MENTORSHIP ASSESSING

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Preparation for Mentorship &  Assessing.

Introduction.

Learning in practice is an important part of the curriculum and accounts for approximately 50% of the pre-qualifying nursing programme in the UK (Andrews and Roberts, 2003).  Supporting students to learn is an important function for both educators and practitioners and thus teaching, assessing and mentoring are fundamental aspects of nurses' roles and responsibilities.

The quality of the clinical learning environment is a national priority for both Trusts and Higher Education Institutes (Rapson, Holding and Shepherd, 2003). In recent years, the impetus for review can be attributable to a variety of sources including recommendations made by the government in 'Making a Difference' (Department of Health (DoH), 1999) and the emphasis on 'Fitness for Practice' by the United Kingdom Central Council (1999). More recently, the 'Placements in Focus' document stressed that the environment should provide an area in which students can experience good quality care and treatment of patients (DoH, 2001). It is recognized that clinical staff exercise a major influence on the quality of pre-registration programmes (Eraut et al, 1995, cited in Stuart 2003 p33). They do much of the teaching, supervision and assessment of students and, as it is likely that this will continue it is imperative that they are capable of fulfilling these roles (Clifford, 1995; White et al, 1994; cited in Stuart 2003 p33).

Various definitions of the terms 'mentor', 'teacher' and 'assessor' have been offered through the years and choosing one in favour of another is a difficult task. The English National Board (1993) defined a mentor as being 'an appropriately qualified and experienced first level nurse who, by example and facilitation guides, assists and supports the student in learning new skills, adopting new behaviors and acquiring new attitudes'. Ashworth and Morrison (1991, cited in Stuart 2003 p34) consider that assessing involves the perception of evidence about performance by an assessor, and the arrival at a decision concerning the level of performance of the person being assessed. The teacher function, according to Morton-Cooper and Palmer (2002), involves sharing knowledge through experience and critical enquiry, facilitating learning opportunities and focusing on individual needs and learning styles to promote ownership and responsibility for continuing professional education. Activities that mentors and assessors are expected to provide include planning learning opportunities for and with students to enable them to achieve their individual learning needs, facilitating and supporting the learning process, assessing learning and, providing feedback to students on their performance (Neary, 2000; Eraut et al, 1995; cited in Stuart 2003 p33). However, Pulsford, Boit and Owen (2002) recognize that the distinct activities that each term implies have often become blurred together. I favour Bennett (2003) who defines the mentor simply as 'the nurse who supervises students, enables learning and assesses students in the practice setting'. This fits with what seems to be the case currently.

This portfolio provides the evidence required to determine competence in facilitating learning in the practice area and the assessment of students and fulfils the learning objectives within the module NM3.157 - Preparation for Mentorship and Assessing (see Table of Evidence). In presenting my evidence, I will address the points made by McMullan et al (2003) who define a portfolio as 'a collection of evidence, usually in written form, of both the products and processes of learning. It attests to achievement and personal and professional development by providing critical analysis of its contents' (McMullan et al, 2003; cited in Webb 2003 p601).      

In discovering how to facilitate learning successfully and enabling me to become competent at teaching and assessing students, I believe critical analysis and reflection of experiences to be vital. Teekman (2000) suggests critical reflection is stimulated by perceived discrepancies between a learner's beliefs, values or assumptions and new information, knowledge, understanding or insight. In order to allow me to demonstrate how my experiences relate to theory and how this theory can be applied to my future practice, I believe it necessary for the following two papers to follow a purposeful structure and have chosen Kolb's experiential learning cycle (Fig. 1). Kolb (1985) recognized that learning happens in a cycle with both experiential and cognitive processes being involved. The cycle is, therefore, a useful tool for reflecting on teaching and assessing experiences. Learning Outcome 6.5. 

Fig.1

                                        Concrete Experience; is gained through

                                      becoming involved openly in new experiences.

Active Experimentation; involves                                        Reflection; involves thinking                    

using theories to make decisions and                               about and observing experiences            solve problems in new situations.                                    from many different perspectives.

                                  Abstract Conceptualization; involves generalizing

                                  and building your observations into personal theories

                                                 about how the world behaves.

Preparation for Mentorship &  Assessing.

Critical Analysis of  a Teaching Experience.

"It is in  fact  nothing short of  a miracle  that  the modern methods of  instruction  

have not  yet  entirely  strangled the  holy curiosity of inquiry; for  this delicate l

little plant, aside from stimulation, stands mainly in need of freedom; without this it

goes to wrack and ruin without fail".

