Two more assignments submitted and suddenly I'm halfway through the course. Everyone told me that the time would fly past and they were right, it really has flown. I'm looking back at all I've done and learnt and feeling quite proud of myself and yet I can still look at all there is to learn and feel overwhelmed by it all. Over the past 18 months I have seen a variety of women with very different needs,and a variety of different midwives with different ways of working. I've seen normal births and I've seen births that needed high levels of expertise in order for mother and baby to survive - all of which I have learnt from. Sometimes it can feel like what we do at Uni, is a distant cry from what we do on placement. After all our first 18 months of training has been focused on normality but of course what we see on placement can be very different. One thing I have learnt is that remaining focused on what is normal, helps to identify when something isn't within the realms of normality.
A simple example of this is when we first palpate the uterus to see what position the baby is in, in a woman who is 40 weeks pregnant. Focusing on normality, we would expect the baby to be in a head down position so if the baby is not in that position, we can identify this and then act appropriately. At the beginning of my training I didn't really have a clue what position the baby was in but with practice I soon began to be able to tell. I even managed to identify a baby in the breech position. As I've continued in my training, I've become more and more confident and even at an earlier stage of pregnancy, can often identify the position. That said, I am not afraid to say when I'm not sure and to ask the midwife I am working with to have a feel and see what she thinks. It's essential to be comfortable enough to say "I don't know". There is no shame in not knowing something, there is shame in pretending that you do.
It's not unknown for a doctor to request a second opinion and I've witnessed qualified midwives ask for another midwife's opinion. Yet I know it can be difficult to say 'I don't know'. I'd say it's probably more difficult at the beginning of your training because you don't know yet whether or not you should know the answer and whether you'll look foolish if you don't know. I still maintain that you look far more foolish if you pretend to know the answer....you will get caught out. These days when I come across a term I don't know - usually when booking someone, they mention a medical condition I've never heard of - I'll ask the midwife I'm working with, or I'll look it up. We can't know everything after all.
So if you are about to start your first placement then there is your first bit of advice - don't be afraid to say you don't know something. BUT don't wait for someone else to find out for you - look it up - google is your friend!
Showing posts with label assessment. Show all posts
Showing posts with label assessment. Show all posts
Tuesday, 4 October 2011
Tuesday, 9 November 2010
Assessment, Assignments and Exams
I have now had half of my results for the year, thankfully all passed, and it's got me thinking about the different ways in which we are tested. Before even getting into University we all had to pass a Maths and English test and it has felt a bit like we've been constantly tested since then. So I thought I'd tell you all a bit more about the tests that we've had to do and how I have "survived" them.
Academic Skills - 2000 word assignment.
I enjoyed this assignment in some ways and in other ways it frustrated me. The assignment was, depending on our prior experience, teaching/reminding us how to write an essay and how to source references. We also had sessions on how to do Harvard Referencing and four activities designed to help us so that by the time we came to actually write our assignment we'd done most of the work already. For the assignment itself we had to summarise our chosen article and then write about how we it links to our future role. Finally we had to talk about the academic skills we had learnt in the process. I enjoyed it from the perspective that I actually enjoy writing essays and I enjoy doing further reading. I felt frustrated because I was limited by it in so many ways. I would have enjoyed exploring the focal point of my article some more but it wasn't what the assignment was for. That said I am thoroughly enjoying researching my psycho-social assignment which is my next one due in.
Practice Assessment Document (PAD)
I have made reference to this book before. This is the book we carry everywhere with us on placement. For each placement that we do we have key areas that we have to achieve e.g. supporting women to breastfeed in challenging circumstances, recognise the onset of labour, be the initial port of contact for pregnant women, competently provide information regarding screening etc... You'll have to excuse me a little here as my book is currently with my personal tutor so I have had to rely on my memory and I couldn't recall exactly how they were written. When I first got my book and I looked through everything that we had to get signed off, it felt so overwhelming. Once on placement it almost felt even more overwhelming. The opportunity to get anything looked at let alone signed off, felt very remote. However I soon learnt you had to find the right balance of forceful, respectful and keen. However it is important to note that the balance can be different for everyone that you work with. I certainly found it far easier to get my book signed once I was into the Community part of my placement. Anyway for each section of our PAD we have to have at least one formative assessment before the summative assessment is done and a mark awarded. The mark given definitely depends on who you are working with, not just your ability and it seems that our mentors were every bit as confused as us; however in their defence it is a fairly new way of doing it so they are still learning too.
