The support that mentors receive in the clinical setting

The Role of the Link Lecturer in the Perioperative Environment

As a result of the demise of the two-tier system of clinical teacher and lecturer, all teachers were assigned to clinical areas in which they facilitate the development of an educational milieu to support student learning in practice. This article highlights the role of the link lecturer within the perioperative environment. It focuses on how this multi-faceted position can assist students to link theory and practice, and addresses key issues relating to mentorship, clinical credibility and educational audit.

Workplace culture and the practice experience of midwifery students: A meta-synthesis

AIM

To describe midwifery students' practice experience and to explore facilitators and barriers to positive clinical learning experiences.

BACKGROUND

Practice experience is a vital component of every midwifery course. Course dissatisfaction and attrition of midwifery students has been attributed to sub-optimal practice experiences. Events or actions experienced by midwifery students that trigger dissatisfaction and attrition need to be identified.

EVALUATION

A meta-synthesis was based on that developed by Noblit and Hare.

KEY ISSUES

Students perceive workplaces as poorly prepared for their arrival and subsequent support. Students' experience in the practice setting is influenced by the existing workplace culture. Workplace culture influences institutional functioning and individuals within the culture. Enculturation of students into the midwifery culture and subsequent learning is affected by the support received.

CONCLUSIONS

The practice experience of midwifery students was profoundly influenced by workplace culture. Students tended to have polarized accounts of their experience that were predominantly negative.

IMPLICATIONS FOR NURSING (MIDWIFERY) MANAGEMENT

To provide an optimal environment for midwifery students; midwifery managers and individual midwives need to be aware of the facilitators and barriers to midwifery student development in the practice setting.

Stepping up, stepping back, stepping forward: Student nurses' experiences as peer mentors in a pre-nursing scholarship

Mentorship is an essential part of the registered nurse's role, yet few opportunities exist for student nurses to mentor others during pre-registration programmes. This paper reports student nurses' experiences of mentoring school pupils during a pre-nursing scholarship. Focus groups were conducted with fifteen final year student nurses (14 female, 1 male) in two university campuses in Scotland. Discussions were audio recorded and transcribed verbatim, and data analysed thematically. Three interconnected themes emerged: 1) stepping up; 2) stepping back; 3) stepping forward. 'Stepping up' was a process through which student nurses rapidly assumed responsibility for mentoring pupils, facilitated through the attitudes and actions of students' mentors and students' control over pupils' practice experiences. 'Stepping back' encapsulated attitudes and behaviours that enabled student nurses to mentor pupils that involved considerable judgement around how unfolding events in practice could provide learning and development opportunities, and emotional acuity to support pupils through, sometimes challenging, practice situations. 'Stepping forward' described how students' mentoring experience allowed them to appraise and affirm nursing knowledge and skills, and gain greater appreciation of the reality and complexity of mentorship in clinical practice. Peer mentoring may prepare student nurses for future mentoring roles and aid their transition into clinical practice.

A phenomenological study into the impact of the sign-off mentor in the acute hospital setting

Mentoring provides an essential quality assurance mechanism within undergraduate support and assessment of nurses. Recent changes to the standards for supporting pre-registration learners in clinical practice have provided additional structure to this process. Existing evidence suggests there are numerous challenges such as balancing clinical and mentoring priorities and making appropriate decisions; evidence about the sign-off mentor role in particular is currently lacking. This study explores the impact of the sign-off mentor role within the acute setting utilising a phenomenological approach. A purposive sample of 6 sign-off mentors contributed to data collection via the use of semi-structured interviews. Data were collected using a digital tape recorder and transcribed verbatim. Analysis of findings allowed for the development of 3 main themes which are accountability, time and commitment. A key finding of this study is the change in focus for sign-off mentors to one of assessment of clinical competence and professional regulation as opposed to mentors who have concentrated on the teaching and pastoral aspects of this role. However, sustainability requires further investment in this new role from a managerial and educational perspective. Recommendations include further attempts to embed protected time into organisational processes, the consideration of limiting students to sign-off mentors when mentoring a final placement student and negotiating maximum number of exposures to this role within a set time frame.

