Faculty of Medicine and Health Sciences School of Health Sciences Mentor Update 2015 Mentor Name: Date of Update: Date of passing Mentor Preparation Programme: ____ / ____ / ____ Revised version – November 2014 DH/SW/EN 1

Section 1 – Introduction and curriculum issues Section 2 - The Role of the mentor Section 3 – Assessments Section 4 – Triennial review and sign off information Section 5 – Case studies Section 6 – Summary and resources Mentor update 2

Section 1 Introduction and curriculum issues 3

Aims and Objectives of the Mentor Update Programme This update will enable you to Identify the curriculum that students are currently following Describe the NMC (2008) domains within the Standards to Support Learning and Assessment Describe how to develop a placement pathway for students to follow (hub and spoke) that maximises learning and assessment opportunities Identify when to undertake relevant assessment processes during a placement Describe how to correctly complete the assessment documentation Identify how to develop relevant action plans for a range of student scenarios Explain the importance of formative assessment and giving regular feedback Identify the importance of the role and the accountability and responsibility that the role requires Describe the role of the sign off mentor and the triennial review Identify the support networks available to you to help you mentor students Understand that acting as a positive mentoring role model can influence and support delivery of NHS values Have current knowledge of NMC approved programmes Are able to discuss the implications of NMC requirements Have the opportunity to discuss issues related to mentoring, assessment of competence and fitness for safe and effective practice *NMC SLAiP (2008 pg.30) 4

The mentor must understand the eight key domains that are associated with undertaking the mentor role. (NMC Standards 2008) The eight key domains are: Establishing effective working relationships Facilitation of learning Assessment and accountability Evaluation of learning Creating an environment for learning Context of practice Evidence-based practice Leadership These domains can be applied within the context of inter-professional learning (IPL) and working in today’s modern healthcare setting. NMC Domains 5

During the programme all students, whatever their nursing field, will experience four field placements and two generic (non-field) practice learning opportunities where the skills, attributes and technical abilities required by all student nurses can be acquired and demonstrated. In the last year of the programme all practice learning opportunities will be within the student’s chosen field, facilitating the acquisition of knowledge, skills and attributes that students must acquire in order to practise safely and effectively in their chosen field of nursing. Nursing Curriculum BSc Field Specific Field Specific Generic 6

MSc Curriculum – Key Themes Inter-professional and multi-agency awareness Leadership capability development Service improvement Research consumerism to ensure practice is evidence based Cross field experience Experience of working with service users in the community Living well with multiple and long-term conditions Case managed care Self-care (primary care, crisis intervention, public health) Urgent care 7

The Nursing curriculum covers All degree and MSc programmes Fields (not branches) of nursing Two semesters per year - longer placements involve one module per semester One comprehensive formative assessment followed by one summative attempt in practice Graded component – nursing attributes Curriculum Details 8

The Hub forms a primary placement learning opportunity where the student will spend the majority of their clinical time during a Module placement allocation. HUB i.e. ward or department HUB i.e. ward or department Hub and Spoke Placements Outpatients Day Surgery Specialist Nurse Occupational Therapist Physiotherapist Assessment Unit A Spoke is any additional placement learning opportunities the student needs in order to experience relevant patient journeys and achieve the placement learning outcomes. 9

Think about the patient journey in your work area and the different healthcare professional or specialists practitioners that will be involved in delivering patient care. What elements would you use to design your own hub and spoke? What would be the disadvantages of having too many spoke placements? Feedback Reflective Question 10

The placement of students in the curriculum exposes all students to all fields of nursing and some midwifery experience. Placement Plans Year 1 YearPlacement AreaSemester 1 Foundations of nursing Semester 2 Essential nursing practice 1AdultNursing homes, surgery, MH ChildLDChild acute Learning DisabilityChild acute +two weeks HVLD adult + children Mental HealthAdult acute, nursing homes, MH MH community 11

The placement of students in the curriculum exposes all students to all fields of nursing and some midwifery experience. Placement Plans YearPlacement AreaSemester 1 Health and well-being Semester 2 Long term conditions 2AdultLong term, community + 2 week HV ChildHV + 2 week acute, Specialist community + 2 week acute Learning DisabilityAdult acute, LD Mental HealthLD, MH acute or NRP or outreach Year 2 12

The placement of students in the curriculum exposes all students to all fields of nursing and some midwifery experience. Placement Plans YearPlacement AreaSemester 1 Meeting complex needs Semester 2 Preparation for future practice 3AdultAdult critical + emergencyAdult management ChildNICU, theatres or A&E or CAU Learning DisabilityLD secure, LD community Mental HealthComplex MH Care Year 3 13

