Mentor Update 08/09 University Campus Suffolk

Session Aim & Objectives This mentor update aims to give you an opportunity to discuss key issues surrounding mentorship in practice At the end you will be able to: – Make informed judgements of competence using the UCS grading taxonomy –Debate some key issues and devise strategies to support learners

New NMC requirements Record of Achievement Documents mentor / student interviews for all placements Lasts for three years Aims to support ‘sign off’ mentors signing final proficiency to register Also includes: –Student action plans for following placements –Extra meeting sheets –Mentor action plans (to be added) Essential Skills Clusters Aim to focus students on essential elements of practice Includes: –Medicines Management –Infection Control –Communication, compassion –Nutrition & fluid management –Care Organisation MIDWIFERY –Normal labour & birth –Consultation with mother –Breast feeding –Communication –Medicines Management The NMC also requires all students’ drug calculation skills to be assessed in practice. Students must achieve 100% and can only use calculators to check (this includes students with dyslexia or dyscalculia)

The role of the Associate Mentor Stage 1 All registrants become an Associate Mentor on qualifying Associate mentors DO NOT have any mentorship qualification To compliment your role as mentor Associate mentors should not be assessing competence in skills If an Associate mentor does sign skills off in the PA Document – a mentor MUST countersign This is to ensure all aspects (knowledge, skills & attitudes) related to each skill have been adequately assessed + that the taxonomy has been used correctly Please refer to your Trust’s guidelines / policy Key responsibilities: –Act as a safe role model –Support those new to integrate into practice –Contribute towards effective learning experiences –Share knowledge & skills with learners –Provide feedback for assessment –Provide support to mentors –Demonstrate a commitment to own CPD –Have effective communication skills

Components of an holistic assessment Holistic assessment Of competence Knowledge Understanding Evidence based practice Reflective practice Problem solving & Decision marking Technical skills Professional Codes Attitude Ethics Stuart C (2006) Assessment, Supervision & Support In Clinical Practice (2 nd Ed). Churchhill Livingstone, London p78

Questioning.. CategoryCognitive activity required Sample question words Example questions KnowledgeRecallWhat, Identify, Define, When, Describe, List What is the definition of.. ComprehensionUnderstandingCompare, Explain, Differentiate Explain how handwashing can reduce infection ApplicationSolvingApply, Consider, How would, How would you gain consent if a patient has difficulties communicating? AnalysisExploration of reasoning Support your.., What assumptions, What reasons What information would you need to support the use of this intervention? SynthesisCreatingThink of a way, Create, Plan, Suggest Given all the information in this case, suggest the initial care required EvaluationJudgingConsider, Which would, Defend, What is the most appropriate.. Out of the two possible interventions, which is the most appropriate for this client?

LevelKey Criteria for Assessment of Skills ExposureEX  Is exposed to a skill/activity as an observer.  Is able to describe underpinning knowledge. Participation (minimum for 1 st Yr nursing) PA  Participates in skill/activity under direct observation.  Needs prompting and guidance.  Safe all of the time and effective some of the time.  Lacks confidence.  Has a basic understanding of the underpinning knowledge. Identification (minimum for 2 nd Yr nursing) IDPerforms the skill/activity under supervision, but some guidance may be required in some aspects of nursing care.  May lack confidence in some aspects of nursing care, but is safe and effective all of the time.  Identifies and applies knowledge of the skill/activity. Internalisation (minimum for 3 rd Yr nursing & all years midwifery) IN  Is able to perform the skill under supervision.  Is confident, safe and effective all of the time.  Has the capacity to perform with minimal/no guidance.  Is able to demonstrate the key aspects of the skill and apply them in practice. DisseminationDI  Is confident and executes the skill in a timely manner. Is safe and effective all of the time.  Is able to critique the underpinning knowledge and influence the practice of others.

Exposure The student will have observed a competent practitioner carry out aspects of care. The student will be able to discuss with the practitioner why and how certain aspects of care were carried out. Can identify sources and types of information which can enhance their application of knowledge to practice.

Participation The student is able to participate in care under close supervision of a competent practitioner Demonstrate knowledge by analysing care given Able to provide a basic rationale for care Shows ability to perform manipulative skills, communication and problem solving skills with guidance

Identification Able to participate in care with less prompting and increased confidence Shows greater ability to communicate effectively demonstrates a wish to acquire further information Able to analyse and interpret information and apply problem solving and skills and knowledge base to meeting different situations.

Internalisation The student is able to explain the rationale for nursing action. Requires less supervision Ability to transfer knowledge to new situations Seeks and applies new knowledge and research findings Demonstrates ability to use problem solving skills, and critical analysis and evaluation.

Dissemination Plans, implementation and evaluates care for a group/clients under minimal supervision. Advises others, shows ability to teach junior colleagues Ability to manage self effectively Shows ability to manage care delivery by junior staff. Critical analysis, evaluation and decision-making skills demonstrated.

Group Activity - Over to you: –Look at the given scenario –Discuss the main issues as a group –List the actions you would follow –Identify a spokesperson to feedback

Exploding the Myths of Assessment! 1 st Yr students can only achieve participation This is only an observational placements therefore the mentor can not sign off any skills UCS will over-rule any referrals in practice Experience 1,2,3 means students must do all skills in Terms 1,2,3 Students must work with their mentors for every shift to be assessed in practice Student nurses have a lack of knowledge or experience to contribute to decisions in practice This is a 2 week placement therefore I don’t need to plan any learning experiences for you – just watch and learn

Student feedback… Positive mentoring ‘I become a more enthusiastic learner when my mentors give support. We really need their support and motivation during the learning process.’ ‘I was given every opportunity to learn and encouraged to be part of the ward and patient care, MDT, ward management, it was a very positive and informative placement.’ Students felt that good mentors often used non verbal communication such as smiling, open posture, tone of voice ‘They encouraged me to overcome my fears and carry out a lot of procedures I didn’t think I would be able to do.’ All these traits helped students motivation, increase self confidence, feel part of the team, whilst being acknowledged for their role in care delivery. Negative experiences Students feel disempowered by: – a lack of understanding, –mentors preventing learning, –being given limited responsibility –previous experience not being recognised –Receiving feedback in front of patients or staff –Limited contact with their named mentor –Mentors lack of understanding about how to complete practice assessment documentation ‘Management wanted to use me as a member of staff, even though students are supernumerary. It felt as though my learning and values did not matter..’ ‘ I was made to feel very unwelcome… I felt very much ignored. They were not welcoming towards me..and had an attitude that they didn’t want students there. I was not happy.’ (Lofmark & Wikblad, 2001; Elcigil & Sari, 2006; Bradbury-Jones, Sambrook & Irvine, 2007)

Useful Resources UCS Link Lecturers / Personal tutors / Programme Leader Allocations Office Clinical Practice Facilitators & Practice Education Facilitators UCS Mentor Newsletter – published each term, available on the Trust intranet UCS website – dedicated placement/mentor pages RCN (2007) Guidance for Mentors of Nursing & Midwifery students. RCN London AODP (2006) Standards and Guidance for Mentors. AODP, London NMC (2006) Standards to support learning & assessment in practice. NMC, London