by the end of the year. Exceptions to this are detailed in the Ongoing Achievement Record (OAR).
Indicative learning resources - Basic reading
Alligood, M.A. (2018) Nursing Theorists And Their Work, Elsevier. [Electronic resource]
Ashelford, S. Raynsford, J. and Taylor, V. (2016) Pathophysiology & Pharmacology for Nursing Students, Sage.
Bradshaw, T. and Mairs, H. (eds) (2017) Health Promotion and Wellbeing in people with Mental Health problems, Sage publications.
Brooker, C., Nicol, M. (2015) Alexander’s Nursing Practice 4th ed. Churchill Livingstone.[Electronic resource]
Chenery-Morris, S and McLean, M. (2013) Normal midwifery practice. Sage [Electronic resource]
Delves-Yates, C. (ed) (2015) Essentials of Nursing Practice, Sage.
Downs, M and Bowers, B (2014) Excellence in dementia care: research into Practice McGraw Hill Education [Electronic resource]
Edelman, C.L., & Kudzman, E.C. (2018) Health Promotion Across the Life span, Elsevier.[Electronic resource]
Gates, B., Ferns, D., Welch, J. (eds) (2015) Learning disability nursing at a glance. Wiley-Blackwell. [Electronic resource]
Giger, J.N. (2017) Transcultural Nursing; Assessment and Intervention (7th ed), Elsevier.
Glasper, E.A., McEwing, G., Richardson, J.(eds) (2016) Oxford handbook of children’s and young people’s nursing, Oxford University Press.[Electronic resource]
Gould, D & Brooker, C. (2008) Infection Prevention and Control; Applied Microbiology for Healthcare (2nd ed) Palgrave Macmillan.[Electronic resource]
Griffith, R. & Tengath, C. (2017) Law and Professional Issues in Nursing: Transforming Nursing Practice, Sage.
Hamraie, A (2017) Building Access: universal design and the politics of disability. University of Minnesota Press. [Electronic resource]
Hockenberry, M, Wilson, D, Rodger, C (2018) Wong’s Nursing care of infants and Children. Elsevier [Electronic resource]
Hubert, R.J and Van Meter, K.C. (2018) Gould’s Pathophysiology for the Health Professions, Elsevier. [Electronic resource]
Hyden, L.C. and Antelius, E. (2017) Living with dementia: relations, responses and agency in everyday life. Palgrave [Electronic resource]
Innes, J.A., Dover. A.R., & Fairhurst, K. (eds) (2018) Macleod’s Clinical Examination (14th ed.), Elsevier.
Mutsatsa, S. (2015) Physical healthcare and promotion in mental health nursing. Sage [Electronic resource]
Naidoo, J., and Wills, J. (2016) Foundations for Health Promotion Elsevier.[Electronic resource]
Norman, I. and Ryrie, I. (2013) The Art and Science of Mental Health Nursing Fundamentals of mental health nursing: An essential guide for nursing and healthcare students. [Electronic resource]
Polit, D.F and Back, C.H. (2017) Essential of Nursing Research: Appraising Evidence for Nursing Practice. Wolters Kluwer.
Polit, D.F and Beck, C.T. (2017) Nursing research: generating and assessing evidence for nursing. Wolter Kluwer.
Papadopoulos, I. (ed) (2006) Transcultural Health and Social Care; Development of Culturally Competent Practitioners, Butterworth Heinemann.
Richards, D.A. and Hallberg, I.R. (eds) (2015) Complex Interventions in Health. Routledge.[Electronic resource]
Sethia, B., and Kumar, P. (eds) (2019) Essentials of Global Health, Elsevier.[Electronic resource]
Silverman,J. Kurts,SM and Draper,J. (2013) Sills for communicating with patients. Radcliffe. [Electronic resources]
Stein-Parbury, J. (2018) Patient & Person: Interpersonal Skills in Nursing, Elsevier.
Tashiro, J., Shimpuku, Y., Naruse, K., et. al., (2013) Concept analysis of reflection in nursing professional development. Japan Journal of Nursing Science 10(2):170-179 available at: https://www.evidence.nhs.uk/Search?q=nursing+reflection&sp=on
Trenowerth, S (2017) Promoting recovery in mental health nursing Sage.[Electronic resource]
Uchiumra, H. (ed) (2009) Making Health Services More Accessible in Developing Countries. Finance and Health Resources for Functioning Health systems. Ide-Jetro Series, Palgrave Macmillan. [Electronic resource]
Watson, C. (2018) The Language of Kindness: A Nurse’s Story. Chatto & Windus.
Waugh, A. Grant, A. (2018) Ross & Wilson, Anatomy and Physiology in Health and Illness, Elsevier.
Waugh, A. Grant, A. (2013) Ross & Wilson, Anatomy and Physiology in Health and Illness, Churchill Livingstone.[Electronic resource]
Wright, K. M and McKeown, M. (2018) Essentials of Mental Health Nursing, Sage Publications.
Indicative learning resources - Web based and electronic resources
Nursing and Midwifery Council: www.nmc.org.uk
Royal College of Nursing: www.rcn.org.uk
Department of Health: www.gov.uk/government/organisations/department-of-health-and-social-care
National Institute of Health and Clinical Excellence: www.nice.org.uk
World Health Organisation: www.who.int
Healthtalk online: www.healthtalk.org
Module has an active ELE page
Indicative learning resources - Other resources
American Journal of Nursing
British Journal of Community Nursing
British Journal of Nursing
International Journal of Nursing Studies
Journal of Advanced Nursing
Journal of Clinical Nursing
Journal of Psychiatric and Mental Health Nursing
Nursing Older People
Worldviews on Evidence-based Nursing
|NQF level (module)|
|Available as distance learning?|
|Last revision date|