The placement of students in the curriculum exposes all students to all fields of nursing and some midwifery experience. MSc Placement Plans YearPlacement AreaSemester 1 Promoting Community Health and Well-being Semester 2 Living Well with Multiple and Long Term Conditions 1MSc AdultLong term, community + 2 week HV YearPlacement AreaSemester 1 Acute and Complex Care Semester 2 Professional Practice and Leadership 2MSc AdultAdult critical + emergencyAdult management 14

Students are placed in practice for 50% of their training. Mentors are accountable for making summative assessment decisions and are vital in linking theory and practice. On the next pages you to see an example of how all students can experience other fields and access the experience of other healthcare professionals. Theory and Practice Assessments Intro 15

Mentors are accountable and make decisions for all Blue Areas worth 20 academic credits. Theory and Practice Assessments SemesterAssessment 1 – Year 1 Foundations of Nursing Year (Sept – Feb) 2 week taster in weeks 5 & 6 7 week placement weeks Communication assignment Practice assessment 1 Portfolio 2 – Year 1 Essential nursing practice (Feb – Aug) 11 week placement weeks Group Presentation (EBL) Practice assessment 2 OSCE Year 1 – BSc Only 16

Mentors are accountable and make decisions for all Blue Areas worth 20 academic credits. Theory and Practice Assessments SemesterAssessment 3 - Year 2 BSc 1 – Year 1 MSc Health and wellbeing (Sept-Feb) 12 week placement weeks Empowerment assignment Practice assessment 3 Clinical Report 4 - Year 2 BSc 2 – Year 1 MSc Long term conditions (Feb-Aug) 12 week placement weeks 9-20 Examination Practice assessment 4 Portfolio Year 2 – BSc and Year 1 MSc 17

Mentors are accountable and make decisions for all Blue Areas worth 20 academic credits. Theory and Practice Assessments SemesterAssessment 5 - Year 3 BSc 3 – Year 2 MSc Acute and Emergency Care (Sept-Feb) 12 week placement weeks Practice assessment 5 Dissertation Practice assessment Year 3 BSc 4 – Year 2 MSc Preparation for future practice (Feb- Aug) 12 week placement weeks Portfolio Service improvement proposal Year 3 BSc and Year 2 MSc 18

Section 2 The role of the mentor 19

The Role of the Mentor Mentoring is a protected relationship in which learning and experimentation can occur, skills can develop and results can be measured (Clutterbuck and Megginson 2005). It is a widely used and effective tool for personal and organisational development (Turner 2004). Mentoring is a learning and development process which allows a mentee to discuss any issues or development needs that may have with a more experienced and senior mentor (NHS National Workforce projects). Protégés at different stages maximally benefit from developers at higher stages, given that they will have transcended the limitations that the protégé faces (Chandler and Kram 2005). Mentoring is a relationship which gives people the opportunity to share their professional skills and experiences and to grow and develop in the process (Lewes 2000). It is a skilled activity that can lead to a full-time career as a ‘mentoring professional’ (SFEDI 2011). This list is neither exhaustive or exclusive. 20

What are the qualities you need to have as a mentor? Feedback Reflective Question 21

Use coaching to enhance mentorship Mentoring and Coaching (NHS Scotland) MentoringCoaching Focus on progressFocus on task Usually long-term Usually short term Intuitive feedbackExplicit feedback Develops capabilitiesDevelops skills Driven by mentee/learnerDriven by coach Helps you to work it out Shows you where you yourselfwent wrong 22

Establishing an Effective Working Relationship Positive mentors influence students to do better and to develop more productive and stronger skills throughout their programme. Students develop stronger more professional relationships and are more confident. (Gutierrez 2012) Positive mentoring has been shown to result in higher student competence, confidence and effectiveness. (Hesli et al 2006, Paglis et al 2006 and Williams-Nickleson 2009) Mentoring can significantly aid in career development. (Pomeroy and Steiker 2011) Consider the following; How can you make a student feel welcome to your area? How can a learning contract help both mentor and mentee? 23

The mentor’s role in facilitating independent learning and supporting students in their personal and professional development can be achieved in many ways. Here are some examples: Using knowledge of the student’s stage of learning to select appropriate Learning opportunities to meet individual learning needs Facilitating the selection of appropriate learning strategies to integrate Learning from practice and academic experience Support students in critically reflecting upon their learning experiences in Order to enhance future learning. NMC (2008) Facilitating Learning Consider the following; What learning opportunities are available in your area? How is the mentor fundamentally important in bridging the theory/practice gap? What advantages does a placement plan serve? 24

