Standards to

support learning and

assessment in practice
NMC standards for mentors, practice teachers and teachers
Front cover, from left to right: Julie Dalphinis, Clinical Learning Environment Lead
(West) at the East of England Multi Professional Deanery; Edward Phillips,
Practice Development Nurse for Nursing and Patient Services at Bedford Hospital;
Dr Anna Brown, Director of Studies for Midwifery Degree Programmes at the
University of Surrey.

Photographer: Sam Shiell

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Foreword
Welcome to the second edition of Standards to support learning and assessment in
practice (the standards). A series of NMC Circulars has been produced following an
assessment of the impact of the 2006 edition, and as a result of a high volume of
enquiries received by the NMC. Whilst there is no fundamental change to the standards
themselves, the additional information is intended to support easier application in
practice. The decision has been taken to incorporate the information into this version
of the standards. The opportunity has also been taken to provide an update on wider
policy developments which have impacted on the standards. An overview of the
revisions is provided on pages 9–10.

The standards have outcomes for mentors, practice teachers and teachers, and take
the form of a single developmental framework, outlined in Annexe 1. The framework
defines and describes the knowledge and skills nurses and midwives need to apply
in practice when they support and assess students undertaking NMC approved
programmes that lead to registration or a recordable qualification on the register. The
NMC has agreed mandatory requirements for each part of the register, summarised
below. The outcomes for each role are identified as different stages within the
framework. It is possible to enter or exit the framework at any stage, and each stage is
not dependent on having met the outcomes of a previous stage.

A range of information including an electronic version of the standards themselves, the

Circulars which support implementation and responses to frequently asked questions is
also provided on the NMC’s website at www.nmc.org.uk

The NMC has agreed mandatory requirements for each part of the register. These are:

Nursing
• Students on NMC approved pre-registration nursing education programmes,
leading to registration on the nurses’ part of the register, must be supported and
assessed by mentors.

• From September 2007 a sign-off mentor, who has met additional criteria
(paragraph 2.1.3), must make the final assessment of practice and confirm
that the required proficiencies for entry to the register have been achieved
(paragraph 3.2.6).

• From September 2007 students on NMC approved specialist practice programmes

leading to a recordable qualification on the nurses’ part of the register must
be supported and assessed by sign-off mentors who have met additional
criteria (paragraph 2.1.3), or practice teachers where this is a requirement by
commissioners. The sign-off mentor must make the final assessment of practice
and confirm that the required proficiencies for recording a specialist practice
qualification have been achieved (paragraph 3.2.6).

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Midwifery
• Students on NMC approved pre-registration midwifery education programmes,
leading to registration on the midwives’ part of the register, can only be supported
and assessed by mentors who have met the additional sign-off criteria (paragraph
2.1.3). Sign-off mentors must also make the final assessment of practice and
confirm that the required proficiencies for entry to the register have been achieved
(paragraph 3.2.6).

Specialist community public health nursing (SCPHN)

• Students on NMC approved specialist community public health nursing
programmes, leading to registration on the specialist community public health
nurses’ part of the register, must be supported and assessed by practice teachers.
Where education providers are unable to meet this standard they have been able
to make an application to the NMC for a temporary deferment up to 2010. From
September 2007 the practice teacher must make the final assessment of practice
and confirm that the required proficiencies for entry to the register have been
achieved (paragraph 3.3.6). All practice teachers are required to meet the additional
sign-off criteria (paragraph 2.1.3).

NMC requirements for implementing the standards

The standards update the previously published Standards to support learning and
assessment in practice (NMC 2006) which replaced the previously published Standards
for the preparation of teachers of nurses, midwives and specialist community public
health nurses (NMC 2004).

Nurses and midwives who started teacher preparation programmes prior to

1 September 2007 may complete them – meeting the outcomes of the 2004 standard.

All new entrants to mentor, practice teacher or teacher preparation programmes from
1 September 2007 must meet the requirements of the standards.

The standards will be further reviewed once the UK-wide outcomes of Modernising
Nursing Careers: Setting the Direction (DH 2006) and the Government White Paper
Trust, Assurance and Safety – The Regulation of Health Professionals in the
21st Century (DH 2007) are known and at least every five years thereafter.

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Contents
Introduction
Background
Revisions within this edition
The framework to support learning and assessment in practice
Programme level and length
Recognition of prior learning
Local register of mentors and practice teachers
Review and maintenance of mentor/practice teacher qualifications
Triennial review of mentors and practice teachers
Roles to support learning and assessment in practice
Preceptors
Fitness for practice
Equality and diversity
Supporting students who have a disability

Section 1: The developmental framework and its underpinning principles..................... 19

1.1 The developmental framework...................................................................... 19
1.2 The underpinning principles.......................................................................... 20
1.3 Guidance for applying the underpinning principles....................................... 21

Section 2: Standards for mentors, practice teachers and teachers................................ 23

2.1 NMC mentor standard................................................................................... 23
2.1.1 Criteria for supporting learning and assessing in practice: mentors.............. 24
2.1.2 Competence and outcomes for a mentor...................................................... 25
2.1.3 Criteria for a sign-off mentor.......................................................................... 27
2.2 NMC practice teacher standard..................................................................... 28
2.2.1 Criteria for supporting learning and assessing in practice: practice teacher. 29
2.2.2 Competence and outcomes for a practice teacher........................................ 30
2.3 NMC teacher standard.................................................................................. 32
2.3.1 Criteria for supporting learning and assessment in practice: teachers.......... 33
2.3.2 Competence and outcomes for a teacher..................................................... 33

Section 3: Applying the standards to support learning and assessment in practice....... 37

3.1 Applying the standards to nursing, midwifery and specialist community
public health nursing educational programmes............................................. 37
3.2 Applying the mentor standard in practice...................................................... 38
3.2.1 Mentor preparation programmes................................................................... 38
3.2.2 Continuing professional development for mentors........................................ 39
3.2.3 Allocated learning time for mentor activity..................................................... 39
3.2.4 Supporting learning in practice...................................................................... 40
3.2.5 Assessing learning in practice....................................................................... 42
3.2.6 Signing off practice proficiency...................................................................... 42
3.3 Applying the practice teacher standard in practice........................................ 45
3.3.1 Practice teacher preparation programmes.................................................... 46
3.3.2 Continuing professional development for practice teachers.......................... 46
3.3.3 Allocated learning time for practice teacher activity...................................... 47
3.3.4 Supporting learning in practice...................................................................... 47
3.3.5 Assessing learning in practice....................................................................... 49

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 3.3.6 Signing off practice proficiency...................................................................... 49
3.4 Applying the teacher standard in practice..................................................... 51
3.4.1 Teacher preparation programmes................................................................. 52
3.4.2 Continuing professional development for teachers....................................... 52
3.4.3 Signing off proficiency................................................................................... 52
3.4.4 Allocated learning time for teaching activity.................................................. 53

Section 4: Approval and monitoring of mentor, practice teacher and teacher preparation
programmes
4.1 NMC approval of mentor/practice teacher preparation programmes............ 54
4.2 NMC approval of teacher preparation programmes...................................... 54
4.3 NMC monitoring arrangements..................................................................... 54
4.4 NMC recognition of other teaching qualifications.......................................... 54

Section 5: Glossary, references and annexes................................................................ 56

Glossary.................................................................................................................. 56
References.............................................................................................................. 59
Annexe 1: The developmental framework to support learning and assessment in
practice.................................................................................................................... 62
Annexe 2: The UK Professional Standards Framework for teaching and supporting
learning in higher education.................................................................................... 71
Annexe 3: NMC Circulars........................................................................................ 72
26/2007 Applying due regard to learning and assessment in practice
02/2008 Applying due regard to learning and assessment in practice for student
midwives
33/2007 Ensuring continuity of practice assessment through the ongoing
achievement record

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Introduction
Background
The Nursing and Midwifery Council (NMC) is the regulator for two professions:
nursing and midwifery. The primary purpose of the NMC is to protect the public. It
does this through maintaining a register of all nurses, midwives and specialist
community public health nurses (SCPHN) eligible to practise within the UK, and by
setting standards for their education, training, conduct, performance and ethics. When
setting standards, or issuing any guidance, the NMC consults nurses and midwives on
the register, the public, employers, those involved in the education and training of
nurses and midwives, and prospective nurses and midwives. Once standards have
been set they are reviewed on a regular basis – at least once in every five years.

The Council published standards for the preparation of teachers of nursing, midwifery
and specialist community public health nursing in 2004. The standards were originally
set by the United Kingdom Central Council for Nurses, Midwives and Health Visitors
(UKCC) in 1999, adopted and republished by the NMC in April 2002, and had a minor
review to bring them in line with the new register in August 2004. A complete review
of the standards began in 2003, with a consultation on the proposed new standards
closing in October 2004.

The NMC also considered fitness for practice at the point of registration as a separate
project (consulting from October to December 2005). There were overlapping issues
between both consultations in relation to the quality and nature of support for learning
and assessment in practice.

In August 2006 the NMC published standards to support learning and assessment
in practice, reflecting the responses to both consultations, and the final standards
approved by Council in March 2006. The standards replaced those previously published
for the preparation of teachers of nurses, midwives and specialist community public
health nurses (NMC 2004) and included new standards for mentors and practice
teachers. NMC Circular 17/2007 made explicit the requirement for programme and
placement providers to implement the standards, which have been mandatory since
1 September 2007. This included the requirement for mentor, practice teacher, and
teacher programmes to have gained NMC approval prior to accepting students on to
such programmes from 1 September 2007.

Revisions within this edition

1. Equality and diversity

The standards have been reviewed to ensure they meet the requirements of the NMC
equality and diversity schemes implemented in 2007/8.

These are concerned with promoting equality of opportunity on the grounds of race,
gender, and disability, and treating individuals with fairness, respect and understanding.
They include principles that enhance equal opportunities and recognition of diversity,
such as emphasising the need to tailor learning and assessment in an appropriate way,
recognising that students have many different learning needs and preferences. Further
details can be found on the NMC website, and on page 19.

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2. Post qualifying nursing programmes
2.1 Review of specialist practice qualifications

In the previous edition, a number of references were made to a proposed NMC review
of Specialist Practice Qualifications (SPQ) and the implications for the introduction of
the practice teacher standard. This work will now be informed in the longer term once
the future framework for post-registration qualifications is established by the four UK
Government health departments as outlined in Modernising Nursing Careers (DH 2006).
The NMC will then determine whether regulation will need to be applied and standards
will be set accordingly. The framework for supporting learning and assessment of any
post-registration programmes for which the NMC set standards will subsequently need
to be determined. Until such a time as new arrangements are in place, all reference
to requiring practice teachers to supervise and assess students on SPQ programmes
has been removed from the standards. However, where commissioners of SPQ
programmes require the involvement of practice teachers this should continue e.g. for
district nursing.

2.2 Review of the implementation of the standard for advanced nursing practice

In the previous edition, a number of references were made to the proposed review
of the implementation of the ‘Standard for advanced nursing practice’. An application
was made to the Privy Council in December 2005 to open a subpart of the register.
It was stated within the Government White Paper Trust, Assurance and Safety – The
Regulation of Health Professionals in the 21st Century (DH 2007) that the Department
of Health would discuss the next steps with the NMC.

The White Paper Implementation Plan is awaited and has identified that there will be
cross-over work on revalidation. Until the NMC has received further detail regarding
this work all references to advanced nursing practice have been removed from the
standards.

3. Revised arrangements for the practice teacher standard

Revised arrangements for the introduction of the practice teacher standard were
introduced in April 2007 (NMC Circular 08/2007), which changed the time allowed to
complete a practice teacher qualification from six months to it being normally completed
within six months as detailed in paragraph 3.3.1.

The Circular confirmed that practice teachers were required to be in place to supervise
and assess SCPHN students from September 2007. Where education providers were
unable to meet this standard they have been able to make an application to the NMC for
a temporary deferment up to 2010.

Also, the requirements for practice teachers for SPQs and ANP were deferred, as
explained above.

The practice teacher standard in its entirety will be reviewed in the future in light of the
outcomes of points 2.1 and 2.2 above, and further guidance will be issued at that time.

Currently, practice teacher preparation programmes including arrangements for the

preceptorship period can be implemented flexibly to meet local circumstances such as

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the structure of SCPHN programmes, and placement arrangements.
4. Applying due regard to learning and assessment in practice (see
glossary for definition of due regard)
Since the previous edition of these standards, NMC Circulars 26/2007 (for nursing and
SCPHN) and 02/2008 (for midwifery) (Annexe 3) were issued setting out the ways in
which the principle of due regard may be applied more flexibly (see paragraphs 1.2
and 2.1.3).

5. Sign-off mentors and/or practice teachers

5.1 Confirmation of proficiency

The role of the sign-off mentor and/or practice teacher is to make judgments about
whether a student has achieved the required standards of proficiency for safe and
effective practice for entry to the NMC register. The previous version of the standards
implied that the sign-off mentor and/or practice teacher should provide confirmation of
achievement of practice proficiency directly to the NMC. The sign-off process is integral
to the overall programme assessment requirements which the NMC endorse as part of
programme approval. The programme leader, or lead midwife for education, confirms
to the approved education institution assessment board that both the theoretical and
practice elements have been achieved on completion of the programme. Sign-off
mentors and/or practice teachers are therefore not required to directly inform the NMC
of the practice assessment outcomes. References to the role of sign-off mentor and/or
practice teacher have been modified accordingly (see pages 5, 17 and 18).

5.2 Implementation of the sign-off mentor and /or practice teacher role across the
three parts of the NMC register

Sign-off mentors and/or practice teachers have been a requirement for all students
commencing NMC approved programmes from September 2007.

All sign-off mentors are nurses or midwives who having met the additional criteria
(see paragraph 2.1.3) can make judgements about whether a student has achieved
the required standards of proficiency for safe and effective practice for entry to the
NMC register. However, the role is applied slightly differently across the three parts of
the NMC register. The process for achieving sign-off status for new mentors/practice
teachers is also slightly different. These differences have been set out in this version of
the standards and are summarised below.

5.2.1 Sign-off mentors in nursing

a. Sign-off mentors for pre-registration nursing students

Sign-off mentors are required only for students on final placements.1 This means that
only mentors who support pre-registration nursing students on final placements are
required to meet the sign-off criteria (see paragraph 2.1.3).

1
Sign-off will normally take place in the full placement or period of practice learning. Occasionally this

9
may occur slightly earlier, especially if the final experience is an elective.
From September 2007 those mentors who are subsequently required to become
sign-off mentors must demonstrate that they have met the sign-off mentor criteria in full
(see paragraph 2.1.3), including having been supervised on at least three occasions for
signing off proficiency (at the end of a final placement) by an existing sign-off mentor
before being annotated as such on the local mentor register.

b. Sign-off mentors for students on specialist practice programmes

The requirement for the introduction of Practice Teachers for specialist practice
programmes was revised in NMC Circular 08/2007. As a result sign-off mentors are
required for all students on specialist practice programmes leading to a recordable
qualification on the nurses’ part of the register.

From September 2007 students on NMC approved specialist practice programmes

leading to a recordable qualification on the nurses’ part of the register must be
supported and assessed by sign-off mentors who have met additional criteria
(paragraph 2.1.3) or by practice teachers where this is required by commissioners. For
sign-off mentors this includes having been supervised on at least three occasions for
signing off proficiency at the end of a final placement by an existing sign-off mentor
before being annotated as such on the local register. (This can occur with a student on
any NMC approved programme).

5.2.2 Sign-off mentors in midwifery

Sign-off mentors for pre-registration midwifery students

Sign-off mentors are required for all students on pre-registration midwifery programmes.

From September 2007 all midwives who undertake mentor preparation programmes are
required to have met the additional sign-off criteria (paragraph 2.1.3) including having
been supervised on at least three occasions for signing off proficiency by an existing
sign-off midwifery mentor during the programme.

Since the previous edition of the standards, the NMC has outlined in NMC Circular
13/2007 how sign-off at progression points within a pre-registration midwifery
programme can be used for making summative judgments about safe and effective
practice. This is clarified in NMC Circular 02/2008 and outlined at 3.2.6.

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5.2.3 Practice teachers for students on SCPHN programmes

Practice teachers are required for all students on SCPHN programmes unless a
deferment application has been approved by the NMC as stated in NMC Circular 08/2007.

From September 2007 all nurses who undertake practice teacher preparation
programmes are required to have met the additional sign-off criteria (paragraph 2.1.3).
The process by which nurses and midwives undertaking practice teacher preparation
programmes should consolidate their training and achieve sign-off status was clarified in
NMC Circular 27/2007 and is outlined at paragraph 2.2.

6. Guidance for small scale service providers in applying the NMC’s

Standards to support learning and assessment in practice
The standards (NMC 2006) introduced local registers of mentors and practice teachers
and processes for review and maintenance of mentor/practice teachers qualifications
including annual updating and triennial review (see pages 15 and 16).