Exam - Biological Basis of Health.
A 2 hour exam consisting of 25 multiple choice questions, a midwifery specific diagram and 4 midwifery specific short answer questions. Now I am the first to admit that Biology is not my strong point. When I was at school and was choosing my options (is that showing my age or do they still call it that?) I could choose whatever I wanted. I wanted to do a science but knew it wasn't my strong point so I went to my teachers in turn to ask their advice. They each advised me not to take their subject......and this was a grammar school. looking back I think that says more about the teachers than it does me but hey that was then and this is now. So having said that I do sometimes wonder whether I was really that bad or more that I wasn't good enough. Either way it has left me with this feeling that I am no good at science. Having said that I think I have a good enough understanding of where things are in my body, and how the reproductive system works, and there are certain parts of our lectures I have found easier than others. Anyway to cut a long story short, I studied hard for my exam. Of all my assessments, exams are what I dread the most.
Other students have often asked how I revise and I can only tell you what I do and say that it works for me. During lectures I take extensive notes even if they tell me it's going to be put up on our portal system. Following the lectures, I head to the library and type up my notes (not always immediately before anyone thinks I am a complete geek, I actually tend to do big chunks at a time) and when I reach a part that I've written that I don't understand I can reach for a book and read up some more so that I do understand it. I may include flow charts so that I can see that x leads to y and so on and so forth. I won't say it leads to me remembering it all but it does help and it does mean I understand it better.
Drugs Calculation Test
We had two weeks in which we had to log in and answer 20 drugs calculation questions. We were allowed to use a calculator and perform the test wherever we liked, although they did request that we did it on our own. In the two weeks preceding we could access practice tests so that we could get used to the format and the kinds of questions we'd be asked. We did have to get 100% to pass but in all honesty, would you want me to be correct with drugs calculations anything less than 100%? I wasn't nervous about the test; I hadn't had any problems with the practice questions after all. I guess the only thing I was worried about was making a silly mistake or misreading the question. It would be too difficult to misread mg as mcg or similar. Thankfully I passed first time but I was surprised by how nervous I was when I was doing it.
So what's left for this year? My next task is my Psycho-Social assignment, then my Values assignment and then my PAD for my second placement this year. Oh and I almost forgot, we have a poster presentation as part of our Psycho-Social this Friday; although it's not graded.
My advice to current students and future students is plan early! For us, we were given all our assignment details early, so I started to think about them early. I have had to plan my study time around my children and family commitments. When we had only one lecture in a day, I didn't go home, I went to the library. This gave me time to rewrite parts I wasn't happy with. It also gave me time to look through the assessment criteria and see if I had covered all I needed to. With my revision notes for the Biology exam, starting early meant I was re-covering things rather than learning things for the first time.
Academic Skills - 2000 word assignment.
I enjoyed this assignment in some ways and in other ways it frustrated me. The assignment was, depending on our prior experience, teaching/reminding us how to write an essay and how to source references. We also had sessions on how to do Harvard Referencing and four activities designed to help us so that by the time we came to actually write our assignment we'd done most of the work already. For the assignment itself we had to summarise our chosen article and then write about how we it links to our future role. Finally we had to talk about the academic skills we had learnt in the process. I enjoyed it from the perspective that I actually enjoy writing essays and I enjoy doing further reading. I felt frustrated because I was limited by it in so many ways. I would have enjoyed exploring the focal point of my article some more but it wasn't what the assignment was for. That said I am thoroughly enjoying researching my psycho-social assignment which is my next one due in.
