Critical Reflection on Mentoring and Assessing - Research Paper Example

Critical Reflection on Mentoring and Assessing Introduction Valuable learning can take place within clinical nursing practice, often using reflection as the key strategy. Reflection offers an opportunity for practitioners to enlighten the essential nature of the care by delving into the less articulated structures of knowing. I am a qualified intensive care nurse, and my mentoring placement took place in the Neurosciences Intensive Care Unit (NICU). The importance of mentoring has been highlighted in literature over again, and this mentoring experience, which I am going to reflect on here has taught me the implications, importance, and above all, the significance of my practice as a mentor to a developing professional, where I was able to assess the learning of the mentee and my performance as a mentor both. This reflective exercise will throw light on the intricate complexities of my profession, the demanding ethical implications of my job, and the rigorous requirement of my fitness for standards (NMC, Standards 02.04). This is a written account of it so it may invoke a critical appraisal of my own actions, and as expected will open vistas for self-analysis and experiential self-learning. This would enrich my skill of mentoring by development of knowledge, its transmission, and its use in practice setting (NMC 2004b). Background Throughout this account, I shall use Gibbs (1988) cyclical model of reflection. Reflection offers a subjective and contextual view of the world through my views. In the Gibbs cycle of reflection, every action will invoke a thought or feeling, so I would be able to evaluate those experiences and critically analyze them to make sense of it (Spalding, 1998). A careful analysis would aid a conclusion by consideration of all the alternatives of a happening scenario, so an action plan can be developed for future incidents in the practice. Evidently, this is a cyclical process of thoughts affecting our actions on a given situation where I can make sense of it. This would provide me with evidence as to how effective my actions were, thus creating a learning opportunity for me, and at the end of the cycle I would have new knowledge about the changed perspectives through the critical analysis (Fish and Twinn, 1997). Rationale NMC has well-conceived standards to support learning and assessment in practice. As per these standards, these learning and assessment processes, although designed to train the new entrants, applying the principles of learning theory, have important outcomes for mentors, practice teachers, and teachers (Nursing and Midwifery Council, 2004). This usually assumes the form of a developmental framework, and the development occurs in stages. The whole process of this developmental and assessment framework is required to be supported and assessed by mentors. The midwifery mentors who have additionally qualified to be sign-off mentors as part of their mentorship qualification programme would make the final assessment of practice, and after the assessment, if the registrant qualifies the NMC standards, they would be recommended to be registered (Nursing and Midwifery Council, 2004). To be able to do this, NMC has further designed the framework in such a way that if the outcomes are met within the rigorous provisions of accountability, the registrant nurses will be qualified to be registered. The domains in this framework are establishing effective working relationship, facilitation of learning, assessment with rigorous accountability, evaluation of learning, more importantly creating an environment of learning, establishing context of practice, promoting evidence-based practice, and inducing leadership. This framework will be suited for working in the modern healthcare, and there would be a perspective of inter-professional learning (Nursing and Midwifery Council, 2006). Furthermore, this has a close correlation with the career pathways of the nurses due to the fact that NHS has launched KFC scheme as indicators of terms and conditions of service for their employees (Nursing and Midwifery Council, 2006b). My mentoring experience took place in the unit with a third year nursing student placed in the unit. She was assigned to me. For the reasons of confidentiality, the name of the student or the unit will not be disclosed in this assignment. During this work, I was fully aware of the role of a mentor in developing learning and skills. The English National Board defined mentors as; 'an appropriately qualified and experienced first level practitioner who by example and facilitation guide, assist and support students in learning new skills, adopting new behaviours and acquiring new attitudes' (ENB cited in Woodrow 1994, p.812). The ENB along with the Department of Health (DOH, 2001) later goes on to describe five key elements of mentoring that include assisting, befriending, guiding, advising and counselling the student. Taking all this into account I prepared myself for my mentoring role by reading up on the topics covered in the Supporting Learning and Assessment in Practice module as well as those topics covered during my own nurse training. This included looking at different learning styles, SWOT analysis, assessment principles, reflection on practice, Nursing Midwifery Council (NMC) regulations and the learning environment. This reading refreshed my awareness of the need for good communication, a thorough and effective induction and introduction to me, as the mentor and the unit, as well as being an effective role model. These skills are all ways to ensure effective learning and should be adopted from the start of the first meeting or communication between mentor and student. With the aim of helping my students in practice and with the purpose of linking theory to practice in both academic and practice learning environments with focus on the skill element, I prepared, planned, and implemented this program. The goal was to utilize social learning theory and its application in the context of nursing education. The format I followed aimed at intelligent utilization of cognitive theories, to enable problem solving and the ability to understand and apply principles learned in a variety of clinical situations that they may encounter in practice. I would be satisfied with a lot of critical thinking if my students would apply those principles in the context of nursing work they do, if they are able to critically analyze the