Placement Presentation and Report (PPR) information for trainees

Last Updated on 03/07/2019

The PPR is for the 2014 cohort and earlier only. The structure of the PPR is as follows

Initial Report	submitted at end of each core placement (min 1000 – max 1500 wds excluding references & appendices)
Presentation and Discussion	to be held after placements 2 & 4
Main Report	Submitted following the Presentation / Discussion (maximum 5500 words excluding references & appendices)

The initial report and main report together are no longer than 7000 words. Word count cannot be transferred between the different reports if one is longer or shorter. The word count limits quoted above are upper limits for each report with the exception of the Initial Report which has a lower word limit also. Submissions falling outside of the word limits will be returned to trainees for editing and may be subject to the deadlines policy.

The assessment process

The PPR is assessed by two examiners. They collect evidence from all the different parts of the PPR process for each competency. With the exception of presentation skills, all the competencies will be rated at the end of the process (presentation skills will be rated by examiners at the time of the presentation, but the grade will not be given out at the presentation). The examiners are asked to give you a grade for each competency based on the evidence they have collected across the whole PPR process (with the exception outlined above). They will also give you some written feedback for each competency (sent out with your letter from the exam board following ratification of PPR marks). This is intended to be helpful and to be part of your overall learning and development. The grades are converted to a final mark which corresponds to the University marking procedure (i.e. distinction, good pass, pass, fail, poor fail).The grades examiners are asked to award for the competencies can be found below:

UNACCEPTABLE (U)	The piece of work shows an extremely poor ability in this competence that requires urgent attention. NB: If this grade is given to any competency it automatically leads to the PPR being failed
WEAK (W)	The evidence collected suggests that this competency is below the expected standard at this stage in training.
APPROPRIATE for stage of training (P)	The evidence collected suggests that the competency is of an acceptable/appropriate standard for the stage in training, but does not excel in any way.
ADVANCED for stage of training (V)	There is evidence that good skills in the competency exist, which are above what is expected for a piece of work submitted at this stage of training.
EXCEPTIONAL (E)	Strong evidence has been collected that the trainee has developed this competence to a degree well beyond what would be expected at this stage of training. Use this grade only for outstanding or highly exceptional work.

The competencies being rated in the PPR are based on research exploring the competencies required for training (Phillips, Hatton & Gray, 2001). They are not the BPS competencies. Appendix I outlines how the PPR competencies map onto the BPS competencies and also gives a definition for each competency.

Choosing material for your PPR

It is important to choose a piece of work which demonstrates your development as a practitioner and allows you to provide evidence of the competencies being assessed. The piece of work chosen can take many different forms, but could include a clinical case, an aspect of a case, indirect work, consultation work, group work or any other piece of clinical/placement based work you have undertaken. The piece of work you choose should demonstrate your ability to reflect on the work undertaken; present a rationale for the work which links theory and practice; consider professional, clinical and ethical issues. It should also be a vehicle for you to provide evidence of your competencies for your examiners.

Examiners will be looking for evidence of presentation skills, ability to manage volume of information, reflections, effective communication skills, understanding of professional/ethical issues, ability to apply knowledge and skills and resilience.

A good or complete outcome from a piece of clinical work is not necessarily required as part of the PPR process. Often key learning points can arise from pieces of work where there have been challenges which might not have reached resolution prior to the end of your placement. How you demonstrate your learning and competency development is what the examiners are interested in.

In summary, key factors to consider when choosing material for your PPR are:

whether the piece of work will allow you to provide evidence of all the competencies
whether you can clearly demonstrate your learning and development
it is OK to consider drawing on one or two key aspects of a more complex piece of work, but let your examiners know this is what you are doing and why
you have been able to gain consent to use the piece of work for your PPR

Clinical tutors will discuss with you at your mid-placement meeting the work you are considering using for the PPR. You will also have an opportunity within each teaching block to discuss the piece of work you are intending to use for the PPR with a clinical tutor and your peers. Feedback will be given as to the suitability of the material you are intending to use.

If you are unsure about the suitability of the material you have chosen, please contact your clinical tutor as soon as possible to discuss it further.

