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Practice Education Handbook

Bsc (Hons) Occupational Therapy [Athens]

2012-2013

List of Content
Topic Staff Contact Details Whats in a name? 1. Introduction 2. Responsibilities during practice education 2.1 Student 2.2 Practice educator 2.3 Personal academic tutor 2.4 Practice placement coordinator 2.5 Professional practise tutor 3. Organisation of practice placements 3.1 Practice placement delivery pattern 3.2 Practice placement locations 3.3 Travel and accommodation expenses 3.4 Practice placement allocation process 3.5 Models of supervision during practice placements 3.6 Working relationship between practice educators and students 3.7 Learning agreement 3.8 Reflective diary 3.9 Practice placement portfolio 4. Preparing students for practice placements 4.1 Practice education passport 4.2 Health clearance checks 4.3 Risk Management 4.4 Uniforms 4.5 Handbooks 4.6 Moodle 4.7 Workshops 4.8 Preceptor Education Programme 5. Guidance for practice educators and students: Fitness to practise 5.1 Fitness to Practise Panel 5.2 Monitoring students fitness to practise on the BSc (Hons) in Occupational Therapy 5.3 Disability and health-related issues 5.4 Professional unsuitability Page 5 6 7 7 8 9 9 10 11 12 12 12 13 13 14 14 14 15 15 15 15 16 16 16 16 17 18 18 19

Topic 6. Guidance for practice educators and students: Accountability issues during practice placements 6.1 Insurance 6.2 Health and safety during practice placements 6.3 Meeting religious and cultural practices of students 6.4 Criminal Conviction Checks 6.5 HPC Standards of Conduct, Performance and Ethics 6.6 Attendance policy during practice placements 6.7 Dress code during practice placements 6.8 Routine administration procedures 6.9 Punctuality 6.10 Confidentiality 6.11 Consent to occupational therapy 6.12 Using IT facilities during practice placement 6.13 Use of mobile phones during practice placement 7. Contact mechanisms with and support for students during practice education 7.1 Practice education handbook 7.2 Moodle 7.3 Support mechanisms for practice placement 7.4 Meetings and visits 7.5 Student counselling service 7.6 Practice placement debriefing workshops 8. Contact mechanisms with and support for placement providers and practice educators 8.1 Practice based learning support web site 8.2 Development of new placement sites 8.3 Individual support 8.4 Workshops 9.Learning outcomes for practice placement modules 9.1 Practice Placement 1 9.2 Practice Placement 2 9.3 Practice Placement 3 9.4 Practice Placement 4 10. Guidance for practice educators and students: How to support a student at risk of failing a placement

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Topic 11. Guidance for practice educators and students: How to complete the assessment report forms 11.1 Midway review 11.2 Final evaluation 11.3 Compiling the assessment form 11.4 Awarding an overall grade for a students performance during practice placement 11.5 Guidance for awarding an A grade 11.6 Receiving a failed grade on practice placement 11.7 Deferring a practice placement 11.8 Scheduling of a deferred or retrieval placement 11.9 Student evaluation of practice placements 11.10 Appeals procedure 12. Guidance for practice educators and students: Arrangements for submission of practice placement assessment forms to the University 13. Recommended reading lists for practice placements 13.1 Practice placement 1 13.2 Practice placement 2 13.3 Practice placement 3 13.4 Practice placement 4 14. Bibliography and reference list

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Staff Contact Details

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Name of Institution AKMI Metropolitan College Athens 74, Sorou Maroussi in collaboration with Queen Margaret University, Edinburgh Telephone +30 210 6199891 Fax +30 210 6199320

Staff Panagiotis Siaperas Nicolas Mazis Tatiana Xenou Eliza Maglari Polixeni Skaltsi Ioanna Tsipra Katerina Bourika George Koumantakis Christos Komissopoulos Staff Vicky Makellaraki Staff Ilias Verros

Teaching E-mail psiaperas@amc.edu.gr nmazis@amc.edu.gr txenou@amc.edu.gr TBA TBA TBA TBA TBA TBA School Office E-mail Notes vmakelaraki@amc.edu.gr School Office Administrator Learning Resource E-mail Notes verros@amc.edu.gr IT Resources Manager Liaison Librarian Notes Student Counsellor Student Finance Adviser

Emmanouela Aiginitou library@amc.edu.gr Staff Lina Drontza Student E-mail ldrontza@amc.edu.gr

Marilena Stasinopoulou msta@amc.edu.gr

Whats in a name?

Practice Placement

The practice area in which a student is educated for a stipulated period of time and where professional competence is assessed. The academic member of staff based at the higher education institution who co-ordinates the practice education elements of the programme. This includes the development of new placements and the education of practice educators An academic member of staff who acts as a contact person for a group of students and practice educators throughout a practice placement. The practice placement co-ordinator role normally includes the co-ordination of practice placements across a specific site/sector, liaising with the higher education institution and acting in an advisory capacity to practice educators and students as required during practice experiences This refers to the person supervising students whilst they are on placement. Normally, the practice educator is an occupational therapist who has completed a practice educators course and is familiar with the university assessment regulations and processes.

Professional Practice Tutor

Personal Academic Tutor

Practice Placement Coordinator

Practice Educator

1. Introduction
Welcome to the Practice Education Handbook and to the practice education 6

component of the BSc (Hons) in Occupational Therapy at AKMI Metropolitan College. The purpose of this handbook is to bring together the following information: An overview of practice education An overview of the roles and responsibilities of the student and supporting staff during practice placements Practice education is an integral core element of the curriculum enabling students to integrate theory and practice in a meaningful, reflective and realistic manner. Students have opportunities to apply, practice, consolidate and transfer existing skills and in addition, learn new skills relevant to each practice setting. Students also gain experience in practicing in a safe and ethical manner. In accordance with the World Federation of Occupational Therapists Standards (2002), students will gain experience of working with a range of different people who have wide ranging needs and in different circumstances. Normally, these experiences will encompass working with people of different age groups; individuals and groups/ communities from different socio-economic and cultural perspectives; people who have recently acquired and/or long standing occupational needs and health conditions affecting different aspects of physical and psychosocial functioning. Students will also develop skills in effective service delivery within inter professional, multi agency contexts. These may include both established and emergent services within the statutory, independent and voluntary sectors. Each practice placement module has a set of learning outcomes devised by Queen Margaret University (QMU) and followed by AMC. These outcomes articulate with prior and future university studies and, where appropriate, previous practice placement modules. Emphasis is placed upon the process of practice offering students the opportunity to explore and evaluate practice, and develop professional values to the level of competence required of an entry level practitioner. I hope that that practice education will prove to be a fulfilling and rewarding experience for everyone involved.

2. Responsibilities during practice education

This section of the handbook outlines the roles and responsibilities of the various individuals involved in practice education namely the student, practice educator, personal academic tutor, practice placement co-ordinator and the professional practice tutor. 2.1. Responsibilities of the student During practice education, students responsibilities are to: Assume responsibility for their learning using available resources. Discuss any planned absence with the programme leader in advance of the start date of the placement. Attend all preparatory placement activities on the appointed dates specified by the university. Prepare and maintain their practice education passport. Study and become conversant with the learning outcomes for each practice 7

placement, course assessment requirements and regulations for the practice education component of the programme. Read any pre-placement information materials provided or recommended by the practice educator. Abide by at all times the Health Professions Council Guidance on Conduct, and Ethics for Students. Abide by all health and safety at work issues and be cognisant of policies and procedures specific to the practice setting. Be responsible for any travelling and accommodation costs incurred to and from placement. Be punctual at all times and dressed appropriately as befitting for the placement setting and the work involved. Reflect the status of a team member and respectfully engage with other members of staff at the placement setting as appropriate. Inform the practice educator and AMC if it is not possible to attend placement for any reason. Collaborate with the practice educator to devise a learning agreement for each practice placement. Adhere to matters of patient/client confidentiality as advised by the practice placement setting and the University. Maintain a reflective diary and practice placement portfolio in accordance with the guidelines provided by the University. Be fully prepared for supervision sessions and contribute to the supervision process in a reflective manner. Contribute towards an on-line discussion forum with other students and staff. Contribute towards and actively participate in the mid way and final evaluations of their performance displaying openness to and acknowledgement of other peoples ideas. Contact AMC if there are factors adversely affecting their performance during practice placement. Complete the Student Evaluation of Placement Form and share this with the practice educator at the conclusion of the placement experience. Return copies of the Practice Placement Assessment Form and Student Evaluation of Placement Form to the School Office within 5 working days of completion of placement.

