1 welcome to the registrant awareness study day 2008-9 (previously known as the associate mentor...

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Welcome to theWelcome to the

REGISTRANT REGISTRANT AWARENESS STUDY AWARENESS STUDY

DAY 2008-9DAY 2008-9

(Previously known as the (Previously known as the Associate Mentor Study Day)Associate Mentor Study Day)

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Registrant Awareness Study Day, October 2008.

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AimsAims

• To develop an understanding of the role and responsibilities of a Registrant (Associate Mentor).

• To provide an outline of the contribution a Registrant (Associate Mentor) can make to teaching, assessing and the facilitation of students.


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ObjectivesObjectives

To identify the contribution the Registrant (Associate Mentor) can make to:

• Teaching and the facilitation of learning.• Supporting students in practice.• Assessing students in practice.• Promoting an effective learning environment.• Outline the assessment process and the professional /

legal responsibilities of those involved.• Identify the current programmes in Greater Manchester.


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Objectives Cont’dObjectives Cont’d Link to the NHS Knowledge and Skills

Framework Core Dimensions (NHS 2004):

• Communication.

• Personal and people development.

• Service improvement.

• Quality.

• Equality and Diversity.


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Why Assess?Why Assess?

• Assessment is a key component of every nurse’s role.

• You have a duty to facilitate students of nursing to develop their competence.

(NMC 2008a)

• It is the role of Mentors and Registrants (Associate Mentors) to assess competence and confirm that students are capable of safe and effective practice.

(NMC 2008b)


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Clinical Pathway to MentorshipClinical Pathway to MentorshipMaintain Portfolio

Participate in supervision and assessment of pre-registration students

Complete Mentor Preparation programme at L2, L3, L4

Preceptorship Registrant(Associate Mentor)

Mentor

Completion of preceptorship From September 2007

Prepare to make final assessment

of fitness to enter practice

6 monthsPost qualified

Attend 1 dayPreparationworkshop

Meet additional criteriaBe on the same part orsub–part of the register

Sign off Mentor


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Scenario 1Scenario 1

A qualified Mentor asks you to act as a Registrant (Associate Mentor) for a student nurse who starts her placement in 2 weeks time. What do you need to consider and what resources can you access:

a) Prior to the student’s arrival?

b) On the student’s arrival?


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Role of the MentorRole of the Mentor

Work in conjunction with the Registrant (Associate Mentor) and hold regular meetings to:

• Supervise, support and guide students in practice.

• Contribute towards a supportive learning environment and quality learning experience for students.

• Ensure completion of required assessment documentation.

• Ensure a minimum of 40% contact between the qualified Mentor and student.

Please refer to the Handbook for Mentors & Registrants Please refer to the Handbook for Mentors & Registrants (Associate Mentors) for more information.(Associate Mentors) for more information.


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Role of the Registrant Role of the Registrant (Associate Mentor)(Associate Mentor)

Work in conjunction with the qualified Mentor to:

• Act as a role model.• Assist and support students in learning new knowledge, skills and

attitude.• Help the student to identify their learning needs.• Ensure a minimum requirement of student / Registrant (Associate

Mentor) contact 2 shifts (40%).• Arrange for others to work with and teach the student.• Make an assessment of the student’s progress and give feedback.• Assist with the student’s interview and help the Mentor to complete the

assessment documentation.• Liaise with the Personal Tutor or Academic / Unit Lead where

necessary.


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Professional ResponsibilityProfessional Responsibility

These are required in order to fulfil your role as a Registrant (Associate Mentor) and to adhere to Trust and NMC requirements:

Registration of Registrant (Associate Mentor)• Submit registration form and completed objectives to the

Practice Education Facilitator (as appropriate).

Maintaining competence• Attend an update or undertake the on-line Mentor / Registrant

(Associate Mentor) update annually.• This is an interim role: The “NMC would expect that the majority of

nurses and midwives would at least meet the outcomes of a mentor”.


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Collection of EvidenceCollection of Evidence

Evidence of competency can be demonstrated through:

• Observations, Discussion.• Research articles, appropriate literature searches.• Reflective written account.• Records of training and supervised practice.• Case studies and care plans.• Knowledge of relevant guidelines / assessment tools.• Clinical practice records and log sheets.• Supervised practical skills.

