Health Service Focus

31.03.16

Delivering positive change through revalidation

Source: NHE Mar/Apr 16

John Lee, head of Nursing Studies at the University of Dundee, who led the NMC revalidation pilot at the organisation, talks to NHE about how revalidation can help deliver professional and organisational change.

Nursing and midwifery revalidation can help reinforce positive changes both to individual professionals and institutions if implemented correctly, NHE has been told. 

John Lee, head of Nursing Studies at the University of Dundee, who led the NMC revalidation pilot there, said that revalidation isn’t about reinforcing a negative ethos or focusing on bad practice. “It is about getting nurses to think about the Code and improve what they do,” said Lee. 

“As an educator, I know that getting people to focus on the positive things they do is much better thing than getting them to focus on a negative one. We don’t do that enough.” 

Dundee University was one of two higher education institutions to pilot revalidation, the other being Birmingham City University, and Lee said that there was a high-level of interest from staff in the project. 

“One of the interesting things was that people thought it was going to be something difficult, but then finding it wasn’t necessarily so. They also found the analytical and reflective process useful,” he said. 

Lee also noted that the NMC information around revalidation is quite clear, but higher education isn’t highly represented which led to many questions during the pilot. 

“The NMC information is, naturally, focused to where the majority of its members are, but it is perfectly applicable to people within higher education,” he said.

“The average person working in higher education is already doing the things that are involved in revalidation. For instance, CPD, reflection and reviews are the sorts of things we do on a regular basis. 

“The hardest thing for higher education is to get people to realise they are already doing all this. It isn’t about adding another 20-hours work to what you are already doing. Use what has been used for appraisals. It might not be the same for nurses or midwives working in the clinical environment, but in higher education it is getting people to realise they are already doing a lot of the work already.” 

Don’t make revalidation difficult 

His advice for people working in higher education is not to make revalidation more difficult than it needs to be. 

He added that one of the main questions he was asked during the pilot was: Where am I going to get the 450 practice hours from? Do I need to go back to the clinical environment? “But the NMC defines practice in a whole broad range of ways and teaching at a university is defined as practice,” said Lee. “So, therefore, you don’t have to do any more. What you have to do is do your practice as a lecturer.” 

A further question was around the process of reflection. “It is pointing people back to the template,” he said. “The example that I give is that the NMC revalidation reflection is something that needs to be achievable by everyone working on the register.

“People want to make reflection more difficult than it is. They also want to make it about bad practice. This doesn’t need to be the case. This isn’t about fitness to practise. It is about identifying what people are doing. We can reflect on what things have gone well as well as wrong.” 

He added that there needs to be a strong institutional approach to revalidation, and organisations should ask themselves what they believe revalidation is about? 

“That comes from the top,” said Lee. “But it is about identifying and improving what we do. If you can get the institution to think that then it will get the people in them to do that. It is about identifying that as an approach.” 

However, Lee also noted that this can be a difficult approach to foster. “As much of my job has been talking to management as well as the workers, because it is the way that management approach this which will make the difference,” he said. 

“You cannot change the institutional ethos. Some institutions have a really positive ethos, others don’t. But I don’t think revalidation needs to be seen as reinforcing a negative ethos. There are a million other ways to get people to think about fitness to practise, and whether people should be on the register without conflating that with revalidation.”

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