Reflection OVER A Mentorship Role In Medicine

During this reflective piece of work I will discuss my role, responsibility and accountability as the students assessor and reflect on approaches that I have used within the mentorship role to support and assist in the student to accomplish specified learning effects. The best goal of mentorship is for just one individual to contribute to the professional development of another. (Lanser 2000)

The NMC (2008) identifies a coach as a registrant who facilitates learning, supervises and assesses students in a practice setting up. The scholar spends 50% theory and 50% used; practical training can be an important and significant area of the medical students education.

I was prepared that a third year medical college student would be participating in my practice area a number of weeks prior to the placement start time frame, I used this to my benefit by contemplating about learning opportunities within the practice area.

The NMC state governments that at least 40% of any students time at the position should be put in with a mentor. Therefore the off duty needed to be worked to mirror this, as now it can be an NMC requirement of mentors to prioritise their workload to support support of students. (NMC 2008) From my time as students nurse the better position experiences I had formed were when my coach was ready and had thought about experiences that would improve my learning.

I believe that it is vital that from the first connection with the nursing college student you are building an efficient relationship. The best goal of mentorship is for just one individual to contribute to the professional development of another. Prior to the students start night out it's important that the learner has been approached and enlightened of location, uniform, start time and name of allocated mentor. Fortunately my student contacted my office a couple of weeks before her positioning began. I needed this chance to bring in myself and experienced a little of what things to expect. Baumeister and Leary (1995) suggest that if students feel accepted secure, valued and respected it motivates the students capacity to learn and instils self-assurance. I feel that initial contact will take some of that first day stress away. The effect of the coach on the scholar begins at first contacvt and forms the foundation upon that your mentor/student relationship depends upon.

The Nursing and midwifery council describes eight domains of competency a mentor must achieve to be able to perform the role to a proper standard. They are: establishing effective romantic relationships, Facillitation of learning, creating a learning environment, context of practice/ evidence based practice, analysis and accountability, leadership and analysis of learning.

On my university student Sarahs first day I had developed allocated a chance to orientate and present her to the practice area. It is the mentors responsibility to determine a highly effective working marriage with the student and this starts off with orientating and the environment of ground guidelines. (RCN 2007) Whilst going through the formal, professional, legal, nationwide and local requirements I got conscious about making the orientation an optimistic experience. I released Sarah to the rest of the community medical team. Levett-Jones, Lathlean, Higgins and Mcmillan() in their review mentioned the students need to feel like they belonged as when students feel comfortable they engage with learning opportunities. I believe the frame of mind and motivation of the mentor are necessary in developing a encouraging learn to the positioning experience. (cited in Beskine 2009) Reflecting on my experience as students the negative areas of work placements were not being reinforced by my mentor and feeling under respected and by keeping in mind such experiences Personally i think that it affects could am as a coach.

The benefit of working as a community personnel nurse is that when students is located you interact on a one to one basis and have time to determine the student coach relationship. Using this oppotunity to get an perception into her personality aswell as any concerns she has about the position.

Although it is good to accomplish a good rapport with your university student Wilkes (2006) encouraged caution through the sociable development of the relationship as the professional boundries need to be clear, as getting associated with the scholar socially or psychologically beyond work would effect your integrity when perfoming assessments. Also as a coach you become a job model as well as the Code(2008) takes a nurse to be of good persona honest and trustworthy basing this on ones do behaviour and frame of mind.

The NMC (2008) identifies a mentor as somebody who helps learning, supervises and assesses students in a practice environment. It also describes that in order to do this effectively the mentor will need understanding of the student's stage of learning therefore selecting appropriate opportunities for that one students learning needs.

