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Current pre-registration nursing programmes in the United Kingdom (UK) require students to spend 50% of their programme time in practice, with this practice learning and assessment supported through the process of mentoring. Concerns have been expressed both locally and reflected in the wider literature regarding mentoring, with a specific concern that mentors fail, or may be reticent, to judge student performance as unsatisfactory. However to date few empirical studies have examined how mentors reach an assessment decision. Thus this study set out to examine the concerns expressed using judgement and decision making theoretical frameworks, and investigate how mentors form judgements and reach a decision regarding an assessment of student competence in practice. An embedded mixed methods design was employed for the study. In the first phase student practice assessment documents (PADs) relating to a whole cohort of students (n =41) completing a three year undergraduate pre-registration nursing programme were collected following the final exam board. Documentary analysis of the mentor decisions (n =330) was undertaken to examine mentors’ use and conduct of assessment interview processes, with data contributing to a sampling frame used to identify final placement mentors (sign-off mentors) to invite for interview. In phase two, mentor comments in student PADs were thematically analysed using Braun & Clarke’s (2006) six phase process. Stimulated recall interviews were conducted with the selected sign-off mentors (n = 17) and data analysed thematically. Assessment strategies and documentation were shown to have limited effect on mentor judgements and decisions. Instead mentors formed impressions regarding a student and their practice, which led the management of the assessment process, and formed the basis of formative judgements and the summative decision. Key to any judgement was an evaluation of the student’s ability to function as a reliable member of the team. Mentor judgements were informed by mentor expectations of a student appropriate to the practice area and stage of the student’s programme. Judgements were accumulated over the placement and combined to inform the final decision taken, in a manner that can best be understood and conceptualised with reference to Brunswik’s lens model of social judgement (1952). Recommendations are made for supporting and developing mentor decision making within current assessment systems, and for further work on assessment tools and strategies. Finally recommendations are proposed for research to test the criteria and decision making model developed as well as further understand mentor decision making in the difficult areas identified.

Focus: This thesis gathers data from street sex workers who work in the Managed Approach (MA) in Leeds. Current literature fails to focus on physical or mental health measures, or long-term conditions. Rather, there is a tendency in the sex worker literature to focus on harm reduction, drug use and addiction, and to consider only the risks they pose to others (Department of Health, 2014, Putnis and Burr, 2019). Street sex workers face extreme health inequalities, and without fully understanding the nature or extent of their experiences, from the women's perspective, little can be done to address these. This thesis addresses this gap in the literature using the following research questions. • From the women's perspectives, what are sex-working women's patterns of engagement with health care providers? • From the women's perspectives, what are the critical junctures at which they do and do not seek professional assistance? • What is the impact of criminalisation, stigma, bias on their health outcomes? • What are the implications of these findings for future policy and service provision? Methods: Using Feminist Constructivism, timelines were used alongside semi structured qualitative interviews to capture the women's critical decision-making in their health seeking behaviours. Thematic Analysis (TA) was used to analyse both the timelines and the transcribed interviews - comprising of 16 interviews and timelines from seven interviewees. Findings and Discussion: From the TA, 3 meta narrative threads were generated: service provision; stigma and bias; and adverse childhood experiences (ACEs), trauma and experiences. A key unique contribution of this thesis is the evidence that substantiates both the need to advocate for decriminalisation of sex work, and the decriminalisation of possession of drugs for personal use, if street sex worker health inequalities are to be addressed. Additionally, the rich narrative data provided by the creative methods used that gives a first-hand account of the sex workers' experiences in healthcare. Activist Pedagogy (Aslet, 2014) is identified as a strategic tool for development. A further contribution is methodological, and this thesis demonstrates effectively how creative methods can be used to work with underserved populations.

Under direction from the Nursing Midwifery Council, nurse education is becoming more generic. With an increasing adult focus there is a risk and concern that issues relevant to children's nursing may become diluted or removed altogether. When a child is hospitalised, play becomes an important link to home. It is a way they can take control of what is potentially a very painful and distressing time for them. There is concern that children's nurses may not be taught to assess and plan for the children's play needs - a key part of being able to provide holistic nursing care. The aim was to investigate the education which pre-registration children's nurses receive in play in both academic and clinical arenas. To achieve this three research questions were identified. First what experiences of play do pre-registration children's nurses have whilst out on clinical placement? Secondly what are pre-registration children's nurses taught in university concerning play? Third, what education in play would pre-registration children's nurses like to receive to prepare them for their clinical role? A mixed methods design was utilised. Programme specifications and focus groups have been examined using inductive content analysis and thematic analysis. This was the first time that both programme specifications have been examined, and the opinions and experiences of student children's nurses around play researched. Concerning programme specifications, only 17% cite play. Those that do, make clear links between play and communication and distraction. They do not contain any reference to therapeutic play or the benefits which play in hospital can bring. Focus group discussion centred around two main categories, 'play within hospital' and 'education needs'. Recommendations are made around a number of areas: the content of teaching of play within the curriculum, placement documentation, increased nurse's awareness of the importance of play, parents being supported to play with their children in hospital, and the importance and use of the hospital playroom.