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Practice based learning

Implementation of Collaborative Assessment & Learning Model (CALM)

East Suffolk and North Essex NHS Foundation Trust

Therese Elliott talks about the implementation of a collaborative assessment & learning model


In 2017 we started to look at how we could both improve the experience of learning in practice as well as increasing placement capacity. Following a review of current models and literature relating to based learning and considering the broader context, especially in anticipation of the NMC Future nurse we began to develop and implement a Collaborative Assessment & Learning Model (CALM), which would meet the needs of our organisation.

This model compliments existing models whilst also further developing the learning culture to embrace the new Standards for Supervision and Assessment (SSSA) (NMC 2018). It moves away from a traditional mentoring role to a more collaborative team approach based on a coaching methodology to supporting learning in practice. Coaching conversations emphasises the need to allow the student to explore and express their understanding, rather than supervisors being directive and telling ‘how to’. Coaching supports the use of effective, specific and timely feedback and signposting and facilitating learning in practice.

In the context of changing student-learning culture, recognition of the reality of the working role and environment of care, is vitally important if we are to support student learning in practice. We think that our new way of supporting practice learning will increase confidence for students and help them gain the ability to think critically, apply knowledge and skills to provide expert, evidence-based, direct nursing care that the NMC states is central to registered nursing practice.

Overall project objectives include:

1. To improve the culture of learning within the organisation

2. To improve confidence and competence of students in practice

3. To promote a quality learning environment

4. To increase placement capacity


CALM has been rolled out in a planned approach over 18 – 24 months. Part of the preparation included several key elements such as:

  • Communication with all members of the multi-disciplinary team involved in the delivery of care in the area, i.e. Medical staff and therapists as well as the nurses and non-registrants.
  • Standing Operating Procedure for clinical learning environment placement Selection and Monitoring developed
  • Training package and associated material developed for delivering coaching conversations
  • 1 week student induction, to ensure students suitably prepared to lead care from 1st placement.
  • Electronic and hard copy resources developed such as:
    • electronic tablet on mobile stand for learners to use in the ward areas
    • learning resources related to specific topics
    • learning log
    • student off duty template
  • PEFs facilitate changes and coach the coaches over the first week of implantation then withdraw support as possible

It was important to recognise that whist the underpinning principles would be the same, CALM was not implemented in a “one size fits all” approach. This model provides a framework, which can be adapted to the differing environments, such as critical care, delivery suite or community where a more 1:1 relationship with a patient and student exists.

Within CALM:

  • Students will be coached daily be a registered practitioner, utilising expertise of non-registrants as required to meet learning needs
  • Students will be allocated patients to lead care for, dependent on their experience, prior learning and learning needs not limited to one bay.
  • Students are encouraged to participate in peer learning whilst being coached by a registered practitioner.
  • Students will be encouraged to perform new clinical skills based on ability & supervision as per University and Trust guidance.
  • Students have access to electronic learning resources at the bedside.

Learning and future work:

As one of our aims was to improve the overall culture of learning within the organisation, we are encouraging this approach to be used for all learners within an area. Although implemented with an initial focus on pre-registration nursing students, we are already seeing areas recognising the benefits of utilising this approach with other learners e.g. our international nursing colleagues who are preparing for UK registration.

Our future work will include more focus on developing inter-professional learning and the inclusion of our allied healthcare students within CALM in a more formalised way.

Innovations from around the UK

For more information contact:

Therese Elliott
Pre-registration Education Lead
Non-medical Tutor
East Suffolk and North Essex NHS Foundation Trust