The Turas Professional Portfolio and Advanced Practice

Trainees are expected to record the following in their Portfolio:

• Personal details including NMC PIN Number.
• Learning Plan – the ‘Professional Journal Plan’ in the Portfolio can be used for this purpose.
• Record of Learning – All learning activities (these can be grouped into themes e.g. modules completed, eLearning, supervised practice etc)

• All supervision sessions
• An anonymised list of patients seen (gender, approx age, presenting complaint, diagnosis, management/referral and any key learning points). Trainees may wish to keep this as a spreadsheet or word file and upload into their portfolio periodically. A blank template can be found on the trainee ANP moodle site. 

Remember – no patient identifiable information should be kept in your portfolio.

• Competencies
  • Trainees are expected to work through the appropriate competency document and upload a scanned copy to their Portfolio prior to any supervision meetings (relevant competency documents will be given to trainees during the training). The trainee should self-assess and then the Practice Assessor should go through with the trainee. Competencies should be signed as complete when the assessor has seen satisfactory evidence, within the Portfolio, that the competency has been met. Items listed below can contribute towards evidence of competence achievement and should be cross referenced within the Portfolio. 
• Reflection
  • Trainees are encouraged to regularly write up anonymised reflective accounts relating to patients they have seen or from appropriate learning situations.  
• Feedback
  • Supervisor in Practice Reports. Practice Supervisors are expected to feedback at various points throughout a trainees training using the Generic Feedback form in the Portfolio.
  • Trainees are expected to get feedback from a variety of different people for components 1-3 described below:
    1. Mini-CEX – Trainees should include a number of mini Clinical Examination assessments in their portfolio. A mini-CEX should be used where a Practice Supervisor gives formal formative feedback to a trainee on a consultation. Forms can be found on the Portfolio and ‘a ticket’ can be raised so the supervisor can complete. 
    2. DOPS – Direct Observation of Procedural Skill. Once a trainee has learnt a new procedural skill, the Practice Supervisor should give formal formative feedback using the DOPS form. Forms can be found on the Portfolio and ‘a ticket’ can be raised so the supervisor can complete. 
    3. Case Based Discussion – Trainees will discuss numerous cases with their Practice Supervisors. Trainees are encouraged to keep notes on all their significant discussions and to write up formal case based discussions. The Case Based Discussion template within the Portfolio should be used for this.
    4. Multisource feedback (MSF) – Trainees should request feedback from different clinicians (e.g. ANPs and medical staff) and non-clinicians. The generic feedback form in Portfolio can be used and a ‘ticket’ can be raised for the respondent to complete. 

Ultimately, the Portfolio will become a central part of the final sign-off process and trainees should familiarise themselves with the requirements for this on the Final Sign-Off area on this web page.                                                              

Prior to being recorded as an ANP your line manager needs to confirm that you have completed all the required training for the role and have evidence that you meet all the required competencies. This process is termed ‘final sign-off’.

Final sign-off is required when an individual:

• Completes initial training
• Changes job (especially if it’s in a new speciality)

For final sign-off the ANP trainee should select out the ePortfolio evidence which best demonstrates their learning and competence. The trainee ANP will submit a ‘Share-Pack’ of this evidence to their line manager when they are ready for ‘final sign-off’.

The Final Sign-Off Process

Final Sign-off involves:

• The individual’s line manager who will take the lead on the sign-off process
• The Practice Supervisor or a nominated Practice Assessor
• The Education Institution – this would usually be through evidence of completion of a programme of education (for example a copy of the Postgraduate Diploma in Advanced Practice and/or academic transcript)

STEP 1

The trainee ANP will develop a share pack of evidence within the ePortfolio which meets the requirements of final sign-off. 

