Designing and reviewing a safe and effective learning environment and experience

Reference: LE2

Last Updated 01/03/2019

The AEI, with their practice learning partners, is responsible for ensuring that learning experiences support the student journey. It is up to the AEI, with its practice learning partners, to decide how this will happen. We do not specify how or in which environments learning can be carried out.

All learning experiences, including simulated practice learning environments must comply with the standards we set out in the relevant standards documents for each programmme.

We do not specify what governance systems must be in place or how they are applied, only that they must enable our standards to be met and public protection to be upheld.

In order to ensure a safe, effective and inclusive learning environment or experience programmes should be designed, developed, delivered, evaluated and co-produced with stakeholders including people who use services.

All learning experiences and environments must be designed and reviewed with the needs of students, and public protection in mind.  It is crucial to highlight the importance of local governance of practice placements and the role of local audit by both AEIs and practice placement provider partners in ensuring placements are providing safe and effective learning opportunities.

Find out more about designing and reviewing a safe and effective learning environment and experience in the following pages:

Safe learning environments, consent and balancing learning opportunities with public protection

Prioritising safety is important not only for the student but for any members of the public or people who use services they may come into contact with during their practice learning experience. All students should expect to be placed in a learning environment that is safe, and importantly people must have the right to refuse to be treated or have their care witnessed by a student. The person being cared for must give permission for this to happen, and their consent to this must be informed and obtained in a timely and kind way. If they refuse to give their permission, that decision must be respected and not be questioned as to why, for example, they have chosen not to give permission or have subsequently withdrawn their consent later.

When undertaking supervision of learning opportunities, the practice supervisor must always balance the needs of the student in undertaking learning opportunities to put their knowledge and skills into practice with the need to keep people safe. Not all students are the same, their learning experiences should be tailored to the stage of learning, proficiency and programme outcomes. It is helpful to discuss previous learning and work experience, for example as a healthcare assistant or registered professional. Their approach needs to be student centred.  Levels of proficiency and confidence should never be assumed.

As an example, if a student nurse wants to learn and practice the skill of cannulation the Practice Supervisor should firstly discuss with the student what they already know and have experienced around this skill. Next, the Practice Supervisor will need to be assured that the student has sufficient underpinning knowledge, this may include, for example, a discussion on aseptic technique or sharps disposal; and that it is within the organisation’s policy to permit students to undertake cannulation. The student also will need to be confident that they are able to progress to the practical application of the skill.

The Practice Supervisor would then select a person in their care that clinically needs this procedure and obtain consent from this person making it clear that the student will be performing the skill under direct supervision. The person receiving care must be informed that they are able to decline this, and this will not have consequences for their ongoing care, in line with the requirements of sections 2.5 and 4.2 of the Code.

The procedure would then take place under the direct supervision of the Practice Supervisor who will support the student, prompting if necessary. They should also use their professional judgement to intervene, either because the person is at risk of unnecessary pain, discomfort and distress or if the student is getting overly flustered. Communication and relationship management skills are vital to ensure that the confidence of the student is not diminished and the person receiving care does not suffer harm, undue alarm or loss of confidence and trust in the care they are receiving.

It will also be important for the Practice Supervisor to continually support the person in their care throughout the procedure and afterwards.  At their earliest opportunity they should support and engage with the student in encouraging them to reflect on their developing practice, what they did well and what needs to improve and why.

Relevant NMC standards for this section

Standards framework for nursing and midwifery education

R1.11: promote programme improvement and advance equality of opportunity through effective use of information and data

R1.12: ensure programmes are designed, developed, delivered, evaluated and co-produced with people who use services and other stakeholders

R1.13: work with service providers to demonstrate and promote inter-professional learning and working

S2.1: There are effective governance systems that ensure compliance with all legal, regulatory, professional and educational requirements, differentiating where appropriate between the devolved legislatures of the United Kingdom, with clear lines of responsibility and accountability for meeting those requirements and responding when standards are not met, in all learning environments.

