1. ENHANCED PRACTICE SUPPORT FRAMEWORK Lead MentorMentorsCoaches

2. ENHANCED PRACTICE SUPPORT FRAMEWORK Lead MentorMentorsCoaches To understand the underpinning ethos of the Enhanced Practice Support Framework in preparation for implementing this in own practice area. To understand the roles of the Lead Mentor, the Mentor and the Coach in the Enhanced Practice Support Framework. To understand the skill of coaching within the Enhanced Practice Support Framework. To consider and practise skillful questioning. Aims & Objectives

3. ENHANCED PRACTICE SUPPORT FRAMEWORK Lead MentorMentorCoach Research study in 2014 identified a range of challenges faced by mentors. EPSF emerged as a recommendation and has been piloted in 8 practice areas across Essex, Cambridge and Peterborough. Lead mentors are pivotal to the success of the implementation of the EPSF Lead MentorMentorsCoaches Lead Mentor MentorsCoaches Lead Mentor Mentors Coaches

4. What is the role of a lead mentor? Lead Mentor To promote high quality education of learners in the practice environment. Ensure that facilitation of learners is everyone's business. Act as a support to coaches, mentors and lead education managers. Monitor the quality of mentorship in the practice setting.

5. What does a lead mentor do? Lead Mentor Ensure each student has been allocated to a live mentor for the duration of their placement. Ensure the off- duty identifies, for each student, the coach or mentor that they will be working with on a daily basis. Support mentors and coaches to adopt a skillful questioning approach to learning whilst facilitating the student experience. Oversee the assessment process to ensure timely formative and summative assessment.

6. And…………………………………. Lead Mentor Monitor the quality of practice document completion by mentors and support mentors in their assessment decisions, where necessary. Act as a mentor for trainee mentors. Identify individuals with potential to become mentors. Role model good mentoring and promote a quality learning environment. Escalate practice learning concerns to the Education Managers within the organisation.

7. What did lead mentors in the pilot study say? Lead Mentor Lead mentors perceived coaches (other registered practitioners) as a valuable untapped resource. Lead mentors perceived students to be more confident as they were empowered to identify their own learning needs. ‘I think patients have noticed the difference.’ Lead mentors considered the ward team to have become more positive in their approach to educating students, as everyone was now formally taking part in this.

8. What is the role of the mentor in this framework? Mentors Mentors will still need to comply with the NMC standards......including Annual updating, Triennial review Direct / Indirect supervision of student learning for a minimum of 40% of student placement. The Mentor's responsibility is to PLAN & CO-ORDINATE their students' learning experience and allocate an appropriate coach to each of their students in order for them to meet their daily goal, whilst working towards their practice outcomes. Mentors must retain accountability / responsibility for all aspects of student assessment.

9. What will the mentor do in this framework? Mentors N.B. The coach must be a registered practitioner. The mentor role will have a greater focus on managing the experience of students during their placement through the allocation of a daily coach in advance of each shift. Mentors will be responsible for : Liaising with coaches to receive feedback on their students' performance. Using skillful questioning when working with their students. Liaising with the lead mentor to discuss any concerns about their students' progress.

10. And…………………………………….. Mentors N.B. The coach must be a registered practitioner. Reviewing their students' coaching logs, particularly at formative and summative assessment stages. Developing any action plans with their students. All aspects of formative & summative assessment remain the remit of the mentor.

11. Do mentors still have to work with students? Mentors Mentors will be required to spend time working directly with their students to: Share their expertise with the student Inform their assessment of the student Complete all aspects of the students' Practice Assessment Documents Mentors should also meet with their students at least once per week. YES…………

12. What did mentors in the pilot study say? Mentors 90% believed the EPSF to have improved their experience of mentorship. 80% felt better informed to make assessment decisions. Frequently used terms such as: More manageable Less stressful More focused More enjoyable More facilitative

13. What is the role of the coach in this framework? Coaches Coaches will be central to the success of the student experience in their placement and will support the development of their professional identity as a registered nurse. Within this framework all registered practitioners will be expected to act in a coaching role with students and will receive preparation to understand the EPSF and their role within it.

14. Why do coaches have to be registered practitioners in this framework? Coaches Student nurses are preparing to enter a professional register and must be able to demonstrate the skills and attributes of a registered nurse. To achieve this, they must spend substantial time with a registered practitioner. The coach may decide that the student should spend some time working with an HCA/HCSW as part of their experience. Effective skillful questioning requires in-depth knowledge. All registered nurses are bound by the NMC Code 2015 to facilitate learners and act as a professional role model. Supporting learners keeps practitioners up to date. Feedback to learners must always come from the coach or their mentor

15. What is Coaching in the Enhanced Practice Support Framework? Lead MentorMentorsCoaches

16. Coaching "A one-to-one conversation focused on the enhancement of learning and (the) development (of a daily goal)....where the coach facilitates the...learning of the coachee through questioning, active listening and appropriate challenge in a supportive and encouraging climate." (Van Nieuwerburgh, 2012)

17. The skills involved in successful coaching Skillful questioning High quality listening Guiding Encouraging Trusting Supporting (Rollnick & Miller, 2012)

18. Skillful Questioning

19. Applying Skillful Questioning List the open questions you might ask a student to explore their understanding of each of the following: A patient's prescribed drug (e.g. Digoxin for a patient with atrial fibrillation). A patient whose blood pressure is high. The challenges faced when nursing a patient with dementia. The Glasgow Coma Scale

20. COACHING USING THE T-GROW MODEL Topic....Tell me what you want to gain from today and how this fits with your stage of training? Goal.... What is your actual goal for this shift? Reality.... What experience do you have related to this already? Options.....What is available / happening today that will support you in achieving this goal? What options do we have? Way Forward.......What else could you have considered today? What do you think you would do differently next time? How can you further improve? TopicGoal Options Reality Way Forward

21. Anglia Ruskin University Student Coaching Log Topic Goal Reality Options Way Forward Signature Coach Date Provides guidance for the daily goal to be achieved by the student. Student's responsibility to complete documentation. Coach's responsibility to sign document to agree accuracy of student's notes. The coaching log provides written evidence that the mentor can review and also acts as a record of the student's experience. Only the coach -a registered professional- can sign the student coaching log

22. University of Essex Progress Sheet Provides guidance for the daily goal to be achieved by the student. Student's responsibility to complete documentation. Coach's responsibility to sign document to agree accuracy of student's notes. The progress sheet provides written evidence that the mentor can review and also acts as a record of the student's experience. Only the coach -a registered professional- can sign the student’s reflection on their goal Personal Care (PP1) – PROGRESS SHEET Date Experience and Comments Signature 2 December 2016 Goal: To demonstrate privacy, dignity and respect towards service users I have participated in the provision of personal hygiene needs and discussed patient preferences with the patient. I tried to consider how the patient might be feeling when being bed-bathed and took several measures to try to maintain dignity e.g. drew curtains, ensured no part of the patient’s body was exposed unless being washed, and talked and listened to the patient whilst delivering care, including them in decisions. A doctor entered whilst the patient was being bed bathed which compromised dignity and respect. Next time I will consider using a dignity peg to prevent intrusion into the bed space during personal care. J. Jones (student) R. Murray (coach)

23. What do coaches do in this framework? Coaches At the beginning of the shift...take 5 minutes to support the student in formulating a goal for the day related to one of their practice competencies. Allow the student 5-10 minutes to document their goal in their coaching log. Support the student to work through their goal by ensuring appropriate support and experiences are available to them. It is essential that this takes place at the beginning of the shift and not retrospectively.

24. And………………………………………… Coaches During the shift, use skillful questioning to help develop the student's critical thinking skills. Meet with the student for a few minutes before the end of the shift to discuss their progress. Allow the students 5-10 minutes to document this feedback and sign their log for accuracy of the entry before the end of the shift. Liaise with the student's mentor to ensure they are aware of their student's progress.

25. What did the coaches in the pilot study say? Coaches 92% believed their experience of coaching to have promoted their professional knowledge and skills. 86% reported the experience to have encouraged them to become mentors. Frequently cited terms: Empowering Developmental Beneficial Enjoyable

26. What did students say?........ 88% reported working with a registered nurse every day of their placement. Students reported feeling valued by registered nurses who demonstrated a willingness to spend time with them and help shape their understanding of the role of the registered nurse. 89% considered their experience to be good or excellent. 81% received daily feedback on their learning and believed their learning to have been focused.

27. ENHANCED PRACTICE SUPPORT FRAMEWORK Lead MentorMentorsCoaches Changing Practice Learning: The Student Experience \\anglia.local\fs\Add-Priv-Storage\pt3\Dropbox - Student experience of the Enhanced Practice Support Framework_mp4_mp4.mht