Update for Nursing Mentors
2016
Supporting Undergraduate Pre-registration
Nursing Students in practice
NMC Mentor Update – the basics
1.
2.
3.
4.
5.
6.
7.
How do you become a mentor? And stay on the mentor register?
Where is the register of NMC approved mentors and what information must be
held?
What is a sign off mentor, how do you become one, why were they introduced?
How much time in practice must student nurses spend with a mentor?
What resources are available to support mentors?
What are the obligations of the mentor:
–
First day
–
First week
–
Half way through
–
End of placement
–
Making fair judgements about NMC Practice Standards AND Clinical Skills
–
Dealing with a potentially failing student
Common questions about placements
• Can students do long days, weekends and night shifts?
• Can a student be left without direct supervision in a patient/service user
homes on a community placement?
• Are all placements assessed i.e. must be passed?
• Can students work extra shifts to ‘make up’ hours in a placement?
• Does NHS Professional or agency work count as practice hours?
• How are practice placements quality assured?
• Is there is a list of what students can and cannot do in practice?
• What is a hub and spoke model?
What is new?
Lord Willis (2015) The Shape of Caring Review report –
Raising The Bar
Recommendations:
• Patient involvement to increase
• NMC to consider 2+1+1 year model and explore the development and
implementation of a year-long preceptorship programme for newly
qualified registered nurses
• NMC to consider different fields of practice e.g. community
• NMC should review its current mentorship model and standards,
informed by the outcome of the RCN review
• Universities should work with Health Education England (HEE) to explore
in greater depth the causes for leaving the pre-registration programme
• HCA Role - HEE should set the competency standards for care/ Care
Certificate mandatory/ Access to nursing easier
In Leeds:
• Leeds Beckett University and the University of Leeds have
started to consult on NMC revalidation for our preregistration nursing courses (due during 2016 – 17)
All aspects under review :
• Taught element of programmes
• Practice placements
• Student practice assessment documents
To consider:
• Grading of practice
• Electronic practice assessment documents
Feel free to feedback via me or course teams
NMC (2008) “Mentors are responsible and accountable for
…providing…constructive feedback”
We know that students:
• Value feedback
• Want specific not generic feedback
• Want negative as well as positive feedback
• Need formative as well as summative feedback
• Can find feedback :motivating, increases their confidence, promotes
personal development, improves self esteem, reduces stress, develops
competence
We know that mentors:
• Find giving feedback stressful at times
• Difficult to give to weaker students
Duffy, K. 2013. Providing constructive feedback to students during mentoring. Nursing
Standard. 27, 31: 50 – 56
• Reflect on students who you have recently mentored…
• How do you give constructive feedback to students?
Value of formative (v. summative) feedback:
“Assessment discussions can help students develop
‘situational understanding’ that will help them…. negotiate
their way through the competing and contradictory values
that they encounter as they perform care.”
Phillips et al, 2000. Practice and assessment in nursing and midwifery: doing it for real. London.
ENB.
Principles:
• Set realistic goals
• Gauge students expectations of feedback by self
assessment
• Ensure it is informed by evidence (prepare)
• Be timely -give as close as possible to events
• Be specific and balanced
• Document feedback discussions
• Invite student to contribute
• Involve university if risk of failing or mentor needs support
Adapted from: Walsh, D. 2010. The Nurse mentor handbook. OUP. Maidenhead.
Feedback Models
•
•
•
•
A = Ask for self-assessment
R = Reinforcement
C = Correct
H = Help by building improvement plan with learner
• Praise sandwich(!) with caution
Being fair and transparent:
 Reliability:
 Would different assessors award same mark/result/grade?
i.e. consistency
 Validity:
 Does the assessment method measure what it is supposed
to measure?
 How do you ensure assessment is fair?
Making fair judgements on students :
•
•
•
•
•
•
Direct observation by you
Working alongside you
Discussions with you
Indirect observation
They work with others in team who give you feedback
Evidence of work completed
Think about stage student is at:
• Stage 1 novice
• Stage 2 care of single client & family/carer – non- complex
cases
• Stage 3 – care of groups of clients & families/carers and for
complex cases
Consider importance of assessing against objective criteria
rather than subjective or normative criteria
Transactional analysis (Eric Berne)
• How we respond to
each other
• 3 states:
Parent
Voice of
authority
Directive
Controlling
Adult
Self
determined
Deliberation
over actions
Child
Emotional
feelings
Spontaneous
reactions
Compliant/
resistant
Key principles of feedback and assessment
1. Interview process: preliminary, intermediate and final
2. Development plans
• Emphasis on intermediate review/feedback/action
plans
3. Evidence of achievement in practice of practice standards
Professional Behaviours in Practice
•
•
•
•
•
•
•
•
•
The student maintains confidentiality at all times
The student is respectful and courteous to others
The student is sensitive to the needs of others
The student is non judgemental
The student’s personal hygiene and appearance is in accordance with the
organisations dress code / uniform policy
The student maintains appropriate levels of client/patient privacy and dignity
The student’s timekeeping is satisfactory and he/she communicates appropriately
if unable to attend placement
The student demonstrates openness, trustworthiness and integrity
The student makes consistent effort to achieve the requisite standards of care and
learning.