Please ensure that any client/service related material you use as part of the PPR process is made anonymous in the write up to protect client confidentiality.

Consent

Please ensure that you have gained appropriate consent to use any confidential information and as a minimum you have undertaken the following:

Shared the information from the PPR client information sheet with the intended individual(s) you would like to seek consent from
Adapted the method of giving the information to match the ability level of the person/people seeking consent from to ensure that any consent given is fully informed
Approached a suitable alternative person if the individual does not have capacity to consent i.e. a main carer (family member or keyworker) or an advocate who could act in their best interest
Your supervisor is fully aware of the steps you are taking to gain consent and your progress in achieving this
You have recorded the whole process undertaken in the individual’s clinical notes or in process notes if undertaking consultation or service related developments

Some services/supervisors have developed forms to be completed for client notes. Please complete them in line with the processes outlined above.

If a significant proportion of your write up is likely to cover and report on work with staff and it is possible they could recognise themselves in your write up (e.g. series of supervision/consultations) you will need to seek the consent of the individual staff members. As above please discuss with your supervisor and document carefully the steps you have taken in the most appropriate place (e.g. process notes/supervision records).

If you wish to present a piece of work based on a series of consultations and or supervision sessions with another professional which requires you to outline information gained about a client through this process, it is important that client consent is gained even though you have had no direct contact with them. It is important that you ask the professional concerned to approach the client on your behalf. Below are some suggestions about wording/considerations to support the professional to do this:

That as part of their work and to ensure the quality of their work they have discussed the clients’ case with a psychologist to gain a psychological perspective.
The psychologist is in training and wants to use the content of the discussions between me (the professional) and the psychologist as part of a piece of work they have to submit as part of their training.
The focus will be on how the trainee is developing their skills in terms of how they have been helping/supporting me, but they will also need to give some background details about the discussions I have had with them about the work we have done together.
The psychologist has asked me to ask you if this is OK. They will make sure that any details they give are anonymous.
They have given me an information sheet to give/go through with you so you are able to make an informed decision about whether this is OK or not.
The client can choose to say no – which will not affect their treatment in any way.

An information sheet is available for clients to help them make an informed choice about whether or not to consent to their material being used as part of the PPR process. This information sheet is appended to this document at the bottom of the page.

Please remember to give an indication that consent has been obtained and any steps taken to facilitate the process in the introduction to your Initial Report. It would be appropriate to append any adapted materials to the Initial Report to demonstrate part of the process you undertook to gain consent.

Initial report

Maximum word limit 1500 words (excluding references and appendices). Please note that the word limit is an upper word limit for this part of the PPR. Pieces of work with fewer words are acceptable (but no lower than 1000 words). Unused word count cannot be transferred to the main report.

The initial report is submitted at the end of each placement. You will need to ask your supervisor to complete a supervisor declaration form and return it to us via email (downloadable from the bottom of the page).

The initial report is designed to be as close to a written communication you have undertaken in the programme of your work as possible e.g. a final letter to a family/individual client, report of the outcome of a group, report of a period of staff consultation to the commissioner of the work etc. It can include additional material such as illustrations/pictures if this is appropriate to the communication and is suitably anonymised is required.

The initial report is submitted at the end of each placement and stored by the office. It cannot be altered between first hand-in and submission of full report. However, reflections on the initial report (e.g. omissions, ideas subsequent to doing the initial report or reflections on the style/structure for example indicated by service you are in) that may have come out of the presentation and discussion can be added to the main report. This is intended to be helpful to help you develop a sense of your own report writing style.

Examiners will read and use your initial report to orientate themselves to your work prior to your presentation. Evidence from the initial report will be collected at the same time as your main report. The key area of competence examiners will be assessing when they read your initial report is your ability to adapt your writing style to the intended audience (Written communication competency). They will also collect evidence of other competencies if present in your initial report.

