January 2013

Providing Feedback to Learners

A useful aide memoire for mentors

Reviewed by A Jenkin, 2013

Acknowledgments Our thanks go to academic and clinical colleagues who have helped to critique and add to this document and include Julie Hicks, Caroline Wright and colleagues from the Renal / Haemodialysis Unit, Derriford Hospital. This document was originally developed in 2009 by A Jenkin and P Wooldridge but has now been adapted by the BSc (Hons) Paramedic programme.

Reviewed by A Jenkin, 2013

Index

Content Page

Useful information about terms used within the document

4

Providing feedback to learners

5

Formative assessment

6

Challenges or concerns

7

Value added Comments

8

key themes for mentors

10

Ongoing achievement record

11

Strengths and weaknesses chart

12

Template of a SCOT analysis

13

Reviewed by A Jenkin, 2013

Useful information about terms used within the document.

Ongoing achievement is recorded via a Portfolio

A record of learners’ progression that results from their activity within clinical practice. The document is completed by the learner but the mentor may be asked to contribute towards it. The learner should produce their portfolio within 5 days of commencing a new placement and its content used to contribute toward developing a learning contract or development plan for the learner. .

Learning contract A learning contract refers to a list of identified learning objectives that have been agreed by the learner and mentor. These learning objectives have been agreed as achievable in the current learning environment and time allocated. A learning contract is a fluid document and might need to be amended as the objectives are met.

Formative assessment Commonly know as the assessment period whereby the learner is ‘forming’ their ideas and progression is beginning to take place. It is an opportunity for the mentor to discuss and identify to the learner the stage of progression to date. It is helpful to mention both good points of the learners practice and where further progression should and needs to be made. Do use the learning contract or development a plan to help the learner work towards their formative assessment.

Summative Learning Outcomes

The requirement for the mentor to identify whether the learner has successfully completed the required summative learning objectives for the particular stage of their academic programme. Refer to: Colleagues the learner has worked with The learning contract or development plan Summative learning outcomes (SLO’s) Programme/module handbook.

Placement Development Team

This team is there to support and offer guidance to the mentors. They can be consulted at any stage of the learners’ placement especially if the mentor or others have concerns or questions. Involve the PDT earlier rather than later. The team include: SWAST PDT lead University PDT lead Placement co-ordinator Programme area-link lecturer.

Audit trail

As a mentor it is good practice to keep some form of written evidence of any activity that you have been involved with the learner. This does not mean that you keep notes about everything that occurs on a daily basis, but you could keep a record of the weekly debrief/ tutorial for example. It means that should you ever be asked to present any evidence about a learner you have it at hand. Likewise you could also store good examples of activity the learner has undertaken such as a project or reflection etc

If it is not written down it was not done!

Reviewed by A Jenkin, 2013

Providing feedback to learners

Providing feedback to a learner is an essential part of your role as a mentor as it is a method of provided structured information to aid a learner’s progression through their academic and practice placement pathway. It is valued both by the learner and by the academic institution. It is a sad fact that unfortunately some learners have moved through their placements without their placement mentor being aware of the learners’ strengths and weaknesses. Indeed some learners reach their final placement before mentors identify those who should not be allowed to progress further. This is disappointing for all involved. Therefore mentor preparation is a mechanism which helps and prevents ‘failure to fail’. However, vigilance is needed. By being robust in reporting and providing feedback at the end of each placement, is some measure or indication of what progress needs to be attained and or met. This activity, if undertaken in a systematic manner will further contribute towards preventing a failure to achieve situation. Each academic institution and its programmes have specific clinical practice assessment needs for their learners. This document is not going to mention all of these programme requirements. Instead it is going to look at the principles of practice when providing feedback to a learner. The Health and Care Professions Council and other professional Colleges such as the College of Paramedics would agree that it is appropriate to continually monitor a learner’s progress. Within the Paramedic programme as well as others, it is also important to monitor professional behaviour. Professional behaviour is a learnt behaviour that the learner needs to understand and abide by if they are to be successful in their future profession. Thus commentary is also welcomed on the students’ motivation, attitude and behaviour as well as comments regarding the professional development in clinical practice.

