The aim of this assignment is to critically reflect on the experience of mentoring and assessing a student in clinical practice. As the student was on a four week placement the assessment process will be discussed incorporating the qualities of the mentor and the effect it can have on the mentor/student relationship. In turn evaluating the learning environment and teaching strategies used including learning styles, reflecting on how they were applied to help the student. Finally, the evaluation of overall performance as a mentor.
For the purpose of this work a pseudonym will be used to maintain confidentiality hence the student will be known as ’A’. ( NMC Code of Conduct 2007) It has been accepted that assessment of students in practice is integral to the mentor’s role, it ultimately ensures public protection and patient safety as it should be the means of deeming a practitioner as either competent or incompetent (Watson et al 2002). The importance of assessment in practice has been reiterated by the Royal College of Nursing who called for provision of protected time for mentor’s and students to complete teaching and assessing (RCN 2007a).
In order to create an environment conducive to learning, the learner must be assisted by the mentor to identify their learning needs (NMC 2006). On ‘A’ ’s first day, after orientation, we were able to draw up a range of learning opportunities so that there was an awareness of what ‘A’ hoped to gain from the community experience. ‘A’ was also advised on the standards to be achieved throughout the placement . I felt it was important to ascertain specific personal boundaries in order to establish a respectable mentor / student relationship( ) .
The initial assessment was carried out to identify ‘A’ ‘s learning outcomes, in this teaching/assessment strategies, learning opportunities were discussed. ‘A’ was encouraged to participate to aid planning. I ensured that each day time was made available for the student to research and develop his knowledge base using the variety of resources available. ‘A’ expressed a desire to explore the areas around care planning, wound care management and multidisciplinary working. Learning outcomes help to ensure that both mentor and student take an active role in the learning that occurs (Quinn, 2000).
On working with ‘A’ for a few days and after building up a relationship with him it was important to identify ‘A’ ‘s learning style. It is important to identify a learner’s style so that material can be adapted to facilitate effective learning (McNair, 2007). Learners have preferences for certain kinds of information and ways of using that information to learn (Chambers et al 2000). Honey and Mumford have undertaken an enormous amount of work on the type of activities through which different people learn best (Chambers et al 2000).
According to Honey and Mumford (1992) there are four learning styles; Activists, reflectors, theorists and pragmatists. With this in mind I used open ended questions to evaluate A’s learning style (Hinchcliff 1999). It revealed that both of our learning styles corresponded to reflector and pragmatist. This enabled a positive and empathic exchange of learning and teaching experiences between both student and I which enabled me to adapt and utilize a variety of teaching techniques. However, if I and the student were off differing learning styles material can be adapted to facilitate effective learning (McNair, 2007).
The Nursing and Midwifery Council (2006) has developed standards which indicate that mentors should try and achieve ‘best fit’ with the level and type of learners that they come across in practice. It was clear from ‘A’‘s first day that he was learning in an andragogical way. This became apparent when drawing up learning opportunities. As A was a mature student with recent higher education experience he already had his objectives in mind and knew what he wanted to gain out of his community placement.
Knowle (1998) suggested that students who entered higher education see themselves as self directed because they have made a decision that they want to learn about a particular subject. Andragogy recognises that adults demand to learn things that are relevant to them, and relevant to their life experiences rather than assuming they know nothing (Atherton, 2005). Hence as time progressed ‘A’ became less dependant on me and was able to self direct his learning , in turn increasing his confidence and enhancing his community experience by spending time with other disciplines to enable him to achieve the university set competences.
The qualities of the mentor are an important element of the learning environment. This includes professional and personal qualities such as professionalism, a friendly nature, understanding and patience (Beskine 2009). Added to this the learner must be made to feel welcome through staff attitudes, this will help the learner to become integrated into the clinical environment (Hutchinson, 2003). Throughout the learning experience I felt that I had a strong professional relationship and that being ‘A’ ’s mentor being approachable and friendly enabled us to maintain a trusting relationship conducive to learning.
This relationship, according to ‘A‘, reduced stress and anxiety. Locken and Norberg (2005) state that anxiety in students becomes reduced when mentors are able to build a good working relationship with their student and are able to work with them for almost all of their placement. One potential barrier in creating an effective learning experience is the personal attributes of the mentor. Although there are guidelines from the Nursing and Midwifery Council (2006) to support the role of the mentor, there are no rigid rules about how mentors teach in the clinical environment.
Therefore the success of teaching relies on the personal enthusiasm of the individual mentor (Cardwell, Corkin, 2007). This is dependent on a variety of factors including ; staff levels, number of available mentors, equipment and other resources available, time constraints and balancing mentor workload . ‘A’ had given me positive feedback on performance as a mentor and made very encouraging and positive comments. He felt he was integrated into the learning environment and felt part of the team.