Text messaging to support off-campus clinical nursing facilitators: a descriptive survey

BACKGROUND

Managing large student cohorts can be a challenge for university academics, coordinating these units. Bachelor of Nursing programmes have the added challenge of managing multiple groups of students and clinical facilitators whilst completing clinical placement. Clear, time efficient and effective communication between coordinating academics and clinical facilitators is needed to ensure consistency between student and teaching groups and prompt management of emerging issues.

METHODS

This study used a descriptive survey to explore the use of text messaging via a mobile phone, sent from coordinating academics to off-campus clinical facilitators, as an approach to providing direction and support.

RESULTS

The response rate was 47.8% (n=22). Correlations were found between the approachability of the coordinating academic and clinical facilitator perception that, a) the coordinating academic understood issues on clinical placement (r=0.785, p<0.001), and b) being part of the teaching team (r=0.768, p<0.001). Analysis of responses to qualitative questions revealed three themes: connection, approachability and collaboration.

CONCLUSIONS

This study demonstrates that use of regular text messages improves communication between coordinating academics and clinical facilitators. Findings suggest improved connection, approachability and collaboration between the coordinating academic and clinical facilitation staff.

Exploring cognitive skill development in midwifery education

Changes in maternity services and the role of the midwife mean that the midwife must provide flexible, evidence-based, woman-centred care. As the lead professional, the midwife must use a high level of professional judgement, clinical reasoning and decision-making to enable choice while ensuring the safety and wellbeing of mother and infant. Delayed development of these cognitive skills is suggested by the continuing theory-practice gap, suboptimal practice and students requiring to conform to non-evidence-based practice. The purpose of this research was to explore midwifery students' understanding and experience of the development of cognitive skills. The research employed analysis of undergraduate midwifery programme documentation and a focus group discussion with student midwives from second and third year of the programme. Document analysis and thematic analysis of the interview data indicated a lack of emphasis on cognitive skill development and a sense that these skills improve naturally through exposure to clinical practice. The findings suggest a need to change our approach to learning in clinical practice and to conduct further research to improve understanding of mechanisms to support the development of cognitive skills.

Designing and implementing an ambulatory oncology nursing peer preceptorship program: using grounded theory research to guide program development

Having enough staff to provide high-quality care to cancer patients will become a growing issue across Canada over the next decades. Statistical predictions indicate that both the number of new diagnoses and the prevalence of cancer will increase dramatically in the next two decades. When combining these trends with the simultaneous trend toward health human resource shortage in Canada, the urgency of assuring we have adequate staff to deliver cancer care becomes clear. This research study focuses directly on oncology nurses. Guided by the grounded theory methodology, this research study aims to formulate a strategic, proactive peer preceptorship program through a four-phased research process. The goal of this research is to develop a program that will support experienced staff members to fully implement their role as a preceptor to new staff, to facilitate effective knowledge transfer between experienced staff to the new staff members, and to assure new staff members are carefully transitioned and integrated into the complex ambulatory cancer care workplaces. In this article, the data from the first phase of the research project will be explored specifically as it relates to establishing the foundation for the development of a provincial ambulatory oncology nursing peer preceptorship program.

A pilot study on conducting mobile learning activities for clinical nursing courses based on the repertory grid approach

In clinical nursing courses, students are trained to identify the status of the target patients. The mastery of such ability and skills is very important since patients frequently need to be cared for immediately. In this pilot study, a repertory grid-oriented clinical mobile learning system is developed for a nursing training program. With the assistance of the mobile learning system, the nursing school students are able to learn in an authentic learning scenario, in which they can physically face the target patients, with the personal guidance and supplementary materials from the learning system to support them. To show the effectiveness of this innovative approach, an experiment has been conducted on the "respiratory system" unit of a nursing course. The experimental results show that the innovative approach is helpful to students in improving their learning achievements. Moreover, from the questionnaire surveys, it was found that most students showed favorable attitudes toward the usage of the mobile learning system and their participation in the training program.