Placement providers were identified as being responsible for developing and

maintaining the local registers and undertaking triennial review.

Since the introduction of the standards, however, it has become clear that some smaller
scale placement providers, particularly in the independent sector (e.g. nursing homes),
may not be best placed to undertake this responsibility. NMC Circular 28/2007 enabled
education providers to take responsibility for developing and maintaining local registers
of mentors/practice teachers, providing annual updates, and undertaking triennial
reviews, as appropriate, through negotiation with small scale providers with whom they
work in partnership.

7. The ongoing achievement record and sharing of personal

information
The standards have been updated in respect of principles for sharing personal
information necessary to maintain continuity of assessment and to ensure safe and
effective practice through the ongoing achievement record, as outlined in NMC Circular
33/2007 (Annexe 3). The term ‘student passport’ is no longer being applied to the
ongoing achievement record.

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. Previous discrepancies in Annexe 1
A number of inconsistencies have been corrected relating to Annexe 1 regarding the
outcomes for mentors and practice teachers.

In the table on page 62 (Mentor – stage 2, domain Creating an environment for

learning) the words ‘development of others’ were inadvertently omitted from the last
bullet point and have been added.

At 2.1.2 in the text (Mentor – stage 2, domain Establishing effective working

relationships) the outcome ‘develop effective working relationships based on mutual
trust and respect’ has been removed from the text. In the table on page 62 this outcome
appears in its correct place under stage 1 of the framework (registered nurses and
midwives).

At 2.1.2 in the text (Mentor – stage 2, domain Evaluation of learning) the wording of
outcome ‘contribute to evaluation of student learning and assessment experiences
– proposing aspects for change resulting from such evaluation’ has been amended
slightly to ensure consistency with this outcome in the table on page 66.

At 2.2.2 in the text (Practice teacher – stage 3, domain Establishing effective working
relationships) outcome ‘have effective professional and interprofessional working
relationships to support learning for entry to the register and education at a level beyond
initial registration’ appeared in the text at practice teacher – stage 3, and in the table
at mentor – stage 2. This outcome applies to practice teacher – stage 3 and has been
inserted into the table on page 62. For mentor – stage 2, the outcome should read ‘have
effective professional and interprofessional working relationships to support learning for
entry to the register’ and has been inserted into the text at 2.1.2, and amended in the
table on page 62.

At 2.2.2 in the text (Practice teacher – stage 3, domain Facilitation of learning)

outcome ‘foster professional growth and personal development by use of effective
communication and facilitation skills’ has replaced the previous wording to ensure
consistency with that in the table on page 63.

At 2.2.2 in the text (Practice teacher – stage 3, domain Leadership) outcome ‘lead and
contribute to evaluation of the effectiveness of learning and assessment in practice’ has
been inserted into the table on page 70 as this had been inadvertently omitted in the
previous version.

The framework to support learning and assessment in practice

There is a single developmental framework to support learning and assessment in
practice. It defines and describes the knowledge and skills nurses and midwives need
to apply in practice when they support and assess students undertaking NMC approved
programmes that lead to registration or a recordable qualification. The NMC has
identified outcomes for mentors, practice teachers and teachers so that there is clear
accountability for making decisions that lead to entry to the register.

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There are eight domains in the framework, each with identified outcomes at the
four developmental stages. The domains are:

1 Establishing effective working relationships

2 Facilitation of learning

3 Assessment and accountability

4 Evaluation of learning

5 Creating an environment for learning

6 Context of practice

7 Evidence-based practice

8 Leadership

The framework has been designed for application within the context of inter-professional
learning and working in modern healthcare.

The way the framework has been designed makes Accreditation of Prior (Experiential)
Learning (AP(E)L) possible. Approved educational institutions (AEIs) can use their own
AP(E)L processes to map prior learning from other qualifications or work experience.
These processes are confirmed at programme approval. AP(E)L provides the facility for
stepping on or stepping off the framework at various points of development, as well as
recognition of existing qualifications.

The developmental framework takes account of the NHS Knowledge and Skills
Framework and standards set by other health and social care regulators for supporting
learning and assessment in practice. It also recognises the HE Academy requirements
for teachers working in higher education settings, ensuring that there is a fit between the
NMC requirements for teacher preparation and those defined by the HE Academy.

The developmental framework gives service and education providers opportunities

to develop other roles that meet local requirements for supporting learning and
assessment in practice – such as practice education facilitator or lecturer practitioner.

Programme level and length

The NMC has determined minimum lengths and academic levels for programmes to
prepare mentors, practice teachers and teachers. It is expected that all preparation
programmes include work-based learning to enable new knowledge, skills and
competencies to be applied in practice. These requirements are set out in section 3 in
relation to each outcome in the framework.

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Recognition of prior learning
The NMC does not expect mentors, practice teachers and teachers who have
undertaken a preparation programme previously approved by one of the National
Boards, or since April 2002 undertaken preparation approved by programme providers
to have to repeat such preparation. The NMC advises that:

• Nurses and midwives already holding a mentor or practice teacher qualification

recognised by programme providers, should map their current qualification and
experience against the new NMC standard and meet any outstanding outcomes
through continuing professional development (CPD).

• Nurses and midwives who have existing teaching qualifications recorded on the
NMC register and who are actively engaged in teaching students on NMC approved
programmes should, by virtue of their qualifications and experience, already meet
the new standard. However they are advised to use the outcomes for teachers in
the framework to guide their CPD.

• Nurses and midwives who hold qualifications that may be considered comparable
to mentors or practice teachers, and which were not previously approved by one
of the previous National Boards or by a programme provider, e.g. NVQ assessor,
must use the AP(E)L processes available as specified previously and undertake
any further education as required by the programme providers to ensure that they
meet the standard. The nature of such education may be academic, work-based or
a combination of both.

Local registers of mentors and practice teachers

Placement providers are responsible for ensuring that:

• An up-to-date local register of current mentors and practice teachers is held and
maintained.

• They have currency by regularly reviewing the local register and adding or removing
names of nurses and midwives as necessary.

Education providers should use the (local) register to confirm that there are sufficient
mentors and practice teachers who meet the NMC standards to support learning and
assessment in practice, to adequately support the number of students undertaking the
range of NMC approved programmes currently being offered.

Mentors who are designated as being able to sign-off proficiency at the end of a
programme (to be known as ‘sign-off mentors’) must be annotated as such on the local
register. While all mentors may assess individual competencies, only those who have
met additional NMC criteria to be a sign-off mentor (paragraph 2.1.3) are entitled to
sign-off practice.

All midwifery mentors will have met the sign-off criteria as part of their preparation
programme.

Practice teachers will have this authority assigned following a period of preceptorship
after having successfully completed the practice teacher programme (NMC Circular
27/2007).

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Teachers who work in both practice and academic settings, e.g. lecturer practitioners,
must have met the additional sign-off criteria and have a current practice-based role in
order to be annotated on the local register. These teachers will be subject to triennial
review (see Triennial review of mentor and practice teacher below) in the same way as
mentors and practice teachers.

Review and maintenance of mentor or practice teacher qualifications

Mentors or practice teachers must demonstrate their knowledge, skills and competence
on an ongoing basis. Placement providers must ensure that:

• Each mentor or practice teacher is reviewed every three years (triennial review)
to ensure that only those who continue to meet the mentor/practice teacher
requirements remain on the local register.

• Mentors who meet the criteria for signing-off proficiency in practice at the end of a
programme are annotated on the local register.

• Arrangements are in place for appraising mentor/practice teacher performance,

addressing concern where appropriate, and for adding and removing individuals
from the local register – including mentors identified as having met the criteria to be
able to sign-off proficiency.

Triennial review of mentors and practice teachers

The nature of the triennial review of mentors and practice teachers is for the placement
providers to determine but may form part of an employer-led personal development
appraisal.

To be maintained on the local register the individual must have evidence of having:

• Mentored at least two students (practice teachers to have supervised at least one
student)2 with due regard (extenuating circumstances permitting) within the three
year period.

• Participated in annual updating – to include an opportunity to meet and explore

assessment and supervision issues with other mentors/practice teachers.

• Explored as a group activity the validity and reliability of judgements made when
assessing practice in challenging circumstances.

• Mapped ongoing development in their role against the current NMC mentor/practice
teacher standards.

• Been deemed to have met all requirements needed to be maintained on the local
register as a mentor, sign-off mentor or practice teacher.

2
This must be a student intending to enter the SCPHN part of the register.

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Roles to support learning and assessment in practice
As a result of consultation the NMC has set standards for mentors, practice teachers
and teachers that must be achieved to support and assess students undertaking NMC
approved pre-registration nursing and midwifery, and SCPHN programmes. The NMC
has determined mandatory requirements for each part of the register.

These are:

Nursing

• Students on NMC approved pre-registration nursing education programmes,

leading to registration on the nurses’ part of the register, must be supported and
assessed by mentors.

• From September 2007 a sign-off mentor, who has met additional criteria (paragraph
2.1.3), must make the final assessment of practice and confirm that the required
proficiencies for entry to the register have been achieved (paragraph 3.2.6).

• From September 2007 students on NMC approved specialist practice programmes

leading to a recordable qualification on the nurses’ part of the register must
be supported and assessed by sign-off mentors who have met additional
criteria (paragraph 2.1.3) or practice teachers where this is a requirement by
commisisioners. The sign-off mentor must make the final assessment of practice
and confirm that the required proficiencies for recording a specialist practice
qualification have been achieved (paragraph 3.2.6).

Midwifery

• Students on NMC approved pre-registration midwifery education programmes,

leading to registration on the midwives’ part of the register, can only be supported
and assessed by mentors who have met the additional criteria for sign off
(paragraph 2.1.3). Sign-off mentors must make the final assessment of practice and
confirm that the required proficiencies for entry to the register have been achieved
(paragraph 3.2.6).

Specialist community public health nursing

Students on NMC approved specialist community public health nursing programmes,

leading to registration on the specialist community public health nurses’ part of the
register, must be supported and assessed by practice teachers. All practice teachers
will be required to meet the additional sign-off criteria (paragraph 2.1.3) on successful
completion of the practice teacher programme, and following a period of preceptorship
(NMC Circular 27/2007).

Where education providers are unable to meet this standard they have been able
to make an application to the NMC for a temporary deferment up to 2010. From
September 2007 the practice teacher must make the final assessment of practice and
confirm that the required proficiencies for entry to the register have been achieved
(paragraph 3.3.6). Where deferment has been given, sign off may be undertaken by
sign-off mentor.

16
Preceptors
The original standard for teachers included an advisory standard for preceptors. The
NMC supports and strongly recommends that preceptorship be made available to
nurses and midwives following initial registration. The original standard has been
strengthened and guidelines published in NMC Circular (NMC 21/2006).

Fitness for practice

The purpose of the standards to support learning and assessment in practice is
to assure the Council that those who make judgements of students have been
appropriately prepared to assess performance in practice against the relevant NMC
standards. Overall achievement of relevant standards of proficiency leads to registration
or a qualification that is recorded on the register.

Throughout an NMC approved programme, mentors/practice teachers (who are on

the local register) will assess competence in practice and confirm that students are
capable of safe and effective practice. Specific competencies for entry to the register or
recording a qualification are clearly identified within each of the Standards of proficiency
for nursing, midwifery or specialist community public health nursing (NMC 2004) and
Standards for specialist education and practice (UKCC 1994).

The NMC requires confirmation at the end of such programmes that both practice and
theory parts of the programme have been successfully achieved. In practice settings
a sign-off mentor or practice teacher will consider the practice evidence to make a
judgement that all competencies have been met and that the student is considered
proficient. They will then sign off the practice part of the programme.

Sign-off mentors and practice teachers who sign off students as being proficient in
practice are confirming to the programme provider that the student has met the defined
NMC standards of proficiency and is capable of safe and effective practice. In addition,
teachers of nurses, midwives and specialist community public health nurses who sign
off successful completion of the approved programme for registration, or for recording
a qualification, are confirming that all of the NMC programme requirements have
been met.

Mentors, practice teachers and teachers who sign off all, or part of the practice
component of a programme leading to registration are accountable to the Council
for their decisions. Confirmation by the mentor or practice teacher that the student
is capable of safe and effective practice will be considered by the assessment board
along with other assessed outcomes to determine whether the student has met all
requirements for successful programme completion.

Equality and diversity

All public bodies including the NMC, health providers and education establishments
have a duty to promote equality of opportunity on the grounds of race, gender and
disability, whilst within the private sector it has long been recognised that best practice
in promoting equality and diversity has many benefits. Mentors, practice teachers,
and teachers through their role-modelling of best practice play a vital role in promoting
equality of opportunity by treating students with fairness, respect and understanding.

17
Mentors, practice teachers, and teachers will also bring their own experiences and
perspectives and these standards will help ensure that discrimination however
unintentional is less likely to occur.

The NMC recognises the importance of supporting all students to achieve their full
potential in both practice and academic learning environments. NMC approved
programmes are open to all applicants providing that they are able to meet the defined
selection criteria. This includes the NMC entry requirements for literacy, numeracy, good
health and good character as specified in the standards of proficiency for the relevant
programme, and any educational requirements set by programme providers.

Supporting students who have a disability

Programme providers will have made decisions related to any declared disabilities or
health conditions when undertaking selection processes. They are bound by the general
duties of the Disability Discrimination Acts (1995 and 2005) and will have determined
the nature of any reasonable adjustments to support achievement of programme
requirements.

The NMC advises that all mentors, practice teachers and teachers should receive
disability equality training. Programme providers should work in partnership to prepare
placement areas for supporting students with disabilities and prepare students for the
demands the placements will make of them. In particular, the learning environments in
practice and academic settings should enable students to be confident that disclosure
of their specific needs will not lead to discrimination. Consideration should be given to
allocating time for mentors, practice teachers and teachers to meet the special needs of
students with disabilities.

18
Section 1: The developmental framework and its
underpinning principles
1.1 The developmental framework
The framework has been designed to facilitate personal and professional development.
The domains and outcomes enable nurses and midwives to plan and measure
their achievement and progress. The framework enables nurses and midwives
and approved educational institutions to map other learning, such as previous
preparation programmes e.g. NVQ Assessor or Verifier, in order to determine credit
for prior learning. The NMC expects nurses and midwives to include CPD for their
teaching roles in their personal development plans. Nurses and midwives may wish
to develop a portfolio of evidence mapped against the outcomes of particular stages
of the framework to demonstrate how they are developing the knowledge, skills and
competence related to supporting learning and assessment in practice. Not all of the
stages in the framework apply to all parts of the NMC register; this is clarified in Section
3 related to applying the standards.

The framework (see Annexe 1) is underpinned by five principles (paragraph 1.2). It

has eight domains, each with an overall descriptor. There are four stages setting out
the supervision, teaching and ongoing requirements of mentors, practice teachers
or teachers each with more specific outcomes relevant to one of the eight domain
descriptors. The NMC would expect that the majority of nurses and midwives would at
least meet the outcomes of a mentor.

It is possible to enter and exit the framework at any stage; this means that no one stage
is a pre-requisite for a subsequent stage. If a decision is taken to use the framework
developmentally, credit should be awarded for prior knowledge, skills and experience
achieved in a previous stage.

1 2 3 4

5 6 7 8

Five Nurses and midwives

principles
ABCDE
Mentor

Practice teacher

Teacher

19
Stage 1 reflects the requirements of The Code: Professional standards of practice and
behaviour for nurses and midwives (NMC, 2015)3. All nurses and midwives must meet the
defined requirements, in particular:

Stage 2 identifies the standard for mentors. Nurses and midwives can become a
mentor when they have successfully achieved all of the outcomes of this stage. This
qualification is recorded on the local register of mentors

Stage 3 identifies the standard for a practice teacher for nursing4 or specialist
community public health nursing. Nurses and midwives can become a practice
teacher when they have successfully achieved all of the outcomes of this stage. This
qualification is recorded on the local register of practice teachers

Stage 4 identifies the standard for a teacher of nurses, midwives or specialist

community public health nurses. Nurses and midwives can become a teacher when
they have successfully achieved all of the outcomes of this stage. This qualification
may be recorded on the NMC register on application to the NMC and payment of the
relevant fee.

The NMC will approve preparation programmes for these standards and monitor their
implementation (section 4: Approval and monitoring of mentor, practice teacher and
teacher preparation programmes).