2.2. Responsibilities of the practice educator Practice educators (PE) play a key role in the professional development of occupational therapy students. Practice educators responsibilities are to: Obtain information on the learning outcomes for the specific practice placement, course assessment requirements and regulations for practice placements from the Practice-based Learning Support web site: http://mcs.qmu.ac.uk/PBL/ Forward pre-placement information to the student in advance of the start of the placement. This includes an overview of the service, clear directions and travel information, recommended pre-placement reading and any other information considered helpful. Offer the student an induction into health and safety at work at the start of the placement. 8

Review materials contained in the students practice education passport. Provide a timetable outlining the overall structure of the placement and the responsibilities of the student. Negotiate a supervision structure with the student incorporating the learning agreement as part of this process. Offer individualised constructive feedback to the student on a regular basis, identifying timing of feedback sessions. Maintain records of supervision sessions. Review the students practice placement portfolio at least once during the practice placement and offer verbal comment. Sign on a weekly basis time cards verifying number of hours completed by the student during each practice placement. Undertake the appropriate assessment of the student on practice placement and be conversant with the guidelines provided by AMC and QMU. Contact the students personal academic tutor if there are concerns pertaining to the students well being, behaviour or quality of performance over all. Take cognisance of comments made in each Student Evaluation of Placement Form and to use this as an integral part of a constructive evaluation process. Attend and participate in meetings, workshops associated with practice education. 2.3. Responsibilities of the personal academic tutor The personal academic tutor (PAT) is a lecturer from the programme team who acts as a named point of contact for a group of students and practice educators during a practice placement. Key responsibilities are: To offer support throughout the placement, responding to requests for advice and information from practice educators and their students, fielding any onsite problems, offering pastoral support and guidance as required. To negotiate an appropriate plan of action with the practice educator and student if there is a serious concern pertaining to the quality of the students performance, well-being and/or behaviour. To liaise with the professional practice tutor if concerns arise about a students performance during a practice placement. 2.4. Responsibilities of the practice placement co-ordinator The practice placement co-ordinator (PPC) plays an essential role in fostering a culture whereby practice placements are seen as a positive activity contributing towards staff continuing professional development and recruitment within the service. The practice placement co-ordinator: Collaborates with AMC to identify new placement opportunities alongside new service delivery developments. Co-ordinates the annual return of the AMCs health and safety forms. Co-ordinates the returns for AMC requests for placement offers where possible, within the timescale identified. Brings to the attention of AMC as soon as possible potential difficulties arising which may result in the cancellation of a placement. Co-ordinates responses to students letters of introduction/record of previous experience forms. 9

Ensures staff acting in their capacity as practice educators have adequate training and demonstrate ongoing commitment to their professional role. Offers support to practice educators taking into account the time and resources necessary for student supervision. Brings to the attention of AMC any issues creating difficulty on placement which may not be reported by the practice educator or student. Takes cognisance of comments made in each Student Evaluation of Placement Form and to use this as an integral part of a constructive evaluation process. Attends and participate in meetings, workshops and other events associated with practice education.

2.5 Responsibilities of the professional practice tutor The professional practice tutor (PPT) is responsible for the co-ordination, development and review of practice education within the framework of the BSc(Hons) Occupational Therapy curriculum. The professional practice tutors responsibilities are: To engage with local, regional, national networks to promote and facilitate the continuing sustainability of practice education within the occupational therapy curricula and across the broader profile of allied health profession programmes offered by the AMC Faculty of Health and Human Sciences. To collaborate with placement providers to comply with practice education guidance and standards provided by academic, regulatory and professional bodies. To plan and implement a range of mechanisms for the distribution and cascading of practice education documentation and information to practice placement co-ordinators, practice educators and students. To plan a comprehensive, balanced placement profile for each preregistration occupational therapy student ensuring that as far as is possible, satisfactory notice is given to the practice placement co-ordinators network, practice educators and students. To prepare students for their roles and responsibilities during practice education. To co-ordinate AMC contact mechanisms for students and practice educators during practice placements. To review each student's progress and placement grade as assessed and recommended by practice educators. To contribute towards the education of existing and potential practice educators. To take cognisance of feedback from all stakeholders in practice education and use this as an integral part of a constructive evaluation process.

3. Organisation of practice placements

3.1. Practice placement delivery pattern

The BSc (Hons) Occupational Therapy [Athens] programme employs two practice placement models. These are a full time, block placement model and an integrated model, where students undertake placements along with coursework in the same week. The integrated model is a well established
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model within health care courses and recognises the pivotal role of practice placements in the educational process. This framework maximises opportunities to synthesise theory and practice. The delivery pattern for practice placements is illustrated in Table 1.
Table 1: Practice placement delivery pattern for BSc (Hons) Occupational Therapy [Athens] Year of Placement Programme Year 1 Year 2 Year 3 Year 4 PPP1 PPP2 PPP3 PPP4 Semester 2 2 2 1 Duration 6 weeks f/t 8 weeks f/t 6 weeks f/t 8 weeks f/t Placement Days 30 days 40 days 30 days 40 days Hours 217 288 217 288

In order to meet standards established and monitored by professional bodies, it should be noted that by the end of Practice Placement 4 students must have successfully completed a minimum of 1000 hours of practice education (COT, 2008; WFOT, 2002). The exact number of hours is monitored through completion of weekly time cards. These are provided by AMC and are checked and signed by the practice educator on a weekly basis. Absence of a written record of the appropriate number of hours may result in students having to complete extra placement hours prior to graduation. If difficulties arise with placement hours, practice educators and students are actively encouraged to draw this to the attention of AMC so that a mutually acceptable plan of action can be developed.
Students are required by the professional bodies to complete a minimum of 1000 hours of practice education (COT, 2008; WFOT, 2002) and to honour the programme regulations. At the conclusion of each placement, students must retain and securely store their placement time cards. These may be required to validate placement hours at any time during the programme. Students may not book holidays during practice placement modules. Public holidays are not included in the overall placement hours. Hours gained from failed practice placements may not compensate for time lost in subsequent placements (COT, 2008).

3.2. Practice placement locations Placements are located in Athens in locations close to the campus thus ensuring that both students and practice educators can be effectively supported by the programme team. Students undertake placements in locations where there are established agreements in existence between AMC and placement providers. Placements will be in a diverse range of settings in preparation for the realities of practice and may include private hospitals, private rehabilitation centers, private psychology clinics, municipal health centers, cerebral palsy Greece. 11

Efforts will be made where possible, to accommodate the needs of disabled students, those who have family and caring commitments or students with exceptional circumstances through the allocation of practice placements within reasonable travelling distance of their place of residence. The responsibility is with the student to bring their circumstances to the attention of the professional practice tutor prior to the allocation of placements. 3.3 Travel and accommodation expenses There is no provision by AMC for accommodation whilst on placement. It is the students responsibility to arrange suitable accommodation for the duration of their placements using the information resources available in AMCs on line platform. 3.4. Practice placement allocation process Specific allocation of students to placement sites is completed normally 6 weeks before the start date of the placement and displayed in Moodle. The practice placement coordinators network is notified by post/e-mail when allocations have been completed for each practice placement module. Students forward a record of previous experience form and introductory letter to the relevant practice placement co-ordinator or specific placement site at least six weeks advance of each practice placement. AC students will have their Clinical Practice Placements at rehabilitation centers, psychiatric clinics, centers for treatment of cerebral palsy, which belong in their majority to the private sector and sign a contractual agreement with AMC. The students will enhance their portfolio with particular clinical cases that they undertake their intervention.

Students complete a practice placement planning form on-line and upload this to an electronic drop box in Moodle. The practice based learning team use this information to help inform the allocation process. Placements are allocated by the professional practice tutor according to the profile of students practice placement experience to date, their development needs and placement availability. Normally students would not be placed in a service where they have worked previously but in rotation to different available locations. Efforts are to be made where possible, to accommodate the needs of disabled students, those with family responsibilities and caring commitments or students with exceptional circumstances. There is no provision by C for accommodation whilst on placement. Yet, all placement locations have been chosen so as to be close to the AMC campus premises. Students are responsible for organising suitable accommodation for the duration of their placements.

3.5. Models of supervision during practice placements Within the context of the BSc (Hons) Occupational Therapy [Athens], a variety of supervision models are used throughout practice placements to provide flexible, supportive learning experiences (NHS Education for Scotland, 2007). Examples include: 3.5. 1. Apprenticeship model (1:1)

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One student per practice educator. The practice educator structures the student learning experiences and provides direct supervision and role-modelling to the student throughout the course of their placement. The degree of supervision and the amount of responsibility given to the student may vary, depending on the practice setting. 3.5. 2. Peer assisted learning model (2:1) One practice educator supervises two or more students. Here the emphasis is on peer and self-directed learning where the students support each other and work together and the practice educator acts as a resource, providing guidance to the student, monitoring performance and providing opportunity for the students to take increasing responsibility with service users. Benefits of this model include development of team-work skills, increased problem-solving skills and a sense of shared-ownership of the learning experience. 3.5.3. Split/Shared Model (1:2) In this model, the education of a student may be shared between two or more members of a team within a workplace. Combinations might include an experienced practice educator and a new practice educator; two practice educators from different organisations and the placement being structured around the patient journey for example, from primary to secondary care. This model may be an attractive option for practitioners who work parttime, or if the practitioners caseload is coupled with management responsibilities. 3.5.4. Project focused model This model is influenced by global drivers to prepare students for practice in a changing health and recognises the need for contemporary occupational therapists to possess skills and leadership for working preventatively within complex systems and whole populations (COT 2008; Scaffa 2010; Townsend & Polatajko 2007). Students are engaged to implement projects and /or undertake a key role in a developmental aspect of project work. Professional supervision is provided by an occupational therapist, this may be on a faceface basis, by distance via telephone and/or information technologies. Throughout the placement, an identified mentor at the host site co-ordinates the learning outcomes. Students may work in pairs or groups during these placements affording opportunities to realise the benefits of peer assisted learning. 3.6. Working relationship between students and practice educators during practice placements Students will work closely with their practice educators during practice placements. It is important to remember that practice educators first responsibilities are to service users and that in addition to facilitating students learning they have many additional responsibilities to deal with on a day to day basis. Giving consideration and thought to practice educators needs and responsibilities should enable the establishment of a good collaborative working relationship. In addition to ongoing informal supervision from the practice educator, normally, students receive a weekly formal supervision session during the full time placement. If these sessions are not forthcoming from the practice educator, it is the students right to request them. 13