After orientation and Sarah shadowing me on the few appointments I thought it was important to carry out the initial interview so we're able to discuss learning needs and opportunities in my own particular area. Sarah had not had a past community location and didn't know very well what is open to learn therefore we had an informal discussion to recognize the opportunities. During the initial interview I also founded the students degree of knowledge and objectives. I had noticed that Sarah was quite shy and was quite anxious. We appeared through her portfolio from earlier placements and she had handed each one. Also by looking at the university requirements defined in her portfolio I could find out if Sarah was aware of her needs out of this placement. My original impression was that she may need more support than I had fashioned anticipated at her stage of learning. It made an appearance that she wasn't confident in her talents. Sarah did point out that she believed she would require support and assistance as the community setting was a totally new experience on her behalf. Its also important to consider that studies have shown that placements can be very stressful for students especially in their first and third years of training. (Stuart 2007 cited in Beskine2009) Taking my concerns into consideration and Sarahs need we then created a learning contract, the goals established were predicated on mutually discovered need. I made a decision that initially I'd become as Berne(1961) detailed nurturing parent or guardian to Sarah to demonstrate boundries to ensure she thought safe. Until her self confidence grew, then your romance would be on an adult-adult basis on a single level for discussions and mutual goals. Although fluctuations between different ego point out as different circumstances occur throughout the coach student relationship. To be able to help Sarah I believed that by performing as an advocate would promote her confidence and self-esteem. (Neary 2000) To formulate a highly effective learning agreement it really needs essential components as detailed by Stuart (2007) learning targets, the activities to help in these, strategies and resources for learning.

As a documented health professional you have a responsibility to guarantee the safety of the public. Therefore by mentoring pre-registration nurses you are in charge of making sure students fulfil their learning results for your practice area and develop practice competence. (NMC 2006)

Assessing a student's competence may become complicated by the mentor's subjective view of what is capable? (Higgins and McCarthy 2005) Duffy (2003) concurs it is often easier to identify clear incompetence than those students borderline on achieving competence. Mentors need to address the issue of non-competence as soon as it is accepted. The analysis Duffy (2003) carried out found that mentors tended to give students the benefit of hesitation. A view which has been highlighted in a recently available survey in the Medical Times (2010) which said 40% of mentors taking part in the survey passed students as they could not provide sufficient facts to rear up their concerns.

Before ending up in the student to discuss the issue it's important to collect facts which has business lead to your concerns about the student's competence. Going right through assessment paperwork can help point out if learning final results are attainable for that one students capacity. This information would be helpful for you to explore/understand explanations why the student is not attaining and early talk can fast students to consider their practice thus facilitating improvement. (Duffy and Hardicre 2007) As the university student doesn't seem to be aware of their limits, for patient safeness it is essential that you smoothly alert the scholar with their unconscious incompetence but if the motivation is there I would as a mentor be comfortable that they could develop competence.

Feedback is a sizable part of analysis and progression and in this specific issue it's important to provide opinions so the student is aware that they are not meeting the required standard. An effective coach should offer honest and constructive opinions to students (RCN 2007) Constructive responses is objective and non-judgemental and should be based on specific observation to encourage talk and allow future understanding how to take place. (Pearce 2004) It can be appealing to avoid supplying negative feedback but performance cannot be improved without knowledge of what was incorrect (Stuart 2006)

Feedback to the student would get by means of the reward sandwich. NMC (2006) uses this form of reviews in its documents where it state that mentors should contribute to the evaluation of learner learning and examination activities by proposing aspects for change therefore of evaluation.

Mentors should remain positive and supportive also make an effort to empathise with the student and how they'll be being. A learning agreement/action plan that is designed collaboratively with the mentor and scholar can specify the particular student will understand how it will be achieved and the time scale where its success can be measured. (Nicklin and Kenworthy 2003) The RCN also advises regular conferences between the coach and student to discuss progression and make adjustments to action programs predicated on the students learning. (RCN 2007)

Ultimately the NMC in safeguarding the wellbeing of the public sets specifications for pre-registration theory and practice competency and requires students to be fit for practice and purpose at the idea of enrollment. (NMC 2008)

Some of the learning outcomes were easy to assist in with experiences that were available from a community placement but others not easily accommodated. In order to treat this we discussed other specialisms within the city neighbourhood team where she could hang out to achieve results.

In the initial interview with my scholar it was important to recognize what level of learning she was at and also determine her inspiration to learning. Rogers (2002) implies adults come to learning with motives and that they have their own private expectations of the training process and maintain personal explanations why they would like to learn. After talking about mutual prospects from the position it is essential to understand the student's style of learning to be able to best facilitate learning activities and opportunities and choose appropriate learning ways of integrate her learning practice and academic experience. Also to be effective learner's students also needs to be aware of and understand their own learning style and manage their own learning. (Siviter 2004)

There are various ideas on learning styles, I chose to give my university student a questionnaire predicated on the idea by Honey & Mumford (2000). This model is divided into four categories Activist, Reflector, Theorist and Pragmatist. The activist is open up minded, enthusiastic and looks forward to immersing themselves into new experiences. The characteristics of your reflector are careful observers. Using all the information available to them to make conclusions. Theorists think things through in a reasonable manner and value rationally and objectivity. Finally pragmatist action quickly on ideas and are willing to put new techniques into practice.