In relation to the core dimensions linked to KSF:• Communication.• Personal and People Development.• Health, Safety and Security.• Service Improvement.• Quality.• Equality and Diversity.


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Programmes Leading to Programmes Leading to RegistrationRegistration

The University of Manchester / MMU:• Diploma: multiple exit - Diploma, Diploma with 40 degree level

credits, Degree.

University of Salford:• Diploma: multiple exit - certificate, Diploma, Diploma with 60 degree

level credits (Ordinary Degree).

All Universities:• Degree: multiple exit – certificate, Diploma, Degree, Degree (RN).• Fast Track: Assistant Practitioner, Graduate Entry, AP(E)L – over

two or two and a half years.

Part Time Programmes:• University of Salford – over four and a half years.

NB: Nursing should work towards becoming an all graduate profession (NMC, 2008).


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Partner Higher Education Partner Higher Education InstitutionsInstitutions

• The University of Manchester

• University of Salford

• Manchester Metropolitan University

• Bolton University


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Placement RegulationsPlacement Regulations

• Varies across programmes and HEIs

• See handout and University Websites for details

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Criteria University of Salford The University of Manchester MMU

Programme Diploma / Ordinary Degree: Adult, Child, Mental Health.

BSc (Hons): Adult, Child, Mental Health.

DPSN (Diploma): Adult, Mental Health.

BNurs (Degree): Adult, Child, Mental Health.

DipHE / BSc: Adult.

Entry Requirements 2 A Levels @E or above. GCSE English Language & Maths @ C or above.

2 A Levels @ C or above.GCSE English Language & Maths @C or above.

5 GCSE’s @ c or above, incl English Lang & Maths or equivalents. Also desirable: Science GCSE @ C or above & 2 AS levels @ C or above or equivalents. CRB & health check.

3 A Levels @ C or above. GCSE English Language & Maths @ C or above.

5 GCSE’s @ C or above, including English Language & Maths.

Hours Per Week 37.5 37.5 37.5 – 1 day per week in HEI (= 7.5 hrs). As from 09/08: 28 hrs in practice & 1 day per week in HEI.

Various – students work an 8 hour day.

37.5

Nights Min of 4 weeks in 3 yrs.150 hours.

Min of 4 weeks in 3 yrs150 hours.

Up to 6 weeks in years 2 & 3. Min of 4 nights in 3 years. Min of 4 weeks in 3 yrs. 15o hours.

Weekends Max of 2 weekends in 4. Max of 2 weekends in 4. Max of 1 or 2 weekends in 4. Can be asked to work 2 weekends in 4.

Max of 2 weekends in 4.

Bank Holidays Do not work BH’s. Do not work BH’s. At the placements discretion, but must still work hours as above.

At the placements discretion, but must still work 37.5 hrs.

Do not work BH’s.

Long Days Not advised to work long days but can be worked if is the placements normal shift pattern.

Not advised to work long days but can be worked if is the placements normal shift pattern.

Can be worked if is the placements normal shift pattern to a max of 1 per week if it is educationally driven.

Can be worked if is the placements normal shift pattern.

Can be worked if is the placements normal shift pattern.

Sickness / Absence Max of 27 days in 3 yrs. Max of 27 days in 3 yrs. 100% attendance expected with the exception of authorised absence.

Min of 80% academic attendance. All practice must be made up.

Max 25 Days in 3 yrs.

Travel Expenses Available for journeys greater than home to university base.

Available for journeys greater than home to university base if in receipt of the maintenance bursary.

Available for journeys greater than home to university base.

Available for those students eligible for a Means Tested Bursary.

Available for journeys greater than home to university base if in receipt of the maintenance bursary.

Learning Outcome / Proficiencies

Generic based on NMC outcomes / proficiencies.

Generic based on NMC outcomes / proficiencies.

Module specific outcomes based on NMC outcomes / proficiencies.

Module specific outcomes based on NMC outcomes / proficiencies.

Generic based on NMC outcomes/proficiencies.

Evidence of Achievement

The student may provide evidence in portfolio in addition to Personal Development Plan.

The student may provide evidence in portfolio in addition to Personal Development Plan.

The student must provide evidence to support each learning outcome.

The student must provide evidence to support each learning outcome.

The student may provide evidence in portfolio in addition to action plans.

