facilitating learning in practice - open university · facilitating learning in practice is a free...

Facilitating learning in practice

About this free course

This free course is based on Level 2 study in Nursing and Healthcare Practicehttp://www.open.ac.uk/courses/find/nursing-and-healthcare-practice

This version of the content may include video, images and interactive content that may not be optimisedfor your device.

You can experience this free course as it was originally designed on OpenLearn, the home of freelearning from The Open University –www.open.edu/openlearn/health-sports-psychology/facilitating-learning-practice/content-section-over-view

There you’ll also be able to gain a Statement of Participation and a digital badge when you complete thecourse, which you can use to demonstrate your learning.

Copyright © 2016 The Open University

Intellectual property

Unless otherwise stated, this resource is released under the terms of the Creative Commons Licencev4.0 http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en_GB. Within that The Open Universityinterprets this licence in the following way:www.open.edu/openlearn/about-openlearn/frequently-asked-questions-on-openlearn. Copyright andrights falling outside the terms of the Creative Commons Licence are retained or controlled by The OpenUniversity. Please read the full text before using any of the content.

We believe the primary barrier to accessing high-quality educational experiences is cost, which is whywe aim to publish as much free content as possible under an open licence. If it proves difficult to releasecontent under our preferred Creative Commons licence (e.g. because we can’t afford or gain theclearances or find suitable alternatives), we will still release the materials for free under a personal end-user licence.

This is because the learning experience will always be the same high quality offering and that shouldalways be seen as positive – even if at times the licensing is different to Creative Commons.

When using the content you must attribute us (The Open University) (the OU) and any identified author inaccordance with the terms of the Creative Commons Licence.

The Acknowledgements section is used to list, amongst other things, third party (Proprietary), licensedcontent which is not subject to Creative Commons licensing. Proprietary content must be used (retained)intact and in context to the content at all times.

The Acknowledgements section is also used to bring to your attention any other Special Restrictionswhich may apply to the content. For example there may be times when the Creative Commons Non-Commercial Sharealike licence does not apply to any of the content even if owned by us (The OpenUniversity). In these instances, unless stated otherwise, the content may be used for personal and non-commercial use.

We have also identified as Proprietary other material included in the content which is not subject toCreative Commons Licence. These are OU logos, trading names and may extend to certainphotographic and video images and sound recordings and any other material as may be brought to yourattention.

Unauthorised use of any of the content may constitute a breach of the terms and conditions and/orintellectual property laws.

We reserve the right to alter, amend or bring to an end any terms and conditions provided here withoutnotice.

All rights falling outside the terms of the Creative Commons licence are retained or controlled by TheOpen University.

Head of Intellectual Property, The Open University

2 of 137 http://www.open.edu/openlearn/health-sports-psychology/facilitating-learning-practice/content-section-overview?LKCAMPAIGN=ebook_MEDIA=ol Thursday 25 February 2016

http://www.open.ac.uk/courses/find/nursing-and-healthcare-practice?LKCAMPAIGN=ebook_&MEDIA=ou

http://www.open.edu/openlearn/health-sports-psychology/facilitating-learning-practice/content-section-overview?LKCAMPAIGN=ebook_&MEDIA=ol


http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en_GB

http://www.open.edu/openlearn/about-openlearn/frequently-asked-questions-on-openlearn


ContentsIntroduction 5Learning outcomes 6NMC-approved mentorship programme 7Week 1 8

1 What is mentorship? 102 Defining the regulator’s position on mentoring 19Quiz - Week 1 25Week 1 Summary 25

Week 2 251 Learning theories 272 Adult learning 353 Learning styles 374 Communities of practice 39Quiz - Week 2 40Week 2 Summary 40

Week 3 411 Learning development 422 Learning trajectories 433 Skills acquisition 454 Bloom’s Taxonomy 51Quiz - Week 3 57Week 3 Summary 57

Week 4 571 Establishing effective mentoring relationships 582 Open communication 633 The mentoring relationship and motivation 674 Potential conflict in mentoring relationships 685 The importance of your relationships with others 71Quiz - Week 4 73Week 4 Summary 73

Week 5 731 Themes of nursing mentoring 742 Perceptions and expectations 753 Establishing a supportive learning environment 774 Interventions to support learning in practice 795 Empowering professionalism within the learning environment 83Quiz - Week 5 85Week 5 Summary 86

Week 6 861 What is assessment? 872 Types of assessment 88



3 Evidence to inform assessment 904 Developing effective questioning 935 Documentation 956 Feedback 97Quiz - Week 6 100Week 6 Summary 100

Week 7 1011 The underperforming student 1032 Feedback 1043 Failing the student 1064 Support for mentors 1095 Regulatory requirements for mentors keeping records 111Quiz - Week 7 112Week 7 Summary 112

Week 8 1121 Prioritising competing demands 1142 Evaluating practice learning 1163 Peer review 1184 Maintaining contemporary practice 1205 Your next steps 123Quiz - Week 8 124Week 8 Summary 125

Keep on learning 125References 126Further reading 133Acknowledgements 134



IntroductionAre you interested in mentorship or looking to develop your mentorship skills? Inparticular, are you involved in nurse mentorship? If so, then this free 8-week course isfor you.The course explores the principles and best practices underpinning mentorship. Theauthors draw on their experience in nursing to help you develop your knowledge,understanding and skills of mentorship practice that can be applied to many workplaceenvironments.For practising nurses, this course also contributes towards The Open University's Nursingand Midwifery Council (NMC) approved Mentorship programme, which you can registerfor online at The Open University website.Facilitating learning in practice is a free course which lasts about 8 weeks, withapproximately 3 hours' study time each week. You can work through the course at yourown pace, so if you have more time one week there is no problem with pushing on tocomplete another week's study. You can also take as long as you want to complete it.

This material is based on an Open University badged course. You can access and enrol onthe full course on OpenLearn.

Badges are not accredited by The Open University but they're a great way to demonstrateyour interest in the subject and commitment to your career, and to provide evidence ofcontinuing professional development.

Introduction


http://www.open.ac.uk/courses/short-courses/kg006#registration



Learning outcomesAfter studying this course, you should be able to:

l identify relevant strategies to help apply tools and techniques of mentorship in practice

l review the workplace environment to identify opportunities and recognise constraints that may influence theprovision of effective mentorship

l develop a reflective approach, which can be utilised in the workplace through the identification of learning needsand development of a personal development plan

l reflect on how to use this course to become an effective mentor.

NMC-approved mentorship programmeAlthough mentorship is a universal concept that is applied to support the growth anddevelopment of others, the authors of this course are all from nursing backgrounds. Theyhave drawn from their own experiences and insight in health care practice to illustrate andencourage learning through the activities that you will explore. If you are from a non-nursing background, the content remains relevant, but you will need to consider examplesthat draw out learning relevant to your own expertise.Some of the content of this course focuses on the NMC standards for mentorship. Thiscould constrain learning to UK practices, as the NMC standards only apply to the fournations of the UK and not further afield. However, by applying the standards we haveprovided a simple framework for exploring mentorship. In reality, you could insert anyother professional framework that defines expectations on mentorship. Use this learningopportunity to think broadly and creatively – after all, you will be seeking to effectivelysupport and guide others.

Mentorship programmeThroughout this course you will find mentorship programme boxes. These have beendesigned for inclusion specifically for learners who are accessing and studying this courseas part of The Open University’s NMC mentorship preparation programme, KG006Facilitating learning in practice: mentorship portfolio assessment. If you are notparticipating in this mentorship programme you do not need to read these boxes.

If you are, please read on …If you are participating in the NMC mentorship programme, you should have alreadyregistered, or be preparing to register, on KG006 Facilitating learning in practice:mentorship portfolio assessment. KG006 requires you to build a body of evidencewithin a portfolio to demonstrate that you have achieved mentoring competencies. Youare advised to consider using the learning activities included in these studies in yourportfolio as sources of evidence to demonstrate achievement against NMC-requiredmentor competencies (see your portfolio).A number of activities suggest that you develop an action plan as part of your personaldevelopment. If you go to the resource website for KG006 you will find under the tab‘Resources and forums’ a template of an action plan that you can download and use asyou develop your range of mentorship skills. Try to keep your action plan live anddynamic so that it becomes a tool that enables you to identify your development needs.Negotiate support and guidance with others and use the action plan regularly so thatyou can monitor your progress as you develop your mentoring skills.From the forum on the KG006 website you will have access to guidance and supportwhere you will be able to query issues relating to mentorship practices, obtain furtherinformation and references that are helpful to mentorship development, and findinformation as to how you might escalate concerns related to any poor practice you seeas a learner. These are all part of your professional responsibilities as a registerednurse.

NMC-approved mentorship programme



Week 1Welcome to Week 1 of this free course, Facilitating learning in practice. This week you willstart to examine the key themes of mentoring. A great deal of a nurse’s time is spentsupporting, guiding and assessing others. The Nursing and Midwifery Council (NMC), theprofessional regulator for nursing and midwifery, made explicit in The Code: ProfessionalStandards of Practice and Behaviour for Nurses and Midwives (NMC, 2015, pp. 8–15)that there is an onus on practitioners acting as mentors to:

l share your skills, knowledge and experience for the benefit of people receiving careand your colleagues by providing honest, accurate and constructive feedback tocolleagues, and to support students’ and colleagues’ learning to help them developtheir professional competence and confidence

l be accountable for decisions to delegate tasks and duties to other people byensuring that only tasks and duties are delegated that are within the other person’sscope of competence

l uphold the reputation of the profession (nursing and midwifery) at all times by actingas a role model of professional behaviour for students and newly qualified nursesand midwives to aspire to.

Whether driven by professional codes or being aware of how you can use your experienceto benefit others, mentorship is something that you cannot avoid. You may be studyingthis OpenLearn course alongside the Open University course KG006 Facilitating learningin practice: mentorship portfolio assessment, with the intention of using the activities youcomplete as part of your study as evidence towards increased knowledge and skilldevelopment to apply for entry onto a local mentor register. Once on such a register, youwill then be able to independently support and assess pre-registration nursing students.This course was written with such learners in mind, with many examples being verynursing-focused. However, mentorship has global interest, so you might also beinterested in this if you are acting in a mentor role already and are seeking to update yourskills, or you might have a very genuine interest to know what learning is needed beforenurses step into mentorship roles. If you fit either of these two categories, please use thelearning as you consider appropriate.Watch this video that Fiona Dobson, one of the course authors, has recorded as anintroduction to this week’s study:

Video content is not available in this format.Week 1 Introduction

Week 1



The NMC currently use a set of Standards to define mentorship, identify their reach ofpractice and determine the competencies that mentors working in nursing need to attain.This is an important document for any nurse and we recommend that you go tothe NMC website, where you can access a PDF document to download and print for yourongoing reference.Throughout this course you will find mentorship programme boxes like the one below.These have been designed for inclusion specifically for learners who are accessing andstudying this course as part of The Open University’s NMC mentorship preparationprogramme, KG006 Facilitating learning in practice: mentorship portfolio assessment. Ifyou are studying KG006, the following box indicates how this week’s content links to theNMC standards to support learning and assessment in practice (2008). If you are notstudying KG006 you do not need to read the box; however, you will still find it useful todownload the PDF.

Mentorship programmeIf you are completing this course as part of an NMC mentorship preparation programme,the materials and activities in this week’s study relate to all NMC domains, i.e.:

l Establishing effective working relationships

l Facilitation of learning

l Assessment and accountability

l Evaluation of learning

l Creating an environment for learning

l Context of practice

l Evidence-based practice

l Leadership.

Week 1


http://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-to-support-learning-assessment.pdf


As you heard in the video, this week’s study will examine broadly the concept ofmentorship and particularly consider how this is described by the NMC.After this week, you should be able to:

l reflect on the mentor’s role and consider how a mentor can aid or hinder learning andsupport in practice

l consider your experience of mentorship and critically analyse what you can bring tothe role

l start to develop build an action plan around strategies you will develop or adopt tohelp you become an effective mentor.

Before you start, The Open University would really appreciate a few minutes of your timeto tell us about yourself and your expectations of the course. Your input will help to furtherimprove the online learning experience. If you’d like to help, and if you haven't done soalready, please fill in this optional survey.

1 What is mentorship?

Figure 1 Mentorship

The NMC standards state that assessment and evaluation of learning are core outcomesfor a practitioner to determine if working in the role of mentor. This is often not the case formentorship in other settings, where it centres on supporting and guiding learning ratherthan making judgements.Eric Parsloe, of The Oxford School of Coaching and Mentoring, provides a usefuldefinition of mentorship in which mentoring is seen to:

Week 1


https://www.surveymonkey.com/r/FLP_Start


support and encourage people to manage their own learning in order that theymay maximise their potential, develop their skills, improve their performanceand become the person they want to be.(Eric Parsloe, The Oxford School of Coaching & Mentoring)

This quote appears in a short but informed paper by MentorSET that presents mentoringas a powerful tool for personal development and empowerment, and as an effective wayof helping people to progress in their careers. The authors suggest that mentorship is apartnership between two people (the mentor and the learner) who normally work in orshare similar experiences, so the mentor can help the learner to problem solve in anempathetic manner – understanding the context of the challenge. The mentor relationshipis also seen as one based on mutual trust and respect. These are going to be themes thatyou will visit throughout this course, but particularly in Week 4, where you will examinediffering aspects of the mentoring relationship in some depth. If mentoring works well, theMentorSET paper speculates that effective mentoring enables the learner to developconfidence to explore new ideas or experiences.

Activity 1 The mentoring roleAllow 30 minutes

The following video was developed by Jane Stubberfield (University of Plymouth) in2010 as part of the ‘Learning from WOeRK’ project that designed open educationalresources to support professional development in the workplace. The video is titled‘What is mentoring?’ and provides a lot of information concerning the broad nature ofthe mentor role – specifically how the role relates to coaching, training and advising.

Video content is not available in this format.What is mentoring?

Week 1


http://www.mentorset.org.uk/what-is-mentoring.html


Watch the video and make notes on what it says about the mentor role in a notebook.Once you have had the opportunity to listen to this video carefully, construct your owndefinition of what you see as the defining roles of a mentor. Think about your ownexperience of being mentored. How does your definition compare to your experienceof being mentored?

DiscussionHopefully you will see a relatively good match between what is being proposed in thevideo against your own experiences of being mentored. As stated above, the videodoes not make the role of assessor explicit – but across other functions, there wasprobably a good synergy.The distinctions that were drawn between mentoring, coaching, training and advisingwere also interesting. Did you notice, for example, that Stubberfield viewed theconcept of mentoring more broadly than these other concepts and suggested thatmentoring bought together many differing ways of supporting others and helping themlearn?

Next you will hear from Ann Marie McKeegans, an alumnus of the OU pre-registrationnursing programme who has recently taken steps to becoming an NMC-recognisedmentor herself.

Week 1



1.1 Expectations of a mentor

Figure 2 What are your expectations?

In the following video, student mentor Ann Marie describes what expectations she had ofa mentor when she commenced the pre-registration nursing programme. She also sharesher experiences of being mentored and what she feels that she will bring to her futurementoring practice.

Video content is not available in this format.Ann Marie

Week 1



From this video you are able to see what Ann Marie looked for in mentors and what impactthese practitioners had on her personal and professional development. Ann Marie wasalso able to reflect on how these experiences have impacted on her new role as adeveloping mentor.It is impossible to ensure with certainty that students and mentors enter the mentoringrelationship and are always able to establish positive working relationships. This themewill be addressed in Week 4, when you will explore conflict, and in Week 7, when you willlook at the thorny issue of managing the ‘failing’ student. What is the impact on learningwhen relationships go astray?It is also worth noting at this time that it is highly probable that both mentors and studentsenter into a mentor relationship with preconceived expectations. This will in part beexamined in Week 4, but you might wish to consider how this might impact on yourdeveloping mentor role and why it is essential that you are aware and own these featuresso that you are able to guide and support the student to achieve their optimalperformance.

Activity 2 ‘Toxic’ mentoringAllow 30 minutes

Watch the following video, which was designed by the University of Hertfordshire:

Video content is not available in this format.University of Hertfordshire

Week 1



Although designed around a trainee teacher’s experience, the six ‘should not’behaviours identified in the video can easily be transferred to nursing. Consider eachbehaviour and answer the following questions:

1 Reflect on whether you have experienced or observed each ‘toxic’ behaviour inpractice.

2 Consider the impact that this behaviour had on learners and on the process oflearning.

3 Consider the actions that you can take to direct you away from these identifiednegative behaviours to enable more successful interaction with students.

DiscussionThree initial observations of the mentor are that he:

l was completely uninterested in the mentor or the mentoring relationship

l continually failed to listen

l lacked any focus on the learner or aspects of possible learning.

The six ‘should not’ behaviours identified were:

l don’t make the person feel unwelcome

l don’t overload the learner with mountains of information

l don’t fail to make time of the learner

l don’t cancel mentoring sessions as they are important

l don’t fail to listen

l don’t discourage – always try to give balanced feedback.