The initial report can take various formats to reflect the piece of work you are reporting on. It must always be introduced by a short appropriately anonymised statement (written in APA style) to orientate the examiner to:

The service you are working in
How the work came about
The audience the content of your initial report is aimed at i.e. a letter to family/referrer/report of a group etc
What the content of the initial report is i.e. report, initial assessment letter, therapeutic letter at stage x, report of consultation, report of service development initiative
How consent was obtained to write up the piece of work (with any anonymous information appended if appropriate e.g. consent form, letter/e-mail from relevant individual). Please see section on consent

The remainder of the initial report should be written in the style you used on placement.

Please add in additional context where appropriate within the main body of the initial report to facilitate the examiners understanding. It is important that enough context is given to allow the initial report to make sense on its own i.e. a person with no prior knowledge of the piece of work is able to understand what kind of service the material is from, who the document is aimed at and what the issues were and how they were addressed. However, please be aware that the initial report is designed to capture a certain point in your work and is not meant to cover the entirety of the work undertaken. The additional context added is to facilitate understanding of the time point you are capturing.

Below are some examples of introductions to initial reports:

I was based in child & family psychology service in an urban area. A referral from paediatrician X was received requesting advice and input for the family around anxieties attending school. Below is an extended letter written to the family following my input with them. Consent was gained through discussion with parents and as the client was considered too young to give fully informed consent.

My placement was in a behavioural intervention team in a learning disability service. A referral was made by a local voluntary provider team leader Y for input around behavioural management issues with client Z. Following consultation with my supervisor and the team leader it was agreed that the main focus of my intervention would be with the staff team. Below is an account of the work carried out with the staff team written for the staff team to access. I consulted the staff team at a training event for their consent to use this piece of work for my PPR. I distributed the information sheet to them all as part of the process. The team consented to my using the material for the PPR. The client was unable to give their consent due to a lack of capacity, I consulted with their family advocate to seek consent to use the client’s material in my PPR. The family advocate consented to my using their family member’s material for my PPR.

I was based in a tier three Community Adolescent and Children’s Mental Health (CAHMS) service. A review of referrals by the CAMHS team indicated the need for running a group for adolescents with autistic spectrum disorder, aimed at improving social functioning. This was conducted by the trainee, together with a qualified clinical psychologist and an advisory teacher. Below is a short account of the content of the group sessions and client outcomes, along with some of the process issues highlighted within the group. Consent from the group and my co-facilitators was sought through discussion and distribution of the PPR information sheet. All consented to my use of the material from the group.

The Older Adult psychology service my placement was in provides regular consultation sessions to the staff working on [name] inpatient ward to discuss any clients they have concerns about. One of my tasks on placement was to lead these consultations sessions. The following report provides a summary description for the service manager on how I have conducted the consultations over the course of the placement, in what ways they have been helpful, and how they should proceed in the future, together with some relevant examples. Consent to use the information gained through the consultation sessions was gained through discussion with individuals attending the sessions and their seeking consent from their clients.

My placement was in an Adult Community Mental Health Team (CMHT) in a regional town. I was asked to run an anger management group for six clients during my placement. The following document was the summary of the group work which was sent back to the referrer of one of the clients once the group had finished. Consent to use the group material for my PPR was discussed with the group in the initial group session and revisited at the final session where I gained consent from the group.

Presentation & Discussion

The presentation is 15 minutes. For this reason it would be good to plan and develop a clear structure for your presentation. It may be that you choose to present one aspect of your work which demonstrates all of the above e.g. an issue/dilemma your work presented you with, or an overview of the piece of work. Areas to consider when developing your presentation include:

Orientating your examiners to the piece of work e.g. very brief intro/background/service context (please bear in mind examiners will have access to your initial report just prior to your presentation.)
Outlining what you intend to address and/or outline your rationale for focusing on particular aspects of the work (important if you are choosing to focus on a part of case rather than all)
Key points from the work e. how you approached the piece of work/assessment material / formulation/synopsis of work/ outcomes
Key learning points for you & your personal reflections on your own development
Professional/ethical issues
Critical reflections of the work
Theory-Practice links

PowerPoint or other presentation aids are encouraged. Photographs or video material of clients are not encouraged even if identifying features are masked. Facilities for PowerPoint presentations will be available at the PPR presentation day. Please ensure you have your presentations on a memory stick and have also e-mailed them to yourself via your Lancaster University e-mail account for the presentation day. If you require any alternative presentation aids (e.g. OHP projector, flipchart, bluetac, pens etc) please inform the office two weeks before the presentation day. If you ask the office after this they cannot guarantee they will be able to provide the aid requested. Therapeutic material/props (e.g. puppets/pictures) can be used if they support and enhance presentation. Please do not use/bring if they are just for the examiners to look at following the presentation.

