Nursing and Student
Introduction
The aims of the assignment is to examine how the reflective account or our experience of facilitating learning opportunities assessing and teaching a student will help the future development with in the mentor or practice teacher role. In order to achieve this teaching session, educational theories. The formulation of a lesson plan wills be included focusing on my objectives rational for my action. In assessment session a brief Introduction will be given on relevant theories, concepts and principles of assessment in practice with further discussion of the assessment process. Assessing a student in clinical area will take place.
Effectiveness of my mentoring will be critically analysed and skills in teaching and assessing will be reflected up on evaluation of developing my mentorship role will be discussed, highlighting any changes that can be made to my practice to improve mentorship. It has now mandatory requirement that qualified nurses and midwives becomes mentors affect one year of registration and practice (N. M. C 2008). Mentors play a vital role in supporting, teaching and assessing students in practice Quinn (2007) define a mentor as someone who experienced, and many cases more senior than the learner, and who provide support, encouragement, and guidance.
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Part II : Role as a Mentar
An N. M. C. 2008 mentor is registrant who following successful completion of an N. M. C approved mentor preparation programme. According to N. M. C mentor should exclusive the knowledge, skills and competence are required to meet the defined outcome. Mentors are responsible and accountable for organizing and co-ordinating students learning activities in practice (N. M. C 2008). Mentor need to supervising students in learning situations and providing them with constructive feed back on their achievements. Mentor should assess the total performance including skills, attitudes and behaviours.
The fitness for practice and purpose report of the U. K. C. C. post Commission Development Group 2001 looked at the competencies of newly qualified Nurses. They concluded that the mentor was to be responsible to contribute constructively to the learning environment for the evidence progress of student, be approachable and supportive to gain confidence of the students have knowledge of assessment tools to assess the competence in order to ensure patient safety, be competent to share knowledge of patient care, make time for interviews to discuss the specific requirements of the student.
Provide time for reflection and encourage enquiry based learning. As per N. M. C 2008 there is a developmental frame work to support learning and assessment in practice. There are 8 dominants in the frame work. It includes: 1Establishing effective working relationship 2Facilitation of learning 3Assessment and accountability 4Evaluation of learning 5Creating an environment for teaching 6Evidence based practice 7Leadership As per N. M. C standard Student need to spend minimum 40% of the time with their mentor.
As a role as mentor, their knowledge, skills and competency need to update an ongoing basis. Each mentors as reviewed every 3 years to ensure that only those who continue to meet the mental requirements. Remain on the local register mentor at least two student with due regard with in 3 years period participate annual updating. Duffy states that N. M. C. Standard for the preparation of mentors provides a tool for preparation but it is the mentor knowledge, skills, ineffectively arrying out their role that protect the public by ensuring that students who are lacking incompetence do not progress to become registered nurse or midwives. The reality of being a mentor is that as per R. C. N tool kit for Nurses 2007 all mentors supporting students, gain registration, have responsibility to ensure that they are fit. Mentor should be prepared to assess student performance in practice and will be accountable for their decision to pass, refer or fail a student. N. M. C recognise that failing student may be difficult and that all assessment decision must be evidence based, mentor should recognise various assessment……that direct care, simulation, OSCES and other…… Common criteria for sign off mentor, the N. M. C states Registrant who makes judgement about whether a student has achieved the required standards of proficiency for safe and effective practise must be on the same part or sub part of the register as that which the student is intending to enter. Only sing off mentors and practise teachers that are the same part of the register and the same field of practise.
May confirm to N. M. C that student have met relevant standards of proficiency for the particular programme leading to registration. Signing off proficiency must be assessed by all existing sign-off mentor at least 3 occasions. The role of mentor on the preparation of practitioners who are fit for practice is paramount. However mentor need to be supported in her demanding role (Glyniscells pellet 2006). Mentors in the study identified constraints on their role owing to staff shortage, busy clinical work atmosphere, too many students.
This result in lack of time to spend with students and left mentor feeling guilty. Kathleen Duffy (2004) identified some mentors failed to fail students early on their programme, pick things up later. Nurse mentors are faced with many difficulties in fulfilling the dual role of facilitator and assessor (Sharples Ketal 2007)
Assessment
Assessment defined as the measurement of candidate’s level of competence in theoretical and practical Nursing Skills (Brooker 2001, as cited in Howard and Eaton, 2003, page 46).