All these behaviours seemed to have significant and detrimental impacts on thestudent’s ability and opportunities for learning. You only need to consider the changesin the trainee teacher’s non-verbal patterns to realise the effect that her mentor had onher personally. As you develop your mentoring skills, these behaviours should be

Week 1



avoided; instead, you should look to adopt practices that where learning is optimisedrather than affected negatively. Tied into this is the need to recognise andaccommodate differences – whether those differences are associated with personalitytraits or cultural manifestations.As a developing mentor you need to get under the surface and recognise, for example,that an overtly enthusiastic person may not necessarily always be a good student; youshould rely on a number of observations to inform your judgement on a student’scompetence and confidence.

Mentorship programmeIf you are studying this learning as part of an NMC mentorship preparation programme,develop this activity further to consider Question 3 in greater detail. In theIntroduction and guidance section of the course you were directed to an action plan thatcould be downloaded from the resources website for KG006 Facilitating learning inpractice: mentorship portfolio assessment. Download this action plan and identify at leastfive actions that you can take to improve the success of your mentoring practices. This isespecially important given that you will be supporting students in environments that areoften very busy and where you may feel under pressure.

Why don’t you talk your thoughts through with your supervisor, who will be guiding yourpractice and determining your competence to take on the role of mentor, and use thisreflection and discussion time as part of your record of ‘protected study’? Remember thatyou should aim to keep your action plan dynamic – that is, you constantly add or amend itas your competence increases. It is likely that the action plan could contribute to essentialpieces of evidence that you use to demonstrate achievement of competencies in yourportfolio.

1.2 Avoiding unhelpful mentoringDavid Clutterbuck (n.d.) provides a light-hearted perspective on what he sees as twelvehabits of the toxic mentor:

1 Start from the point of view that you – from your vast experience and broaderperspective – know better than the mentee what's in his or her interest.

2 Be determined to share your wisdom with them, whether they want it or not – remindthem frequently how much they still have to learn.

3 Decide what you and the mentee will talk about and when; change dates and themesfrequently to prevent complacency sneaking in.

4 Do most of the talking; check frequently that they are paying attention.5 Make sure they understand how trivial their concerns are compared to the weighty

issues you have to deal with.6 Remind the mentee how fortunate s/he is to have your undivided attention.7 Neither show nor admit any personal weaknesses; expect to be their role model in all

aspects of career development and personal values.8 Never ask them what they should expect of you – how would they know anyway?9 Demonstrate how important and well connected you are by sharing confidential

information they don't need (or want) to know.

Week 1


http://www.open.edu/openlearn/ocw/mod/oucontent/view.php?id=20026


10 Discourage any signs of levity or humour – this is a serious business and should betreated as such.

11 Take them to task when they don't follow your advice.12 Never, never admit that this could be a learning experience for you, too.

Again, it is not difficult to see how these toxic behaviours accurately capture many of thebehaviours displayed in the trainee teacher video in Activity 2; nor is it difficult to findresources in literature that consider further this concept of ‘toxic mentoring’. This is not anew concept. Darling (1986) published extensively in the mid-1980s on the subject ofmentoring and toxic mentoring. She identified four behaviours that continue to beunhelpful in the mentoring relationship. These are shown in Table 1.

Table 1 Darling’s toxic mentor behavioursType Characteristics

Avoiders The elusive mentor who is never available to the learner to set and review theirpractice and goals or to provide support, challenge and role modelling.

Blockers The mentor who blocks the learner’s development by preventing them fromaccessing learning by either over-supervising or withholding knowledge orinformation.

Destroyers The mentor uses challenges and tactics such as humiliation that set out to destroythe learner’s self-confidence.

Dumpers This type of mentor believes in ‘sink or swim’, and will often deliberately leave thelearner in situations where they are out of their depth.

You may be thinking or saying to yourself that ‘this will not be me’. Indeed, you areprobably undertaking this course because you have a genuine desire to support thedevelopment of others. However, health care practice is messy and increasingly,practitioners feel under pressure. In a recent short documentary on the health of the NHSthat focused on Accident and Emergency provision, the reporter interviewed a number ofstaff who spoke about the facility being at breaking point. In addition, it was particularlydisconcerting to hear one nurse say that it was not uncommon now to think of simplypacking up and going home in the middle of shifts because of pressure in the workplace tomeet increasingly difficult targets with limited resources. This registrant spoke of workpressure, a general lack of staffing and unrealistic expectations all affecting practitioners.You may be working within similar constraints as a mentor. How can you avoid slippinginto poor supporting practices such as those in the video or humorously shared byClutterbuck, and those that have been known for years from the work of Darling in the1980s? You might wish to think about this and determine your strategies for ensuring thatyou retain consistent and offer effective and good mentoring practice. After studyingFacilitating learning in practice you will have the opportunity to pick up on this thread toexamine best practice and develop strategies that help you mentor with confidence inenvironments that often add complexity to the learning experience.

1.3 Mentors’ qualities and skillsYou will also examine the qualities and skills of a mentor over coming weeks and considerwhat you bring to the mentoring role. The following activity provides a taster of what is tocome and again draws on the work that Jane Stubberfield developed in 2011 as part ofthe ‘Learning from WOeRK’ project at the University of Plymouth.

Week 1



Activity 3 Qualities and skills of a mentorAllow 30 minutes

Watch the following video, which discusses the qualities and skills that mentors needto be effective in their role.

Video content is not available in this format.Qualities and skills

Note down any areas of interest that you think are worthy of further reading andreflection that might help you develop your mentorship competency.At the end of the video, the audience is invited to respond to a question: ‘If you wantedto recruit a mentor, what eight qualities and skills would be most important to youand why?’Consider what your response to this question would be and then compare this with thequalities and skills that you think you can offer as a mentor. If you are working inpractice and are able to, you might wish to test out your self-awareness of what youbring to a mentor role with a critical friend. If you find there are areas for development,please add these to your mentoring action plan as necessary.

DiscussionHopefully you enjoyed this video as much as I did – I particularly appreciated itsstructure as a mini-teaching session and how it drew from relevant sources ofinformation to inform its content. At just eight minutes long; it held my interest andfocus. Kay and Hind’s (2009) work, A Practical Guide to Mentoring, informed mythinking on the qualities and skills that I would look for if recruiting a mentor. I wasinterested to see less attention given to specialist knowledge and experiencecompared to personal skills, such as being a motivator and qualities like being able toopen doors for the learner. I think the challenge for me in focusing down to eightqualities or skills was in determining what I could actually leave out. How did yourespond? Were you able to further develop your mentoring action plan?

Week 1



So far you have taken a ‘broad brush’ approach to mentorship, looking briefly at what amentor does and then at how mentorship is played out – hopefully to improve the learningof others but, in the case of toxic mentoring, the impact of negative role modelling onlearning. Although you may be reflecting on your learning to date and saying ‘not me’ tothe negative behaviour, in reality workplace pressure is something that you will feel orexperience at some time. By highlighting these issues you have the opportunity toconsider strategies for self-management of best practices.You are now going to focus on the framework that the NMC uses to define its standardsfor mentorship. This has been used because we (the authoring team) anticipate that manyof the learners working with this material will be using it as part of an NMC mentorshippreparation programme. The material is only a framework, however, and the specificscould easily be amended for other professional disciplines that define its mentoringstandards.

2 Defining the regulator’s position on mentoringFor the remainder of study this week, you will find it really helpful to have a copy of theNMC’s Standards to Support Learning and Assessment in Practice (2008) to work with.Information and activities will refer you to specific sections of this document as youexamine what professional regulation require from nurses who practise as mentors. If youhaven’t already, we recommend that you go to the NMC website where you can accessthis PDF document to download and print for your ongoing reference.The NMC makes clear that nurses taking on the role of mentor are responsible andaccountable for the following (in Section 2.1 of Standards to Support Learning andAssessment in Practice):

l organising and coordinating student learning activities in practice

l supervising students in learning situations and providing them withconstructive feedback on their achievements

l setting and monitoring achievement of realistic learning objectives

l assessing total performance – including skills, attitudes and behaviours

l providing evidence as required by programme providers of studentachievement or lack of achievement

l liaising with others (such as mentors, sign-off mentors, practice facilitators,practice teachers, personal tutors, programme leaders) to provide feed-back, identify any concerns about the student’s performance and agreeaction as appropriate

l providing evidence for, or acting as sign-off mentors with regard to makingdecisions about achievement of proficiency at the end of a programme.(Please note that this final aspect is for a sign-off mentor only.)

(NMC, 2008)

The responsibilities expected by the profession are significant and extend well beyond the‘critical friend’ concept often seen with mentors in other fields of practice. The NMCexpects mentors to fulfil complex roles that include the ability to organise, coordinate,supervise, monitor and assess the learning of others and, in addition, communicate andliaise as needed to ensure that the best support can be offered to all learners. This is a

Week 1




role that requires practitioners to engage in continuing professional development postqualification and demonstrate competence across a range of mentor outcomes prior tosupporting learners independently.

2.1 The developmental frameworkThe NMC regards mentoring as part of a developmental framework that extends fromregistration as a nurse or midwife and extends to encompass senior practitionerspractising in teacher roles (Figure 3). At each stage there is an increasingly complex set ofcompetency outcomes that require demonstration. Mentoring is positioned at stage 2 inthis developmental framework. Over time there is no reason why nurses should not beable to develop increased competence and pursue roles as practice teachers andteachers if the entry requirements determined by the NMC can be met.

Figure 3 NMC developmental framework

To set the mentor role in context, the NMC define five principles that underpin thepractices of each stage. These are labelled in Figure 3 as A to E and are explained inTable 2.

Table 2 NMC principles for supporting learning andassessmentPrinciple NMC advice and guidance relating to

A Due regard

B Continuing professional development

C Level of qualification necessary to support learners

Week 1



D Preparation for role and demonstration of achievement of outcomes

E For teacher – Stage 4 only

Mentorship programmeIf you are undertaking this study as part of an NMC mentor preparation programme, you willfind further information on each of these principles in Section 1.3 (‘Advice and guidance forapplying the underpinning principles’) of Standards to Support Learning and Assessment inPractice (NMC, 2008).

The NMC defines eight domains for supporting learning and assessment (Table 3).

Table 3 NMC domains for supportinglearning and assessmentDomain Category or focus of the domain

1 Establishing effective workingrelationships

2 Facilitation of learning

3 Assessment and accountability

4 Evaluation of learning

5 Creating an environment for learning

6 Context of practice

7 Evidence-based practice

8 Leadership

Mentorship programmeIf you are studying this as part of an NMC mentorship preparation programme, you need toknow that these eight domains form the overarching competencies that you will need todemonstrate by providing suitable evidence in your portfolio for KG006 Facilitating learningin practice: mentorship portfolio assessment. If you have registered for KG006, it might behelpful at this point to open your portfolio to the section on ‘Records of achievement’ to geta feel for these domains (you might find it easier to consider domains as ‘categories’) andtheir related competencies.

Demonstrating your competenceThe following activity is an opportunity to start to think about how to demonstrate to othersyour competence in all the outcomes and competencies required of the mentoring role.

Week 1



Activity 4 Competence and outcomes of a mentorAllow 30 minutes

Table 4 contains published information located in Section 2.1.2 of the NMC (2008)document Standards to Support Learning and Assessment in Practice, entitled‘Competence and outcomes for a mentor’.In this table you will find the eight domains and related outcomes and competenciesdefined by the NMC that practitioners need to demonstrate if they are seeking to takeon the mentoring of pre-registration nursing students.

Table 4 Competence and outcomes for a mentor (NMC, 2008)Domains Competence and outcomes required of a mentor

Establishing effectiveworking relationships

l Demonstrate an understanding of factors thatinfluence how students integrate into practice set-tings.

l Provide ongoing and constructive support to facil-itate transition from one learning environment toanother.

l Have effective professional and interprofessionalworking relationships to support learning for entry tothe register.

Facilitation of learningl Use knowledge of the student’s stage of learning to

select appropriate learning opportunities to meetindividual needs.

l Facilitate the selection of appropriate learningstrategies to integrate learning from practice andacademic experiences.

l Support students in critically reflecting upon theirlearning experiences in order to enhance futurelearning.

Week 1



Assessment andaccountability

l Foster professional growth, personal developmentand accountability through support of students inpractice.

l Demonstrate a breadth of understanding of as-sessment strategies and the ability to contribute tothe total assessment process as part of the teachingteam.

l Provide constructive feedback to students and assistthem in identifying future learning needs andactions.Manage failing students so that they mayenhance their performance and capabilities for safeand effective practice, or be able to understand theirfailure and the implications of this for their future.

l Be accountable for confirming that students havemet, or not met, the NMC competencies in practice.As a sign-off mentor, confirm that students havemet, or not met, the NMC standards of proficiency inpractice and are capable of safe and effectivepractice.

Evaluation of learningl Contribute to the evaluation of student learning and

assessment experiences – proposing aspects forchange resulting from such evaluation.

l Participate in self- and peer evaluation to facilitatepersonal development and contribute to the devel-opment of others.

Creating an environment forlearning

l Support students to identify both learning needs andexperiences that are appropriate to their level oflearning.

l Use a range of learning experiences, involvingpatients, clients, carers and the professional team,to meet defined learning needs.

l Identify aspects of the learning environment thatcould be enhanced, negotiating with others to makeappropriate changes.

l Act as a resource to facilitate personal and profes-sional development of others.

Context of practicel Contribute to the development of an environment in

which effective practice is fostered, implemented,evaluated and disseminated.

l Set and maintain professional boundaries that aresufficiently flexible for providing interprofessionalcare.

l Initiate and respond to practice developments toensure that safe and effective care is achieved, andan effective learning environment is maintained.

Week 1



Evidence-based practicel Identify and apply research and evidence-based

practice to their area of practice.

l Contribute to strategies to increase or review theevidence base used to support practice.

l Support students in applying an evidence base totheir own practice.

Leadershipl Plan a series of learning experiences that will meet

students’ defined learning needs.

l Be an advocate for students, supporting them inaccessing learning opportunities that meet theirindividual needs – involving a range of otherprofessionals, patients, clients and carers.

l Prioritise work to accommodate support of studentswithin their practice roles.

l Provide feedback about the effectiveness of learningand assessment in practice.

Select one domain (for example ‘Creating an environment for learning’) that has fourassociated outcomes/competencies. Next, consider what evidence you could provide– such as certificated learning, summary accounts of service-user interventions,testimonies, presentations, project work, observation or other sources – that allowsyou to demonstrate competence in each.Make notes of your suggestions, remembering that any outcome/competence mayrequire more than one source of evidence. Additionally, capture the rationale for whyyou are making these choices.

DiscussionFor the purpose of this week’s study, this activity is time-limited. At this stage you haveonly considered one of eight domains and the evidence sources selected would beunique to you given your practice, your probable interdisciplinary ethos, and thestudents and service users you interact with that provide unique opportunities forlearning.

Mentorship programmeIf you are using this study as part of an NMC mentorship preparation programme and haveregistered on to KG006 Facilitating learning in practice: mentorship portfolio assessment,you will need to consider not one, but all eight domains. Here are a few suggestions toconsider that might help you to determine and manage your sources of learning andevidence:

l Remember that some sources of evidence could be used against more than oneoutcome/competency. This is especially true if you are reflecting on and writing upinterventions with service users in the form of a critical incident technique, forexample.

l Remember that it is sometimes necessary to use more than one evidence sourceto confirm your competence.

Week 1



l Keep your evidence current and get yourself into the habit of regularly reviewingwhat you have learnt and participated in that could be used as evidence sources.

As you consider each domain – and this will be a necessary activity as you consider yourKG006 portfolio – remember to negotiate protected learning time for this practice-focusedactivity.

Well done! You have completed the last of the activities in this week’s study before theweekly quiz.

Quiz - Week 1Complete the Week 1 quiz to assess your learning. By working your way through thequestions, you have made a great start in developing your knowledge and understandingof learning theories, identifying your learning styles, promoting collaboration, andchallenging professional practice.

Week 1 practice quiz.

To view this content please access the complete course on OpenLearn.

Week 1 SummaryIn this first week of study for Facilitating learning in practice you have had the opportunityto broadly consider the mentoring role along with the qualities and values that enhance orcan hinder the mentor efficiency. These are themes that will be revisited throughout thecourse as we develop content and help you understand the complexities associated withmentorship. We have mentioned the regulator’s (e.g. NMC) expectation of the mentor asboth a supporter of students and as an assessor. This adds complexity to your mentoringrole, but we are confident that by engaging with this course, you will have the confidenceand competence to meet professional requirements for mentorship.Next week you will begin to look at theories associated with learning, motivation andperception. When this is applied to mentoring it will give you insights into how others learnand enable you to reflect on ways to make learning meaningful to others.

Week 2In Week 1, you were given an overview of the Facilitating learning in practice course andintroduced to mentorship and the Nursing and Midwifery Council (NMC) (2008) Standardsthat support learning and assessment in practice. In this week you will look at three keytheories (behaviourist, cognitive and humanistic), identify learning styles, and explorecommunities of practice. Watch this video, where Fiona Dobson introduces the week’swork:

Video content is not available in this format.

Week 2




Week 2 Introduction

Health care has a variety of contexts where learning takes place: it might be a busychildren’s ward, a community mental health centre or a frantic accident and emergencycentre. These settings are important learning environments, and you can adapt variousteaching and learning theories and strategies to appropriately share information withindividuals, who will learn in different ways. You need to draw on a range of skills andbehaviours in order to meet the learner’s needs.However, it is important for you to remember that there are many learning theories thathelp us to understand how people learn, how learning occurs and how the teacher caninfluence the individual’s learning. You will focus on three key learning theories thatdemonstrate how individuals learn:

l behavioural theory (Skinner, 1938; Pavlov, 1927)

l cognitive theory (Bruner, 1961; Ausubel, 1968)

l humanistic theory (Rogers, 1983; Maslow, 1987).

