Management of Student Whose Standard of Practice are of Cause for Concern - Research Paper Example

MANAGEMENT LEARNER WHOSE STANDARD OF PRACTICE ARE OF CAUSE OF CONCERN Introduction Mentorship is a relationship between a person being mentored (mentee) and the person mentoring (mentor). The mentee is less-experienced individual who is supported into maturation by an experienced or knowledgeable mentor. This relationship sees to the improvement of confidence, ensures professional development and enhances willingness to learn (Levett-Jones et al 2009, p. 316). The mentor has responsibility to confirm, teach, accept, coach, counsel, protect, sponsor and befriend a mentee. The most important role however, is to see the mentee to a final assessment. Due to a close relationship with mentees most mentors find it hard to fail them (Bray & Nettlton 2007, p. 850). Some weaknesses exhibited by students such as learning difficulties, poor personal hygiene are ignored. The decision to fail a student must be supported by sufficient evidence. Some mentors are put off by amount of paperwork required. Others simply give up after their decision has been ignored or overturned by universities. At times universities actually exert too much pressure on mentors who fail students. This trend proves to be disastrous as it puts patients and the general public at great risk. It is through clinical placement that most students are initiated into nursing practice (Quinn 2008, p.162). These placements have capability to either demoralize or inspire students. According to studies carried out among nursing students’ majority gain fewer skills than expected from placements. They are exposed to same environment of work and practically no learning takes place (Bulman & Schutz 2008, p. 432). Occasionally due to poor preparation and unrealistic expectations placements become unfruitful for students. A number of factors contribute to success or failure of placements. These include quality of mentor, environment of learning, nature of student and Higher Education Institution. There must be due preparation, coordination, collaboration and support between mentor, student and Higher Education Institution (Bastable 2008, p. 198). It is expected at the end of placement period all parties to be contended and fulfilled. There must be a sense of achievement and success for mentor and mentee. For most mentors however, decision to fail a student is taken personally. It becomes a sign of betrayal or failure on their part. Students on the other hand do not take such a decision lightly. In fact a students’ reaction to failure makes mentors reluctant to fail them. These mixed feelings can be effectively dealt with once the process becomes all inclusive (Bray & Nettlton 2007, p. 849). The Role of Mentor It is the role of mentors to offer much needed guidance and support in the practice area. Through support of mentors students are able to achieve goals set for placement. The mentor has to aid students and enable them apply theory to practice (Cree & MacAuley 2000, p. 432). In their evaluation and assessment they must be willing to give constructive feedback. They ensure students reflect in their experiences, practice and performance. The responsibility of mentors is to certify students are prepared and ready for practice, purpose and final award (Allin & Turnock, 2007 p. 189). As role models mentors must be skilled and knowledgeable. The effectiveness of a mentor rises from ability to enable students develop confidence and necessary skills for practice. As much as it seems difficult for most mentors it is important to be able to foster a professional relationship with mentees. This however, does not mean personal relationship should be abandoned. In fact mentors need to befriend students (Bayley, Chambers, & Donavan 2004, p. 302). This enables them provide supervision at an appropriate level. In addition mentors must give constructive feedback, show honesty and help with learning experiences (Gray & Smith 2000, p. 1545). In performing these tasks with honesty and integrity, mentors do much good to the public, institutions of learning and students. Accountability There are a number of roles played by mentors. The work mentors delegates to another person must be done well. They must offer necessary support and supervision (Gopee 2008, p. 129). In assessing and supervising a student, a mentor is accountable to what is taught, assessed and learned. The mentor delivers judgement in regard to a student’s fitness for practice. They ensure personal standards of students adhere to set standards of practice (Gray & Smith 2000, p. 1546). For students must have high standards of care delivery. There must be no error of judgement or compromise in case required standards are not met. The mentor is accountable for a student’s general performance. They are also held accountable for standards of assessing and testing. Since they spent a certain amount of time with students, mentors rely on observation in making final assessment and judgment. They have to inform both students and other staff on their progress (Jowett & McMullan 2007, p. 268). Students Responsibility In order for placement to be effective and productive, students must be familiar with