Aim of feedback Perhaps the most important aim of feedback is to ensure the learners’ standard of professional practice meets the required standard of keeping the patient safe in their delivery of quality care. Additional aims of providing feedback from one placement to another are to:

Enable a mentors judgment to be made regarding the learners’ overall performance whilst on the placement

Track those elements of the learners professionalism relating to approach, behaviour and attitude

Summarise a learners development of applied knowledge

To feed forward to future mentors any concerns or challenges

Identify any particular strengths the learner has and to build upon these

Ensure learners receive constructive feedback and to offer suggestions on how to make further improvements to promote progress

Provide an audit trail and monitor the learners practice development so that the learner makes a meaningful contribution towards overall professional performance and academic achievements suitable for professional registration as required by professional bodies and statutory regulation

Reviewed by A Jenkin, 2013

Formative assessment: Faculty of Health, Education and Society programmes often ask mentors to make a judgement within the formative assessment on (for example) a measure of competence. Within the clinical portfolio of evidence you will find three categories for your learners’ progression. You can add to the formative process by signing the relevant stage as the learner achieves it:

Taught

Can undertaken be via simulation in practice

Stage one Performed under direct guidance to a satisfactory standard

Stage two Performed under observation / indirect supervision to a satisfactory standard

This measure of competence often requires a tick (or the registered practitioners initial) in a box to reflect both yours and the learners’ perception of level of progression. However, there is additional commentary required as regards learners’ progress. So this is where you agree with the learner to any required amendments of their learning contract and write some comments regarding their developing skills. The following shares ideas of what could be said in a statement regarding ‘overall performance’.

The ‘not yet satisfactory’ statement in this example would need to be passed on to the learners’ personal tutor at the University and the mentor would be recommended to expand upon these concerns in a separate statement, prior to the learner leaving the placement area. Do ensure the learner has a copy of this statement and keep a copy for your own records and for audit purposes.

Whether a formative or summative assessment, it is important that written feedback often via the portfolio or an ongoing achievement record of practice assessment document is of use to the next mentor. Even if the learner does not have a formal ongoing achievement record, similar information may be entered into a

Witness statement

Evidence products of their own work

Reviewed by A Jenkin, 2013

Direct observations

Placement mentors commentary

Other form of learner feedback form

Transcript of a Q&A session The important aspect is that future mentors can see what development has been achieved and what needs to be further developed. Think about a time when you received a learner into your clinical area and considered such statements as

I am not certain what the previous mentor felt but...

I am sure this learner would have learnt to... I have real concerns about this learner...... Challenges or concerns: this example relates to ‘reporting information’ but could apply to any practice component. The point is that any concerns or challenges are passed on to the next mentor.

Reporting information......................................................................................... ............................................................................................................................ ............................................................................................................................. ............................................................................................................................. Other example ............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

Question: documents often ask for ‘value added comments’, what are these?

Reviewed by A Jenkin, 2013

Value added Comments These are comments that offer information regarding the professional image, general impression or other aspects of the learner. An opportunity to do this is often included in the summative learning objectives forms or final report where there is a blank section for placement mentors commentary. Examples could included

Professional behaviour and attitude Such as, communication skills, attitude to the team, conscientious and patient centred approach

How do the learners manage issues such as managing their shift work in relation to their child care, time keeping, conforming to the regular shift patterns of the placement area?

Since healthcare delivery involves 24 hour care, learners are expected to work shifts, and in order to experience the 24 hour care provision, are encouraged to be active in pre and post shift activities (vehicle checks, vehicle cleaning, incident de-briefs and patient handovers). On some occasions this will include varying start times. Weekend shifts and night duty are part of the 24 hour care provision and learners encouraged to work these shifts. The aim is to provide the learner with a realistic experience of emergency, urgent, unplanned, primary and secondary care, which involves more than a 9 – 5 day.

Professional development:

How has the learner demonstrated the following?

Self-confidence

Self-motivation

Self-evaluation

Interpersonal Skills: How has the learner demonstrated thoughtful consideration of others? Self-Management:

How has the learner demonstrated their ability to take responsibility for their own professional development?

Has the learner been conscientious to follow their learning contract

Seek feedback

Undertake reflections of their learning and share them with the mentor Situational Leadership

Has there been an opportunity for the learner to demonstrate leadership during placement? If so, has the learner used these opportunities to develop any leadership skills?

Interprofessional Learning

Has the learner demonstrated an ability to work with other professionals during placement?

Change Management

How has the learner adapted to change? For example organisational, procedural, staff and or client focused change.

The mentor is not expected to use all of these examples for each learner but rather to support their own thinking and ideas about the learners’ progression. These ideas can be reviewed to create an overall written account of the learners’ development and progression.