Each practice placement module has a unique set of learning outcomes, devised by QMU and adhered to by AMC. These outcomes articulate with prior and future coursework and previous practice placement modules. Learning outcomes increase in complexity as the student progresses through the programme and each placement provides one of the building blocks for future ones. Practice educators collaborate with students to identify how AMC learning outcomes for each practice placement will be achieved and help the student to determine a clear pathway for achieving these through the development of a learning agreement. 3.7. Learning agreement For each practice placement students prepare a learning agreement in collaboration with their practice educator(s). This enables students to focus on aspects of practice in which they wish to have more experience and helps them to capitalise upon learning opportunities specific to each practice setting. Learning agreements foster the integration of theory and practice through their emphasis upon prior learning and exploration of the process and outcome of learning. Students negotiate and fulfil the learning objectives and are active partners in their own learning process. Consequently, there is shared responsibility for the outcome of the learning experience as students work in partnership with their practice educator(s) to try to secure a successful outcome. Students and practice educators are provided with access to the learning agreement handbook either through Moodle or QMUs Practicebased Learning Support web site at http://www.qmu.ac.uk/pbl/OccTherapyHome.htm 3.8. Reflective diary Students use reflective diaries as part of the process of learning and reflection and in preparation for supervision sessions with their practice educator(s). The diary in part, focuses on specific aspects of practice and students use it to plan and prepare for work. Students and practice educators have access to an electronic copy of the reflective diary handbook. 3.9. Practice placement portfolio As part of their professional development students compile a practice placement portfolio during placements using a pro- forma developed by the programme team. The use of portfolios gives students opportunities to evidence and reflect upon their learning. This process prepares students for using portfolios to evidence their continuing professional development after completion of their studies. Students and practice educators are provided with electronic copies of the portfolio handbook. 4. Preparing students for practice placements Approaches to assist students to prepare for placements are blended to allow flexibility of delivery and to accommodate for different learning styles. These include interactive workshops, group work, personal development planning, self evaluation activities, directed reading and e-learning. Key aspects of the preparation process will now be described in more detail below. 4.1. Practice education passport All students maintain a practice education passport. The passport has been developed 14

in consultation with placement providers and its primary goal is to enable students to assume responsibility for aspects of the placement preparation process. The Passport acts as a site for formal assessment by the University Practice-based Learning Team in order to verify that students have completed all of the compulsory preparation tasks before being permitted to go on placement. Students are required to collate documents, certificates and maintain records of having completed compulsory tasks and activities in preparation for progression to placement. It the students responsibility to present this evidence to the practice educator during the induction phase of placement. 4.2. Health Clearance Checks According to the regulations of the Greek Ministry of Education, all students have to deliver prior to their registration health clearance documents from a dermatologist, a pathologist, a psychiatrist and a chest CT at the beginning of each academic year. The same regulation applies to the teaching staff as well, to allow a teaching permit to be issued by the Ministry of Culture. Copies of the Health Clearance Documents are delivered to the relevant office of the Ministry supervising KEME (Centres of PostLyceum Education) and to AMC. 4.3. Risk Management Students receive introductory education and training upon a range of health and safety issues including: Manual handling legislation Risk assessment; moving and handling of objects and people Wheelchairs Walking aids

These topics are compulsory elements of the curriculum and occur prior to the first practice placement. Certificates of attendance are provided to students for retention in their practice education passport. 4.4. Uniforms AMC asks for the application of a strict dress code by all students, following hygiene rules, in laboratory and practical classes and at placements. Students are supplied uniforms bearing the AMC logo.

4.5. Handbooks Prior to Practice Placement 1 (PP1) students receive hard copies of the: Practice Education Handbook; Health Professions Council Standards of Conduct Performance and Ethics; Health Professions Council Guidance on Conduct and Ethics for Students; Health Professions Council Standards of Proficiency: Occupational Therapists; College of Occupational Therapists Code of Ethics and Professional Conduct. NHS Education for Scotland Quality Standards for Practice Placements All of these documents must be retained in the Practice Education Passport. Whilst students are not expected to read these materials all at once, they are required to read their contents and to refer to them during practice placements. 15

4.6. Moodle Practice placement modules are supported by the AMcs virtual learning environment Moodle. This provides a useful platform for the implementation of a phased approach to placement preparation. In addition each Moodle module area houses a bank of information resources and materials including useful web links, discussion areas, sources of accommodation, handbooks, assessment forms, templates for reflection and reading materials. 4.7. Workshops Interactive workshops facilitated by the professional practice tutor enable students to prepare for each practice placement. These tend to be incorporated into the Occupational Therapy Modules in level 1-3. Workshops focus upon topics salient to each practice placement such as: review of the aims for each placement and exploration of how these will facilitate the integration of theory and practice; professional conduct during practice placements; learning styles and the learning cycle; professional and clinical reasoning; review of the assessment format for each placement; preparation for and review of self evaluation on placements; developing and using learning agreements on practice placements; developing and using a professional development portfolio.

4.8. Preceptor education programme (PEP) for health care professionals and students Students are advised to complete this interactive on-line programme of study to complement the face-face pre placement workshops. Each module requires 45-60 minutes completion time including a reflective element. Students should download the module certificates of completion and store these in their practice education passport. Web link: www.preceptor.ca/

Table 2: Modules from the PEP Programme undertaken for each practice placement PEP Module PP1 PP2 PP3 PP4 x Orientation Developing (really useful) learning x objectives Giving and receiving informal feedback x Understanding and fostering clinical x reasoning Fostering reflective practice x Advanced reflective practice x Dealing with conflict x Formal evaluation processs x 16

5. Guidance for practice educators and students: Fitness to practise

5.1 Fitness to Practise Panel AMC has an obligation to ensure that graduates from its healthcare programmes are fit to practise. This means AMC needs to consider whether students: have a long-term health condition or disability which could prevent them from practising safely without supervision; have any criminal convictions or cautions which could make them unsuitable for registration; have demonstrated that they can maintain the standards of conduct expected of a health professional. Students studying to become a professional in a regulated profession have certain responsibilities and they are expected to meet high standards of conduct and ethics throughout their studies. They are advised that their behaviour on placement and in private life has the potential to affect their eligibility for registration with the Health Professions Council. If AMC becomes aware of an issue regarding a students behaviour it may initiate Fitness to Practise proceedings. Where there are serious concerns a Fitness to Practise Panel may be convened by QMU. The Fitness to Practise Panel has the authority to impose a range of sanctions including requiring a student to suspend study or even leave the programme (QMU, 2009).

5.2. Monitoring students fitness to practice on the Occupational Therapy [Athens] Fitness to practise is monitored through the following procedures: On Application 1. Each applicant must sign a health declaration.

BSc

(Hons)

2. Each applicant must comply with the AMC regulations regarding criminal convictions. During the programme 1. Students are required to declare whether or not they have a conviction or caution as part of the annual matriculation process. 2. Students are required to work within the framework of the Health Professions Councils Standards of Conduct, Performance and Ethics. 3. Students are required to complete an annual self- declaration of fitness to 17

practise form 4. Records of absence will be kept for each student noting the duration and the reasons for absence. Students must inform both the practice educator and University of any absences from placement. A supporting medical certificate needs to be obtained to cover absences of five working days or more from placement. 5. All students are expected to adopt a responsible attitude towards attendance at classes and practice placements. Punctuality is essential. 5.3. Disability and health issues Disabled students should experience the same broad range of practice settings as nondisabled students to enable them to demonstrate that they have achieved the learning outcomes for each placement. In this respect a physical or mental impairment includes sensory impairments, mental illness or mental health issues, specific learning difficulties such as dyslexia and conditions such as diabetes and epilepsy. Practice education involves a range of relationships, rights and responsibilities, some legal, and others negotiable between the student, AMC and placement provider. AMC acknowledges that not all information about a students disability or health problem may be relevant to placement providers and that information should normally be provided on a need to know basis. In some situations however, the implications of these may impact upon the placement provider and AMC may therefore be obliged to ensure that the information is passed on. For example where students are working with vulnerable groups there may be other health and safety considerations. Moreover provision of this information enables College staff to liaise with placement providers and arrange any necessary support or adjustments that students need to enable fulfilment of the learning outcomes of the placement. Students should keep their personal academic tutor or programme leader and practice educator informed of any changes to their health and disability status. AMC will seek to put in place measures to support students with health problems so far as is practical. It is essential that students discuss any concerns they may have with staff as early as possible. When a student goes to the AMC Disability Advisor to have an Individual Learning Plan agreed, they must consent to their information being passed on to the Programme Team. Disabled students are actively encouraged to meet with the AMC Disability Advisor to discuss their Individual Learning Plan including any necessary support or adjustments which may be necessary to enable them to meet the learning outcomes of each practice placement. Normally, requests for a meeting are initiated through the annual self declaration of health and disability procedure via Moodle. To protect service users safety, students must inform their practice educators and AMC immediately if they contract a communicable disease. Concerns raised by practice educators related to fitness to practice - which may 18

manifest as adverse reactions to clients/situations and may be related to health problems, are normally investigated by the Programme Leader. If the AMC Student Advisor becomes aware that a students medical condition may pose a risk to patient safety, the Programme Leader will be informed. If it is judged by the programme team that the student may not be safe to commence placement, or if a practice educator raises such a concern during placement, normally, a referral will be made to the Fitness to Practise Panel. In the interests of a students and/or service users safety, AMC may act to suspend a student temporarily pending the outcome of Fitness to Practise proceedings in order to remove the student from placement or prevent him or her from starting a placement. A student, who appears to have developed a health related problem during the programme that could affect fitness to practice, may be required to provide an independent medical report and /or occupational health assessment regarding his/her fitness to practise.