You will have the opportunity to explore these learning theories and apply them to yourpractice. This will strengthen and capitalise on your learner’s strengths, and maximisetheir learning and development. You will compare pedagogy and andragogy in thedevelopment of adult learning, identify your learning style, and explore communities ofpractice as a feature of group learning where individuals share common beliefs andvalues and actively engage in learning together.

Mentorship programmeIf you are completing this session as part of an NMC mentor preparation programme, thematerials and activities relate to the following NMC domains:

Week 2





l Creating an environment of learning.

You should have registered on KG006 Facilitating learning in practice: mentorship portfolioassessment, which requires you to build a body of evidence towards demonstratingachievement of NMC mentor competencies. You are advised to consider using the learningactivities included in this week’s study in your portfolio as sources of evidence indemonstrating your achievement against the NMC competencies.

After this week, you should be able to:

l increase your knowledge and understanding of learning and teaching theories, andtheir application to practice

l compare and contrast andragogy and pedagogy in support of teaching andmentoring others

l identify your learning style and consider how this can influence how you learn

l recognise that learners may have a preferred style of learning

l explore communities of practice.

1 Learning theoriesThis section introduces you to specific learning theories that explain how individualsacquire information and organise their skills and knowledge during the learning process.To stimulate your thinking about learning, you will consider a set of images that are linkedwith specific learning theories, and then watch online videos that offer explanations forsome of the theories.The first two activities in the behaviourist theory section are intended to raise yourawareness and increase your knowledge and understanding of ‘classical conditioning’and ‘operant conditioning’.

1.1 Behaviourist learning theoryThe two principles of learning identified in behaviourist learning theory – ‘classicalconditioning’ and ‘operant conditioning’ – demonstrate that:

l people are influenced by their environment

l contiguity and reinforcement, whether positive or negative, are essential for thelearning process.

Both principles focus on reinforcing certain behaviours through repetition and practice.Figure 1 summarises the work of Pavlov and his salivating dog experiments.

Week 2



Figure 1 Pavlov’s dog – an example of classical conditioning (‘UCS’ = unconditionedstimulus; ‘UCR’ = unconditioned response; ‘CS’ = conditioned stimulus; ‘CR’ =conditioned response)

Activity 1 Classical conditioning10 minutes

Look at Figure 1 and then watch this video on Pavlov’s classical conditioningexperiment, which gives an insight into the sequence of events that are involved inclassical conditioning. Spend some time reflecting on how you learn and retaininformation, and provide an example of how the principle of this theory could inform thelearning support you offer to others.

Video content is not available in this format.Classical conditioning

Week 2



DiscussionYou may have noticed from watching the video that Pavlov believed we are born withcertain innate, unconditioned responses, such as salivating at the sight of food. Beforewe are conditioned, there is no salivation; therefore, there is no conditioned response(CR). Dogs naturally salivate at the sight of food, so this is an unconditionedresponse (UR).After conditioning, Pavlov discovered that if he rang a bell every time he fed the dog,he could make the dog salivate just by ringing the bell in the absence of any food. Thebell became the conditioned stimulus (CS) and salivation the conditioned re-sponse (CR).Applying this theory to teaching is rather simplistic, because individuals do not respondto stimulus in the same way as animals. However, its principles can be useful toconsider: in an education context, the behaviourist teacher is perceived as being incontrol of the environment and so directs the student learning. In a practice setting, theteacher provides a prompt that acts as a stimulus for the learner to carry out theactivity. An example of Pavlov’s theory is the automatic learned response that isobserved when a buzzer, emergency bell or pager is activated in the practice settingand a staff member instinctively responds to it rather than ignores it.

You will now move on to consider the other principle of behavioural theories – that ofoperant conditioning.

Week 2



Activity 2 Operant conditioningAllow 10 minutes

Look at Figure 2.

Figure 2 A rat in a ‘Skinner box’ (McLeod, 2007)

Now watch the Harvard University video below, from YouTube, on Skinner’s operantconditioning. Skinner observed that rats that were rewarded with food when theyaccidentally touched a bar eventually learned to press the bar intentionally. Provide anexample of how this principle would inform the learning support you offer to others.If you are reading this course as an ebook, you can access this video here:Reinforcement Theory

DiscussionYou may have observed that behaviour is either reinforced by reward or weakened bypunishment. Skinner’s work has contributed to the idea of maximising learning throughpositive reinforcement with a reward such as praise. The reward has to be givenimmediately and consistently to be effective; any delay in giving it renders itmeaningless, because the reinforcement is not linked to the operant behaviour.In teaching, Hinchcliff (2004) suggests that ‘social enforcers’ are required, such assmiles, nods and verbal encouragement, all of which can be given to the learner duringor immediately after a successful event. Such action will encourage the learner torepeat the behaviour, as well as promote self -confidence. Walsh (2014) suggests thatbehaviourist approaches to teaching are very useful for teaching specific clinical skillsin practice – for example, interpreting diagnostic tests, conducting a cognitivebehavioural assessment and taking blood pressure, where repetition enables thelearner to master the skill.Simulation is another method of learning that has its roots in behaviourist theory. Thisrelies on the principles of feedback, which should help the student progress towards adesired goal (Hinchliff, 2004) – for example, a competent performance of

Week 2


https://www.youtube.com/watch?v=YIEt6TrjJXw


cardiopulmonary resuscitation on a mannequin. Many universities with nursingdepartments have increasingly sophisticated simulated environments where learnerscan express themselves more freely in learning specific skills in safety.

The next section on cognitive theories explores the work of Bruner and Ausubel.

1.2 Cognitive theoriesCognitive theorists think that learning is an internal process that involves higher-ordermental activities such as memory, perception, thinking, problem solving, reasoning andinformation processing. Walsh (2014) adds that the principles of the cognitive theories areuseful in teaching because they encourage problem solving, analysis and experimenta-tion.

Activity 3 Bruner and Ausubel’s cognitive theoriesAllow 10 minutes

Watch this video about two cognitive theories that we found on YouTube. It is a slightlyunusual animation but does convey the main points. Consider how Bruner explains themeaning of discovery learning and how Ausubel discusses the way that new learningis assimilated and incorporated with existing information. Reflect on how you learn andretain information using this approach.If you are reading this course as an ebook, you can access this video here:Cognitive learning theorists

DiscussionYou will find that Bruner (1961) developed discovery learning and suggested thatteaching should focus on problem solving, which stimulates the learner’s curiosity. Therole of the teacher here is to pose questions or problems that motivate learners to seekanswers in an active discovery way.Ausubel (1968) believed that the teacher needs to link the learner’s prior knowledgewith what they need to know, which should be potentially meaningful and capable ofbeing understood. Another example of Ausubel’s approach is to give the learnerreading material prior to a lecture or skill session so that they have prior knowledge ofthe subject, thus encouraging them to engage more readily with new material.

Although cognitive theorists concentrated on teaching by emphasising how we learn,process and retrieve information, it is important to recognise that the student’s previouslearning and accomplishments should not be ignored. You need to remember whenapplying cognitive theory that the student’s starting point is crucial, and that the materialshould be presented in a logical sequence with the focus on the bigger picture(Walsh, 2014).You will now consider Gestalt theory, an example of which is shown in Figure 3.

Week 2


https://www.youtube.com/watch?v=_Sy8n5DRa7A


Figure 3 An example of Gestalt theory

Activity 4 Gestalt theoryAllow 5 minutes

Look at Figure 3 and try to make sense of what you are seeing.

DiscussionYou may have observed that when you looked at the vase (or two faces in profile) thatyou were selecting cues from the image and drawing inferences from it in order tomake sense of what you were looking at. This is termed ‘perception’.

The three main exponents of the Gestalt theory of perception were Max Wertheimer(1880–1943), Kurt Koffa (1886–1941) and Wolfgang Kohler (1887–1967), who originallystudied perception, developed the principles of perception resulting in Gestalt theory oflearning. The Gestalt theory of learning proposes that people see things as unified wholesand not as separate components (Quinn, 2001).It is an important theory to remember in the practice setting, because learners may missvital cues due to the service user experiencing perceptual problems that can be altered bytheir illness. The learner needs to be aware of this and can either give an explanation orreassurance to the individual, thus clarifying any misunderstanding that may occur. Acomprehensive assessment that identifies a service user’s perceptual difficulties isrequired in this situation.If you use the Gestalt approach in teaching, it is important to use bright visual aids andchange activities at frequent intervals so that you hold the learners’ attention. Quinn(2001) suggests that the teaching should be for insight rather than just giving information,so that the learner has an ‘aha!’ moment (meaning ‘I have got it’) when learning concepts.

Week 2



You will now study humanistic theories, which are concerned with human growth anddevelopment, and stress the importance of the interpersonal relationship between theteacher and the learner.

1.3 Humanistic theoriesHumanistic psychology is a general term for theories that take feelings, attitudes andvalues into account. The teacher is the facilitator and creates a democratic, student-centred, welcoming and safe environment. In this type of environment, the teacher isexpected to promote self-confidence and self-esteem, and the learner is encouraged tospeak freely without the fear of criticism (Rogers, 1983).You will find that principles of the humanistic theory can be applied to practice: itemphasises person-centred care, where the service user is given choice and autonomy,and the nurse shows empathy and compassion for the individual.Figure 4 depicts the humanistic theory of adult learning where the teacher acts as afacilitator of learning and encourages the active involvement of all individuals in the group.

Figure 4 The humanistic theory in practice

Figure 5 shows Maslow’s hierarchy of needs, which you will look at in more detail inActivity 5.

Week 2



Figure 5 Maslow’s hierarchy of needs

Activity 5 Maslow’s hierarchy of needsAllow 5 minutes

Watch this video from YouTube, which explains Maslow’s hierarchy of needssuccinctly with an amusing overtone. Note how this theory relates to the education oflearners.If you are reading this course as an ebook, you can access this video here:Maslow's Hierarchy of Needs

DiscussionYou may have noted that Maslow’s (1987) hierarchy of needs assists us inunderstanding the role that motivation plays in teaching when basic needs (such asfood, water and sleep) are not met – the lack of these basic needs can affect thelearner’s learning.The hierarchy of needs is based on many assumptions and has been criticised forbeing too simplistic, yet it is recognised that a learner’s basic needs must be satisfiedbefore higher-order needs such as self-esteem and self-actualisation can be met. Forexample, you need to be aware that if a learner is hungry, or tired, or anxious, theycannot concentrate on learning a particular procedure.It is important to remember that what is regarded as a perceived need for oneindividual may be quite different for another. Therefore, an assessment of the learner’sneeds and goals as they perceive them should be conducted in the learning situation(Keating, 2006).

In the next section you will compare the differences between andragogy and pedagogy,and the principles underlying the two different approaches to learning.

Week 2


https://www.youtube.com/watch?v=dmtmxYbDhKA


2 Adult learningThis section looks at the two differing approaches to adult learning that also fall under theumbrella of humanistic psychology: andragogy and pedagogy.Andragogy is based on the work of Malcolm Knowles (1990), a humanistic educator whoidentified four key principles in this type of learning:

l Self-concept: adults take responsibility for their own learning and are involved inplanning and evaluating their learning.

l Experience: past experience and prior knowledge is used as resource for learning.

l Readiness to learn: individuals take responsibility for own learning and ensure thelearning is relevant.

l Orientation learning: it is essential to apply the learning to life experiences.

Knowles distinguishes between andragogy and pedagogy. He claims that andragogy, oradult learning, encourages a proactive approach to learning where inquiry and autonomyare key features. By contrast, pedagogy is teacher-centred and is closely associated withteaching children. However, it should be noted that generalisations are made regardingthese two different approaches to learning because both may be appropriate for childrenand adults depending on their circumstances.Pedagogy is perceived as teacher-centred because the teacher decides what has to belearned and the individual’s prior knowledge is not always taken into account. However,Knowles argues that andragogy and pedagogy should be seen as parallel rather than asopposing concepts. Walsh (2014) agrees that teaching children using mainly apedagogical approach is a somewhat crude perspective, because andragogy is now usedalmost extensively with this specific learner group.The next activity gives you some insight into the two different approaches to learning. Youmight find it helpful to consider how these approaches have assisted you in your learningand can be used in teaching others.

Activity 6 Comparison of andragogy and pedagogyAllow 20 minutes

Watch this video from YouTube, which compares pedagogy and andragogy inlearning. It was produced by the PC3 project, which ran at Leeds MetropolitanUniversity from 2008 to 2012.If you are reading this course as an ebook, you can access this video here:Andragogy (Adult Learning)Reflect on the comparisons that have been made and consider how these twoapproaches are used when teaching learners in practice.

DiscussionYou may have discovered from watching the video that assumptions are still madeabout andragogy and pedagogy. Table 1 presents some of these assumptions, but youmay have noticed in practice that the pedagogical approach is used for certainsituations – for example, patient safety, where you are given specific instructions thatrequire compliance.Table 1 Assumptions of pedagogy and andragogy (Quinn, 2001)

Week 2


https://www.youtube.com/watch?v=vLoPiHUZbEw


Table 1Assumptions Pedagogy Andragogy

Students needto know

Students must learn what they aretaught in order to pass tests

Adults need to know why theymust learn something

Student’s self-concept

Dependency: decisions about learningare controlled by teacher

Adults take responsibility for theirown learning

Role ofstudent’sexperience

Teacher’s experience seen asimportant; student’s experience is seenas little use as a resource

Adults’ greater and more variedexperience is a rich resource forlearning

Readiness tolearn

Dependent on what the teacher wants Adults’ readiness relates to themlearning things they need toknow

Student’sorientation tolearning

Learning equates with the subject Learning involves problemsolving and task-centredapproaches

Student’smotivation

From external sources such as teacherapproval grades and parentalpressures

Largely internal such as self-esteem, quality of life and jobsatisfaction

The next activity examines the behavioural, humanistic and cognitive theories of learningin far more detail, as well as their application within the practice learning environmentwhen mentoring learners.

Activity 7 Application of learning and teaching theories to practiceAllow 1 hour

Read pages 85–94 of The Nurse Mentor’s Handbook (Walsh, 2014), which gives agood overview of the behavioural, humanistic and cognitive theories, includingapplication to nursing practice. Review the approaches and then assess how eachtheory is utilised in practice when mentoring learners. Draw on your experience andmake brief notes of your views.

DiscussionYou might have reflected that all three theories in this extract are valuable in practice,depending on the right circumstances and the learning need. You may have noticedthe importance of repetition and putting the learner at ease when repeating particularskills in practice, and recognising anxiety in your learner when commencing a newplacement because it can hinder their learning.Furthermore, the extract emphasises the variety of ways that students learn andsuggests that the teacher needs to adopt an eclectic approach to suit the needs oflearners. Opportunities should be created within a practice setting that is non-judgemental and sensitive to the different styles of learning. When you engage inteaching, you should use a range of methods and strategies presented in a logicalsequence. While each theory presents a unique way of interpreting learning, thelearning experience should be perceived as pleasurable, with time allocated forreflection and taking appropriate action as and when required.

Week 2


http://www.open.edu/openlearn/ocw/mod/resource/view.php?id=20109


You concentrate next on your learning style and will have the opportunity to identify yourpreferred style of learning.

3 Learning stylesLearning theorists believe that everyone has their own learning style – a way of taking onboard information that is unique to each individual (Walsh, 2014). It is therefore importantfor you to be aware that learners may have a preferred style of learning, but need to beencouraged to use a range of styles to maximise their learning experience.Kolb (1984) developed the learning cycle, which showed the different types of learningpreferences that individuals hold. He believed that individuals learn by progressingthrough the four stages in a particular order, commencing with concrete experience,reflective observation, abstract conceptualisation and active experimentation. Kolbargues that it is imperative for an educator to know their personal learning style, asindividuals tend to teach predominantly using their own learning style; however, youshould adapt your teaching to best fit your audience.The four stages identified by Kolb are shown in Figure 6.

Figure 6 Kolb’s learning cycle (Kolb, 1984)

Honey and Mumford (2006) adapted Kolb’s work and developed their own ‘learningstyles’: activist, reflector, theorist and pragmatist. They explained how individuals processnew information; for example, how the information is learnt and retained. The four stylesare summarised below:

l Activists learn best by being creatively involved; they like to immerse themselves innew experiences and enjoy being thrown in at the deep end. They learn by doing

Week 2



rather than reading or listening, are said to be open-minded, and are receptive tostimulations, case studies and role modelling.

l Theorists like to consider problems. They strive to understand concepts andintegrate them into their thinking. They learn through logic and facts via lectures andreading, seeking to understand the theory behind and reason for what they observe.

l Reflectors learn best by standing back, observing and reflecting upon what they seeand experience. Reflective writing and journals are likely to help them learn. Theylearn best by watching, thinking and talking things through rather than participating.

l Pragmatists like to try out new ideas and engage in problem solving. They learn byapplying things to practice, testing and experimenting to see if they work. They arereceptive to role modelling and like to ‘get things done’.

You can find out what is your learning style by completing the next activity, which is an OUlearning style questionnaire based on the work of the learning style theorists.