Reviewed by A Jenkin, 2013

A mentors own audit/record. It is essential that mentors keep their own record of feedback to learners. This can be a photocopy of the summative commentary sheet or a copy of the learners’ collection of evidence and or a copy of an ongoing achievement record. This documentation can include

Learners contract

Formative Assessments

Summative Assessments

Witness statements

A mentors own notes Whatever resource is used it can be facilitated by completing the required programme documentation in a timely manner. So wherever possible, make appointments for the learning contract, formative assessment, summative assessment or final review at the beginning of the learner placement.

Still have concerns about what to write? On the next page, are themes or cues created according the level of the learners practice (1st, 2nd and 3rd years). Again, they can be used to formulate questions or act as prompts when considering the learners general level of progression.

Reviewed by A Jenkin, 2013

This grid offers areas of key themes for mentors when needing to write about a

learner’s progression.

1st year learners 2nd year learners 3rd year learners

Subject knowledge Sound knowledge of the basic concepts Levels of safety and responsibility Clinically safe, and accurate, requiring some supervision Begins to develop own professional principles and judgement and is therefore able to challenge ideas Characteristics of performance Increasingly efficient, co-ordinated and confident in the delivery of care Needs some reminders and prompting to facilitate the delivery of care in non-routine situations Levels of supervision Evaluates own performance, although appreciates regular feedback Begins to interact effectively within a team and is able to develop professional partnerships Recognises personal strengths and areas for development

Subject knowledge Sound understanding of the principles of professional practice, and will have learned to apply those principles widely. Levels of safety and responsibility Clinically safe, accurate when working alone with minimal supervision Applies own professional judgement and experience to make clinical decisions and is able to accept challenge from others Characteristics of performance Proficient, co-ordinated and confident in the delivery of care Needs minimal prompting to facilitate the delivery of care Levels of supervision Actively seeks and makes use of feedback Begins to take a leadership role in care delivery and within a team Evaluates own performance and others performance

Subject knowledge Understanding of a complex body of knowledge, some of it at the current boundaries of professional practice Levels of safety and responsibility Clinically safe, accurate when working alone without supervision Able to critically review evidence, arguments and assumptions to reach sound clinical decisions; and is able to accept challenge from others Characteristics of performance Highly proficient, co-ordinated and confident in the delivery of care Needs no prompting to facilitate the delivery of care Levels of supervision Actively seeks and makes use of feedback Takes a leadership role in care delivery and within a team Evaluates own performance and others performance

Reviewed by A Jenkin, 2013

An on-going achievement record can take the form of many guises. The learners or mentors who wish to devise their own format of evidence can do so and an example might be

This page is normally an A4 page size, and it needs to contain meaningful commentary that will be read by the next mentor, member of the programme team or other. Consider for a moment the last learner that you worked with, use the lines below to write summative commentary. Do by all means refer back to the pages in this document to give you ideas to help you form what you are going to say.

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PLACEMENT Area....................................................................... MENTOR ..................................................................................... Dates of Placement...................................................................... Mentors comments: (Consider students enthusiasm, attitude, willingness to learn, areas of strength, areas to develop – including issues and concerns)

Mentors Signature.......................................................... Qualification.................................................................... Date of last mentor update.............................................

Reviewed by A Jenkin, 2013

Strengths and weaknesses chart It is perfectly acceptable for the mentor to ask the learner to complete a SCOT analysis as preparatory work

STRENGTHS Highlight what you has been done well, the skills and achievements over the placement period For example: Knowledge of subject Characteristics: Determination, Hard working, Reliable, Trustworthy Commitment to learning and high standards of patient care Participating positively to promote change

CHALLENGES Highlight areas where personal or organisational development could help to improve effectiveness. Use this section to discuss initiatives, projects or events that did not turn out as successfully as planned and examine the reasons for this For example Too hard on myself Lack confidence when working with..... Need to be more positive when ......

OPPORTUNITIES Highlighting the opportunities had and how they inform future professional practice development For example Went to main theatre with the patient and observed .... Discuss team management and begin to consider taking responsibility for .......

THREATS Identify factors that may have (or are having) a detrimental effect on your work. This may include future challenges that you anticipate For example Poor time management when ........

On the following page is an example of a SCOT form that could be given to the learner

Reviewed by A Jenkin, 2013

Please feel free to photocopy this as required.

STRENGTHS Highlight what you has been done well, the skills and achievements over the placement period

CHALLENGES Highlight areas where personal or organisational development could help to improve effectiveness. Use this section to discuss initiatives, projects or events that did not turn out as successfully as planned and examine the reasons for this

OPPORTUNITIES Highlighting the opportunities had and how they inform future professional practice development

THREATS Identify factors that may have (or are having) a detrimental effect on your work. This may include any anticipated future challenges

Once completed, please hand this back to your mentor.