Triennial Review
Mentor Evidence Record
Mentor Name
Clinical Placement Name
University Link Lecturer Name
3 Year Period Commencing
Completion Date
Developed by Jayne Pentin, Professional Development Nurse and the Practice Learning
Facilitator, 2014
1
Index
Page
Staff details
Guidance for Mentors
How to collecting evidence for this portfolio
What happens if all the standards are not met?
Evidence for the 8 NMC domains for Student 1
Evidence for the 8 domains for Student 2
Triennial Review Checklist
Reflection Notes
Notification Form
Triennial Review Exception Report
Action Plan
2
3
4
5
5
6 -13
14 -21
22
23
24
25
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Staff Details
The purpose of this document is to provide mentors with a record of their mentorship
experiences with two students over a three year period. It has been developed to reflect
the NMC domains (NMC, 2008)
For some mentors, the opportunity to mentor students may occur only infrequently so it
may be difficult to remember what experience you gave students whilst mentoring them
if you only come to write up your portfolio at the end of the three year period. It is also
important that mentors keep the information about students on this document
anonymous and only the student’s ID number should be used. Space has been provided
for you to record this number.
Mentor qualification held (please circle)
ENB997, ENB998, MIP, SLIP, PGCE, PGDIPE,
D32/33, A1
Other
Date qualification obtained
Dates of annual mentorship updates
1
2
3
Number of students mentored in the three
year period
Year 1
Year 2
Year 3
Date and nature of reflective event
Reference; ‘Standards to support learning and assessment in practice’ (2008) Nursing
and Midwifery Council, London
http://www.nmc-uk.org/Publications/Standards/
3
Guidance for Mentors to Meet the NMC Standards to Support Learning
and Assessment in Practice (NMC 2008).
Introduction
The NMC Standards require that every 3 years all mentors provide evidence that they:
are currently registered
hold an NMC recognised mentor qualification
have completed a mentor update in the last 12 months
have mentored at least 2 students (extenuating circumstances
permitting)
have explored as a group activity the validity and reliability of the
judgements they have made when assessing practice i.e.: during your face
to face update
have mapped their practice against the 8 NMC domains
This portfolio is intended to guide and support qualified mentors to evidence that they
have achieved the NMC Standards (NMC, 2008)
Reference; ‘Standards to support learning and assessment in practice’ (2008) Nursing
and Midwifery Council, London
http://www.nmc-uk.org/Publications/Standards/
4
How to collect evidence for this portfolio
Mentors are required by the NMC to map their achieved evidence against the 8 domains
that are outlined in the Mentor Standards.
The Learning Outcomes in these 8 domains have been grouped together according to the
type of activity so that the evidence collected can be used to support more than one
outcome.
Mentors are encouraged to form peer groups to discuss the process of supporting
students and to verify that the outcomes have been met. Once completed you will need
to discuss the portfolio with your line manager or clinical lead and that person will need
to confirm that this evidence is a good and robust reflection of your mentoring activity.
This may be done as part of your personal development plan during your annual
appraisal or as a separate activity. Your manager and you will the need to complete the
notification form at the end of this portfolio and return it to:
Mr Doug Bodey
Practice Learning Facilitator
Corporate Nursing
2nd Floor
Trust Headquarters
Beckett Street
Leeds
LS9 7TF
0113 2065355
Or by email to doug.bodey@nhs.net
What happens if all the standards are not met?
If you are struggling to find suitable evidence for a particular domain then please contact
Doug Bodey at the address above and he will help you either identify possible evidence
or to develop an action plan to help you achieve the standards within an agreed time
frame.
If you have been unable to complete the Triennial review then please complete the
notification form and your name will be placed on the INACTIVE section of the Mentor
Register until you have completed the action plan.
