Table of Contents
This reflection will explore how the eight domains highlighted in the ‘Standards to support learning and assessment in practice’ guidance (Nursing & Midwifery Council (NMC), 2008) was used to support a student nurse in placement. As a nurse, I follow the NMC (2015) Code of Conduct by ‘being a model of integrity and leadership for others to inspire to.’ A role of a mentor is to enable learning, oversee and assess the practice of students (NMC, 2008).
As a mentor, I will be reflecting the support given to a student on her placement during her second year of her studies. My mentoring abilities will be assessed based on my capability to facilitate informal discussions, formal interviews and feedback to my student (NMC, 2008), regular feedback provides an encouraging influence on learning experiences (Thompson, 1998).
Establishing Effective Working Relationships
On the student’s first day, I completed an initial interview, orientation to practice, introductions to colleagues and discussed boundaries and guidelines of the ward including policies, procedures, working hours and sickness. Students can experience anxieties in an unfamiliar setting, so an appropriate induction aims to alleviate anxieties and answer questions (Sharif and Masoumi, 2005). The Hierarchy of Needs suggests for a student to accomplish self-actualisation, basic needs must be met by having access to food, water, warmth, shelter, security and safety (Maslow, 1987).
Communication is vital whilst working with others regarding interviewing, assessing, teaching and education (Sully and Dallas, 2005). Being an effective communicator involves used of verbal, non-verbal and written communication. During interactions, I must maintain eye contact, have open body language and maintain a calm and reassuring tone. Communication must have clear expectations and be supportive of others through leadership skills, knowledge and motivation (Scammell, 1990). A mentor – student relationship is built on acceptance of each other, mutual understanding and rapport, providing time and interpersonal skills such as listening appropriately (Gopee, 2010). A SMART action plan was developed during interviews and when opportunities were unavailable, other services/resources where signposted to.
Creating a Learning Environment
In my workplace, we have access to a nursing office but are required to ‘hot desk’ – this can be potentially harmful regarding employee dissatisfaction, social tensions and lack of ownership (Lynee et al., 2011). This could impact the student’s ability of accomplishing full potential due to inconsistency in their placement (Maslow, 1987). My responsibility as a mentor is to identify a suitable place for the student to settle throughout placement.
Placement quality can be monitored through a variety of ways including interviews, questionnaires and feedback (Paterson & Burns, 2007). Placement evaluation has been described as a “significant contribution to the quality assurance of placement learning” (The University of Wolverhampton, 2014). NMC require placement evaluation is offered in a “non-threatening environment and given the findings of the Francis Report (2013) it is important that students are able to give honest feedback without fear of repercussions.” Evaluations provide constructive criticism, concerns and compliments which can only improve and maintain high standards.
Facilitation of Learning
For learning, I must consider different styles to cater my teaching and communication approach on an individual basis taking consideration people’s strengths and weaknesses (Fleming et al., 2011). Sims and Sims (1995) describe learning styles as a systematic understanding of how to absorb, retain and process information. There are four learning styles identifiable by Honey and Mumford (1982), these are: Activist, theorist, pragmatist and reflector.
Skinner’s behaviourism theory (1974) suggests environment is essential for learning. The process of the environment being right, means learning is more likely to occur. Bandura (1971) suggests observation and feedback can reinforce behaviour. Positive feedback for positive behaviours makes it more likely for the same behaviours to be repeated. Maslow’s Humanistic learning theory (1968) is based on these same principles, he suggests in order to learn there is a need for growth and a need for positive regard. Reece and Walker (2000) debate Maslow’s theory advising it is dependant on the environment whether this hinders or aids the learning process.
Theory of self-determination suggests learning in others can be encouraged or discouraged grounded on social influences (Koludrović & Ercegovac, 2015). Students should be encouraged meeting goals and their full potential. Students whom experience lots of criticism and negativity are unlikely to develop a respectable rapport with their mentor (Niederriter et al., 2017). Burns (1978) would recommend the use of transformational leadership where “leaders and their followers raise one another to higher levels of morality and motivation.” The aim of transformational leadership is to motivate and achieve goals, this motivation to learn, advance knowledge, experiences and skills to support development through role modelling (Bass 1985).