Practice Assessment Document (PAD)
I have made reference to this book before. This is the book we carry everywhere with us on placement. For each placement that we do we have key areas that we have to achieve e.g. supporting women to breastfeed in challenging circumstances, recognise the onset of labour, be the initial port of contact for pregnant women, competently provide information regarding screening etc... You'll have to excuse me a little here as my book is currently with my personal tutor so I have had to rely on my memory and I couldn't recall exactly how they were written. When I first got my book and I looked through everything that we had to get signed off, it felt so overwhelming. Once on placement it almost felt even more overwhelming. The opportunity to get anything looked at let alone signed off, felt very remote. However I soon learnt you had to find the right balance of forceful, respectful and keen. However it is important to note that the balance can be different for everyone that you work with. I certainly found it far easier to get my book signed once I was into the Community part of my placement. Anyway for each section of our PAD we have to have at least one formative assessment before the summative assessment is done and a mark awarded. The mark given definitely depends on who you are working with, not just your ability and it seems that our mentors were every bit as confused as us; however in their defence it is a fairly new way of doing it so they are still learning too.
Exam - Biological Basis of Health.
A 2 hour exam consisting of 25 multiple choice questions, a midwifery specific diagram and 4 midwifery specific short answer questions. Now I am the first to admit that Biology is not my strong point. When I was at school and was choosing my options (is that showing my age or do they still call it that?) I could choose whatever I wanted. I wanted to do a science but knew it wasn't my strong point so I went to my teachers in turn to ask their advice. They each advised me not to take their subject......and this was a grammar school. looking back I think that says more about the teachers than it does me but hey that was then and this is now. So having said that I do sometimes wonder whether I was really that bad or more that I wasn't good enough. Either way it has left me with this feeling that I am no good at science. Having said that I think I have a good enough understanding of where things are in my body, and how the reproductive system works, and there are certain parts of our lectures I have found easier than others. Anyway to cut a long story short, I studied hard for my exam. Of all my assessments, exams are what I dread the most.
Other students have often asked how I revise and I can only tell you what I do and say that it works for me. During lectures I take extensive notes even if they tell me it's going to be put up on our portal system. Following the lectures, I head to the library and type up my notes (not always immediately before anyone thinks I am a complete geek, I actually tend to do big chunks at a time) and when I reach a part that I've written that I don't understand I can reach for a book and read up some more so that I do understand it. I may include flow charts so that I can see that x leads to y and so on and so forth. I won't say it leads to me remembering it all but it does help and it does mean I understand it better.
Drugs Calculation Test
We had two weeks in which we had to log in and answer 20 drugs calculation questions. We were allowed to use a calculator and perform the test wherever we liked, although they did request that we did it on our own. In the two weeks preceding we could access practice tests so that we could get used to the format and the kinds of questions we'd be asked. We did have to get 100% to pass but in all honesty, would you want me to be correct with drugs calculations anything less than 100%? I wasn't nervous about the test; I hadn't had any problems with the practice questions after all. I guess the only thing I was worried about was making a silly mistake or misreading the question. It would be too difficult to misread mg as mcg or similar. Thankfully I passed first time but I was surprised by how nervous I was when I was doing it.
So what's left for this year? My next task is my Psycho-Social assignment, then my Values assignment and then my PAD for my second placement this year. Oh and I almost forgot, we have a poster presentation as part of our Psycho-Social this Friday; although it's not graded.
My advice to current students and future students is plan early! For us, we were given all our assignment details early, so I started to think about them early. I have had to plan my study time around my children and family commitments. When we had only one lecture in a day, I didn't go home, I went to the library. This gave me time to rewrite parts I wasn't happy with. It also gave me time to look through the assessment criteria and see if I had covered all I needed to. With my revision notes for the Biology exam, starting early meant I was re-covering things rather than learning things for the first time.
Sunday, 24 October 2010
A week at Uni
I began the week feeling very nervous about my exam. I was glad to have no lectures on the Monday so I could spend the whole day studying. My husband dropped me off at the library straight after we dropped our eldest off at school and I got straight down to work. The first thing I decided to do was my drugs calculation test; as I wasn't concerned about it, I thought I'd get it out of the way. I was more nervous doing it, than I expected to be so I made sure to take my time, read every question twice and double checked each answer. Thankfully I passed it first time so I could then forget about it.
