Mentoring and Enabling Learning in the Practice Setting

Mentoring and enabling accomplishment in the lam screen background A reflective composition of my consume of facilitating tenet, appraiseing and teaching a savant or co-worker, and how this experience will aver my future set aboutment inwardly the mentor or traffic pattern teacher position. Student Number 2930211 Word Count 3150 touch off 1 Introducing the Mentorship usance I am a band five registered paediatric treat base on an orthopaedic and spinal surgical ward in a tertiary paediatric hospital.I am currently engaging in completing my training to arrive a qualified mentor. This reflective account details my experiences assessing, teaching and facilitating the information of a bookman during their intrust found erudition, and how this experience whitethorn affect my future hold. Throughout the account, in recite to protect the identities of slew, trust and clinical setting involved confidentiality will be maintained via the use of pseudonyms or omissio n of names ( breast feeding and Midwifery Council (NMC), 2008a).The blend of usage ground learning is to append experience, serving an in-chief(postnominal) reference in develop the skills of the bookman in interacting with patients and their families assisting in technical, psychomotor, interpersonal and colloquy skills (Ali and Panther, 2008). Practice based learning nominates an opportunity to link theory and practice, and promotes skipper identity development (Fishel and Johnson, 1981). Practice based learning is similarly life-or-death in the profession of nursing c completely competent to the vocational nature of the work, and sine qua non of assessing clinical competency and safeguarding the public (Rutowski, 2007).By ensuring specific standardiseds be met with judicial decision in practice, it impellingly fits that school youngsters argon fit for practice at point of registration (NMC, 2004). My demonstration of demonst order my eligibility to supervis e and assess assimilators in a practice setting and successful completion of the NMC approved mentorship programme will allow me to encounter the definition of a mentor (NMC, 2004), and perform an important role that all nurse has to assume formally, sooner or later (Ali and Panther 2008, calculate 1)Figure 1. (Synthesised using NMC 2008b, Rutowski 2007, Beskine 2009) Part 2 The NMC Standards In order to mark off that in that respect is a set train for die harding learning and perspicacity in practice, the NMC devised and provided a set of standards for which mentors, practice teachers and teachers are compulsory to meet (NMC 2008b, Ali and Panther, 2008). The concur mandatory requirements occupy a developmental framework, the standards, and learning regarding application of the standards to sound judgment in practice.The competency and outcomes for a mentor are underpinned by eightsome domains (Figure 2, NMC, 2008b). Figure 2. (NMC, 2008b) Number Domain 1 Establis hing effective works births 2 Facilitation of learning 3 judicial decision and account office 4 Evaluation of learning 5 Creating an environment for learning 6 Context of practice 7 Evidence-based practice 8 Leadership When catching the eight domains within my declare clinical practice area I consider establishing effective working relationships and leading to be of particular splendour.The establishment of an effective working relationship is merry due to working together with families and providing bang for the family as the patient, rather than unsloped the child (Casey, 1988) in order to provide a good standard of worry. Establishing effective working relationships also serves to reduce sad pupil experiences and level ability to assure competence to practice (Beskine 2009, Dowie 2008). When considering the importance of family centred guardianship, as easily as the promotion of an effective working relationship, leaders is a get a line theme.Leadership in my cli nical setting involves role modeling, improving care and influencing opposites (Cook, 2001) as closely as considering situational forms of leaders (Faugier and Woolnough, 2002) when communicating with various parties in incompatible situations. Leadership in my practice setting could position from working with a severe family, which whitethorn require participative leadership, or a situation where I need to be assertive. I must frequently act as an advocate for the child (Children Act 1989), requiring a much than autocratic access code (Bass and Bass 2008).Both establishing effective relationships and leadership require skill, knowledge and experience and whoremonger be central to providing feature care (Department of health 2004). Key passkey challenges surrounding learning and sagacity in my practice area include difficulty due to the busyness and laging levels on my ward, which is kn let to affect the quality of assessment in practice (Phillips et al, 2000). The p ush of clinical commitments and lack of available time has an affect on the organisation and supervision of scholarly persons during clinical situation (Caldwell et al 2008).Other difficulties whitethorn include inconsistency in performance influencing assessment of fitness for practice (Duffy and Hardicre 2007a), or pupils who are not compliant with sustain available and provided should they be helplessness (Duffy and Hardicre 2007b). Reluctance to fail a impuissance scholarly person due to poor assessment or ascending the failing process too difficult (Duffy 2003) also serves as a passkey challenge in my practice area.The NMC Standards to support learning and assessment in practice (2008b) do provide a framework for mentors, but due to the nature of the document it is not comprehensive enough to consider all aspects of competence assessment (Cassidy, 2009). It could be considered that some level of assessment rest subjective despite the framework being provided, due to the inherent nature of the involved profession and the variation of skills to be assessed.Holistic assessment of competence is difficult to structure a framework, particularly when considering a students self-referent execute to give their knowledge skills and attitude with stimulated intelligence (Freshwater and Stickley 2004, Clibbens et al 2007). These issues may become more prevalent when considering the possibility of a mentors failure to fail a student (Duffy, 2003). These is somewhat rectified by the responsive development of betoken off mentors who make a last-place judgement on the fitness for practice of the student at the end of their training (NMC 2008b).Further support lav be given to the NMC standards to support learning and assessment in practice (NMC 2008b) by documents such as Guidance for mentors or nursing students and midwives (Royal College of care for (RCN), 2007) a toolkit which assists in providing support and strategies for mentors. Part 3 My pra ctice based assessment session Practice based assessment is a total mode of assessing the knowledge, skills and attitude of a student (Bloom 1956, Wallace 2003), but is building multiform to ensure objective management (Carr, 2004).To accommodate a diversity of patients and needs (Dogra and Wass, 2006), opposite types of assessment are necessary, all of which are part of the mentor student relationship (Wilkinson et al 2008, Figure 3, NMC 2008b). Figure 3. ( Wilkinson et al, 2008) Type of assessment translation Mini clinical evaluation exercise. Snapshot of student performing mettle clinical skill. eject be integrated into ward environment or routine patient encounter (e. g gaining a inconvenience polish off from a patient) Direct observation of procedural skills.Observing a student harbour out a procedure and providing feedback by and bywards (e. g performing infertile non touch technique to congeal a dressings trolley). Case based discussion. A structured interview t o research behaviour and judgement (e. g discussing aspects care of a patient and what a student did or observed). Mini consort assessment. A group of qualified professionals providing feedback on an individuals performance, includes self assessment (e. g feedback from other nurses that supervise a student in their clinical situation).The method of assessment must be considered in terms of reliability, cogency, acceptability, educational impact, and embody effectiveness in order to evaluate the suitability of the assessment itself (Chandratilake et al, 2010). Assessment of formal knowledge allows review of conceptual knowledge, including considering potential risks or other influencing factors. Assessing an individual in practice, or their craft knowledge, allows reflection and development on experiential learning (Price, 2007).Both formal and craft knowledge are required to be continuously assessed to recognize the student in order to understand how the student reads risk situ ations and uses concepts to address practice requirements (Price, 2007). When assessing students it is important to establish quatern key areas (Hinchliffe 2009, figure 4). Figure 4. (Hinchliffe 2009) Key area Description friendship What do they know? Skill What do they do? Performance How well do they do it? Motivation Why do they do it, and how do they feel about it? Continuous assessment has limitations with regards to validity and reliability for legion(predicate) reasons.There is a requirement for co-ordination surrounded by educators and service providers to agree on assume assessment path tracks for formative and summative assessment, allowing an take over level of assessment and practice theory link (Price, 2007). A mentor in a complex clinical setting combined with the pressure of continuous assessment on students in front of patients, family, relatives and other professionals has an impact on performance and may increase the anxiety of the student or the tax tax as sessor (Price, 2007). Anxiety may also be ca apply by the mentors eeling of competence to assess, the student feeling desex to be assessed (including contributing personal factors), as well as changes in curriculum causing mentors to feel less competent in assessing genuine areas (Price, 2007). My assessment was of the competence of a first year student utilising inconvenience oneself assessment tools sequesterly to successfully gain a pain tote up from a post operative patient. I considered this to be an area of importance due to the integral part of professional training pain assessment is recommended to serve considering pain as the fifth vital sign (Royal College of nursing (RCN),2008).Considering the expectations of first years participation in sight vital signs, competence is important for patient