5.4. Professional unsuitability Professional unsuitability refers to observable behaviours and/or attitudes inferred from behaviour which make students unfit to enter, continue with or qualify from a professional programme of study (COT, 2010). If certain behaviours and/or attitudes are exhibited during practice placement by students then concerns may arise about their suitability for the profession. These may include: Actions that are likely to constitute an unacceptable risk to the student and others; Actions that are harmful to service users, staff or members of the public; Use of abusive language, obscene comments, verbal harassment, and comments or remarks that discriminate on the basis of sex, race or any other irrelevant distinction; Conduct that could bring into disrepute the reputation of the occupational therapy profession and is prejudicial to the best interests of service users; Breach of confidentiality, misuse of confidential material relating to a service user; Boundary violations with service users; Incapacity for work due to the influence of alcohol or use or possession of illegal drugs; Theft, deliberate misuse of or damage to equipment or materials; Being persistently unpunctual for placement; Inadequate standards of record keeping; Persistent absenteeism without good cause; Attitudes such as disloyalty, dishonesty, insensitivity, intolerance, irresponsibility, lack of commitment, lack of initiative, poor motivation, unreliability If a concern arises about a students behaviour and or attitudes during practice placement, the processes outlined below will be followed: 19

1. The practice educator should contact the students personal academic tutor immediately. Normally a meeting will be arranged and discussions will take place with both the practice educator and student. A summary of the meeting will be recorded on the link lecturers report form by the university member of staff. Copies of the link lecturers report will be forwarded to the programme leader, practice educator and the student. A copy of the report will also be retained in the students University file. 2. The students practice educator should identify and document areas causing concern and requiring improvement from the student within the supervision record. The student should be referred to the relevant sections of the Health Professions Council Guidance on Conduct and Ethics for Students (HPC, 2009) and the College of Occupational Therapists Code of Ethics and Professional Conduct (COT 2010). 3. In order that students are given reasonable opportunity for improvement the improvement period should be determined, taking into account: the time by which the student can reasonably effect an improvement; the practice educators need to make a suitable assessment of the improvement; the likelihood of any reoccurrence; any other factors relevant to the individual situation. 4. In order that students are given reasonable opportunity for improvement, the improvement period should be determined, taking into account: the time by which the student can reasonably effect an improvement; the practice educators need to make a suitable assessment of the improvement; the likelihood of any reoccurrence; any other factors relevant to the individual situation. 5. Any improvement must be sustained otherwise further action will be taken.

Formal stage This stage is for those behaviours that have not been resolved through the system described previously. 1. The issues that have arisen and consequent actions taken are referred to the Programme Leader. 2. The Programme Leader will discuss the current situation with the student and the practice educator and review the evidence available in collaboration with the Head of Division. 3. If the allegation cannot be resolved locally by the Programme Leader and AMC Director, the matter will be referred to the QMU academic link person who will arrange a contact with the student. At this point in the interests of service user safety the College may take action to suspend the student temporarily in order to remove them from the placement

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4. The QMU academic link person will then consult with the AMC Administration on whether or not the matter should be dealt with summarily or referred to a Fitness to Practise Panel 5. In cases where the conduct giving rise to concern is linked to a mental health condition the students case will normally be referred to the Fitness to Practise Panel as health matter 6. The Fitness to Practise Panel has the delegated authority to reach the following decisions listed below: The student continues on the programme; The student continues on the programme but is cautioned, meaning that if any further fitness to practise issues arise in the following twelve months, the student will be dealt with for both matters; The student continues on the programme subject to fulfilment of certain conditions as specified by the Panel; The student is required to suspend study to allow time for medical investigations (for cases where unacceptable behaviour is linked to a mental health condition); The student is required to suspend study for up to twelve months; The student is advised to transfer to an alternative programme; The student is required to withdraw.

6. Guidance for practice educators and students: Accountability issues during practice placements
During practice placements, students are accountable to the practice educator for issues concerning work within the placement setting. Students are advised that they remain accountable to AMC for the fulfilment of the learning outcomes for each practice placement module and the development of professional conduct 6.1. Insurance AMC ensures that for each practice placement there is adequate insurance cover. This is co-ordinated on an annual basis by the placement administrator. The AMC Health and Safety Checklist is forwarded to the professional practice co- ordinators who arrange for its completion and return to the placement administrator at AMC. It is the responsibility of the student/car owner to ensure that they have adequate insurance cover if using their car for travel during placement. A copy of the insurance policy certificate should be held in the practice education passport for inspection by the practice educator. 6.2. Health and safety during practice placements Many health and safety issues can arise within the practice. Some of these are more likely to be associated with certain client groups, for example children who have additional support needs, people with specific medical conditions or a physical disability. Students need to be aware that they may be faced with situations that require careful consideration and that in all clinics a high standard of hygiene must be maintained. Students who have questions about health and safety matters seek guidance from their practice educators, or their personal academic tutor as appropriate. All practice educators and students have a responsibility to ensure that 21

students on placement are appropriately aware of the health and safety regulations for each setting that they attend.

Practice educators should provide students with an induction into health and safety issues at the setting of the placement. This should cover issues such as fire regulations, first aid availability, protection of personal and service property and safety in care of patients, clients, staff and self. In addition the practice educator should provide students with information the placement providers equal opportunities and anti-discriminatory policy and any other policy specific to the placement setting. The practice educator has a duty of care towards all of the service users on their caseload and a responsibility for case management. Students undertake aspects of an occupational therapy process under the direction of the practice educator. It is inappropriate for students to take decisions regarding admission, discharge or referral of clients to other agencies, other than in consultation with the practice educator. Students are advised to observe and recognise the limits of their level of competence as they have a legal duty to be clear regarding competence if asked to undertake tasks beyond their ability. They should not be involved in procedures for which they have not received training. AMC must be informed immediately of any accident or health risk that may occur for the student or any service users and other people they are working with. Practice educators and students are advised to complete the placement providers internal accident or incident report forms as soon as possible. 6.3. Meeting religious and cultural practices of students during practice placements Organisations have policies which address diversity and inclusion and these apply to students accepted on placement. These policies include a commitment to: Promoting equal opportunity and diversity during employment Ensuring all employees are treated fairly and valued equally Ensuring that religious and cultural needs are valued and met Where students have particular religious or cultural needs in terms of requests ( e.g. time for prayers, national holidays, cultural dress) which may conflict with the working practices of the placement provider (e.g. health and safety issues in relation to dress code) consideration will be given, where possible to varying or adapting practices to enable such needs to be met. Agreements between the student and placement provider may occur prior to or at the outset of any placement as part of the induction process. The involvement of AMC may be required to ensure that the needs of both the student and the placement provider are being met. 6.4. Criminal Conviction Checks Applicants with serious criminal convictions, notably those convicted of violence, sexual or drug offences, may be excluded from programmes as they may be unable to undertake certain clinical education placements or find employment on completion of the programme. Exclusion should not however be automatic. Most ex-offenders are essentially law-abiding citizens and will not re-offend. In reaching a decision about an applicant, therefore, programme teams are asked to take into account the age, nature 22

and relevancy of the conviction, the applicants attitude to it and his or her achievements since the conviction. Dependent on the case students may be admitted to the programme, but would be informed that, subsequent progression to practice placements and successful registration with the HPC via the International route cannot be guaranteed. Students will be responsible for and required to declare any criminal convictions during their period of registration. All applicants will be obliged to complete and sign the criminal convictions sector in the application form. Important! Failure to provide your Criminal Record Document will result in a deferral of the practice placement.

6.5 Health Professions Council Standards of Conduct, Performance and Ethics While on placement it is expected that students will behave in a professional manner, adhering to the Health Professions Council Standards of Conduct, Performance and Ethics at all times. Practice educators who have concerns about a students conduct during practice placement are advised to contact the students personal academic tutor as soon as possible.

6.6. Attendance policy during practice placements Students and practice educators are advised that if any changes have to be made to scheduled placement dates then these must be approved by AMC. Any pre- arranged absence from placement requires be discussed with and approved by the programme leader. Planned absences will be allowed, only in exceptional circumstances. Students are expected to inform practice educators of any absences from placement due to ill health or personal circumstances as soon as possible on their first day of absence. Practice educators must be informed daily of any extended absence. If a student is absent from placement for 3 working days or more, it is essential that they communicate this to their personal academic tutor. Absences from placement for 5 working days or more must be supported by a medical certificate and forwarded to the programme leader at AMC. If a student chooses to withdraw from a placement without prior discussion and approval of AMC, normally a fail grade will be awarded for the practice placement module. However if extenuating circumstances occur which preclude prior discussion (such as serious illness or a sudden family bereavement) then a course of action will be mutually agreed. 6.7. Dress code during practice placements Students will be expected to conform to policy agreed within individual service settings. Practice educators will make these requirements known to students in advance of starting the placement. Some practice placement sites may require a uniform whereas in other settings smart, casual dress is the norm. AMC asks for the application of a strict dress code by all students, following hygiene rules, in laboratory and practical classes and at placements. Students are supplied uniforms bearing the AMC logo. 23

Students are advised to dress professionally (e.g. smart trousers, shirt and jumper) and for ease of movement wear comfortable clothing. Tight, short or low cut clothing would not be considered appropriate. Underwear should not be visible either through clothing or because outer clothing does not cover underwear adequately. Uniforms if worn during placement, must be clean and changed on a daily basis. Cardigans and sweatshirts worn for warmth should suit the colour of the uniform and these should be removed when working with service users. When a scarf or a veil is worn, students should ensure that the flow of the garment promotes effective communication and safe moving and handling. Scarves or veils should be changed on a daily basis. Footwear must be clean and in good repair, low heeled, closed toed rubber soled, non- pervious shoes are recommended. Black or navy shoes are preferable, however in some settings clean trainers of a non- pervious material are permissible. Socks should be plain in keeping with the colour of the uniform. Most placement sites will have a strict policy regarding the wearing of jewellery. This is for students safety as well as that of service users. Policies allow for religious/cultural observance -a ring (plain band) a bangle (plain) or a necklace worn next to the skin is allowed. Normally, one metal smooth studded earring per lobe is permitted. Body piercings and tattoos may cause concerns in some placement settings and consequently may need to be removed or covered up. Watches are permissible however these may need to be removed throughout the course of the day. Hair falling over the face during practical work is not acceptable and would require appropriate action. Hair should be tied back off the collar and nails kept clean and short. Nail polish, artificial finger nails or nail extensions should not be worn within the placement setting. Name badges must be visible and worn at all times, some settings may also require an additional security pass. These may be removed if they will injure a service user on close contact and then re-applied. A student whose personal appearance is deemed to be inappropriate by the practice educator or most senior member of staff present in the practice area may be asked to leave the practice setting and reported absent until they return dressed appropriately. Placement hours may be deducted for this absence.