their responsibilities. They must have accumulated certain amount of skills and knowledge to be applied effectively in placement under guidance of a mentor. The first responsibility is to read and understand handbooks related to the program. The reason and expectations for placement must be known beforehand (Calman et al 2002, p. 520). This saves much time and avoids confusion once in placement. It is also important to contact mentors prior to commencement of placement. Familiarising one another on a personal and professional level guarantees a meaningful relationship. In some way it shows professionalism in the conduct of a student. Theoretical knowledge pertaining to placement is a must for students. The mentor will primarily deal with guidance and assessment. Student’s priority in the entire exercise is practice (Drennan 2002, p. 476). A solid background on theory of placement will make work easier and smooth for both mentor and student. They must maximize their experience in the course of placement period through creating opportunity for learning (Calman et al 2002, p. 518). They literary direct their education. This means ensuring interaction with staff members and patients. On working with the latter, students must identify their status at the earliest opportunity. This establishes rapport, builds confidence and understanding. A patient’s confidentiality must be upheld at all times and respect of their every wish. Students must keep away from procedures of which adequate supervision is lacking or not duly prepared. A proper understanding of responsibility and accountability dictates student’s work under supervision (Morton-Coper & Palmer 2000, p. 234). This may either be a midwife or a registered nurse. Dealing with Failing Students In any particular placement there are students who fail to meet required standards or fail to progress. It is important for such students to be identified earlier such that opportunities for improvement are provided (Nursing and Midwifery Council 2006). There are a number of behaviours which may identify such weaknesses. For instance a student may exhibit poor organizational skills or show inadequate preparation, poor health; limited interaction and communication skills (Duffy & Hardicre 2007, p. 28). There are those who cannot respond to constructive criticism and or their clinical performance is inconsistence. Mentors must be willing to offer necessary supervision and support to affected students. In assessing students, mentors must be rigorous, show fairness and transparency (Gray & Smith 2000, p. 1547). This takes a process whereby both formative and summative assessments are carried out. It is a way of advising and judging the student. The one informs the other if conducted in a timely manner (Duffy 2003) The first and most important step to take is arranging a meeting with the student. The student must be made aware of the reason for such a meeting. The issue must be discussed in a professional manner (Phillips, Schostak & Tyler 2000, p. 209). This implies context of a particular concern must be well understood by the student. There must be sufficient evidence to fully back the concerns. In this session every response must be honest and given with no ambiguity. Similarly, a student must be provided with an opportunity for self-assessment. One might be aware of own weaknesses. Again, the problem might have risen from staff or institutional weaknesses (Dorsey & Baker 2004, p.262). The feedback gotten from a student is therefore critical for improvement. This situation must be discussed with others. These include practice facilitator or clinical placement. It is important the link person at Higher Education Institution be made aware of the concerns. The should all be involved in an open and straight forward communication (Neary 2000, p. 468).The Institution of higher education, student and mentor must work together and ensure effective communication. This helps in a big way to clarify certain issues and see to a student’s progress. In the course of the exercise the mentor and students must work closely together. On their part mentors create more opportunities for learning and support in areas where a student exhibited weakness. Plan for Action Progress can only be realized once an action plan is drawn. The student must contribute to making of the plan. The plan must clearly indicate assessment criteria. In addition the student must be made aware of a time frame to achieve certain set goals (Gaberson & Oermann 2006, p. 567). Sometimes in order to avoid biases other mentors need to be involved. There might be personality clashes between student and assigned mentor. This calls for other mentors assessments as well. Their testimonials are essential in enhancing reliability and validity to final assessment (Duffy & Hardicre 2007, p. 29). It would be difficult for a number of mentors to be biased on one student. Again, it makes students feel the issue is handled in a professional manner. Therefore concerns raised are given adequate attention and seriousness they deserve. The student should be contacted on a consistent basis and never to be neglected (Stuart 2007, p.180). The mentor must ensure progress review is conducted within a week. Remedial actions