1.2 The underpinning principles

The underpinning principles for supporting learning and assessment in practice for
any student undertaking an NMC approved programme leading to registration or a
qualification that is recordable on the register are that nurses and midwives who make
judgments about whether a student has achieved the required standards of proficiency
for safe and effective practice must:

A be on the same part or sub-part of the register as that which the student is intending
to enter. NMC Circulars 26/2007 (for nursing and SCPHN) and 02/2008 (for
midwifery) (Annexe 3) set out the ways in which the principle of due regard may
be applied more flexibly without reducing the degree of rigour applied to assessing
student competence. (See glossary for definition of due regard);

B have developed their own knowledge, skills and competency beyond that of
registration through CPD – either formal or experiential learning – as appropriate to
their support role;

C hold professional qualifications at an appropriate level to support and assess the

students they mentor/teach, i.e. professional qualifications equal to, or at a higher
level than, the students they are supporting and assessing and;

3
Any subsequent changes to this document must be considered in the context of the most up to date
version.
4
For nursing this would apply to SPQ programmes where commissioners require practice teachers to be
used.

20
D have been prepared for their role to support and assess learning and met NMC
defined outcomes. Also, that such outcomes have been achieved in practice and,
where relevant, in academic settings, including abilities to support interprofessional
learning. In addition:

E Nurses and midwives who have completed an NMC approved teacher preparation
programme may record their qualification on the NMC register. Other teaching
qualifications may be assessed against the NMC teacher outcomes through the
NMC accreditation route.

1.3 Guidance for applying the underpinning principles

Principle A

Nurses and midwives who make judgements about whether a student has
achieved the required standards of proficiency for safe and effective practice
must be on the same part or sub-part of the register as that which the student is
intending to enter.

The NMC recognises that, as part of interprofessional learning and working, others will
contribute to learning and assessment in practice. These may be nurses and midwives
from other professions. However to ensure public protection, only those who are NMC
sign-off mentors or practice teachers may confirm overall achievement of proficiency
that demonstrates a students’ fitness for practice. They determine that the student has
met the relevant competencies or standards of proficiency for entry to the register or for
a qualification that is recordable on the register (see circular 26/2007 in Annexe 3 for
further information on interprofessional placements).

Other mentors, practice teachers or teachers may be involved in developmental

(formative) assessment where the student is gaining a breadth of experience but
where their learning is not intended to demonstrate competence as a nurse, midwife
or specialist community public health nurse. For example, midwifery students may
have a placement in a nursing environment, nursing students may have a social work
placement, specialist community public health nurses may spend time with other
professionals involved in child protection or public health. These placements are to gain
a breadth of experience and normally do not involve assessment of competence related
to the professions they intend to enter. In such placements the right person to assess
outcomes (developed as part of the whole programme) would be the professional who
has the knowledge, competence and experience in that area of practice.

In relation to nursing students the standards of proficiency have to be achieved within

the context of the branch programme they are studying – adult, mental health, learning
disability and children’s nursing. The NMC recognises that within every field of practice,
and between professional groups, there will be areas of shared competence.

The mentors or practice teachers who sign off proficiency for nursing students must
have a mark on the register that corresponds with the branch programme the student is
studying.

21
Principle B

They must have developed their own knowledge, skills and competency beyond
that of registration through CPD – either formal or experiential learning – as
appropriate to their support role.

The NMC supports and advocates lifelong learning for all nurses and midwives and
requires evidence of CPD for mandatory renewal of registration. Mentors and practice
teachers, acting as role models, will be able to demonstrate clinical decision-making
abilities, enabling students to gain a holistic view of professional roles. The increased
evidence-base that mentors and practice teachers have developed and shared with
their students will help students to learn how to justify decision-making in their own
practice and to begin to take responsibility for these decisions.

Principle C

Their professional qualifications will be at an appropriate level to support

and assess the students they mentor/teach, i.e. they must hold professional
qualifications equal to, or at a higher level than, the students they are supporting
and assessing.

Mentors, practice teachers and teachers must hold professional qualifications that are at
least equal5 to the students for whom they support learning and are assessing. Equal in
this context means registration level, i.e. initial registration or SCPHN. Students benefit
from being exposed to mentors, practice teachers and teachers who have developed
themselves to a standard beyond that at which they are learning, in both academic and
practice qualifications.

Principle D

They have been prepared for their role to support and assess learning and
met NMC defined outcomes. Also, that such outcomes have been achieved in
practice and, where relevant, in academic settings, including abilities to support
interprofessional learning.

The NMC has agreed that it will approve mentor and practice teacher preparation
programmes so that that they can be assured of the consistency of preparation for
supporting learning and assessment in practice. Preparation programmes for teachers
are already approved by the NMC and will continue to be so. Principle D is achieved
within the context of interprofessional learning and working – therefore the guidance
given for Principle A applies. However the NMC would expect that the majority of
mentors, practice teachers and teachers would be nurses and midwives and would
have been prepared to meet the NMC outcomes defined in this framework, and that this
would be a requirement where proficiency is being assessed.

5
With regard to initial registration the NMC no longer offers second level preparation and accepts that
those registrants on the second level sub-part of the nurses’ part of the register will, through meeting
NMC renewal of registration requirements for CPD, have developed their knowledge, skills and
competence beyond their initial registration. Programme/placement providers must satisfy themselves
that second level nurses who will be involved in supporting and assessing students have the knowledge,
skills and competence to do so.

22
Principle E

Nurses and midwives who have completed an NMC approved teacher preparation
programme may record their qualification on the NMC register. Other teaching
qualifications may be assessed against the NMC teacher outcomes through the
NMC accreditation route.

The NMC will record a teaching qualification for those who have undertaken an NMC
approved teacher preparation programme and successfully achieved the outcomes of
stage 4 of the framework. Recognition of prior learning will be in accordance with the
process detailed in paragraph 4.4.

Section 2 – NMC standards for mentors, practice teachers

and teachers
2.1 NMC mentor standard
An NMC mentor is a registrant who, following successful completion of an NMC
approved mentor preparation programme – or comparable preparation that has been
accredited by an AEI as meeting the NMC mentor requirements – has achieved the
knowledge, skills and competence required to meet the defined outcomes.

A mentor is a mandatory requirement for pre-registration nursing and midwifery

students.

Mentors who are assessing competence must have met the NMC outcomes defined in
stage 2 of this standard, or be supervised by a mentor who has met these outcomes.
Those who sign off proficiency must have met the additional criteria to be a sign-off
mentor (see section 2.1.3). All midwife mentors must have met the additional criteria to
be a sign-off mentor.

Once mentors have been entered on the local register (normally held by placement
providers) they are subject to triennial review (see Roles to support learning and
assessment in practice in the introduction).

Mentors are responsible and accountable for:

• Organising and co-ordinating student learning activities in practice.

• Supervising students in learning situations and providing them with constructive

feedback on their achievements.

• Setting and monitoring achievement of realistic learning objectives.

• Assessing total performance – including skills, attitudes and behaviours.

• Providing evidence as required by programme providers of student achievement or

lack of achievement.

23
• Liaising with others (e.g. mentors, sign-off mentors, practice facilitators, practice
teachers, personal tutors, programme leaders) to provide feedback, identify any
concerns about the student’s performance and agree action as appropriate.

• Providing evidence for, or acting as, sign-off mentors with regard to making
decisions about achievement of proficiency at the end of a programme.

2.1.1 Criteria for supporting learning and assessing in practice – mentors

Nurses and midwives who intend to take on the role of mentor must fulfil the following
criteria:

• Be registered in the same part or sub-part of the register as the student they are to
assess and for the nurses’ part of the register be in the same field of practice (adult,
mental health, learning disability or children’s). See Circular 26/2007 for further
information (Annexe 3).

• Have developed their own knowledge, skills and competence beyond registration
i.e. been registered for at least one year.

• Have successfully completed an NMC approved mentor preparation programme

(or a comparable programme which has been accredited by an AEI as meeting the
NMC mentor requirements).

• Have the ability to select, support and assess a range of learning opportunities in
their area of practice for students undertaking NMC approved programmes.

• Be able to support learning in an interprofessional environment – selecting and

supporting a range of learning opportunities for students from other professions.

• Have the ability to contribute to the assessment of other professionals under the
supervision of an experienced assessor from that profession.

• Be able to make judgements about competence/proficiency of NMC students on the

same part of the register, and in the same field of practice, and be accountable for
such decisions.

• Be able to support other nurses and midwives in meeting CPD needs in accordance
with The Code: Professional standards of practice and behaviour for nurses and
midwives (NMC, 2015).

24
2.1.2 Competence and outcomes for a mentor

Mentor competencies are achieved by successful completion of an NMC approved

mentor preparation programme that achieves all of the outcomes of stage 2. These
outcomes are as follows:

Establishing effective working relationships

• Demonstrate an understanding of factors that influence how students integrate into
practice settings.

• Provide ongoing and constructive support to facilitate transition from one learning
environment to another.

• Have effective professional and interprofessional working relationships to support

learning for entry to the register.

Facilitation of learning
• Use knowledge of the student’s stage of learning to select appropriate learning
opportunities to meet individual needs.

• Facilitate the selection of appropriate learning strategies to integrate learning from

practice and academic experiences.

• Support students in critically reflecting upon their learning experiences in order to

enhance future learning.

Assessment and accountability

• Foster professional growth, personal development and accountability through
support of students in practice.

• Demonstrate a breadth of understanding of assessment strategies and the ability to

contribute to the total assessment process as part of the teaching team.

• Provide constructive feedback to students and assist them in identifying future

learning needs and actions. Manage failing students so that they may enhance
their performance and capabilities for safe and effective practice or be able to
understand their failure and the implications of this for their future.

• Be accountable for confirming that students have met, or not met, the NMC
competencies in practice. As a sign-off mentor confirm that students have met, or
not met, the NMC standards of proficiency in practice and are capable of safe and
effective practice.

Evaluation of learning
• Contribute to evaluation of student learning and assessment experiences –
proposing aspects for change resulting from such evaluation.

• Participate in self and peer evaluation to facilitate personal development, and

contribute to the development of others.

25
Creating an environment for learning
• Support students to identify both learning needs and experiences that are
appropriate to their level of learning.

• Use a range of learning experiences, involving patients, clients, carers and the
professional team, to meet defined learning needs.

• Identify aspects of the learning environment which could be enhanced – negotiating

with others to make appropriate changes.

• Act as a resource to facilitate personal and professional development of others.

Context of practice
• Contribute to the development of an environment in which effective practice is
fostered, implemented, evaluated and disseminated.

• Set and maintain professional boundaries that are sufficiently flexible for providing
interprofessional care.

• Initiate and respond to practice developments to ensure safe and effective care is
achieved and an effective learning environment is maintained.

Evidence-based practice
• Identify and apply research and evidence-based practice to their area of practice.

• Contribute to strategies to increase or review the evidence-base used to support

practice.

• Support students in applying an evidence base to their own practice.

Leadership
• Plan a series of learning experiences that will meet students defined learning
needs.

• Be an advocate for students to support them accessing learning opportunities that

meet their individual needs – involving a range of other professionals, patients,
clients and carers.

• Prioritise work to accommodate support of students within their practice roles.

• Provide feedback about the effectiveness of learning and assessment in practice.

26
2.1.3 Criteria for a sign-off mentor

Underpinned by principle A which states that:

Nurses and midwives who make judgements about whether a student has
achieved the required standards of proficiency for safe and effective practice
must be on the same part or sub-part of the register as that which the student is
intending to enter.

Only sign-off mentors6 and practice teachers that are on the same part of the register
and in the same field of practice may confirm that students have met the relevant
standards of proficiency for the particular programme leading to registration or a
qualification that is recordable on the NMC register.

Placement providers must ensure that a nurse or midwife designated to sign-off

proficiency for a particular student at the end of a programme is:

• Identified on the local register as a sign-off mentor or a practice teacher.

• Registered on the same part of the register.

• Working in the same field of practice as that in which the student intends to qualify.

And additionally to be a sign-off mentor they must have:

• Clinical currency and capability in the field in which the student is being assessed.

• A working knowledge of current programme requirements, practice assessment

strategies and relevant changes in education and practice for the student they are
assessing.

• An understanding of the NMC registration requirements and the contribution they

make to the achievement of these requirements.

• An in-depth understanding of their accountability to the NMC for the decision they
must make to pass or fail a student when assessing proficiency requirements at the
end of a programme.

• Been supervised on at least three occasions for signing off proficiency by an

existing sign-off mentor (see paragraph 5.2 in introduction).

• A working knowledge of current programme requirements, practice assessment

strategies and relevant changes in education and practice for the student they are
assessing.

• The achievement of these requirements.

6
Placement providers will decide in the first instance who may be considered as a sign-off mentor and
annotate these mentors accordingly. The NMC would expect that such mentors would meet all criteria
except that of being supervised by an existing sign-off mentor. All midwife mentors will be sign-off
mentors.

27
• An understanding of the NMC registration requirements and the contribution they
make to meeting these requirements.

• An in-depth understanding of their accountability to the NMC for the decision they
make to pass or fail a student when assessing proficiency requirements at the end
of a programme.

2.2 NMC practice teacher standard

An NMC practice teacher is a registrant who normally will have previously fulfilled the
NMC requirements to become a mentor, and who has received further preparation
to achieve the knowledge, skills and competence required to meet the NMC defined
outcomes for a practice teacher.

The NMC requires all students undertaking a programme leading to registration as a

specialist community public health nurse (SCPHN) to have a named practice teacher.
Practice teachers must have met NMC requirements defined in this standard, or be
supervised by a practice teacher who has met them. Once practice teachers have
been entered on the local register (which will be held by placement providers) they
are subject to triennial review (see Triennial review of mentor and practice teacher in
the introduction).

In September 2007 the process by which nurses undertaking practice teacher

preparation programmes should achieve sign-off status was clarified (NMC Circular
27/2007). Trainee practice teachers must be supervised by an existing sign off practice
teacher on at least one occasion for signing off proficiency of a SCPHN student at the
end of their final placement.

Following successful completion of the programme the trainee practice teacher can
be entered on the local register as a practice teacher. They should then undertake a
period of preceptorship supported by an existing sign-off practice teacher. The nature of
the period of preceptorship should be determined by the local placement provider, but
would normally be for a year during which time further supervised sign-offs of SCPHN
students should be undertaken.

Once the period of preceptorship is completed and the preceptor is satisfied that the
preceptee is competent in signing off proficiency, the preceptee can be annotated
as a sign-off practice teacher. The period of preceptorship can then be extended if
necessary, but this should not continue beyond the date of their first triennial review.

The practice teacher should continue to receive support from other experienced practice
teachers when making final placement assessment decisions, until they have received
the first triennial review and been identified as continuing to meet the criteria to be able
to sign off proficiency.

28
NMC practice teachers are responsible and accountable for:
• Organising and co-ordinating learning activities, primarily in practice learning
environments for pre-registration students, and those intending to register as
a specialist community public health nurse (SCPHN) and specialist practice
qualifications where this is a local requirement.

• Supervising students and providing them with constructive feedback on their

achievements.

• Setting and monitoring achievement of realistic learning objectives in practice.

• Assessing total performance – including skills, attitudes and behaviours.

• Providing evidence as required by programme providers of the student’s

achievement or lack of achievement.

• Liaising with others (e.g. mentors, sign-off mentors, supervisors, personal tutors,
the programme leader, other professionals) to provide feedback and identify any
concerns about the student’s performance and agree action as appropriate.

• Signing off achievement of proficiency at the end of the final period of practice
learning or a period of supervised practice.

The practice teaching role will be supported by appropriate professional and academic
qualifications, and practice development activity, to provide an evidence-base for
teaching. Practice teachers will have met the additional criteria for a sign-off mentor
(section 2.1 .3) as part of their preparation. The practice teacher role may vary
according to the nature of the student they are supporting. Specific additional criteria,
where appropriate, are identified in the relevant standards of proficiency for nurses,
midwives and specialist community public health nurses.

2.2.1 Criteria for supporting learning and assessing in practice – practice teacher

Nurses who intend to take on the role of practice teacher, and who will be assessing the
student’s fitness for practice, must fulfil the following criteria:

• Be registered in the same part of the register, i.e. SCPHN, and from the same
field of practice e.g. school nursing, health visiting, occupational health nursing (or
relevant SPQ where this is a local requirement) as the student they are to assess
(see NMC Circular 26/2007 Annexe 3).

• Have developed their own knowledge, skills and competence beyond registration
i.e. registered and worked for at least two years, and gained additional qualifications
that will support students in SCPHN, or SPQ where this is a local requirement.

• Have successfully completed an NMC approved practice teacher preparation

programme or a comparable programme that has been accredited by an AEI as
meeting the NMC practice teacher requirements. And, normally, having previously
met the outcomes for acting as a mentor and gained experience in this role.

29
• Have the abilities to design, deliver and assess programmes of learning in
practice settings – supporting a range of students in their area of practice,
i.e. pre-registration, SCPHN, CPD of peers, other professionals.

• Be able to support learning in an interprofessional environment – selecting and

supporting a range of learning opportunities for students from all professions –
relevant to their level of practice and specialist expertise.