6.8. Routine administration procedures Students are expected to make themselves aware of and abide by service standards relating to the carrying out of routine administrative task. Discussion will typically cover the practice educators recommendations about duties such as answering the telephone writing up case notes, filing, keeping statistics, booking transport other administrative duties. 6.9. Punctuality Some service users receiving occupational therapy attend on a timed appointment basis, with service standards specifying a protocol which has to be followed if they are kept waiting beyond a maximum time. All students are therefore expected to be
24

punctual, beginning and ending sessions on schedule to ensure the smooth running of the service. 6.10. Confidentiality Students are required to adhere to service providers guidelines and policies on confidentiality during their practice placements. Confidentiality of service users must be respected and protected at all times and information should only be used for the purpose for which it was given. Service user case notes and records, are the property of the placement provider they must be kept physically secure and must never be removed from the placement setting. Any written work completed for the placement should be stored as a confidential record. It is expected that students will maintain the boundaries of confidentiality outside their placement both in discussions, presentations and written course work for AMC. Names should never be mentioned when discussing clients with other students, in seminars or in students written work. The identity of service users, staff and the organisation hosting the placement must be protected and permission for the use of case material sought following the policies and guidelines of the placement provider. Data must be anonymised, for example name, address, date of birth, full post code and any other details that might reveal the identity of a service user must be removed Information obtained from service users files for case studies, presentations, portfolio activities or session plans is confidential. Service users must be anonymised by use of pseudonyms which are clearly marked as such. Staff members must be referred to by their role rather than name and the placement provider in general terms rather than by name of institution. 6.11. Consent to occupational therapy Gaining a service users consent to occupational therapy is a fundamental aspect of practice and as such is contained within both the Health Professions Council Standard of Conduct Performance and Ethics as well as the College of Occupational Therapists Professional Standards for Occupational Therapy Practice. Students and practice educators are advised to ensure that service users are fully informed of the students status and have given their permission for interventions to carried out by a student. 6.12. Using placement providers IT facilities during practice placement Students are responsible for familiarising themselves with the local regulations to ensure that they do not abuse the IT facilities offered to students on placement. Computer pass words must be kept secure. Any computer facilities offered to students during placements are provided for academic work only, i.e. for use in learning and pursuit of their studies. They must not abuse these facilities for any other purpose, e.g. playing computer games, excessive social use of e-mail, or for recreational internet use. Health sciences students studies may involve internet searches drawing upon on anatomical terms and phrases. This may generate unwanted links to objectionable websites. Students are advised to use wherever possible, specific health science related search engines which have been recommended by the QMU and AMC teaching staff . 25

Students may accidentally access internet sites they did not mean to. This might happen because they have clicked on a misleading link, they clicked on a link by accident, or because a site has been hijacked. They may also find that they get bombarded by unsolicited and explicit pop-up advertising. If any of these things happen whilst students are out on placement, they should: Take a note of the URL (web address) of the site and the time it was accessed Tell someone immediately. If possible, show them what happened Record the details of the site accessed, before logging off the computer. Tell their practice educator as soon as possible Tell local IT staff (any alerts regarding inappropriate internet use will go to them first) Contact their personal academic tutor at AMC to advise them of what has happened

6.13. Use of mobile phones during practice placements Organisations offering practice placements may have a policy regarding the use of mobile phones, including camera phones, stating where and in what circumstances such devices are permitted or prohibited. In general, if students cannot see a sign permitting the use of mobile phones, it should be assumed that their use is prohibited. Where the use of mobile phones is permitted, students must ensure that the ring tone is switched to low volume, or vibrate or the silent mode is enabled on the device. Students are advised that service user confidentiality, privacy and dignity must be maintained at all times. They must never use mobile camera phones to take photographs and video recordings of service users during practice placement. Mobile phones may interfere with the operation of medical equipment therefore students wishing to use a mobile phone are advised to temporarily relocate to an area designated as being safe for this purpose.

7. Contact mechanism with and support for students during practice placements
The programme team is committed to students learning experiences being one that facilitates an active and interactive process that promotes intellectual autonomy. Attention is paid to fostering their abilities to be self- directed learners during practice education. 7.1. Practice education handbook The practice education handbook, which is issued prior to PP1 covers a range of issue and topics relating to practice placements. It also contains the e-mail addresses and contact telephone numbers for all of the post graduate programme team. 7.2. Moodle Each Moodle placement module houses a bank of useful practice-based learning resources and materials for students. Resources include web links, handbooks, assessment forms, templates for reflection and reading materials. 26

7.3. Support mechanisms for practice placement 1 All practice placements, are full time (8 hours) per day. Study time will be needed for preparation of work for the placement as well as reflection and written work relating directly to the placement (portfolios etc). Moodle provides a forum for group support and communication throughout all practice placements. Students participate in on-line discussions facilitated by their personal academic tutors at designated points throughout the placement. Guidance on how to prepare for and participate in these on-line discussions is given in preparatory sessions held at AMC. Activities are designed to promote a community of learners, facilitate the development of students self-assessment skills and foster attitudes which value continuing professional development. Personal academic tutors encourage active knowledge sharing amongst the cohort through the use of peer generated feedback. 7.4. Meetings and visits If there are concerns about a students performance and well- being during practice placement a meeting can be arranged at the request of either the practice educator and/or the student. A student who fails a practice placement will be offered individual meetings with the professional practice tutor to prepare a personal development plan for a retrieval placement 7.5. Student counselling service Students experiencing any personal difficulties while on placement are encouraged to use the College Student Counselling Service. This service is confidential and sessions can be arranged to suit the students timetable. All students are welcome to use the service, which can also provide information on other sources of help that may be more appropriate. 7.6. Practice placement debriefing workshops A practice placement debriefing workshop is held at the concluding phase of each placement offering students a further opportunity to integrate the experience of practice placement context with the learning environment of AMC. Students evaluate their personal and professional development with the professional practice tutor, discuss relevant issues and prepare for future practice placements.

8. Contact mechanisms with and support for placement providers and practice educators
Links between the AMC environment and the practice community underpin the design of the BSc (Hons) in Occupational Therapy [Athens]. Practice education is a dynamic phenomenon requiring innovative flexible support mechanisms that are reflective of the rapidly changing nature of health and social care, including the growing use of information technology. 8.1. Practice-based learning support web site This web site was developed in 2008 by the QMU School of Health Sciences. It is a school wide resource and the occupational therapy page sits along side other programmes in the School. The web site has been designed to help make the role of placement supervision easier by providing links to useful websites related to practice27

based learning, along with electronic versions of all the forms that practice educators need for practice placements. We hope that this resource will prove useful and supportive, and we welcome any recommendations from practice educators for further developments to the occupational therapy section of the web site.

Practice based learning support web site This can be accessed via the following link: http://mcs.qmu.ac.uk/PBL/ Click on Occupational Therapy then, BSc (Hons) Occupational Therapy

8.2. Development of new placement sites Practical advice is available from AMC to services considering the feasibility of offering practice placements to occupational therapy students from AMC

8.3. Individual support During practice placements the students personal academic tutor is available via email and/or telephone to answer any queries. Additional support and guidance is available to practice educators who are working with marginal students and very able students. AMC staff may arrange three way meetings at the request of the practice educator.

8.4. Workshops A variety of day workshops for practice educators have been developed by the AMC programme team according to the QMU standards. Normally they are delivered on campus. Workshops cover aspects such as: Overview of the occupational therapy curricula Models of supervision during practice placement Developing objectives for practice placements Giving feedback and writing practice placement assessment reports Supporting disabled students on practice placement From reflection to reflexivity Conceptual models of practice Fitness to practise

9. Learning outcomes for practice placements

9.1. Practice Placement 1 (PP1) Year 1: Professional Practice Placement 1 Year of Placement Programme Year 1 PPP1 Semester 2 Duration 6 weeks f/t Placement Days 30 days Hours 217 28

Professional Practice Placement 1 (PPP1) offers students the first opportunity of learning in a practice setting. They are acquiring knowledge and a repertoire of skills for functioning in practice placements. Students observe, practice and reflect on their performance. They take an active role with clients, applying knowledge and developing professional reasoning skills The focus of PPP1 includes opportunities to: gain an understanding of occupational therapy in one practice context establish the foundations for safe, effective and ethical professional practice establish the foundations of continuing professional development establish the foundations of effective professional communication initiate the development of professional skills, attitudes and values reflect upon and evaluate personal performance exploring how the major concepts and principles of occupational therapy relate to practice gain exposure to service users with a range of health conditions and social circumstances examine the relationship between occupational performance, health and well-being 9.2. Practice Placement 2 (PP2) Year 2: Professional Practice Placement 2 Year of Placement Programme Year 2 PPP2 Semester 2 Duration 8 weeks f/t Placement Days 40 days Hours 288

Professional Practice Placement 2 (PPP2) encourages students to draw upon and integrate knowledge from their university based studies and previous learning from PPP1. During this placement they actively contribute to the practice setting. Emphasis is on practice and experience of the occupational therapy process, problem solving and communication. The focus of PPP2 includes opportunities to: experience an area practice significantly different from that encountered in PP1 participate in safe and effective service delivery further develop appropriate professional skills, attitudes and values reflect on and evaluate personal performance continue to evidence professional development

9.3. Practice Placement 3 (PP3) Year 3: Professional Practice Placement 3 (PPP3) 29

Year of Placement Programme Year 3 PPP3

Semester 2

Duration 6 weeks f/t

Placement Days 30 days

Hours 217

The third practice placement provides the students with the opportunity to broaden and consolidate their knowledge of practice. Students gain a greater degree of autonomy, adopting a co-worker role with their practice educator and assume joint responsibility for active service provision. This placement will enable students to: gain a greater degree of autonomy in the work setting actively participate in all aspects of service delivery demonstrate an analytical approach to all aspects of service delivery explore how research findings might be integrated into practice reflect on and evaluate personal performance continue to reflect and build evidence of professional development observe and, where appropriate actively participate in work in an inter professional / multi agency setting.