Assessment in clinical practice ensures safety and competent standard of practice. Assessment is a critical element of the mentoring process, as Duffy (2204) explains mentors must ensure that assessment of clinical skills does occur as required. Many mentors have been passing students who should have failed in the hope that they will improve later although they are aware that this puts patients at risk. Kathleen Duffy was commissioned by the N. M. C to investigate the reasons for this.
The four main issue is that emerged in her report of January 2003 included the mentor leaving the indication to the student about their problem for too late in their placement, the mentor having difficulty to take action during their placement because such action could eventually cause critical consequences to the student, the mentor having to face the challenge of a weak student because Nursing is viewed as a caring profession and such action would be uncaring and lack of adequate time for assessors in the clinical environment to work with students (Fraser et al 1998), lack of support for the mentor from lecturers when faced with a fail situation (Sharp 2000). Stuart (2007 page 1) defined assessment as the judgement of performance during clinical practice and any other ways of measuring professional learning. There are 3 methods of assessment. They are Continuous Assessment, Formative Assessment and Summative assessment. Continues assessment provides a measure of how the student is progressing according to the level and knowledge expected at each stage of their training (R. C. N 2007).
The assessment consists of formative and summative dimensions, the later being as all the outputs from the student in the clinical area are observed, providing opportunities for Nursing Practice to be explored and not missed. Gibbs (1998) suggests that assessment should be continues as they are more authentic. Formative assessment occurs throughout the placement and during learning activities using feedback and feed forward and can determine whether re-explanation, arrangement of further practice or moving to the next level is required. Summative assessment normally takes place at the end of the placement and focuses on how much students have learned and have the learning outcomes been met. It does judge achievement of the specified competencies for the student to progress in training.
The formative and summative assessment are reliant on each other as Formative Assessment provides a facilitating process which guides and increases learning and serves to give a series assessments whereby a summative assessment can be made. Regardless of the type of assessment, employed every effective assessment must meet the four cardinal criteria. Which are Validity, Reliability, Discrimination and Utility (M. Quinn 2007). Dogra and Wass (2006) note any assessment of clinical performance need to accommodate the diversity of patients and their needs. So performance is judged in terms of cultural sensitivity. A mentor has an important part to play in the assessment of practical work, as well as providing education, role modelling and direct feed back (Nicklin & Ken worthy 2000).
We assess the knowledge of the students and how competent they are (what) (In the case of the student nurse, how competent she is in administering oral drugs). The staff nurse achieved this by asking the questions set out in the lesson plan (appendix 4) and evaluating the return demonstration. We assess because (why) we need to test the progress of the student, provide feedback to learners leading to future improvement and demonstrate to students that they have attained a goal or acquired a new skill (Cox & Harper 2000). In this situation, the staff nurse assessed (How) the skills and competency of the student through questioning and observing the return demonstration.
As part of the preparation for the role of the mentor, the assessment of the student nurse related to the practical procedure of drug administration began prior to the procedure itself. The student mentor assisted the learner previously with information about other topics and skills in the clinical environment which helps her to reduce assessment stress as the learner was comfortable due to previous interactions as predicted by Calnan, 1983. In addition to this, to ensure that all relevant issues were covered, the mentor observed the student throughout the lesson by using a performance checklist as stated by Quinn, 2000 (p. 231) which was designed to identify the knowledge, skills and attitude required for efficient performance.
The mentor also communicated clearly and assertively, which helps to interact in a more effective way (Wondrak, 1998). He gave verbal guidance to the learner and informed the student, prior to approaching the ward area that feed back would be presented in the privacy of the office to avoid embarrassment and promote confidence and discussion between the two. When I assessed my student the assessment tool choose to use observation and the use of checklist. Questioning, an important part of the assessing was aided by blooms classification system which enabled the student mentor to ask questions at different intellectual levels to determine the level of knowledge of the student. The learner received ample time to answer the questions to her full potential.
To facilitate self reflection, the staff nurse encouraged the student to discuss (Muijs & Reynolds, 2005) upon her own performance and the students realised how the assessment enhanced here knowledge. A mentor is also provided with the privilege to provide feed back targeting the improvement of the student. The staff nurse chose to give constructive feed back where criticism follows praise and then ends with a positive note which is hoped to give the student adequate confidence to deal with more negative aspects of his/her performance (Neary, 2000). The assessing section of the teaching session proved comparatively easier. I used Blooms Classification system to formulate questions at different intellectual levels in order to understand extend of the student knowledge.