are also organized where appropriate. In case these efforts fail to yield any progress then necessary actions must be taken. The most immediate is to organize a tripartite meeting. In this meeting arrangements are made beforehand with the clinical link lecturer. The presence of a lecturer is very important. This meeting will see to drawing another action plan. The contribution and input of a lecturer is essential in providing sufficient evidence and documentation (Barrett 2007, p. 372). These weekly reviews would last for the duration when the student is experiencing difficulties. Similarly, discussions carried out during reviews must be well documented. Assessment forms must contain each and every concern dealt with in the course of placement. The document should clearly and carefully explain each and every concern (Barrett 2007, p.368). In addition all actions taken to try and alleviate the problem must be documented as well. Failure to Fail a Student and Implications The decision to fail a student is inevitable. However, mentors find it difficult to fail students. There are a number of reasons for this reluctance. Some reasons are genuine concerns, others not. All the same, it is important for all students to meet required standards of practice (Mallick & McGowan 2007, p. 55). Nursing just like any other profession has standards which must be met in full. A mentor who fails to fail a student lowers professional standards and endangers safety of patients and public in general. It is better to hurt feelings of a student than put lives of patients at risk. Considering the nursing profession deals with human lives, there should be no room for error. The decision made by a nurse can see to recovery or death of a patient. Mentors should therefore ensure students are competent and fit for practice. This action requires confidence and courage on the part mentors (The Open University 2001). However, in making this decision mentors are not alone. They are assured of enough support if all necessary actions have been taken. Once enough support and guidance was given to a student, the assessment becomes evidence-based. It is critical and mentors must adequately understand the responsibility given to them. The final assessment and overseeing a student’s placement lies with mentors. The standard of practice exhibited by a student will determine the grade to be awarded. Mentors therefore determine whether a student advances in the profession or not. Support for Mentors There are normally complaints from students who feel they have been wrongly assessed. According to research most decisions to fail students are overturned by administration (Duffy 2003). This can be frustrating to mentors. For this reason final assessment must be arrived at gradually. This is through involving other people including the student (Watson 2000, p.589). Higher education institutions must ensure support is granted to mentors, students and the environment of learning. There are a number of personnel such as personal tutor, link lecturer who assist in some of these roles. The personnel ensure evaluation system in place is effective; changes on the program are communicated on time and support is given to both students and mentors (Drennan 2002, p. 479) The placement providers see to smooth running of the entire placement program. They work in conjunction with higher education institutions and mentors to oversee a student’s progress. They also ensure mentors are suited and prepared well for their role. In the course of placement, these providers ensure mentors are given appropriate support. When a student fails to show progress, providers stand by mentors to offer support and additional needs as required. Placement providers ensure learning environment is effective and mentors are adequately supervised (Rose & Best 2005, p. 215) Apart from placement providers there are link lecturers, practice facilitators who also aid both students and mentors (Barrett 2007, p.370). They ensure effective communication occurs between placement providers and higher education institution. The links ensure contact details are available for placement staff. This is in addition to giving advice, support and guidance whenever it is needed. Conclusion Nursing as a profession is faced with a lot of challenges. Apart from shortage of staff, there are a myriad of challenges encountered on a daily basis by professionals. Training and assessment of students is just another of the challenges. Mentors continue to pass failing students despite apparent danger to patients and entire public. There are a number of reasons for this trend. Most mentors do not understand their work properly. This makes them ineffective when handling problem cases. On the other hand students are unwilling to cooperate fully with mentors. Higher Education Institutions also take a share of the blame. According to some mentors decisions to fail students have been overturned by administration. For this reason it is important all stakeholders to collaborate in the final assessment of students. In case a student fails to progress as expected, more people should be involved to offer support. There must be sufficient evidence to fail a student. In sessions where guidance, counselling