My student experienced that she was a reflector and was determined by understanding nursing processes to become able to work well and be a valuable team member. I experienced that the strategy I'd commence to be able to meet the needs of an reflective learner would be facilitating experiential learning followed by reflective practice. Students reap the benefits of action planning to assist them through the transitional period onto new position areas by setting up goals (Quinn & Hughes 2007) A learning contract that is designed collaboratively by the mentor and college student can specify the actual university student will learn, how it will be achieved and span of time. (Nicklin & Kenworthy 2003). Considering this we decided to match the medical procedure to learn with specific learning results from the student's stock portfolio and mentioned in the original interview process.

Urinalysis was the skill that people centered on in this exercise. So that it was appropriate to teach this skill in the sluice area which was a quiet and spacious area where we wouldn't be disturbed. We mentioned possible explanations why as a nurse you would take this test for example infection so that as a reflective learner I thought that I should explain how her capacity and knowledge of urinalysis would advantage her when working as a fully experienced nurse. We then experienced the procedure showing all the professional medical equipment needed and different ways in obtaining a sample. I tried to relate with practice to allow the student to consider what she's learned to future position areas.

In order for all of us to reflect on the task we went to a tranquil office to avoid distraction. Studies show having quality time for reflection and someone to one discussion using their coach were very important to the student. Watson(2000)

I felt that the university student centred teaching strategy worked well well with this particular learner as she learned best by doing and reflecting on the procedure afterwards rather than simply being educated by others. Kolb's(1984) learning cycle describes four levels in the learning process from the experience to applying the new learnt information to similar situations, and for that reason an element of reflective learning.

NMC (2006) claim that prioritised workload when you are mentoring giving you time to carry out the coach role. I ensured that the allocated workload would allow me to have more time for effective tuning in and discussion. Also it provided us the possibility to discuss incidents of the day and reflect and give feedback on a regular basis.

The procedure for assessment I feel must be continuous and producing with my student Sarah due to her lack of confidence I didn't want to increase any panic by making formal assessments of her practice. As the ENB/DOH( 2001)document a mentor should watch a students accomplishment of a time period to ensure validity in examination. Having identified the training that needed to happen from the university stock portfolio and personal development on the students part as discussed in the training deal. The NMC (2007) clearly outlines the requirements for assessments of college student nurses. The students performance should be evaluated used with accountability resting with the coach who is carrying out the assessment. It is important that a student is able to self assess, and after our conversation in the initial interview Sarah did see that she needs more support to enhance her self-confidence, and for this reason we designed this inside our learning contact combined with the learning outcomes in her stock portfolio. Additionally it is important for a student confidently issues to self evaluate as they'll see that progression is being made in their learning, therefore attaining confidence. (chap. examination of student practice from uni lib) A continuous analysis of the students practice is a far more reliable tool as supervising/evaluating the student over a day to day basis in a tranquil environment it is much more likely to reflect the real ability of that university student. (Stuart 2007)

The NMC (2006) under the command domain specifies that mentors need to show leadership features within the practice environment. Personally i think that by planning group of learning opportunites for the student and prioritising workload to ensure time to support the student i have achieved this. Without planning or prioritising a occupied workload it could inevitabley be to the detriment of the students experience.