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Student 1
Student ID :
Placement Date:
Domain 1.Establishing Effective Working Relationships
1, Learning Outcomes;
1.1 Demonstrate an understanding of factors that influence how students integrate into practice settings, KSF G1 C1 C2
1.2 Provide on-going and constructive support to facilitate transition from one learning environment to another, KSF G1 C1 C2
1.3 1.3 Have effective professional and inter-professional working relationships to support learning for the entry to register, KSF G1 C1 C2
Think about how students learn, what factors influence their learning and how you helped them settle into your clinical environment?
Think about how you helped the student to adapt to a new learning environment what skills have they bought with them from their previous
placement and the difference from learning in university to the clinical environment. How have you helped the student to develop professional
and inter-professional relationships?
7
Domain 2.Facilitation of learning
Learning Outcomes;
2.1 Use of knowledge of the student’s stage of learning to select appropriate learning opportunities to meet individual needs, KSF G1 G2
2.2 Facilitate a selection of appropriate strategies to integrate learning from practice and academic experiences, KSF G1 G2
2.3 Support students in critically reflecting upon their learning experiences in order to enhance future learning, KSF G1 G2
E.g.: What did you do to find out the stage of learning the student was at and how did you adapt learning opportunities to meet their needs.
How did you help the student to relate theory to practice? What reflective opportunities did you afford the student?
8
Domain 3.Assessment and accountability
Learning Outcomes;
3.1 Foster professional growth, personal development and accountability through support of students in practice, KSF G1 C2 C4
3.2 Demonstrate a breadth of understanding of assessment strategies and ability to contribute to the total assessment process as part of the teaching
team, KSF G1 C2 C4
3.3 Provide constructive feedback to students and assist them in identifying future learning needs and actions, manage failing students so that they
may enhance their performance and capabilities for safe and effective practice or be able to understand their failure and the implications of this for
their future, KSF G1 C2 C4
3.4 Be accountable for confirming that students have met or not met the NMC competencies in practice, KSF G1 C2 C4
3.5 As a sign-off mentor confirm that students have met or have not met the NMC standards of proficiency and are capable of safe and effective
practice, KSF G1 C2 C4
E.g.: How did you help the student to address issues of accountability? What sort of assessment strategies did you use i.e. observation role play etc.
How did you provide the students with feedback and identify plans/actions to expand their learning. If your student was failing what did you do to
support them who did you contact and how did you feel about your accountability in ensuring the student is a safe and knowledgeable practitioner?
If your current role precludes you from assessing students in practice you can make an exception report see page 25
9
Domain 4.Evaluation of learning
Learning Outcomes;
4.1 Contribute to the evaluation of student learning and assessment experiences, proposing aspects for change resulting from such evaluation
4.2 Participate in self and peer evaluation to facilitate personal development and contribute to the development of others
E.g.: How did you evaluate what the student had learnt and how they practiced? Did you have to propose changes at all?
How did you reflect on your own skills as an assessor what do your peers think of how you mentor students. How did the mentor experience affect your
own professional and personal development?
10
Domain 5.Create an environment for learning
Learning Outcomes;
5.1 Support students to identify both learning needs and experiences that are appropriate to their level of learning, KSF G1 C2 C4 C5
5.2 Use a range of learning experiences, involving patients, clients, carers and the professional team, to meet defined learning needs, KSF G1 C2 C4 C5
5.3 Identify aspects of the learning environment which could be enhanced, negotiating with others to make appropriate changes, KSF G1 C2 C4 C5
5.4 Act as a resource to facilitate personal and professional development of others, KSF G1 C2 C4 C5
E.g.: How did you support the student to identify their own learning needs and experiences which were appropriate to the stage of training they were
at? Think of some examples where patients or carers were involved in the students learning experience.
Are there any issues in your clinical environment that disadvantage potential student learning opportunities, (this could be lack of mentors, no quiet
place to sit and talk, off duty miss-match etc.) If so how did you address the issues? How did you act as a resource to your student to assist them to
personally and professionally develop?
11
Domain 6.Context of practice
Learning Outcomes;
6.1 Contribute to the development of an environment in which effective practice is fostered, implemented, evaluated and disseminated, KSF C2 C4 C5
6.2 Set and maintain professional boundaries that are sufficiently flexible for providing inter-professional care, KSF C2 C4 C5
6.3 Initiate and respond to practice developments to ensure safe and effective care is achieved and an effective learning environment is maintained,
KSF C2 C4 C5
E.g.: As a mentor how do you contribute to ensuring that your clinical environment is suitable for students to learn in?
Is the practice in your clinical environment of a high standard where good practice is encouraged implemented evaluated and shared by all staff and if
so what is your part in that. How did you maintain professional boundaries with your student? How do you keep your own practice current and update
your own knowledge i.e. mandatory training, personal study and other courses.
12
Domain 7.Evidence based practice
Learning Outcomes;
7.1 Identify and apply research and evidence based practice to their area of practice, KSF C2 C5
7.2 Contribute to strategies to increase or review the evidence base used to support practice, KSF C2 C5
7.3 Support students in applying an evidence base to their own practice, KSF C2 C5
E.g.: How do you apply research to support your practice and how do you demonstrate this to the students you mentor?
Think about how you contribute to the use of evidence based practice in your clinical environment. How did you encourage the student to use evidence
based practice and check this application whilst in your clinical environment, (for example reading articles or books or ward learning packages or
critically reviewing articles together on a specific illness a patient had that the student cared for).
13
Domain 8.Leadership
Learning Outcomes;
8.1 Plan a series of learning experiences that will meet students’ defined learning needs, KSF G1 G6 G7 C1 C2
8.2 Be an advocate for students to support them accessing learning opportunities that meet their individual needs, involving a range of other
professionals, patients, clients and carers, KSF G1 G6 G7 C1 C2
8.3 Prioritise work to accommodate support of students within their practice roles, KSF G1 G6 G7 C1 C2
8.3 Prioritise work to accommodate support of students within their practice roles, KSF G1 G6 G7 C1 C2
E.g.: Consider what specific learning experiences you used to meet the students learning needs. How did you act as the students advocate to ensure
that their learning needs were met what other professionals did you find for her to work with and how did you ensure that they provided a good
experience. What strategies did you use to ensure that you fulfilled your responsibility as a Registered Nurse with a group of patients to care for and
mentoring a student at the same time? How did you provide feedback to your student of the effectiveness of their learning in practice?
14
Student 2
Student ID :
Placement Date:
Domain 1.Establishing Effective Working Relationships
Learning Outcomes;
1.4 Demonstrate an understanding of factors that influence how students integrate into practice settings, KSF G1 C1 C2
1.5 Provide on-going and constructive support to facilitate transition from one learning environment to another, KSF G1 C1 C2
1.3 Have effective professional and inter-professional working relationships to support learning for the entry to register, KSF G1 C1 C2
Think about how students learn, what factors influence their learning and how you helped them settle into your clinical environment?
Think about how you helped the student to adapt to a new learning environment what skills have they bought with them from their previous
placement and the difference from learning in university to the clinical environment. How have you helped the student to develop professional and
inter-professional relationships?
15
Domain 2.Facilitation of learning
Learning Outcomes;
2.1 Use of knowledge of the student’s stage of learning to select appropriate learning opportunities to meet individual needs, KSF G1 G2
2.2 Facilitate a selection of appropriate strategies to integrate learning from practice and academic experiences, KSF G1 G2
2.3 Support students in critically reflecting upon their learning experiences in order to enhance future learning, KSF G1 G2
E.g.: What did you do to find out the stage of learning the student was at and how did you adapt learning opportunities to meet their needs.
How did you help the student to relate theory to practice? What reflective opportunities did you afford the student?