Pre-Registration Student Nursing University Rules & RegulationsPre-Registration Student Nursing University Rules & Regulations

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Curriculum Core ComponentsCurriculum Core Components

• 1 year Common Foundation Programme and 2 year Branch Programme.

• Equal weighting for the accreditation of theory and practice.

• An outcomes based standards of proficiency approach.

• Portfolio of evidence to demonstrate fitness for practice, award and purpose.

• Use of PBL, blended learning, VLE


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Curriculum Core ComponentsCurriculum Core Components• Clinical Skills Teaching.

• Students are supernumerary

• Essential Skills Clusters (NMC 2007).

• Longer clinical placements with 12 weeks consolidation at the end of the programme.

• Requirement to be exposed to other branches (EU Directives).


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Points to Consider for the Points to Consider for the Facilitation of LearningFacilitation of Learning

• Stage in training.• Previous experiences.• Hubs & Spokes.• Learning styles.• Students with a disability.• Maintain equality and diversity.• Practice based learning opportunities.


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Rotational PlacementsRotational Placements• HUB = base placement.

• SPOKE = holistic view of patient care.

• Spoke placements are to be negotiated between the student and Mentor.

• Rotational placement is a programme of rotation set up within a Hub placement (often a unit base).

• Group Spokes.

NB: See Policy in relation to Hub and Spoke PlacementsRegistrant Awareness Study Day, October 2008.

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Hub and SpokeHub and Spoke


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Example of Spoke PlacementsExample of Spoke Placements

Vascular Lab

Vascular Lab

OsteoporosisNurse

OsteoporosisNurse

MicrobiologyDepartment

MicrobiologyDepartment

Endoscopy Department

Endoscopy Department

Rheumatology Nurse

Specialist

Rheumatology Nurse

Specialist

Pharmacy/Aseptics

DeptPharmacist

Pharmacy/Aseptics

DeptPharmacist

PhysiotherapistPhysiotherapist

RadiologyDepartment

RadiologyDepartment

ECGDepartment

ECGDepartment

Medical Ward

Medical Ward


Two Hubs – Same Spokes

THEATRE A & E

TWO HUBS

Palliative Care / MacMillan Outreach Team

POSSIBLE SPOKES


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Learning StylesLearning Styles

• Our attitude and behaviour can determine our preferred way of learning.

• It is well known that people learn in different ways.

• Honey & Mumford (1982) identified 4 preferences or styles of learning:– Activist; Reflector; Pragmatist; Theorist

• Flemming (2007) formulated VARK;– Visual; Aural; Reading/writing; Kinaesthetic


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The ActivistThe Activist

• Tends to act first and consider the consequences later.

• Learns best when involved in new activities, but can get bored with implementation or long explanations.

• Learns less well listening to lectures or following precise instructions.


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The ReflectorThe Reflector

• Likes to stand back and look at situations from different perspectives.

• Learns best from observing others at work or when given the opportunity to review what has happened.

• Learns less well when rushed or when they are asked to lead in a situation.


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The TheoristThe Theorist

• Tends to be perfectionists who like to think problems through step by step.

• Learns best in structured situations where they have prior knowledge or can ask questions.

• Learns less well in unstructured situations, or situations where they have no prior knowledge or have to deal with emotional issues.


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The PragmatistThe Pragmatist

• Wants concepts that can be applied in practice.

• Learns well when they can practice techniques or can see an obvious link with their job.

• Learns less well where learning is all theory or when there is no apparent pay back for them.


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Learning StylesLearning Styles

ACTIVIST

PRAGMATIST REFLECTOR

THEORIST

• I learn best when I am able to try new activities and can see the benefits for my patients / students, team or myself.• I learn less well from formal lectures and tend to get bored if learning is repetitive or does not seem relevant.


VARK (2007)VARK (2007)

Further methods of aiding teaching and learning:

• Visual – use pictures, posters and equipment to explain and demonstrate new skills.

• Aural – use discussion and explanations. Some students may record information given in teaching sessions.

• Read / Write – use notes, definitions and flow diagrams to remember information.

• Kinaesthetic – need to experience the skill to be able to understand and internalise it.

28Registrant Awareness Study Day, October 2008.

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Challenge for the MentorChallenge for the Mentor

• Appreciate that your own learning style may not suit your student.