safety (Lomas 2009) . I would consider this assessment a direct observation of a procedural skill (Wilkinson et al 2008). An observing qualified mentor was present and observi ng at all points of the assessment and feedback. The observing assessor provided written feedback regarding the assessment provided (Appendix 2).The assessment was planned including the criteria and a number of questions developed, to test the learners understanding (appendix 1). The criteria for assessment was structured and at an appropriate level for the student on both a theoretical and concrete level (Stuart, 2007). The developed questions were aimed to make the student provide rationale for their choices within and around the assessment, aiming to make the assessed skill less of a series of tasks and provide a more versatile skill applicable in different ways (Cassidy, 2009).I waited until the ward was quiet to ensure there would not be interruptions and the assessment would not be compromised (Rutowski, 2007). Initially, I introduced myself to the student, as it was the first time we had met, this aimed to familiarise myself with the student and aim to reduce their anxiety ( Price, 2007). I went on to tell the student what exactly I wanted them to do, approximately how keen-sighted it would take and reassured them not to be worried as this was not a formal assessment, aiming to reduce anxiety (Price 2007) and make expectations clear.It was identified by my observing assessor that I did not enquire as to former experiences of the learner. Although I knew that the student was a first year and the assessment was appropriate as such, enquiring further into their experiences may piss provided a link that would take for altered the assessment in some way and perhaps suck up assisted in supporting further growth ( cleanman and Pelle, 2002). My assessor also felt that outcomes should have been more clearly identified at the initiation of the assessment.Though the information was provided, and in an appropriate environment (Price, 2007) a shorter almost green goddess point summary at the end of discussing outcomes may help to prepare the student for what is expected of them (Stuart, 2007) and reduce confusion or anxiety (Price, 2007). When the student had completed the first criteria, I asked her my first question. This took into consideration the students approach to converse (Dickson et al, 1997) and their knowledge of basic child development (Sheridan et al 1997), knowledge applicable to core skills in many ways.The student correctly introductoryitised the order of pain evaluation, completing the second criteria (International association for the speculate of pain (IASP) 1994, Broome 2000). I asked the student the second question at this point, the student demonstrated theoretical ability to integrate with the nursing team to provide safe and effective care (Stuart 2007, Lomas 2009). Finally for the assessment the student communicated well with the child and their family demonstrating effective family centred care (Casey 1988) and successfully gained an appropriate pain score (IASP 1994) using the Wong-Baker faces pain rating (Wong et al 2001).After the pain score had been gained I asked my final question which was how oftentimes should pain observation be done, which the student correctly responded to in abidance with RCN (2008). My observing assessor felt that at points my speech was too unbendable and noted that I required to repeat myself on occasion. Speaking at a slower rate allow a student to brave and understand information given to a best(p) level, and prevents them from becoming overwhelmed with information faster than they can process it (Prozesky 2000).I provided a feedback session for the student, aiming to develop a sustainable proactive learning relationship with the student (Cassidy, 2009), which included an action plan made with the student (Appendix 3). Considering that the student was essentially competent at the skill, the action plan was counselingsed on gaining a greater range and experience in order to gain a more reflexive experienced quality regarding the skill and provide more holistic competence (Cassidy, 2009).The feedback was provided positively and constructively and seemed to help with the students self esteem with regards to the skill, creating a more supportive working relationship and conducive learning environment (Clynes and Raftery, 2008). The student-mentor relationship is crucial to the students learning experience (Ali and Panther 2008, Beskine 2009, Goppee 2008, NMC 2008b, Wilkes 2006, White 2007). Effective conversation skills can help identify a student causing adjoin at an early stage in order to pre-empt failure (Caldwell et al, 2008).Though feelings of somberness or failure may be felt by the student and mentor from failing assessment, and this provides a challenge, it is important for mentors not to avoid these situations if a student has not met desired outcomes as this may have farthest reaching implications on student progression (Duffy and Hardicre 2007a, Duffy and Hardicre 2007b, Wilkinson 1999). The feedback was schedul ed and provided shortly after the session aiming to give the student prompt support if required and to correct any unsatisfactory behaviour if present (Duffy and Hardicre 2007b).Considering the feedback, and my