S2.2: All learning environments optimise safety and quality, taking account of the diverse needs of, and working in partnership with, service users, students and all other stakeholders

R2.1: comply with all relevant legal, regulatory, professional and educational requirements

R2.2: ensure programmes are designed to meet proficiencies and outcomes relevant to the programme

R2.3: comply with NMC programme standards specific to the programme being delivered

R2.4: comply with NMC Standards for student supervision and assessment

R2.5: adopt a partnership approach with shared responsibility for theory and practice supervision, learning and assessment, including clear lines of communication and accountability for the development, delivery, quality assurance and evaluation of their programmes

R2.6: ensure that recruitment and selection of students is open, fair and transparent and includes measures to understand and address underrepresentation

R2.7: ensure that people who use services and representatives from relevant stakeholder groups are engaged in partnership in student recruitment and selection

R2.12: confirm that students meet the required proficiencies and programme outcomes in full, demonstrating their fitness for practice and eligibility for academic and professional award

R2.13: provide all information and evidence required by regulators

R2.14: regularly review all learning environments and provide assurance that they are safe and effective

R2.15: have the capacity, facilities and resources in place to deliver safe and effective learning opportunities and practical experiences for students as required by their programme learning outcomes

R2.16: be compliant with the NMC standards for education and training for all periods of learning undertaken outside the UK

R2.17: improve quality, manage risk and disseminate effective practice through the proactive seeking and appropriate sharing of information and data

R2.18: proactively identify and act on any areas for improvement, regularly measuring programme performance and outcomes against the NMC standards and requirements, and other recognised quality frameworks in education

R2.19: appoint appropriately qualified and experienced people for programme delivery

R2.20: identify programme leaders to confirm that all proficiencies have been met by each student by the end of their programme, and

R3.3: have opportunities throughout their programme to work with and learn from a range of people in a variety of practice placements, preparing them to provide care to people with diverse needs

R3.5: are supervised and supported in practice learning in accordance with the NMC Standards for student supervision and assessment

R3.6: are supervised according to their individual learning needs, proficiency and confidence

R3.8: are assigned and have access to a nominated practice assessor for a practice placement or a series of practice placements in addition to a nominated academic assessor for each part of the education programme, in accordance with the NMC Standards for student supervision and assessment

R3.14: are provided with the learning and pastoral support necessary to empower them to prepare for independent, reflective professional practice

R3.15: are well prepared for learning in theory and practice having received relevant inductions

R3.16: have opportunities throughout their programme to collaborate and learn with and from other professionals, to learn with and from peers, and to develop supervision and leadership skills

R3.17: receive constructive feedback throughout the programme from stakeholders with experience of the programme to promote and encourage reflective learning, and

R3.18: have opportunities throughout their programme to give feedback on the quality of all aspects of their support and supervision in both theory and practice

S4.1: Theory and practice learning and assessment are facilitated effectively and objectively by appropriately qualified and experienced professionals with necessary expertise for their educational and assessor roles.

R4.1: comply with all standards and requirements in the NMC standards for education and training

R4.2: act as professional role models at all times

R4.7: liaise and collaborate with colleagues and partner organisations in their approach to supervision and assessment

R5.5: curricula are co-produced with stakeholders who have experience relevant to the programme

Standards for student supervision and assessment

1.1: practice learning complies with the NMC Standards framework for nursing and midwifery education

1.2: practice learning complies with specific programme standards 

1.3: practice learning is designed to meet proficiencies and outcomes relevant to the programme

1.4: there are suitable systems, processes, resources and individuals in place to ensure safe and effective coordination of learning within practice learning environments

1.5: there is a nominated person for each practice setting to actively support students and address student concerns

1.6: students are made aware of the support and opportunities available to them within all learning environments

1.7: students are empowered to be proactive and to take responsibility for their learning

1.8: students have opportunities to learn from a range of relevant people in practice learning environments, including users of services, registered and non-registered individuals, and other students as appropriate

1.9: learning experiences are inclusive and support the diverse needs of individual students

1.10: learning experiences are tailored to the student’s stage of learning, proficiencies and programme outcomes, and

1.11: all nurses, midwives and nursing associates contribute to practice learning in accordance with the Code.