The practical demonstration was easy to assess as the checklist provided the exact actions that I should be looking for an assessing. I felt confident while assessing the student and observed every step he took carefully. Assessing is something that I thought it is always done automatically rather than theoretically and methodically it was quite interesting to relate it to theory. My assessor was pleased with my performance and advised me to keep it up. I think my confidence in the subject influenced the student to learn more from me as the image presented through usually givers other a good impression. If a situation arises again I would try my best to keep up my good performance. I feel that the improvement I could make realise on time.
I should probably try to make the session longer so that the student has enough and more time to understand, improve, reflect and perfect. It would also help me to build up a better support with the student. This session provided me enough confidence. TEACHING Professional teaching in Nursing, Midwifery and Specialist Community Public Health Nursing, teaching is an International Enterprise that aims to facilitate learning. It is characterised by an acceptance of responsibility for facilitating other people’s learning by means of planned and purposeful educational interventions (Quinn 2007 p. 183). Teaching can either be formal or informal. Formal is normally pre-planned whereas informal teaching tends to be spontaneous (Hinchiff 2004).
For effective teaching to be carried out, it is important to understand the process of learning. Reece & Walker (2000) defines learning as a relatively permanent change. There are different learning theories associated with teaching, firstly, behaviourism, this theory is based on stimulus and response Pavlow (1936 - 1949) among other physiologist experimented on this theory. The humanist theory is however linked to feelings and experience. Maslow (1971) defines this theory as motivation and hierarchy of needs. Meaning the student must identify what he or she wants to learn. Lastly, the cognitive theory, this theory involves thinking and the mind.
According Hinchiff (2004) suggest that some key elements are essential in creating a good environment for the student, which are approachable staff, welcoming confident enough to share knowledge supportive, helpful, available and contactable and knowledgeable. Teaching session was carried out to prepare staff nurse to be a mentor oral drug administration was the topic chosen for this session. The rationale for this decision is the fact it is an integral part of a patients care. I notice that numerous management students have been failing their drug assessment test. There are two management students in our ward, next week they have a drug exam. I choose this topic to try to create a difference to these unfortunate occurrences.
Knowles indicate that adults are self directed and expect to take responsibility for decisions motivated about by the identification of humanistic needs (Knowles 1985). My students are adult and thus I chose andragogy to teach my students. Andragogy is defined as the art and science of helping adults to learn. In contrast pedagogy, which can be defined as the art and science of teaching children (Knowles 1973)? According to Knowles 1990, andragogy is where a student controlled approach is employed and thus enhance the students self concept, promotes autonomy, self direction and critical thinking. While encouraging reflection on experience and involves student in the diagnosis, planning, enacting and allows the student to evaluate his or her own learning needs (Knowles 1990).
On other hand, Pedagogy implies that learning occurs as a result of the input of others, the student - teacher relationship is unequal - student’s look-up to their teacher, teaching methods is teacher-led and the teacher accepts responsibility for the students learning (Hinchiff 2004 p. 69). The session took place in the staff room at the acute respiratory unit on Tuesday afternoon at 16. 30 hrs commenced after coffee break. The time chooses as there would be less activity compared to morning time. The rationale for this decision was to maximize concentration by the student and me (Gibbs 1998). The room was calm and quiet and devoid of any disturbance. It was also well ventilated, spacious and bright which ensured comfort for everyone in to the room. The atmosphere was positive for learning. The session was well planned and the room was arranged beforehand to produce the best possible learning atmosphere.
The student mentor prepared handouts for the students prior to the teaching session in order to provide record of what had to be taught (Hinchiff 2004). The mentor prepared a lesson plan before the lesson, thus ensuring that everything was prepared; she made SMART aims and objectives (Hinchiff 2004) to reach perfectionism. British National Formulary was used to teach the student where to look for information pertaining to groups of drugs. The domains of learning described in Booms Taxonomy were used for the session. In Bloom’s Taxonomy, the Domains of learning include Cognitive, the Psychomotor and the affective (Bloom 1972). I started the session by introducing myself and my assessor to the students. In addition I explained the aims and objectives of the lesson.