own reflections on the assessment, there is need for my future development. I will also endeavor to lecture more slowly and learning more about the student former to assessment. , and provide a more clear identification of outcomes . I would consider gaining feedback on the students performance from the patient and their family in the future. This would allow us to take into account the view of the service user and family to promote clinical integrity and family centred care is of a gritty quality (Department of wellness 2004, Casey 1988).Overall, my observing assessor thought that my assessment of the student was appropriate for their level of knowledge, skill and attitude (Bloom 1956, Hinchliffe 2009, NMC 2008b) and effective in determining the level of competency in th is area. Part 4 My practice based teaching session I active a teaching plan (appendix 4), a powerpoint presentment (appendix 7), handout of the presentation and a handout of the various tools for pain assessment (appendix 8) before my teaching session.This teaching took a mostly behaviourist approach as fence to a cognitive approach, however, discussion during the learning allows for a more cognitive approach(Figure 5). I arranged for a qualified mentor to observe and assess my teaching and the feedback I provided to the student (appendix 5). They provided written feedback on my session (appendix 6 and appendix 9). My assessor noted positive use of further see and handouts, to enhance the students personal knowledge and support for further great(p) learning (Knowles 1990, Beskine 2008).Provision of printed handouts, particularly with space for notes beside them, may help accommodate students who have dyslexia, and may otherwise struggle to reap the information provided (White, 2007). Figure 5. (Synthesised from Bullock et al 2008, Goppee 2008, Hinchliffe 2009) acquirement theory Description Behaviourist Information provided by teacher, student relatively passive. Cognitive (humanisitic) Student centred. More useful in vocational teaching like nursing. Relates past experience (knowledge or theory).I booked and lively the seminar room on the ward to ensure there wouldnt be disturbances, a formal teaching session with clear aims of what to achieve (Goppee, 2008). Utilising a space like this creates a professional and friendly environment luck create a good learning environment (Beskine 2008, Hand 2006). My assessor observed that I had created a welcoming environment. My assessor commented on the high quality of the evidence based content within the teaching session, my own skill and knowledge in this particular area.Providing good evidence based information assists in providing excellence in care (Department of Health 2004, Beskine 2008). victimisation examples from practice also helped describe to the learner applications of the theory to practice (Knowles 1990). My assessor noted my good eye contact and body language, reassuring the student pull aheads continued attention, interest and a positive relationship (Dickson et al 1997). My assessor commented upon the open questions I asked, keeping the student interested, engaged and relating to practice, encouraging cognitive learning (Figure 5).Further learning revolved around the student as an crowing learner identifying how to best expand their knowledge in this area by approaching it in a more kinaesthetic learning demeanor (Pashler et al 2009, Figure 6). Figure 6. (Synthesised from Dunn et al 1996, Given and Reid 1999) Learning vogue Advantages Disadvantages Visual Learns through images, visual tools or imagining events. May need more time to complete tasks. May have decreased interest in theoretical values. Auditory Learns well through talks or lectures.Absorbs sequenced u nionized information well. May use checklist. Highly unlikely to be able to multitask. Can focus on one area at a time and neglect the big picture. May not work well in groups. Kinaesthetic (Tactile) Learns through doing. Tends to enjoy the experience of learning. Finds it sluttish to demonstrate. May miss instructions or information if presented orally. May find paying attention to detail difficult. My observing assessor noted that at some points the speed of the session was a little too fast.This may cause the student to become confused or not absorb the information that I am teaching (Prozesky 2000). On reflection I can use this experience to expand my personal knowledge and how to develop further (OCallaghan 2005). I will speak more slowly so that the learner can gain more from my teaching session, and consider the student as an adult learner with previous experiences, which can be used as a resource (Knowles 1990). I could also have asked how the student learned best and accom modated their learning style effectively (Rassool and Rawaf 2007).A wider range of learning styles (figure 6) would accommodate all types of learning (Rassool and Rawaf 2007, Pashler et al 2009). I would also devote more emphasis on patient safety issues (Beskine 2008). Part 5 The Leadership skills required by a Mentor I am aware that being a mentor is part and parcel of leadership behaviour (Girvin, 1998). Transformational leadership concentrates on the ability to influence situations or people by affecting their methodology of thought and role modelling (Girvin, 1998).Transformational