• Consider how to adapt your placements learning opportunities to meet all the learning styles.

• Ultimately try to achieve a mix between theory, practice, structured teaching and experiential learning.


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Action Plan for LearningAction Plan for Learning

Consider how you could adapt your teaching / mentoring style to suit each of the following student types:

• Activist student.

• Reflective student.

• Theorist student.

• Pragmatist student.


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How to Evaluate Effectiveness How to Evaluate Effectiveness of Learningof Learning

• Questions and answers.

• Observation.

• Performance to achievement of outcomes or standards of proficiency.

• Feedback from placement team.


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Scenario 2Scenario 2

Part 1:

The student has been in placement for 3 weeks and you will be assisting the qualified Mentor in undertaking the mid-point interview in 2 days time.


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Supporting StudentsSupporting Students

Why should Mentor / Registrant (Associate Mentor) support students?

Students must be supported in identifying their learning needs and making the best of the learning opportunities provided.

Placements must provide adequate support and supervision for students.

(DH 2001)


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What Makes a Good Placement?What Makes a Good Placement?

What makes a

goodplacement

What makes a

goodplacement


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The Good PlacementThe Good Placement

A good placement should include the following:

• Consistent support and supervision.• Appropriate preparation and orientation.• Appropriately qualified Mentors / Registrants (Associate

Mentors).• Assistance to link theory and practice.• Help to match learning needs against learning

opportunities.• Regular feedback on progress given to student.• All placements meet quality standards.

NB: This list is not exclusive.


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What Makes a Good Mentor / What Makes a Good Mentor / RegistrantRegistrant (Associate Mentor) ?(Associate Mentor) ?

Whatmakes a

goodmentor

Whatmakes a

goodmentor


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The Good Mentor / Registrant The Good Mentor / Registrant (Associate Mentor)(Associate Mentor)

A good Mentor / Registrant (Associate Mentor) requires the following skills:

• Coaching.• Supporting.• Instructing / developing.• Listening.• Inspiring.• Encouraging.• Managing risks.• Opening up avenues of opportunity.• Giving constructive and timely feedback.• Being a good role model of professional behaviour.

NB: This list is not exclusive.


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Giving Feedback to StudentsGiving Feedback to Students• Giving timely feedback is the backbone of good supervision.

• In order to develop students must receive regular feedback about their progress – positive and negative.

• A feedback sandwich consists of constructive criticism “sandwiched” between 2 examples of praise or positive feedback: i.e. positive / negative / positive.

• To be effective feedback must be as precise as possible and suggest solutions for how negative practices can be changed.

NB This list is not exclusive.


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Assessment SupportAssessment Support

Student and Mentor / Registrant (Associate Mentor) support should come from the whole nursing team plus:

• The Academic in Practice / Directorate Liaison Teacher.

• The Personal Tutor.

• The Unit / Module Lead.

• The Academic Tutor.

• The Programme Leader.

• The Practice Education Facilitator.


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Guidelines for Dealing with Issues Relating to Clinical PlacementsGuidelines for Dealing with Issues Relating to Clinical Placements

Joint discussion to take place between Student, Mentor and Placement Educational Lead (PEL)

Issue/problem identified within a clinical placement

Personal Tutor to liaise with Mentor & PEL to support Student/resolve issue

Academic in Practice / Practice Education Facilitator to liaise with

Mentor and PEL and support placement area to resolve issue

Personal Support IssueStudent/Mentor to contact Personal Tutor (Programme

Support Team if sickness/absence issue)

Placement IssueStudent or Mentor to liaise with Academic in Practice from relevant University and inform the Placement

Education Facilitator.The Student must document the issue and forward to

the AiP or Personal Tutor.

Programme Leader to liaise with the Head of

School/Department & Trust Senior Manager for further

action

Personal Tutor /Practice Education Facilitator to liaise with Mentor and PEL to

support placement and Student

Disciplinary/Conduct IssueMentor to liaise with PEL, Academic

in Practice and Personal Tutor

Lessons learnt & changes made as required, preventing future

reoccurrence

YesIssue resolved

NoFurther action required

AiP/Personal Tutor to inform Practice Education Facilitator and refer the

issue to the appropriate Programme Leader and Trust Senior Manager

Academic/Student Progression IssueMentor to liaise with Personal Tutor from relevant University and inform the Placement Education

Facilitator


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Concerns Regarding Student ProgressionConcerns Regarding Student Progression Mentor may wish to discuss

progression issues with Practice Education Facilitator, prior to meeting with the student.