and support are offered, everything must be well documented. An action plan must be drawn by the mentor in collaboration with a student and link lecturer. The action plan will see to improvement of student’s performance. If all these steps are observed failure to achieve required standards will not come as a surprise. Similarly, the student will have no cause to complain as final assessment will be justified by evidence. Bibliography Allin, L & Turnock, C 2007, Assessing Students Performance in Work-based Learning. Making Practice-Based Learning Work. Retrieved on 27 November 2010 from www.practicebasedlearning.org Barrett, D 2007, The Clinical Role of Nurse Lecturers: past, present and future. Nurse Education Today; Vol. 27, No. 7, pp. 367-374 Bastable, S 2008, Nurse Educator: Principles of Teaching and Learning for Nursing Practice 3rd Ed. London Jones and Barlett Bayley, H Chambers, R & Donavan, C 2004, The Good Mentoring Toolkit for Healthcare Oxford Radcliffe Bray, L & Nettlton, K 2007, Assessor or mentor? Role confusion in professional education. Nurse Education Today, Vol. 27, No. 8, pp. 848-855 Bulman, C & Schutz, S 2008, Reflective Practice in Nursing 4th Ed. Oxford Blackwell Publishing Burns, S & Bulman, C (eds) 2000, Reflective Practice in Nursing: the Growth of the Reflective Practitioner 2nd Ed. Oxford: Blackwell Science Calman, L, Watson, R, Norman, I, Redfern, S & Murrels, T 2002, Assessing practice of student nurses: methods, preparation of assessors and student views. Journal of Advanced Nursing, Vol. 38, No.5, pp. 516-523 Cree, V & MacAuley, C (eds) 2000, Transfer of Learning in Professional and Vocational Education London: Routledge Drennan, J 2002, An evaluation of the role of the clinical placement coordinator in student nurse support in the clinical area. Journal of Advanced Nursing, Vol. 40, No. 4, pp.475-483 Duffy, K & Hardicre, J 2007, Supporting failing students in practice 1: assessment. Nursing Times, Vol. 103, No. 47, pp. 28-29 Duffy, K 2003, Failing Students: A Qualitative Study of Factors that Influence the Decision Regarding the Assessment of Students’ Competence in Practice. Retrieved on 27 November 2010 from http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=1330&Keyword Gaberson, K & Oermann, M 2006, Clinical Teaching Strategies for Nursing 2nd Ed New York Springers Gopee, N 2008, Mentoring and Supervision in Healthcare London Sage Gray, MA, Smith, LN 2000, The Qualities of an effective mentor from the student nurse’s perspective: findings from a longitudinal qualitative study. Journal of Advanced Nursing; Vol. 32, No. 6, pp. 1542-1549 Higgs, J & Titchen, B 2001, Practice Knowledge and Expertise in the Health Professions Oxford: Butterworth Heinemann Jowett, S & McMullan, M 2007, Learning in Practice – practice educator role. Nurse Education in Practice, Vol. 7, pp. 266-271 Levett-Jones, T, Lathlean, J, Higgins I & McMillan M 2009, ‘Staff-student relationships and their impact on nursing students’ belongingness and learning’ Journal of Advanced Nursing Vol. 65, No. 2, pp. 316-324 Mallick, M & McGowan, B 2007, Issues in practice based learning in nursing in the United Kingdom and the Republic of Ireland; results from multi professional scoping exercise. Nurse Education Today, Vol. 27, pp. 52-59 Marsh, S et al 2004, Assessment of Students in Health and Social Care: Managing Failing Students in Practice. www.practicebasedlearning.org Dorsey, L E & Baker, C M 2004, Mentoring Undergraduate Nursing Students; Assessing the State of the science. Nurse Educator, Vol. 26, No.6, pp. 260- 265 Morton-Coper, A & Palmer, A 2000, Mentoring, Preceptorship and Clinical Supervision Oxford: Blackwell Neary, M 2000, Supporting students learning and professional development through the process of continuous assessment and mentoring. Nurse Education Today; Vol. 20, pp. 463-474 Nursing and Midwifery Council 2001, Preparation of Mentors and Teachers – A new framework of guidance. London: Nursing and Midwifery Council Nursing and Midwifery Council 2006, Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers. London: NMC Phillips, T, Schostak, J & Tyler J 2000, Practice and Assessment in Nursing and Midwifery: Doing it for real. London: English National Board for Nursing, Midwifery and Health Visiting Quinn, F M 2008, The Principles and Practice of Nurse Education 4th ed. Cheltenham: Stanley Thornes. Rose, M & Best, D (eds) 2005, Transforming Practice through Clinical Education, Professional Supervision and Mentoring, Elsevier Churchill Livingstone, Edinburgh Sharples K et al 2007, Supporting the Mentors. Nursing Standards Vol. 21, No. 39, pp. 44-47e Support that mentorst mentors receive in the clinical setting. Nurse Education Today; 20: 585-592ublic of Irelamd; r Spouse, J & Redfern, S 2000, Successful Supervision in Health Care Practice Oxford: Blackwell Science Stuart, CC 2007, Assessment, Supervision and Support in Clinical Practice. London Churchill Livingston The Open University, 2001, Assessing Practice in Nursing and Midwifery Milton Keynes: The Open University for the English National Board for Nursing, Midwifery and Health Visiting Watson, S 2000, The support that mentors receive in the clinical setting. Nurse Education Today, Vol. 20, pp. 585-592 Read More