Educational assessment of veterinary nurses

Health issues or disabilities that may require reasonable adjustments

Students requesting reasonable adjustments are likely to have one or more of the following physical disabilities, mental health conditions, learning difficulties or neurodevelopmental conditions:

• Learning difficulty or specific learning difficulty such as dyslexia or dyscalculia
• Autistic Spectrum Disorder (ASD)
• Speech, Language and Communication Needs (SLCN)
• Deaf and/or hearing impairment
• Vision impairment
• Multisensory impairment
• Physical disability
• Attention Deficit Hyperactivity Disorder (ADHD)
• Mental health conditions

These conditions may require the student to have one or more of the following needs:

• Cognition and learning needs
• Communication and interaction needs
• Sensory and physical needs
• Social, emotional and mental health needs 

Assessment of the Day One Competences

The Day One Competences (DOC) describes the knowledge required by veterinary nurses at the point of registration. The type of assessments used to assess the DOC is not defined by the RCVS. Providers can therefore choose the most appropriate assessment types. 

It should be noted that all modules or units of the qualification that address the DOC must include an unseen (closed book) examination as an element of the assessment strategy. This does not necessarily need to be a written examination.

Examples of how reasonable adjustments could be made to the assessment of knowledge may include:

• Supervised rest breaks
• Extra time
• Private space to read the question paper out loud
• Coloured overlays
• Alternative room arrangements
• Use of reader
• Use of scribe
• Use of assistive technologies

Where appropriate to the learning or assessment outcome, the use of Universal Assessment Design (UAD) is encouraged. UAD refers to the practice of creating assessments that are accessible and fair for all students, regardless of their abilities, disabilities, or backgrounds. The goal is to eliminate unnecessary barriers while maintaining the validity and rigour of the examination. UAD draws on principles from Universal Design for Learning (UDL) and ensures assessments measure the intended learning or assessment outcomes without being influenced by unrelated factors. The aim is to ensure that assessments accurately measure students’ knowledge and skills without being hindered by barriers relating to the assessment format or delivery.

Assessment of the Day One Skills

The assessment of the Day One Skills (DOS) takes place in both the clinical practice setting and the learning environment. Clinical Supervisors (CS) working within the clinical practice setting are responsible for confirming that students are competent in all of the DOS.

Once competency has been confirmed, the student will be eligible to sit the summative practical assessment designed to sample competence of the DOS. This assessment is normally in the form of an Objective Structured Clinical Examination (OSCE) or similar practical examination. The purpose of this examination is to sample the assessment decisions made by the CS. It normally takes place in a simulated environment.

Although the DOS are not time restricted (so additional time could be offered to a student as a reasonable adjustment, subject to the context of the competence in question), the tasks within them are mandatory for all students to successfully complete. 

It should be noted that in some cases a student has a disability that has such a profound and significant impact on them that they are unable to meet the RCVS competence standards, despite reasonable adjustments. However, as assistive technology advances, and equipment and mechanisms for support become more readily available, the focus for decision making may become more on how 'reasonable' the adjustment or support required is in terms of resources, rather than determining if such adjustments can be implemented. 

Examples of how reasonable adjustments could be made to the assessment of the DOS may include:

• A student with a hearing impairment using an electronic stethoscope to perform part of a clinical assessment of a patient. The student still meets the outcome of performing a full assessment, but with supportive equipment that involves a slightly different approach or method.
• A student with severe anxiety could take regular breaks after performing a clinical assessment and could have a quiet space available beforehand and afterwards. The task would remain the same; however, reasonable adjustments would be put in place to help minimise the impact of their anxiety.
• A student with a neurodevelopmental condition could be given additional time in between tasks to consider and process information. The task would remain the same; however, the reasonable adjustments would enable the space and time needed to process the information so they could then make the required decisions on patient care.
• A student with mobility difficulties could be provided with adjustable tables and chairs in the treatment room to help them access the animal at the correct level for them. The task would remain the same; however, the environment and equipment would be adjusted to enable the barrier of reaching the animal to be removed.

There may be aspects of the skill which do not need to be 'hands on', for example: another member of staff may assist by completing aspects of the patient treatment which is not being assessed.

The competence standard cannot be met if the student describes the process to the person supporting them without actually demonstrating it. For example, if the student is required to approach and handle patients but requests that someone else does this for them, and describes how it should be done, they cannot be deemed competent as they have not performed the skill. However, if they demonstrate how to approach and handle the patient, but due to their disability they are unable to restrain the patient for the entire length of the procedure, this could be considered acceptable as they are actually performing the skill.

While readers and scribes may be permitted in written examinations and assessments, their use must be carefully considered when evaluating competence of the DOS and PBs. Many of these competences require students to demonstrate their ability to communicate effectively and efficiently, both verbally and in writing.

Assistive technology can be used where appropriate, but the reliance on human readers and scribes is generally not suitable in such assessments. It is crucial for students to independently demonstrate their communication skills as required by their profession.

Where students are using a reader, scribe or assistive technology extensively and there is limited evidence that they are able to read or make handwritten records, as may be required for a number of DOS, an additional sampling of the CS's decision making could be undertaken. This is especially important if the Objective Structured Clinical Examinations (OSCEs - the practical examination) can be passed without students achieving marks awarded for reading and writing skills, such as record keeping and reading information.

Assessment of Professional Behaviours

The assessment of Professional Behaviours (PBs) is a crucial component of veterinary nurse education and training, ensuring that students develop the professionalism expected of a Registered Veterinary Nurse (RVN).

The RCVS requires students to achieve level 4 in each of the PBs before they can attain their qualification. At this level, students are expected to demonstrate independence and competence across all areas of practice. Specifically, they should be able to work with limited guidance or support, while being aware of their own limitations and seeking assistance when needed. This enables them to work autonomously, confidently, and competently.

The key behaviours assessed include:

• Reliable and adaptable application of knowledge and skills
• Working within legal and ethical boundaries
• Demonstrating initiative and the ability to self-reflect
• Managing their own time and workload
• Strong communication skills
• A positive attitude toward feedback and guidance
• Professional accountability
• Commitment to ongoing professional development
• Maintaining a professional and clinical appearance
• Awareness of their own wellbeing
• Effective collaboration within the veterinary team

Throughout their education and training, students will develop the skills needed to meet these PBs. The PBs serve as competence standards, outlining the behaviours students should demonstrate as they work through the DOC and DOS. Unlike the DOS, which has specific requirements on how certain tasks should be performed, the PBs focus on the broader competences and behaviours expected at a professional level.

For instance, a student performing a subcutaneous injection will be taught how to complete the task competently, following established protocols. The focus is on their technical ability, with little variation in the approach. However, when it comes to the PBs, students will develop individual strategies to demonstrate their competency. For example, students are expected to manage their own time and workload, but some students, particularly those with learning difficulties or neurodevelopmental conditions, may find this challenging. While the competency itself cannot be adjusted, the strategies or tools used to demonstrate the competency can be adapted to suit individual needs, with some students benefiting from using tools such as electronic scheduling reminders or other visual aids.

Please note: this general guidance does not purport to be legal advice and is not to be relied upon as legal advice. Students and education providers should take their own advice in the particular circumstances and as required.