How to write an action plan with a nurse or nursing student
Intended for healthcare professionals
How to series    

How to write an action plan with a nurse or nursing student

Simon Downs Teaching fellow and paramedic field lead, School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, England
Deanna Hodge Teaching fellow and lead for practice education, University of Surrey, Guildford, England

Why you should read this article:
  • To enhance your understanding of the purpose of an action plan to support a nursing student or nurse

  • To learn about the procedure for writing an action plan with a nursing student or nurse

  • To know which stakeholders to involve in the development of an action plan

Action plans are commonly used in nursing practice and nurse education to support nurses and nursing students to meet specific objectives, particularly if they face challenges in achieving the level of knowledge and/or skills required by their role or course. Action plans may be used, for example, with preregistration or post-registration nursing students during a placement or with registered nurses for whom there are concerns regarding their professional practice. In that context, an action plan is essentially a set of objectives that the nurse or student is asked to work towards.

• The objectives set in an action plan should be SMART – specific, measurable, achievable, realistic and time-bound.

• An action plan should feature resources and activities that will support the person to achieve the objectives, as well as the evidence needed to demonstrate successful completion and a time frame.

• An action plan is one strategy that can be used to support nurses or nursing students to progress in their practice or learning.

‘How to’ articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of:

• How this article might improve your practice when writing an action plan with a nurse or nursing student.

• How you could use this information to educate colleagues on writing an effective action plan with a nurse or nursing student.

Nursing Standard. doi: 10.7748/ns.2022.e11839

Peer review

This article has been subject to external double-blind peer review and checked for plagiarism using automated software



Conflict of interest

None declared

Downs S, Hodge D (2022) How to write an action plan with a nurse or nursing student. Nursing Standard. doi: 10.7748/ns.2022.e11839


Please note that information provided by Nursing Standard is not sufficient to make the reader competent to perform the task. All clinical skills should be formally assessed according to policy and procedures. It is the nurse’s responsibility to ensure their practice remains up to date and reflects the latest evidence

Published online: 08 August 2022

An action plan is a succinct written document, ideally one side of an A4 sheet of paper, which features the steps needed to achieve one or more specific objectives. An objective is a short, focused statement of something that needs to be completed or achieved. Occasionally the term ‘goal’ is used instead of ‘objective’. Action plans are commonly used in preregistration and post-registration nursing practice. The term ‘personal development plan’ may be used instead but the format will be the same.

An action plan is one strategy that can be used to assist nurses or nursing students in achieving the level of knowledge and/or skills required by their role or course. An action plan may be used with a preregistration nursing student, with a post-registration nursing student (that is, a registered nurse who is undertaking an additional course) or with a registered nurse for whom there are concerns regarding their professional practice. An action plan is usually developed, discussed and agreed during a meeting with the nurse or nursing student and any other stakeholder.

This ‘How to’ article explains how to write an action plan with a nurse or nursing student and how to conduct an action plan meeting.

Preparation and equipment

When preparing to write an action plan, you need to ensure you are aware of the reasons why it is needed. For example, if this is for a student who finds it challenging to meet their objectives or for a qualified nurse whose practice is of concern, a clear understanding of the context, as well as sensitivity to it, will be crucial to achieving positive outcomes.

Ahead of the action plan meeting, it is advisable to reflect on how you want to complete the action plan with the student or nurse. You will need to ensure that everyone involved – the nurse or student, the practice assessor or practice supervisor, the university link lecturer or tutor, and so on – has read the paperwork beforehand and that you are using the appropriate template, if there is one. If you are supporting a preregistration student, most universities will have an action plan template within the practice assessment documentation. In the case of a post-registration student, most universities will have appropriate documentation. If you are supporting a qualified nurse whose practice is of concern, the nurse’s employer may have an action plan template – possibly available on the organisation’s intranet. Performance management policies will be involved and compliance with employment law will be required. If needed, you can seek guidance from the organisation’s senior management and/or human resources department.

Writing a draft action plan before the meeting can be useful to steer the discussion. However, it is important to think of the action plan as something that is developed with the student or nurse, not imposed on them. For an action plan to be effective the objectives, and what everyone involved needs to do towards achieving them, should be discussed and agreed jointly. An action plan needs to be tailored to the individual as learning styles differ.

You will need to set a date for the meeting, book a meeting room and invite all relevant parties – for example, the university link lecturer or tutor in the case of a preregistration or post-registration student, or other members of the team in the case of a nurse. The number of attendees should be kept as small as possible, as attending a meeting with a large number of people can be intimidating for the student or nurse. The meeting must take place somewhere private where you will not be interrupted – it may need to take place away from the placement setting (for students) or role setting (for nurses).


  • 1. Introduce all attendees and outline the purpose of the meeting.

  • 2. Conduct the meeting so that the student or nurse feels involved and empowered, avoiding a purely didactic approach. As objectives are set, discuss with the person how they may be best achieved, including in terms of resources.