• Be able to use agreed criteria for cross-professional assessment and supervise

NMC mentors and other professionals using such criteria.

• Be able to make judgements about the competence/proficiency of NMC students,

for registration on the same part of the register and be accountable to the NMC for
such decisions.

• Be able to provide leadership to all those involved in supporting learning and

assessing in practice for NMC students – enabling effective learning environments
to be developed.

2.2.2 Competence and outcomes for a practice teacher

The competencies of a practice teacher are achieved by successful completion of an

NMC approved practice teacher preparation programme achieving all of the outcomes
of stage 3. These outcomes are as follows:

Establishing effective working relationships

• Have effective professional and interprofessional working relationships to support
learning for entry to the register, and education at a level beyond initial registration

• Be able to support students moving into specific areas of practice – or a level of

practice beyond initial registration, identifying their individual needs in moving to a
different level of practice.

• Support mentors and other professionals in their roles to support learning across
practice and academic learning environments.

Facilitation of learning
• Enable students to relate theory to practice whilst developing critically reflective
skills.

• Foster professional growth and personal development by use of effective

communication and facilitation skills.

• Facilitate and develop the ethos of interprofessional learning and working.

Assessment and accountability

• Set effective professional boundaries whilst creating a dynamic, constructive
teacher-student relationship.

• In partnership with other members of the teaching team, use knowledge and
experience to design and implement assessment frameworks.

30
• Be able to assess practice for registration, and also at a level beyond that of
initial registration.

• Provide constructive feedback to students and assist in identifying future learning

needs and actions, managing failing students so that they may either enhance
their performance and capabilities for safe and effective practice, or are able to
understand their failure and the implications of this for their future.

• Be accountable for confirming that students have met, or not met, the NMC
standards of proficiency in practice for registration, at a level beyond initial
registration, and are capable of safe and effective practice.

Evaluation of learning
• Design evaluation strategies to determine the effectiveness of practice and
academic experience, accessed by students, at both registration level and those in
education at a level beyond initial registration.

• Collaborate with other members of the teaching team to judge and develop
learning, assessment and to support appropriate practice and levels of education.

• Collect evidence on the quality of education in practice, and determine how well
NMC requirements for standards of proficiency are being achieved.

Creating an environment for learning

• Enable students to access opportunities to learn and work within interprofessional
teams.

• Initiate the creation of optimum learning environments for students at registration

level and for those in education at a level beyond initial registration.

• Work closely with others involved in education – in practice and academic settings
– to adapt to change and inform curriculum development.

Context of practice
• Recognise the unique needs of practice and contribute to development of an
environment that supports achievement of NMC standards of proficiency.

• Set and maintain professional boundaries, whilst at the same time recognising the
contribution of the wider interprofessional team and the context of care delivery.

• Support students in exploring new ways of working, and the impact this may have
on established professional roles.

Evidence based practice

• Identify areas for research and practice development based on interpretation of
existing evidence.

• Use local and national health frameworks to review and identify developmental
needs.

31
• Advance their own knowledge and practice in order to develop new practitioners, at
both registration level and education at a level beyond initial registration, to be able
to meet changes in practice roles and care delivery.

• Disseminate findings from research and practice development to enhance practice

and the quality of learning experiences.

Leadership
• Provide practice leadership and expertise in application of knowledge and skills
based on evidence.

• Demonstrate the ability to lead education in practice, working across practice and
academic settings.

• Manage competing demands of practice and education related to supporting

different practice levels of students.

• Lead and contribute to evaluation of the effectiveness of learning and assessment

in practice

2.3 NMC teacher standard

An NMC teacher is an NMC registrant who, following successful completion of an
NMC approved teacher preparation programme, has achieved the knowledge, skills
and competence required to meet the NMC defined outcomes of stage 4 of the
developmental framework.

The NMC teacher standard is mandatory for those nurses and midwives based in higher
education who support learning and assessment in practice settings for students on
NMC approved programmes. The NMC recognises that some academic teachers will
not be nurses or midwives, but will instead have specialist knowledge and expertise
that contributes to professional education. The NMC will, through its quality assurance
processes, verify that the majority of teachers who make a major contribution to NMC
approved programmes hold, or are working towards, a teaching qualification that meets
the outcomes of stage 4 of the developmental framework.

NMC teachers are responsible for:

• Organising and co-ordinating learning activities in both academic and practice

environments.

• Supervising students in learning situations and providing them with constructive

feedback on their achievements.

• Setting and monitoring achievement of realistic learning objectives in theory and

practice.

• Assessing performance and providing evidence as required of student

achievement.

32
Their teaching role will be supported by appropriate professional and academic
qualifications and ongoing research, education and/or practice development activity to
provide an evidence base for their teaching. Only teachers who work in both practice
and academic settings e.g. lecturer practitioners may assess practice.

2.3.1 Criteria for supporting learning and assessing in practice – teachers

Nurses and midwives who intend to take on the role of teacher must fulfil the following
criteria:

• Be registered in the same part or sub-part of the register as the students they
support.

• Have completed at least three years post-registration experience, gained additional

professional knowledge and skills, and have experience in an area where students
are gaining practice experience relevant to their registration.

• Have extended their professional knowledge, relevant to their field of practice, to

at least first degree level, prior to undertaking an NMC approved post-graduate
teacher preparation programme.

• Have the abilities to lead programme development and co-ordinate the work
of others in delivering and assessing programmes of learning in practice and
academic settings – supporting a wide range of students.

• Able to support interprofessional learning and working, selecting and supporting

a range of learning opportunities for students from all professions, and supporting
practice development.

• Have the ability to generate and use cross-professional assessment criteria,

supervising mentors, practice teachers and teachers from other professions in the
implementation of such criteria.

• Able to teach and assess in both practice and academic settings, contributing
to decisions about fitness for practice of NMC students for both registration and
qualifications at a level beyond initial registration – and be accountable to the NMC
for such decisions.

• Able to provide leadership in education in both practice and academic settings,

e.g. nurse/midwife consultant roles, clinical academic roles, programme leader, etc.

2.3.2 Competence and outcomes for a teacher

The competencies of a teacher are achieved by successful completion of an NMC

approved teacher preparation programme achieving all of the outcomes of stage 4 of
the developmental framework. This preparation programme must have included, as part
of the overall programme, a period of assessed teaching activity to include experience
in both academic and practice settings, at least equivalent to a minimum of 12 weeks
(or 360 hours), with students studying an NMC approved programme.

33
The competencies of a teacher are:

• Demonstrate effective relationship building skills sufficient to support learning, as

part of a wider interprofessional team, for a range of students in both practice and
academic learning environments and supporting mentors and practice teachers.

• Facilitate learning for a range of students, within a particular area of practice and
where appropriate, encourage self-management of learning opportunities and
provide support to maximise individual potential.

• Assess learning, in order to make judgements related to the NMC standards of

proficiency for entry to the register or, for recording a qualification at a level beyond
initial registration, being the final point of accountability for ‘fitness for practice’
decisions.

• Determine strategies for evaluating learning in practice and academic settings to

ensure that the NMC standards of proficiency for recording a qualification at a level
beyond initial registration have been met.

• Create an environment for learning, where practice is valued and developed, that
provides appropriate professional and interprofessional learning opportunities and
support for learning to maximise achievement for individuals.

• Support learning within a context of practice that reflects healthcare and educational
policies, managing change to ensure that particular professional needs are met
within a learning environment that also supports practice development.

• Apply a knowledge and practice evidence-base to their own work and contribute to
the further development of such an evidence-base for practice.

• Demonstrate leadership skills for education within practice and academic settings,

• The outcomes for a teacher to meet the competencies are as follows:

Establishing effective working relationships

• Demonstrate effective relationships with other members of the teaching teams, in
practice and academic settings, based on mutual trust and respect.

• Maintain appropriate supportive relationships with a range of students, mentors,

practice teachers and other professionals.

• Foster peer support and learning in practice and academic settings for all students.

• Support students to integrate into new environments and working teams to enhance
access to learning.

34
Facilitation of learning
• Promote development of enquiring, reflective, critical and innovative approaches to
learning.

• Implement a range of learning and teaching strategies across a wide range of

settings.

• Provide support and advice, with ongoing and constructive feedback to students, to
maximise individual potential.

• Co-ordinate learning within an interprofessional learning and working environment.

• Facilitate integration of learning from practice and academic settings.

• Act as a practice expert to support development of knowledge and skills for practice.

Assessment and accountability

• Set and maintain professional boundaries that are sufficiently flexible for
interprofessional learning.

• Develop, with others, effective assessment strategies to ensure that standards

of proficiency for registration, or recordable qualifications at a level beyond initial
registration, are met.

• Support others involved in the assessment process – students, mentors and peers.

• Provide constructive feedback to students and assist them in identifying future

learning needs and actions, managing failing students so that they may either
enhance their performance and capabilities for safe and effective practice, or be
able to understand their failure and the implications of this for their future.

• Be accountable for their decisions related to fitness for practice for registration or
recordable qualifications – underpinning such decisions with an evidence-base
derived from appropriate and effective monitoring of performance.7

Evaluation of learning
• Determine and use criteria for evaluating the effectiveness of learning environments
– acting on findings, with others, to enhance quality.

• Foster and participate in self and peer evaluation to enable students to manage
their own learning in practice and academic settings and to enhance personal
professional development.

• Evaluate the effectiveness of assessment strategies in providing evidence to make

judgements on fitness for practice.

• Report on the quality of practice and academic learning environments to

demonstrate that NMC requirements have been met, particularly in relation to
support of students and achievement of standards of proficiency.
7
Only those teachers with a practice role and who have met the additional criteria for a sign-off mentor
may assess students in practice settings.

35
Creating an environment for learning
• Develop, in partnership with others, opportunities for students to identify and access
learning experiences that meet their individual needs.

• Ensure such opportunities maintain the integrity of the student’s professional role
whilst responding to the interprofessional context of practice.

• Determine, with others, audit criteria against which learning environments may be
judged for their effectiveness in meeting NMC requirements.

• Support and develop others involved to ensure that learning needs are effectively
met in a safe environment.

• Explore and implement strategies for continuous quality improvement of the

learning environment.

Context of practice
• Support students in identifying ways in which policy impacts on practice.

• Contribute effectively to processes of change and innovation – implementing new

ways of working that maintain the integrity of professional roles.

• Negotiate ways of providing support to students so that they can achieve their
learning needs within the context of professional and interprofessional practice.

• Act as a role model to enable students to learn professional responsibilities and

how to be accountable for their own practice.

• Adapt to change, demonstrating to students how flexibility may be incorporated

whilst maintaining safe and effective practice.

Evidence-based practice
• Advance their own knowledge and practice abilities through access to, and
involvement in – where appropriate – research and practice development.

• Consider how evidence-based practice, involving patients, clients, carers and other
members of the health and social care team, enhances care delivery and learning
opportunities.

• Empower individuals, groups and organisations to develop the evidence-base for

practice.

• Disseminate findings from research and practice development to enhance the

quality of learning, care delivery and academic environments.

36
Leadership
• Demonstrate effective communication skills to facilitate delivery of educational
programmes that lead to registration or a recordable qualification.

• Initiate and lead programme development and review processes to enhance quality
and effectiveness.

• Develop effective relationships with practice and academic staff, who are involved
in programme delivery, to ensure clarity of contribution and strategies to respond to
evaluation of learning experiences.

• Demonstrate strategic vision for practice and academic development relevant to

meeting NMC requirements.

• Manage competing demands to ensure effectiveness of learning experiences for

students.

• Lead, contribute to, analyse and act on the findings of evaluation of learning and
assessment to develop programmes.

• Provide feedback about the effectiveness of learning and assessment in practice.

Section 3 –Applying the standards to support learning and

assessment in practice
3.1 Applying the standards to nursing, midwifery and specialist
community public health nursing education programmes
The NMC has acknowledged that nurses, midwives and specialist community public
health nurses have different needs when applying the standards to support learning and
assessment in practice.

These are clarified as:

• Nursing education – requires mentors, practice teachers and teachers to provide

the full range of support and assessment required to meet the needs of
pre-registration, and specialist practice education

• Midwifery education – requires only mentors and teachers.

• Specialist community public health nursing education – requires practice teachers

and teachers.

37
3.2 Applying the NMC mentor standard in practice
From 1 September 2007 the NMC mentor standard is mandatory for supporting the
learning and assessment of pre-registration nursing and midwifery students. NMC
requirements will be updated in the future in the light of the review of specialist practice
qualification and advanced nursing practice, as explained in the introduction to this
document.

The standard for mentors needs to be read in conjunction with the relevant Standards
for pre-registration nursing education (NMC 2010), Standards for pre registration midwifery
education (2009), Standards for specialist education and practice (UKCC 1994) and also
with respect to the Nursing and Midwifery Council (Education, Registration and Registration
Appeals) Rules Order of Council 2004 (SI 2004 No 1767) hereafter referred to as the Education
Rules; and the Nursing and Midwifery Council (Midwives) Rules Order of Council 2004
(SI 2004 No 1764) hereafter known as the Midwives Rules.

The following requirements are set by the NMC for implementing the mentor standard.
Guidance is provided to help interpret the requirements.

3.2.1 Mentor preparation programmes

Mentor preparation programmes must be:

• At a minimum academic level of HE Intermediate level (previously known as level 2)

or SCQF Level 8.

• A minimum of 10 days, of which at least five days are protected learning time.

• Include learning in both academic and practice settings.

• Include relevant work-based learning, e.g. experience in mentoring a student under

the supervision of a qualified mentor, and have the opportunity to critically reflect on
such an experience.

• Normally, be completed within three months.8

• Should provide a foundation for undertaking an NMC approved practice teacher

programme.

• Allow AP(E)L to be applied to up to 100% of the programme, and recognise

previous preparation of an equivalent nature and standard. It is for placement
providers to determine if an individual meets the NMC additional criteria to
sign-off a student’s proficiency (section 3.2.6), and therefore they may be placed
immediately on the local register with an annotation to identify this.

8
All midwifery mentors are required to meet the additional criteria to be a sign-off mentor (see section
3.2.6) as part of their preparation programme; the length of this programme should be adjusted to take
account of this requirement to allow time for midwifery mentors to be supervised as a sign-off mentor on
at least three occasions.

38
3.2.2 Continuing professional development for mentors

The NMC requires all qualified mentors to maintain and develop their knowledge, skills
and competence as a mentor through regular updating. The NMC requires placement
providers to maintain a record of current mentors and, where appropriate, (and in
partnership with local education providers) to make provisions for annual updating of
these nurses and midwives.

The purpose of annual updating is to ensure that mentors:

• Have current knowledge of NMC approved programmes.

• Are able to discuss the implications of changes to NMC requirements.

• Have an opportunity to discuss issues related to mentoring, assessment of

competence and fitness for safe and effective practice.

Mentors should be prepared to demonstrate to their employers, and NMC quality

assurance agents as appropriate,9 how they have maintained and developed their
knowledge, skills and competence as a mentor. Placement providers will consider
evidence of updating as part of triennial review.

3.2.3 Allocated learning time for mentor activity

The NMC recognises that nurses and midwives who are mentors are primarily
employed to provide care for patients and clients. Pre-registration students have
supernumerary status and can expect to be able to work with mentors. All students
must be supervised at all times, either directly or indirectly. Being a mentor requires a
commitment. The NMC requires that as a minimum:

Whilst giving direct care in the practice setting at least 40% of a student’s time must be
spent being supervised (directly or indirectly) by a mentor/practice teacher.

The nature of supervision will vary from direct to indirect depending upon the:

• Nature of the activity the student is engaged in.

• Evidence of their current competence.

• Need to assess achievement of NMC outcomes or competencies for progression on

the programme.

Mentors will use their professional judgment and local/national policy to determine
where activities may be safely delegated to students and the level of supervision
required. They are accountable for such decisions and for ensuring public protection.

They will need time, when undertaking work with a student, to be able to explain,
question, assess performance and provide feedback to the student in a meaningful way.
9
All NMC approved programmes are monitored regularly. This may involve NMC quality assurance
agents in practice and education visits to examine evidence that NMC requirements are being met.

39
3.2.4 Supporting learning in practice

The NMC requires mentors to support learning in practice for several reasons
(section 2.1):

• Provide support and guidance to the student when learning new skills or applying
new knowledge.

• Act as a resource to the student to facilitate learning and professional growth.

• Directly manage the student’s learning in practice to ensure public protection.

• Directly observe the student’s practice, or use indirect observation where

appropriate, in order to ensure that NMC defined outcomes and competencies are
met.