Tuesday we had a full day of lectures and meetings which none of us really wanted, as we'd rather have been preparing for the exam. In fact there were quite a few empty chairs. We began the day with a cohort meeting although it was meant to be a skills lecture, we ended up switching the two around. The cohort meeting gave us an opportunity to raise any issues that had come up over placement, problems we'd come up against and also to celebrate our successes. It seems that the difficulties were things that had come up time and time before. There were quite a few girls that had had problems having their books signed off - that their mentors would repeatedly put it off, and then it would be too late. There also seemed to be a huge variation in the marks we'd been given. There is a mark guide and we'd been advised to explain that the mark scheme was based on us as first years and therefore we'd possibly need to push for higher marks if we felt we deserved it. Unfortunately some mentors would mark us as first years assuming the marking criteria would remain the same over the three years and wouldn't listen to any opinion given by the student. It certainly made me realise how lucky I had been with my mentor and how I'd been marked for my placement.
There was also some discussion about the attitude towards students from some of the midwives. It's very obvious those that are happy to work with students and those that aren't. Simply put it is an essential part of their job but like any job I guess, everyone has parts they don't want to do....doesn't make it easy for us as students however. We talked quite a lot about the different ways we had handled it and hopefully it will help us for our future placements.
We then had our skills lecture, personal tutor group meeting and finally a psycho-social lecture. It would have been far better to have had the psycho-social lecture at the beginning of the day as many people left by the end of the day, and I found it hard to concentrate by that point. Once we'd finished for the day I went straight to the library to squeeze in some final study for the exam. I must confess it wasn't very successful as I was very tired by then.
So Wednesday came and the nerves were fluttering. We were due to have a lecture for Values at 9 but I confess I skipped it in favour of some more last minute study. At 12 I made my way over to the room along with some of my colleagues. The exam was two hours long and afterwards there was the typical postmortem. I found it much harder than I'd expected in some parts and other parts were ok. I simply hope I have done enough to pass it!
The next couple of days were far nicer without the exam hanging over us, though we'll all be grateful in about 6 weeks when we get the results. We're already thinking ahead to our next assignment and also our next placement. And we're also beginning to think about our transition time when we can choose what we'd like to do for 3 weeks; well 100 hours. I've got a few ideas and it's a case of deciding which one to go for. Next year I think I would like to go and learn about fertility treatment and then potentially use that experience to follow through with my final dissertation.
Tuesday we had a full day of lectures and meetings which none of us really wanted, as we'd rather have been preparing for the exam. In fact there were quite a few empty chairs. We began the day with a cohort meeting although it was meant to be a skills lecture, we ended up switching the two around. The cohort meeting gave us an opportunity to raise any issues that had come up over placement, problems we'd come up against and also to celebrate our successes. It seems that the difficulties were things that had come up time and time before. There were quite a few girls that had had problems having their books signed off - that their mentors would repeatedly put it off, and then it would be too late. There also seemed to be a huge variation in the marks we'd been given. There is a mark guide and we'd been advised to explain that the mark scheme was based on us as first years and therefore we'd possibly need to push for higher marks if we felt we deserved it. Unfortunately some mentors would mark us as first years assuming the marking criteria would remain the same over the three years and wouldn't listen to any opinion given by the student. It certainly made me realise how lucky I had been with my mentor and how I'd been marked for my placement.
There was also some discussion about the attitude towards students from some of the midwives. It's very obvious those that are happy to work with students and those that aren't. Simply put it is an essential part of their job but like any job I guess, everyone has parts they don't want to do....doesn't make it easy for us as students however. We talked quite a lot about the different ways we had handled it and hopefully it will help us for our future placements.
We then had our skills lecture, personal tutor group meeting and finally a psycho-social lecture. It would have been far better to have had the psycho-social lecture at the beginning of the day as many people left by the end of the day, and I found it hard to concentrate by that point. Once we'd finished for the day I went straight to the library to squeeze in some final study for the exam. I must confess it wasn't very successful as I was very tired by then.
So Wednesday came and the nerves were fluttering. We were due to have a lecture for Values at 9 but I confess I skipped it in favour of some more last minute study. At 12 I made my way over to the room along with some of my colleagues. The exam was two hours long and afterwards there was the typical postmortem. I found it much harder than I'd expected in some parts and other parts were ok. I simply hope I have done enough to pass it!