  • 3. Encourage an initial discussion of objectives against the requirements of the person’s course or role, especially in areas of concern, to gain a balanced view of the situation, remembering that all students and registered nurses have a positive contribution to make to their placement or work environment.

  • 4. For students, objectives may be pre-determined in a preregistration or post-registration practice document. In that case, the meeting consists of explaining the objectives, discussing how they can be achieved and determining how the student can be supported to achieve them.

  • 5. If there are no pre-determined objectives, objectives need to be discussed, agreed and recorded in writing during the meeting. Ensure that objectives are SMART – specific, measurable, achievable, realistic (or relevant) and time-bound.

    • Specific: the objective(s) must be focused and clearly linked to a specific learning outcome. They must be clearly worded so that all parties understand what is expected of the person. Use verbs that focus on the outcome, such as ‘identify’, ‘demonstrate’, ‘define’ and ‘explain’, rather than verbs that focus on the process, such as ‘learn’ ‘understand’ or ‘consider’.

    • Measurable: the objective(s) must be quantifiable and the action plan must explain how achievement will be measured. For example, if the outcome is improved timekeeping, the evidence section will include the time for starting and ending a shift, the expected times for breaks and possibly who to inform when leaving the ward.

    • Achievable: the objective(s) must be realistic and achievable within the set time frame and with the resources available.

    • Realistic (or relevant): the objective(s) must not be too ambitious or too far below the person’s capabilities. They must be relevant to what the person needs to achieve.

    • Time-bound: the action plan must specify the time frame within which the objective(s) must be achieved, and all parties must be aware of that time frame.

  • 6. Include a ‘suggested resources and activities’ section that will support the person to achieve each objective. For example, reading a specific chapter in a textbook to address a knowledge deficit, gaining exposure to certain patient groups to broaden one’s perspectives, or working with a particular colleague to learn from an experienced member of the team.

  • 7. Include an ‘evidence’ section that will detail what the nurse or student needs to do to demonstrate that they have achieved their objective(s). This could be discussing the knowledge base, being observed in practice by a colleague or completing a short piece of written work, according to what is most appropriate for the objective(s). Several sources of evidence may be requested for one objective.

  • 8. Specify the time frame within which each objective must be achieved. This is usually a period of weeks. The time frame may differ for each objective and must be achievable, realistic and agreed with the person. There may be time constraints to consider, such as a university requirement for students to progress within a course.

  • 9. Invite all attendees to sign the action plan. It is good practice that attendees sign against each objective, as opposed to signing only once for the whole document, as it marks that agreement has been reached and that everyone is aware of what the action plan involves.

  • 10. Agree time points when the nurse’s or student’s progress towards achieving their objectives will be reviewed, and ensure there is protected time for review meetings.

Table 1 shows an example of an action plan setting objectives for a preregistration nursing student undertaking a placement on a cardiology ward – the layout and the terms used will vary.

Table 1.

Example of an action plan for a preregistration nursing student undertaking a placement on a cardiology ward


Evidence base

The demonstration of competence in clinical practice has long been considered essential in preregistration and post-registration nursing programmes (Duffy 2003, Nursing and Midwifery Council (NMC) 2018b, 2018c). Action plans are commonly used in nursing practice and nurse education to support nurses and students to meet specific objectives, particularly if they face challenges in their role or course.

Historically, in the UK, the person supporting and assessing preregistration nursing students in clinical practice was called a mentor and that role was undertaken by an NMC-registered professional. In 2018, the NMC updated that approach and created two separate roles of practice supervisor and practice assessor (NMC 2018b). Practice supervisors can be drawn from across the multidisciplinary team to reflect the fact that healthcare delivery is a multidisciplinary undertaking. Practice assessors are NMC-registered professionals – or for prescribing programmes qualified prescribers – who assess and confirm students’ achievement of practice learning for a placement or series of placements (NMC 2018b). In other parts of the world, the term ‘mentor’ may still be used.

Preregistration nursing students’ learning on clinical placements is assessed against objectives set by the university as part of an accredited programme that meets the standards of the regulatory body – for example, the NMC in the UK. The NMC recommends using an action plan if a practice assessor becomes aware of concerns regarding a student’s performance during a placement (NMC 2018b, 2018c). In addition, the student and their practice supervisor can agree on objectives relating to opportunities available on the placement and/or arising from the student’s self-assessment of their progress. An action plan can be used to assist in achieving all of these objectives.

The key to an effective action plan is well-formulated SMART objectives (Brown et al 2016). SMART objectives were first used in management but are also appropriate in healthcare (Revello and Fields 2015). There appears to be a lack of robust evidence to back up the use of the SMART acronym, which is mainly based on a practical approach. Ogbeiwi (2017) argued that a basic requirement of effective goal setting is that objectives are formulated using a clear and logical structure or framework. Each step in the action plan links to the next and it is important to consider the overall plan and ensure it flows logically (Canadian Nurses Association 2022).