Interim interview is the first more formal diagnosis of the students talents/progress so far. The learning effects/competences were reviewed and recorded at first interview by means of a learning agreement. I ensured that we had time to go over Sarahs progress and competences. Although Sarah has made improvement with her self-confidence there is still areas to boost therefore a new action plan was designed and mutually agreed. We clarified the area of weakness and suggested how she'd improve further and established for her to utilize other assessors within the team in like manner ensure fairness. (Gopee 2008) Feedback is vital in the process of formative evaluation Pryor (1998) highlighted the importance of responses not only figuring out what the scholar has learned but also what they may attain in future practice. ( cited in Gopee 2008) Feedback should when possible get in private (RCN 2007) as this might prevent other folks from hearing any discussion. Addititionally there is the prospect of the 'audience impact' (Quinn and Hughes 2007) where the student feels that many people are watching or hearing the reviews in her performance. Feedback is most effective when given at that time or soon after and activity occurs. This means that the experience is still fresh in both mentor and students mind. Which means information discussed is more appropriate and detailed which makes it more useful for the student. Not merely is a coach there for supervising and helping the pupil it is beneficial to the scholar when giving detailed feedback it guides the to learn what is expected of these to improve that one episode of nursing. My priority was making Sarah feel safe when receiving opinions as within the interim interview there still remained things to improve on. I ensured that my body terminology was warm and open up. Giving eyeball contact and smiling and nodding. It is important that when offering positive responses she felt that we was honest and when discussing reviews on a far more constructive basis she noticed i was self-assured in the info that I was imparting. We collaboratively devised an action arrange for the last couple of weeks of placement. Regarding Sarah boosting her management skills also to gain self-confidence in her own decision making. The NMC (2004) declare that prior to accessibility to the register pre-registration students should be able to control the delivery if treatment with the scope of ones own responsibility. (cited Duffy&Middleton 20??) To assist in this I delegated the care and attention of patients within the residential home, as employed in community it is not easy for the scholar to work independently without direct supervision due to going to patients within their own homes. But in the home home environment I was around but not directly supervising. At this time in the placement I experienced that Sarah got developed her assurance and that this experience would help in realising her own features.

As Sarah got now spent a couple of weeks within the practice environment and within the city medical team she started to start about previous activities whilst on placement. She believed that not absolutely all of her connections with her mentor has not been a good experience. Darling (1984) do some research about the mentor/mentee marriage and creating the training environment and the ones mentors who didn't develop a positive environment he referred to as toxic mentors. Three different types of the toxic mentor were dumpers, blockers and destroyers. The first of these describes those individuals who 'dump' there students into experiences out of there depth. Blockers were those who didn't allow the learner to partake in learning opportunities. Destroyers as the word describes, destroys a student self-assurance by undermining them and criticising without offering another possibility. Darling (1984) was also in a position to identify what the basic attributes that a mentor should have, functions as an inspirer, investor and supporter. (cited in Pellatt 2006) Whilst talking about the subject with Sarah it became evident that her self confidence have been knocked by two negative mentor experiences in the past. As a woman who is quiet in mother nature was having difficulty recovering from this. Refecting on my talk with Sarah I came up to understand the impact the mentor can have on the college student and how harmful this have been for Sarah.

I was luckily enough to have the ability to be a part of all of Sarahs placement and therefore feel that hanging out with my student put me in a much better position to examine and be quite happy with my analysis on Sarahs ability. It enabled us to give attention to areas were highlighted in the original meeting. (Stuart 2006)

Working in community one of the problems as a mentor that you've little control over is the learning environment. Whilst for the interviews I could ensure we'd a noiseless room back again at bottom. And reflective conversations occurred in the car. The specific learning environment transformed every visit to different homes. As Sarah hadn't experienced a community placement before I sensed that I'd notify her of issues that may arise. These included poor health, living conditions but also reviewed that we live within a culturally and socially diverse environment.

The last interview is the only summative area of the evaluation process as a mentor it is my job to think about the students capabilities all together in my judgment and also pull on other associates experience with my university student. Therefore as an objective view, also by using the university portfolio as a guide to see if all learning effects have been completed. As a mentor I know of the accountability that I've when deciding if students meets the mandatory standard. Especially on the students last position there can be no 'profit of doubt' as the pre-registered college student won't have time to build up before subscription occurs. Time was allocated by the end of the ultimate conference to ask the university student how she acquired found her experience with me as a mentor.

The role of the mentor is vital in the stage immediately prior to pupil nurses achieving subscription is critical in producing nurses who are fit for practice and goal. (NMC 2004)

The study completed by Duffy and Middleton(20??) concurred that a longer last placement provides students time to stay and become part of the team motivating their self-assurance to expand. It allows the learner to get their useful skills up to the required standard and also growing their management competences, an important skill within the staff nurse role.