Mentor discusses concerns with the student, clearly stating specific areas of concern and relating them to the learning outcomes. An

action plan is negotiated between the mentor and student. A review date is agreed. Discussion and plan documented in student

placement documentation.

Mentor to inform Practice Education Facilitator and Academic Tutor about concerns and action plan.

Review of action plan.

Partial or no improvement.

Mentor to have clear discussion with student about progression, highlighting which learning outcomes may not be met by the end of the placement. Continue with or amend action plan.

Mentor to inform Practice Education Facilitator and Academic Tutor.

An individual action plan/learning contract will be required, tailored to the nature of the concerns and carried over to the next placement area.

This will be developed by the Unit Team and the Academic Tutor, and Examinations Office informed.

* In placement areas where there is no Practice Education Facilitator, mentors would contact the Academic Tutor directly.

Satisfactory progression.

Mentor to inform Practice Education Facilitator and

Academic Tutor.

Student may wish to discuss the situation with their Academic Tutor.


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Scenario 2Scenario 2Part 2:

At the mid-point interview the student indicates that he / she has settled in well to the placement area and is meeting his / her Learning Objectives.

However, you have been approached by several members of the team voicing concerns regarding the student’s ability to perform essential nursing skills when delivering nursing care.


The Purpose of Assessment The Purpose of Assessment is to:is to:

• Recruit to academic programmes and / or careers.

• Maintain professional standards.

• Motivate students.

• Provide feedback on performance / progress to students, mentors and HEI’s.

• Prepare students for their professional career.


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What to Assess?What to Assess?

These are measured against the NMC outcomes and proficiencies:

• Knowledge and understanding.• Skills.• Attitudes and behaviour.• Direct patient care.• Indirect aspects of patient care.• Communication / interpersonal skills.• Competence.


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Nursing Assessment CriteriaNursing Assessment Criteria

Professional / Ethical:

• Code of Conduct.• Legislation.• Equality.

Care Delivery:

• Communication.• Health promotion.• Nursing process.• Evidence Based Practice.• Clinical judgement.

NMC Outcomes / ProficienciesCare Management:

• Maintaining safe environments.• Inter-professional working.• Management skills.• Key skills.

Personal & Professional Development:

• Safe and effective practice.• Enhancing practice.• Nursing Process.• Evidence Based Practice.• Clinical Judgement.


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Indicators of AchievementIndicators of Achievement

NOVICEADVANCED BEGINNER

COMPETENTEXPERT

Adapted from Benner (1984)

YEAR 1 YEAR 2 YEAR 3 POST-REG


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Novice / Safe Practitioner:

• Performance is guided by rules and objectives.

• Lacks a strategy for practice.

• Whole situation is not understood.

• No experience of the situation.

• Inability to discuss reasons for practice.


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Advanced Beginner / Emerging Practitioner:

• Has prior experience of the situation.

• Can identify overall important aspects of a situation.

• Unable to sort out priorities in a situation.

• Compares, contrasts and discriminates aspects of the situation.

• Beginning to develop a strategy for practice.


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Indicators of AchievementIndicators of AchievementCompetent / Effective Practitioner:

• Has a long-range view of practice.

• Develops a strategy for practice.

• Practice informed by analysis and problem solving.

• Identifies own practice goals and formulates plans for achieving these.

• Can manage many aspects within a situation.


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Methods of Assessing Students Methods of Assessing Students in Practicein Practice

• Observation.

• Testimony.

• Explanation.

• Role play (tutorial sessions).

• Written evidence.

• Questioning.

• Demonstrating application of prior knowledge / skills.Registrant Awareness Study Day, October 2008.

What makes an Assessment What makes an Assessment fair?fair?

• Validity.• Reliability.• Feasibility.• Discriminating power.

An assessment is fair if the learners are given every opportunity to demonstrate their true potential and the mentor is provided with the chance of making an accurate judgment about that ability.


Barriers to FairnessBarriers to Fairness

• Learning environment.

• Prejudice / stereotypes / personalities.

• Lack of knowledge or support.

• Physical.

• Personal problems.