9.4. Practice Placement 4 Year 4: Professional Practice Placement 4 (PPP4) Year of Placement Programme Year 4 PPP4 Semester 1 Duration 8 weeks f/t Placement Days 40 days Hours 288

During this final placement students will be expected to demonstrate a competent level of attainment in all aspects of practice and that they have the knowledge, skills and attitudes appropriate for practice now and in the future. This placement will enable students to: work as independently as possible at pre-registration level assimilate and synthesize knowledge and skills prior to completion of studies provide evidence of independence in all aspects of learning effectively integrate research findings into practice enhance the development of an analytical approach to all aspects of practice realistically evaluate effectiveness of interventions effectively contribute to multi professional and inter agency working reflect on and evaluate professional performance 30

10. Guidance for practice educators: How to support a student at risk of failing a practice placement
Whilst being relatively rare, students failing practice placements does happen and can be a very stressful situation for all concerned. These guidelines are aimed at reducing some of the stresses and ensuring that a fair process is in place to help support the student and practice educator concerned. A student who is considered to be at risk of failing a placement should be made aware of this no later than the mid way evaluation. AMC should also be notified in order to plan for timely support. Once students are aware of practice educators concerns, they have the opportunity to improve their performance. This should enable students to reflect on their performance and with the support of practice educators develop strategies to overcome the difficulties experienced. Students may continue to fail in the same competencies if they do not respond to feedback given or are unable to change their performance sufficiently/consistently. The points below outline the process of assisting a student at risk of failing a PP. Any concerns about the students performance should be raised with the student and discussed and factually documented during supervision. A supplementary supervision form may assist in the discussion and recording of such issues. The word fail must be clearly used in this discussion and the practice educator should provide examples where there are gaps in the students existing repertoire of knowledge/skills and attitudes. Students should discuss issues that might be impacting on their performance with their practice educators. The student does not have to disclose personal details but is encouraged to reveal sufficient information for the practice educator and student to assess any potential impact on the students performance. Students are advised to disclose health issues that may be affecting their performance whilst on placement. Practice educators are advised to contact the students personal academic tutor if they have serious concerns about a students performance and would like additional support. The personal academic tutor will negotiate a plan of action for providing support and guidance for the student and practice educator. The personal academic tutor, student and practice educator should identify: Reasons for the student failing Areas of strength Clear objectives for improvement in areas of weak performance A time to review progress The practice educator, student and personal academic tutor should collaborate to identify required changes in the students performance. The development of an action plan including SMART objectives (specific, measurable, achievable, realistic/relevant and time related) for improvement in areas of 31

weak performance provides a means of clarifying if/when sufficient change in performance has occurred. These objectives can be recorded on a learning agreement form. Following the discussion and development of a collaborative plan of action the personal academic tutor will contact the practice placement within an agreed time frame to assess progress and provide ongoing support to the student and practice educator. The student should be encourage to use reflection as much as possible to allow them to assess their own performance giving some focus to where things go well as well as those where performance has not been so good. Practice educators should document areas of both unsatisfactory and adequate/sound performance in order to record concerns more formally for evidence at supervision and the half way and final reports. This information should be shared with the student. If the student has not been able to retrieve their performance by the final evaluation then the practice educator should ensure that that the verbal and written comments are in line with the QMU grade descriptors and that the student is left with a clear picture of where their performance did not meet expected levels. A member of the AMC programme team can also be present at this discussion if felt appropriate. A student who has failed a practice placement will be offered an individual meeting with the professional practice tutor for formal debriefing session(s) and to discuss and prepare for the retrieval of the failed placement.

11. Guidance for practice educators and students: How to complete the assessment report form
Practice educators and students are provided with hard and electronic copies of the practice placement assessment forms. These can be used throughout the placement as a basis for discussion between to help students with self-reflection on their own performance. The purpose of the assessment process is to:To provide feedback to students on their performance To identify strengths and weaknesses in the students professional practice and modify learning accordingly To provide a basis for discussion in relation to the students performance To provide a documented record of students level of competence in relation to their stage of education Assessment of learning on practice placements may be by direct observation, discussion, written evidence, feedback from colleagues, service users and the students own self- evaluation. Practice educators complete an evaluation of students learning and performance in five core areas: 32

Professional Development Professional Communication Skills Occupational Therapy Process Integrating Knowledge into Practice Organisation and Management 11.1 Mid way review (formative assessment) The midway review takes the form of a discussion between the practice educator and the student. It guides the actions to be taken by the practice educator and student during the remainder of the placement. Areas requiring further development and priorities to be addressed in the second half of the placement should be highlighted. At this stage new learning objectives may be formulated. Written comments only should be made on the assessment form. The purpose of these comments is to provide feedback to students so that they can gain an appreciation of their strengths and weaknesses, giving them the opportunity to modify and/or further develop specific aspects of their performance before completing the placement. Students are expected to prepare for the midway review by completing the students comments sections for each of the five core areas and discuss their comments and any other issues relating to the placement with the practice educator. This selfassessment process contributes towards the development of students professional judgement by encouraging them to reflect on their practice and identify evidence of meeting their learning objectives. Both the practice educator and student must sign and date their midway review comments on the report form.

11.2. Final evaluation (summative assessment) The final evaluation should be completed at least one day before the end of the practice placement and discussed with the student. This provides the student with the opportunity to review the report before signing it and returning it to the practice educator. Written comments should be made in the practice educator comments sections of each core area of the form and these must be signed and dated. In addition, for each of the criterion practice educators are asked to place a cross in the middle of one of the boxes between the X and Y axes that best represents their judgement of the students level of performance in relation to his/her stage of the course. This must be completed with reference to the University Grade Descriptors provided in the final section of the assessment form. Practice educators are advised to refer to the descriptors before undertaking this task. Where a particular criterion is not applicable to the practice setting or where the student has not been assessed on a particular criterion, then N/A should be inserted in the grid. AMC requests that practice educators document the reason(s) for lack of opportunity in the practice educator comments section. Students are expected to prepare in advance for the final evaluation and complete 33

the students comments sections for each of the five core areas. All student comments must be signed and dated. 11.3. Compiling the assessment form The following list of points is intended to assist practice educators in the compilation of the assessment forms. Feedback should be: 1. Individualised and relevant, demonstrating empathy and attention to the particular development needs of the student, rather than comparing with or generalising to other students. 2. Goal-directed, providing assistance and increased understanding of what is expected or required, with a focus on the needs of the clients and relationship to the learning goals of the student. At the mid-way appraisal learning objectives may need modification or new ones developed. It is helpful to summarise the key points in the practice educators comments section in the form of a development/action plan. 3. Behaviour- focused, rather than personality focused. Feedback that refers to what the student does, allows scope for change. 4. Respectful, demonstrating mindfulness of acceptable boundaries, respecting confidentiality and using language that is non-judgemental. 5. Balanced, comment on strengths and what the student did well with areas of weakness or that require further growth. Written feedback should be constructive and structured so that students are clear about specific aspects of their performance requiring further development and/or improvement. 6. Collaborative, inviting student involvement and agreement in identifying strengths and weaknesses, in seeking solutions, reaching conclusions and formulating plans for future action, facilitating self-evaluation. 7. Change focused (non-evaluative), exploring specific strategies to maintain strengths and improve weaknesses and facilitating a problem-solving approach that highlights the consequences both positive and negative of particular behaviours or actions. Encourage improvement with practical and specific suggestions and evidence required from the student to demonstrate further achievement. 8. Factual (not generalised), providing evidence-based examples based on observed performance that highlight actual strengths and weaknesses of modifiable behaviours that have been observed. Provide specific suggestions for improvements to what students are doing, or occasions where positive behaviour was demonstrated, and discussing outcomes of each behaviour. 9. Aligned to the university grade descriptors. Check for congruence between written comments and the actual grade(s) awarded 11.4. Awarding an overall grade for students performance during practice placement Assessment forms are graded in the range A-G in accordance with the Queen 34

Margaret University criteria for undergraduate modules (QMU, 2010). In assigning an overall grade, practice educators must refer to the University Grade Descriptors provided on the assessment forms and identify the final grade awarded by circling one of the grades on the front page of the assessment form. Students who are awarded a grade D or above by the practice educator, are considered to be safe in practice and will pass the placement. The final grade is subsequently converted into a percentage by the professional practice tutor in line with University grade to mark conversion rules. (QMU, 2010). Practice educators should always bear in mind that they are making a judgement about the students performance in relation to what is reasonably expected of a student at that level of the programme and not in comparison with a qualified occupational therapist.

