Slide 13 of 24 Notes:
The model described here and in the next slide was drawn from interviews with nurses and midwives describing their 'day'.  They described what should happen and then always said why it didn't.  There were always the interruptions, the unexpected necessitating re-prioritisation.  The levels of 'doing' refer to increasing 'units' of complexity as motor skills are combined into techniques, which are then combined into tasks, with tasks combined into routines with routines combined to produce the 'day's' work. The assessment text should interrogate and be interrogated for evidence regarding the levels of ‘doing’ that must be accomplished if the clinical area is to be effectively managed and the public are to have confidence in practitioners.  I use confidence here in order to shift attention from a notion of a minimum standard of safety to practice.  Aiming at a minimum too often has the effect of achieving the minimum and not the maximum.  The level of confidence I would like to see is from knowing that one is receiving the best, not the minimum.  By taking this focus, attention is shifting also from the individual alone, to the individual in a community of practitioners who must act together to achieve high quality care.  Each individual thus becomes assessed according their contribution to that process.  It is a holistic view that I am attempting to sketch here.  Too often professional action is fragmented into a series of tasks to be assessed and this slide could easily be re-defined as arguing for a fragmented approach to the assessment of learning.  This is why it should be seen in conjunction with the next slide: