The aim of this assignment is to focus on the mentors role to confirm that the nursing student has or has not met the assessment criteria required for a clinical placement. It will also analyse issues of mentor accountability, reliability and the importance of constructive feedback to the student. I will be exploring my knowledge and experience as a mentor and my role will be critically analysed from my teaching session and my student assessment. I will look at how my role as a mentor can facilitate learning and promote effective assessment in practice and also explore my role to support the students who are failing.
The Nursing and Midwifery Council (NMC 2008a), defines "the role of a mentor as someone who facilitates learning, supervises and assesses learners in practice setting." The mentor is a key support to students in practice, this is where students apply their knowledge, learn key skills and achieve the required competence for registration.
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Mentors are accountable to the NMC for their decision that students are fit for practice and that they have necessary knowledge, skills and competence to take on the role of registered nurse or midwife (NMC, 2008a). According to Morton &Palmer (2000), mentors should display positive role modelling behaviours on duty. This gives the student the opportunity to observe the role modelling behaviours in action. When mentoring, nurses play a vital part in quality assurance by contributing to the educational audit of placement (Royal College of Nursing 2007).
The NMC (2008) standards support learning and assessment in practice; they outline the principles to be achieved in order to become a mentor. It is also essential for mentors to maintain professional knowledge and skills and to reflect on experiences that facilitate learning. This is in agreement with the standards of conduct, performance and ethics for nurses and midwives (NMC 2008). As a mentor I have the privilege and responsibility for helping students translate theory into practice. According to NMC (2008) while supporting and assessing learners the mentor should have the following qualities to establish an effective working relationship, facilitation of learning, assessment and accountability, evaluation of learning, creating an environment for learning, context of practice, evidence based practice and leadership.
During my mentorship programme to develop an effective mentor student relationship I arranged an introductory meeting with my identified learner. She was a student nurse, who had never worked in a Critical Care environment. According to Quinn (2000) the introductory meeting is essential as it helps the mentor to get to know the student, their personality, previous experience and their learning needs. Quinn then explains that the learning environment should be pleasant and comfortable. I was then able to give her a detailed orientation of the unit and provided her with an induction pack. Recent research suggests that an effective orientation to a clinical placement can help students feel relaxed and promotes motivation for learning through early identification of learning objectives (Worrall 2007).
During our initial conversation I identified that she had a positive attitude towards the challenging area of Critical Care where she never had any experience. As a mentor I shared my knowledge and experience with my student and she shared some of her previous experience as well. Mentors should use effective communication and facilitation of skills to develop a personal and professional relationship (Ali &panther 2008).We discussed an action plan, based on her personal and professional development to date which incorporated university policy. We discussed her objectives and arranged the date of mid-placement interview and final assessment. As part of the mentor's role we should identify individual learning needs and specific learning difficulties in moving to a different level of practice. For the purpose of facilitation of learning, mentors should relate theory to practice while developing critically reflective skills (NMC 2008).
Assessment is a critical element of the mentoring process. Duffy (2004) stated that mentors must ensure that assessment of clinical skills does occur as required. It is essential that mentors provide opportunities for learning and assessment. They must also support students to self -assess and reflect on their learning and ensure any assessment of a student is valid and reliable and that performance can be demonstrated consistently. The assessment of clinical competence has returned to centre stage of education. The NMC is developing competencies for the new 2010 pre registration curriculum and a framework for teaching, learning and assessment. The knowledge and skills framework link competency gives the opportunities for nurses to develop their role.
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The aim of the assessment was to assess the learner's performance and competence in chosen procedure. As part of my mentoring course I had to choose a mentor to support and supervise me, who had already attained her mentorship course. Carr (2008) explained that new mentors often do feel apprehensive about being responsible for learner's assessment. Although the new mentor needs support from senior colleagues and their department in order to carry out teaching and assessment. Sharples (2007) mentions that a mentor may be unable to teach and supervise learners because of patient care demands and overall workload. A new mentor needs support in a challenging environment like critical care to take as this new role.
An additional part of the mentor's role is that of accountability. When any work is delegated to a student who is not yet registered with the NMC, the mentor is accountable. They must ensure that the individual who undertakes the work is able to do so in a competent manner and make sure that they are given appropriate support and supervision. Stuart (2007) states that the areas a mentor is accountable for are
--- Personal standards of practice
--- Standards of care delivered by learners
--- What is taught, learned and assessed
--- Standards of teaching and assessing
--- Professional judgements about student performance.
The mentor supports learning and assessment in practice and makes judgements relating to a student's fitness for practice and registration. Mentors are accountable to the NMC for such judgements and responsible for informing higher education institute staff of any concern regarding student performance or progress.