Activity 8 Learning style questionnaireAllow 40 minutes

Go to the Skills for OU Study website (open it in a new tab or window) and completethe learning style questionnaire before returning here. Write a short reflective summaryof what you have learned about yourself and how this reflection will improve yourteaching.

DiscussionYou will find that the questionnaire suggests what type of learning style you possess,whether you are an activist, reflector, theorist or pragmatist. Once you have identifiedyour learning style, think about the DiscussionWhich learning style did you identify with? Was it a comfortable fit or did you think,‘That could be me sometimes’? You may have felt you were being pigeonholed andthat you use different learning styles at different times. Learning preferences aretendencies that evolve over time and change according to what you are doing. Anawareness of your learning preferences can help you to think of learning as involving aprocess of acting, reflecting, thinking and doing. Recognising your preferences alsomeans that in order to learn you may sometimes need to do things in a way that maynot be in keeping with your natural inclinations.influence that your preferred learning style might have on your ability to learn. Knowingwhat types of learning activities you naturally gravitate towards will help you identifyother stages of the learning cycle that you can engage with to optimise learning.

Critics of learning styles (Tennant, 1997; Coffield et al., 2004; Martin, 2010) argue that theclaims made about learning styles are exaggerated and possibly too simplistic – thatindividuals draw on more than one learning style when processing information. Youshould therefore use a mix of styles when trying to learn information rather than focusingon just one particular style, because learning is a holistic activity. The key to makinglearning effective in practice is to work through the process of reflection many times, andfrom multiple perspectives, recognising your preferences to engage in certain activitiesmore than others. The ways in which you reflect and the things that you reflect on will allplay a part in the quality of your learning and your teaching of other learners.

Week 2


http://www2.open.ac.uk/students/skillsforstudy/learning-style-activity.php


In the next section, you explore communities of practice that promote collaborativelearning and engagement with professional groups in nursing to develop and managenew knowledge and emerging practice.

4 Communities of practiceThe focus of this final section of learning and teaching is on communities of practice(CoPs), which involve a group of individuals who share beliefs and expertise, and workcollaboratively to improve teaching skills and academic performance. CoPs (Figure 7)emphasise how communities learn outside of the formal setting as they share stories andbest practice.

Figure 7 Communities of practice

Activity 9 Communities of practiceAllow 40 minutes

Read pages 248–51 of ‘Building on Wenger: communities of practice in nursing’, anextract from an article by Andrew et al. (2008).Consider how you could use the ideas from the extract to introduce a CoP in yoursetting. Identify who you would include as the members of your CoP, and how this CoPcan develop and manage new knowledge and emerging practice.

Discussion

Week 2




This extract produces a framework that builds on the work of Wenger (1998, 2002) andespouses the usefulness of CoPs in promoting informal professional learning whenembedded in the workplace. These CoPs are usually time-limited and thrive or diedepending on member engagement. They have the potential to allow practitioners andacademics to collaborate to challenge and change practice.Andrew et al. (2008) reveal that the literature is critical of Wenger’s approach, becausehe firmly believed that CoPs could evolve anywhere because of individuals’ sharedinterest, including community development – this is perceived in reality as a simplisticand unrealistic answer to a complex issue.

Mentorship programmeIf you are studying towards an NMC mentor qualification, you might like to discuss Activity 9with your supervisor and record your ideas, which can be used as evidence in yourportfolio.

Quiz - Week 2Well done, you have completed the last of the activities in this week’s study before theweekly quiz.Complete the Week 2 quiz to assess your learning. By working your way through thequestions, you have made a great start in developing your knowledge and understandingof learning theories, identifying your learning styles, promoting collaboration, andchallenging professional practice.



Week 2 SummaryThis week you have examined a range of learning theories – including behaviourist,cognitive and humanistic – and have applied these theories to practice. You havecompared andragogy and pedagogy and came to the conclusion that both approachesare appropriate for adult learning depending on the circumstances. An opportunity toidentify your learning style is encouraged, but an eclectic approach in teaching ispreferred, which is sensitive to the different styles of learning that learners may presentwith when they engage in the learning process. CoPs are a useful framework that promotecollaboration and challenge practice but aim to change it whilst embedding professionallearning in the practice setting.Next week you will adopt strategies to maximise the learning opportunities for others. Youwill also explore and apply a range of models and tools to enhance your learning that willincrease your effectiveness in supporting others.

Week 2




Week 3So far you have had the opportunity to consider the overall concept of mentorship – inparticular, how this relates to supporting students on pre-registration nursing pro-grammes. You have also been provided with an oversight to the Nursing and MidwiferyCouncil (NMC) (2008) document that defines the standards for mentors – Standards toSupport Learning and Assessment in Practice. As potential mentors in development, youare asked to pay particular attention to Stage 2, as this is the defined set of competenciesrequired of this role.This week will consider how learning can be optimised and what strategies you mightadopt as a future mentor to maximise learning opportunities for others. Some of the workyou will look at is dated – particularly that of Bloom’s Taxonomy of Educational Objectives,the origins of which date back to 1956. However, in all instances the models discussedcontinue to be refined and therefore remain contemporary to inform and evaluatelearning.Here’s Fiona Dobson, introducing the week’s work:


In certain activities you will have the opportunity to reflect on your practice to examinestrategies that you might adopt to enhance the learning of others.It is likely that you have come to this week’s study with experience of learning ‘in’ and‘from’ practice. Therefore, these themes may not be new. However, as you prepare to takeon mentoring roles, the focus of this week on models or tools to enhance learning willprovide resources that you might adopt to increase your effectiveness in supportingothers.

Week 3



Mentorship programmeIf you are completing this course as part of an NMC mentor preparation programme, thematerials and activities in this week’s study relate primarily to the following NMC domains:




l Creating an environment for learning.

You should have already registered on KG006 Facilitating learning in practice: mentorshipportfolio assessment, or be preparing to do so. KG006 requires you to build evidence withina portfolio to demonstrate achievement of NMC mentor competencies. You are advised toconsider using the learning activities included in this week’s study in your portfolio assources of evidence to demonstrate achievement against required competencies.

After this week, you should be able to:

l consider ways that you learn and recognise factors that help and hinder yourlearning, and possibly the learning of others

l evaluate a variety of models that describe skills acquisition

l consider how such models help you as the learner to develop your own skills as amentor

l apply models of skills acquisition in practice to effective support and develop others.

1 Learning developmentYou are constantly exposed to opportunities for learning, although you may not alwaysrecognise them as such. Think back to a time when you were a student; perhaps astudent of nursing. It is probably easier to detail the learning that came from formal andexplicit learning activities – such as a teaching session that a more experiencedpractitioner offered to explain some clinical skill – than to pinpoint the informal learningthat can occur if you reflect on interactions that you are involved in.Before you look at some theory that underpins learning, spend a few minutes onActivity 1, which asks you to consider learning from recent occurrences. You do not haveto focus on learning from healthcare practices – although please feel free to use suchexamples if relevant.

Activity 1 Learning and its enablers and inhibitorsAllow 15 minutes

Start by selecting one or two examples of activities that you have recently beeninvolved in that were new experiences for you. You might want to keep a record of yourcomments to this activity in a notepad so that you can revisit your responses later, ifyou find that helpful.For each activity respond to the following statements or questions:

Week 3



l Provide a description of the activity.

l What helped you learn?

l Did you experience any inhibitors to learning?

l What changes happened as a result in participation of this activity?

l How would you describe your learning from this activity to others?

DiscussionAs author to this week’s material, recently I witnessed a newly registered nurse beingsupervised giving intravenous medication – on this occasion to a patient who was insevere pain and had not responded to previous oral drug medication (I assume) toalleviate or control his symptoms. By the time he had his medication reviewed and astronger drug (this time intravenous) prescribed, he was agitated and distressed. Hewas also pleading for the staff to leave him alone and allow him to sleep, as he statedhe was exhausted. Although I witnessed this from the periphery as an observer, therewas every indication that he was not prepared to play the role of the compliant patient.Indeed, I would argue that his distress and agitation offered richness to the learningthat would not have been possible with a more compliant patient.Into this mix the nurse was seeking to develop and demonstrate new skills ofcompetence in administering intravenous therapy. From my observation point, I did notsee the process and potential learning associated with the preparation of theintravenous drug, nor any discussions that followed the actual administration of thedrug; but what I saw was an impressive demonstration of multiple skills at the bedside,many of which could be transferred to other caring interventions. For example, Iwitnessed skilled interpersonal skills that sought to calm the patient, carefullyexplaining how this medication was designed to be more effective than that previouslyused. I also saw a willingness to allow sufficient time for questioning and sharing ofconcerns. The reason for supervision was explained fully, and there was evidence ofcare and attention being given to the intravenous drug administration procedure andrecord-keeping. I was confident that the knowledge of intravenous drug administrationwas demonstrated, along with recognition of person-centred needs and understandingof the drug itself.

During your assessment of a learning activity, did you map out the process of learning asa series of steps akin to that of a learning curve, or classify the learning under commonthemes – such as knowledge, understanding and skills?

2 Learning trajectoriesWhether you are learning for yourself or supporting others to learn, learning does notoccur as a straight progression – it is often viewed as a process that contains growth,peaks, troughs and plateaus (Atherton, 2013a). You might have reflected a little on this inActivity 1, especially as you considered inhibitors to learning. Atherton (2013a) depicts atypical learning curve in Figure 1.

Week 3



Figure 1 A typical learning trajectory

Such a curve is probably easier to plot out for the large skills learnt during life, although asimilar pattern would probably emerge if we were to examine in microscopic detail thelearning from the many small skills that we constantly engage in.This illustration of the learning curve immediately took me back many years when I waslearning to drive. I remember starting with so much confidence and enthusiasm – graspingand running with every suggestion that my instructor offered and making tremendousprogress in the early weeks. I also remember struggling with hill starts and becoming veryfrustrated because I could not master this skill. To this day I still avoid driving in areas thatrequire hill starts if possible. I believed I had reached the peak of my confidence and wasperforming competently when I entered my driving test only to have hopes dashed when Ifailed the test at the first attempt. Having to pick myself up and rekindle the earlierenthusiasm and confidence was essential in order to prepare for a subsequent test (thistime successful!). During the development of that skill I could identify with all stages of thedepiction above – the fast and slow learning, and the peaks, plateaus and troughs.The following activity allows you to plot out your learning against such a curve.

Activity 2 My learning curveAllow 15 minutes

In your notebook, and using one of the selected learning activities that you explored inActivity 1, draw a graph with time on the x-axis and competence on the y-axis, asshown in Figure 1. Next plot out your learning as you developed increasingcompetence in the intervention. Focus on all aspects of this learning curve, i.e. anyupward trajectories, plateaus, troughs and declines in the learning that occurred.What pattern emerged?

Week 3



DiscussionYour diagram is likely to be different to Figure 1; indeed, if you were to select anotheractivity; it would be different again. What you are most likely to have drawn, however,is a learning curve that is not perpendicular but one that has many twists and turns.Were you able to identify any circumstances that clearly affected your ability toprogress – for example, any unhelpful feedback or comments from others? Studentsthat you support will themselves be on a learning pathway towards competence. If youfound aspects of behaviour unhelpful, it is likely that those you mentor in the future willalso be similarly challenged.

It is perhaps also worth remembering that although you will be supporting others to seekconsistent and competent practice at a level indicative of their development, students willalso experience periods where their confidence plateaus or dips. You might wish toconsider how you might react to this so that you can provide the most effective support toenable, encourage and nurture their development and competence.

3 Skills acquisitionIn the acquisition of any skill, a major focus must be on the reliability of the performance.For nursing this has to be at levels defined by the Essential Skills Clusters detailed asAnnex 3 in the NMC (2010) Standards for pre-registration nursing education.

Mentorship programmeIf you are completing this session as part of an NMC mentor preparation programme, youwill need to be familiar with the skill levels expected of students at various points in theirdevelopment, as detailed by Annex 3: Essential Skill Clusters.Remind yourself of these requirements, paying particular attention as to how the skillsbecome more complex as the student moves through Progression Points of their pre-registration nursing programme.

The need to ensure that skills are practised reliably is particularly true as you support andassess students. Atherton (2013a) argues that any student can get it right occasionally –this is seen as beginner’s luck – but what counts must be the consistency of theirpractices, with progress of learning assessed against this consistency.

3.1 Skills development: Reynolds’ modelDeveloping the theme of skill acquisition, Atherton (2013a) adapts Reynolds’ (1965)model. It was originally designed to examine skill development in social work, but istransferrable to other professional groups. Reynolds suggested that learning skills waslargely a matter of the learner ‘soaking in’, so that performance becomes less self-conscious as learning progresses, and that the transition from one phase to anotherenables the learner freedom to concentrate on other things.Reynolds’ model of skill acquisition is shown in Figure 2, where the horizontal linerepresents a notional threshold of ‘competence’.

Week 3


http://www.nmc.org.uk/globalassets/sitedocuments/standards/nmc-standards-of-proficiency-for-preregistration-nursing-education.pdf


Figure 2 Reynolds’ model of skill acquisition

Applied to the practice of nursing, it is probably true to assume that in the early phases ofthis model, students are unlikely to possess the confidence to analyse their own practicethoroughly and share their insights with others. Atherton (2013a) suggests that there isoften ‘mystique and fragility’ associated with the skill development in these early phasesand it is not until the later phases (relative mastery and seeing the skill as second nature)where the learner might confidently share learning with others.Now pause for a moment and consider Reynolds’ model.

Activity 3 Application of Reynolds’ model for skills developmentAllow 30 minutes

Select a skill that you feel confident with – perhaps one that you would see as ‘secondnature’. If relevant, you are encouraged to consider one that relates to your healthcarepractice. Try to select a skill that you have developed over time and that was not theresult of a one-off learning opportunity.As a suggestion, Activity 1 used the observation of a newly registered nurse beingsupervised in intravenous drug administration. To get to the point of intravenousadministration, much learning would need to have been undertaken – for example,around infection control, cannulation, safe drug calculations and key pharmaceuticalunderstandings. You do not have to use this example, but try to consider a skill thathas a similar rich history of development.Table 1 can be downloaded as a Word document. Once accessed, complete the table,breaking down your selected skill against Reynolds’ phases of skill acquisition.

Table 1 Reynolds’ model of skill acquisitionPhase of skill acquisition The detail of what was involved Describe how you felt

Help!

Have a go

Hit and miss

Sound

Relative mastery

Second nature

Week 3




DiscussionAs your examples and experience are unique, it is impossible to provide a standard.‘one size fits all’ response to this activity. But were you able to relate to Atherton’sobservation that the early phases are clouded by mystique and that confidence isdeveloped through ongoing rehearsal and reflection?

3.2 Skills acquisition – the ‘conscious competence’ modelThe phases in Reynolds’ model are not dissimilar to those described in the ‘consciouscompetence’ model: each model reflects a series of steps or routes through to possiblecompetence. In this model, a significant feature is the focus on conscious as well asunconscious learning. Although the origins of the ‘conscious competence’ model aresomewhat uncertain, the model remains essentially a very simple and helpful explanationof how we learn in stages. Very simply, learners are thought to begin their skilldevelopment at Stage 1 ('unconscious incompetence'), passing through Stage 2('conscious incompetence') and Stage 3 ('conscious competence'), ideally to reach Stage4 (‘unconscious competence'). The simplicity of this model reinforces the need to ensurethat as you work with students, you need to assess their stage of development rather thanmake ill-founded assumptions.An article by Chapman (2015) suggests that learners will not be able to achieve‘conscious competence’ until they have become consciously and fully aware of their ownincompetence. It goes further to suggest that failing to recognise and respond toappropriate staged learning is the ‘fundamental reason for the failure of a lot of trainingand teaching’. The authors argue that it is essential to establish awareness of a weaknessbefore attempting to begin training and move learners through the stages towardsconscious competence. The authors argue, perhaps correctly, that people best respond totraining when they are aware of their need for it and can see the personal benefit they willderive from achieving it. If you’d like to read the full article, it’s available online.Table 2 came from the article described above. You might be aware of other modelspresented in similar ways, such as the Johari Window – a tool that supports insight onlevels of self-awareness. It is not appropriate to go into more detail about the JohariWindow here, but a short article has been suggested as part of recommended reading forthis week if you wish to follow this up further.

Table 2 Conscious competence matrix (Chapman, 2015)Competence Incompetence

Week 3


http://www.businessballs.com/consciouscompetencelearningmodel.htm


Conscious Stage 3: Conscious competence

l The person achieves 'con-scious competence' in a skillwhen they can perform itreliably at will.

l The person will need to con-centrate and think in order toperform the skill.

l The person can perform theskill without assistance.

l The person will not reliablyperform the skill unless theyare thinking about it – the skillis not yet 'second nature' or'automatic'.

l The person should be able todemonstrate the skill tosomebody else, but is unlikelyto be able to teach it well toanother person.

l The person should ideallycontinue to practise the newskill and, if appropriate, com-mit to becoming 'uncon-sciously competent' at it.

l Practise is the single mosteffective way to move fromStage 3 to Stage 4.