Please be clear in your presentation when you are using words which are your clients words and when you are using your own words to prevent confusion. Please ensure that you anonymise all client material to preserve confidentiality. Please make it clear you have done this in your presentation and that you are using pseudonyms.

Where you have chosen not to include a formulation, please be prepared to discuss why you haven’t included one (e.g. not applicable to approach used i.e. SFBT).

The presentation is 15 minutes. You will be given a one minute warning and asked to stop at 15 minutes. It is advisable to practice your presentations so that they do not over-run.

Following the presentation there will be 10 minutes of discussion with you about your piece of work led by the examiners.

You will then be asked to leave the room while the examiners discuss your work and agree feedback points (approximately 10 minutes). Following this you will be invited back into the room to receive brief feedback and be given your feedback points to address in your main report. The feedback points given will be based on your presentation. They consist of three strengths and three areas the examiners would like you to address in the context of your main report. Please ask for clarification at the time the points are given if you are unsure of anything concerning them.

Examples of possible feedback points:

Please expand on the issue you raised concerning boundaries. Please discuss in relation to the impact on the work (both professional and personal), your reflections and policy/best practice guidance.
We would like more evidence of your ability to adapt your work to best meet the needs/ability level of the client. Please also consider and discuss the implications of this issue in relation to working with his population.
Please describe, discuss and comment on how the experience you described in your presentation in relation to the therapeutic alliance has impacted on your development as a clinician. What have you learnt from it?
Please clarify your understanding of and application of XX theory to your piece of work. Please critique the approach you took and reflect on at least one other approach which you could have applied.

The feedback points will be copy typed and be made available to you as soon as possible (we aim to send them out by e-mail on the same day as the presentations).

The presentation will be video-recorded. The recordings are made available to examiners to help them decide what grades to award. Trainees will have access to the presentation, discussion with examiners and feedback recording as soon as possible following the presentation day. You will be asked to sign a disclaimer stating that you will not use the recording for anything other than your own learning (e.g. not post on YouTube).

Be aware that presentation skills is one of the competencies being examined and that the examiners are collecting evidence about your presentation skills.

Main report

The main report can be up to 5500 words long (excluding references and appendices). Please note the word limit quoted is an upper word limit, shorter reports are acceptable. The carrying over of word count not used in the initial report is not allowed. The main report style and format should conform to current APA guidance. Please write the main report in the first person.

The structure for the main report is deliberately fluid to allow:

for variation in pieces of work
for inclusion of material pertaining to the examiner feedback
for one aspect of work within a complex case to be reported on (rather than all)
your examiners insight into your ability to structure a piece of work (written communication competency)

The main report forms a significant part of the PPR process. It is important to ensure that you have provided evidence of your development/ability in relation to the competencies in the main report. In order to operationalise this, below is an outline of the key areas to cover in your main report divided into two main areas.

When the main report is sent out to your examiners, they are also sent the initial report and asked to read it again before they read the main report. You might want to consider this and the information your examiners have had access to in your presentation when writing your introductory paragraph to the main report.

The balance of how many words you allow per area/point will depend on the piece of work you are reporting on and the feedback points from the Presentation and Discussion. It is expected that areas highlighted in the feedback points will potentially carry more words, but will not form the sole foci of the main report. Depending on the feedback points you may wish to weave the points into the main narrative or address them in separate sections.

Examples of how trainees have previously structured their main reports are below:

A traditional case report format i.e. background information, hypotheses, assessment, formulation, intervention and outcome.
A ‘step by step’ approach documenting the journey through the piece of work and influences on decision making and their learning at different points
A structure explicitly guided by the competencies (although be careful that this doesn’t lead to a disjointed report)
Or a mixture!