Grade A: Outstanding performance In allocating this grade the practice educator is recognising an outstanding performance. For the stage of the programme, the student shows exceptional ability, an excellent, safe performance has been consistently demonstrated throughout the majority of the placement. Grade B: Very good performance In allocating this grade the practice educator is recognising a very good performance. For the stage of the programme, a very good standard has been demonstrated. A very good, safe performance, consistently demonstrated throughout the majority of the placement. In awarding a grade in this range the practice educator will be looking for essentially the same kind of evidence as used for the A banding, but will mark in this range where the evidence is not as strong in relation to each of the five core categories. The students performance does on the assessment form. Grade C: Average performance In allocating this grade the practice educator is recognising an average performance. For the stage of the programme, an average performance has been demonstrated, i.e. a performance typical of a student at this stage of the programme. A good, safe performance consistently demonstrated for the majority of the placement. Grade D: Satisfactory performance In allocating this grade the practice educator is recognising a satisfactory performance. For the stage of the programme the students performance is satisfactory and safe, consistently demonstrated for the second half of the placement.

On assessment a student who achieves a grade D or above, is considered to be safe in practice and will pass the placement Grade E: Fail In allocating this grade the practice educator is recognising an unsatisfactory performance. The student has required significant additional support and guidance 35

than is expected of a student at this stage in the programme. The student has failed to achieve some of the AMC learning outcomes for the practice placement and is demonstrating unsafe practice on a regular basis. Grade F: Poor fail In allocating this grade the practice educator is recognising a clear failure. A poor attempt to address the issues of practicing within this area that does not meet the criteria for an acceptable performance in a significant number of areas. The student has failed to achieve a significant number of learning outcomes for the practice placement. Grade G: A bad fail In allocating this grade the practice educator is recognising a clear failure. The student has failed to achieve the majority of the University learning outcomes for the practice placement

11.5. Guidance for allocating an A grade A student may achieve higher grades in the practice placement modules than in the college-based modules. Occasionally this may be an inaccurate representation due to:Pressure from the student to increase the grades Wishing to reward the student for fitting in to the placement area particularly well Misinterpretation of the University grade descriptors The following is a list of points to assist in the evaluation process:Keep written records of A standard performance in the five core areas. These might have been observed by the practice educator or reported by other members of staff. Ask the student to provide his/her own examples of A standard performance. If the student is achieving the equivalent of an A standard performance at the midway evaluation, the practice educator should contact AMC and ask to speak to the professional practice tutor. Keep students informed of this process so that they are aware they need to consistently demonstrate evidence of an A standard performance. It is hoped that these guidelines will ensure greater rigor in the allocation of an A grade, contributing towards the assessment process by providing a second objective viewpoint. Ultimately it is the practice educators responsibility to evaluate the students performance and allocate a grade that represents the abilities and aptitudes of the student in relation to the marking criteria.

Practice educators experiencing difficulties reaching a final decision are actively encouraged to contact the AMC Practise Placement Co-ordinator. 11.6 Receiving a fail grade on practice placement A student who fails a placement will be permitted one attempt only to retrieve a failed practice placement module. The hours of failed practice education will not count 36

towards the minimum requirement of 1000 hours. If the module is ultimately failed and retrieval processes for the module have been exhausted then the student will be asked to withdraw from the programme. A student may also be denied the opportunity to retrieve the module if the failure originally occurred on grounds of professional unsuitability (COT, 2008). 11.7. Deferring a practice placement Students who are unable for legitimate reasons to undertake the placement at the allotted time or who have to withdraw from placement for such reasons as ill health will have a placement arranged at a deferred time. This will count as a first attempt. 11.8. Scheduling of a deferred or retrieval practice placement Normally, a retrieval or deferred practice placement will occur over the summer before the student may progress to the next level of the programme. 11.9. Student evaluation of practice placements At the conclusion of each placement students complete an evaluation of placement form and discuss its content with their practice educators. The purpose of this evaluation is offer constructive feedback to the practice educator, the placement provider and AMC to enable ongoing enhancement of the learning environment. A copy of this form should retained by the placement provider. A copy of this form should also be forwarded to AMC by the student 11.10. Appeals procedure A student wishing to appeal against a decision in practice education may do so by following the procedures and practices set out in the Academic Appeals Regulations (QMU, 2010). An appeal may be considered if: Information is provided that was not and could not have been reasonably made available at the time the undertaking of the practice placement; There was a material irregularity in the conduct of the assessment process during the practice placement. Appeals should be submitted in writing to the Academic Registrar within 21 days of completion of the practice placement. The students statement should provide the following information in support of the appeal: name and matriculation number; up-to-date contact address for correspondence, including e-mail address; title and year of programme ; result being appealed; the grounds for appeal, supporting evidence and remedy being sought.

12. Arrangement for submission of the practice placement assessment forms to AMC
The return of the practice placement assessment form and student evaluation of practice placement form to AMC is the responsibility of the practise placement tutor. These forms must be submitted the assessment box in the University School Office 37

Reception within five working days of completion of placement. Practice educators are asked to ensure that students are given a master copy of the completed assessment form before leaving the placement site. The practice placement team cannot respond to requests from students for copies of completed practice placement assessment forms at a later date. At the conclusion of each placement, students must retain and securely store their placement time cards. These may be required to validate placement hours at any time during the programme. Absence of a written record of the appropriate number of practice placement hours may result in students having to complete extra placement hours prior to graduation. 13. Recommended reading lists for practice placements 13.1. Practice Placement 1 Atwal, A., & Jones, M. eds. 2009. Preparing for practice in health and social care. [on-line book] Chichester: Wiley-Blackwell. Bossers, A., Bezinna, M.B.,Hobson, S. Kinesella, A., MacPhail, A., Schurr, S. , Moosa, T., Rolleman, L., Ferguson, K., Deluca, S., Macnab, J. & Jenkins, J. 2007. Preceptor Education Program (PEP) for Health Care Professionals and Students. URL: http://www.preceptor.ca Duncan, E.A.S. 2009. Skills for practice in occupational therapy. Edinburgh: Churchill Livingstone. th Duncan, E.A.S. ed. 2011. Foundations for practice in occupational therapy. 5 ed. Edinburgh: Churchill Livingstone Healey, J. & Spencer, M. 2008. Surviving your placement in health and social care: A student handbook. Maidenhead: Open University Press. Health Professions Council. 2009. Guidance on conduct and ethics for students. London: Health Professions Council. Health Professions Council. 2008. Standards of conduct, performance and ethics. London: Health Professions Council. Hull, C., Redfern, L. & Shuttleworth, A. 2005. Profiles and portfolios: a guide for nd health and social care. 2 ed. Basingstoke: Palgrave McmIllian. Iwama, M.K. & Turpin, M.J. 2011. Using occupational therapy models in practice: a field guide. Edinburgh: Churchill Livingstone rd Thompson, N. 2009. People skills. 3 ed. Basingstoke: Palgrave McMillan.

13.2. Practice Placement 2 Atwal, A., & Jones, M. eds. 2009. Preparing for practice in health and social care. [on-line book] Chichester: Wiley-Blackwell. Bossers, A., Bezinna, M.B.,Hobson, S. Kinesella, A., MacPhail, A., Schurr, S. , Moosa, T., Rolleman, L., Ferguson, K., Deluca, S., Macnab, J. & Jenkins, J. 2007.Preceptor Education Program (PEP) for Health Care Professionals and Students. URL: http://www.preceptor.ca College of Occupational Therapists. 2007. Professional Standards for Occupational Therapy Practice. London: College of Occupational Therapists. Duncan, E.A.S. 2009. Skills for practice in occupational therapy. Edinburgh: Churchill 38

Livingstone. Gahye, T. & Lilleyman, S. 2006. Learning journals and critical incidents: reflective nd practice for health care professionals. 2 ed. London: Quay Books Healey, J. & Spencer, M. 2008. Surviving your placement in health and social care: A student handbook. Maidenhead: Open University Press. Health Professions Council. 2009. Guidance on conduct and ethics for students. London: Health Professions Council. Health Professions Council. 2008. Standards of conduct, performance and ethics. London: Health Professions Council. Laver Fawcett A.J. 2007. Principles of assessment and outcome measurement for occupational therapists and physiotherapists: theory skills and application. [on-line book]. Chichester: John Wiley & Sons Sumsion, T. ed. 2006. Client centred practice in occupational therapy: a guide to nd implementation. 2 ed. Edinburgh: Churchill Livingstone.

13.3. Practice Placement 3 Atwal, A., & Jones, M. eds. 2009. Preparing for practice in health and social care.[online book] Chichester: Wiley-Blackwell. Bossers, A., Bezinna, M.B.,Hobson, S. Kinesella, A., MacPhail, A., Schurr, S. , Moosa, T., Rolleman, L., Ferguson, K., Deluca, S., Macnab, J. & Jenkins, J. 2007.Preceptor Education Program (PEP) for Health Care Professionals and Students. URL: http://www.preceptor.ca Boyt Schell, B.A. & Boyt Schell, J.W. eds. 2008. Clinical and professional reasoning in occupational therapy. Philadelphia: Lippincott Williams and Wilkins. College of Occupational Therapists. 2007. Professional Standards for Occupational Therapy Practice. London: College of Occupational Therapists. Duncan, E.A.S. 2009. Skills for practice in occupational therapy. Edinburgh: Churchill Livingstone Sinclair, K. Facets of clinical reasoning. In: Creek, J. & Lawson Porter, A. eds. 2007. nd Contemporary issues in occupational therapy: reasoning and reflection. 2 ed. [online book]. Chichester: John Wiley & Sons. Healey, J. & Spencer, M. 2008. Surviving your placement in health and social care: A student handbook. Maidenhead: Open University Press. Health Professions Council. 2009. Guidance on conduct and ethics for students. London: Health Professions Council. Health Professions Council. 2008. Standards of conduct, performance and ethics. London: Health Professions Council. Taylor, R.R. 2008. The intentional relationship: occupational therapy and the use of self. [on-line book]. Philadelphia: F.A.Davis Co.