Stage 2: Conscious incompetence

l The person becomes aware ofthe existence and relevance ofthe skill.

l The person is therefore alsoaware of their deficiency in thisarea, ideally by attempting ortrying to use the skill.

l The person realises that byimproving their skill or ability inthis area, their effectivenesswill improve.

l Ideally the person has a mea-sure of the extent of theirdeficiency in the relevant skill,and a measure of what level ofskill is required for their owncompetence.

l The person ideally makes acommitment to learn andpractice the new skill, and tomove to the 'conscious com-petence' stage.

Week 3



Unconscious Stage 4: Unconscious competence

l The skill becomes so practisedthat it enters the unconsciousparts of the brain – it becomes'second nature'.

l Common examples are driv-ing, sports activities, typing,manual dexterity tasks, listen-ing and communicating.

l It becomes possible for certainskills to be performed whiledoing something else; for ex-ample, knitting while reading abook.

l The person might now be ableto teach others in the skillconcerned, although aftersome time of being uncon-sciously competent the personmight actually have difficulty inexplaining exactly how they doit – the skill has becomelargely instinctual.

l This arguably gives rise to theneed for long-standing uncon-scious competence to bechecked periodically againstnew standards.

Stage 1: Unconsciousincompetence

l The person is not aware of theexistence or relevance of theskill area.

l The person is not aware thatthey have a particular defi-ciency in the area concerned.

l The person might deny therelevance or usefulness of thenew skill.

l The person must becomeconscious of their incompe-tence before development ofthe new skill or learning canbegin.

l The aim of the trainee orlearner and the trainer orteacher is to move the personinto the 'conscious compe-tence' stage, by demonstratingthe skill or ability and thebenefit that it will bring to theperson's effectiveness.

Pause again now to reflect on the value and insight that this information might offer as youprepare yourself to support and develop others in a mentor role.

Activity 4 Applying the ‘Conscious competence’ modelAllow 45 minutes

Imagine you are working with a student who is on a pre-registration nursingprogramme. They have recently moved to your practice speciality and they have toldyou that they have little experience with many of the specialist skills that they expect tosee. You seek to teach and evaluate their learning in a relevant clinical skill.The skill you decide upon does not have to be highly complex; it could be, for example,blood pressure monitoring or undertaking nutritional assessments.Once you have selected your teaching episode, complete Table 3(which you can also download as a Word document) based on the consciouscompetence model to describe how you think the student might present at each stageof the model. Use the information presented in Table 2 above to guide your thinking ifyou consider this to be relevant. At each stage, identify strategies that you would useto move the student forward to the next stage where and when relevant.

Week 3




Table 3 Reflections on the conscious competence modelStage of model Anticipated behaviour

of the learnerYour strategies for helping progress thedevelopment of the learner

Unconsciousincompetence

Consciousincompetence

Consciouscompetence

Unconsciouscompetence

DiscussionLet’s just look briefly at an example of two possible responses to this activity, with theassumption that you work with older people and that you have specialist interest inensuring that individuals have access to, and receive, adequate nutrition. On thisoccasion you decide to teach the student about the importance of nutritionalassessment and dietary management.During Stage 1 (unconscious incompetence), you probably identified that you need touse time observing and questioning the student on what they do or don’t know.Fundamentally you find that at this stage, the student appears to know little about thespecial needs of the older person related to nutrition. You see no evidence of anyassessment being undertaken on the suitability of food offered, nor of their healthhistory, the condition of the mouth or any feeding challenges associated with impairedphysical ability or weight. Your responsibilities at this stage are about ensuring publicsafety by effectively monitoring the student, offering instruction to aid teaching and(where necessary) intervening to promote timely evidence-based practises. At thisstage you probably would have identified the need for timely feedback so that learningopportunities (which may not have been recognised by the student) are provided.Moving to Stage 3 (conscious competence), you should have suggested that youwould expect to see the student demonstrate effective skills in all areas related tonutritional assessment. At this stage, you might consider the student to be rather ‘rule-based’ than demonstrating the ability to practice spontaneously; but you are confidentthat they are safe. In terms of your role, rather than a teacher you probably sawyourself more as a facilitator who encourages the student to arrive at a place wherethese practices become so ingrained that they become normal activities requiring verylittle thinking.You are likely to have ongoing opportunities throughout work and life that will informyour teaching and facilitation, and determine the ways that you choose to support thepractices of others. The tools you have explored so far may provide you with aframework to support and develop others. This is a core activity of mentors, regardlessof where you are practising your mentoring skills.

Mentorship programmeIf you are studying this resource as part of an NMC mentor preparation programme, use thereflections from this activity as evidence towards demonstration of achievement of

Week 3



competencies in your practice portfolio on KG006 Facilitating learning in practice:mentorship portfolio assessment.

So far you have examined what your learning development looks like and thought abouttools that help you break down and define how skills are developed. In Section 4 you willlook at another model – that of Bloom – that again helps you to break down learning.Bloom’s model is an important one to examine, as many programmes of study useadapted versions of this model to construct learning outcomes. These form the basis ofassessment and evaluation.

4 Bloom’s TaxonomyThe other core role of many mentors – especially those working with pre-registrationnursing students – is assessment. You will be looking at assessment later in this course;however, because this week’s study is looking to the many tools or models that informlearning, it is also pertinent to examine a tool that enables you to break down thecharacteristics of the learning into identifiable themes (often used to categorise learningoutcomes) that enable evaluation or assessment of learning to happen.The model you will review was created by Benjamin Bloom. In 1956, while working at theUniversity of Chicago, he developed his taxonomy (classification) of educationalobjectives that have become a key tool in structuring and evaluating learning.The origins of Bloom’s work are derived from higher education and were designed topromote higher-order thinking in learning such as analysing and evaluating. Over manyyears this model has had an impact beyond the higher education sector and is frequentlynow used in schools, for example, to question and promote learning. Likewise with thestudents you work with, the model can help to structure your design of questions topromote and assess learning.Before you seek to explore how Bloom’s thinking might impact on your role as a mentor,you first need to examine the theory that underpins this model.

4.1 Bloom’s domainsBloom’s model consists of three domains. When Bloom used the term ‘domain’ he wasreferring to set values that share similar properties. Bloom’s three domains areidentified as:

l cognitive

l affective

l psychomotor.

Cognitive domainThe cognitive domain is the most used part of the model and the domain that is mostprominent when you engage in any search on Bloom’s Taxonomy. It is also this domainthat has seen the more significant modification, with Lorin Anderson (a former student ofBloom’s) changing the categories from noun to verb formats, engaging in minorsequencing readjustment of the two higher-order categories (see Figure 4) and creating a

Week 3



process and levels of knowledge matrix. (You could optionally explore this at the end ofthis week’s content if you are using this study as part of an NMC mentor preparationprogramme.)The original domain reflected learning development through the thinking skills shown inFigure 3.

Figure 3 Bloom’s original cognitive domain

Anderson and Krathwohl’s (2001) adaptations are shown in Figure 4.

Figure 4 Adapted cognitive domain (Anderson and Krathwohl, 2001)

Week 3



Note the changes in categories in Figure 4 compared with Bloom’s original proposition(Figure 3) from noun to verb formats and the minor sequencing readjustment of the twohigher-order categories, as mentioned above.

Affective domainThe affective domain is concerned with values, or more precisely perhaps with perceptionof value issues, and ranges from awareness (receiving), through to being able todistinguish implicit values through analysis. This domain is represented in Figure 5.

Figure 5 Bloom’s affective domain

Psychomotor domainBloom never completed work on the psychomotor domain (Figure 6), although othershave attempted to complete the model. As with other domains, what is proposed is amodel of skills acquisition (like the models you looked at earlier in this study).

Week 3



Figure 6 Psychomotor domain adapted from Bloom’s original work (based on Dave(1975))

4.2 Examining the relevance of Bloom’s model to your mentoringpracticeIn many respects, the one-dimensional depiction of each domain suggests a simplicitythat is probably misleading. In each domain, there is an expectation of increasingcomplexity and competence, whether that is in knowledge and understanding (thecognitive domain), attitudes and values (the affective domain), or in skills (thepsychomotor domain).You would probably find evidence of the use of Bloom’s Taxonomy, or an adaptation of it,in many nursing programmes across the UK. This would predominantly be seen in theconstruction of learning outcomes that are often expressed under headings such asknowledge and understanding, cognitive and professional skills – which all align toBloom’s thinking. Given that learning outcomes clarify the intent of the programme andare the building blocks upon which assessment is determined and measured, theimportance of Bloom’s work cannot be ignored.At the beginning of this section, it was suggested that the model can help structure thedesign of questions that enable you to promote learning in others as well as serve as aplatform for the assessment of learning. Let’s briefly look at that as a final activity for thisweek’s study.Table 4 is an extract taken from work by Don Clark (1999) and published online. This usesthe revised categories of the cognitive domain and provides examples of activities (in thiscase broadly focused), along with key words that could indicate whether learning hasoccurred at the desired level.

Table 4 Revised cognitive domain (adapted from Clark, 1999)Category Examples and key words (verbs)

Week 3


http://www.nwlink.com/~donclark/hrd/bloom.html


Remembering: Recall or retrieve previouslearned information.

Examples: Recites the safety rules.

Key words: defines, describes, identifies,knows, labels, lists, matches, names, outlines,recalls, recognises, reproduces, selects,states.

Understanding: Comprehending themeaning, translation, interpolation andinterpretation of instructions and problems.State a problem in one's own words.

Examples: Explains in one's own words thesteps for performing a complex task.

Key words: comprehends, converts, defends,distinguishes, estimates, explains, extends,generalises, gives an example, infers, inter-prets, paraphrases, predicts, rewrites, sum-marises, translates.

Applying: Uses a concept in a new situation orunprompted use of an abstraction. Applieswhat was learned in the classroom into novelsituations in the workplace.

Examples: Applies laws of statistics toevaluate the reliability of a written test.

Key words: applies, changes, computes,constructs, demonstrates, discovers, manipu-lates, modifies, operates, predicts, prepares,produces, relates, shows, solves, uses.

Analysing: Separates material or conceptsinto component parts so that its organisationalstructure may be understood. Distinguishesbetween facts and inferences.

Examples: Gathers information from adepartment and selects the required tasks fortraining.

Key words: analyses, breaks down, com-pares, contrasts, diagrams, deconstructs, dif-ferentiates, discriminates, distinguishes, iden-tifies, illustrates, infers, outlines, relates, se-lects, separates.

Evaluating: Makes judgements about thevalue of ideas or materials.

Examples: Explains and justifies a newbudget.

Key words: appraises, compares, concludes,contrasts, criticises, critiques, defends, de-scribes, discriminates, evaluates, explains,interprets, justifies, relates, summarises, sup-ports.

Creating: Builds a structure or pattern fromdiverse elements. Puts parts together to form awhole, with emphasis on creating a newmeaning or structure.

Examples: Designs a machine to perform aspecific task.

Key words: categorises, combines, compiles,composes, creates, devises, designs, ex-plains, generates, modifies, organises, plans,rearranges, reconstructs, relates, reorganises,revises, rewrites, summarises, tells, writes.

Activity 5 Applying characteristics of Bloom’s modelAllow 30 minutes

Use the following example:

You are supporting in a mentoring role a first placement student nurse whohas admitted to having very limited experience of healthcare practices priorto starting their pre-registration nursing programme six months ago. Thestudent is now on the final week of their placement and you have arranged ameeting with them to discuss their progress.

Week 3



In all fields of nursing practice, one of the areas for development that needs to be metby students is that ‘people can trust the nurse to respect them as individuals and striveto help them preserve their dignity at all times’. (Domain 1: Care, Compassion andCommunication). The specific skills underpinning this overarching statement (NMC,2010, pp. 107–8) are for the student to:

l demonstrate respect for diversity and individual preference, valuing differences,regardless of personal view

l engage with people in a way that ensures dignity is maintained through makingappropriate use of the environment, self and skills, and adopting the appropriateattitude

l use ways to maximise communication where hearing, vision or speech iscompromised.

Using one or more of the above statements, determine the following:

1 What categorisation in Bloom’s cognitive domain would reflect achievement ofyour chosen statement(s)?

2 What activities or behaviours might you observe that would lead you to believethat the student has achieved this competence?

CommentLet’s just look at the third competence statement: ‘use ways to maximisecommunication where hearing, vision or speech is compromised’. The adjective hereis ‘use’. Looking again at Table 4, ‘use’ is part of the ‘Applying’ categorisation, i.e. thatthe student is able to apply what is learnt in the workplace. Although an inexactscience, this is probably a fair representation of the complexity of the skills that wouldneed to be shown to demonstrate the competence. It would definitely require morethan ‘remembering’ and ‘understanding’ what to do; the application here is crucial. Soin reality they are probably at Tier 3 of six in the cognitive domain at this time.The second part of this activity asked for behaviours that might suggest competence.In considering this statement, you might, as a mentor, assess the student’sinteractions with service users who have compromised aural, visual and oral functions.Did the student adjust their techniques to provide person-centred care? Were theirinterventions effective? Did you receive feedback from service users themselves toaffirm or discredit your assumptions?

Mentorship programmeIn this exercise you have only looked at one competence against one domain – that of thecognitive domain. If you are studying this course as part of an NMC mentor preparationprogramme, please extend this activity to look at more competencies required of pre-registration nursing students at the three progression points in theStandards for Pre-registration Nursing Education, considering each across cognitive,affective and psychomotor domains as defined onthe Big Dog & Little Dog’s Performance Juxtaposition website.

This is a substantial piece of work, but will provide you with an opportunity to consider verycarefully the expectations of students of nursing across levels of their programme and what

Week 3


http://eoe.hee.nhs.uk/files/2014/04/NMC-Educational-Standards-16-sept-Standards-for-pre-registration-nursing-education-20100816.pdf



you might look for when asked to support, guide and assess the student in meeting thesecompetencies.

Quiz - Week 3Well done! You have completed the last of the activities in this week’s study before theweekly quiz.Complete the Week 3 quiz to assess your study of the facilitation of others’ learning.



Week 3 SummaryAs you become increasingly familiar with the tools that you have examined this week, themore confident and competent you will become in opening up relevant learningopportunities for others. In addition, the tools provide a means to pitch your questioningand direct your observations so that you are effectively able to evaluate what learning,and at what level, this learning has occurred. Ultimately this will lead to greater insightsand consistency in your mentorship support and assessment of learners.This week’s study has encouraged you to apply models of learning to your everydaypractice, so rehearse and reflect on tools that help you support the development of thelearning process. This practical application continues next week, where you will movefrom an oversight on learning to the principles underpinning mentorship itself. Week 4 isall about effective working relationships, motivating others, managing possible conflictand how you are expected to continually develop your enhanced skills as a mentor.

Week 4This week you will explore the factors that can contribute to forming a successfulrelationship with your students. Setting goals and challenges for them is an important partof the relationship, so your learning from last week about skill acquisition and attainmentof competence is essential to determine goals that are realistic, achievable andappropriate to their stage of learning.You will also look at aspects of the relationship that can cause conflict. Nurse mentorshave to assess the students that they are supporting, so being confident to give negativefeedback that is constructive and developmental is fundamental to your professionalmentoring relationship.In the following video, Fiona Dobson introduces Week 4 and reminds you about the badgequiz at the end of this week.


Week 4




Mentorship programmeIf you are completing this course as part of a Nursing and Midwifery Council (NMC) mentorpreparation programme, the materials and activities in this week’s study relate primarily tothe following NMC domains:


l Assessment and accountability.

After this week you should be able to:

l identify eight key components that contribute to effective mentoring

l analyse the impact of your own and others’ non-verbal communication onmaintaining effective relationships

l give feedback in a way that is motivational and developmental

l plan your own support networks that underpin your maintenance of competence as amentor.

1 Establishing effective mentoring relationshipsRecent research involving students, mentees and mentors has explored and identifiedvarious elements that contribute to or undermine successful mentoring relationships(Teatheredge, 2010; Straus et al., 2013; Eller et al., 2014). The findings highlight factorsthat you may consider to be common sense, but this should be viewed positively. First,this confirms that there is nothing mysterious about being an effective mentor. Second, itsuggests that you should be able to identify many of the components of successful

Week 4



mentoring relationships by drawing on your own life experiences, which may includebeing a student, mentee or mentor.

Activity 1 Recognising factors that contribute to effective mentoringrelationshipsAllow 15 minutes

Watch the video produced by the NHS local learning platform, which shows two relatedinteractions between a student and his mentor. As you watch, make a note of thefactors that might make a positive impact on their mentoring relationship. Play the clipagain and add any factors that you missed during your initial viewing. Keep your list offactors to hand, as you will need it again for Activity 2.

Video content is not available in this format.NHS local learning platform

Eller et al. (2014) conducted an extensive research study with students and their mentorsfrom various academic disciplines, including natural sciences, nursing/health sciences,engineering, and technology. Using a defined technique for achieving consensus throughtwelve focused group discussions, the behaviours considered helpful for effectivementoring relationships were organised into eight themes, termed key components (seeFigure 1).

Week 4



Figure 1 The key components of effective mentoring relationships (adapted from Elleret al., 2014, p. 817)

Activity 2 Linking your observations to the key components of effectivementoring relationshipsAllow 30 minutes

Refer to the eight key components identified by Eller et al. (2014) in Figure 1 anddecide whether the factors that you identified from the video clip can be associatedwith these components. Copy out Table 1 (or download a copy) and add yourobservations.