Outlined below are areas you may wish to include/consider in order to provide evidence of the competencies in your report (please note this is not meant to be an exhaustive list):

Key learning points
Reflections on the processes of the work undertaken and how this is helping you to prepare to be a fully qualified clinician e.g. nature of the client group, the supervisory process, the nature of the work etc.
Any ethical/professional/clinical/diversity issues in the work & what you have learnt from them.
Critical analysis/evaluation of the literature & where/how this work sits within the literature/policy context (local, regional & national). To include a formulation/ synthesis of psychological understanding (with diagram where appropriate).
Critical evaluation of outcome including critical reflections on the approach taken to measure change and critique of the relevant literature

Preparation for the PPR

Be mindful of all pieces of work you undertake on placement as they could be potential material for the PPR. Keep a reflective diary of the work you undertake – this will help you with the PPR process, particularly when you are trying to remember key decision making or shift points.

Gather information, literature and policies as you go along – again this will help stagger your prep for the PPR and help prevent being an additional stressor at the time of the PPR presentations.

Please be prepared to have materials available which support the PPR process before you leave your placements. This is in case you may need to append extra information to your main report (e.g. outcome of neuro assessment). Please be aware that you need permission from the author of any letters/reports/documents to use as part of the examination process. Please ensure that your client has given their consent for confidential material to be used. Please anonoymise all information to be stored and be mindful of how and where you store this information (i.e. if stored electronically that access is password protected. Hard copies of information are held in a secure place e.g. in a locked filing cabinet).

PPR organisational processes

Prior to the PPR presentation day you will be sent a list of examiners together with a form asking you to declare if any of the examiners are known to you in any capacity. We will not be asking you to declare in what capacity they are known to you to preserve confidentiality (e.g. personal tutor). We do not need to know about anyone who you know very casually or have met only once or twice. We only need to know about individuals where the examination process would be compromised by their prior knowledge of you. The examiners will also be sent a trainee list and asked to declare if any trainees are known to them. Again we will not be asking for details about in what capacity trainees are known to them. This is to prevent us inadvertently allocating a trainee to an examiner where they are known to each other. It is important for this information to be returned as quickly as possible to allow the slot allocation to take place.

Slots for the PPR day will be randomly assigned by the office taking into account the information received about individuals who are known to each other.

Trainees will be notified of their allocated time slot at least two weeks in advance of the day. Please note this is the time slot only not which stream (e.g. child/adult).

Please try to arrive 30 minutes before your allocated slot on the day. Information detailing which stream you have been allocated to is available 30minutes before your slot. (i.e. child or adult, OA/Health/Neuro or LD).

Programme staff will act as chair people for the PPR process. Clinical tutors also act as reserve examiners. In the event that a clinical tutor will need to be an examiner, they will not examine trainees they are responsible for either in a clinical tutor position or research tutor position.

Draft reading

Draft reading is not offered for the initial reports by the programme team. As this piece of work is expected to be very similar to work undertaken on placement, please approach your supervisors to draft read the initial report.

Draft reading will be offered by the programme team for the main report submitted for PPR1. Draft reading for the PPR2 will not be offered unless there are identified additional support needs.

Absenteeism for PPR day

If you are absent on the day of the presentation because of illness you will be asked to provide a medical note from your GP to this effect in accordance with University guidelines for absenteeism for examinations Please report your ill health in the usual manner. If you are aware in advance that you will not be able to attend the presentation day due to extenuating circumstances, please advise the Chair of the Exam Board as soon as possible. Similarly if you are delayed on the day of the presentation for whatever reason, please inform the office as soon as possible. Individual circumstances will be considered by the Chair of the Exam Board and PPR co-ordinator in relation to rescheduling the presentation process.

Identifiers in the PPR

Trainees are required to make anonymous all identifying information relating to the client/service in their PPR. If identifiers are found in submitted work, the trainee will be asked to resubmit the piece of work with the identifier removed. If the identifier is found in the Initial Report, the trainee will be asked to resubmit the initial report with their main report. If the identifier is found in the main report, the trainee will be asked to resubmit the main report as soon as possible.