What makes an effective learning environment?
Consider the obligations of:
• The placement area team
• The mentor
• Resources for learning
• The host organisation
Practice placement evaluation
The following statements are considered by the students when completing an evaluation of a
practice placement and rated either: Yes, No, Not Applicable
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
I felt my education provider prepared me for the placement experience.
I was informed of my placement allocation with sufficient time for me to make contact with the placement.
I found the information I needed on the placement profile at www.healthcareplacements.co.uk
I had an induction and orientation to my environment, including health and safety information
I had somewhere safe to store my belongings whilst on placement.
The placement provided me with access to resources which helped me with my learning
There was sufficient access to internet and IT facilities whilst on placement
The learning opportunities available in this placement enabled me to achieve my learning outcomes
I was encouraged to take part in practice activities appropriate to my level of experience
I had sufficient opportunities to receive feedback after being observed in practice
The placement provided me with the experience of working inter-professionally
I received timely support from my course/programme team whilst on placement when I needed it
Early in the placement my learning needs were discussed with my mentor / practice educator
My named mentor(s) / practice educator(s) and the wider team were able to facilitate my development and recognised the
importance of my learning needs
With the support of my mentor(s) / practice educator(s) I was able to work towards my placement learning outcomes
Staff in the practice area were friendly, helpful, included me as part of the team and had time to answer my questions
I understood the process for raising concerns within the placement
My mentor(s) / practice educator(s) understood and followed the student assessment process
My development in practice was informed by on-going constructive feedback
Where applicable, the placement encouraged service users/carers to provide performance feedback during my practice placement
My final assessment was fairly assessed and focused on feedback about my performance across the whole placement
I would recommend the placement setting to friends and family if they needed similar care or treatment
I was satisfied with the standard of patient/client care on my placement
I was satisfied with the standard of my educational experience on my placement
Any concerns I raised were dealt with appropriately
I would recommend this placement as a valuable learning experience
www.healthcareplacements.co.uk
“ I felt included in the team during my placement”.
a) What is the role of the mentor in ensuring students feel part
of the clinical team?
b) How would you deal with negative feedback from students
about your clinical area?
c) Discuss how you evaluate your own your effectiveness as a
mentor
Scenario
Generally your clinical area receives positive feedback from students…
However, recently 3 students have provided an evaluation of their placement in your
area. Although agreeing with all other statements, 2 students answered, yes, and 1,
no, to the question:
16. Staff in the practice area were friendly, helpful, included me as part of the team
and had time to answer my questions
a)
b)
c)
What is the role of the mentor in ensuring students feel part of the clinical team?
How would you deal with negative feedback from students about your clinical
area?
Discuss how you evaluate your own your effectiveness as a mentor?
Student Experiences
“Nursing students’ self-concept, confidence, resilience, self
efficacy, the extent to which they were willing to question or
conform to poor practice, motivation to learn and future career
decisions were influenced by the extent to which they
experienced belongingness.”
Levett – Jones,T., Lathlean, J., Higgins, I. & McMillan, M. 2009. Staff – student
relationships and their impact on nursing students’ belongingness and learning.
Journal of Advanced Nursing, 65, 2 , 316 - 324.
Contacts and Resources
Practice Placement website: www.practiceplacements.leeds.ac.uk
• Contains resources for mentors and students
• Copies of student documentation
• Contact details for the Universities
Leeds University Placement Unit:
Responsible for allocations of students for University of Leeds and Leeds
Beckett University, contactable at:
Placements@healthcare.leeds.ac.uk or 0113 3431375
Health Care Placements website: www.healthcareplacements.co.uk
• Profile of all practice placements in Yorkshire
• Mentor register
• Student online evaluation facility
• Educational audits
August 2015 LTHT guidance:
“It has come to our attention at recent mentor updates that there is confusion
around whether or not students are able to be involved in prepping and mixing up IV
drugs while under supervision… we have sought clarity about this from Lesley-Ann,
Clinical Educator in Pharmacy, and she has confirmed that as long as the student is a
final year student, competent in ANTT, and is DIRECTLY supervised, they can
reconstitute drugs. Under no circumstances can they be the second checker or
administer these.”
Source: Debbie Casey, Leeds Beckett University (2015)
Scenarios:
1. You are mentoring a first year student in your practice learning environment. Another
student discloses that they have seen a discussion on a social networking site posted by the
student you are mentoring stating that the student does not feel supported by you, as the
mentor.
2. Mark is a 2nd year pre-registration student. He is 4 weeks into his placement. When he sees
his personal tutor in University, he complains that his preliminary interview did not occur
until 2 weeks into the placement, that Jane, his mentor, ….. has not updated herself
recently…..” and she is frequently working different shifts to him. What should his personal
tutor do?
3. You are mentoring a second year student who is in week 3 of an 8 week practice learning
experience. Based on your observations and questioning, you notice that the student’s
underpinning knowledge is poor when undertaking a particular intervention. As part of your
support strategy you give the student a workbook previously developed which you ask to be
completed within a week. You then receive a telephone call from a lecturer in the University
who states that the student feels that you (mentor) have unrealistic expectations of them.