It was important to ensure that continuous assessment of my student throughout the placement period was undertaken. This provided a measure of how they were progressing according to the level and knowledge expected at each stage of her training. During the placement we identified her learning needs that were relevant for Critical Care. She was having concerns about preparing an intubation trolley in the unit for an emergency situation. I arranged some teaching sessions initially and for that I prepared some learning material adhering to Critical Care policy. I provided a hand outs and power point presentation. Within the teaching session I gave her opportunities to ask questions and after that we carried out some practical sessions. I realised learning is more effective through the practical session rather than just verbally teaching.
After my teaching and practical session, I reassessed my student to confirm whether her knowledge had been improved and she fulfilled her learning objectives. I created a questionnaire and performance check list. This exercise was monitored by my own mentor. She was given an evaluation form so that she was able to assess my effectiveness of teaching. Menix (2007) describes the evaluation of learning as an integral and critical part of any education programme to assess the effectiveness of the event. This also gives the opportunity to students to ask questions and encourages them to clarify their queries and misconceptions of their educational needs.
A mentor needs to determine the success of teaching assessment will be reliable if it gives similar results when used on separate occasions and with different assessors. It was important for me as a mentor to determine the success of my teaching and accuracy of my assessment. This is because my student should be able to deliver her learning across a range different care giving situations with a consistent level of performance. I was able to discuss with other associate mentors to ascertain if she had managed a consistency of performance and my interpretations of student's performance were at the same levels as other assessors.
A mentor should provide formative and summative assessment for the students to help them achieve their objectives and improve their clinical experience. Formative assessment takes place throughout the placement and it focuses on student learning and progress (Reilly &Oermann 1990). However, Philips et al (2000) suggest that the assessor should formally review the student's progress and identify any difficulties in the early stages rather than later period of the placement. I was able to provide intermediate assessment to my student. I was able to describe which areas she needed to improve and also discussed her strengths. However, a summative assessment usually takes place at the end of the placement, it measures how much the student has learned and to what extent the learning outcomes have been achieved. Rowntree (1987) suggests that satisfactory summative assessments can be the result of a series of effective formative assessment. It is very important to encourage the students in self -assessment as it will help students to feel that they own the learning and can thus control the way they meet their objectives (Stoker 1994). According to Chambers (1998) self assessment is an efficient and effective learning opportunity for the students to identify their own strength and weakness. I completed the assessment criteria in the base of my student performance and competence. However Dolan (2003, pp 132-141) states that "at the moment the NMC uses competence to explain skills and ability to practice safety effectively without the need for supervision". I discussed her progress and achievements and emphasised the area for further improvement.
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As a mentor I strongly believe that as part of the mentorship it is very necessary and useful to provide timely and constructive feedback. According to Gray & Smith (2000) constructive feedback helps the student to develop their objectives to fulfil their needs. A recent study by Clynes& Rafery (2008) shows constructive feedback increases student's confidence, self esteem and their clinical skills. My student improved her skills and knowledge after the intermediate assessment. I was able to give the feedback in a sandwich form. I explained her positive qualities and then encouraged her in the areas that she needed to concentrate on and then I finished the session with a positive comment about her skills. She was quite satisfied with her feedback and she took notice of which areas had to be improved and understood the importance of gaining more knowledge for her future development.
My student passed her assessment and I was able to finalise her placement with a grade B. It was not necessary to review her practice or even fail her on this placement. As a qualified mentor I have a responsibility to confirm that nursing students are capable in safe and effective practice and most important to identify the underperforming students (NMC 2006).
When the mentor identifies a student who may fail it is important to liaise with the university and review student's assessment criteria with their link lecturer. According to Maloney et al (1997) failing students need to be informed about any areas of concern as soon as possible, so they have the opportunity to improve on their performance. Mentors should able to give appropriate advice to improve their performance. Mentors should identify the issues then check the student previous assessment results and if necessary, seek opinions from these previous assessors. Smith et al (2001) stressed that regular meetings with students gives them time to reflect on their performance and both student and mentors can identify areas where they are weak. They can also plan learning opportunities to meet their learning objectives. However, some students may feel anger, aggression and denial and may verbally abuse their mentor. Failing students may blame previous mentors, lack of appropriate placement and their university courses (Duffy 2004). However other students recognise their clinical and theoretical weakness and are relieved when mentors highlight area that they need to improve (Zuzelo 2000). Mentors will require courage and confidence to fail a student and should always take help from the university to ensure that the right decisions are made (Stuart 2007). The mentors should follow the plan of action outlined for failing or not progressing student for their emotional and professional support. The NMC Standard (2006) states that mentors must keep sufficient and evidence based records to support their decision.
Through this assignment I have been give the opportunity to critically analyse my role as a mentor and give confirmation that my student has met the assessment criteria. I had a positive experience that enabled me to share my knowledge with my student which encouraged me to research and read current articles which in turn increased my own knowledge. I felt that when explaining procedure/theory I should have communicated with the student in a less complicated manner and that will help the students for easy understanding. I realised the mentors accountability reliability and responsibility on assessment and important role in decision making like passing or failing and supporting the failing students as well. I thoroughly enjoyed my experience as a mentor and looking forward to sharing my skills and knowledge with future learners.