An identifier is classed as anything which could ultimately compromise the identity of the individual(s)/service reported on in the piece of work. This could include the inadvertent use of individual’s real name, name/location of service based in/visited, address (part or whole) of individual/service, name of supervisor, name of NHS trust.

Examiners are asked to bring the existence of identifiers to the attention of the PPR Coordinator/chair of the Exam Board as they need to be noted together with action taken under the Exam Board business, Examiners are asked to consider the significance of the identifier and record it either under Standard Setting (minor use of identifier) or Professional Behaviour (significant use of identifier).

Failure of the PPR

If an Unacceptable (U) grade is given for any competency rating, then the PPR is automatically failed. If a U grade is awarded for any competency other than the Presentation Competency, the exam board will make a recommendation based on feedback from examiners about how to proceed with resubmission.

If a trainee presents extremely poorly on the presentation day (e.g. because of anxiety) to the extent that the examiners would consider awarding a U rating for the Presentation Competency, the trainee will be informed of this immediately and will be offered an opportunity to present again (where possible on the same day). If following this second attempt the examiners still feel a U rating is justified, then a fail for the PPR is recorded and the PPR assessment would need to be retaken at a different time. This matter would then be referred to the Exam Board for a decision on how to proceed.

If examiners are concerned about the content of the presentation given (i.e. trainee describes something which could be deemed as professional misconduct), they are asked to seek advice from the PPR Co-ordinator/Chair of the Exam Board at the time of the presentation. Outcome options following consultation with the Chair of the Exam Board are the resumption of the original presentation process, the presentation of the PPR material from the alternative placement and/or referral to the Exam Board about how to proceed. If it is decided that the trainee needs to present their alternative PPR material, this will be scheduled in as soon as is practically possible with a different examiner pair. Or, if the concern is deemed sufficient to require action by the employer, the PPR assessment process will be suspended whilst advice is sought from the Clinical Director/employing body as to how to proceed.

Study time

The PPR for all trainees will take place in a two week study block. Trainees are strongly encouraged to not take leave during allocated PPR study time.

PPR results

Trainees will receive a letter informing them of the outcome of their PPR from the exam board following the board meeting in the January following the PPR process. Trainees will also receive examiner feedback on the individual competencies.

References

Phillips, A., Hatton, C., Gray, I., Baldwin, S., Burrell-Hodgson, G., Cox, M., Hoy, J., McCormick, R., Rockliffe, C. and Wilson, J. (2000). Core competencies in clinical psychology: A view from trainees. Clinical Psychology ,1, 27-32.

Phillips, A., Hatton, C. & Gray, I. (2001). Which selection methods do clinical psychology courses use? Clinical Psychology, 8, 19-24.

Phillips, A., Hatton, C. & Gray, I. (2004). Factors predicting the short-listing and selection of trainee clinical psychologists. Clinical Psychology and Psychotherapy, 11, 111-125.

Outline of PPR competencies

PPR Competencies	BPS Competencies maps onto
Presentation skills considers verbal and non verbal communication plus associated planning and performance skills in presenting	communication & teaching
Written communication considers style in relation to appropriateness for intended audience, coherence, structure and flow.	communication & teaching
Knowledge and skills focuses on the demonstration of knowledge i.e. that the trainee has the appropriate information and understanding. In turn they are able to apply the knowledge in the form of clinical skill and techniques	assessment / formulation / intervention / evaluation / communication & teaching / service delivery
Analysis and critical thinking considers creativity in transferring theory and adapting its application to practice across context(s) together with a focus on problem solving and the ability to synthesise information from multiple sources	assessment / formulation / intervention / evaluation / service delivery / personal & professional development
Reflection and integration focuses on evidence of a reflective stance taken in relation to the work and the process of integrating learning from the reflective process.	personal & professional development / transferable skills
Professional behaviour focuses on evidence of professional behaviour during the examination process (including the presentation) and in the work described.	personal & professional development
Resilience considers the ability to face challenges confidently and persist appropriately despite setbacks and or complexity.	personal & professional development / transferable skills
Standard setting focuses on the setting of appropriately high standards in the quality of one’s work and behaviour.	personal & professional development / transferable skills