Mentorship And Competency Based Education

Student mentor is currently working as an endoscopy sister a role newly taken up from may 2018Working in a very busy endoscopy unit where different types of endoscopic procedures are carried out and we tend to have student nurses on a regular basis therefore I decided to enroll in the mentorship and competency based training to become a qualified mentor to facilitate assessment, teaching and learning for students in practice.

Background

Before the mentorship course came about nursing students were given supernumerary status, being included in the numbers during a shift. There was no formal mentoring.

Originally UK set up the standards for educational roles plus series of processes to strengthen learning and assessment. This was adopted by the NMC 2002 revised 2004. NMC standards to support learning and assessment in practice. Pre-registration students must be mentored in practice areas and the role of such mentors is to ensure students are fit for practice, support the student to achieve learning outcome, act as a role model professionally, assess students and provide constructive feedback.

In addition as the NMC required that registered nurses must be able to share knowledge, skills and experiences in support of students in practice Nursing students are expected to spend 50 percent of their training in practice based placement and during these placements they must work together with a qualified mentor for at least 40 percent of their time spent there. Mentors are to make sure students in practice acquire the right knowledge, skills, professional attitudes they require to perform according to standards so that when they qualify the public will be well protected.

Mentors are to support students and colleagues to help them develop their professional competence and confidence "NMC code 2015" 9.4To achieve this there are eight (8) domains developed by the NMC to support the learning and assessment of nursing students in practice "RCN 2015 NMC 2008"These domains are as follows:

1. Establishing effective working relationships

It is the responsibility of the practice area and the mentor to make sure plans are put in place even before the student arrives on the first day. These include speaking to students either on phone or meeting prior to their first day to prepare a working rota, take their personal needs into consideration. Students must be included in the team. If prior meeting is not possible the allocated mentor should make it a point to meet with the student on arrival of their first day, greet them warmly, introduce them to the team, orientate them to the placement area, talk about what to expect from both parties, talk about co mentors and how to work with them.

In my department where I work as a charge nurse / sister this practice seems to exist. We understand that full orientation and building of good working relationships cannot be established on the first day so therefore we do not underestimate this throughout the period of students placement.

We also make a plan for students to be orientated to other multidisciplinary teams. Our department has so many of such. We allocate our students to spend a day or couple of days with all other teams.

2. Facilitation of learning

As part of facilitating good learning experience there should be a proper planning between the mentor and the student during their first meeting. This is a good time to talk about expectations and setting goals towards achieving them. A time to find out more about the student, their individualities, character, ability, needs, what they already know, and their style of learning. Based on these objectives and plans are made. This is because people study differently according to Kolb's experiential learning cycle, which suggests that there are four (4) different learning styles:

• Concrete experience-engaging in an activity or experience
• Reflective observation-reflecting on the activity or experience
• Active experimentation- trying and testing new skills and abilities
• Abstract conceptualization-gaining knowledge or skills from the experience.
• Two men Peter Honey and Alan Mumford also noticed this and identified four (4) separate learning styles

1. Activist - learning by doing
2. Pragmatist - wants to know if it works
3. Reflector - wants to thoroughly understand before trying
4. Theorist - want to understand the principles behind a thing a bit more.

Bearing these in mind when dealing with students mentors need to consider their individualities so as to facilitate effective learning.

In my department I normally see such meetings going on even though I am not a qualified mentor. I see protected times between mentor and student. We need to allocate such moments to identify students’ needs.

Assessment and accountability

Assessment and learning is an approach to teaching and learning that creates feedback which is then used to improve student's performance. It is the process of collecting, measuring and interpreting the knowledge, clinical skills and professional attitude of the learner/student. It also helps to know what learning has been achieved and what needs improving through providing feedback and putting action plans in place. According to NMC 2008 there are such assessment techniques as observation, direct patient care, simulation, case studies, written portfolio, self-reflection, OSCEs etc.