• Differing expectations between Mentors.

• Time.


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When to Assess?When to Assess?

• Assessment is not to be one moment in time.

• Assessment must be an ongoing process.

• Learning deficits must be identified as soon as possible and remedial action taken.

• Students must be given the opportunity to make good any deficits.

• Completed in normal working hours.


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Plan of Assessment InterviewsPlan of Assessment InterviewsThe Initial Interview: Week 1 (preferably on day 1)• Student induction.• Student self assessment.• Identify learning needs & learning opportunities.• Discuss / negotiate development plan.• Set a date for the mid-point interview.

The Mid-Point Interview: Half Way Through Assessment Process• Joint assessment of learning outcomes.• Discuss strengths and weaknesses.• Plan remedial action – development plan.• Confirm the date and time for the final interview and ensure that the Mentor

is available.

The Final Interview: Last Week of the Assessment Process• Assess overall performance against outcomes/proficiencies and

development plans.• Identify areas for further development.• Documentation countersigned by Mentor.Registrant Awareness Study Day, October 2008.

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Assessment DocumentationAssessment Documentation Includes some or all of the following:

• Practice Assessment Document.

• Clinical Skills Log.

• Essential Skills Clusters.

• OSCE.

• PDP / Action Plans.

• Learning Contracts.

• Ongoing Record of Achievement (Student Passport).


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Scenario 3 aScenario 3 a

At the final interview the student presents evidence of extra learning activities that they have undertaken, with your support, following the discussion at the mid-point interview.

However, despite this you still feel that the student has failed to achieve the required level of competence.


Scenario 3 b


As the student presents some good evidence and an improvement in the student’s ability to perform clinical skills has been observed, the final decision is that the student has passed but has areas for further development.


Scenario 3 c


You are aware that the student has asked for help and guidance and has worked very hard to participate as much as possible in performing clinical skills. She has also attended spoke placements and teaching sessions to enhance her knowledge and understanding.


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Legal and Professional Legal and Professional ResponsibilitiesResponsibilities

• As part of the teaching process you will delegate some aspects of patient / client care to your student. However you......

... Must establish that the person you delegate to is able to carry out your instructions, that they are supervised and supported and that you check that the delegated task reaches required standards.

(NMC 2008a)


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Failure to FailFailure to Fail(Duffy 2003)(Duffy 2003)

Findings:• Mentors do not always identify and deal with problems early enough

in students’ placements.• Weak students are often given the benefit of the doubt, and passed,

when there were clear doubts about competence and performance.

Recommendation:• If the Registrant (Associate Mentor) has any doubts about the

student’s proficiency they must involve the qualified Mentor, ward manager and academic staff at the earliest opportunity.

• The Registrant (Associate Mentor) must take their responsibilities seriously in order to protect the public.


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Failure to Achieve - ProcessFailure to Achieve - Process

• Timely, constructive feedback and documentation.

• Unit Leader / Personal or Academic Tutor.• AiP / DLT• Learning Contract / Development Plan drawn up

to facilitate retrieval.• Failure to meet Learning Contract / Development

Plan during the retrieval period would mean failure at the second attempt.


What Next?What Next?

• Work with a qualified Mentor.

• Complete your Key Objectives.

• Return your Key Objectives to the Practice Education Facilitator to be entered onto the Live Register of Mentors and Registrants (Associate Mentors).

• Receive certificate once registered.

• Attend an Annual Update.

• Gain Experience in the Role.

• Apply for the Preparation for Mentorship Module.62


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Reference ListReference List

• DH (2001): Placements in Focus: London: HMSO.• DH (2004): NHS Knowledge and Skills Framework:

London: HMSO.• Duffy, K (2003): Failing Students: A Qualitative Study:

London: NMC.• Fleming (2007): Teaching & Learning Styles: VARK

Strategies: New Zealand. • Honey, & Mumford (1982): Manual of Learning Styles:

Maidenhead: Peter Honey Publications Ltd.• NMC (2008a): The Code: London: NMC.• NMC (2008b): Standards to Support Learning and

Assessment in Practice: London: NMC.


1 welcome to the registrant awareness study day 2008-9 (previously known as the associate mentor...

Documents

associate mentor study

qualified mentor

support students

facilitation of students

students arrival

role of mentors

students of nursing

guide students