The assessment of practice in nursing and midwifery education programs across England was examined to determine its validity, reliability, fairness, and effectiveness in maintaining and developing the quality of care. The research was conducted in two phases. Phase 1 was designed to identify theoretical and practical areas of concern that would frame the rest of the study. Phase 2 consisted of in-depth studies of workplaces as sites for structuring project opportunities to conceptualize the development of practice-driven curricular and assessment projects and case studies of the key relationships underpinning assessment/assessment in the workplace. A total of 518 interviews, 219 observations of practice, and several shorter observations of discrete elements of practice were conducted. A three-stage model for moving from a piecemeal quasi-structure to an integrated assessment infrastructure was outlined. The elements of the three stages were as follows: (1) networks and dialogue nodes serving as an infrastructure for trust; (2) collaborative structures for education, curriculum development, and assessment of practice in practice; and (3) development and monitoring structures supporting full-fledged assessment monitoring. Although assessment quality assurance practice and deployment of resources varied greatly across England, environments with the characteristics of the proposed assessment infrastructure were found. (Contains 11 figures and 95 references.) (MN)