The following requirements enable effective mentorship to be realised:

NMC Requirements Guidance

Every student has a named mentor for Mentors should be allocated prior to
each period of practice learning. commencement of a placement. This
should be sufficiently in advance of the
placement to enable both the student and
their mentor to prepare adequately for the
placement. The NMC would recommend
that, at a minimum, this should be one
week prior to commencement of the
placement.
Mentors should not normally support more Mentors need to be able to commit
than three students, from any discipline, at themselves to supporting learning and
any point in time. assessment in practice. Their workload
need to reflect the demands of being a
mentor.
Whilst giving direct care in the practice At all times students must be directly
setting at least 40% of the student’s or indirectly supervised in the practice
time must be spent being supervised setting. The mentor’s responsibility is to
(directly or indirectly) by a mentor/practice plan and co-ordinate the student’s whole
teacher.10 When in a final placement this learning experience, determining the
40% of the student’s time is in addition amount of direct supervision required
to the protected time (one hour per by the mentor, and what experience
week) to be spent with a sign-off mentor may be through indirect supervision
(paragraph 3.2.6) (student working independently). Some
experience may be supervised by
others (other professionals, mentors or
practice teachers). The named mentor is
accountable for their decisions to let the
student work independently or with others.

10
In some NMC approved programme there is a specified requirement for the amount of practice that is
supervised to exceed 40%.

40
NMC Requirements Guidance
An ongoing achievement record including Students are expected to keep a record
comments from mentors must be passed of their learning experiences, identifying
from one placement to the next to enable evidence to support achievement of
judgements to be made on the student’s NMC outcomes and competencies and
progress. (Further detail: see circular where further support and supervision
33/2007 in annexe 3) is required. This record should be made
available to the named mentor at the
beginning of a new experience to enable
discussion of strengths and areas for
improvement.

Students must be kept fully informed

regarding the ways in which information is
intended to be shared, used and stored,
including the length of time it is to be
retained and when it will be destroyed.
(Data Protection Act 1998)
The mentor should have access to a Support and supervision may be provided
network of support and supervision to by, for example, other mentors, practice
enable them to fulfil their mentoring facilitators, practice teachers or link
responsibilities, assist them in making tutors, with due regard to the part of
complex judgements regarding the register and field of practice. Where
competence such as failing a student and necessary, inexperienced mentors should
to support their professional development. seek support from a sign-off mentor who
has met the NMC additional criteria for
assessing proficiency.
Placement providers are responsible for The register will provide evidence for
ensuring that an up-to-date local register quality assurance purposes that there are
of mentors is maintained, with annotations a sufficient number of mentors, who met
of those who have met the NMC the NMC standards, to support learning
additional criteria for assessing proficiency and assessment in practice related to
(sign-off mentors). NMC approved programmes.

Placement providers are responsible The NMC sets general requirements

for triennial review of mentors to ensure for remaining on the local register (see
that only those who continue to meet the introduction – triennial review). It would
NMC’s mentor requirements remain on be a matter for placement providers to
the local register. determine locally any additional criteria
needed for mentors to remain on the
register.

41
3.2.5 Assessing learning in practice

Mentors will have been prepared to assess student performance in practice and will
be accountable for their decisions to pass, refer or fail a student. The NMC recognises
that failing students may be difficult and that all assessment decisions must be
evidence-based. Sign-off mentors who assess proficiency in the final placement or at
the end of a period of supervised practice will have met additional criteria set by the
NMC (section 3.2.6).

NMC Requirements Guidance

Most assessment of competence should Students must normally demonstrate
be undertaken through direct observation their competence in the practice setting.
in practice. However, where experience is limited,
e.g. basic life support skills, simulated
experience or OSCEs may be used. The
majority of assessment should be through
direct observation.
Mentors should be involved wherever Summative assessment using simulation
possible, when competence is assessed may occur where opportunities to
through simulation. demonstrate competence in practice
are limited. Mentors should be involved
in designing, using and evaluating such
assessment strategies.
Mentors should consider how evidence The NMC recognises that the total
from various sources might contribute to assessment strategy would include
making a judgement on performance and assessment through various means i.e.
competence. direct care, simulation, OSCEs and other
strategies.
Mentors should seek advice and guidance Inexperienced mentors may require
from a sign-off mentor or a practice support from a sign-off mentor or practice
teacher when dealing with failing students. teacher when faced with a failing student
to help them to communicate concerns,
identify action and evaluate progress.

3.2.6 Signing off practice proficiency

In order to ensure public protection the NMC needs to be assured that students have
been assessed and signed off as capable of safe and effective practice at the end of a
programme. Additional criteria have been defined for the mentor to be able to sign-off
proficiency in practice at the end of a programme (paragraph 2.1.3).

Placement providers will determine when a mentor has met the additional criteria and
will be annotated as a sign-off mentor on the local register. The NMC statutory midwifery
committee has decided that all midwife mentors must have met the additional criteria to
be sign-off mentors.

42
Due regard
In accordance with underpinning principle A (paragraph 1.2):

• Only a registered nurse may sign off a nursing student (the nurse must have a mark
on the nurses’ part of the register that coincides with the branch programme the
student has undertaken).

• Only a registrant with the same SPQ may sign off a SPQ student

• Only a registered midwife may sign off a midwifery student.

Confirmation of proficiency
The sign-off mentor, who has met the NMC additional criteria for assessing proficiency,
is responsible and accountable for making the final sign-off in practice – confirming
that a student has successfully completed all practice requirements. This confirmation
will contribute to the portfolio of evidence considered by the AEI’s examination and
assessment board. The NMC requires mentors who have not yet met the additional
criteria to be supported by a sign-off mentor or a practice teacher if it is the student’s
final placement, or when failing a student.

NMC Requirements Guidance

The NMC has identified progression Confirmation is required at points where a
points within each approved programme student may not progress without a formal
where confirmation is required that decision that they have met the outcomes
students have met specified outcomes or competencies of a previous part of the
and competencies. programme.

For pre–registration midwifery

programmes a sign-off mentor is
required to confirm the outcomes at
each progression point – NMC Circulars
24/2007 and 13/2007.

For progression points for nursing and

SCPHN see the relevant standards
of proficiency for nursing and SCPHN
(NMC2004). For these programmes
a sign-off mentor/practice teacher is
required to confirm the outcomes only at
the end of the programme.11

11
For pre-registration nursing, mentors rather than sign-off mentors are required to sign-off outcomes for
entry to the branch.

43
NMC Requirements Guidance
All mentors may assess specific NMC competencies may be achieved
competencies throughout the programme. throughout the programme, unless
otherwise indicated in programme
standards. A mentor may confirm
achievement of competencies, including
those to be achieved at, or by, a
progression point. Only a sign-off mentor,
who has met the additional criteria, may
sign-off proficiency at the end of a final
period of practice learning.
Mentors must keep sufficient records The NMC considers it important that
to support and justify their decisions on mentors have an audit trail to support
whether a student is, or is not, competent/ their decisions. Throughout a placement
proficient. where a critical decision on progress is to
be made the mentor should ensure that
regular feedback is given to the student
and that records are kept of guidance
given.
In the final placement of a pre-registration Mentors are responsible and
programme, mentors are required to be accountable for making decisions on
either a sign-off mentor, or supported by the student’s achievement of outcomes
a sign-off mentor or a practice teacher, and competencies. They may assess
in order to make final decisions on competencies throughout the programme
proficiency. but only a sign-off mentor or a practice
teacher may make final assessment of
proficiency.
Sign-off mentors must have time allocated Sign-off mentors will require allocated
to reflect, give feedback and keep records time to ensure that students have effective
of student achievements in their final feedback on their performance so that the
period of practice learning. This will be ultimate decision on their proficiency is not
the equivalent of an hour per student per unexpected. The time allocated may need
week. This time is in addition to the 40% to be greater earlier in the placement and
of the student’s time to be supervised by a reduced as they become more confident
mentor (paragraph 3.2.4). and competent.
Only sign-off mentors, who have met The final assessment of proficiency
the additional criteria, must sign off draws on evidence of assessment over
achievement of proficiency at the end a sustained period of time. The sign-off
of the programme, unless the mentor is mentor may use the student passport and
being supervised by a sign-off mentor or other evidence to see if competence has
practice teacher who should countersign been achieved and maintained previously,
that the proficiency has been achieved by as well as demonstrated in the current
the student. placement.

44
NMC Requirements Guidance
The programme leader/lead midwife AEI Examination or Assessment Boards
for education must confirm to the AEI should ensure that confirmation is
Examination/Assessment Board that all received, based on recorded evidence,
NMC requirements have been met (to that all NMC requirements have been met.
the best of their knowledge) for individual The AEI examination board must consider
students presenting evidence of sign-off the record of achievement of practice
practice from a sign-off mentor or practice proficiency, signed at the end of the final
teacher. period of practice learning by a mentor
who has met the NMC additional criteria.
The student must self-declare their good Good health and good character will have
health and good character for entry to the been assessed for admission to, and
register. continued participation in, the programme.
Students should be encouraged to advise
their personal tutors of any issues that
may affect this. They are responsible and
accountable for their self-declaration to
the NMC when applying for registration.
The programme leader/lead midwife for A registrant who is the programme
education must provide a supporting leader/lead midwife for education, or their
declaration of good health and good designated deputy, whose name has
character of the student for registration. been previously notified to the NMC, must
complete a declaration in support of the
student’s self-declaration. There should
be an audit trail of evidence (normally in
the student’s record).

3.3 Applying the NMC practice teacher standard in practice

The NMC practice teacher standard is mandatory for supporting learning and
assessing nurses and midwives studying for registration as a specialist community
public health nurse (SCPHN), and also for specialist practice qualifications where this is
a local requirement.

The NMC standard for practice teachers needs to be read in conjunction with
Standards of proficiency for specialist community public health nursing (NMC 2004) and
Standards for specialist education and practice (UKCC 1994), and also with respect
to the Education Rules (SI 2004 No 1767). The following requirements are set by the
NMC for implementing the practice teacher standard. Guidance is provided to assist
interpretation of the requirements.

45
3.3.1 Practice teacher preparation programmes

Practice teacher preparation programmes must:

• Be a minimum academic level of HE Honours (previously known as level 3) or

SCQF Level 9.12

• Include at least 30 days protected learning time – to include learning in both

academic and practice settings.

• Include relevant work-based learning with the opportunity to critically reflect on such
an experience, e.g. acting as a practice teacher to a student in specialist practice
under the supervision of a qualified practice teacher.

• Meet the additional criteria for a sign-off mentor.

• Normally be completed within six months.

• Should provide a foundation for undertaking an NMC approved teacher preparation

programme.

• Allow AP(E)L to be applied to up to 100% of the programme. Previous preparation

of an equivalent nature and standard should be recognised. It is for the education
provider to determine if this allows the individual to be placed immediately on the
practice teacher register without the need for further preparation.

• The content of a previous mentor programme, where appropriate, may be

accredited, enabling the practice teacher programme to be completed in less time.

3.3.2 Continuing professional development for practice teachers

The NMC requires all practice teachers to maintain and develop their knowledge, skills
and competence through annual updating. Additionally they would need to maintain
and develop their extended knowledge and skills gained for practice in a specialist
area. The NMC requires placement providers to maintain a record of current practice
teachers and, where appropriate – in partnership with local education providers, to
make provisions for annual updating of these nurses (see section 2 and Triennial review
of mentor and practice teacher in the introduction).

The purpose of annual updating is to ensure that practice teachers:

• Have current knowledge of NMC approved programmes.

• Are able to discuss the implications of changes to NMC requirements.

• Have an opportunity to discuss issues relating to supervision, assessment of

competence and fitness for safe and effective practice.

12
This may vary according to the needs of specific professions and any additional requirement will be
identified within the Standards of proficiency for each part of the NMC register.

46
Practice teachers should be prepared to demonstrate to their employers, and NMC
quality assurance agents, as appropriate,13 how they have maintained and developed
their knowledge, skills and competence as a practice teacher. Placement providers will
consider evidence of updating as part of triennial review.

3.3.3 Allocated learning time for practice teacher activity

The NMC recognises that nurses and midwives who are practice teachers are primarily
employed to provide care for patients and clients. Students gaining registration as a
specialist community public health nurse, are required to undertake a period of practice
during which they would normally work on a one-to-one basis with their practice
teachers.

The nature of supervision will vary from direct to indirect depending upon the:

• Nature of the activity the student is engaged in.

• Evidence of their current competence.

• Need to assess achievement of NMC outcomes or competencies for progression on

the programme.

Practice teachers will use their professional judgment and local/national policy to
determine where activities may be safely delegated to students and the level of
supervision required. They are accountable for such decisions.

Practice teachers will need time, when undertaking work with a student, to be able
to explain, question, assess performance, and provide feedback to the student in a
meaningful way. A practice teacher should be allocated to a SCPHN student throughout
the programme (or sign-off mentor where this has been agreed through the deferral
process – see NMC circular 08/2007).

3.3.4 Supporting learning in practice

The NMC requires practice teachers to support learning for several reasons
(section 2.2):

• Provide support and guidance to the student when learning new skills, applying new
knowledge and transferring existing knowledge and competence to a new context
of practice.

• Act as a resource to the student to facilitate learning and professional growth.

• Manage the student’s learning in practice in order to ensure public protection.

• Directly observe the student’s practice, or use indirect observation where

appropriate, to ensure that NMC defined outcomes and competencies are met.

13
All NMC approved programmes are monitored regularly. This may involve NMC quality assurance
agents in practice and education visits to examine evidence that NMC requirements are being met.

47
The following requirements enable effective practice teaching to be realised:

NMC Requirements Guidance

Every SCPHN student (and SPQ student Practice teachers should be allocated
where this is a local requirement) has a prior to commencement of supervised
named practice teacher. practice. This should be sufficiently in
advance of the placement to enable both
the student and their practice teacher to
prepare adequately for the placement.
Practice teachers should support only one Practice teachers need to be able to
SCPHN student (or SPQ student) at any commit themselves to supporting learning
point in time. and assessment in practice. Their
workload needs to reflect the demands of
being a practice teacher.
An ongoing achievement record must Students are expected to keep a record
be maintained and reviewed regularly of their learning experiences, identifying
throughout the student’s supervised evidence to support achievement of
practice experience to enable judgements NMC outcomes and competencies and
to be made on the students. For further where further support and supervision is
details see Circular 33/2007 in annexe 3. required. This record should be reviewed
at intervals by their named practice
teacher during their supervised practice
experience to enable discussion of
strengths and areas for improvement.
Placement providers are responsible for The register will provide evidence for
ensuring that an up-to-date local register quality assurance purposes that there are
of practice teachers is maintained. a sufficient number of practice teachers,
who meet the NMC standards, to support
NMC approved programmes leading to a
recordable specialist practice qualification
or SCPHN registration. Students must be
kept fully informed regarding the ways
in which information is intended to be
shared, used and stored, including the
length of time to be retained and when
it will be destroyed. (Data Protection Act
1998)
Placement providers are responsible The NMC sets general requirements
for triennial review of practice teachers for remaining on the local register (see
to ensure that only those who continue introduction – triennial review). It would
to meet the NMC practice teacher be a matter for programme providers
requirements remain on the local register. to determine any additional criteria for
practice teachers to remain on the local
register.

Students must be kept fully informed regarding the ways in which information is
intended to be shared, used and stored, including the length of time it is to be retained
and when it will be destroyed. (Data Protection Act 1998)

48
3.3.5 Assessing learning in practice

Practice teachers will have been prepared to assess student performance in practice
in programmes leading to registration as a SCPHN. They will be accountable for their
decisions to pass, refer or fail a student. The NMC recognises that failing students
may be difficult and that all assessment decisions must be evidence-based. All
practice teachers will be deemed to have met the NMC additional criteria for signing off
proficiency (section 3.3.6) at the end of a programme by virtue of, where relevant, their
previous mentor experience and the preparation they have undertaken for their practice
teacher role.

NMC Requirements Guidance

Assessment of competence should Students must demonstrate their
be undertaken through both direct competence in the practice setting. The
observation in practice and evidence nature of their programme may require
gained from indirect observation. that they are able to work autonomously
with a defined caseload by the end of
the programme. Practice teachers will
seek evidence of their performance from
patient/user satisfaction reports,
self-reports from students, observation
by other colleagues and their own direct
observation.
Practice teachers should be directly Summative assessment using simulation
involved in assessing competence may occur where opportunities to
through simulation. demonstrate competence in practice is
limited, e.g. a simulated case conference
for child protection.
Practice teachers should consider how The NMC recognises that the total
evidence from various sources might assessment strategy would include
contribute towards making a judgement evidence from direct observation, witness
on performance and competence. statements from other professionals,
contributions from patients/clients and
other strategies.
Inexperienced practice teachers should Inexperienced practice teachers
seek guidance from experienced practice may require particular support from
teachers/teachers when making complex experienced practice teachers/teachers
judgements, such as failing a student. when faced with a failing student to help
them to communicate concerns, identify
action and evaluate progress.