Table 1 Linking your observations to the key components of effectivementoring relationshipsKey components of an effective mentoringrelationship

Observed factors from the videoclip

Open communication and accessibility

Goals and challenges

Passion and inspiration

Caring personal relationship

Mutual respect and trust

Exchange of knowledge

Independence and collaboration

Role modelling

Week 4




Were you able to add an observation against each of the components? If not, play thevideo again with the components in mind and decide whether there are other factorsthat you either missed or did not necessarily associate with effective mentoring. Addthese to the table too.

DiscussionTable 2 shows some possible observations, but you may have others.

Table 2 Possible observations to the key components of effectivementoring relationshipsKey components of an effectivementoring relationship

Observed factors from the video clip

Open communication andaccessibility

Jane, the mentor, is available throughout the time thestudent, Paul, is carrying out the observations. Janeencourages open communication by asking how Paulfelt the intervention had gone. There is good eyecontact between Jane and Paul during the post-observation discussion, and she uses positive promptssuch as nodding and smiling.

Goals and challenges Jane sets Paul a new set of goals when she exploreswith him whether he has sufficient information to makea decision about appropriate pain relief for the patient.She indicates the need to establish the patient’sreported level of pain and to check his wound.

Passion and inspiration Jane highlights her considerable experience as aregistered nurse and her real desire, even though itmight sound ‘corny’, to inspire her students so that theyenjoy nursing as much as she does.

Caring personal relationship Paul is unsure about the best way of managing thesecond patient’s pain. He has no hesitation in seekinghis mentor’s advice, suggesting that he values therelationship and feels supported by it.

Mutual respect and trust Paul appears to be comfortable when discussingaspects of care that he has initially missed. Thisindicates that he believes Jane will not respond in apunitive way. Instead, she will enable and encouragehim to find solutions to his patient’s pain problem. Janegives Paul pointers as to his next actions, but she trustshim to know how to assess the patient’s pain level andto check his wound. She trusts and respects that he willcarry out the interventions correctly.

Exchange of knowledge Jane discusses the process of recording observationswith Paul, which enables him to highlight what heknows – for example, the importance of a strong,regular pulse, and that removing the patient’s arm fromhis sleeve rather than rolling up the sleeve might havebeen a better alternative.

Independence and collaboration Jane allows Paul to carry out taking the blood pressurewithout interruption, encouraging independence. Theywork closely together to determine the best approachfor managing the second patient’s pain.

Week 4



Role modelling Jane explains to the first patient that she is there toobserve the student, thus role modelling theimportance of offering explanations to patients. Paulmirrors this approach by explaining to the patient theoutcome of taking his pulse manually. Jane consistentlypresents herself in a professional manner, both inappearance and behaviour. She demonstrates a calm,assured approach that reassures the students shesupports.

1.1 Additional roles for nurse mentorsThe components identified by Eller et al. (2014) provide a comprehensive insight into theessentials of an effective mentoring relationship and it is likely that you have been able toattribute all of your observed factors to one or more of the components. However, perhapsyou have one or two observations that don’t seem to fit very well, or at all. Reading otherpapers about the nature of mentoring relationships will offer alternative insights andbroaden your thinking. Teatheredge (2010), for example, emphasises the importance ofreducing student anxiety as a key function of the mentor relationship, whilst Wilson (2014)identifies protecting the student from danger as an integral component.In Activity 2, you may have identified another key component (Eller et al., 2014) thatappears to be missing from the effective mentoring relationship: assessing competence.In many professional spheres this is not typically seen as a function of the mentor role.However, the NMC (2008) specifies ‘assessment and accountability’ as one of the eightdomains that nurse and midwife mentors must be competent in, and this specific issue isaddressed in Weeks 6 and 7.

Mentorship programmeIf you are studying towards an NMC mentor qualification, you should be allocated a nursingstudent to support in practice. Now you have finished learning about mentoringrelationships, you might work through the following suggestions in the practice setting, inorder to provide evidence for your portfolio against the NMC domain:

l Establishing effective working relationships.

At the end of the first five days of your time together, write a reflective summary thatexplores how you feel you have addressed the eight key components of an effectivementoring relationship, giving examples.

If there are components that you haven’t addressed yet or that you feel haven’t goneparticularly well, you can focus on these as the relationship continues.

As your time together nears its end, seek feedback from your student about theachievement of the eight components. What worked well, what could have beenapproached differently and what would your student have liked more or less of?

Using this feedback, return to your original reflective summary and reconsider theeffectiveness of your mentoring relationship. Add any additional examples, thoughts orfeelings to your summary to show how your approach to the mentoring relationship hasdeveloped or changed.

Week 4



Identify the one key component that you feel was the least well developed in thisrelationship and that you will focus on the next time you are supporting a student.

2 Open communicationThe way in which you communicate with your students or mentees is fundamental to yourmentoring relationship. You may already have well-honed communication skillsdeveloped through life experiences including your work role or roles – but if you haven’tthought recently about the factors that make for good communication, now is the time toreview these.As you know, effective communication involves both verbal and non-verbal skills.Although the words that we use and the speed, rhythm and pitch at which we speak allserve to support the meaning and clarity of our communication, it is often our non-verbalskills that will enhance or detract from this clarity.Watch this short video from YouTube, created by About.com, to remind yourself about thevarious aspects of non-verbal communication.If you are reading this course as an ebook, you can access this video here8 Types of Nonverbal Communication YouTubeIn case you need a prompt for future reference, the eight points are:

1 facial expression2 hand gestures3 paralinguistics4 body language5 proxemics6 eye gaze7 haptics8 appearance.

Being aware of and deliberately using your non-verbal communication skills can makeyour relationship with your students much more rewarding for them and less stressful foryou. In the video in Activity 1, Jane’s facial expressions and gaze are welcoming andindicate enthusiasm; she also uses gestures of positive reinforcement such as noddingand the pitch and rhythm of her voice to create a sense of calmness, suggesting there isample time for discussion.One of the mentors who participated in Wilson’s research study into the experiences ofmentors commented, ‘I’ll have my approachable face on so people can come and find me’(Wilson, 2014, p.315). These mentors understand the impact of non-verbal communica-tion on their students’ emotions and deliberately employ strategies that encourageinteraction. Consequently, their students feel comfortable to approach them for feedbackor advice; this in turn reassures the mentors that their students are practising safely andappropriately, and that the patients/service users are therefore well cared for.

Activity 3 Delivering feedbackAllow 40 minutes

Week 4


https://www.youtube.com/watch?v=csaYYpXBCZg


Question 1

One of the most important aspects of open communication identified by mentors(Huybrecht et al., 2011) and by students (Foster et al., 2014) is the provision offeedback.Drawing on your own experiences of giving or receiving feedback, and fromreading these extracts from a paper by Clynes and Raftery (2008), answer thequestions below and then read the suggested answers.What is the purpose of giving feedback?

AnswerThe aim is to offer the student insights into their performance. You can reinforcepractices that are done safely and accurately, and behaviours that are productive. Youcan also highlight skills that need further development and conduct that is not yetsufficiently professional.

Question 2

How might you give informal feedback?

AnswerYou might do it spontaneously, whilst working alongside the student. This gives you theopportunity to make direct observation and enables you to relate your comments to thespecific nursing intervention taking place at that time. Some students may notrecognise this impromptu approach as a form of feedback. Informal feedback can alsotake place away from the practice setting, for example during a conversation on theway to the bus stop or back to the car park. This may be useful, but you need to becareful about confidentiality or potentially leaving the student disheartened at the endof a tiring day if you mention something that hasn’t gone too well just before setting offto your respective homes.

Question 3

What is formative feedback?

AnswerThis feedback usually takes place in a planned way. For example, you might arrangeto meet the student every couple of weeks during their practice learning experience inorder to review their ongoing progress and reflect on the strengths and limitations ofwhat has been achieved. It should help you and the student plan the focus for the nexttwo to three weeks of experience.

Question 4

What is summative feedback?

AnswerThis feedback usually takes place at defined points in a student’s practice learningjourney. You will be providing a summary of all that has been achieved whilst thestudent has been gaining practice skills and experiences with you and the wider team,and making judgements as to whether the NMC skills and competencies have beenachieved at the required level.

Week 4




Question 5

When is the best time to give feedback?

AnswerIf your feedback is required to correct the student’s performance of a skill, it is best todo this as close to completion of the skill as is feasible. This will allow the student theopportunity to improve their performance the next time the skill is carried out.Waiting until the end of a practice learning experience to highlight poor practice is notsupportive of the student’s development and could potentially put patients at risk. It ispreferable not to correct a student in front of a patient, as this can be demoralising andundermine the student’s self-esteem. However, there can be occasions when thestudent’s intended action will cause harm, so feedback must be immediate.Nevertheless, there are ways in which you can still make this a positive intervention.There is a difference between saying ‘Stop, not like that!’ in a loud voice compared witha quieter interjection such as ‘Just before you do X, talk me through the possibleoptions here’.

Question 6

What factors can interfere with giving feedback?

AnswerAs a nurse, your priority is always to your patients. In busy everyday practice it can beextremely difficult to find appropriate and sufficient time to provide meaningfulfeedback to the student. Finding time to give feedback can also be affected by periodswhen either the mentor or the student are on leave and so not available to either giveor receive feedback.When you consider the key components that contribute to effective mentoringrelationships, it is clear that the mentor and the student may become close. As thementor, this can make it difficult for you to give critical feedback, as you may feel thatthis will affect your ongoing relationship with the student.

Question 7

How would you prepare to give formal feedback?

AnswerAllow sufficient time for delivering the feedback. Typically, more time is needed forsummative feedback, as there are more elements to discuss. If you have to providecorrective formal feedback, arranging to do this at the end of the working day mayraise anxiety in the student, who is then likely to be distracted throughout the day andtherefore perform less well. Do think through how you will balance the negativeaspects of the student’s performance with the elements that are done well. Thestudent needs to leave the feedback session feeling that they have skills in place thatcan be built on, whilst recognising that there are particular actions that have to betaken forward immediately in order to become a safe, effective practitioner.

Question 8

What elements contribute to high-quality feedback?

Week 4



AnswerAsking the student to analyse their own performance of a particular intervention with aspecific patient can prove to be fruitful to you and the student. The student maydemonstrate to you an awareness of those elements of the skill that were deliveredaccurately and highlight areas where there was a lack of certainty or dexterity. This willallow you to concur with and reinforce the student’s perceptions, or suggest otherfactors that you feel may have been overlooked. The important point is to be specific.An overall comment such as ‘Well, that didn’t go very well’ doesn’t offer the studentinsight into why you felt it didn’t go well and therefore what to focus on to makeimprovements.

Question 9

What might you do to make the provision of feedback easier?

AnswerAllow yourself sufficient time. Ensure the feedback can be given in privacy with nointerruptions. You need to ensure that colleagues know that you cannot be interruptedfor the next X minutes. Think through what you would like to say to the student, andalso how the student might respond. Being prepared for particular types of responsesuch as anger or crying can help you deal with these more appropriately.

The next time you need to offer formal feedback, you should think through the processfirst:

l Aim to ensure that you have taken into account the place and timing of yourfeedback.

l Make preparations that will help to ensure that the receipt of feedback is a positiveexperience, even if the feedback itself is negative.

l Structure the feedback so that it is meaningful and can therefore support personaland professional growth, development and achievement.

Mentorship programmeIf you are studying towards an NMC mentor qualification, here is another activity that youmight undertake in the practice setting in order to develop evidence for your portfolio, in thefollowing domain:

l Assessment and accountability.

Observe your student undertaking a nursing intervention and, if appropriate, review anyassociated records made by the student in relation to the intervention. At the end of yourobservation, offer feedback to your student.

Make a list of those elements of the feedback process that you feel went well, and notethose aspects of the process that did not go as you intended or were missed (whetherintentionally or unintentionally).

Identify what you will do differently next time to address those aspects of the process thatyou felt were less successful or were unintentionally missed.

Week 4



Finally, give a rationale for those aspects of giving feedback that you intentionally omitted.

3 The mentoring relationship and motivationA recent study by Foster et al. (2014) identified that, according to students, the mostfrequently valued behaviours in the mentoring relationship are teaching and explaining.Clearly, these two interrelated activities contribute to students’ learning in practice, but aremost likely to have a positive effect when the student feels motivated to learn.Understanding the factors that help to stimulate and maintain this motivation will influencethe way in which you approach your teaching.A well-established, tried and tested model of learning motivation is the Attention,Relevance, Confidence, Satisfaction (ARCS) model (Keller, 2008).Keller first proposed his holistic theory of motivation to learn in 1983. His comprehensivereview and synthesis of motivational literature led him to identify four conditions that needto be in place for a student to be motivated to learn:

l The learner’s curiosity must be aroused, so therefore the learner gives Attention tothe situation.

l The learner must recognise the Relevance of the situation in terms of achievingdesired goals.

l The learner must feel Confidence that the required learning is achievable.

l The learner must believe that because personal incentives will be met, Satisfactionwill result.

His theory has become represented by the ARCS model of motivation to learn.

Activity 4 The principles of the ARCS model of motivation to learnAllow 20 minutes

1 Watch the video presentation from YouTube by Professor Lisa Johnson, whichexplains the principles of the ARCS model. Once you’ve watched the video, youcan use the model’s principles to plan a learning opportunity for your students.

If you are reading this course as an ebook, you can access this video hereARCS Motivation Model - Learning Design

2 Download the ‘ARCS model of motivation to learn’ template and read through ourexamples on the template. Then use the ‘Your example’ column to identify alearning opportunity that commonly occurs in your own workplace environmentaround which to develop your own strategies for delivering a teaching sessionthat is likely to motivate students to learn and achieve competence in practice.Write down your chosen strategies in the final column. If you can’t identifyanything from your own work environment, think about other areas of your life andhow you might encourage others to learn.

DiscussionThe challenge with teaching and learning in practice settings is that specific learningopportunities are difficult to forward-plan and teaching often takes place sponta-

Week 4


https://www.youtube.com/watch?v=RpjVprPeSo0



neously, within the context of that moment in time. However, by thinking throughactivities that frequently take place within your practice environment, you can developa range of motivation strategies that you can use when a day-to-day activity alsobecomes a learning opportunity for your student.Whilst the ARCS model focuses specifically on the strategies that motivate learners toengage and achieve, there are other useful educational models that combine some ofthese strategies with other educational principles (Gagné, 1985). Thomas (2012)provides an excellent example of the practical application of Gagné’s ‘nine events ofinstruction model’, so is well worth reading if you can access a copy.

4 Potential conflict in mentoring relationshipsIn any relationship there is always the potential for conflict or relational breakdown, andmentoring is not excluded from these problems. Ensher and Murphy (2011) describe thisas ‘the dark side’ of the mentoring relationship, and list a range of behaviours on the partof both the mentor and the mentee that can contribute to such conflict (Table 3).

Table 3 The ‘dark side’ of mentoring (adapted fromEnsher and Murphy, 2011)Negative behaviours of mentors Negative behaviours of students

Bullying

Jealousy

Abuse

Neglect

Betraying trust

Damaging reputation

Ignoring mentor advice

Being ungrateful

Activity 5 Identifying workplace-specific examples of these negativebehavioursAllow 15 minutes

Drawing on your own experiences within the workplace/practice environment, recallany situations that you have observed or comments that you have heard that couldrepresent examples of negative behaviours.

DiscussionHere are some examples drawn from the academic literature and from ourexperiences in nursing to illustrate these behaviours.

Mentorsl Bullying:

l Constantly correcting a student’s performance in front of patients, under-mining the student’s confidence and subsequently impacting on ability andcompetence.

Week 4



l Always sending the student off to carry out tasks that will not contribute tolearning about nursing care, such as cleaning the sluice or taking specimensto the laboratory.

l Jealousy:

l Failing to answer questions from the student because no one answered yourquestions when you were a student. Why should it be any different forstudents today?

l Abuse:

l Blaming a student for not carrying out an intervention when there hadn’tbeen an opportunity for this to take place. For example, asking a student tocarry out an observation and then criticising the student for not recording theintervention within one minute of the initial request.

l Neglect:

l Deliberately ignoring any attempt by the student to introduce themselves byfailing to make eye contact and walking away when they speak.

l Failing to arrange informal meetings with your student to provide anopportunity for feedback and reflective learning.

Studentsl Betraying trust:

l Having been assessed as competent by the mentor, failing to practise in away that demonstrates this competence and therefore calling into questionthe trust that the mentor has placed in the student.

l Damaging reputation:

l When challenged by another registered nurse about the way in which anintervention is being carried out, responding by saying, ‘Well that’s how mymentor taught me,’ knowing full well that it wasn’t.

l Telling another student who has been allocated to the same mentor howawful the mentor is: ‘Hopeless at teaching and doesn’t know what she’sdoing.’

l Ignoring mentor advice:

l Insisting a service user has breakfast at their bedside instead of walking tothe dining room, as the mentor advised, because the service user is so slowand it will take far too long.

l Being ungrateful:

l Not appreciating the time the mentor has taken to arrange an additionallearning experience with a colleague in another practice area and failing toturn up.

l Failing to say ‘Thank you’ for support and advice offered either during or atthe end of the practice learning experience.

Week 4



4.1 Other types of professional conflictIn addition to relational conflict and negative behaviours, for those of you who are studyingthis course in preparation to become a nurse mentor there are other types of professionalconflict that can arise.