Assessment is a critical part of the mentoring process. Duffy (2004) sees mentors as essential in: “… ensuring that assessment of clinical skills does occur as required. Passing students who should have failed or in the hope that they will improve later put’s patients at risk…” As a mentor you must Provide opportunities for learning and assessment Encourage students to self-assess and reflect on their learning Ensure any assessment of a student’s skills are valid and reliable, and that the level of skill can be consistently demonstrated Assessment and Accountability “… ensuring that assessment of clinical skills does occur as required. Passing students who should have failed or in the hope that they will improve later puts patients at risk…” Consider the following? What is the difference between formative and summative assessment? How can more formative assessment help you? 25

How would you create an environment suitable for learning? Feedback Reflective Question 26

The key influences on disability issues are: Equality Act 2010 Disability Discrimination Act (DDA) 2005 Public Sector Duty Impact assessments In the DDA, a person has a disability if they have a physical or mental impairment and the impairment has a substantial and long- term adverse effect on their ability to perform normal day-to-day activities. When should you ‘make reasonable adjustments’? Disability Issues Used by kind permission Rain Ashford 27

Increasingly care provision involves the input of a diverse range of professionals, often working across traditional health and social care boundaries. As professional boundaries and practices develop, this provides a challenge to ensure effective inter-professional care within a positive learning environment. Change is considered to be a normal consequence of modern living, especially within the progressive field of health and social care. However, the change process is often problematic with a deal of resistance from those who perceive the new order as a threat. When might you encounter a lot of resistance? Context of Practice Used by kind permission K. Kendall 28

Evidence Based Practice Mentors are encouraged to act as a role model in own practice to encourage the learner in applying an evidence-base in their practice. In order to do this, there are a number of things you should do. Identify and apply research and evidence-based practice to your area of practice. Contribute to strategies to increase or review the evidence base used to support practice. Support students in applying an evidence base to their own practice. 29

What kind of characteristics enable you as a mentor to present yourself as a positive role model? Consider how being a mentor/coach influences the development pf NHS values (2013) and a culture of compassionate care? Feedback: Positive Role Model 30

The NMC (2008:56) indicates that a mentor must “… demonstrate leadership skills for education within practice and academic settings”. Specific outcomes include: Planning a series of learning experiences that will meet student’s needs Be an advocate for students to access relevant learning opportunities What other mentoring leadership activities can you think of? Leadership 31

Other Leadership Activities Here are some other mentoring leadership activities you may have identified. (Gopee 2008) Prioritise work to accommodate support of students Keep calm! Consider crises! Health and Safety Use formative assessment Provide feedback about the effectiveness of learning and assessment in practice Allow student time and to talk through the processes Be aware of assessment theory and research of the failing student Consider resources Consider the patients! Consider your body posture and paralinguistics Use professional judgement Allow reflection and give feedback Arrange time for assessment process and treat it as “protected” - let staff know Allocate mentors appropriately 32

Section 3 Assessments 33

Assessment Documents 1.Written comments should offer constructive feedback and reflect the mark awarded. 2.Complete the front section overall result of assessment and ensure all dates are accurate. 3.Written feedback should be included in the end summative section of the document as well as a signature to indicate the student has passed. 4.Include sufficient evidence in the assessment document to show how the outcomes were achieved. 5.Ensure you clearly circle the practice assessment pass. 6.Completing the mentor evaluation at the end of the assessment document would be helpful. Here is some guidance for completing assessment of practice (AoP) documents. The format of the AoP is the same for pre registration students in training and Return to Practice (RTP) Nursing students. Both students in training and RTP students are classed as “pre registration” students and therefore are accepted as students that can be evidenced for triennial review purposes. 34

Assessment of Practice Document The assessment of practice (AoP) document is used in every clinical placement to record how students have been formatively and summatively assessed on learning outcomes and nursing attributes that the students cover within each placement. It is vitally important that this document is filled in correctly and that the assessment process is followed. Signing the AoP document as a mentor is stating that the mentor is active and is accountable for their practice as outlined in the NMC (2008) Standards of Learning and Assessment in Practice (SLaiP). This section will cover how to fill in the document, how to follow the assessment process, undertake relevant assessment interviews and how to record correctly relevant formative and summative assessment decisions. 35

Assessment of Practice Document On the first page of the form you enter the details seen here in purple and ensure that the appropriate responses are circled. *Please be aware that in undertaking this summative assessment and completing the details below you are confirming that you are an ‘active’ Mentor and accountable for your practice as outlined in NMC (2008) SLAiP guidance. 36

Assessment of Practice Document You enter all relevant information and the form is signed by the mentors and supervisors. 37