3.3.6 Signing off practice proficiency

In order to ensure public protection the NMC needs to be assured that students have
been assessed and signed off as being capable of safe and effective practice at the end
of a programme. Practice teachers must have met the additional criteria to be able to
sign-off proficiency in practice at the end of a programme (section 2.1.3).

49
Due regard
In accordance with underpinning principle A (section 1.2):

• Only a registered SCPHN may sign-off a SCPHN student. The SCPHN must also
be from the same field of practice that coincides with the field that the student has
undertaken (see NMC Circular 26/2007, Annexe 3).

Confirmation of proficiency
The practice teacher is responsible and accountable for making the final sign-off in
practice confirming that a student has successfully completed all practice requirements
for a SCPHN qualification. This confirmation will contribute to the portfolio of evidence
considered by the approved educational institution’s examination/assessment board,
who will confirm to the NMC that the proficiencies in relation to both theory and practice
and programme requirements have been successfully achieved.

NMC Requirements Guidance

Practice teachers must keep sufficient The NMC considers it is important that
records to support and justify their practice teachers have an audit trail to
decisions on whether a student is or is not support their decisions.
competent/proficient.
Practice teachers must have time Throughout supervised practice
allocated to reflect, give feedback and experience the practice teacher will
keep records of student achievement require time to ensure that the student has
in the final period of practice learning. effective feedback on their performance
This will be the equivalent of an hour per so that the ultimate decision on their
student per week. proficiency is not unexpected.
The practice teacher must sign-off The practice teacher is responsible and
achievement of practice outcomes, accountable to the NMC for confirming
competencies and final proficiency. that outcomes, competencies and NMC
standards of proficiency have been met,
which take account of outstanding issues
e.g. a repeat placement.
The programme leader must confirm to AEI Examination and Assessment
the AEI Examination Board that all NMC Boards should ensure that confirmation is
requirements have been met (to the received, based on recorded evidence of
best of their knowledge) for individual both theory and practice assessment, that
students presenting evidence of all NMC requirements have been met and
sign-off of practice from the student’s proficiency achieved.
named practice teacher.

50
NMC Requirements Guidance
The student must self-declare their good Good health and good character will
health and good character for entry to a have been assessed for admission to
new part of the register. and maintenance on the register at initial
registration, and again for entry to and
continued participation in the current
programme. Students should advise their
Personal Tutors of any issues that may
affect this. They are responsible and
accountable for their self-declaration to
the NMC when applying for registration in
a new part of the register.
The programme leader/official A declaration of the student’s
correspondent must provide a supporting self-declaration must be completed by
declaration of good health and good a registrant who is the programme
character of the student for registration. leader/official correspondent (or her
deputy), whose name has been previously
notified to the NMC, There should be an
audit trail of evidence (normally in the
student’s record).

3.4 Applying the NMC teacher standard in practice settings

The NMC teacher standard is mandatory for those nurses and midwives who are
teachers employed in higher education and who support students on NMC approved
programmes in practice settings. The NMC recognises that AEIs will have other
teachers, who are not nurses and midwives, who will contribute to teaching on NMC
approved programmes in their area of specialist expertise. The NMC will, through
its quality assurance processes verify that the majority of HE teachers who support
NMC students in practice settings have attained, or are working towards, a teaching
qualification that meets the NMC outcomes from stage 4.

Approved educational institutions that employ teachers holding an NMC approved

qualification will determine the requirements for applying the standard in academic
settings. The NMC is concerned that those nurses and midwives who meet the
outcomes of stage 4 of the framework are able to apply their knowledge, skills and
competence in practice and academic settings. The NMC requires that 50% of learning
for its approved pre-registration and specialist practice programmes takes place in
practice.

NMC nurse, midwife and specialist community public health nurse teachers must have
contemporary experience to be able to support learning and assessment in practice
settings. Such experience may take a variety of forms, such as: acting as a link tutor,
supporting mentor development and updating, having an active clinical role for a part of
their time, supporting clinical staff in their professional development in practice, being
involved in practice development to support the evidence-base from which students
draw, and contributing to practice-based research.

51
3.4.1 Teacher preparation programmes NMC approved teacher programmes must:

• Be at a minimum academic level of postgraduate study, i.e. postgraduate certificate,

diploma or degree (M level), according to the requirements of programme providers.

• Be at least one academic year in duration.

• Include a minimum of 12 weeks (360 hours) teaching practice.

• Demonstrate achievement of all of the outcomes of stage 4.

Programme providers should take account of the UK Professional Standards

Framework for teaching and supporting learning in higher education (HE Academy,
February 2006 – see Annexe 2). This framework was developed by the Higher
Education Academy on behalf of the Higher Education sector and commissioned
by Universities UK, the Standing Conference of Principals (SCOP) and the UK HE
funding councils. The model provides a descriptor-based approach for HE institutions
to determine their own criteria in the application of the standards framework. It is based
upon applying areas of activity, core knowledge and professional values.

The UK Professional Standards Framework (above) complements the NMC Standards

to support learning and assessment in practice. The framework is designed to be sector
owned and applied to various staff groups from teaching assistants to those who have a
substantive teaching role. This would allow programme providers to seek accreditation
of their NMC approved teacher preparation programmes and, potentially, to have
outcomes for mentors and practice teachers recognised by the HE Academy.

3.4.2 Continuing professional development for teachers

The NMC requires all NMC teachers to maintain and develop their knowledge, skills
and competence as a teacher through regular updating. Those teachers employed in
approved educational institutions will need to meet the requirements of their employers
for scholarly activity. The NMC also requires that teachers focus on the practice aspects
of their roles and ensure their knowledge of practice is contemporaneous and that,
where appropriate, their skills are fit for safe and effective practice.

Teachers should be prepared to demonstrate to their employers, and NMC quality

assurance agents, as appropriate,14 how they have maintained and developed their
knowledge, skills and competence as teachers.

3.4.3 Signing off proficiency

Teachers are responsible for signing off the academic component of the programme.
Many teachers will be involved in supporting learning and assessing assignments
throughout the programme. The Programme Leader for Nursing or the Lead Midwife
for Education, whose name has previously been notified to the Council, will make the
final sign-off for the programme. They must ensure that they have seen evidence that
the practice component of the programme has been signed off by a sign-off mentor or a
practice teacher.

14
NMC approved programmes and providers are subject to monitoring as part of the NMC’s UK wide QA
framework.

52
Only teachers who have a practice-based role, and who have met the additional criteria
for a sign-off mentor (section 2.1.3) may undertake sign-off of practice. This may apply
where teachers have a role requiring them to take a practice caseload, as well as work
in academic settings.

3.4.4 Allocated time for practice teaching activity

Approved educational institutions will employ nurses and midwives who have
successfully met the outcomes of stage 4 and recorded their qualification on the
register, and other teachers who are not nurses and midwives. The NMC expects
teachers who are nurses and midwives to be able to support learning and assessment
in both academic and practice learning environments. Teachers are therefore
expected to spend a proportion of their time supporting student learning in practice
(Recommendation 26 from Fitness for Practice, UKCC 1999). The NMC advises that
this should be approximately 20% of their normal teaching hours.

Teachers in HE might specialise in teaching, research or practice and these

specialities may at times be in conflict. The NMC requirement for teachers to support
practice-based learning may be achieved through a variety of strategies such as:

• Acting as a clinical teacher or a link tutor.

• Preparing, supporting and updating mentors and practice teachers.

• Taking part in practice-based action learning groups.

• Contributing to practice development.

• Undertaking practice-based research activity.

• Any other strategies that would enable teachers to maintain practice knowledge
and awareness, and where appropriate, practice skills, i.e. midwifery teachers
would require effective registration as a midwife, specialist community public health
nurses teachers would normally have a limited caseload, nurse teachers working in
specialist areas may similarly wish to maintain a limited caseload.

It is for programme providers to ensure that students have access to a sufficient number
of teachers with expertise in practice, teaching, research and development to support
their learning in both practice and academic learning environments.

53
Section 4 – Approval and monitoring of mentor, practice
teacher and teacher standards

4.1 NMC approval of mentor/practice teacher preparation programmes

The NMC has agreed two routes for the approval of mentor/practice teacher preparation
programmes. Programme providers may choose the option best suited to their
purposes. The routes are:

Route 1

Route 1 would be suited to NMC programme providers seeking approval for NMC
programmes leading to registration: Nursing, Midwifery and SCPHN. A combined
event could consider the pre-registration programme and a mentor/practice teacher
programme. Separate documentation would be necessary for the mentor/practice
teacher preparation programme.

Route 2

Framework approval events allowing one event to approve all standards set by the
NMC as teaching roles. Route 2 would be best suited to those programme providers
who already offer an NMC approved teacher preparation programme and who would
be interested in developing these further to provide outcomes for mentors and practice
teachers. Such programmes should provide stepping on and stepping off points and
processes for AP(E)L to recognise achievement of previous stages (or equivalent) in the
developmental framework. This route would also be suitable to those who do not offer
an NMC approved pre-registration programme but who would wish to have approved
mentors – such as those programme providers offering return to practice programmes
or the overseas nurses programme.

4.2 NMC approval of teacher preparation programmes

The NMC already approves teacher preparation programmes leading to a recordable
qualification on the register as part of its quality assurance processes. This arrangement
will continue unchanged.

4.3 NMC monitoring arrangements

Reports of quality assurance activities, annual monitoring, and list of approved
programmes are published on the NMC website at www.nmc.org.uk

4.4 NMC recognition of other teaching qualifications

The NMC recognises that some nurses and midwives may undertake teacher
preparation programmes for their own interest and career development before making
the decision to become a nurse, midwife or specialist community public health teacher.
The NMC has previously offered a route for recording such a teaching qualification
where it is deemed comparable to the NMC standard for the preparation of teachers.
The NMC has agreed that this route should continue.

54
In such cases, the NMC requires sufficient evidence to demonstrate that the entry
criteria for teacher preparation have been met, that the programme undertaken is
comparable to that of an NMC approved programme in nature and content and that
the registrant can provide evidence of mapping their learning and experience to
demonstrate the current NMC requirements have been met. This includes evidence
of assessed teaching activity, comparable with students studying an NMC approved
programme for a period equivalent to a minimum of 12 weeks (or 360 hours). Such
evidence must be verified by a nurse, midwife or specialist community public health
nurse teacher, who has a recorded teaching qualification on the NMC register.

Nurses and midwives intending to use the NMC recognition route to record a teaching
qualification must be able to provide evidence that they:

• Meet NMC criteria for entry to a teacher preparation programme.

• Have undertaken continuing professional development, at least to first degree level,

relevant to their area of practice.

• Have undertaken a post-graduate programme of teacher preparation.

• Have mapped their learning and experience to demonstrate that the outcomes of
stage 4 have been met. This must be verified by a registrant who already has a
teaching qualification recorded on the register and is currently employed to teach
students in education leading to registration or a recorded qualification with the
NMC.

• Are able to supply a reference from practice to support that they have the ability to
teach students in practice.

• Confirm that they have undertaken at least 12 weeks (or 360 hours) of assessed
teaching activity with students on an NMC approved programme leading to
registration or a recordable qualification. An NMC registrant who has a recorded
teaching qualification on the register must have assessed such teaching activity.

• Such nurses and midwives would need to prepare a portfolio of evidence for local
assessment by an NMC registrant who has a teaching qualification recorded on
the register and who is employed at an NMC approved educational institution. This
registrant will confirm to the NMC that evidence has been provided that all stage 4
outcomes have been met.

55
Section 5 – Glossary, references and annexes
Glossary

Glossary of terms
Accreditation of Process of awarding credit for formal or experiential learning by
Prior (Experiential) mapping it against defined learning outcomes of the programme
Learning (AP(E)L) offered (see NMC QA Factsheet I/2004).
Approved An institution recognised by the NMC to provide NMC approved
Educational programmes. Normally these are in higher education, however
Institutions (AEI) the Nursing and Midwifery Order 2001 allows the NMC to
approve other institutions to deliver programmes that meet NMC
standards.
Approval A process whereby the partners (see below) present their
programme for external scrutiny (or validation) which, if
successful, leads to joint approval by the NMC and the approved
educational institution.
Competency A competency describes the skills and abilities to practise
safely and effectively without the need for direct supervision.
Competencies are achieved incrementally throughout periods
of practice experience during a programme. At the end of the
final period of practice experience or supervised practice it is the
evidence of achievement of all competencies that enables
sign-off mentors or practice teachers to decide whether
proficiency has been achieved.
Due regard Differentiates between the nurses’, midwives’ and specialist
community public health nurses’ parts of the NMC register
as well as specific fields of practice within nursing, e.g. adult,
children, mental health and learning disability. Mentors and
practice teachers normally assess others only with due regard to
the parts on which they, themselves, are registered.
Fitness for Requires the student to demonstrate that they are practising
practice safely and effectively, have met the standards of proficiency and
all other requirements to become registered.
Lead Midwife for Named person within an approved educational institution
Education responsible for leading midwifery education and involved in
all processes relating to the approval and monitoring of NMC
approved midwifery programmes.
Local register of Placement providers hold a register of all current mentors,
mentors/practice including sign-off mentors and practice teachers, that have met
teachers the NMC outcomes for these roles and have additionally met the
NMC requirements for maintenance on the register.
Mentor A registrant who has met the outcomes of stage 2 and who
facilitates learning, and supervises and assesses students in a
practice setting.

56
Glossary of terms
Nurses and This term refers to a nurses and midwives whose names are
midwives held on the NMC register. There are three parts of the register:
nursing, midwifery and specialist community public health
nursing. In addition, the term midwife has a legal definition: “A
midwife is a person who having been regularly admitted to a
midwifery education programme, duly recognised in the country
in which it is located, has successfully completed the prescribed
course of studies in midwifery and has acquired the requisite
qualifications to be registered and/or legally licensed to practise
midwifery.” (ICM 2005).
Outcomes Outcomes identify the skills required at each stage of the
framework to meet the defined final competencies.
Parts of the The NMC register, which opened on 1 August 2004, has three
register parts: nurse, midwife and specialist community public health
nurse. A mark on the register identifies the field of practice, i.e.
adult, children, mental health and learning disability nurses.
Postgraduate A postgraduate preparation programme is normally undertaken
following graduation from a first degree (or equivalent) and,
normally, at Master’s level. Academic outcomes may be of
postgraduate certificate, diploma, degree or a specified number
of M level credits.
Practice A student is deemed proficient when they have successfully met
proficiency all of the NMC standards of proficiency for nursing, midwifery
or specialist community public health nursing, at the end of an
NMC approved programme. Practice proficiency may only be
signed off by a practice teacher or a mentor who has met the
NMC additional criteria.
Practice teacher A registrant who has gained knowledge, skills and competence
in both their specialist area of practice and in their teaching role,
meeting the outcomes of stage 3, and who facilitates learning,
supervises and assesses students in a practice setting.
Preceptorship The process through which existing nurses and midwives
provide support to newly qualified nurses and midwives.
Proficiencies These are contained within the standards of proficiency for
each of the three parts of the register. Fitness for practice is
demonstrated by meeting all NMC proficiencies and other
requirements by the end of the programme.
Programme Programme providers are partnerships formed between
providers AEIs and service partners providers who provide placement
opportunities for students on NMC approved programmes.
Normally these programmes are 50% theory and 50%
practice. All partners are responsible for ensuring that learning
opportunities and support for learning and assessment is
available in both theory and practice learning environments.
Quality Assurance The initial approval to allow a programme to be delivered
(QA) and ongoing monitoring during the lifespan of NMC approved
programmes.

57
Glossary of terms
Recordable A qualification, approved by the NMC that may be recorded on
qualification the NMC register.
Registrable A qualification approved by the NMC that enables admission to a
qualification part of the NMC professional register.
Registrants Previously used by the NMC to describe nurses and midwives
whose names are held on the NMC register.
Rules Rules are established through legislation and they provide
the legal strategic framework from which the NMC develops
standards, e.g. Education, Registration and Registration Appeals
Rules 2004 (SI 2004/1 767).
Sign-off mentor Mentors are required to meet specified criteria in order to be
able to sign-off a student’s practice proficiency at the end
of an NMC approved programme. All midwife mentors and
practice teachers will have met the requirements through their
preparation programme.
Specialist The NMC register has a part for registered specialist community
Community Public public health nurses (SCPHN). The Council has agreed
Health Nurse standards of proficiency for entry to this part of the register.
Existing groups of nurses have migrated to this part of the
register; these include health visitors, school nurses (who hold
a specialist practice qualification) and occupational health
nurses (who hold a specialist practice qualification). Nurses and
midwives who work in public health roles, and can demonstrate
that they have met the academic and practice standards of
proficiency for this part of the register, may be able to apply to
be registered as SCPHN.
Standards The NMC is required by the Nursing and Midwifery Order 2001
to establish standards of proficiency to be met by applicants
to different parts of the register. The standards are considered
to be necessary for safe and effective practice [Article 5(2)(a)].
These are set out within the standards of proficiency for each of
the three parts of the register. The standards support the rules,
are mandatory and gain their authority from the legislation.
Teacher A registrant who has undertaken an NMC approved teacher
preparation programme, or equivalent and successfully
achieved the outcomes defined in stage 4 of the developmental
framework.