Activity 6 Insights into potential conflicts within the mentoring roleAllow 15 minutes

Watch the interview with Amy Johnson, an experienced mentor who identifies some ofthe other types of conflict that she has encountered in her role.

Video content is not available in this format.Amy Johnson

Write a short summary of the types of conflict that are described.

Mentorship programmeIf you are studying towards an NMC mentor qualification, here is a final activity relating tothis week’s learning that you might undertake in the practice setting in order to developevidence for your portfolio, in the following domain:

l Leadership.

Arrange a meeting with your own supervisor to discuss the types of conflict described bythe experienced mentor.

Week 4



Share your summary of the types of conflict described (you might do this before themeeting to give your supervisor the opportunity to consider the issues).

Discuss with your supervisor the actions or approaches you feel it would be appropriate totake for each of these conflict types.

Add these actions or approaches to your summary as a reminder of safe, effective andprofessional mentoring practice.

5 The importance of your relationships with othersNurses may engage in two very different types of mentoring relationship.The first is often found among more experienced members of the nursing profession, whoseek out another experienced colleague to act as a support and sounding board for theircareer development. These informal relationships may last for a year or longer, buttypically reach a natural point of conclusion when one or both members of the relationshipfeel that there is no further gain to be achieved.The second is the relationship between mentor and nursing student. This has definedstart and finish points, and typically lasts for considerably less than a year. Whether youare in a mentoring relationship with a colleague or with nursing students or both, each willopen you to new experiences and learning of your own. Whether you are inexperiencedas a mentor or have some experience in the role, you will continue to benefit from thesupport and guidance of more masterly colleagues, so do seek out your own supportnetworks.

Activity 7 Identifying and building your own support networkAllow 20 minutes

Watch the interview with Charlie Austin, a practice development nurse at Guy’s and StThomas’ Hospital. She describes the types of support for mentors that her ownorganisation has already put in place along with ideas for other types of support thatmight also prove useful.

Video content is not available in this format.Charlie Austin

Week 4



Now develop an action plan for yourself that shows how you plan to address your ownongoing need for guidance. This could include identification of a personal mentor, whowill continue to offer you support and feedback as your mentor role develops.If you have identified a personal mentor, you could share your action plan with themand seek advice about other useful contacts within your organisation. Add these toyour plan if they sound useful to you.

There is an increasing awareness of the support that is needed by mentors to enablethem to deliver their mentoring role effectively, so you may be surprised by theopportunities that are available to assist you in forming your own supportive relationships.You will continue to develop and refine your mentoring skills through practice andexperience. At some point it is likely that your manager, a continuing professionaldevelopment nurse, a clinical educator or another colleague with responsibility fororganising and supporting students’ practice learning experiences, will feel that you areready to become a sign-off mentor.In preparation for this role you might find it useful to read through the following sections ofthe NMC (2008) standards in order to understand the purpose of the role and the criteriathat must be met before undertaking this role:

l Page 12: revisions to the standards relating to the sign-off mentor role

l Page 16: roles to support learning and assessing in practice

l Page 17: fitness for practice

l Pages 27–8: criteria for a sign-off mentor.

Talk to your mentor if you have one and find out how the process of becoming a sign-offmentor is delivered within your organisation. You should add the contact details of therelevant individuals or team responsible for supporting sign-off mentor preparation to youraction plan for future reference.

Week 4








Quiz - Week 4Now it’s time to complete the Week 4 badge quiz. It is similar to previous quizzes but thistime, instead of answering five questions, there will be 15.

Week 4 compulsory badge quiz.


Week 4 SummaryThis week you have reviewed the importance of relationships to effective mentoring, bothfor yourself and for your students. In addition to exploring the key components of effectivementoring relationships you have also considered how to avoid or manage conflictassociated with the relationship, the specific issues of how to give feedback as part ofopen communication and how to use motivation strategies to stimulate and engagestudents in practice learning.Next week you will explore the learning opportunities that are available in your practiceenvironment, so keep the ARCS model in mind because you are likely to find usefulrelationships between these opportunities and ways to motivate your student.

Week 5In Weeks 3 and 4 you learnt about your role as a mentor in facilitating teaching andlearning, and the importance of building effective relationships with both colleagues andstudents in this process. This week you will be looking more specifically at how your rolein facilitating learning relates to the practice environment. You will be able to explore yourown perceptions of the learning environment and complete activities that encourage youto develop your knowledge and insight of a range of interventions that you could utilise tosupport learning in practice.Here’s Fiona Dobson introducing Week 5.


Week 5




Mentorship programmeIf you are completing this session as part of a Nursing and Midwifery Council (NMC) mentorpreparation programme, the materials and activities relate to the following NMC domains:


l Creating an environment for learning


l Evidence-based practice.

Evidence of completion of the learning activities included in this session must be includedwithin your practice portfolio.


l develop an awareness of your own perceptions and expectations of a learningenvironment

l identify interventions to support learning in practice

l explore ways of planning activities to meet learners’ needs

l appreciate the importance of professional socialisation.

1 Themes of nursing mentoringIt is useful to begin this section by considering how mentoring nursing students in practiceplacements has evolved. Jokelainen et al. (2010) provided a systematic review of theconcept of mentorship in ensuring quality of placement learning, which you may wish to

Week 5



consider in relation to your own area of practice. Two themes emerged from Jokelainenet al.’s systematic review (p. 2854):

1 ‘Facilitating nursing students’ learning by creating supportive learning environmentsand enabling students’ individual learning processes.’

2 ‘Strengthening students’ professionalism by empowering the development of theirprofessional attributes and identities, and enhancing attainment of students’professional competence in nursing.’

These themes will be considered in the following materials and activities.The Willis Commission (2012) identified that the quality of practice learning experiencesfor students need to be reviewed urgently, with motivated and knowledgeable mentorsseen as having a key role in enhancing the student experience in relating theory topractice. The role of mentor in optimising learning opportunities within the practiceenvironment is fundamental to the student learning journey and should be seen as acentral responsibility in shaping the future nursing workforce.The further reading section provides suggestions for other articles that you may wish toinvestigate at the end of this week’s module if you have access library facilities. There aremany other useful reading materials available within both public and healthcare libraryfacilities, and some may be accessible via the internet to inform your learning.

2 Perceptions and expectationsYou may be asked to mentor a student who has experience from a previous placement, orit may be a first placement for a student who has no care experience at all. Each studentwill have different learning needs and will have formed perceptions of the practice areaprior to commencing their placement experience. They may have already createdexpectations of you as their mentor and the possible learning opportunities that theybelieve will be available. These may be based on:

l preconceived ideas based on other students’ accounts

l their understanding of the clinical area from media sources

l personal experience

l academic sources relating to their study.

Students commencing a new placement may be extremely apprehensive, no matter whatstage of their studies they have reached. For others, it may be a placement they are reallylooking forward to, or one they feel confident that certain skills they have learnedpreviously will be transferable to this area. Perceptions of a placement area can beconstructive but may also be destructive (Brennan & McSherry, 2007; Houghtonet al., 2013), so it is important to take time to discuss these perceptions with the student,and work together to develop a realistic action plan of learning opportunities. A clearoverview of the clinical environment, including the type of patient care interventions thatthey can expect to see, will help the student focus on the reality of the learningexperience.The next activity encourages you to think about your own perceptions and learningopportunities for a variety of placement environments.

Week 5



Activity 1 Perceptions of learning environmentsAllow 30 minutes

Figure 1 shows different practice areas – some of them you may be familiar with, someyou may not. For each one, consider the following questions and make some notes:

l What are your perceptions of these environments?

l What do you consider are the possible learning opportunities available forstudents?

Figure 1 Various learning environments (clockwise from top right): a care home, wherepeople may have learning disabilities, or physical or mental health conditions; healthvisiting; a walk-in centre; a patients’/clients’ home; emergency care; and an intensivecare unit

Week 5



DiscussionThis activity may have led you to think about your experience as a learner. We all learnfrom experiences, good and bad, but the most important thing is that we have thecapacity to reflect, learn and subsequently improve practice. By doing this activity youwill have explored:

l your current thinking about learning opportunities

l perceptions of clinical environments that may be rooted in personal experience

l what you would want to learn from these practice areas

l the knowledge/skills you already have that could be transferable.

When discussing student perceptions, it is important to reflect the positive learningopportunities of the placement environment, even though this may not reflect theirexpectations.

3 Establishing a supportive learning environmentMcIntosh et al. (2013) explored the perceptions and experiences of 130 mentors ofnursing students, and concluded that mentors feel that they are the most important sourceof support for students in practice. Additional literature supports this view, and suggeststhat ensuring a supportive clinical learning environment can reduce both student anxietyand attrition (Moscaritolo, 2009; Robinson, 2013). It is important that you have anoverarching interpretation of your placement area as a starting point to build upon.

Activity 2 SLOT analysisAllow 20 minutes

Think about your own views on how you perceive your placement area as a supportivelearning environment. If you can, you should also gather views and opinions fromcolleagues, current students, clinical leaders/managers, support staff, and relevantmembers of the multi-disciplinary team.Using any information from others and your own views, copy and complete thefollowing SLOT analysis to consider the strengths, limitations, opportunities andthreats of your placement area. You can also download a copy.

Week 5




Figure 2 SLOT analysis

DiscussionThere may be differing opinions as everyone has individual likes, dislikes, perceptionsand learning preferences. However, it is important to consider these in addition to yourown viewpoints to foster and encourage a collaborative learning environment.

Mentorship programmeIf you are completing this session as part of an NMC mentor preparation programme, usethe protected learning time allowed to discuss your SLOT analysis at a team meeting. Youmay want to ask mentorship to be a standing agenda item in order to encourage sharing ofideas, foster supportive networks and provide a forum to discuss suggestions to improvethe student learning experience.

You may come across accounts similar to the following:

Week 5



l ‘When I was a student, you were told what to do and you just got on with it – youdaren’t question Sister.’

l ‘Students today have it too easy! They don’t want to get their hands dirty.’

It is important that these viewpoints are not left unchallenged. Use current evidence tosupport new ways of thinking in ensuring all staff working within your placement area:

l are positive about student learning

l have an understanding of their involvement in the learning opportunities planned forstudents.

4 Interventions to support learning in practiceAs a mentor, you will of course endeavour to ensure that the practice experience is thebest it can possibly be for the learner. Successful planning and preparation for learners isessential and can be assured through an educational audit process. This helps to identifywhere standards help the learner to achieve the required competencies within the practiceenvironment. Various interventions can contribute to these standards and help supportlearning in practice.

Mentorship programmeIf you are completing this as part of an NMC mentorship preparation programme, there is arequirement that an educational audit is completed at least once every two years(NMC, 2010).

Use the protected learning time allowed to find out who your educational link is from yourlocal university and also the practice learning environment lead within your employingorganisation. Discuss with them the individual audit tool that is used and the process ofeducational audit within your area.

Access your practice area’s current audit and reflect on the above discussion todemonstrate your understanding of this process. This can be included within your portfolioof evidence.

Activity 3 Checklist of interventionsAllow 15 minutes

Develop your own checklist of interventions that you might use to support studentlearning.

DiscussionThe following list gives examples of interventions that you can adopt to support studentlearning in the practice environment, although this list is not exhaustive.

l Access the most recent placement audit to check recommended action points.

l A robust, up-to-date student induction pack should be available, which includesessential information such as where to access policies and procedures, staffdetails, IT access, and working patterns.

Week 5



l Ensure that current, relevant, evidence-based learning resources are availablerelating to the practice area.

l Liaise with education providers and practice placement link staff to confirm detailsof the student, their date of arrival and any changes to practice documentation orlearning requirements.

l Plan your working pattern to ensure that you, as the mentor, are working to therequired professional body standards with your student. Inform relevant staff ofthe date and time when the student will be commencing placement.

l Ensure a planned, protected time on Day 1 to discuss perceptions, expectationsand learning goals, university requirements and schedule for assessments inpractice, practice environment learning opportunities, and meeting dates forreviews.

l Get to know your student: what their strengths are, which areas they feel theyneed further support with and details of any previous experiences. Let the studentknow you’re interested in them and their learning development. Negotiate andagree ground rules.

l Negotiate a learning plan that is realistic and includes working with members ofthe multidisciplinary team (with dates and times agreed in advance). This mayinclude attending relevant staff seminars, workshops or conferences that wouldenhance the learning experience, including following a ‘patient journey’.

l Allow the student to take ownership of their learning and encourage them tosuggest alternative opportunities that may be facilitated.

l Act as a role model. Be positive, enthusiastic and facilitative, and ensure that youplan regular one-to-one meetings to reflect and discuss learning that is occurring.

l Challenge constructively to facilitate critical reflection on situations in practice.

l Ensure that the student feels valued and part of the team. For example, ensurethat they have someone to go to lunch or a coffee with, involve them incommunications with the wider team, encourage their suggestions or opinions,and acknowledge their previous knowledge and skills.

l Remember that all students have individual learning needs. Don’t presume that afinal-year student will be confident with their skills or competencies, or that a newstudent will have no experience. Take time to assess the student’s capabilities inorder to facilitate new learning opportunities, and revisit any areas that needfurther support and guidance.

l Support participation in clinical tasks and competencies in a non-threateningmanner, demonstrating encouragement to increase confidence. Give regular,constructive feedback on performance.

l Be open to learn from your student. Gather feedback on your own performanceas a mentor and reflect on ways to improve.

l Remember how it felt to be a student!

Week 5



4.1 Cooperative learningCurrent literature considers the impact of cooperative student support on the learningjourney in practice as an addition to formal mentorship arrangements. This is an area thatyou may think about implementing within your own place of work. Ruth-Sahd (2011)discusses student nurse dyads that create a community of learning in the practice setting:first year students are paired with a more experienced student for support and mutuallearning and reflection.This concept of cooperative learning is well evidenced within classroom settings throughstrategies such as problem-based learning, where student groups co-construct knowl-edge and apply it to care situations (Roy and Andrews, 2008). Using this to enhancelearning in practice environments is a strategy that you may want to consider withindividual students depending on the specific resources available in your practice area. Inparticular, this has been shown to help ease anxiety and increase socialisation wherestudents perceive themselves to be ‘all in the same boat’ (Hatmaker et al., 2011;Houghton, 2014).

Activity 4 Scenarios in practiceAllow 15 minutes

Read the three case studies below. Identify the learning opportunities that theypresent.

Stacey is a second-year student nurse who has arrived at your practice areaa day earlier than you expected. She is wearing jewellery (bracelets andnecklace) and her uniform appears to be dirty and creased. She mentionsthat she needs to have early shifts planned for the next three weeks due tochildcare arrangements and would like to have the opportunity to go out andwork with a variety of community services. However, you had alreadyplanned her working pattern to complement yours. She appears anxiousand states that she is very nervous about this placement.

Conor is a final-year student nurse who has recently returned to hisprogramme of study after a period of absence due to a previously failedmodule. He arrives at your placement area and says that he feels he hasforgotten many of the skills and competencies previously learnt. He alsomentions that he is thinking of leaving nursing as soon as he completes theprogramme, as he has not experienced many positive placements over thepast two years and just wants to complete his degree so that he can moveonto a graduate programme elsewhere.

Jo is a first-year student nurse who has previously worked as a Health CareAssistant within a community setting. She arrives at your placement area anhour early, smiling and feeling very positive to be part of the team. Sheknows three members of staff within the placement and goes to have coffeewith them before her identified work pattern begins. You hear her laughingand joking with staff, saying that she’s done more as a HCA than she’sexperienced as a student nurse to date and is fed up of just talking to clients.

Discussion

Week 5



You will have identified what your responses would be as a mentor, how comfortable orconfident you would be in addressing some of the issues presented, and what you feelworks does or does not work well in optimising learning opportunities within the clinicalenvironment. Additionally, you might have had the opportunity to speak withexperienced practitioners to determine how they might have best facilitated learning inthe three case studies. You may have also considered the possibility of cooperativestudent support. The individual mentor–student relationship will create a variety ofresponses that depend on the clinical and learning situation. What is paramount is thatthese responses and actions:

l are underpinned by evidence-based practice

l protect patient safety

l are fully explained to, and understood by, the student

l promote quality patient care

l adhere to professional body requirements and standards.

Remember that you need to seek support as necessary and do not feel that you haveto solve every issue that arises. Your own response, had you faced the situationsdescribed in the case studies above, may have been to contact relevant personnelwho could help both yourself and the student. This could be your own mentor assessoror other colleagues, manager, practice link staff, the student’s personal tutor, or othersupport networks. It is always useful to seek support sooner rather than later.

Mentorship programmeIf you are completing these learning materials as part of an NMC mentor preparationprogramme, use the protected learning time allocated to discuss with your own mentorassessor or other experienced practitioners how you would facilitate the learning in theabove case studies.

Reflect on your own experiences with students in the practice environment. Reflect on thepositives and negatives of these, what you have learned, and what you would do differently.It may relate to your own experience of inputting to a learning opportunity with a student, oras an observer of a mentor/student relationship. Write this as a case study to include inyour portfolio, remembering to ensure confidentiality. Specifically include:

l how the student’s learning needs were identified

l how learning opportunities were planned and facilitated

l how the learning was evaluated.