Assessment of Practice Document In the Record of Preliminary Interview section, you ensure that the appropriate responses are circled. 38

Date set for formative assessment:25/2/14 (usually the mid-point but no later than 3 weeks prior to the end of the placement) Signature of Mentor:­­­­____________sig_____________________ Date: 22/1/14 Signature of Student:_____________sig____________________ Date: 22/1/14 SUMMARY of PRELIMINARY INTERVIEW DISCUSSION : Please include any relevant comments upon individual learning needs, learning opportunities and mutual expectations: The student and mentor have had an opportunity to discuss areas of interest to her within this surgical placement. The Student has a placement plan agreed with her and has been orientated to the ward. The ward handbook has also been provided, which has shown the student how the ward works, the ethos of care delivery, such as NHS values, break allowances and resources available. The student has said that they do not have any learning support needs. Off duty has been discussed and negotiations between the student and mentor will ensure that student accesses full exposure to the ward routines. The learning outcomes have been discussed between the mentor and students and as the student will be have in spoke placement to theatres, they will be formatively assessed on these and bring a spoke formative record back to the ward for review. (The theatre mentor has been contacted in relation to this). The remaining outcomes will be assessed by observation, discussion/asking questions and reviewing the 3000 words of evidence the student will produce in the form of a skills analysis and a reflection on a professional issues (two pieces of work 1500 each). This will support most of the learning outcomes although some may be covered by observational/discussions only. Discussions have also been held between student and mentor in relation to how the nursing attributes will be assessed. A formative assessment date has been set for 3 weeks before the end of the placement to review if the student is on course to achieve their learning outcomes and review any actions that need addressing. The student will however get formative feedback on how they are progressing on a regular basis (minimum weekly). The mentor and student have agreed a learning contract in relation to how the student will behave, take responsibility for their learning and achieve evidence/competence. The mentor has agreed as part of this contract to facilitate learning opportunities and arrange time working with the MDT i.e. dietician. 39

Assessment of Practice Document You fill in the formative and summative assessment details, and sign off the results. 40

Assessment of Practice Document You fill in your assessment of nursing attributes and score both formative and summative assessments. 41

Assessment of Practice Document 42

Assessment of Practice Document 43

Assessment of Practice Document Here you make a record of the interview which is signed and dated by the mentor and the student. 44

Assessment of Practice Document Here you enter your comments on the student’s performance, including any specific strengths and areas for development. You also specify areas it will be important for the student to focus upon in future placements. This section is signed by student and mentor. 45

Assessment of Practice Document 46

The formative spoke form is for use by students and mentors or supervisors in a Spoke area involving short periods, for example a day with a specialist practitioner or a week in a specialist area. It should be used where a student wishes to provide evidence for Formative Assessment of learning outcomes whilst in a Spoke area and should be presented to the named Hub Mentor as part of the formative or summative assessment interview. This document should then be retained in the student’s portfolio alongside other written evidence of learning and achievement and the main Assessment of Practice document. Formative Form 47

On the second page of the form you enter the details seen here in purple. Formative Form 48

Next you identify formative learning opportunities available for the student. Formative Form 49

Next you identify and sign off the formative learning opportunities available for the student. Formative Form 50

Finally the student reflects on the visit and formative learning experience. Formative Form 51

The summative spoke form is for use by students and mentors or supervisors in a Spoke area. It should be used where a student wishes to provide evidence for Summative Assessment of learning outcomes whilst in a Spoke area and should be presented to the named Hub Mentor as part of the formative or summative assessment interview. This document should then be retained in the student’s portfolio alongside other written evidence of learning and achievement and the main Assessment of Practice document. If mentors in summative spoke placements make summative decisions on at least one learning outcome, this is evidence that can be used for triennial review purposes. Summative Spoke Form 52

On the first page of the form you enter the details seen here in purple. Summative Spoke Form 53

On the next page you enter the learning outcomes. This section is then signed and dated by the student and the mentor or supervisor. Summative Spoke Form 54

You complete the Student Summary of Evidence, noting evidence of achievement relating to the learning outcomes identified previously. Summative Spoke Form 55

You complete the feedback, commenting on the evidence presented by the student to demonstrate achievement of specific learning outcomes. It is then signed and dated as you see here. Summative Spoke Form 56

Here you note any learning or professional issues that might be addressed in the Hub or future placement settings. You then sign and date your entry. Summative Spoke Form 57

Students are supernumerary in practice and will need mentoring continuously throughout their placement; however they must access a ‘live’ mentor for 40% of the placement in order to undertake their assessment of practice. When setting shifts for students, there may be a need for both student and live mentor to make suitable arrangements to allow them to work together for the required 40% of the placement. Setting Shifts 58