I chose to use observation of a health care assistant maintaining patent airway and suctioning a patient during a gastroscopy procedure but on a colleague based on our local endoscopy and trust policies. Given prior notice for about a week he was prepared and told what to expect which he consented to. No checklist required but goals were set, specific questions planned which at the end of the observation and assessment were achieved. These goals were SMART (specific, measurable, achievable, realistic, with time). Evidence of the assessment process is attached in the appendix.

Based on the assessment and observations the assessor received good feedback from both the learner and the observer. During our discussion it was noted and agreed that student mentor felt a bit nervous. Reflecting on this, nervousness could affect confidence which did not happen during this period. We could work on being more relaxed during assessment next time. Also we could work more on protected time for such assessment period.

Since mentors are expected to spend at least 40 percent of their working time with the student my department ensures this happens most times to facilitate more frequent assessment meetings with their students. Once assessment has taken place more frequently that gives the mentor the opportunity to determine how well the student is progressing hence the decision to pass placement. It is expected that it is not all students that will pass all their placements. According to Kathleen Daffy's study "Failure to fail" 2003 some mentors "fail to fail" students in placement with the hope that they will do better in their next placement and by so doing not protecting the public they will end up looking after. Patients and service users are being put in danger by these mentors. Safeguarding the patient should be a mentor’s priority when considering whether to fail or pass a student. Even though the decision to fail a student is difficult to make it is in the best interest of the public to do so and should be evidence based and after seeking other professional advice from Link lectures and practice facilitators RCN 2017.It is better to fail a student and get them prepared well than putting the public in danger. Assessing a student is one of their important roles of a mentor and he or she must act with integrity because they are responsible for confirming whether their students have met the NMC competency or not.

Evaluation of learning

Evaluation of learning is key to knowing how much learning has taken place from what the student knows and where they are, if the teaching has been effective or helpful and whether the objectives have been achieved or not.

The importance of evaluating learning is often undervalued and failure to do so can have a negative impact on the student and future learning. As a registered mentor there are different ways to evaluate a student's learning by interacting, working closely, verbal feedback, written comments, observation, feedback from other colleagues, patients and their families and students themselves. Continuous evaluation might not always be positive for the student during this learning process but as a good mentor it will help to develop new strategies and action plans towards building the student up. The main priority here is towards patients/service users, which is protecting the public.

Creating an environment of learning

It is very important to create a conducive atmosphere or environment for learning to thrive. Students’ expectations in their placements is to learn practical and professional skills and develop their professional competence and skills. It is a co responsibility of both mentor and student to make this happen. Though students are expected to work with their named mentors for 40 percent of their whole placement other co mentors and team members and multidisciplinary team should all come on board and be involved nevertheless the student also has a major role to play for effective learning to take place.

In my department students are well integrated into the team giving them the opportunity to maximize their competencies. It is also important to identify any barriers or challenges that may affect learning and must find a way to address them.

Evidence-based practice

Every clinical decision or judgment made must be based on evidence and research. Evidence based practice in health care is the way forward. The mentor’s role is to help and teach the student to follow such evidence based practices. Healthcare organizations need nurse leaders who can develop nursing care, are an advocate for the nursing profession and have a positive effect on healthcare through leadership.

Leadership in nursing can be also defined as motivating and empowering individuals to adapt and develop their role and quality of direct patient care. Leadership is a skill required for managerial purposes. As a mentor you need such skills as being able to plan, organize, te

ach, and be an advocate. This even helps your student to have more confidence in you as a mentor. You should be able to teach students how to acquire the right knowledge and use it effectively to show competency and productivity. A mentor should be knowledgeable, be able to manage people and time effectively, support students and colleagues and should be a good team player. Nevertheless not all mentors have the ability and skills to be good leaders.

Going through this mentorship course, assessment and writing this essay I have learnt and now understand a lot more what it takes to be an effective mentor. The role of a mentor, the background and history behind the mentorship course. Also learnt to understand the challenges some students face, the available resources to manage them to come out and qualify as good and competent future nurses. The eight (8) domains developed by the NMC to facilitate effective teaching and learning and also appreciate more the benefits of mentors not "failing to fail" students so as to protect the heath and safety of the public at the long run.