Mentoring in nursing education: perceived characteristics of mentors and the consequences of mentorship

This paper presents the initial research results of mentorship in Flanders, Belgium. A validated questionnaire has been used as well as a semi-structured interview, to investigate perceived characteristics, advantages and drawbacks of mentorship, as well as practical aspects in mentoring education. The questionnaire has been validated for the Dutch language. The response rate of 62% has been rather high. The ability to give feedback, experience, availability of time and a positive attitude were the elements considered important for mentors. In spite of workload, lack of time and drawbacks such as adverse effects on the team work on the ward, transferring of enthusiasm onto students was still possible. Benefits for mentors were immaterial and included closer follow-up of new developments, teaching and sharing of experiences. The benefits outweighed the drawbacks. Support by mentoring courses, additional study and especially of link lecturers proved to be beneficial. Especially the help of link lecturers proved to be necessary in problems and in evaluation of "unsafe" students. In the latter case, the link lecturer helps to solve the inherent conflict of interest by being mentor and assessor at the same time.

Longitudinal evaluation of the impact of placement development teams on student support in clinical practice

AIMS

To investigate the impact of a new structure for supporting healthcare students and mentors in practice placements (Placement Development Teams).

INTRODUCTION

The English Model National Partnership Agreement for healthcare education required Strategic Health Authorities, Higher Education Institutions and National Health Service Trusts to redesign strategies for student support. Placement Development Teams are one English University's response to this.

MATERIALS AND METHODOLOGY

This study was phase 2 of a longitudinal qualitative evaluation of Placement Development Teams. Data were collected after establishment of Placement Development Teams, and compared and contrasted with those collected prior to their implementation. Telephone interviews were conducted with key educational stakeholders in Trusts and Strategic Health Authorities. Focus groups were conducted with third year non-medical healthcare students and first year paramedics working in 16 NHS Trusts in the south west peninsula of England.

RESULTS

Pre-Placement Development Teams, themes from the students' data were: Supportive and unsupportive behaviour of staff; Mentor allocation; Placement allocation; Benefits of students to the placement area and Perceived control over the learning experience. Post-Placement Development Teams, the themes were Communication; Supportive and unsupportive behaviour of staff; The effect of peers on the placement experience; Knowledge and perceptions of the work of the PDTs. Form the staff data, pre-Placement Development Teams the themes were: Vision for improving student support. Post-Placement Development Teams themes from the staff data were how they provided a central point of contact for student and mentor support; and how they supported students and mentors.

CONCLUSION

Support of students and mentors is particularly important following the introduction of The English Model National Partnership Agreement for healthcare education. Placement Development Teams can facilitate partnership working between higher education institutions and placement providers for student support.

Preceptoring nursing students: registered nurses' perceptions of nursing students' preparation and study approaches in clinical education

Preceptorship influences Registered Nurses' (RNs) daily work to different degrees depending on nursing students' knowledge, and willingness to learn. Consequently, it is of the utmost importance to investigate how RNs assess nursing students in clinical education. The aim of this study was to describe RNs' perceptions of nursing students' preparation and study approaches at hospital workplaces, and to explore relationships between RNs' perceptions and their personal/clinical characteristics. A cross-sectional design was used. In 2006, 142 of 196 RNs at a Swedish hospital answered a questionnaire (response rate 72.5%). The majority of RNs (63-84%) rated students' study approaches highly and thought students comprehended the outcomes of learning. Fewer (45-49%), rated students as having adequate theoretical knowledge highly and were of the opinion that they had acquired knowledge about the unit. Statistically, non specialist nurses rated significantly higher compared with specialist nurses. Significant positive correlations were found between the RNs' perceptions of nursing students and their interest in preceptoring. The extent to which preparation programmes, established in collaboration between a university and a hospital, had improved preceptors and nursing students was not graded. Further descriptive and intervention studies are therefore needed.