He was pleased to fulfil his learning objectives and said that he enjoyed the way teaching took place as I took into consideration his individual learning style. During ‘A’ learning experience, he was assessed by me using various methods and at various points of the learning/teaching experience. After two weeks a formative assessment was carried out; this was an informal process and was a discussion between myself and ‘A’ on how he was progressing towards meeting his competencies. According to Walton and Reeves (2001), this is the time where problems can be picked up and resolved and also a time for personal development.
At this point myself and ‘A’ discussed his development and we were both very pleased with his progress. Although one aspect at this point was lack of belief when undertaking tasks. Identifying a problem at the formative stage enables it to be rectified by the summative stage (Sharples 2007). Stuart (2007) supports this, stating that without knowledge of what has been done well or not so well, behaviour cannot be changed and it may become rooted if it is not dealt with. Mentors are accountable to the Nursing and Midwifery Council for their decision in assessing student nurses and the responsibility should be taken seriously (NMC 2006).
Duffy (2003) outlines a procedure for managing failing, weak students and emphasis that action can be taken to help them improve once their problems have been identified. If ‘A’ was deemed not to be progressing as well as required then I would be required to arrange a meeting with the community placement manager as a means to creating new plans to achieve new objectives. The summative assessment stage is more formal and it is where paperwork is signed off and the learner is deemed competent at certain skills (Walton and Reeves 2001).
A’ was assessed using his practice placement documentation and also the competencies drawn up in the learning outcomes. Questioning was also used, according to Nicholl and Tracey (2007), questioning facilitates learning by requiring the student to actively participate and acquire a deeper understanding of the subject. After a teaching session questions were asked of ‘A’ as to ascertain how much he had learned, but the main method of assessment was observing ‘A’ carry out the skill. By using the gestalt theory I was able to reflect on the success or otherwise of the teaching element involved in the placement.
This theory maintains that learning takes place in small stages and links are made between these stages until the whole concept of understanding (Kohler, 1947) is reached. With regard to teaching with ‘A’, it also took place in stages; research, discussion, observation and practice. It was felt that adequate teaching of a subject would not have taken place if each aspect were not covered. For example, on teaching A how to use a blood sugar monitoring machine he researched the purpose and correct technique of usage.
We reinforced through discussion and observation whilst I undertook the procedure. The teaching all came together as ‘A’ was deemed competent in applying the skill to a patient. Upon reflection the overall learning experience was extremely positive as ‘A’ was able to achieve competencies within an environment conducive to learning which was extremely encouraging to witness. I recognized that this needs to be a flexible process that may need adapting with future students, as every student will have an individual style of learning and it is upto me to adapt to this to aid best learning.
It was identified by ‘A’ that he would have benefited by having an up to date induction pack before undertaking placement so anxiety levels may be able to be reduced prior to the community placement. This would have probably made an improvement on the learning experience. In response to this an action plan has been drawn up to update the directory on the university website so students can access up to date information concerning this particular community placement. The RCN (2007) recommends providing new students with an induction pack as it will prepare them for the placement ahead.
When giving feedback, I ensured that the technique known as the ‘praise sandwich’ (Hinchcliff 2004) was utilized. It consists of providing negative feedback between positive feedback, although I ensured that all negative feedback was delivered in a positively constructive manner. For example when discussing confidence levels with‘A’ I gave advice on how to improve confidence. This was delivered after stating how well the student was progressing and prior to the me expressing pleasure with the students overall performance.
When reflecting on what I found difficult about the learning experience, I found self assessment quite difficult, but using Gibbs reflective cycle at the end of the placement this enabled me to identify personal strengths / weaknessess which will ensure that I become a more competently aware practitioner and will enable me to develop in order to provide the best teaching possible. Diekelman (2004) argues that abilities essential to today’s nurse are self assessment, peer assessment and lifelong learning.
Through the testimony of colleagues, I was encouraged by positive feedback and also pleased with the support given from the mentor facilitator . After much reflection, analysis and evaluation of the entire learning experience, the importance of mentorship has been reiterated to me again and again and it is clear that nursing would come to a standstill without mentors who can facilitate an environment and personality conducive to learning. The increased emphasis for the government on providing care in the community has also made mentoring students in this setting increasingly important (Ripley 2007).
In conclusion I recognise the importance of understanding the role of mentor / assessor and also the importance of developing a professional and supportive relationship with the student. This is vital in aiding the student to have a comprehensive learning experience as well as identifying the individual learning style and recognising what constitutes a conducive learning environment. It can be seen that the mentorship role can highlight both weaknesses and strengths in the mentor and also aid in quality care delivery . I am looking forward to further developing the role and contributing to the education of our future nurses.
January 9, 2018
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