16
Domain 3.Assessment and accountability
Learning Outcomes;
3.1 Foster professional growth, personal development and accountability through support of students in practice, KSF G1 C2 C4
3.2 Demonstrate a breadth of understanding of assessment strategies and ability to contribute to the total assessment process as part of the teaching
team, KSF G1 C2 C4
3.3 Provide constructive feedback to students and assist them in identifying future learning needs and actions, manage failing students so that they
may enhance their performance and capabilities for safe and effective practice or be able to understand their failure and the implications of this for
their future, KSF G1 C2 C4
3.4 Be accountable for confirming that students have met or not met the NMC competencies in practice, KSF G1 C2 C4
3.5 As a sign-off mentor confirm that students have met or have not met the NMC standards of proficiency and are capable of safe and effective
practice, KSF G1 C2 C4
E.g. How did you help the student to address issues of accountability? What sort of assessment strategies did you use i.e. observation role play etc.
How did you provide the students with feedback and identify plans/actions to expand their learning. If your student was failing what did you do to
support them who did you contact and how did you feel about your accountability in ensuring the student is a safe and knowledgeable practitioner?
If your current role precludes you from assessing students in practice you can complete exception report see page 25
17
Domain 4.Evaluation of learning
Learning Outcomes;
4.1 Contribute to the evaluation of student learning and assessment experiences, proposing aspects for change resulting from such evaluation
4.2 Participate in self and peer evaluation to facilitate personal development and contribute to the development of others
E.g.: How did you evaluate what the student had learnt and how they practiced? Did you have to propose changes at all? How did you reflect on your
own skills as an assessor what do your peers think of how you mentor students. How did the mentor experience affect your own professional and
personal development?
18
Domain 5.Create an environment for learning
Learning Outcomes;
5.1 Support students to identify both learning needs and experiences that are appropriate to their level of learning, KSF G1 C2 C4 C5
5.2 Use a range of learning experiences, involving patients, clients, carers and the professional team, to meet defined learning needs, KSF G1 C2 C4 C5
5.3 Identify aspects of the learning environment which could be enhanced, negotiating with others to make appropriate changes, KSF G1 C2 C4 C5
5.4 Act as a resource to facilitate personal and professional development of others, KSF G1 C2 C4 C5
E.g.: How did you support the student to identify their own learning needs and experiences which were appropriate to the stage of training they were
at? Think of some examples where patients or carers were involved in the students learning experience. Are there any issues in your clinical
environment that disadvantage potential student learning opportunities, (this could be lack of mentors, no quiet place to sit and talk, off duty missmatch etc.) If so how did you address the issues? How did you act as a resource to your student to assist them to personally and professionally
develop?
19
Domain 6.Context of practice
Learning Outcomes;
6.1 Contribute to the development of an environment in which effective practice is fostered, implemented, evaluated and disseminated, KSF C2 C4 C5
6.2 Set and maintain professional boundaries that are sufficiently flexible for providing inter-professional care, KSF C2 C4 C5
6.3 Initiate and respond to practice developments to ensure safe and effective care is achieved and an effective learning environment is maintained,
KSF C2 C4 C5
E.g.: As a mentor how do you contribute to ensuring that your clinical environment is suitable for students to learn in? Is the practice in your clinical
environment of a high standard where good practice is encouraged implemented evaluated and shared by all staff and if so what is your part in that.
How did you maintain professional boundaries with your student? How do you keep your own practice current and update your own knowledge i.e.
mandatory training, personal study and other courses.
20
Domain 7.Evidence based practice
Learning Outcomes;
7.1 Identify and apply research and evidence based practice to their area of practice, KSF C2 C5
7.2 Contribute to strategies to increase or review the evidence base used to support practice, KSF C2 C5
7.3 Support students in applying an evidence base to their own practice, KSF C2 C5
E.g.: How do you apply research to support your practice and how do you demonstrate this to the students you mentor?
