Mentoring and Supervision in Healthcare - Essay Example

Aim of this essay will be critical analysis of an assessment process and decision I have been involved in as a co mentor duringfinal interview with a student. Introduction. The ENB and DOH (2001b) defined mentorship as the role of the nurse, midwife or health visitor who facilitates learning and supervises and assesses students in the practice setting. Since mentors spend most time with students in the clinical area, they are in the best position to judge student’s capabilities and to guide and assist them in developing and achieving their learning objectives. The NMC (2006) states that nurses who take on the role of mentorship must be registered with the NMC and be on the same part register as the student they assess. Mentors are required to support students learning in an inter professional environment, as well as assess and judge their proficiency. Mentors should be able to support students in meeting continuing professional development needs in accordance with The Code of NMC (2008). This description highlights the importance the NMC places on the support of students in the clinical placement area. Mentor will be an advisor, role model, teacher, coach, supporter, supervisor, guide, and assessor. Nursing standard (2008, p36). This essay critically analyses an assessment process and decision one has been involved in as a co or associate mentor. This would normally be the midway or final interview with a student, where as assessment judgment is being made. This essay will discuss critically, as well as evaluate the role of the mentor in nursing, including the associated professional accountability in the context of the development of professional healthcare practice. The NMC (Nursing and midwifery council) standard (2008a) states that a mentor is a mandatory requirement for pre-registration nursing and midwifery students. Demonstrate skill in their role as a facilitative and effective mentor to student in the practice area. Evaluate the role of the mentor in relation to evidence based care and the context of practice. Author obtained verbal consent from those who are involved in this assignment. Facilitate learning The code of conduct (2008a) states that a mentor should facilitate students and others to develop their competence, transferring the skills of a staff nurse in terms of assessing planning, implementing, evaluating and managing patient care, to manage the learning process of a student (p22) facilitators concentrate on providing the resources and opportunities for learning rather than managing and controling learning. Downie and Basford (2003) sates that development of interpersonal and communication skills are necessary to become an effective facilitators of student learning. Murray, Rosen and Staniland (2010) cited that the mentor has a professional responsibility of facilitating students learning needs, as well as providing the appropriate learning opportunities to help the student meet the required level of proficiency in her practice assessment. As a registered nurse on a busy ward I always enjoy supporting student nurses whilst they are on placement with us. There is an apparent shortage of qualified mentors on the ward, and within my last personal development review with my line manager I identified a need to attain the mentorship qualification. Evidence suggests that various factors, such as the mentor-student relationship and the mentor’s knowledge, competencies, attitude and communication skills play an important role in students’ learning (Wright 1990, Baillie 1993,Campbell et al 1994, Andrews and Chilton 2000,Andrews and Roberts 2003, Pellatt 2006). Assessment The assessment process in nursing is usually linked to the three areas of Blooms taxonomy. That is knowledge, skills and attitude (Walsh, 2010). Author preferred to do continuous assessment of the third year student who was on her six week placement in progressive care. In continuous assessment, Students performance is under scrutiny over the duration of the placement. I did the initial assessment of the student on her fourth day of the placement. Learning contract was prepared and agreed as it gives structure and guidance for teaching, learning and assessment when it is carefully negotiated and planned (Stuart, 2007). Also I discussed and clarified ground rules on both sides. It is essential that mentor should make sure that the student understands and complies with the ground rules, because mentor has ultimate accountability for a student. The learning contract included learning about 12 lead ECG. One of the characteristic of the clinical learning is that actions are supported by rationale (Price"2005). I demonstrated the procedure of 12 lead ECG with rationale of each steps of procedure. The student practiced it under supervision at all the time to maintain supernumerary status after this in order to develop skill and confidence (Beskine, 2009). Author used learning contracts, observation of practice, reflective discussion and questioning as assessment methods in the continuous assessment of the skills. The NMC (2008a) states that majority of assessment should be through direct observation. Observation allows testing of what the student can do problem-solving skills, attitudes and values (Hand, 2006). Walsh(2010) states that initial interview, ensure that mentor understand the student’s learning outcomes for the placement and that student understand your expectations, how their development and learning will be assessed and specifically what mentor will be looking for as evidence of achievement. After discussion with her it was decided that a teaching session surrounding the safe use of blood glucose monitoring equipment would be of benefit to her, as it was a procedure that was often required on the ward. It would cover one of her learning outcomes, and I agreed to facilitate this. Wallace (2003) notes, that it is important to reduce the possibility of exposing student or patient to any risk, until the student has acquired sufficient skill and knowledge when carrying out a practical procedure. The importance of assessment by a mentor is therefore crucial to ensure students become proficient in practical skills. The commonly held principle that accountability comes from training and education, is evident within the student nurse role. According to Pennels (1997) if accountability comes with knowledge, students are rightfully protected from full accountability until trained. Although responsible for their actions their knowledge base may be inadequate to allow accountability. Therefore, professional accountability lies with the registered nurse that a student nurse works with. It was reassuring for me that she and I had quickly developed an effective working relationship in which I had confidence in her ability to always ask if she became unsure about a situation. She appeared to fully understand her role as a student nurse as identified in the NMC guide for students of nursing and midwifery (NMC 2006a). Set the dates for midway and final interviews so that the student is aware of these well in advance and can prepare themselves adequately. It may be appropriate to ensure that these dates are recorded in the placement diary/off-duty as appropriate. Identify