3.1 Involving service users in assessment
In response to health policy initiatives, the patient, service user or carer voice has become a fundamental concept in the quality assurance processes of both nursing practice and education (Casey and Clark, 2014). The NMC’s Standards for Pre-registration Nursing Education (NMC, 2010) requires that ‘programme providers must make it clear how service users and carers contribute to the assessment process’.
However, there are few empirical studies to suggest a robust mechanism to achieve effective service user feedback in practice assessment. This may be due to ethical implications of asking patients for feedback relating to student performance. Service users and relatives are vulnerable in care situations and should not be coerced to be involved with student assessment.
Activity 3 Gaining service user feedback
What factors do you think should be considered before asking a service user or carer for feedback relating to care delivered by a student?
Factors you might have considered could include:
- Patients may feel they are required to give ‘positive feedback’.
- Patients may feel ‘pressured’ into agreeing to give feedback and cannot say no.
- Patients may feel responsible for the ‘pass’ or ‘failure’ of the student.
- Patients may have concerns about their anonymity.
- Patients may feel too ill and weak to make an informed judgement.
- Relatives may feel that it will affect their loved ones’ care if they don’t comply.
- Relatives’ perceptions of care received may differ from those of the patient.
- Patients or relatives don’t understand what is expected of them.
- There may be bias in choosing patients; for example, only choosing patients who have the same language skills, culture or religion, or who are undemanding, don’t complain and have already expressed positive feedback about their care.
Despite these potential challenges, the literature does suggest that service users, carers and relatives can be instrumental in highlighting particular performance capabilities relating to the care they receive, such as privacy, compassion, dignity and communication skills (Atkinson and Williams, 2011). Service user and carer involvement can provide additional evidence to the mentor within the student assessment process as part of shared decision making.
- You may already have a tool or template in use within your practice environment or may consider developing one with relevant stakeholders, including patients, relatives and colleagues.
- Consider the use of both verbal and written feedback, including questionnaires or surveys that are specific with clear criteria or cue questions. There may be instances where it is appropriate for the student to be present when discussing an episode of care delivery with the service user or carer. In certain circumstances, you may wish to speak with the service user or carer alone to gain their feedback or ask them to complete a written feedback form.
- Patient selection should be considered carefully, and consent sought.
- Assure anonymity. You, as the mentor, should ask the service user for information or feedback – not the student.
- Consider the way you ask a service user for feedback. It may be appropriate to ask how they felt about the care delivery received and any suggestions for improvement.