13.4. Practice Placement 4 nd Fazio, L.S. 2008. Developing occupation centred programs for the community.2 ed Pearson/Prentice Hall: Upper Saddle River, NJ. Flecky, K. & Gitlow, L. eds. 2011. Service learning in occupational therapy education: philosophy and practice. Sudbury, Mass: Jones & Bartlett Publishers Health Professions Council. 2008. Standards of conduct, performance and ethics. London: Health Professions Council. Health Professions Council. 2007. Standards of Proficiency: Occupational Therapist. London: Health Professions Council. K Kronenberg, F., Pollard, N. & Sakellariou, D. eds. 2011. Occupational therapies 39

without borders Volume 2: Towards an ecology of occupation-based practices. Edinburgh: Churchill Livingstone Elsevier. Lorenzo, T. 2006. Practice and service learning in occupational therapy: enhancing potential in context. [on-line book] Chichester: John Wiley. Pollard N., Dikaios, S. & Kronenberg, F. eds. 2009. A political practice of occupational therapy. Edinburgh: Churchill Livingstone. Scaffa, M.S., Reitz, M.S. & Pizzi, M.A. 2010. Occupational therapy in the promotion of health and wellness. Philadelphia: F.A.Davis Co. Townsend, E.A. & Polatajko, H.J. 2007. Enabling occupation II: advancing an occupational therapy vision for health and well being. Ottowa: Canadian Association of Occupational Therapists

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14. Bibliography and references Atwal, A. & Jones M. eds. 2009. Preparing for practice in health and social care. [online book] Chichester: Wiley-Blackwell. College of Occupational Therapists. 2010. Code of ethics and professional conduct. London: College of Occupational Therapists. London: College of Occupational Therapists. College of Occupational Therapists. 2010. Occasional Paper 2: Professional suitability. London: College of Occupational Therapists. College of Occupational Therapists. 2009. Curriculum guidance for pre-registration education. London: College of Occupational Therapists. College of Occupational Therapists. 2008. College of Occupational Therapists prerd registration education standards.3 ed. London: College of Occupational Therapists. College of Occupational Therapists. 2006. Developing the occupational therapy profession: providing new work-based learning opportunities for students. London: College of Occupational Therapists. College of Occupational Therapists. 2004. Guidance on disability and learning. London: College of Occupational Therapists. Crowther, C. 2008. Uniform policy. NHS Lothian Disclosure Scotland. 2010. Protection of Vulnerable Groups Scheme. [on-line] Available from: www.disclosurescotland.co.uk/guidance/index.html [Accessed 6 January 2011]. Duncan, M. & Alsop, A. 2006. Practice and service learning in context. In: Lorenzo, T., Duncan, M., Buchanan, H. & Alsop, A. eds. Practice and service learning in occupational therapy: enhancing potential in context. Chichester: John Wiley & Sons. Fortune, F., Farnworth, L. & McKinstry, C. 2006. Project-focussed fieldwork: core business or gap fillers? Australian Occupational Therapy Journal, 53 pp. 233-236. Healey, J. & Spencer, M. 2008. Surviving your placement in health and social care. Maidenhead: Open University Press. Health Professions Council. 2010. Guidance on conduct and ethics for students. London: Health Professions Council. Health Professions Council. 2009. Guidance on health and character. [on-line] London: Health Professions Council. Available from: http://www.hpc- uk.org/assets/documents/ 10002C17Guidanceonhealthandcharacter.pdf [Accessed 3 September 2010] Health Professions Council. 2009. Standards of education and training. London: Health Professions Council. Health Professions Council. 2009. Your guide to our standards for continuing professional development. [on-line] London: Health Professions Council. Available from: http://www.hpc-uk.org/assets/documents/1000119FShort_guide_to_CPD.pdf [Accessed 3 September 2010] Health Professions Council. 2008. Standards of conduct, performance and ethics. London: Health Professions Council. Health Professions Council. 2007. Standards of proficiency: occupational therapists. London: Health Professions Council. Health Professions Council. 2007. A disabled persons guide to becoming a health professional. [on-line] London: Health Professions Council. Available from: http://www.hpc- uk.org/assets/documents/ 1000137FAdisabledperson'sguidetobecomingahealthprofes sional.pdf [Accessed 3 September 2010]. Hocking, C & Ness, N,E. 2002. Revised minimum standards for the education of occupational therapists. Sidney: World Federation of Occupational Therapists. Kronenberg, F. & Pollard, N. 2005. Overcoming occupational apartheid: a preliminary exploration of the political nature of occupational therapy. In: Kronenberg, F., Algado, S.S. & Pollard, N. eds. Occupational therapy without borders: learning from the spirit of survivors. Edinburgh: Elsevier Churchill Livingstone. NHS Education for Scotland. 2010. Stakeholder statement in support of practice placements for allied health professions in Scotland. [on-line] NHS Education for 41

Scotland. Available from: http://www.nes.scot.nhs.uk/media/690620/stakeholder_statement.pdf [Accessed 5 September 2010] NHS Education for Scotland. 2010. Enhancing the quality of AHP practice education. [on-line] NHS Education for Scotland. Available from: http://www.nes.scot.nhs.uk/media/503687/final_web_enhancing_quality.pdf [Accessed 5 July 2010]. NHS Education for Scotland. 2008. Quality Standards for practice placements. [online] NHS Education for Scotland. Available from: http://www.nes.scot.nhs.uk/media/503691/qspp_leaflet.pdf [Accessed 5 June 2010] NHS Education for Scotland. 2007 Models of practice placement for the allied health professions: a guide. [on-line] NHS Education for Scotland. Available from: http://www.nes.scot.nhs.uk/media/2863/models_version2apr07.pdf [Accessed 5 July 2010] NHS Lothian. 2008. Guidance on the use of mobile communication devices in health care premises. NHS Scotland. 2008. NHS Scotland Dress Code. [on-line] NHS Scotland: Scotlands Health on the Web (SHoW). Available from: http://www.show.scot.nhs.uk/publications/publication.asp?name=&org=%25&keywor d=NHS+Scotland+Dress+Code&category=1&number=10&sort=tDate&order=DESC& Submit=Go [Accessed 3 September 2010] NHS Scotland. 2003. NHS Code Of Practice On Protecting Patient Confidentiality. Edinburgh: Scottish Executive. Queen Margaret University. 2009. Fitness to practise policy. [on-line] Available from: http://www.qmu.ac.uk/quality/gr/default.htm#pol. [Accessed 20 January 2010] Queen Margaret University. 2008. Disability policy. [on-line] Available from: http://www.qmu.ac.uk/quality/qm/AZindex.htm#d [Accessed 18 August 2010] Queen Margaret University. 2010. Academic appeals regulations. [on-line] Available from: http://www.qmu.ac.uk/quality/qm/AZindex.htm. [Accessed 3 September 2010] Queen Margaret University. 2010. Assessment regulations. [on-line] Available from: http://www.qmu.ac.uk/quality/qm/AZindex.htm. [Accessed 3 September 2010] Queen Margaret University. [no date]. Using Computers On Placement. [on-line] Avail. from: http://www.qmu.ac.uk/quality/qm/AZindex.htm. [Accessed 20 Sept. 2010] Scaffa, M.S., Reitz, M.S. & Pizzi, M.A. 2010. Occupational therapy in the promotion of health and wellness. Philadelphia: F.A.Davis Co. Scottish Credit Qualification Framework. 2007. The SCQF Handbook. [on-line] Available from: http://www.scqf.org.uk/AbouttheFramework/LevelDescriptors.aspx. [Accessed 17 December 2009] Scottish Government. 2008. Health Clearance For Tuberculosis, Hepatitis B, Hepatitis C And HIV For New Health Care Workers In Direct Contact With Patients. Edinburgh: Scottish Government. Townsend, E.A. & Polatajko, H.J. 2007. Enabling occupation II: advancing an occupational therapy vision for health and well being. Ottowa: Canadian Association of Occupational Therapists Townsend, E. & Whiteford, G. 2005. A participatory occupational justice framework. In: Kronenberg, F., Algado, S.S. & Pollard, N. eds. Occupational therapy without borders: learning from the spirit of survivors. Edinburgh: Elsevier C. Livingstone. Tuning Occupational Therapy Project Group. 2008. Reference point for the design and delivery of degree programmes in occupational therapy. Bilbao: Publicaciones de la Universidad de Deusto. Whiteford, G. 2004. Occupational issues of refugees. In: Molineux, M. ed. Occupation for occupational therapists. Oxford: Blackwell Publishing. Wood, A. 2005. Student practice contexts: changing face, changing place. British Journal of Occupational Therapy, 68(8) pp. 375-378. Quality Assurance Agency. 2007. Code of practice for the assurance of academic quality and standards in higher education:9 Work-based and placement learning. Gloucester: Quality Assurance Agency Quality Assurance Agency. 2001. Subject benchmark statements: occupational therapy. Gloucester: Quality Assurance Agency 42