Quality Education for a Healthier Scotland
The mentor role in supporting and
assessing competency and
progression of students
Dr Kathleen Duffy
NHS Education for Scotland Nursing and Midwifery
Practice Educator
NHS Lanarkshire Practice Development Centre
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Quality Education for a Healthier Scotland
NMC Standards to Support Learning
and Assessment in Practice
• Stage 2 outcomes
• Domain 3 - accountability
and assessment
Quality Education for a Healthier Scotland
NMC Scholarship Report (Duffy 2003)
Quality Education for a Healthier Scotland
Recommendations
Mentorship preparation
Include the topic of:
• dealing with a failed clinical assessment
• dealing with practical aspects and emotional reactions
• the formal processes
Failure early in the programme preferable to
failure later in the programme
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Quality Education for a Healthier Scotland
Recommendations
Nurse Education Programmes
• Tripartite arrangements to support mentors in their
clinical assessment role
• Lecturers have a role in clinical assessment
• Debriefing with mentors after a failed assessment
• Passing on of information between placements
• Learning outcomes pertinent to professional behaviour and attitude be given prominence within clinical assessment documentation
• Cognisance be given to the time commitment
associated with a possible fail scenario
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Quality Education for a Healthier Scotland
Recommendations
Future research
• National survey to establish how many
students fail practice on clinical grounds
• Lecturer’s view of the tensions that exist
• Explore ‘borderline status’ in clinical
assessment
• Further review and debate regarding clinical
practice assessment tools
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Quality Education for a Healthier Scotland
Quality Education for a Healthier Scotland
‘Failing’ literature
• Gainsbury (2010)
• Mead et al (2011)
• Brown et al (2012)
• Heaslip and
Scammell (2012)
• Hunt et al (2012)
Key messages
10-40% mentors
reluctant or under
confident
Failure in theory
outstrips practice by
5:1
Quality Education for a Healthier Scotland
‘Failing’ literature
• Skingley et al (2007)
• Jervis and Tilki
(2011)
• Black et al (2013)
Key messages
• Explore beliefs,
expectations &
prejudices
• Help to deliver
difficult messages
• Emotional support
• Moral courage
Quality Education for a Healthier Scotland
International ‘Failing’ literature
•Luhanga et al (2007,
2008a, 2008b)
•Tanicala et al (2011)
•Larocque and
Luhanga (2013)
•DeBrew & Lewallen
(2014)
Quality Education for a Healthier Scotland
Literature from other disciplines
• Dudek et al (2005)
• Frellsen et al (2008)
• Cleland et al (2009)
• Finch (2009)
• Parker (2010)
• Basnett & Sheffield
(2010)
• Furness (2011)
• Finch & Taylor (2013)
• Malihi-Shoja et al
(2013)
• Poletti & Anka (2013)
• Rawles (2013)
• Schaub & Dalrymple
(2013)
• Eno & Kerr (2013)
Quality Education for a Healthier Scotland
Mentorship literature
Chandan and Watts (2012)
Quality Education for a Healthier Scotland
Recommendations Mentorship
preparation
2004
Include the topic of:
• dealing with a failed
clinical assessment
• dealing with practical
aspects and emotional
reactions
• the formal processes
2014
• Consider the selection of
mentors – choice?
• Explore the emotional
aspects of assessing
competence
• Introduce the concepts of
courage and resilience
• Coaching /Constructive
feedback skills
• Role modelling/ Escalating
concerns
• Challenging students
constructively
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Quality Education for a Healthier Scotland
Recommendations –Nursing
programmes and providers
2004
• Tripartite arrangements to
support mentors in their clinical assessment role
• Lecturers have a role in clinical assessment
• Debriefing with mentors after a failed assessment
• Passing on of information between placements
• Learning outcomes pertinent to professional behaviour and attitude be given prominence within clinical assessment documentation
• Cognisance be given to the time commitment associated with a possible fail scenario
2014
• Identify and support mentors who lack confidence to fail
• Tripartite arrangements to support mentors and supervising mentors in their assessment role
• Lecturer’s role in assessment/practice education infrastructure
• Debriefing with mentors after a failed assessment
• Cognisance be given to the time commitment associated with mentorship (workforce planning)
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Quality Education for a Healthier Scotland
Recommendations – Future Research
& Debate
2004
• National survey to establish how many students fail practice on clinical grounds
• Lecturer’s view of the tensions that exist
• Explore ‘borderline status’ in clinical assessment
• Further review and debate regarding clinical practice assessment tools
2014
• Practice Education
Facilitators’ views of the
tensions that exist
• Explore ‘borderline status’ in
practice based assessment
• Research regarding practice
assessment tools
• Student’s perspective of
failing
• Widespread debate and
discussion regarding the
challenges highlighted by
Robinson et al (2012)
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Quality Education for a Healthier Scotland
Your student…………… Our future
Quality Education for a Healthier Scotland
References
Arskey H, O’Malley L. (2005) Scoping Studies: Towards a Methodological Framework.
International Journal of Sociological Research Methodology 8, 19-32
Basnett, F. and Sheffield, D. (2010) The impact of social work student failure upon practice
educators. British Journal of Social Work, 40, 2119-2136
Black S, Curzio J, Terry L (2013) Failing a student nurse: A new horizon of moral courage.
Nursing Ethics (online). Available at
http://nej.sagepub.com/content/early/2013/08/28/09697330134955224
Brown L, Douglas V, Garrity J, Shepherd C K. (2012) What influences mentors to pass or
fail students? Nursing Management 19 (5), 16-21
Chandan M., Watts C. (2012) Mentoring and pre-registration nurse education. Available at:
http://www.williscommission.org.uk
Cleland, J.A. Knight, L.V. Rees, C. E. Tracey, S. and Bond, C.M. (2008) Is it me or is it
them? Factors that influence the passing of underperforming students. Medical
Education, 42, 8, 800-809.