Unfortunately it must be recognized that not all students will achieve the mandatory outcomes to be competent and safe experts. Duffy (2005) explained that there should be the recognition that some students need to are unsuccessful. It is important to be aware as a mentor the assessments that people are taking is to guard professional benchmarks, patients and everyone. Within my time with my learner it was essential that both Sarah and i accepted her insufficient confidence and doing this early as you can interventions can be initiated within the task placement to achieve the required competences.

As the mentor is responsible it is important that combined with the professional standards and competences outlined, the NMC require that the registrants are of good health insurance and character. Another aspect that the mentor is in charge of. Most coaching within the practice area does deal with those aspects, the medical skill itself and the interpersonal and management skills included. The educational taxonomy considers that any learning topic needs to be judged from three perspectives with regards to what the student must learn. Those being psychomotor; the physical skills to carry out the work. Cognitive; the knowledge of the evidence platform for the work. Affective is the capability to conduct the duty with the appropriate communication and interpersonal skills.

The examination was mainly ongoing in a formative basis and using the helps of learning contracts and facilitating success of the outcomes by allocating patients and tasks, liasing with professionals. On all the duties I noticed that my learner Sarah had came with a lack of self confidence but through the process of practice reviews and representation and the support she was presented with from myself and the community nursing team every one of the results were achieved well.

As a mentor it is my responsibility to recognize and apply research and proof based practice to my part of practice (NMC 2008) I believe it is important that as a mentor you should examine your personal talents and weaknesses concerning me it's important which i gain confidence in my own talents as a nursing student mentor.

Feedback from the student point of view on the practice area as a learning environment is advantageous as it is area of the ongoing analysis of the training environment. As it reviews the training opportunities and audits the position so to build up skills of the experts within the team. Allowing the labor force to contribute in producing the profession for another generation of nurses. (ENB/DOH 2001) Also these audits will focus on the practice areas where students are battling to achieve and thus giving the School opportunity to solve the concerns.

The College or university have a responsibility to where possible ensure the position gets the necessary opportunites to aid adequate learning experience to indicate the scholar experience. (RCN 2006)

Action programs are defined as 'a must achieve device that identifies competences that require to be performed by an discovered date through the practice position, non achievement of which would lead to a fail make being given. ' (Gopee 2008)

It is vital within any analysis that a mentor perfoms you are prepared, fair, objective, genuine timely and give effective feedback. Each one of these componets means that evidence accumulated and documented within the students stock portfolio is a true objective illustration of the students competences and ability.

Barriers that would affect the mentors role is noted by Gopee (2008) organisation, lack of resources, personality clashes frame of mind problems either pupil/mentor. To be a mentor the primary challenge in being able to perform mentor responsibilities is that there surely is inadequate time for you to fulfil this role along with your clinical duties. Obviously on a day to day basis it is hard to forsee how your entire day may go as you never know what you will find when you open up the entranceway to each patient. But to minimalise this whenever you can I put my control and management skills into practice so that opportunites /experience were planned to the scope and timetabled approximately we're able to with the nature of the profession. Therefore reassuring the scholar that we my motivation was that she received the best out of her experience within the city medical team.

By placing an action plan also helps promote root skills such as planning, scheduling, goal setting, discussions and management.

Skinners theory devised in1974 expresses that the surroundings is vital to any learning that takes place and if the environment is suitable then learning will happen as relationships are shaped from replies to stimuli and reinforcement of the occurs. (cited by Quinn 2000)

As part of Sarahs action plan we discussed other resources available to her for example having practice days and nights with other specialists within the neighbourhood clubs.

Nurses are anticipated to have the ability to validate their professional medical decisions with research structured information that results in care should be patient centred and clinically effective. (DOH 2000) Within the community some of the treatments we offer for example compression therapy for treatment of leg ulcers have a large evidence base with the treatment but also as a professional we also use the evience from patients coping with these condtion and consider both those as facts to provide a rational for several decisions made about treatment. Fitzpatrick(2007) in her books review discovered that ideas on what data centered practice was depended on the perspective of the average person. Research can be sourced from experts, books and views of patients.

All evaluation descisions must be data based. That is seen as vital as the continuing future of the occupation, in both its integrity and knowledge are in the hands of students currently training to become authorized nurses. (Side 2006)

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