Criteria for placement failure

Introduction

The criteria for failure reflect the requirements of the profession, as set out in the following documents:

  • Health Professions Council (2008). Standards of Conduct, Performance and Ethics. London: Health Professions Council
  • Health Professions Council (2016) Guidance on Conduct and Ethics for students. London: Health Professions Council
  • Health Professions Council (2009). Standards of Proficiency for Practitioner Psychologists. London: Health Professions Council
  • British Psychological Society (BPS) (2008). Generic Professional Practice Guidelines (2nd edition). Leicester: British Psychological Society.
  • British Psychological Society (2007). Committee on Training in Clinical Psychology: Criteria for the accreditation of postgraduate training programmes in clinical psychology: Appendix 4: Guidelines on Clinical Supervision. Leicester: British Psychological Society.
  • Division of Clinical Psychology (1995) Professional Practice Guidelines. Leicester: British Psychological Society.
  • British Psychological Society (2005). Code of Conduct, Ethical Principles & Guidelines. Leicester: British Psychological Society.
If a trainee does not fulfil these requirements on a practice placement by the end of that placement, to a standard acceptable to the placement supervisor and the programme staff, this will result in a recommendation made to the exam board that a failure of that practice placement is recorded. This recommendation is made by means of the evaluation form "Supervisor's Evaluation of Trainee" (SAT). The supervisor will recommend to the Examination Board whether, overall, the placement (i.e. the trainee's achievement of expected learning outcomes) falls into the category 'unsatisfactory' rather than 'satisfactory'.These judgements and the subsequent recommendation are informed by the above standards, the training of the programme staff, the training of the supervisors, and by the goals and intended learning outcomes as articulated in the placement contract agreed between trainee and supervisor (and approved by the visiting clinical tutor) at the start of the placement. These requirements are operationally defined as criteria for placement failure and are set out explicitly in this document below.

It is worth noting that, prior to the evaluation of the trainee's placement performance, there are opportunities to monitor trainee progress, both via weekly supervision sessions and also staff visits; the mid-placement visit of a visiting clinical tutor to the placement is particularly important. Where there are placement difficulties, the course has specific guidance on procedures to be followed and these are contained in the Practice Placement handbook.

In the case where the supervisor recommends that, overall, the placement ratings are 'unsatisfactory', the External Examiner will be asked to comment and will be sent samples of the trainee's work and the placement Log Book, prior to the Examination Board.

The Examination Board will consider the SAT form, the Log and its relation to the Contract, the views of the External Examiner and any other relevant material, before making its recommendation to the University. The Criteria for Placement Failure (below) will form a focus for the Examination Board discussion and recommendation.

Criteria for Placement Failure

1. Clinical experience

Within the contract there will be goals relating to:

  • Range and number of clients
  • Client problems and settings
  • Individual and/or group work
  • Types of clinical involvement e.g. assessment, intervention, consultancy, direct/indirect work, models to be used
It may be that goals need to be slightly revised, particularly at mid-placement review with a visiting member of course staff, to encompass unforeseen developments. For example, if certain types of referrals are not available, alternative work may be found; if work with client(s) proves to be much more detailed than originally envisaged, then simply adding to client numbers may be inappropriate. That is a matter for discussion at mid-placement review.

However, if by the end of the placement, the trainee has been unable to fulfil the clinical goals to the satisfaction of the supervisor, then following consultation, the supervisor may decide to recommend an 'unsatisfactory' rating on this aspect of the work.

2. Clinical Competence

The contract will contain goals that relate to all areas of clinical competence, within the limits of what areas of competence are reasonable to expect to develop on a specific placement (e.g. it will not be possible to develop skills in working with children on all placements). However, the goals of all four placements over the three year programme, will, in total, provide each trainee with a complete set of opportunities to achieve all of Health Professions Council (2009) Standards of Proficiency for Practitioner Psychologists, and to acquire all of the competencies to satisfy the British Psychological Society (2007) Committee on Training in Clinical Psychology: Criteria for the accreditation of postgraduate training programmes in clinical psychology.

This is why the achievement of the goals/ expected learning outcomes articulated in the placement contract is so important to judgements about whether the trainee's performance on placement should be deemed satisfactory or not - they relate directly to the achievement of the requirements of the profession as listed in the introduction to this document.