58
References
• Department of Health (2004) The NHS Knowledge and Skills Framework, London,
HMSO

• Department of Health (2006) Modernising Nursing Careers Setting the Direction,

London, Department of Health

• Department of Health (2007) Trust, assurance and safety: the regulation of health
professionals in the 21st Century, London: The Stationery Office (Cm 7013)

• Disability Discrimination Act (1995), Norwich, HMSO

• Disability Discrimination Act (2005) An act to amend the DDA 1995: and for
connected purposes, Norwich, HMSO

• Higher Education Academy (2006) The UK Professional Standards Framework for

teaching and supporting learning in higher education, London, HE Academy

• International Confederation of Midwives (2005) Definition of the Midwife, The

Netherlands, ICM

• The Nursing and Midwifery Council (Education, Registration and Registration

Appeals) Rules Order of Council 2004 (SI 2004 No 1767), Norwich, Office of Public
Sector Information (OPSI)

• The Nursing and Midwifery Council (Midwives) Rules Order of Council 2004 (SI
2004 No 1764), Norwich, Office of Public Sector Information (OPSI)

• Nursing and Midwifery Council (2004) Consultation on a standard to support

learning and assessment in practice, London, NMC

• Nursing and Midwifery Council (2004) Standards for the preparation of teachers on
nurses, midwives and specialist community public health nurses, London, NMC

• Nursing and Midwifery Council (2004) Standards of proficiency for pre-registration

nursing education, London, NMC

• Nursing and Midwifery Council (2004) Standards of proficiency for pre-registration

midwifery education, London, NMC

• Nursing and Midwifery Council (2004) Standards of proficiency for specialist

community public health nurses, London, NMC

• Nursing and Midwifery Council (2005) Consultation on fitness for practice at the
point of registration, London, NMC

59
• Nursing and Midwifery Council (2015) The Code: Professional standards of
practice and behaviour for nurses and midwives (NMC, 2015)

• Nursing and Midwifery Council (2008) The Prep handbook, London, NMC

• United Kingdom Central Council for Nursing, Midwifery and Health Visiting (1994)
Standards for specialist education and practice, London, UKCC

• United Kingdom Central Council for Nursing, Midwifery and Health Visiting (1999)
Fitness for Practice, London, UKCC

60
NMC Circulars

• 20/2006 Introduction of the Standards to support learning and assessment in

practice

• 21/2006 Preceptorship Guidelines

• 08/2007 Revised arrangements for the introduction of the practice teacher standard
in relation to specialist community public health nursing programmes

• 13/2007 Preparing midwife mentors to meet the NMC’s Standards to support

learning and assessment in practice

• 17/2007 Approval process and timetable to implement the Standards to support

learning and assessment in practice for NMC Approved Programme Providers

• 26/2007 Applying due regard to learning and assessment in practice

• 27/2007 Sign-off status and preceptorship for Practice Teacher students

• 28/2007 Guidance for small scale service providers in applying the NMC’s
Standards to support learning and assessment in practice

• 33/2007 Ensuring continuity of practice assessment through the ongoing

achievement record
• 02/2008 Applying due regard to learning and assessment in practice for student
midwives

61
 Annex 1
The developmental framework to support learning and assessment in practice

Domain Stage 1 Stage 2 Stage 3 Stage 4

Nurses and midwives Mentor Practice teacher Teacher
Demonstrate effective relationship building skills sufficient to support learning, as part of a wider interprofessional team, for a range
of students in both practice and academic learning environments
Establishing effective working • work as a member of a • demonstrate an • have effective professional • demonstrate effective
relationships multi-professional team, understanding of factors and inter-professional relationships with other
contributing effectively to that influence how students working relationships to members of the teaching
team working integrate into practice support learning for entry to teams in practice and
settings the register and education academic settings based
• support those who are new at a level beyond initial on mutual trust and respect
to the team in integrating • providing ongoing and registration
into the practice learning constructive support to • maintain appropriate
environment facilitate transition from one • be able to support students supportive relationships
learning environment to moving into specific areas with a range of students,
• act as a role model for safe another of practice or a level of mentors, practice teachers
and effective practice practice beyond initial and other professionals
• have effective professional registration, identifying
• develop effective working and interprofessional their individual needs in • foster peer support and
relationships based on working relationships to moving to a different level peer learning in practice
mutual trust and respect support learning for entry to of practice and academic settings for
the register all students
• support mentors and other
professionals in their roles • support students to
to support learning across integrate into new
practice and academic environments and working
learning environments teams to enhance access
to learning

62
 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Facilitate learning for a range of students, within a particular area of practice where appropriate, encouraging self-management of
learning opportunities and providing support to maximise individual potential
Facilitation of learning • co-operate with those • use knowledge of the • enable students to relate • promote development of
who have defined support student’s stage of learning theory to practice whilst enquiring, reflective, critical
roles contributing towards to select appropriate developing critically and innovative approaches
the provision of effective learning opportunities to reflective skills to learning
learning experiences meet individual needs
• foster professional growth • implement a range of
• share their own knowledge • facilitate the selection and personal development learning and teaching
and skills to enable others of appropriate learning by use of effective strategies across a wide
to learn in practice settings strategies to integrate communication and range of settings
learning from practice and facilitation skills
academic experience • provide support and
• facilitate and develop the advice, with ongoing and
• support students in ethos of interprofessional constructive feedback
critically reflecting upon learning and working to students, to maximise
their learning experiences individual potential
in order to enhance future
learning • co-ordinate learning
within an interprofessional
learning and working
environment

• facilitate integration of
learning from practice and
academic settings

• act as a practice expert to

support development of
knowledge and skills for
practice

63
 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Assess learning in order to make judgements related to the NMC standards of proficiency for entry to the register or for recording a
qualification at a level above initial registration
Assessment and • work to the NMC Code • foster professional growth, • set effective professional • set and maintain
accountability for nurses and midwives personal development boundaries whilst creating professional boundaries
in maintaining own and accountability through a dynamic, constructive that are sufficiently flexible
knowledge and proficiency support of students in teacher-student for interprofessional
for safe and effective practice relationship learning
practice
• demonstrate a breadth • in partnership with other • develop, with others,
• provide feedback to others of understanding of members of the teaching effective assessment
in learning situations and to assessment strategies and team use knowledge and strategies to ensure that
those who are supporting ability to contribute to the experience to design and standards of proficiency for
them so that learning is total assessment process implement assessment registration or recordable
effectively assessed as part of the teaching frameworks qualifications at a level
team beyond initial registration
• be able to assess practice are met
• provide constructive for registration and also at
feedback to students and a level beyond that of initial • support others involved in
assist them in identifying registration the assessment process,
future learning needs and students, mentors and
actions. Manage failing peers
students so that they may
enhance their performance
and capabilities for safe
and effective practice or
be able to understand their
failure and the implications
of this for their future

64
 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Assess learning in order to make judgements related to the NMC standards of proficiency for entry to the register or for recording a
qualification at a level above initial registration
Assessment and • be accountable for • provide constructive • provide constructive
accountability confirming that students feedback to students and feedback to students and
have met or not met the assist them inidentifying assist them in identifying
NMC competencies in future learning needs and future learning needs and
practice and as a sign- actions, manage failing actions, manage failing
off mentor confirm that students so that they may students so that they may
students have met or not enhance their performance enhance their performance
met the NMC standards of and capabilities for safe and capabilities for safe
proficiency and are capable and effective practice or and effective practice or
of safe and effective be able to understand their be able to understand their
practice failure and the implications failure and the implications
of this for their future of this for their future

• be accountable for • be accountable for their

confirming that students decisions related to fitness
have met or not met for practice for registration
the NMC standards of or recordable qualifications,
proficiency in practice underpinning such
for registration at a level decisions with an evidence
beyond initial registration base derived from
and are capable of safe appropriate and effective
and effective practice monitoring of performance

65
 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Determine strategies for evaluating learning in practice and academic settings to ensure that the NMC standards of proficiency for
registration or recording a qualification at a level above initial registration have been met
Evaluation of learning • contribute information • contribute to evaluation • design evaluation • determine and use
related to those learning of student learning and strategies to determine the criteria for evaluating the
in practice, and about assessment experiences, effectiveness of practice effectiveness of learning
the nature of learning proposing aspects for and academic experience environments, acting on
experiences, to enable change resulting from such accessed by students findings, with others, to
those supporting students evaluation at both registration level enhance quality
to make judgements on and those in education
the quality of the learning • participate in self and peer at a level beyond initial • foster and participate in
environment evaluation to facilitate registration self and peer evaluation
personal development to enable students to
and contribute to the • collaborate with other manage their own learning
development of others members of the teaching in practice and academic
team to judge and develop settings and to enhance
learning, assessment personal professional
and support appropriate development
to practice and levels of
education • evaluate the effectiveness
of assessment strategies in
• collect evidence on the providing evidence to make
quality of education in judgements on fitness for
practice, and determine practice
how well NMC
requirements for standards • report on the quality of
of proficiency are being practice and academic
achieved learning environments to
demonstrate that NMC
requirements have been
met, particularly in relation
to support of students and
achievement of standards
of proficiency

66
 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Create an environment for learning, where practice is valued and developed, that provides appropriate professional and
interprofessional learning opportunities and support for learning to maximise achievement for individuals
Create an environment for • demonstrate a commitment • support students to identify • enable students to • in partnership with others,
learning to continuing professional both learning needs and access opportunities to opportunities for students
development to enhance experiences that are learn and work within to identify and access
own knowledge and appropriate to their level of interprofessional teams learning experiences that
proficiency learning meet their individual needs
• initiate the creation
• provide peer support to • use a range of learning of optimum learning • ensure such opportunities
others to facilitate their experiences, involving environments for students maintain the integrity of the
learning patients, clients, carers at registration level and student’s professional role
and the professional team, for those in education whilst responding to the
to meet defined learning at a level beyond initial interprofessional context of
needs registration practice

• identify aspects of the • work closely with others • determine with others,
learning environment involved in education, in audit criteria against which
which could be enhanced practice and academic learning environments
negotiating with others to settings, to adapt to may be judged for their
make appropriate changes change and inform effectiveness in meeting
curriculum development NMC requirements
• act as a resource to
facilitate personal and • support and develop
professional development others involved to ensure
of others that learning needs are
effectively met in a safe
environment

• explore and implement

strategies for continuous
quality improvement of the
learning environment

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 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Support learning within a context of practice that reflects health care and educational policies, managing change to ensure that
particular professional needs are met within a learning environment that also supports practice development
Context of practice • whilst enhancing their own • contribute to the • recognise the unique • support students in
practice and proficiency, development of an needs of practice and identifying ways in which
a registered nurse or environment in which contribute to development policy impacts on practice
midwife, act as a role effective practice is of an environment that
model to others to enable fostered, implemented, supports achievement • contribute effectively to
them to learn their unique evaluated and of NMC standards of processes of change and
professional role disseminated proficiency innovation, implementing
new ways of working that
• set and maintain • set and maintain maintain the integrity of
professional boundaries professional boundaries, professional roles
that are sufficiently whilst at the same
flexible for providing time recognising the • negotiate ways of providing
interprofessional care contribution of the wider support to students so
interprofessional team and that they can achieve their
• initiate and respond to the context of care delivery learning needs within the
practice developments to context of professional and
ensure safe and effective • support students in interprofessional practice
care is achieved and exploring new ways of
an effective learning working and the impact this • act as a role model to
environment is maintained may have on established enable students to learn
professional roles professional responsibilities
and how to be accountable
for their own practice

• adapt to change,
demonstrating to students
how flexibility may be
incorporated whilst
maintaining safe and
effective practice

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 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Apply evidence-based practice to their own work and contribute to the further development of such a knowledge and practice
evidence base
Evidence-based practice • further develop their • identify and apply • identify areas of research • advance their own
evidence base for research and evidence and practice development knowledge and practice
practice to support based practice to their area based on interpretation of abilities through access to
their own personal and of practice existing evidence and involvement in, where
professional development appropriate, research and
and to contribute to the • contribute to strategies • use local and national practice development
development of others to increase or review the health frameworks to
evidence base used to review and identify • consider how evidence-
support practice developmental needs based practice, involving
patients, clients, carers
• support students in • advance their own and other members of
applying an evidence base knowledge and practice the health and social care
to their own practice in order to develop new team, enhances care
practitioners, at both delivery and learning
registration levels and opportunities
education at a level beyond
initial registration, to be • empower individuals,
able to meet changes in groups and organisations
practice roles and care to develop the evidence-
delivery base for practice

• disseminate findings from • disseminate findings from

research and practice the research and practice
development to enhance development to enhance
practice and the quality of the quality of learning and
learning experiences care delivery and academic
environments

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 Domain Stage 1 Stage 2 Stage 3 Stage 4
Nurses and midwives Mentor Practice teacher Teacher
Demonstrate leadership skills for education within practice and academic settings
Leadership • use communication skills • plan a series of learning • provide practice leadership • demonstrate effective
effectively to ensure experiences that will meet and expertise in application communication skills
that those in learning students’ defined learning of knowledge and skills to facilitate delivery of
experiences understand needs based on evidence educational programmes
their contribution and leading to registration or a
• be an advocate for • demonstrate the ability to
limitations to care delivery recordable qualification
students to support lead education on practice,
them accessing learning working across practice • initiate and lead
opportunities that meet and academic settings programme development
their individual needs, and review processes
• manage competing
involving a range of other to enhance quality and
demands of practice
professionals, patients, effectiveness
and education related
clients and carers
to supporting different • develop effective
• prioritise work to practice levels of students relationships with practice
accommodate support and academic staff
• lead and contribute to the
of students within their involved in programme
evaluation of effectiveness
practice roles delivery to ensure clarity of
of learning and assessment
contribution and strategies
• provide feedback about the in practice
to respond to evaluation of
effectiveness of learning
learning experiences
and assessment in practice
• demonstrate strategic
vision for practice and
academic development
relevant to meeting NMC
requirements
• manage competing
demands to ensure
effectiveness of learning
experiences for students
• lead, contribute to, analyse
and act on the findings of
evaluation of learning and
assessment to develop
programmes
• provide feedback about the

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effectiveness of learning
and assessment in practice
Annexe 2
The UK Professional Standards Framework for teaching and supporting learning
in higher education

HE sector-owned standards

The HE Academy has developed a National Professional Standards Framework for

Teaching and Supporting Learning in Higher Education. The framework was developed
by the Higher Education Academy on behalf of the Higher Education sector and
commissioned by Universities UK, SCOP and the UK HE funding councils. The model
provides a descriptor-based approach for HE institutions to determine their own criteria
in the application of the standards framework. It is based upon applying areas of activity,
core knowledge and professional values. These areas are applied to learning outcomes
and assessment activities within professional development programmes in order to
demonstrate application of the standards.

Areas of activity, core knowledge and professional values within the framework

Areas of activity

1 Design and planning of learning activities and/or programmes of study

2 Teaching and/or supporting student learning

3 Assessment and giving feedback to learners

4 Developing effective environments and student support and guidance

5 Integration of scholarship, research and professional activities with teaching and

supporting learning

6 Evaluation of practice and continuing professional development

Core knowledge

Knowledge and understanding of:

1 The subject material

2 Appropriate methods for teaching and learning in the subject area and at the level
of the academic programme

3 How students learn, both generally and in the subject

4 The use of appropriate learning technologies

5 Methods for evaluating the effectiveness of teaching

6 The implications of quality assurance and enhancement for professional practice

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Professional values

1 Respect for individual learners

2 Commitment to incorporating the process and outcomes of relevant research

scholarship, and/or professional practice

3 Commitment to development of learning communities

4 Commitment to encouraging participation in higher education, acknowledging

diversity and promoting equality of opportunity

5 Commitment to continuing professional development and evaluation of practice

Please see www.heacademy.ac.uk for further details.

Annexe 3: Circulars
Circular: Applying due regard to learning and assessment in practice.
Nursing and Midwifery Council Circular
Index Number: NMC Circular 26/2007
Issue Date: 21 Sept 2007
Review Date: 21 Sept 2008
Replaces: New circular
Category: Nursing General/Specialist Community Public Health Nurses
Status: Action

Summary

This circular:

• responds to challenges currently experienced in the application of due regard

in meeting the Standards to support learning and assessment in practice (NMC
August 2006) hereafter referred to as ‘the Standards’.

