2013 Guidelines for conducting ANM's Examination Indian Nursing Council Combined Council Building, Kotla Road, Temple Lane, New Delhi-110002 Guidelines for Conducting ANM’s Examination Indian Nursing Council Combined Council Building, Kotla Road, Temple Lane, New Delhi-110002 Copyright @ 2013 by Indian Nursing Council All rights reserved. No part of this publication may be reproduced, reviewed, abstracted, stored in a retrieval system or transmitted in any form or by any means including photocopying without the prior written permission of the Indian Nursing Council, New Delhi. Disclaimer: The names and situations used in case discussions in this manual are fictitious and does not bear any resemblance to any person alive or dead. Any resemblance is purely coincidental. First Edition 2013 Printed ……2013 PREFACE The Government of India (GoI) is committed to increase the number of deliveries attended by skilled healthcare providers, strengthening the quality of pre-service nursing and midwifery education. In its efforts to increase skilled attendance at birth, the Ministry of Health and Family Welfare of India (MoHFW) along with Indian nursing council developed operational guidelines for strengthening pre service education for nursing and midwifery education cadre in January 2013 which aimed to Strengthen the foundation of nursing and midwifery education across the country and initiating with ten high focus states of India, resulting in higher functioning educational institutions and better prepared service providers i.e. ANMs and nurse midwives who are competent, confident and ready to work, especially in rural areas. In order to strengthen the Auxiliary nurse midwives (ANMs) and General Nursing and midwifery (GNMs) education, Indian nursing council has taken the initiative of developing National Nodal Centers (NNCs) of excellence to train the ANM teachers on MNCH-FP skills as per GoI guidelines; revised the curriculum, admission eligibility for ANMs from 10 to 10+2, and added 6 months of internship. The long felt need to conduct competency based examination and certification for the ANMs had helped to evolve the “Guidelines for conducting ANM examinations” This Guidelines for conducting ANM examinations is intended to guide the state nursing councils, examination boards and ANM teachers clearly on critical competencies of ANMs related to RMNCH+A and IMNCI and various methods of assessment for knowledge, skills and attitude. I hope that all the state nursing councils, examinations boards and ANM teachers will take this forward in planning and implementing the competency based examination to all ANMs. In addition, they will take other innovative measures which will help in preparing the competent and confident Auxiliary nurse midwives upon graduation. New Delhi Shri.T.Dileep Kumar Date: ……., 2013. President, INC ACKNOWLEDGEMENT In the development and finalization of these guidelines, numerous people were involved in ensuring the content was comprehensive, practical and appropriate for the Auxillary Nurse Midwives (ANMs) education. I would like to express my sincere thanks to Shri T. Dileep Kumar, President, INC, Dr. Asha Sharma, Vice President, INC and Dr. Bulbul Sood, Country Director Jhpiego and her team for their commitment and support to ensure that the guidelines are comprehensive and readily available for implementation of the revised ANM curriculum of 2 years that is focused on development and evaluation of competencies of various areas of RMNCH+A and IMNCI. I would earnestly acknowledge the contribution and the technical support given by Ms. P. Princy Fernando form Jhpiego in preparation and typing of the guidelines. The developed guidelines were reviewed, edited by secretary to align it with the prescribed revised syllabus and current GoI guidelines on RMNCH+A & IMNCI. The draft guidelines were presented to the registrars of all state nursing councils and examination boards and finalized incorporating their inputs in the meeting at INC on 8-9 April, 2013. New Delhi Surekha Sama Date: , 2013 Secretary, INC LIST OF CONTRIBUTORS Shri.T. Dileep Kumar President,INC Dr. Asha Sharma Vice President, INC Ms. Surekha Sama Secretary, INC Dr. Bulbul Sood Country Director,Jhpiego Dr. Somesh Kumar Director-Programs, Jhpiego Dr. Rashmi Asif Director- Clinical Services and trainings, Jhpiego Ms. P. Princy Fernando Nursing and Midwifery Education Officer, Jhpiego Ms. Celine Gomes Documentation and Publications Officer, Jhpiego List of all registrars of SNRC and examination boards to be added TABLE OF CONTENTS 1. Introduction -------------------------------------------------------------------------------------------------- 1 2. Objectives ----------------------------------------------------------------------------------------------------- 1 3. Expected Competency of ANMs ----------------------------------------------------------------------- 1 4. Suggested Activities for Evaluation ------------------------------------------------------------------ 2 5. ANM Theory Examination ------------------------------------------------------------------------------ 6 5.1 Blue Print of ANM Theory Examination ------------------------------------------------------ 6 6. Responsibilities of SNRC -------------------------------------------------------------------------------- 9 6.1 For Theory Examination ------------------------------------------------------------------------- 9 6.2 For Practical Examination -------------------------------------------------------------------- 10 6.3 Establishment of Skills lab by SNRC ------------------------------------------------------ 12 6.4 Financial Implication --------------------------------------------------------------------------- 12 7. Objective Structured Clinical Examination (OSCE) ------------------------------------------ 13 8. Strategies for Conducting Examination ----------------------------------------------------------- 15 8.1 Identify the Skills Lab -------------------------------------------------------------------------- 15 8.2 Identification of Human Resource ---------------------------------------------------------- 15 8.3 Selection of Skills --------------------------------------------------------------------------------- 15 8.4 Rotation of ANM Students – I year and II year in Skill Labs for Four Practical Exams ----------------------------------------------------------------------------------- 21 Annexures Annexure 1: Sample Check list ------------------------------------------------------------------------------ 24 Annexure 2: OSCE Score Summary Sheet --------------------------------------------------------------- 25 Annexure 3: Sample of filled OSCE Score Summary Sheet ---------------------------------------- 27 Annexure 4: OSCE Checklists – Child Health Nursing --------------------------------------------- 28 Annexure 5: OSCE Checklists – Midwifery -------------------------------------------------------------- 60 Annexure 6: List of Skills Lab Location at High Focus States ----------------------------------- 100 Annexure 7: Documentation of OSCE -------------------------------------------------------------------- 103 1. Introduction Auxiliary Nurse Midwives (ANMs) play major role in improvement of the health and family welfare service. The National Rural Health Mission (NRHM) has been launched by Government of India (GoI) to bring about improvement in the health system and health status of people, especially those who live in the rural areas of the country. The Indian Nursing Council (INC) revised the syllabus by having series of consultations with various stake holders and the components of skilled birth attendant (SBA) and integrated management of neonatal and childhood illnesses (IMNCI) have been integrated in the syllabus. Several meeting with stakeholders for “strengthening pre service nursing and midwifery education” were held at New Delhi under the chairpersonship of Additional Secretary & Managing Director, NRHM, GoI. During the meeting, it was decided to implement the revised syllabus and competency based certification with internship. To meet the above purpose, Indian Nursing Council has developed this guideline for conducting competency based examinations, which will ultimately guide the nursing councils, ANM teachers and examiners for preparation and conduction of objective structured clinical examination (OSCE). 2. Objectives for conducting OSCE:  To strengthen the implementation of 2 years revised ANM curriculum and competency based training  To improve the teaching skills of the teachers at ANMTC with focus on clinical training and practice of ANM  To prepare the ANM with hands on clinical practice  To better prepare the ANMs with an effective practice in delivering services at the community  To bring about quality in implementation of ANM program in the country  To regulate the examination methods for all ANM schools in the country  To implement the uniform standards of assessment of ANMS 3. Expected Competency of ANMs First Year Community health nursing and health promotion:  Describe community structure  Community assessment and home visiting  Health assessment of individuals of different age groups  Describe health organization and team responsibilities  Perform nutritional assessment  Demonstration on cooking using culturally accepted diet.  Conduct IEC activities related to nutrition( Preparation of Health education materials like charts, posters, models, puppets)  Health education activities- demonstration, celebration of nutrition day, safe motherhood day, nurses day in group/individual  Assess personal hygiene, and health education  Assess environmental sanitation  Assess mental health status of an individual and counsel or refer Guidelines for Conducting Examination for ANMs 1 Child health nursing:  Assess growth and development of children  Assess health status of children  Care of the sick child (<2months and 2months – up to 5 years)  Counsel mothers about feeding of infants and young child (Demonstration on complementary feeding) Primary health care nursing and health centre management:  Administer immunization safely  Give care to the sick child (<2months and 2months – up to 5 years)  Provide first aid in various emergencies  Provide primary medical care  Organize and manage health Sub-center  Render care at home Second Year Midwifery:  Assessment and care of normal pregnant women  Conducting normal delivery  Recognize different degrees of tears, give emergency care and refer  Assessing and care of postnatal mothers and newborns  Assessing and referring mothers at risk  Counsel eligible couples about different methods of contraception  Prepare acceptors for sterilization and IUCDs  Detection of cervical cancer  Management of sick neonates and children (IMNCI) 4. Suggested activities for evaluation: Every student ANM should perform/participate in all the suggested activities as listed below during her training period. The teacher should ensure that each student work book*is completed of suggested activities before taking annual examination. First year Areas Activities for evaluation 1. Community health nursing  Preparation of health organizational chart  Return demonstration of home visit  Conduct field visits  Preparation of IEC material- ( Preparation of Health education materials like charts, posters, models, puppets)  Demonstration of counseling technique  Mapping Village  Conduct community survey 2. Health promotion  Demonstration of cooking methods of balanced diet A) Nutrition  Nutrition education to a group  Counseling on nutrition – individual, family and special needs like Antenatal, postnatal, complimentary feeding, pre-school child, school age, adolescence, old age and post sickness feeding  Planning diet of a family assigned * The work book for ANM student, to be published by INC shall be procured by each school for ensuring the learning by doing the suggested activities. Guidelines for Conducting Examination for ANMs 2