Some of the requirements are in areas that are not specific to a practice placement area. For example, skills in teaching, research, consultation and organisational work can be acquired on most placements. These areas will focus on, for example, opportunities for team work, meetings to be attended, services to be visited and liaison with other professionals. The acquisition of these proficiencies, in particular, are cumulative of the three years of training, and it is with this in mind that achievements on any one placement will be assessed. However, all areas of proficiency will be assessed through the lens of a developmental framework. As such, the rating "requires attention" on the SAT form (which is available to assessing supervisors for all the specific areas of competence, although not on the overall rating) will refer to those areas of competence where it is recommended that subsequent placements and their respective contracts should focus. As a result, the "requires attention" option is not available to final placement supervisors, as the trainee should satisfy all proficiency and competence standards by the end of their final placement.

It is not possible with this section to be prescriptive about number of goals not achieved (or 'seriousness' of a single goal not met) to warrant an 'unsatisfactory' rating. Instead, once it is identified that a trainee is at risk of failing on a placement, there is a process that is followed to make the specific concerns of the supervisor (after discussions with programme staff as well as the trainee concerned) clear and explicit, which will in turn also involve the creation of clear, explicit and achievable goals during the remainder of the placement. Only if a trainee fails to achieve these goals will an unsatisfactory rating be awarded. It allows the assessment of trainees in this respect to be sensitive to the cumulative process of professional training and the complexities of professional standards.

3. Ethical and Professional Behaviour

In all aspects of clinical work the trainee must comply with the HCPC Standards of Conduct, Performance and Ethics, and the BPS Code of Conduct, Ethical Principles and Guidelines. Within these documents, and within the DCP Professional Practice Guidelines there are descriptions of how practitioners are expected to behave. The HCPC also provides guidance on conduct and ethics for students. Unprofessional or unethical behavior on the part of trainees may lead to disciplinary action. Such behavior might also lead to consideration within the programme's Fitness To Practice processes but is also grounds to consider placement failure. All three (or any combination) of these avenues may be appropriate to pursue at the same time, should the breach of ethical or professional boundaries merit it. Such professional matters are so crucial to training they are considered within the programme as part of the Induction in the first month.

Appropriate professional behaviour on placement is a wide issue and something that should be 'shaped' and discussed within supervision. The areas that the supervisor will be regularly monitoring and discussing will include:

  • Reliability (time keeping; diary management; placement administration)
  • Organisation of workload and managing priorities
  • Degree of independence appropriate to the stage of learning
  • Ethical issues such as consent, confidentiality, record keeping, keeping within the legal framework.
Again, whilst it is not possible to be specific about any one problem behaviour that would lead to an 'unsatisfactory' rating, over all the items listed the supervisor will be expecting appropriate professional and ethical standards of behaviour. Should the trainee not demonstrate behaviour to the satisfaction of the supervisor, e.g. (i) where the trainee is frequently late or absent for meetings or (ii) does not take confidentiality into account within clinical practice, then this should, in the first instance, be the subject of discussion in supervision. If the trainee does not respond to feedback, does not learn to behave in a sufficiently professional way, and does not meet very specific goals (that may be set down after consultation with staff and supervisor at mid-placement visit) then the supervisor may give an 'unsatisfactory' rating on this section of the SAT. As highlighted above, disciplinary and/or fitness to practise concerns may arise simultaneously and be pursued separately from any determination about pass or failure of a placement.

4. Overall failure of a placement with a final summary rating of 'unsatisfactory' on the SAT

There may be a number of sections or only one section of the SAT that the supervisor considers 'unsatisfactory'. There are no prescribed number of 'unsatisfactory' categories that will lead automatically to the SAT form recommending a failed placement to the Examination Board.

The implications of the failure to meet a single goal may be as important as the number of goals not met. For example, (i) if with client work the trainee, despite extensive supervision, cannot formulate the problems of any of the clients then this may lead to overall failure of the placement by the Examination Board (ii) if there is a single example of gross professional misconduct this will usually lead to failure of the placement (and most likely the programme). The visiting clinical tutor will be available to support the supervisor and trainee in the event of placement difficulties and to discuss, with the supervisor, particular aspects of the SAT form and to give guidance as appropriate in consultation with the Clinical Director as necessary.