placement-specific outcomes and the student’s individual learning goals. Identify what `essential skills’ the student must achieve during the placement and set the dates for summative assessment in relation to these skills. Ensured that mentor work for a sufficient time with them in order that she can judge their performance. I also informed co-mentors, and seek the opinions of colleagues so that the assessment is done appropriately. Arrange insight visits and facilitate them to work with other health care like outreach and associated staff. Frequent assessment been made regularly to review their evidence and achievement. To enable an effective teaching session to take place, I as the facilitator needed to select an appropriate environment which was safe, clean, private and comfortable. It was also important that my learner, clinical mentor and myself were guaranteed time free from interruptions. Good communication skills are paramount when mentoring students, and diplomacy and tact must be employed when students need extra help in challenging situations. It is also worth noting that as a mentor with good communication and practical skills facilitating a well planned teaching session, I still experienced some anxiety. Price (2005) notes this often happens when your practice is being held up as exemplary and your knowledge may be tested later. On reflection I felt the teaching session achieved all the objectives set, and she was able to demonstrate this to me in both verbal feedback and the self assessment sheet provided. I also received positive verbal and written feedback from my clinical mentor. Good feedback will foster the growth throughout the placement and the process of continuous assessment relies upon good working relationships between student and the mentor. It consist both formative and summative elements (Walsh, 2010). The NMC mentor standard (NMC, 2008a) indicates that mentors are responsible and accountable for assessing total performance of students- including skills, attitudes and behaviors. The NMC is concerned with holding mentors accountable for the actions of their students as well as all other requirements in The NMC Code (2008b). Elcock and Sharples (2011) cited that main purpose of the midway interview is to discuss with the student of their progress and performance to date’ identifies strength and weakness, outcomes achieved and those areas where further development (p107). It is important to allow student to assess their own learning, as self-assessment helps the student to take ownership of their learning and take control over the way they meet their learning needs. Do not leave it all to the final interview. I re-confirmed the date of the final interview. Provide the opportunities for deficiencies to be overcome and given support and reassurance. Liaise with University staff if there are significant concerns about performance. Discussed with them what they think about their experiences in frequent reflective discussions. Final interview. One of the last events to take place during a student’s placement is the final interview to finalize assessment and complete required sections in the practice assessment document, complete the ongoing achievement record, receive final feedback from the student on your performance during the placement, debrief on significant events. Elcock and Sharples 2011) provide summarized feedback to the student on their overall performance during the placement which is vital for the ongoing development of the student. Final interview is your last chance to identify the student’s strengths and areas for further development. At the end of this process, the Mentor is required to indicate whether the student has demonstrated the knowledge, skills and attitudes to achieve the practice learning outcomes. This must be confirmed by the Mentor’s name (in block capitals) and signature in the relevant box (along with a date of assessment) on each outcome page. To assist Mentor’s in making a judgement on a student’s achievement, performance criteria are provided for each learning outcome. These give an indication of the knowledge, skills and attitudes that are expected of a student in achieving that particular outcome Mentors need to be familiar with all assessment of practice documentation. Copies are available in Clinical Placement Student Resource Folder. Encouraged to contact the Link Lecturer, Clinical Placement Facilitator or Placement Quality Lead if needed. Conclusion. Assessment is very important to ensure quality of training, to maintain credibility of the nursing profession and for public protection. Again the proof continuous assessment relies upon good working relationships between student and the mentor. The role of mentor is important to ensure that students are competent and well prepared for practice at the point of registration. Building a good working relationship with the student is essential to become a good mentor and to alleviate student’s fears. Facilitation of learning occurs automatically in practice placements, when mentor uses and experience to promote the students achievement and being about student’s learning style. In conclusion, the module gave me a chance to embark on the researching of the mentorship program. From this experience, I learned that one need not to fear asking for help when it deems required since failure to do so would more often than not lead to disastrous consequences. Initial assessment is needed to identify learning objectives. As a mentor I have to invest my time and energy in supporting my student, listening and motivating her as well as encouraging high standards. Giving feedbacks is also necessary, as failure to do so can lead to serious professional implication. Critical analysis At the end of the process the Mentor needs to indicate whether the student has demonstrated the knowledge, skills and attitudes to achieve the practice learning outcomes However, one thing to content with about the third-year student I choose to assess while the student was on her six week placement in progressive care is that the student had various shortcomings. As found out, this student had poor documentation skill. In mentorship and in the nursing professional as a whole, record keeping is such a vital element for both the student practicing nursing and the teacher. According to the code of conduct (2008a), a mentor should facilitate students and others to develop their competence, transferring the skills of a staff nurse in terms of assessing planning, implementing, evaluating and managing patient care, to manage the learning process of a student (p22) facilitators are concentrate on providing the resources and opportunities for learning rather than manage and control learning. In this respect lack of relevant material be it skill or cooperation can impact negatively to the whole process of assessment and mentorship. REFERENCE Ali, P.A, and Panther, W. (2008).professional development and the role of mentorship. Nursing standard. June25, vol 22(42).p 35-36.april 3 2008. [Accessed 13 December 2012] Aston, L. and Hallam, P. (2011).Successful mentoring in Nursing. 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Vol 19 (21). P1364-1366. http://standards.nmc-uk.org/PreRegNursing/statutory/competencies/Pages/Competencies.aspx Read More