The next couple of days were far nicer without the exam hanging over us, though we'll all be grateful in about 6 weeks when we get the results. We're already thinking ahead to our next assignment and also our next placement. And we're also beginning to think about our transition time when we can choose what we'd like to do for 3 weeks; well 100 hours. I've got a few ideas and it's a case of deciding which one to go for. Next year I think I would like to go and learn about fertility treatment and then potentially use that experience to follow through with my final dissertation.
Sunday, 10 October 2010
Towards the end of placement now
I shall soon be going back into Uni, sitting my first exam, submitting my first assignment and doing a drugs calculation test. It already feels like I've come a long way since May and whilst I still have a long way to go, I am pleased with what I have already learnt. I've really enjoyed being able to apply some of the things we learnt in University to placement and I can definitely say some things were a lot easier to understand when we applied them to real women.
So what have I learnt so far? I've learnt about the importance of using the correct professional terminology in the notes....apparently writing "sore boobs" is not professional and yes I did do that. When pointed out to me, I was actually quite embarrassed but hey I'm here to learn after all. The other errors I made were a lot less embarrassing - thrombocytopaenia instead of low platelets is not obvious after all.
I have learnt that feeling for the top of the uterus is harder than it seems and that muscle can confuse me. Also it's important not to assume that just because the measurement doesn't appear to fit with gestation length, doesn't mean I have measured wrong. You can also move the uterus to fit what you want it to and it's obviously important not to do this. Holding the measuring tape quite tight can also affect the measurement and it seemed that I did that frequently. Women's pubic bones are at different heights and it's important to make sure you do measure from it and some women's are harder to feel than others. It's also quite surprising how many women go commando.
I feel I have also learnt how to manage my time better when talking to women. My first booking appointments I'd let women and their partners talk away but my more recent booking appointments I have been more confident to take control and move the appointment along when needed. It's important to recognised when women need to talk but it's also important to recognise when it's not necessary so to speak. Goodness knows I have the gift of the gab and can talk all day long....just ask anyone who knows me; but a community midwife has to manage her time effectively in order to fit all the appointments in.
That some days I feel quite confident and that I know what I am doing and other days I feel like my brain fell out overnight and I haven't got a clue. So on the Thursday, I "ran" the clinic. I was confidently palpating, writing notes, checking urine and blood pressures and then on Monday at clinic, I felt like I fumbled my way through, guessing rather than knowing and being very grateful that my mentor was there to confirm or correct my findings. I was assured it is quite normal to have days like this though.
I have found that many women are interested in me as a student and are very happy to be a part of their care. Before I started I wondered whether I would have anyone who would object to me being there but so far that hasn't been the case. The feedback I have been given from women and their partners has been very positive and I have been wished luck for my future from many of them. As part of my Placement Assessment Document I have to get feedback from two women and I found it quite hard to ask but both were really happy to do it for me, and gave me lovely feedback.
I have learnt the value of continuity and how much of a difference it can make to my learning and my confidence. I always knew that I'd work with a lot people when I came out on placement, I planned to make myself as useful and as amenable as possible but I completely underestimated how much it would affect me. I never thought I would get upset so early on in my training. In some ways, I think it's been an important learning curve for me and I hope that with my future placements I will know how to manage whilst working with a variety of mentors. On the other hand, I do believe that it's a common issue for student midwives and can make it harder to learn how to do things. It's certainly feedback I will take back to university but I am sure it's something they have heard time and time before.
I have also learnt how much pressure I put on myself and that my own high standards can serve to upset me if I don't reach them. When I think how embarrassed I was about writing "sore boobs" instead of breast tenderness, I also need to remember how much I have learnt. After all if my mentor is happy to come and go from the room whilst I do bookings, then she must be happy with how I am doing and confident in my abilities and therefore I shouldn't beat myself up quite so much when I make a mistake. Certainly none of the mistakes I've made have been life threatening after all.
And alongside all of this I have improved upon my clinical skills. I am now confident at taking women's blood pressures. I am no longer at a complete loss when I palpate a woman and am currently working out the baby's position correctly. I have even begun to feel for level of engagement and starting to feel that I can tell the difference. I am able to read the urine dipsticks confidently now, whereas initially I was sometimes unsure whether there was a green tinge on some of the squares or not. I am much more confident on how to locate the heartbeat and tell the difference to maternal heartbeat, and whether or not it is through the cord I can hear it.