STEP 2

The tANPs manager sets a date for the tANP to submit the ‘Share Pack’ and shares this with the Practice Assessor. Both would be expected to review the portfolio and confirm it meets the criteria for final sign-off. As a minimum the following is expected:

• Record of their learning including clinical experience as a trainee.
  • A minimum of 400 hours of supervised practice[1] over a minimum of 1 year
  • Evidence of learning[2] covering the following areas:
    • Clinical assessment
    • Clinical reasoning, judgement and diagnostic decision making
    • Anatomy and physiology
    • Non-medical prescribing
    • Leading, delivering and evaluating care
    • Worked based learning
  • Completion of all academic requirements (record of all modules undertake, including copies of transcripts to evidence results and a copy of their final exit award certificate).
    • Copy of a masters level qualification in advanced practice (or evidence of equivalence [this would normally be 120 credits with a minimum of 50% at masters level).
    • Evidence of being recorded with the NMC as a Nurse Independent Prescriber
    • Evidence of being recorded with Health Board as a Prescriber
  • Completed competencies – The competency framework should be completed and mapped to evidence within the ePortfolio.
  • A range of Work Based Practical Assessments[3] demonstrating competence is managing the broad range of patients seen within the role. This is likely to include:
    • Mini-CEX (min 6)
    • DOPS (min 2)
    • Case Based Discussions (min 10)
  • Reflective Accounts (min 10)
  • Evidence that a broad range of patients has been seen (e.g. an anonymised patient log)
  • Feedback from others (min 4 different people)
  • Satisfactory Practice Assessor reports which confirm the trainee has completed training and has been assessed as competent performing as an ANP

STEP 3

The Practice Assessor and Line Manager will together determine whether the trainee has:

• Passed – Satisfactorily passed all academic requirements and evidence of competence to practice in ANP role contained within ePortfolio.
• Provisional pass – satisfactorily passed all academic requirements, but some minor gaps in evidence of competence.
• Fail – either has still to pass all academic requirements or has major gaps in evidence of competence or both.

STEP 4

If the trainee has passed, the line manager would complete the final sign off form. The trainee will upload and add this to the share pack and forward the  completed share  pack to advancedpractice@ggc.scot.nhs.uk for internal moderation.

If the internal moderator agrees that the portfolio meets all of the requirements then the trainee, employed as Band 7 Annex 21 or Band 6, would be expected to move to a Band 7 at this stage. 

If a provisional pass by either line manager or internal moderator, the line manager would set a period of time (no less than 1 month and usually no-more than 6 months) for the individual to obtain the required evidence.

Trainees employed as Band 7 Annex 21 or band 6 would not normally move until competence has been achieved.

If a fail, the line manager, in consultation with others (which may include the clinical supervisor, education supervisor and Human Resources) the most appropriate course of action for the individual. This may include re-doing part of the training or termination of the traineeship.

If the Practice Assessor and Line Manager cannot agree on a grade the view of the internal moderator should be sought.

STEP 5

As part of quality assurance, it is current practice in NHSGGC for all share packs submitted for final sign-off to be internally moderated by an Advanced Practice Lecturer Practitioner.

STEP 6

A sample of portfolios will be externally moderated each year via the Advanced Practice Academy. This mechanism will involve a suitable expert from another Board reviewing ePortfolios and providing feedback to the line manager, the Board Advanced Practice Lead and the Board Nurse Director.

External Experts will be recorded within their employing Board as an ANP or NMAHP Consultant and either have teaching and assessing qualification or be recognised by the Academy as an ‘External Expert’.

The Academy’s recommendations will be advisory only. Ultimately it will be for the employer to determine whether an individual has met all the requirements to practice.

[1] Supervised practice may involve direct supervision where the supervisor is physically present with the trainee or indirect where supervision is provided at a distance or delegated to another clinician

[2] This may include formal academic modules/courses, clinical courses, eLearning, reflection

[3] Individual specialist areas may require higher numbers that specified here

Final Sign off documentation

Click here to see the ‘Final Sign-off’ documentation that the line manager and supervisor in practice will use to assess the ePortfolio.

Example of an ePortfolio share pack

Please click on the link below to see a dummy ePortfolio for a trainee ANP. In this portfolio you’ll see evidence being gathered to meet the requirements for final sign-off.

Please note the numbering system and ordering being used to make it easier for a reviewer to find the evidence.

Abbreviations used:

MCEX – mini-CEX

DOPS – Direct Observation of Procedural Skill (DOPS)

CBD – Case Based Discussion (CbD)

REF – Reflective Account

FFO – Feedback from Others

SPR – Supervisor in Practice Report

Professional Portfolio – View Share Pack (nhs.scot)

Please note this is ePortfolio is provided as a sample and do not scrutinise the evidence provided, it is indicative of whats required.