(The definition of due regard is given in bold text in the background section page 73).

• sets out ways in which the principle of due regard may be applied more flexibly
without reducing the degree of rigour applied to assessing student competence.

• may be applied with immediate effect in relation to nursing and specialist

community public health programmes as indicated below.

• does not apply to pre-registration midwifery programmes. Further information

related to the assessment of pre-registration midwifery students will follow.

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This circular should be read in conjunction with:

• The Standards to support learning and assessment in practice (NMC August 2006)

• NMC Circular 20/2006

Background

The NMC has addressed some challenges in the application of due regard in the
assessment of practice of approved nursing and specialist community public health
nursing programmes. This includes issues relating to available resource and the need to
make use of inter-professional shared learning opportunities.

Principle A (para 1.2) of the Standards states that NMC registrants:

‘who make judgements about whether a student has achieved the required
standards of proficiency for safe and effective practice must be on the same
part or sub-part of the register as that which the student is intending to enter’

It has been reported that in some circumstances the current application of due regard
for learning and assessment has become either impractical or impossible due to
workforce issues and employment practices. Equally, it is important that students can be
placed with a professional from a different part of the register or a different profession in
order to meet programme outcomes.

As a consequence, the ways in which due regard can be applied have been reviewed
and requirements may now be met by applying the principles set out in Methods 1 to 2c
pages 74–77.

Education providers may apply these principles as described below with immediate
effect without need for programme modification.

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Principles to be applied

Method 1: Existing application

This method is the way in which due regard is currently applied and will likely remain
the most frequently used method. It is also the only method which will apply in
pre-registration midwifery programmes.

The student’s mentor or practice teacher:

• has the specialist skills required to support the placement learning outcomes

• is from the same part of the register and field of practice as the student.

• supervises and monitors progress throughout this period

• assesses component skills related to the programme outcomes.

MENTOR / PRACTICE TEACHER

(due regard)
(specialist skills)

CONFIRMATION OF PROFICIENCY
(with due regard)

STUDENT

Judgements are informed by feedback from colleagues and evidence from other
sources leading to an assessment determining whether the student has achieved
the required standard for safe and effective practice in relation to the particular
field of practice. Fields of practice are usually indicated by marks on the register as
representing the nursing branches but they can also be applied more broadly, e.g. in
relation to a specialist area of practice.

Method 2: Modified application

Three variations of method 2 are set out below and address the complexity of the types
of placements within the different parts of the register and fields of practice.

Method 2a is intended to support the increasing need for nursing and specialist
community public health nursing students to appreciate the interprofessional context in
which they will be working as registrants and the need for placements to be undertaken
in this way may increase. However, methods 2b and 2c are intended as interim
measures to allow programme providers, placement providers and commissioners time
to work together to ensure that adequate numbers of mentors and practice teachers
from all parts of the register and fields of practice are prepared for these roles.

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Method 2a: Where learning and assessment particularly requires specialist
field input
This method enables due regard to be applied where students need to gain experience
with somebody from a specialist field of practice who is not a mentor/practice teacher
from the same part of the register and same field of practice as that which they intend to
enter.

Examples could include:

• a specialist community public health nursing student who undertakes a placement

within a social work environment,

• a mental health nursing student placed within a criminal justice environment

• a learning disability nursing student placed within an adult nursing environment

• a child branch nursing student placed with a specialist community public health
nurse

In these circumstances the student is placed with a specialist placement supervisor

who is a designated practitioner with the skills that the student needs to acquire or be
exposed to. The specialist placement supervisor is normally a professional who has
received preparation in supervising and assessing students in practice settings.

The specialist placement supervisor from a different part of the register or profession:

• directly supervises the student in the required activities that address the specified
learning outcomes related to the specialist experience.

• assesses component skills directly related to the professional’s own area of

competence and scope of practice.

MENTOR / PRACTICE TEACHER

(due regard)
(specialist skills)
SPECIALIST PLACEMENT
SUPERVISOR
Confirmation of
INTERPRETATION (additional specialist skills)
additional
specialist skills
[DIFFERENT PROFESSION
CONFIRMATION OF OVERALL
OR DIFFERENT PART OF
PROFICIENCY THE NURSING REGISTER]
(with due regard)

STUDENT

75
The placement must be overseen by a NMC registrant mentor or practice teacher
with due regard who meets with the student and placement supervisor at agreed
predetermined points to monitor the student’s achievement in the context of the
part of the register that the student intends to enter. The mentor/ practice teacher is
accountable for assessment with due regard and confirming overall proficiency (or not)
at the end of the placement.

NB. Practice assessment in independent/supplementary prescribing programmes is

the legal responsibility of a designated medical practitioner who supports, teaches and
supervises the student with, where possible, an experienced nurse prescriber who
should ensure that learning is applied to specific areas of nursing practice.

Method 2b: Where mentors and practice teachers with due regard are scarce.
This method enables due regard to be applied where students need to gain experience
within a required field of practice or part of the register where there are limited numbers
of mentors/practice teachers available from their part of the register and/or field of
practice. Direct supervision and assessment in the specialist area is provided by other
NMC mentors/ practice teachers without due regard.

Examples could include a:

• mental health branch student supervised by an adult nurse in a general accident

and emergency unit

• general practice nurse student supervised by an adult nurse in a minor injuries unit

• child branch student supervised by a learning disability nurse in a unit for

challenging behaviour

• learning disability nurse supervised by a health visitor in a baby clinic.

A practice supervisor (mentor/practice teacher without due regard)

• directly supervises the student in the required activities that address the specified
learning outcomes related to the specialist experience

• assesses component skills directly related to the professional’s own area of

competence and scope of practice.

76
 MENTOR / PRACTICE TEACHER
(due regard)
(specialist skills)
PRACTICE SUPERVISOR
(Mentor/practice teacher
Confirmation of without due regard)
INTERPRETATION specialist skills

[DIFFERENT PART OF THE

CONFIRMATION OF OVERALL REGISTER]
PROFICIENCY
(with due regard)

STUDENT

The placement must be overseen by an NMC registrant mentor or practice teacher

with due regard who meets with the practice supervisor providing direct supervision
at agreed predetermined points to monitor the student’s achievement in the context
of the part of the register that the student intends to enter. The overseeing mentor/
practice teacher is accountable for assessment with due regard and confirming overall
proficiency (or not) at the end of the placement.

Method 2c: In specialist community public health nursing programmes where

practice teachers are available from the part of the register but not the specific
field of practice.
This enables due regard to be applied where specialist community public health
nursing students are placed within a required field of practice, where there are no
practice teachers from that part of the register to provide direct supervision. Specialist
community public health nurse (SCPHN) registrants from the field of practice provide
direct supervision and assessment in the specialist area.

An example is where there are several health visitor practice teachers but no
practice teachers within the occupational health nursing field of practice. Under these
circumstances:

• an occupational health student is directly supervised by a SCPHN registrant from

the occupational health field of practice

• the placement is overseen by a health visitor practice teacher who meets with the
student and placement supervisor at agreed predetermined points to monitor the
student’s achievement

• the health visitor practice teacher (from the SCPHN part of the register together
with the SCPHN specialist supervisor from the specialist occupational health field of
practice) jointly assess overall proficiency within context of the SCPHN part of the
register and specific field of practice.

77
 PRACTICE TEACHER
(due regard to part of register but not SPECIALIST PLACEMENT
field of practice) SUPERVISOR
(Where insufficient practice
Confirmation of teachers)
INTERPRETATION specialist skills (due regard to field of
practice)
CONFIRMATION OF OVERALL [SAME PART OF THE
PROFICIENCY REGISTER]
(with due regard)

STUDENT

The placement supervisor and the overseeing practice teacher must both take
accountability for the confirmation of proficiency at the end of the placement or
programme.

N.B. The placement supervisor would normally be a registrant on the SCPHN part of
the register who would also be entered on the local mentor register.

Circumstances where due regard need not apply

There are two circumstances where due regard need not apply:

• in the common foundation programme within pre-registration nursing programmes

where the placement is not branch (field) specific. In these circumstances a
mentor from any part of the nursing register may confirm that outcomes have been
achieved.

• in formative placements where proficiencies/learning outcomes are not being

assessed.

Required action

Providers of nursing and specialist community public health nursing programmes may
now apply the principles in this circular in the application of due regard for the respective
parts of the register and fields of practice. In applying the principles, the most important
consideration is safety, public protection and confirmation of overall proficiency. This
requires the specialist placement provider, mentor/practice teacher and student to work
together in determining the overall practice assessment outcome.

All placement arrangements will continue to be monitored through existing practice

placement audit and quality assurance mechanisms.

78
This circular may be reproduced by all to whom it is addressed

This circular has been issued by:

Sarah Thewlis
Chief Executive and Registrar
Nursing and Midwifery Council

Circular: Applying due regard to learning and assessment in practice

for student midwives
Nursing and Midwifery Council Circular
Index Number: NMC Circular 02/2008
Issue Date: 25 January 2008
Review Date: 1 January 2010
Replaces: New Circular
Category: Midwifery
Status: Action

Summary

This circular:

• responds to challenges currently experienced in the application of due regard

in meeting the Standards to support learning and assessment in practice (NMC
August 2006) hereafter referred to as ‘the Standards’.

• sets out ways in which the principle of due regard may be applied more flexibly
without reducing the degree of rigour applied to assessing student competence.

Applying due regard to learning and assessment in practice for student midwives

This circular clarifies the principle of applying due regard in a safe and effective
way across a range of different placements where student midwives may achieve
competence. It should be read in conjunction with the Standards to support learning and
assessment in practice. The content of the circular should be applied with immediate
effect.

Due regard

The principle of due regard underpins the NMC Standards to support learning and
assessment in practice. Principle A (paragraph 1.2 of the Standards) states that NMC
registrants:

‘who make judgments about whether a student has achieved the required standards of
proficiency for safe and effective practice must be on the same part or sub-part of the
register as that which the student is intending to enter’

79
Existing application of applying due regard

Applying due regard is illustrated in the diagram below. In this model the student midwife
is placed with a midwife sign-off mentor (who must have achieved the NMC requirements
for sign-off). This person undertakes a number of functions. These include:

• managing the placement

• planning the student’s learning experiences

• working with them on a day-to-day basis.

In so doing, the midwife sign-off mentor develops an opinion on the student’s

performance and learning progression throughout a practice placement which may be
informed by the assessment of specific tasks and skills. Their opinion is also normally
informed by feedback from colleagues and evidence from other sources. This process
leads to a judgment being made as to whether the student has achieved competence by
reaching the requirements for safe and effective practice set out in the NMC Standards
of proficiency for pre-registration midwifery education.

The existing application of due regard

MIDWIFE SIGN-OFF MENTOR

(due regard)

CONFIRMATION OF PROFICIENCY

STUDENT

Applying due regard where mentors are available but do not meet NMC requirements
for due regard

There are circumstances where it is appropriate for a student midwife to gain

experience by being placed with someone form a different profession who would
feedback to the student and sign-off mentor.

The final judgement as to whether the student midwife has achieved the required
standard for safe and effective practice in relation to a particular aspect of the standards
of proficiency, is made by a midwife sign-off mentor with due regard ‘overseeing’ the
placement.

80
Applying due regard where mentors are available who do not meet NMC
requirements for due regard.

MIDWIFE SIGN-OFF MENTOR

Overseeing placement
(due regard)

Midwife sign-off mentor interprets skills Confirmation of MENTOR FROM A

in the context of midwifery
specialist skills DIFFERENT PROFESSION
(no due regard)
CONFIRMATION OF OVERALL
PROFICIENCY
(with due regard)

STUDENT

In applying the above framework, the most important consideration is safety, public
protection and confirmation of competence . This will be achieved by the mentor (no
due regard), midwife sign-off mentor overseeing the placement (with due regard) and
student working together in detailing the practice assessment outcome.

Action Required

• may be applied with immediate effect in relation to midwifery

This circular may be reproduced by all to whom it is addressed

This circular has been issued by:

Sarah Thewlis
Chief Executive and Registrar
Nursing and Midwifery Council

Circular: Ensuring continuity of practice assessment through the

ongoing achievement record.
Nursing and Midwifery Council Circular
Index number: NMC Circular 33/2007
Issue Date: October 2007
Review Date: October 2010
Supports: Standards to support learning and assessment in practice (NMC 2006)
Category: Standards
Status: Action

81
Summary

The circular sets out the principles for sharing of personal information necessary to
maintain continuity of assessment and to ensure safe and effective practice through
the ‘ongoing achievement record’. This forms part of the assessment of practice
arrangements for all approved programmes.

The Standards to support learning and assessment in practice (NMC 2006, page 30)
requires that:

‘An ongoing achievement record (student passport) including comments from

mentors, must be passed from one placement to the next to enable judgments to be
made on the student’s progress’.

The term ‘student passport’ is no longer being applied to this process due to
differing interpretations and meaning and will in future be referred to as the ‘ongoing
achievement record’.

Education providers must ensure that:

• student’s consent to the processing of confidential data about him or her to be

shared between successive mentors and with the relevant education providers in
the process of assessing fitness for practice.

• robust processes are in place to ensure that where there are issues or concerns
about a student’s progress that these are promptly and appropriately dealt with

• where there are serious concerns about a student’s health or character this should
be reported promptly using established University procedures

• students are actively supported in addressing issues and concerns through a well
defined and time limited development plan, either within a placement or across
successive placements.

• disabled students needs are assessed and student’s are appropriately supported in
addressing the requirements of any development plan.

Requirements

The vehicle for sharing information regarding student progress in practice settings will
normally be through the ‘ongoing achievement record’ that forms part of the assessment
of practice document.

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Consent

Legal advice relating to the Data Protection Act 1998 has confirmed that the NMC ‘is
perfectly competent to require the nurse to consent to the processing of confidential
data about him or her in the process of assessing her fitness to be a nurse’. This data
might include both ‘personal data’ and ‘sensitive personal data’ as described within
Sections 1 and 2 of the Data Protection Act 1998. (In this context ‘nurse’ relates to
student nurse and also applies to student ‘midwife’).

Should the student not consent to the sharing of confidential data, then this would
be incompatible with ensuring fitness for practice and therefore the student would be
unable to meet programme requirements.

Students must be kept fully informed regarding the ways in which information is
intended to be shared, used and stored, including the length of time it is to be retained
and when it will be destroyed.

‘Ongoing achievement record’

Education providers must ensure that:

• student’s consent has been obtained allowing the processing of confidential data
about him or her to be shared between successive mentors and with the relevant
education providers in the process of assessing fitness for practice.

• an ‘ongoing achievement record’, including comments from mentors is passed

from one placement to the next to enable judgements to be made on the student’s
progress.

• student concerns are addressed and where relevant shared with others, including
academic staff.

• sign-off mentors can access records of achievement to inform signing off

proficiency, confirming that ongoing competence and any concerns have been
addressed since the last progression point.

The ‘ongoing achievement record’ forms part of the assessment of practice document
and needs to be of sufficient detail to enable the sign off mentor to confirm proficiency
at the designated point of the programme. All actions must be taken with the full
knowledge of the student. Mentors should not keep their own separate student progress
records, everything should be contained within the assessment of practice document.

The following applies to all assessed placements but may be interpreted more flexibly
for placements of less than four weeks, or for observational experience:

• the student and mentor meet together at the end of a placement to document
strengths, development needs, and any concerns. The document to be shared with
the education provider.

• the student to be responsible for carrying the documentation from placement to

placement with copies retained by the education provider

83
• within 5 days of commencing a placement the documentation to be used by the
student and mentor to develop a development plan and set goals that take account
of strengths, issues and concerns raised in previous placements.

• regular meetings are scheduled to evaluate progress by student and mentor

throughout a placement, (involving academic staff when appropriate) at least at
the mid point and at the end of a placement where strengths and any issues for
development are addressed.

• a specific development plan to address needs and/or concerns can be established

at any point and must set out clear timescales for addressing the needs/concerns

• where a specific development plan has been put in place and concerns remain
then an evaluation session with the mentor must be urgently scheduled and others
involved as appropriate e.g. academic staff.

• where there are causes for concern a student representative might also be present.

Action Required

The above requirements apply to all NMC approved programmes and are effective from
the date of this Circular. They support the requirements set out within the Standards to
support learning and assessment in practice (NMC 2006)

This circular may be reproduced by all to whom it is addressed

This circular has been issued by:

Sarah Thewlis
Chief Executive and Registrar
Nursing and Midwifery Council

84
Contact us
Nursing & Midwifery Council
23 Portland Place
London W1B 1PZ
020 7333 9333
www.nmc.org.uk

Standards to support learning and assessment in practice was first published in August
2006. This second edition was published in July 2008. References to the Code have
been updated to The Code (NMC, 2015).

PB-STLAIP-A4-0708
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