information that they receive, if they synthesize a work plan for themselves by demonstrating attention, retention, reproduction of knowledge in the clinical setting, and above all, by showing zeal and motivation to do a good work (Bahn, 2001). The basic reason for which I decided to have this course program is the professional belief that “mentors and teachers are vital to the preparation of next generation of practice nurses. It is essential that health care students are taught by those with practical and recent experiences of their profession” (NMC, 2005a). I can now recollect how I was able to redefine my role as a contributor to their education in the practice setting, and how I coordinated the student experience and assessed my student's learning. In other words, my program served as an instrument for competence assessment (Calman et al., 2002). Scenario As part of the mentoring package on NICU we send out induction packs to the students two weeks before they are due to start with us. I also spoke to the student and introduced myself over the phone. This meets the NMC requirements (2008) which state that all students should have a named mentor that is allocated prior to the placement start date. We arranged their first shift and I explained how to get to the unit and where I would meet them. During that first shift we were able to utilise and complete the induction form that I comprised with good effect. This ensured that all the important and necessary aspects of the unit where accomplished, as well as addressing the students forthcoming placement aspirations. Within the first few hours the student was fully orientated to the unit and introduced to other members of staff working that shift. We also set the dates for the mid and final point interviews. By the end of the shift the student began to draw up some clinical competencies to achieve during this placement. I also gave the student a SWOT analysis to complete. A SWOT analysis (Strengths, Weaknesses, Opportunities and Threats) is a tool comprised by Learned et al (1969) to identify any potential shortfalls in knowledge or experience but also to highlight areas of strength. It is to be completed before an event or in this case a placement. I used this SWOT analysis during the students' initial interview on day two. We also discussed the students' expectation of the mentors role and responsibilities as suggested by Chow and Suen (2001). All the students who are placed on NICU are in their third year and therefore will have already had plenty of mentor contact. Along with this SWOT analysis, I asked the student to complete a Honey and Mumford (2006) learning styles questionnaire. This was my first experience as a mentor. Thus, I wanted my mentoring activities to facilitate maximal learning for this student. Honey and Mumford (2006) questionnaire would help me to understand their learning needs and also would help me to develop the appropriate style of mentoring customised for this student. Moreover, this could also orientate the student about her learning preferences. Critical Analysis Did I respond to this goal adequately? Yes, I used this SWOT to assist with my forthcoming mentoring role. In the clinical area, based essentially on this, I designed the programme in such a manner that it would enhance the learning of this student and it would develop her skills in handling patients in a neurological intensive care unit. I was evidently nervous, and this question struck me over and over again at least in the beginning. Was there any fitness issue from my perspective? No, I am convinced that as a mentor, I have skills and expertise to prepare students which I am required to do for the new world of health care, and I need to ensure that student learning experiences or needs are fully supported and evaluated. In my vision, mentoring is not just the mechanical prescribed roles that are listed. I totally agree with the fact “Mentoring concerns the building of a dynamic relationship in which the personal characteristics, philosophies, and priorities of the individual members interact to influence, in turn, the nature, direction and duration of the resulting, eventual partnership" (Morton-Cooper and Palmer, 2000). Gray and Smith (2000) as well as Ramage (2003) explained that the mentor has an important influence on the students' placement experience. I was worried that the student nurse may be more knowledgeable than me and that I may be an ineffective mentor. I wanted the student to enjoy their placement on NICU as much as I do. As defined by NMC, the term mentor is used to denote the role of a nurse, midwife, or a health visitor who facilitates learning and supervises and assesses students in the practice setting. This translates into the responsibilities of application of theory; assessing, evaluating, and giving feedbacks; and facilitating learning in practice, performance, and experience (RCN tookit, 2005). All of these are true, but to my reflections, this has another angle of viewing it. A mentor is a faithful guardian, advisor, and teacher (Homer, 800 BC) who is able to inspire self-assurance, enhance self-esteem, and increase self-confidence in the student learners and also challenges and changes own practice; it had always been a two-way process for me, the students learned from me, but I have learned more from the students. The student was excited and very proactive about the opportunities I had presented to them. As Neary (2000) explains a good mentor utilizes every opening to create and maximise learning opportunities. This ties in with the assisting role of a mentor as described by Chow and Suen (2001). As this was my first time as a mentor we were not given a patient at the beginning of the shift. This allowed us time to complete all the necessary induction paperwork and also fully orientate the student to the working environment. There is a lot of equipment associated with every bed space in NICU. I wanted time to explain the main pieces of equipment in a safe manor that allowed the student time to understand its use and feel confident about using it. Price (2004) suggested we walked through the unit talking through a couple of the 'typical patient' scenarios. I allowed the student time to asked questions and select the patient they wanted for the next shift. Looking back, this actually fit well with the necessity of “mentoring work-based learning”, where mentors would facilitate and guide the learners through “work-based learning experience” , which would