                                                                     - Albert Einstein (cited in Rogers, 1983).

Introduction.

Rachel (a pseudonym in accordance with the Nursing and Midwifery Council; Code of Professional Conduct - Clause 5.1, 2002) was a third year student nurse assigned to a team within my workplace during the course of the module. In order to undertake the teaching of Rachel, I acted as her mentor on numerous occasions with my mentor being present on some of these occasions. This paper aims to reflect on how one particular teaching session relates to theories of learning.

Concrete Experience.

The purposes of planned clinical experiences for students of nursing, according to Wong et al, 1998; Conway and McMillan, 2000; (cited in Jackson and Mannix 2001 p270), are primarily to;

  • Provide students with the opportunity to develop their clinical skills;
  • Integrate theory and practice; and,
  • Assist their socialization into nursing.

In planning for teaching Rachel, I aspired to achieve these aims.  Prior to undertaking teaching Rachel, I asked her to review her learning objectives and prepare some ideas of learning experiences that might enable Rachel to achieve them. I then discussed with Rachel her ideas, considering their appropriateness and accounting for her prior experience and the level of knowledge of both parties. After much deliberation, it was mutually agreed that the skill of 'dressing an acute wound' would be one of the practical skills taught during the placement and is the teaching session I will now critique. The learning outcomes formulated from this discussion were for Rachel to;

  • Increase her knowledge of wound care.
  • Prepare resources and equipment correctly.
  • Carry out the procedure using aseptic technique, efficiently.
  • Record the nursing intervention in the care plan. Learning Outcome 6.6.

Pertinent to planning the teaching session were the choice of patient(s) and the difficulties of teaching within the community environment. During one particular day, two visits were planned to patients with acute wounds following surgery. I felt that carrying out a demonstration of the skill with the first patient and then observing Rachel carrying out the skill with the second patient, would be appropriate. Learning Outcome 6.3.

Quinn (2000) alleges that a teaching plan can help to minimize the chances of omitting some vital part of the session to ensure that all the necessary factors have been considered. Thus, I prepared a teaching plan (Appendix I) and some pre-reading material for Rachel including the appropriate local policies/protocols for wound care and journal articles relating to the chosen skill. Immediately prior to the session I motivated Rachel by re-evaluating the learning outcomes to be achieved and the details within the teaching plan. A short question/answer session followed covering any aspects Rachel was unsure of. In demonstrating the skill, I carried it out slowly with Rachel asking questions, as she felt necessary. During the short car journey to the second patient, I encouraged Rachel to reflect on her observations. On arriving at the patient’s home, I introduced Rachel and gained consent for her to carry out the procedure. As the patient was last on our list, there was adequate time for Rachel to carry out the procedure without feeling rushed. I provided verbal guidance and encouragement as necessary. On completion of the skill, Rachel and I reflected on the teaching session.

Reflection.

Reflection is valuable for nurses because it gives them the means whereby they can track there way systematically through practice issues to arrive at new insights and the potential for improvement and change (Taylor, 2000). Reflecting on the teaching session, Rachel and I felt that it went well. Rachel expressed a keen interest in the skill throughout the experience and was motivated to learn and add to her existing knowledge of wound care. I perceived the session to be adequately planned and prepared for and this allowed for the experience to be positive for both Rachel and myself.

The sequence of the teaching plan was not strictly adhered to with questions being raised throughout the session rather than at a specified time. The teaching plan was, therefore, too formal by not accounting for such deviations. Nevertheless, this did not hinder Rachel's learning or the ability to achieve her learning objectives. The strengths of the teaching session included adequate preparation, the time allocated and a good mentor/student relationship. Its weaknesses were that the plan was too formal, the constraints of the environment and a lack of variation in the teaching strategies utilized. The causes of these strengths and weaknesses can be attributed to my (lack of) knowledge of learning theory, as I will now discuss.

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Overall, the teaching session was a success and Rachel claimed that she had learned from it while I believe I have become a competent teacher. Learning Outcome 6.5.

Abstract Conceptualization.                     

Effective teaching, the author believes, is mainly influenced by learning theories, learning styles, teaching strategies and the learning environment. The author will attempt to convey how these factors influenced her teaching and how this influence, in turn, facilitated Rachel's learning. This will be achieved by identifying and relating relevant concepts to the teaching experience (Kolb, 1985).

Learning theories ...

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