Think about how you contribute to the use of evidence based practice in your clinical environment. How did you encourage the student to use evidence
based practice and check this application whilst in your clinical environment, (for example reading articles or books or ward learning packages or
critically reviewing articles together on a specific illness a patient had that the student cared for).
21
Domain 8.Leadership
Learning Outcomes;
8.1 Plan a series of learning experiences that will meet students’ defined learning needs, KSF G1 G6 G7 C1 C2
8.2 Be an advocate for students to support them accessing learning opportunities that meet their individual needs, involving a range of other
professionals, patients, clients and carers, KSF G1 G6 G7 C1 C2
8.3 Prioritise work to accommodate support of students within their practice roles, KSF G1 G6 G7 C1 C2
8.3 Prioritise work to accommodate support of students within their practice roles, KSF G1 G6 G7 C1 C2
E.g.: Consider what specific learning experiences you used to meet the students learning needs. How did you act as the students advocate to ensure
that their learning needs were met what other professionals did you find for her to work with and how did you ensure that they provided a good
experience. What strategies did you use to ensure that you fulfilled your responsibility as a Registered Nurse with a group of patients to care for and
mentoring a student at the same time? How did you provide feedback to your student of the effectiveness of their learning in practice?
22
Triennial Review Checklist
(yes/no)
Mentored 2 students in 3 years
Participated in annual updating with other mentors
Explored as a group activity the validity and reliability of assessment
judgements in practice under challenging circumstances
Mapped on-going development within the 8 domains of the NMC standards
Have all the triennial documentation signed by your manager as a true record
of having met the NMC requirements to be a mentor and/or sign off mentor
Over the page is a section for you to make some notes about the meetings you have
had with students and with colleagues during the group activities when exploring
assessment and discussing challenging situations.
By completing this you will be providing evidence for your manager to discuss with you
and hence feel more confident about signing you off your triennial review.
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Reflection Notes
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NOTIFICATION FORM
MENTOR
Declaration: I declare that the information documented reflects my current practice in
my role as mentor. I have demonstrated my knowledge, skills and competencies as
required by the NMC ‘Standards to Support Learning and Assessment in Practice.’
(2008).
In addition to the above, I declare that I have also mentored a minimum of two preregistration students within a three year period, and I am up to date with my annual
mentor updates.
Name
Signature
Date
Email address
LINE MANAGER
Declaration: I confirm I have reviewed the evidence submitted and this mentor meets
the NMC standards for the Triennial Review
AGREE
DISAGREE
Name
Signature
Date
Email address
If the mentor is unable to meet the NMC standards for Triennial review please also
complete the next sheet
Please return this completed form to Doug Bodey, PLF, Second Floor Trust HQ,
St James’ Hospital, Beckett St, LS9 7TF or attach to e-mail; doug.bodey@nhs.net
25
Triennial Review Exception Report
To be completed when the mentor is unable to meet the NMC standards of the Triennial Review.
Mentor Name
(please tick)
Unable to mentor two students in 3 years due to role
Unable to meet the requirement of Domain 3 as student on an observational placement i.e. less than 4 weeks
Unable to meet the requirement of Domain 3 due as individual does not directly mentor and assess students
Other domains, please specify:
Manager Signature
Manager Name
Date
Title
Please complete the action plan overleaf detailing the action and timeframe to enable the criteria for the Triennial Review to be met.
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Action Plan to achieve outstanding NMC Domain Learning Outcomes for Triennial Review
(This form is to document any development needs that occur following your review)
Mentor Name
NMC Domain
Learning Outcome
Outstanding evidence
How will I achieve this evidence
and by when?
Sign and date
when achieved
Your name will be placed on the inactive part of the register until you can demonstrate that you have met the above outcomes.
Please return this completed form if necessary to Doug Bodey, PLF, Second Floor Trust HQ, St James’ Hospital, Beckett St,
LS9 7TF Or attach to an e-mail to doug.bodey@nhs.net
27