Strengthening and updating supervising staff nurses in educational workshops--an international partnership project

As part of a collaborative project involving Tanzania and Sweden, workshops were arranged for staff nurses in order to develop a forum for discussing the raised demands for supervision of nursing students during their clinical education. The aim was to meet nurses in educational workshops to initiate a dialogue on their views and experiences of supporting and supervising nursing students in their clinical studies. Their experiences of the workshops were also requested. Two groups of nurses in Tanzania (n=30), and six groups in Sweden (n=60) participated. The content, which was agreed between the project leaders in Tanzania and Sweden was carried out either on a whole day workshops or divided at three different occasions. Questionnaires were given before and about two months after, and workshops were also evaluated with an open-ended question immediately after. The nurses both in Tanzania and in Sweden appreciated the workshops as a possibility to create a dialogue and to discuss challenges in the supervision of students. Their views and experiences of the supervision role showed awareness of staff nurses as role models and teachers. Accomplishment of this partnership co-operation through arranging workshops has shown to be an easy and simple way of giving support to staff nurses for the supervision task.

The meaningful experiences of being a Registered Nurse (RN) Buddy

This paper describes the previously unexplored Buddy RN experience. Critical interpretive theory underpinned this exploratory study set in a large metropolitan teaching hospital in South East Queensland. Participants were five RNs who had been Buddies to undergraduate nursing student(s) in the previous 12 months. They were interviewed using semi-structured techniques and their transcribed interviews summarised to identify relevant verbatim data for participant checking. Common themes were generated via critical interpretive analysis and points of tension extrapolated. Four main points of tension were uncovered: Acknowledgement, Experience, Balance and Interruption. These revealed a number of paradoxes: the Buddy RN role is not professionally recognised by bodies that manage nursing; nursing is still influenced by essentialist discourses which perpetuate outdated practices and attitudes to the detriment of the Buddy RN; RNs are compelled to follow direction without question or dissent even though they are mandated by nursing's regulating body to be independent and accountable critical thinkers. A clear articulation of the Buddy RN role in the form of policy is required from nursing's regulating bodies. From this, health service management and universities can initiate the process of creating a framework for preparing, supporting, assessing and educating the Buddy RN.

Judgements about mentoring relationships in nurse education

Much has been written about the use of portfolios and mentoring in the clinical assessment of nursing students in the United Kingdom. Research reports have focused on difficulties in using portfolios, mentoring relationships and mentor preparation. The aim of this study was to deepen understanding of how mentors actually make judgements about students' clinical competence. Qualitative data were gathered in 2006 using a critical incident technique in interviews with a convenience sample of students and mentors from two different geographical regions in the UK. Thematic analysis generally confirmed previous findings regarding the qualities of a good student and resource issues in mentoring. 'Good mentoring' depended on students building a relationship with their mentors, and undertaking a great deal of 'emotional labour' to convince mentors that they were 'good students' in terms of attitudes as well as clinical competence. It seems clear that much of the burden of creating effective mentoring relationships falls on students. At the same time, many issues identified in previous research do not appear to have been tackled, including appropriate mentor preparation and support, the format of portfolios and competency statements, and ensuring that enough time is available for mentoring and student supervision.

'A Juggling Act': an analysis of the impact of providing clinical placements for pre-registration students on the organisation of community nursing and health visiting work

Modernising policies for the NHS have aimed to strengthen the nursing workforce through enhancing professional roles and increasing the numbers of pre-registration students. The current emphasis upon community based health care has led to an increase in the quantity and complexity of the workload for community nurses and health visitors, whilst at the same time educational developments have led to additional responsibilities supporting nursing students on community placements. These issues are explored in this paper which reports findings from a qualitative study in a large city based Primary Care Trust (PCT). The findings demonstrate that the provision of clinical placements for nursing students leads community nurses and health visitors to juggle the demands of their workload with meeting the needs of nursing students and clients. This requires a (re)-organisation of their work, often impacting on the wider team. Additionally the nature of community nursing/health visiting work, shaped by time, space, resources and location, constrains opportunities for clinical learning. If government policies are to be implemented successfully, community nursing and health visiting staff require appropriate support to enable them to fulfil their educational and clinical roles.