So I have just one more week in placement and as I will be working with a different community midwife this week, my mentor completed my summative assessments and as a result gave me my final grade for the placement. I am thrilled to have passed my first placement and to now be able to enjoy my final week, seeing how another midwife works, without the pressure of getting my book signed.
So what have I learnt so far? I've learnt about the importance of using the correct professional terminology in the notes....apparently writing "sore boobs" is not professional and yes I did do that. When pointed out to me, I was actually quite embarrassed but hey I'm here to learn after all. The other errors I made were a lot less embarrassing - thrombocytopaenia instead of low platelets is not obvious after all.
I have learnt that feeling for the top of the uterus is harder than it seems and that muscle can confuse me. Also it's important not to assume that just because the measurement doesn't appear to fit with gestation length, doesn't mean I have measured wrong. You can also move the uterus to fit what you want it to and it's obviously important not to do this. Holding the measuring tape quite tight can also affect the measurement and it seemed that I did that frequently. Women's pubic bones are at different heights and it's important to make sure you do measure from it and some women's are harder to feel than others. It's also quite surprising how many women go commando.
I feel I have also learnt how to manage my time better when talking to women. My first booking appointments I'd let women and their partners talk away but my more recent booking appointments I have been more confident to take control and move the appointment along when needed. It's important to recognised when women need to talk but it's also important to recognise when it's not necessary so to speak. Goodness knows I have the gift of the gab and can talk all day long....just ask anyone who knows me; but a community midwife has to manage her time effectively in order to fit all the appointments in.
That some days I feel quite confident and that I know what I am doing and other days I feel like my brain fell out overnight and I haven't got a clue. So on the Thursday, I "ran" the clinic. I was confidently palpating, writing notes, checking urine and blood pressures and then on Monday at clinic, I felt like I fumbled my way through, guessing rather than knowing and being very grateful that my mentor was there to confirm or correct my findings. I was assured it is quite normal to have days like this though.
I have found that many women are interested in me as a student and are very happy to be a part of their care. Before I started I wondered whether I would have anyone who would object to me being there but so far that hasn't been the case. The feedback I have been given from women and their partners has been very positive and I have been wished luck for my future from many of them. As part of my Placement Assessment Document I have to get feedback from two women and I found it quite hard to ask but both were really happy to do it for me, and gave me lovely feedback.
I have learnt the value of continuity and how much of a difference it can make to my learning and my confidence. I always knew that I'd work with a lot people when I came out on placement, I planned to make myself as useful and as amenable as possible but I completely underestimated how much it would affect me. I never thought I would get upset so early on in my training. In some ways, I think it's been an important learning curve for me and I hope that with my future placements I will know how to manage whilst working with a variety of mentors. On the other hand, I do believe that it's a common issue for student midwives and can make it harder to learn how to do things. It's certainly feedback I will take back to university but I am sure it's something they have heard time and time before.
I have also learnt how much pressure I put on myself and that my own high standards can serve to upset me if I don't reach them. When I think how embarrassed I was about writing "sore boobs" instead of breast tenderness, I also need to remember how much I have learnt. After all if my mentor is happy to come and go from the room whilst I do bookings, then she must be happy with how I am doing and confident in my abilities and therefore I shouldn't beat myself up quite so much when I make a mistake. Certainly none of the mistakes I've made have been life threatening after all.
And alongside all of this I have improved upon my clinical skills. I am now confident at taking women's blood pressures. I am no longer at a complete loss when I palpate a woman and am currently working out the baby's position correctly. I have even begun to feel for level of engagement and starting to feel that I can tell the difference. I am able to read the urine dipsticks confidently now, whereas initially I was sometimes unsure whether there was a green tinge on some of the squares or not. I am much more confident on how to locate the heartbeat and tell the difference to maternal heartbeat, and whether or not it is through the cord I can hear it.
So I have just one more week in placement and as I will be working with a different community midwife this week, my mentor completed my summative assessments and as a result gave me my final grade for the placement. I am thrilled to have passed my first placement and to now be able to enjoy my final week, seeing how another midwife works, without the pressure of getting my book signed.
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