Levelling Up
Angela Brennan and Neil Pybis discuss Level 7 training, why it matters and how they became the first nurse-led OTHM Level 7 Aesthetic Injectables provider in England
At SATA here in Liverpool, we are about to have our first graduates on our Level 7 Diploma in Clinical Aesthetic Injectable Therapies. We wanted to share with you our journey from discussing possibilities in a Tesco coffee shop to becoming the first nurse-led OTHM Level 7 Aesthetic Injectables provider in England and the first OTHM Level 7 provider to be recognised and approved by the JCCP.
Neil and I, who own and run SATA, met around 12 years ago when we first entered the world of aesthetic practice. We became friendly over the course of multiple conferences, study days, and training events, and we recognised that we shared values regarding the position, reputation, and quality of aesthetic education. As nurse prescribers, we have nearly 60 years of clinical experience behind us in areas such as intensive care, accident and emergency, acute care and as community practitioners.
In addition, Neil’s experience as a trainer and speaker for major aesthetic manufacturers and my 17 years experience in higher education as programme developer/leader through to Director of School of Nursing at LJMU ensures that we have an excellent grounding in developing, delivering, assessing and evaluating the quality of clinical education programmes. Indeed, my dissertation for my Master’s degree was on measuring quality in clinical education. So, we think it’s fair to say that we have the knowledge and experience required in the field of aesthetic practice and education.
From the word go, when we first met in that coffee shop two years ago, we have always wanted to ensure that our level 7 programme was awarded by an accredited awarding body and also, importantly, recognised by the JCCP.
Why Level 7?
Some people may question why education for aesthetic practice has to be at the postgraduate level. Is this something the JCCP has thought up?
When we entered aesthetic practice, there were very few options available in terms of education to prepare us for practice in this new field: mostly one- or two-day courses where we did perhaps one or two injections on a shared patient before being let loose.
When you compare this to post-registration requirements for qualified nurses who wish to specialise in a particular field (Specialist Practitioner or Advanced Practitioner awards), it would be almost laughable—if it weren’t so serious.
Thankfully, this situation is now changing due to all the work done following the Keogh Report on the surgical and non-surgical cosmetic sector in 2013.
As a result of the Keogh Report, Health Education England (HEE) conducted a review in two parts of the qualifications that should be required for non-surgical cosmetic interventions. In its final report in 2015, HEE stated that qualifications for botulinum toxin and non-permanent dermal filler should be at Level 7 (postgraduate) rather than, as previously suggested, at Level 6.
The thinking behind this will be familiar to those of us who have undertaken post-registration qualifications in nursing in the past and include;
- The high risk and complexity associated with botulinum toxin and dermal fillers.
- The recognition of the difference between administering injections for drug delivery and administering injections into the face to modify appearance.
- Because it is important for practitioners to be able to deal holistically with a patient who may require a combination of treatments.
- Because practitioners need to make complex decisions and risk assessments regarding their treatment plans which requires learning at Level 7.
The Higher Education Quality Assurance Agency has described Level 7 as follows:
“Much of the study undertaken for master’s degrees will have been set at, or informed by, the forefront of an academic or professional discipline. Students have shown originality in the application of knowledge, and they will understand how the boundaries of knowledge are advanced through research. They will be able to deal with complex issues both systematically and creatively, and they will show originality in tackling and solving problems. They will have the qualities needed for employment in circumstances requiring sound judgement, personal responsibility and initiative in complex and unpredictable professional environments.”
If this doesn’t describe aesthetic practice, then what does? Of course, education in a specialist field of practice needs to be at the postgraduate level. Qualifications for all other specialist fields of practice are at Level 7. As with any post-registration or postgraduate course, some knowledge and skills will be transferable, but a lot will not. We all want to get recognition for our professional status as aesthetic practitioners, and this is only going to help that. This also shows that Level 7 was thought of and decided well before JCCP came along.
How do you know that your programme is at level 7?
This is where the choice of awarding body comes in. Again, thinking back to initial nursing or medical education, we have professional bodies that dictate the education standards, whether this be NMC or GMC, GDC, etc. This will include the length of the programme, clinical hours and expected outcomes for medical and nursing education in England. This means that wherever in the country you undertake your medical/nursing education you can be assured that the standards that you achieve are recognised and transferable. In relation to education for aesthetic practice, this is still not the case. We, therefore, need a way in which outcomes from aesthetic education can be standardised, whether you trained in Liverpool, London or anywhere else. The JCCP has started work in this area by recognising two awarding bodies whom they know meet all the standards for education in aesthetic practice at Level 7. They know because these awarding bodies have had to undergo an approval process to evidence that their curriculum meets the required outcome standards.