Section 4 Triennial review and sign off 59

To be maintained on the local trusts or private sector register the individual must have evidence of having:- Mentored at least two students with due regard within the three year period* Participated in annual updating - including an opportunity to meet and explore assessment and supervision issues with other mentors Explored as a group activity the validity and reliability of judgements made when assessing practice in challenging circumstances Mapped ongoing development in their role against the current NMC mentor standards Been deemed to have met all the requirements needed to be maintained on the providers local register as a mentor or sign off mentor *Pre registration students in training or RTP students Triennial Review 58

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Section 5 Case studies (Independent Study Resources) 62

Here are some typical student case studies. How would you manage each of these students in your area? Case Studies Amanda Hira Kagiso Tom 63

Amanda is a first year student on a first placement. She has no previous experience of nursing and joined the course straight from school. Her family live in Lincolnshire and it is the first time she has been away from home. On her first day in placement you introduce yourself as her mentor and begin the process of establishing a working relationship. She seems to be a shy person who at time is quiet and withdrawn; she does tell you that she was ill whilst taking her A levels but says little more about this. Just before the midpoint of placement you are discussing the progress you are making with your student with other mentors who say she does not seem to be taking her breaks. How would you manage Amanda’s case? Amanda 64

Hira is a mature student with a family who undertook an access course at the local College to enable her to apply for training. She had some difficulties with theory work at the College before starting training and she has recently undergone an assessment for dyslexia. She has been identified as having dyslexia. She is also experiencing childcare problems and although her off duty has been agreed she is asking to change it to suit her childcare requirements. You have noticed that at times she appears disinterested and a little vague. You are also meeting with other mentors to discuss the progress you are making with your student. Other mentors comment that she appears to be having difficulty at handover. How would you manage Hira’s case? Hira 65

Is a third year student within three months of completing the course. He is very confident and sure of himself and you have been aware that he sometimes goes off and does things on his own without checking even though he is working with you. It seems that he has been allowed to do this by other members of staff thinking he is competent as he is about to enter the register. You are also meeting with other mentors to discuss the progress you area making with your student. They seem very pleased that he is using his own initiative and say he is a great help when on duty. How would you manage Tom’s case? Tom 66

Kagiso is a mature student who has moved from South Africa and has decided to undertake her training as she has some experience of healthcare in her own country. At times when she is speaking it is difficult to understand her. She is very interested in her placement but doesn’t seem to appreciate the procedures that are in place in the clinical environment. You are also meeting with other mentors to discuss the progress you are making with your student. The other mentors are concerned about her approach to moving and handling. How would you manage Kagiso’s case? Kagiso 67

Section 6 Summary and Resources 68

Support is available from a number of sources. Fellow mentors Practice Education Department: Deborah Beresford – Diane Nevin – Helen Copeman-Murray – Karen Rapson – Brian Lucas – Marian Hunt – Link Lecturers should be contacted as early as possible if you have concerns about a student. Practice Education Facilitators can also offer support to mentors – use them! There is lots of useful information on the Mentors and Practice Educators website. The link is in Resources. Support 69

Key points The role of the mentor is vital in ensuring the fitness to practice of qualifying students It is essential that when you are mentoring students that you follow the assessment process, adhering to relevant interview timings You are accountable for the assessment decision and giving the student access to the learning opportunities to make a valid and reliable summative assessment decision The discussion to fail is valid if all action plans have been implemented but the student is still deemed to have not met their learning outcomes Undertaking regular formative assessment and giving appropriate feedback is vital in allowing students to understand how they need to develop and progress Support for mentors is available both from the Trusts and the Higher Education Institute (HEI) Assessment methods used must be fair, reliable and valid The learning environment and available resources should be reviewed and audited on a regular basis Be aware of the need to adjust to each student learning styles and put in place any reasonable adjustments where required Mentors are responsible for 50% (60% in midwifery) of a student’s 3 year training. They are the pivotal link between theory and practice Key Points 70

Summary Having completed this on-line update you be able to Identify the curriculum that students are currently following Describe the NMC domains within the Standards to Support Learning and Assessment Describe how to develop a placement pathway for students to follow (hub and spoke) that maximises learning and assessment opportunities Identify when to undertake relevant assessment processes during a placement Describe how to correctly complete the assessment documentation Identify how to develop relevant action plans for a range of student scenarios Explain the importance of formative assessment and giving regular feedback Identify the importance of the role and the accountability and responsibility that the role requires Describe the role of the sign off mentor and the triennial review Identify the support networks available to you to help you mentor students 71

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