Dudek, N.L. Marks, M.B. and Regehr, G. (2005) Failure to fail: The perspective of clinical
supervisors. Academic Medicine, 80, 10, 584-587 supplement.
Duffy, K. (2003) Failing students: a qualitative study of factors that influence the decisions
regarding assessment of students’ competence in practice. Glasgow: Glasgow
Caledonian University. Available from: http://www.nmc-
uk.org/Documents/Archived%20Publications/1Research%20papers/Kathleen_Duffy_Fai
ling_Students2003.pdf
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Quality Education for a Healthier Scotland
References
Duffy, K. (2006) Weighing the Balance: A grounded theory study of the factors that
influence the decisions regarding the assessment of students’ competence in practice.
PhD thesis, Glasgow: Glasgow Caledonian University. Access via
http://rcn.sirsidynix.net.uk/uhtbin/cgisirsi/?ps=VerQF9sVDq/LONDON/185360011/2/100
0
Eno S, Kerr J (2013) ‘That was awful! I’m not ready yet am I?’ Is there such a thing as a
good fail ? Journal of Practice Teaching and Learning. 11 (3), 135-148.
Frellsen SL, Baker EA, Papp KK, Durning SJ. (2008) Medical School policies regarding
struggling students during the internal medicine clerkships: Results of a national survey.
Academic Medicine. 83 (9), 877- 881.
Finch J, Taylor I. (2013) Failure to fail? Practice educator’s emotional experiences of
assessing failing social work students. Social Work Education; The International
Journal. 32 (2) 244-258.
Furness, S. (2011) Gender at work: characteristics of ‘failing’ social work students. British
Journal of Social Work Advanced access published June 7, 1-20.
Gainsbury S (2010) Nurse mentors still ‘Failing to fail’ students. Available from
http://tiny.cc/busbhw
Heaslip V, Scammell J M E. (2012) Failing underperforming students: The role of grading in
practice assessment Nurse Education in Practice. 12 (2) 95-100.
Hunt L A, McGee P, Gutteridge R, Hughes M. (2012) Assessment of student nurses in
practice: A comparison of theoretical and practical assessment results in England.
Nurse Education Today. 32, 351-355. 18
Quality Education for a Healthier Scotland
References
Jervis A, Tilki M. (2011) Why are nurse mentors failing to fail student nurses who do not
meet clinical performance standards? British Journal of Nursing. 20 (9), 582-7
Larocque S, Luhanga FL (2013) Exploring the issue of failing to fail in a nursing program.
International Journal of Nursing Education Scholarship. 10 1 1-8
Luhanga F. Yonge O. and Myrick F. (2007) Precepting the unsafe student: the role of
faculty. Nurse Education Today 28, 227-231.
Luhanga F. Yonge O. and Myrick F. (2008) Failure to assign failing grades: Issues with
grading the unsafe student. International Journal of Nursing Education Scholarship, 5,
1, 1-14.
Luhanga F. Yonge O. and Myrick F. (2008) Strategies for precepting the unsafe student.
Journal for Nurses in Staff Development. 24 (5), 214-219.
Malihi-Shoja L, Catherall D, Titherington J, Mallen E, Hough G & the Comensus Writing
Collective (2013) ‘Ween’t all winners: A discussion piece on ‘failure to fail’ from a
service user and carer perspective. Journal of Practice Teaching and Learning. 11 (3),
8-16.
Mead D, Hopkins A, Wilson C. (2011) Views of nurse mentors about their role, Nursing
Management, 18 (6), 18-23
NHS Education for Scotland (2013) National Approach to Mentor Preparation for Nurses
and Midwives. Core Curriculum Framework (Second Edition) incorporating guidance for
identification and selection of mentors, supervising mentor role and continuing
professional development of mentors. Edinburgh. NHS Education for Scotland.
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Quality Education for a Healthier Scotland
References
Nursing & Midwifery Council. (2008)Standards to Support Learning and Assessment in Practice. 2nd ed. NMC, London.
Parker J (2010) When things go wrong! Placement disruption and termination: power and student perspectives. British Journal of Social Work. 40, 983-999.
Polettii A & Anka A (2013) ‘They thought I wasn’t good enough for social work’- the views of students who failed their practice learning opportunities. Journal of Practice Teaching and Learning. 11 (3), 17-35.
Rawles J (2013) Whose students are they anyway? Could a difference in how practice organisations and higher education institutions perceive social work students be a barrier to collaboration when problems arise in placement? Journal of Practice Teaching and Learning. 11 (3), 59-78.
Robinson S, Cornish J, Driscoll C, Knutton S, Corben V, Stevenson T (2012) Sustaining and managing the delivery of student nurse mentorship: roles, resources, standards and debates. National Nursing Research Unit Kings College, London.
Schaub J, Dalrymple R (2013) Surveillance and silence: New considerations in assessing difficult social work placements. Journal of Practice Teaching and Learning. 11 (3), 79-97.
Skingley A, Arnott J, Greaves J, Nabb J (2007) Supporting practice teachers to identify failing students. British Journal of Community Nursing 12 (1), 28-32
Tanicala ML, Scheffer BK, Roberts MS (2011) Defining pass/fail nursing student clinical behaviours phase 1: moving towards a culture of safety. Nursing Education Perspectives. 32 (3), 155-161.
Veeramah V. (2012) Effectiveness of the new NMC mentor preparation course. British Journal of Nursing. 21 (7), 413-417.
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