Then I asked some few question regarding the drug administration (Cox & Harper 2000) to understand the scope of the student’s previous knowledge us it. The staff used Bloom’s Taxonomy of educational objectives (1956) to formulate questions at different intellectual levels (Bloom 1956) in the session. Staff Nurse described the N. M. C. guidelines and Whippscross Policy of oral drug administration. The Staff Nurse used a drug chart and explained to the student how to read it, explained the important document features to ensure safety. At the end of session the staff nurse demonstrate to the student the administration of oral drugs. The mentor followed the step by step policies of the N. H. S. efore and after the administration of the drug while explaining the rationale for each action. After her demonstration, he asked the student for a return demonstration to facilitate evaluation. Finally, a short feed back session was held in the office and the student was provided with the opportunity to clarify her queries. The staff nurse began with positive feed back and then moved on to negative and constructive feed back. Ultimately the student asked to complete questionnaire to evaluate the session (see appendix 3). After the session, my assessor and myself sat down to reflect on the session. He gave me aspiring feedback about the session.
Reflection
Reflection is a process of reviewing an experience of practice in order to describe, analyse, evaluate and to inform learning about practice (Reid 1993). Reflection enables the practitioner to explore, understand and develop meaning, and also highlights contradictions between theory and practice (Johns 1995). Reflection can be two categories namely reflection on action, which involves looking back at events that have occurred and reflection in action, which involves learning as it happens and adapting to new situations (Bulman & Schutz 2004). Baud et al (1998) defined reflection as an active process of exploration and discovery which often lead to much unexpected outcomes.
Reflection helps to create an environment where professionals are helped to analyse and review their practice, thus enabling the professional to work in a more responsive, creative and untimely more effective manner (Redmond 2004). Reflection has been analysed by many and models have been designed to facilitate reflection. I choose the model, Gibbs’ Reflective Cycle (1998) to help me reflect on my session. I incorporated it into the teaching and assessing of my lesson for a methodical approach. Reflection is said to encourage practitioners to challenge the way they think, feel and believe (Burnard 1989). Reflecting on an experience is a highly skilled activity, it requires an ability to analyse action to make judgements regarding their effectiveness in particular situations.
Clearly, Boyd & Fales see self awareness and learning from experience as the key features of reflection. In Reflection, I felt that , humanistic approach was effective as it helped to make the student felt good about her. Contrary to my early fears, the students appeared to be confident about what she needed to know and asked questions accordingly. I would use pictorial demonstrations because this would have reduced the number of doubts that the students presented as many areas would have been self explanatory. Conclusion To develop the role of the mentor, I have made some recommendations. Staffs needs to be encouraged the student to teaching is a part of their role and need to be enthusiastic about this.
Attending regular mentorship updates in order to provide relevant, evidenced based information and keep abreast of developments in students teaching may motivate them and enhance professional development. A regular informal meeting at L. S. B. U between students and mentors to identify problems that arise and act accordingly. This would give both parties the opportunity to discuss what is expected and reduce barriers in the learning /teaching role and may improve the working relationship between mentors and students. Regular audit which are useful in identifying strength and weakness for teaching in the clinical area and all staff are to take part, they should be informed of date and time of audit and have the opportunity to participate in the ward evaluation. In conclusion becoming a mentor is one of the difficult roles of the nurse.
It is a very big and serious responsibility because it is in the hands of a mentor to shape the development of the potentials and skills of the students. It is not just teaching a student, what he or she knows, it is about making sure that students will be knowledgeable and competent, enough to practice as a Professional Nurse in the future. Mentors are essential part of the Nursing Students and prepare the next generations to inherit our jobs and further improvement. To let students achieve their maximum potential, supportive and experienced mentors are required. An incompetent and different mentor could impair the students motivation to learn and thus create choose in the future.
The N. M. C guidelines state that mentors are essential, however I am afraid they have left out the fact that enough time is also required to maintain the high standards set. This would ensure that students stretch their abilities to the maximum and that mentors are able to reflect upon their experiences and thus improve and perfect themselves to become much more experienced and competent. 10th December, 2008 To, Pauline Mills, Dear Madam, Please find enclosed herewith my mentorship essay preparation. Kindly check and re-correct the essay and return it at your earliest.
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