Writing an action plan is always part of a wider process of support, which will involve meeting the nurse or student at agreed time points to review their progress towards achieving their objectives. An action plan may need to be adapted to changing circumstances (Canadian Nurses Association 2022). For example, the nurse or student may encounter challenges in accessing some of the suggested resources and may require more time. However, there will be a point at which their progress will need to be evaluated and the action plan signed off.

Writing an action plan is one way of giving constructive feedback to a nurse or student. Feedback has been shown to be among the strongest factors influencing learner achievement (Askew 2000, Hattie 2009). Writing an action plan is also one way of making a nurse or student aware that there may be concerns about their progress or performance. For preregistration students, universities will have a procedure and designated tutor(s) to support the action plan process. As soon as concerns arise about a student’s level of knowledge or professional conduct, it is imperative that feedback is provided to them to enable them to reflect on the concerns raised and discuss them with their tutor at university. Some universities may ask that an action plan is developed at the midpoint of a student’s placement. Others may request that an action plan is developed at the summative end point of the placement and the student will implement the action plan in their next placement as required.

Elliott (2016) argued that there is a need for early identification and support of students who are struggling and that cultivating an open and honest professional relationship with them is crucial for their progress. In the case of preregistration students, the NMC regards the role of university tutors, practice supervisors and practice assessors as one of empowering students to be proactive and take responsibility for their learning and professional development (NMC 2018b).

Nurses and students may see an action plan as a sign of failure. It is therefore crucial that there is a two-way conversation and that the action plan is written with the person, is tailored to their needs and is presented as a means of supporting them. Writing an action plan can be a valuable tool to develop a student’s confidence and resilience, as long as practice supervisors cultivate a positive and professional relationship with the student during their placement. Power and Albaradura (2018) recommended a tripartite approach to supporting a student who is struggling or failing – for example, the student, a practice supervisor and an appropriate representative from the university, such as the student’s link lecturer or tutor.

It has been known since the influential work of Duffy (2003) that practice assessors – at the time referred to by Duffy as ‘mentors’ – may not always ‘fail a failing student’. According to Duffy (2003), some mentors may feel that the fact that one of their students does not pass reflects badly on them and is seen as a failure on their part, and they may therefore ensure that the student passes. Findings in a literature review by Elliott (2016) suggested this may still be the case. Duffy (2003) and Elliott (2017) argued that instead of focusing on students who are failing there is a need to identify potential difficulties earlier and to put in place effective management strategies to improve performance. Writing an action plan is one of these strategies.

Writing an action plan may not always be the best way to support students who find it challenging to meet their objectives. Action plans should only be used if the student’s deficiency can be measured against a specific learning outcome or behaviour – for example, attaining a specific level of knowledge, performing a specific nursing intervention or exhibiting a specific professional behaviour. Action plans should not be used to remedy an aspect of a student’s personality, such as excessive shyness or that they never smile. Ongoing constructive verbal and written feedback provided to a student throughout a placement, or to a nurse regarding their practice, may sometimes avoid the need for an action plan.


  1. Askew S (Ed) (2000) Feedback for Learning. Psychology Press, London.
  2. Brown G, Leonard C, Arthur-Kelly M (2016) Writing SMARTER goals for professional learning and improving classroom practices. Reflective Practice. 17, 5, 621-635. doi: 10.1080/14623943.2016.1187120
  3. Canadian Nurses Association (2022) Action Planning. (Last accessed: 18 July 2022.)
  4. Duffy K (2003) Failing Students: A Qualitative Study of Factors that Influence the Decisions Regarding Assessment of Students’ Competence in Practice. NMC, London.
  5. Elliott C (2016) Identifying and managing underperformance in nursing students. British Journal of Nursing. 25, 5, 250-255. doi: 10.12968/bjon.2016.25.5.250
  6. Elliott C (2017) Identifying and managing underperformance in nursing students: lessons from practice. British Journal of Nursing. 26, 3, 166-171. doi: 10.12968/bjon.2017.26.3.166
  7. Hattie J (2009) Visible Learning: A Synthesis of Over 800 Meta-Analyses Relating to Achievement. Routledge, New York NY.
  8. Nursing and Midwifery Council (2018a) The Code: Professional Standards of Practice and Behaviour for Nurses, Midwives and Nursing Associates. NMC, London.
  9. Nursing and Midwifery Council (2018b) Realising Professionalism: Standards for Education and Training. Part 2: Standards for Student Supervision and Assessment. NMC, London.
  10. Ogbeiwi O (2017) Why written objectives need to be really SMART. British Journal of Healthcare Management. 23, 7, 324-336. doi: 10.12968/bjhc.2017.23.7.324
  11. Power A, Albaradura O (2018) Supporting failing students: how collaboration is key. British Journal of Midwifery. 26, 9, 615-617. doi: 10.12968/bjom.2018.26.9.615
  12. Revello K, Fields W (2015) An educational intervention to increase nurse adherence in eliciting patient daily goals. Rehabilitation Nursing. 40, 5, 320-326. doi: 10.1002/rnj.201

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