Why JCCP Approval?
If you choose a Level 7 programme that is awarded by an approved awarding body, does this mean that it will definitely equate to all other Level 7 programmes? Well, the short answer is no.
Going back to our analogy of pre-registration medical and nursing education, several institutions may offer this outcome-based curriculum, but this does not mean that they are all equal in terms of teaching strategies, resources, experience of staff, etc. In the world of higher education, this is where the Quality Assurance Agency (QAA) came in. The method of assuring quality in higher education is in a state of flux at the moment, with QAA withdrawing and the Office for Students (OfS) taking over. However, historically, QAA would undertake assessment and approval visits to a learning provider once every couple of years to ensure the quality of the learning environment, the teaching and learning, the student support and guidance policies, etc. This allowed potential students to judge the quality of the education provider before they gave them their hard-earned money and/or went into debt to obtain a qualification.
The JCCP is presently (and we believe in the future) undertaking this role for aesthetic education. Education providers such as ourselves have the opportunity to undergo an approval process with the JCCP to ensure the quality of the learning provider in all aspects of its curriculum delivery. This final quality assurance process is the only meaningful way that the quality, not only in terms of the level of learning and the curriculum outcomes are standardised, but also the quality of the teaching and learning, quality of teaching staff, resources, quality improvement initiatives etc. are all at the standard required to deliver quality Level 7 education to students.
The JCCP approval process is rigorous (to say the least). It involved the production of all our documentation and a two-hour approval meeting at which we were required to answer questions from a panel of seven experts, including representatives from the JCCP Education Committee, clinical experts and education experts from Higher Education. This process was hard, there is no doubt, but it was extremely useful and enlightening to us, allowing us to drill down into detailed discussions of our teaching and learning methods, how we monitor quality in our programme, our student support and guidance methods, our assessment and evaluation strategies and indeed every aspect of not just what we deliver but how we deliver it.
We believe that the JCCP has an important role to play in ensuring that standards are met and maintained in all aspects of education for aesthetic practitioners of the future. The level and outcome standards of programmes can be assured by the JCCP only recognising awarding bodies that can evidence that these standards have been met. The quality of the student experience, the teaching and learning, the experience of the teachers, the learning resources used, etc, can be assured by education providers undergoing and meeting the JCCP standards for education. In this way, as we go forward, we hope that the qualification of aesthetic practitioners will hold the same value across the board as NMC and GMC post-registration qualifications such as Specialist and Advanced Practitioner.
In the past, and to some extent this is still the case, education and training providers will present their students with certificates stating that they have undertaken a level 7 qualification with X, Y or Z training companies. When it comes to obtaining practice insurance based on these certificates, insurance companies have no knowledge of the status of that certificate, yet in the current environment, they will have to offer insurance based on these certificates. Insurance companies have indicated that they would welcome some standardisation in the level and quality of aesthetic education and training, or at the very least, some kind of accreditation by a body such as the JCCP to enable them to make more informed judgements about the insurance of practitioners.
When a person has trained as a nurse, doctor or dentist, insurance companies don’t need to ask where the training was undertaken because we have national quality assurance processes in place covering this training. We believe that the way forward is to have such a national approach to quality assurance that recognises not just the curriculum but the provider- so that a Level 7 Diploma is actually that, and not a week-long course masquerading as a Level 7 Diploma.
At SATA, we offer the Level 7 Diploma in Clinical Aesthetic Injectable Therapies, awarded by OTHM and approved by the JCCP, both as full Diploma and Fast Track routes.
Our teaching and learning methods are based on a higher education or andragogy approach. Andragogy refers to principles and methods used with adult learners. Adults use their own experiences and the experiences of others to gain a better understanding of the curriculum. The five principles of andragogy are incorporated into the SATA model of education:
- A move from being dependent on others to being self-driven and independent.
- An increasing reservoir of experience, which becomes a deepening resource for their learning- certain things become intuitive.
- As adults move into new roles, their readiness to learn becomes oriented to those roles.
- The application of learning becomes immediate and more problem centred- they encounter problems and immediately apply their knowledge to solve those problems.
- Adults are internally motivated to learn. They want to grow in self-development and acquire new knowledge and skills.
Those first tentative discussion over coffee in Tesco’s have developed over the last 18 months into a Level 7 Diploma that we can be proud to promote to would be or experienced aesthetic practitioners. We would love to hear from you if you would like to discuss any aspect of our programmes or just to have a chat – over coffee.