leadership in nursing encourage autonomy and enable students or staff to reach their potential and promotes good interprofessional rapport ( poll, 2009). By acting as a role model in my clinical setting and pursuance to address obstacles inherent in mentorship on the ward, it is possible that I could not only develop myself and the students that I mentor, but also other mentors on the ward and thei r behaviour and practice in a positive way (Girvin 1998, Pollard 2009).Obstacles such as staffing levels, busy ward environment and the pressure of clinical commitments impact upon me damaging the effective working relationship amidst myself and the student (Beskine 2009, Hurley and Snowden 2008, McBrien 2006). Finding time provide written feedback in a students documentation can be limited (Price, 2007). By e-mailing other mentors evaluations of my shifts with their students it may become common practice providing a greater range of student evaluation and a positive learning environment (Cassidy, 2009).This feedback can accordingly be sent to the mentor at a quieter time, and discussed with the student prior to, signing and entry into their documentation with time being less of an issue. in spite of this being a good use of resources and time management (Beskine 2009) I have already tried this and found often mentors are not interested unless the evaluation bears a particular ne gative weight with regards to poor performance which must be addressed urgently. Anxiety of the student, or my own as the assessor may effect the reliability, subjectivity or the validity of assessment (Price, 2007).Effectively facilitating the learning of students requires flexibility and understanding for different learning styles including (Bullock et al 2008, Goppee 2008, Hinchliffe 2009, Dunn et al 1996) including adult learning (Knowles,1990) and students with learning difficulties (White, 2007). Strong links between practice and theory (Stuart, 2007) must be in place to ensure suitability of assessment and teaching. Along with these issues, the student-mentor relationship must be nurtured to provide a quality learning experience (Ali and Panther 2008, Beskine 2009).Discussing a students pet learning style in their initial interview may encourage the student to engage in a higher standard of adult learning (Knowles 1990, Rassool and Rawaf, 2007). This can help me alter my str ategies to create a better relationship between myself and the student (Beskine, 2009). I am currently supervisory program to a first year student on first placement who has studied in school and sixth form, they do not have a great deal of experience with adult learning, and they have needed additional support and provision of resources to facilitate their learning, articularly with practical(a) skills. Orientation is the admission to a successful placement (Beskine 2009). Students must be assessed fairly and objectively (Ali and Panther 2008, Duffy and Hardicre 2007a), though this may cause unpleasant emotions to both the student and assessor it is important that this is done, to ensure student progression is not damaged (Duffy 2003, Duffy and Hardicre 2007a, Duffy and Hardicre 2007b, Rutowski 2007, Wilkinson 1999) and competence is insured for patient safety (NMC 2008b, Lomas 2009).I aim to ensure that the students I work with and assess are competent and fit for practice (NM C, 2008b). It is important to regularly work with students and have clear objectives from the initial interview (Duffy and Hardicre, 2007a). I am aware that it is my responsibility to ensure concerns with a students performance are raised by midpoint at latest, so that by final interview, there should be no surprises for the students summative assessment of their progress and level of competence (Duffy and Hardicre, 2007a).Asking children and bring ups their opinions on students working with me, and their performance can provide an brain wave into the family centred care the student is providing (Casey, 1988) and may allow a greater interpretation of holistic reflexive performance (Cassidy, 2009). On the negative side, a parent is not aware of the pressures upon the student (Price, 2007). The parent of a sick child is anxious themselves and will be more subjective than objective.In conclusion, mentoring is a complex and diverse role, and one I will take on with focus and and knowl edge, and endeavor to continue to develop as a practitioner, assessor and teacher in the clinical setting. This reflective process has been incredibly valuable in preparing me to be a mentor, and my personal and professional development. I have gained a much deeper understanding of the mentor student process through investigation of the various aspects of NMC standards, as well as various assessment and teaching strategies. Areas on which I must develop are clear, and in completing this ourse I feel adequately prepared, and look forward to further developing my skills and knowledge within this role. REFERENCES References Ali PA, Panther W (2008), Professional development and the role of mentorship, care for Standard, 35-39, Date of acceptance April 3 2008. Bass, B. M. & Bass, R. (2008). The Bass vade mecum of leadership Theory, research, and managerial applications (4th ed. ). upstart York Free Press. 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