Assessor or mentor? Role confusion in professional education

This paper reports on research conducted as part of a multi-professional study involving nursing, medicine and midwifery, which aimed to investigate both mentee and mentor perceptions of the mentorship role and the context within which it is conducted. It is well recognised that mentorship plays a vital part in the support and training of healthcare professionals. Documentation published by regulatory bodies regarding the mentorship role and changes in it's implementation in practice has resulted in confusion among practitioners. This study consisted of questionnaires and semi-structured telephone interviews with both mentors and mentees, within three healthcare professions and focuses on the responses from the nursing profession. The mentors participating in the study struggled with their dual role as assessor and mentor and found conflict within this responsibility. The role of assessor was poorly recognised and the complexity of being both an assessor and a supporter/friend is discussed.

Methodological considerations of undertaking research with clinical mentors in the UK: a critical review of the literature

The subject of this paper is critical review of the reported research approaches used when undertaking clinical mentor research in the UK. The term 'Mentor' is used to denote a clinical practitioner who is responsible for the teaching, assessing and supervision of student nurses undertaking clinical practice. Imperatives such as new quality assurances in the UK are cited as part of the rationale for conducting the review. In these new initiatives, clinical placements are viewed as an integral feature of Higher Education Institution's (HEI) nurse education provision. Within these new quality assurance processes, there is an emphasis on the importance of clinical learning environments and the impact that mentors have on student learning. A critical review of 19 reports that have clinical mentors as their target population was undertaken. Factors such as the subject areas of the studies reviewed, research methodologies, sampling issues, responses rates and ethical considerations were the focus of the critical appraisal. It was found that most studies used postal survey approaches. Methodological weaknesses were found to relate to such things as questionnaire design, sampling and poor response rates. It is concluded that the study gives further insights into the debate about the rigor of nursing research and particularly nurse education research and therefore is of interest not only to nurse education researchers but also to nurse researchers generally.

Mentor evaluation of a year-long mentorship program: a quality improvement initiative

This paper presents 23 mentors' perceptions of their role in a year-long mentorship program during the period 1999- 2002. The majority of mentors were clinical specialists, had bachelor degrees and over five years clinical experience. The mentorship program was informed by the Deming Cycle of Plan, Do, Check and Act. This quality improvement framework was used to evaluate the mentorship program from the mentors' perspective. Information was gathered through surveys and focus group discussions. Responses were analysed to identify three themes of 'Enhancing student learning outcomes', 'Time and resources' and 'Personal and professional growth'. Mentors perceived their role as valuable in students' education and development. Despite concerns regarding adequate time and resources for an effective mentoring program, mentors acknowledged benefits to themselves in terms of personal and professional growth. Their vision and commitment to nursing was also evident in the perceived benefits of the program for the profession.

Mentor preparation: reasons for undertaking the course and expectations of the candidates

This study sought to explore the assumption that potential participants to do the English National Board Teaching and Assessing in Clinical Practice course (ENB 998) were motivated to undertake the programme by a commitment to become a mentor. Two cohorts of students (n=127) were invited to complete a specifically constructed questionnaire and the majority responded (n=115, response rate 90.6%). The results were analysed using SPSS v10 [SPSS Inc., SPSS for Windows, 1999]. The findings suggest that commitment to undertaking the role of the mentor was not the only motivator for those undertaking this programme of preparation. Fifty-eight percentage (n=67) identified enhanced job prospects as a benefit of the course. Recommendations are made that the course should not be universally required for promotion and that it be, solely, identified as a course for mentor preparation. It is also recognised that this approach requires a national movement in this area if it is to succeed.

Student nurse theatre placements. The new curriculum

Following the implementation of the Fitness for Practice (FFP) nurse education curriculum, opportunities are available for student nurses to return to the operating theatre environment during their surgical module. This follows a ten-year absence in most parts of Wales. This article investigates what realistic placement objectives are available for student nurses in Wales and how close mentor supervision can enhance the learning process and promote the clinical experience of theatre nursing.