help the new inexperienced colleagues in developing a programme of learning that would enhance the career potential. This mentor would support learning and assess “learning outcomes” in practice, develop the qualities of fitness in practice, judge the performance status to recommend entry into the register (Ramage, 2003). Mentorship concerns the supervision of students in practice setting, which I did well throughout this mentoring event. As this was my first mentoring experience I was specifically given this time, the unit itself was also well staffed and fairly quiet. However, due to the specialised nature of our unit, and the fact that we are a tertiary referral unit; it cannot always be guaranteed that this level of staffing or this amount of allocated time can be given. We also need to remember that each student will bring their own unique learning styles and pre-conceptions regarding the placement and therefore different styles of mentoring may be required. The feeling of part of the team was an important component of the whole exercise, since it reduces the stress and anxiety of the students. Timmins and Kaliszer (2002) and Beck and Srivastava (1991) have undertaken research that found the clinical experience to be the most stressful and anxiety provoking component for student nurses training program. It was also found that stress and anxiety played a part no matter what year of training the student nurse was in. Looking back, I can now understand that this was appropriate. As a mentor I had to be aware about other factors too. While working with them in an attempt to ensure an effective learning experience for them, I soon discovered that there is a marked difference between the younger students and matured older students. I later discovered while researching that many researchers in this field have propounded the fact that baseline education of the trainees modify their behaviour in the training setting (Richardson, 2000) . I also could recollect similar findings in my experience as a mentor. This is important since my strategies were based upon these findings and facts, and my main goal in this project was to influence the students, to acknowledge their practice achievements by a sound system of exchange of constructive feedbacks, and ultimately facilitation of learning, where I should be able to identify their current learning needs as applied to the clinical setting and as related to their individual progress, where I would be able to create and develop opportunities for the students to identify and undertake experiences to meet their learning needs as a step-ahead to their careers, and through these I would be able to demonstrate custom-made and exclusive strategies that will assist with integration of learning from both educational and practice settings (Price, 2004). As a mentor, one of my important roles were to assess their learning to ensure effective learning experiences of my students, to provide opportunity to achieve learning outcomes for the students by contributing to the development and maintenance of a learning environment (Stuart, 2002). I had also a very important role to learn as a mentor, to devise strategies for quality assurance and quality audit as far as the fitness to serve as a health care nurse is concerned and also to create a free dual-mode constructive but critical feedback exchange system where I could contribute to creation of an environment in which change can be initiated and supported (QAA, 2001). I had the responsibility to identify and apply and disseminate research findings within the area of practice (UKCC, 1999). Conclusion Since it was my first ever mentoring experience, I was quite nervous about it and anxious too about how it would go. This was caught right by my supervisor. She talked about my body language and how important it was to earn confidence of the students in the practice setting. Anyway, I made a resolve that next time onwards this would change. However, my supervisor raised a few questions, I guess, in order to fix my orientation to the actual goal of this mentoring episode. She drove the discussion regarding a critical appraisal of my methods of mentoring, looking at whether my objectives were specific and realistic, were the structure and method appropriate to the material and situation, whether the students’ needs and area of knowledge were identified, whether I interacted with my students and if so, what was the level of interaction, whether the clinical work was logically structured and presented at the right level or not, whether active participation was encouraged and the question technique appropriate. I found that although I did all these things, all need to be more organised and more structured which would come with increasing experience. What I understood was mentorship is an important tool for supervised experiential learning. Through reflective action planning, I have become skilled in changes that influenced the staffs’ perception of me and becoming a mentor has improved my professional position within my work place. As a mentor, I will have an impact on the students’ learning. I realized that reflection allowed me to give my own opinions and criticize myself to develop a better teacher and a better mentor in nursing education of the future age (Butterworth and Faugier, 1997). To conclude my assignment, I have reflected on my first shift as a mentor to a third year nursing student using Gibbs' reflective cycle. Within this, I have defined the role of the mentor using a definition by the ENS and DOH. I have evaluated the need for understanding learning styles and the learning environment as well as describing the changes I have made to facilitate its improvement. I have expressed the need for a good orientation package to the unit. Finally this assignment describes the individual events that took place and where reflection has taken place. I have used literature to support both my opinions and my practice. References References Bahn, D., (2001). Social Learning Theory: Its Application In The Context Of Nurse Education. Nurse Education Today; 21(2): 110-7. BECK, D.L., and SRIVASTAVA, R., (1991). Perceived level and sources of stress in baccalaureate nursing students. Journal of Nursing Education, 30, 127-133. Butterworth, T. And Faugier, J., (1997). Clinical Supervision And Mentorship In Nursing. London: Chapman & Hall. Calman, L., Watson, R., Norman, I., Redfern, S., and Murrells, T., (2002). 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