Some mentors have been described as ‘toxic mentors’ – this means being avoidant, putting others in difficult situations, and being over-critical (Darling, 1985). Key components of being a good mentor includes providing meaning, structure and planning to the placement (Davies et al., 1994). I would always include my student whilst on placement, I would offer opportunities and confirm they was looked after by colleagues in my absence.
Assessment and Accountability
Accountability is essential in the practice of nursing (NMC, 2008) and is described as responsibility for one’s own actions and behaviours (Krautscheid, 2012). During placement, I am accountable for the learning experience of the student. Accountability and assessment work inter-linked as it’s my responsibility as a mentor to assess the student’s performance through knowledge, skills, attitudes and behaviours (NMC, 2008). Aston and Hallam (2011) suggest this is one of the most important roles of a mentor.
Assessment is based on four principles: practicality, transparency and fairness, motivation and validity, and reliability (West, 2007). Several methods recommended by the Royal College of Nursing (RCN) (2009) for assessment include observation, simulation, testimony, student self-assessment, interviews, peer evaluation and reflections. My accountability is to ensure all learning opportunities have been exhausted, students have been given enough time to master skills and to ensure nurses are competent to work with the public. Duffy (2004) states failing students is difficult thing to do however it is my role to give opportunities and feedback for improvement and fail appropriately without hesitation if incompetent. My aim is to support students in being accountable for their own learning and achieving their goals (Lawlor & Hornyak, 2012), this can be completed through SMART action planning (O’Neil & Conzemius, 2005).
Evaluation of Learning
Learning evaluation is described in two ways, formative or summative (Billings & Halstead, 2016). The RCN (2009) highlighted that evaluation and assessment will be required of my student through observation of practice, feedback from professionals and patients and interviewing. Doing this enables me to gain knowledge on the students learning, strengths, weakness and goals. Throughout placement I asked the student to provide me with feedback for my own reflection and goals whilst mentoring (NMC, 2008). Paterson & Burns (2007) would suggest mentors are aware of the stage the student is currently at for when learning is evaluated.
Context of Practice
The NMC (2008) propose mentors maintain a suitable environment which advances assessment and evaluation and empowers inter-professional learning which keeps up with practice developments. The World Health Organisation (WHO) (2010) distinguish inter-professional relationships in education essential to healthcare workforce for future and current patient safety and care. In an acute setting, I work alongside different professionals including doctors, social workers and occupational therapists, this multi-disciplinary team approach provides opportunities for students to work inter-professionally in placement. The benefits of this include gaining and enhancing skills and providing a holistic approach to patient care.
My knowledge as a mentor will help me to facilitate learning effectively, I will do this by keeping up to date with any developments or improvements in practice, techniques and training. I also recognise, having students will also keep me informed with any new or up to date knowledge from university. I am aware of my own competencies and potentially the limitation of my knowledge which can particularly impact some inexperienced student nurses (Walsh, 2014). To successfully meet this domain, I would encourage the student to underpin practice with the use of the trust’s policies, procedures and guidelines and understand national and local drivers for knowledge enhancement.
My role is to support the student bridging the gap between theory and practice by evaluating evidence, reflecting on practice and questioning rationale for interventions whilst remaining supportive (NMC, 2008). The use of socratic questioning may be useful in practice with students for them to consider their answers and to support building confidence and decision-making abilities (Paul & Elder, 2007). Being a good mentor requires respect, trust, acceptance and empathy, having these in your relationship will provide a healthy environment with a nurturing learning style. This is a similar approach to the humanistic approach to teaching developed by Carl Rogers (1994).
As a mentor, and once upon a time student, I recognise the importance of making a student feel accepted and like they are wanted. In a time, where we are short on nurses, making sure we can train the best ones we can is important to me. From this mentorship course, I have learnt a variety of skills and looked up a variety of theories I would like to take in practice and certainly apply whilst working with students in the future. Throughout, my aim is to maintain high standards and share my knowledge and experiences influencing students in their studies. I will continue to follow the NMC Code of Conduct (2015) and continue to be a positive role model in practice.
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