Mentor Update 08/09

University Campus SuffolkUniversity Campus Suffolk

Session Aim & Objectives

This mentor update aims to give you an opportunity to discuss key issues surrounding mentorship in practice

At the end you will be able to:– Make informed judgements of competence using the

UCS grading taxonomy

– Debate some key issues and devise strategies to support learners

New NMC requirementsRecord of Achievement

• Documents mentor / student interviews for all placements

• Lasts for three years

• Aims to support ‘sign off’ mentors signing final proficiency to register

• Also includes:– Student action plans for

following placements– Extra meeting sheets– Mentor action plans (to be

added)

Essential Skills Clusters

• Aim to focus students on essential elements of practice

• Includes:

– Medicines Management– Infection Control– Communication, compassion– Nutrition & fluid management– Care Organisation

MIDWIFERY

– Normal labour & birth– Consultation with mother– Breast feeding– Communication– Medicines Management

The NMC also requires all students’ drug calculation skills to beassessed in practice. Students must achieve 100% and can only

use calculators to check (this includes students with dyslexia or dyscalculia)

The role of the Associate Mentor Stage 1

• All registrants become an Associate Mentor on qualifying

• Associate mentors DO NOT have any mentorship qualification

• To compliment your role as mentor

• Associate mentors should not be assessing competence in skills

• If an Associate mentor does sign skills off in the PA Document – a mentor MUST countersign

• This is to ensure all aspects (knowledge, skills & attitudes) related to each skill have been adequately assessed + that the taxonomy has been used correctly

• Please refer to your Trust’s guidelines / policy

Key responsibilities:

– Act as a safe role model

– Support those new to integrate into practice

– Contribute towards effective learning experiences

– Share knowledge & skills with learners

– Provide feedback for assessment

– Provide support to mentors

– Demonstrate a commitment to own CPD

– Have effective communication skills

Components of an holistic assessment

Holistic assessment Of competence

Knowledge

Understanding

Evidence basedpractice

Reflective practice

Problem solving &Decision markingTechnical skills

Professional Codes

Attitude

Ethics

Stuart C (2006) Assessment, Supervision & Support In Clinical Practice (2nd Ed). Churchhill Livingstone, London p78

Questioning ..

Category Cognitive activity required

Sample question words

Example questions

Knowledge Recall What, Identify, Define, When, Describe, List

What is the definition of..

Comprehension Understanding Compare, Explain, Differentiate

Explain how handwashing can reduce infection

Application Solving Apply, Consider, How would,

How would you gain consent if a patient has difficulties communicating?

Analysis Exploration of

reasoning

Support your.., What assumptions, What reasons

What information would you need to support the use of this intervention?

Synthesis Creating Think of a way, Create, Plan, Suggest

Given all the information in this case, suggest the initial care required

Evaluation Judging Consider, Which would, Defend, What is the most appropriate ..

Out of the two possible interventions, which is the most appropriate for this client?

Level Key Criteria for Assessment of Skills

Exposure EX Is exposed to a skill/activity as an observer. Is able to describe underpinning knowledge.

Participation

(minimum for 1st Yr nursing)

PA Participates in skill/activity under direct observation. Needs prompting and guidance.Safe all of the time and effective some of the time.Lacks confidence. Has a basic understanding of the underpinning knowledge.

Identification

(minimum for 2nd Yr nursing)

ID •Performs the skill/activity under supervision, but some guidance may be required in some aspects of nursing care. May lack confidence in some aspects of nursing care, but is safe and effective all of the time.Identifies and applies knowledge of the skill/activity.

Internalisation

(minimum for 3rd Yr nursing & all years midwifery)

INIs able to perform the skill under supervision. Is confident, safe and effective all of the time. Has the capacity to perform with minimal/no guidance. Is able to demonstrate the key aspects of the skill and apply them in practice.

Dissemination DIIs confident and executes the skill in a timely manner. Is safe and effective all of the time. Is able to critique the underpinning knowledge and influence the practice of others.

Exposure

• The student will have observed a competent practitioner carry out aspects of care.

• The student will be able to discuss with the practitioner why and how certain aspects of care were carried out.

• Can identify sources and types of information which can enhance their application of knowledge to practice.

Participation

• The student is able to participate in care under close supervision of a competent practitioner

• Demonstrate knowledge by analysing care given

• Able to provide a basic rationale for care

• Shows ability to perform manipulative skills, communication and problem solving skills with guidance

Identification• Able to participate in care

with less prompting and increased confidence

• Shows greater ability to communicate effectively demonstrates a wish to acquire further information

• Able to analyse and

interpret information and apply problem solving and skills and knowledge base to meeting different situations.

Internalisation

• The student is able to explain the rationale for nursing action. 

• Requires less supervision

• Ability to transfer knowledge to new situations

• Seeks and applies new knowledge and research findings

• Demonstrates ability to use problem solving skills, and critical analysis and evaluation.

Dissemination

• Plans, implementation and evaluates care for a group/clients under minimal supervision. 

• Advises others, shows ability to teach junior colleagues

• Ability to manage self effectively

• Shows ability to manage care delivery by junior staff.

  • Critical analysis, evaluation and

decision-making skills demonstrated.

Group Activity -

• Over to you:

– Look at the given scenario– Discuss the main issues as a group – List the actions you would follow

– Identify a spokesperson to feedback

Exploding the Myths of Assessment!

• 1st Yr students can only achieve participation

• This is only an observational placements therefore the mentor can not sign off any skills

• UCS will over-rule any referrals in practice

• Experience 1,2,3 means students must do all skills in Terms 1,2,3

• Students must work with their mentors for every shift to be assessed in practice

• Student nurses have a lack of knowledge or experience to contribute to decisions in practice

• This is a 2 week placement therefore I don’t need to plan any learning experiences for you – just watch and learn

Student feedback…• Positive mentoring

‘I become a more enthusiastic learner when my mentors give support. We really need their support and motivation during the learning process.’

• ‘I was given every opportunity to learn and encouraged to be part of the ward and patient care, MDT, ward management, it was a very positive and informative placement.’

• Students felt that good mentors often used non verbal communication such as smiling, open posture, tone of voice

‘They encouraged me to overcome my fears and carry out a lot of procedures I didn’t think I would be able to do.’

All these traits helped students motivation, increase self confidence, feel part of the team, whilst being acknowledged for their role in care delivery.

• Negative experiences

• Students feel disempowered by:– a lack of understanding, – mentors preventing learning, – being given limited responsibility– previous experience not being

recognised– Receiving feedback in front of patients

or staff– Limited contact with their named

mentor– Mentors lack of understanding about

how to complete practice assessment documentation

‘Management wanted to use me as a member of staff, even though students are supernumerary. It felt as though my learning and values did not matter..’

‘ I was made to feel very unwelcome… I felt very much ignored. They were not welcoming towards me ..and had an attitude that they didn’t want students there. I was not happy.’

(Lofmark & Wikblad, 2001; Elcigil & Sari, 2006; Bradbury-Jones, Sambrook & Irvine, 2007)

Useful Resources

• UCS Link Lecturers / Personal tutors / Programme Leader

• Allocations Office

• Clinical Practice Facilitators & Practice Education Facilitators

• UCS Mentor Newsletter – published each term, available on the Trust intranet

• UCS website – dedicated placement/mentor pages

• www.practicebasedlearning.org.uk

• RCN (2007) Guidance for Mentors of Nursing & Midwifery students. RCN London

• AODP (2006) Standards and Guidance for Mentors. AODP, London

• NMC (2006) Standards to support learning & assessment in practice. NMC, London