Upholding the values of the profession, discussing student responsibilities and adaptingto unforeseen circumstances are key to the mentor role. The case studies above alsopresent learning opportunities that can be discussed with the student. You may haveidentified specific areas to discuss with the student, including safety issues, profession-alism, nursing roles, care and compassion, teamwork, required skills and competencies,and communication skills, amongst others. They also give an opportunity to discussindividual learning needs and goals, clarifying skills and competencies that requireadditional supervision, and negotiating appropriate action plans to achieve these.

Week 5



5 Empowering professionalism within the learningenvironmentIt is well documented that students adapt to new clinical environments in different ways,with some adjusting more quickly than others (Ousey, 2009; Anderson, 2011; Brugnolliet al., 2011). Professional socialisation is the process by which the individual learns theculture of the profession (Dent and Whitehead, 2002) and involves changes to thatindividual’s own values, norms and behaviours to align with those ‘expected’ from theprofession. There is much literature concerning professional identity and suggestedreading materials are listed at the end of this session if you would like to learn more aboutthis area.

Activity 5 Exploring values of nursingAllow 15 minutes

Watch the following video from YouTube, produced by the Royal College of Nursing.Please note there is no dialogue in this video, just a music soundtrack.If you are reading this course as an ebook, you can access this video hereThis Is Nursing

l How do you feel this promotes the profession and values of nursing, and howdoes it differ from your own views or values of nursing?

l If you are able to, ask a colleague to watch this video and compare viewpoints.

DiscussionThe video brings into question the variance of individuals’ values system. It may haveespoused a different set of ideas and views to those that you hold (or your colleague, ifthis has been possible), or it may replicate your values on what nursing is.As a mentor, you have a responsibility to act as a role model for the nursing professionand play a key part in the professional socialising of the student. The learningexperiences that a student receives within each practice environment will affect howthey develop and progress as a student to registered nurse, and will help shape theirfuture careers. Instilling values of respect, care, compassion and dignity isfundamental to nursing, so students need to see and experience these values fromtheir mentor and other staff within the practice learning environment in order to mirrorthese when planning and delivering their own episodes of care.

5.1 Professional socialisationSpouse (2000) identified four areas where the mentor can encourage professionalsocialisation within the practice learning environment:

1 To organise and provide a menu of experiences available in the clinical area that arerelevant to the student’s stage of study.

2 To help the student identify areas of particular relevance studies in the curriculum tothe current clinical environment.

3 To help organise learning opportunities to other clinical areas or departments.

Week 5


https://www.youtube.com/watch?v=URlKV0ewrhM


4 To select suitable patients, carers and members from the multi-disciplinary team forthe student to work with to develop identified skills.

The Royal College of Nursing Report (Rejon and Watts, 2014) reviews the evidence tosupport professional nurse socialisation and suggests that inter-professional learningalongside excellent mentorship can ensure a positive transition from student to registrant,helping to reduce attrition and enhance nurse socialisation. However, adequate staffinglevels, adequate resources and support from nurse leaders within the clinical environmentare key to ensuring this success (Masters, 2013). It is a requirement that ‘whilst givingdirect care in the practice setting at least 40 per cent of the students time must be spentbeing supervised (directly or indirectly) by a mentor’ (NMC, 2008).

Activity 6 Who could help?Allow 15 minutes

If you can, think about members of your immediate practice team and those within thewider multi-disciplinary team that you feel would be useful in sharing their expertiseand knowledge in the student learning journey. Otherwise, try to think of teams thatyou have worked with.

l What learning opportunities can they offer to students in their learning?

l What information or preparation will you need to offer these members of staff toensure the student has an effective learning experience?

DiscussionThis may include face-to-face discussions or emails highlighting the benefits to boththe student and the member of staff, such as fulfilling continuing professionaldevelopment hours, sharing expertise through a teaching session, possible reciprocalarrangements with their future students or learners. This may include specific targetareas at different stages of the student nurse training that would be relevant to theirparticular learning outcomes and competencies to be achieved, a particular area/member of staff that provides an excellent role model, or a learning opportunityinvolving a particular specialised area that the student may be unlikely to haveexposure to in the future. It also encourages collaborative working and awareness ofothers’ roles in the planning and delivery of care interventions.

In addition to organising individual and group interaction to help in the professionalsocialisation of the student, McKenzie (2010) argues that new technologies should alsobe utilised to help shape professional identity. Because online learning is now increasinglyused in healthcare education, the mentor in clinical practice can use this as a learningstrategy to allow the student to explore subject areas experienced in practice. Direction toappropriate web links, blogs or video clips can open up a range of alternative ideas andopinions that can then be discussed as part of the reflective learning process.Encouragement to engage in relevant professional group discussion forums will alsoenhance a sense of learning community.

5.2 Using a coaching toolTo help build confidence and a sense of professional identity, the GROW model(Passmore, 2006) is a useful coaching tool that can be adapted to structure practice

Week 5



learning. The confidence of students can increase when they feel they are part of a team,belong to the profession and gain positive feedback from staff, allowing them to ‘fit in’(Chesser-Smyth and Long, 2013).

Figure 3 Adaptation of the GROW coaching model (Passmore, 2006)

However, it is important to acknowledge that the student must also be a ‘proactive agent’in their transition from ‘newcomer’ to feeling part of the team (Hatmaker et al., 2011;Houghton, 2013), and this can be facilitated through effective preparation prior tocommencing the placement area. As a mentor, it may be possible to liaise with theeducation provider or practice link staff to forward information about the placement andoffer a short orientation visit prior to the official starting date. The student can then beproactive in establishing their understanding of the clinical area and role clarity, and startthinking about goals to be achieved.

Mentorship programmeIf you are completing these learning materials as part of an NMC mentor preparationprogramme, use the protected learning time allocated to discuss with your mentor assessorhow you would use the adapted GROW model in Figure 3, to plan and facilitate learning fora day with a student in your practice area.

Quiz - Week 5You’ve nearly reached the end of another week of study. Now it is time for the weekly quiz.This week's quiz won't count towards your badge so only has five questions.


Week 5




Week 5 SummaryIn this section you have explored and reviewed your own learning perceptions andexperiences of mentoring, considered strategies to facilitate a collaborative supportiveenvironment for learning, and identified opportunities to improve confidence, socialisationand empowerment of students in the practice learning environment. Next week you willstart to explore assessment with learners in the practice environment. You will consider avariety of assessment methods that can be used in your mentor role, alongside strategiesfor giving constructive feedback to students.

Week 6In Week 4 you were introduced to elements of assessment and providing feedback thatrelated to building effective relationships with students that you mentor. In Week 5 youwere also introduced to interventions that could contribute to this relationship-building andensure an effective learning environment for the student.This week you will be looking more specifically at the processes of assessment anddelivering constructive feedback in the practice environment. You will explore variousmethods of assessment and how these can help in your decision making, and alsoconsider appropriate feedback strategies. Although you may be a nurse registrant, it isuseful to revisit standards for pre-registration nursing education (Nursing and MidwiferyCouncil (NMC), 2010) as they provide a useful starting point to understand therequirements of assessment throughout the pre-registration nursing programme. Thesestandards can be accessed at the NMC website.Watch the video, where Fiona Dobson introduces Week 6.


Week 6



http://standards.nmc-uk.org/PublishedDocuments/Standards%20for%20pre-registration%20nursing%20education%2016082010.pdf





l Establish effective working relationships.

Evidence of completion of the learning activities included in this session must be included inyour practice portfolio.


l show knowledge and understanding of a variety of assessment methods

l reflect on how these assessment methods can be used in evaluating learning

l show an awareness of constructive feedback approaches

l understand your responsibilities as a mentor in assessing students.

1 What is assessment?We ‘assess’ continuously in a variety of situations in our daily lives. For example, you mayassess what to wear depending on the weather, or what you will buy for dinner dependingon dietary requirements, or patient need depending on their presenting and potentialproblems. However, as a mentor, you will be collecting evidence to support your decisionmaking in the assessment of student competence. This relates to the student’s learning

Week 6



over a period of time and may include an assessment of knowledge and understanding,skills, behaviour, attitudes and professional values, leadership, and team working.

Assessing the students’ learning while they are in practice is one of the mostimportant mentoring roles you will be performing. Assessing a student’sknowledge, skills and attitudes provides you with an opportunity to nurture thestudent and develop their confidence as a practitioner.

(Aston and Hallam, 2014, p. 65).

The NMC’s competency framework (2010) identifies generic competencies in addition tofield-specific competencies that students must achieve to register as a nurse. Otherregulators may have alternative standards and competencies that will need to beadhered to.

Activity 1 Understanding assessmentAllow 15 minutes

l When you think of the term ‘assessment’, what is your immediate reaction andwhat words come to mind?

l Reflect on a situation in your life when your learning was ‘assessed’. This couldbe a situation at school, work, or within your social sphere. How did you feelbefore, during and after the assessment?

DiscussionYou may have chosen an examination at school, a driving test, a sports assessment, acontinual assessment relating to a probation period or an assessment you wereinvolved with during your own career. In many cases the assessment will relate toknowledge, skills and attitudes – the same components as NMC standards.

Listen to the case study below to see if any of the words or thoughts you identified areshared with the person in this case study.

Audio content is not available in this format.Case study

Depending on the assessment you identified, you may have had similar feelings to thosein the case study. Our own experiences and understanding of assessment can influencehow we view our role in assessing others. Therefore, it is important to understand thenature of assessment and how it can be used not only to ensure safe and effectivepractice, but also as an opportunity to promote learning through effective feedback.

2 Types of assessmentThere are many forms of assessment, but the main three domains identified withineducational literature are diagnostic (initial), formative and summative assessment(Figure 1).

Week 6



Figure 1 The three domains of assessment

There is a wealth of literature concerning assessment and assessment frameworks.Suggested reading materials are listed at the end of this week if you would like to learnmore about this area.These three domains of assessment are defined as follows:

l Diagnostic assessment – This is completed when a student begins a specific stageof learning (or placement period) and can initially involve a student self-assessmentand a SLOT analysis to assess the strengths, limitations, opportunities and threatsrelating to the student’s current knowledge, skills and attitudes. It can also includeinitial observations of the student delivering nursing or health care, discussions onparticular areas of practice, and preliminary questioning, in order to give a baselineon which to build and develop action plans and learning strategies.

l Formative assessment – This relates to continuous assessment and incorporatesregular feedback sessions that are planned throughout the specified time allocated inthe learning environment. It gives an opportunity to identify areas of strength andareas that need to be improved, with subsequent action plans developed. It is amethod that can be used to monitor progress and provide immediate and ongoingfeedback within daily learning experiences. This can also include continuousportfolios of evidence that indicate reflections on learning experiences.

l Summative assessment – This is usually a more formal process that is designed toassess specific learning outcomes or criteria at a given point in the student’slearning, usually at the end of a period of study (or placement period). This may bean assignment, examination, objective-structured clinical examination, question and

Week 6



answer discussion, observation, portfolio of evidence, or performance indicatorsincluding skills and competencies.

3 Evidence to inform assessmentPrior to assessing learning and competence, the student should engage in some form ofself-assessment, either by completing a SLOTanalysis (see Week 5) or by self-assessingagainst those criteria required for the particular practice area. Often it can be assumedthat the student will be aware of their own capabilities; however, the process of self-assessment will encourage an opportunity to plan learning. You could discuss with thestudent their:

l knowledge base

l strengths

l limitations

l self-perceptions and confidence.

Nevertheless, this process should only be used as one method of assessment inconjunction with others such as direct observation and questioning, which will be neededto confirm current capabilities. Baxter and Norman (2011) suggest that caution is neededwhen utilising student self-assessment as a method of evidence for competence, asfindings from their study recommend this common practice is less than effective and is notan accurate measure of clinical ability when used in isolation. It does however give aninsight into how the student perceives their own capabilities and their level of confidencein specific areas of practice.

Activity 2 Exploring methods of assessmentAllow 15 minutes

l From Table 1 below, what methods of assessment do you feel you could utilise inassessing students learning in practice?

l Next identify the methods you feel most comfortable with or that you feel youneed more experience with.

Table 1 Methods of assessmentDirect observation Does the student need more practice and

guidance? Additional role modelling may berequired.

Does the student appear nervous when beingdirectly observed? Reflect on the impact of yourpresence and observation technique to ensurethese are performed in a supportive way. Clarifywhen you may need to intervene (i.e. clientsafety).

Questioning of related evidence-basedpractice

Does the student understand the underpinningtheory relating to the skill or competenceperformed?

Week 6



Working alongside the student duringan episode of care or placement period

Holistic assessment over a longer period cangive context to a required competence.Examples of care settings could include anacute care or community setting, a serviceuser’s home, or a health promotion setting.Values and attitudes can be monitored.

Feedback from colleagues, othermentors, service users

Adds to the reliability of decision making andidentifies if overall standards of practice havebeen achieved.

Oral presentation Must be conducted in a supportiveenvironment. Allows the student time toresearch and prepare. Can lead to sharedlearning and new insights.

Reflective discussion/writing Promotes self-awareness and encouragescritical analysis of episodes of care. Helps todemonstrate knowledge learned, what wentwell and what could be done differently in futurecare interventions.

Problem-based scenarios or patientstories

This method can be useful to discuss possiblescenarios that have not been observed. Thesecan determine a student’s understanding andapplication of nursing knowledge to a variety ofsituations and must include holistic care ofpeople with disabilities and learning needs,including visual and hearing difficulties that maynot be physically obvious.

DiscussionAll the above methods provide sources of evidence that can be utilised in your overallassessment of student learning. It is useful to make notes either during or immediatelyafter an assessment and refer to these in future discussions. Encouraging the studentto write down their reflections from the above assessment processes will also help todemonstrate current knowledge and understanding, and identify potential areas forimprovement. Gaining written feedback from colleagues and other mentors is moreeffective than a rushed ad hoc conversation, and can be more productive in identifyingthe student’s potential strengths and limitations. Asking several colleagues who haveworked with the student rather than just one provides a more balanced approach andcan identify if there are multiple concerns or multiple areas of progression that can helpto inform your decision making about a student’s stage of learning (Price, 2012).

Mentorship programmeIf you are completing these learning materials as part of an NMC mentor preparationprogramme, use the protected learning time allowed to discuss the above methods withyour own supervisor/mentor and identify opportunities for further exploration of thesemethods.

Critically reflect on these experiences within your portfolio of evidence to demonstrate newlearning. NMC (2008) requirements state that ‘most assessment of competence should beundertaken through direct observation in practice’ (p. 32).

Week 6



3.1 Involving service users in assessmentIn response to health policy initiatives, the patient, service user or carer voice has becomea fundamental concept in the quality assurance processes of both nursing practice andeducation (Casey and Clark, 2014). The NMC’s Standards for Pre-registration NursingEducation (NMC, 2010) requires that ‘programme providers must make it clear howservice users and carers contribute to the assessment process’.However, there are few empirical studies to suggest a robust mechanism to achieveeffective service user feedback in practice assessment. This may be due to ethicalimplications of asking patients for feedback relating to student performance. Serviceusers and relatives are vulnerable in care situations and should not be coerced to beinvolved with student assessment.

Activity 3 Gaining service user feedbackAllow 10 minutes

What factors do you think should be considered before asking a service user or carerfor feedback relating to care delivered by a student?

DiscussionFactors you might have considered could include:

l Patients may feel they are required to give ‘positive feedback’.

l Patients may feel ‘pressured’ into agreeing to give feedback and cannot say no.

l Patients may feel responsible for the ‘pass’ or ‘failure’ of the student.

l Patients may have concerns about their anonymity.

l Patients may feel too ill and weak to make an informed judgement.

l Relatives may feel that it will affect their loved ones’ care if they don’t comply.

l Relatives’ perceptions of care received may differ from those of the patient.

l Patients or relatives don’t understand what is expected of them.

l There may be bias in choosing patients; for example, only choosing patients whohave the same language skills, culture or religion, or who are undemanding, don’tcomplain and have already expressed positive feedback about their care.

Despite these potential challenges, the literature does suggest that service users, carersand relatives can be instrumental in highlighting particular performance capabilitiesrelating to the care they receive, such as privacy, compassion, dignity and communicationskills (Atkinson and Williams, 2011). Service user and carer involvement can provideadditional evidence to the mentor within the student assessment process as part ofshared decision making.

l You may already have a tool or template in use within your practice environment ormay consider developing one with relevant stakeholders, including patients, relativesand colleagues.

l Consider the use of both verbal and written feedback, including questionnaires orsurveys that are specific with clear criteria or cue questions. There may be instanceswhere it is appropriate for the student to be present when discussing an episode of

Week 6



care delivery with the service user or carer. In certain circumstances, you may wishto speak with the service user or carer alone to gain their feedback or ask them tocomplete a written feedback form.

l Patient selection should be considered carefully, and consent sought.

l Assure anonymity. You, as the mentor, should ask the service user for information orfeedback – not the student.

l Consider the way you ask a service user for feedback. It may be appropriate to askhow they felt about the care delivery received and any suggestions for improvement.

4 Developing effective questioningUnderpinning all of the assessment methods explored previously is effective questioning,which helps to:

l understand the students’ thought processes

l assess students’ critical thinking skills and decision making capabilities

l clarify the processes and actions observed

l ascertain understanding of the various components of a care intervention

l encourage further reflection.

Carlson et al. (2009) suggest that questioning is the most commonly used form ofstudent–mentor interaction, should be planned carefully in relation to the student’s stageof learning and should not be interrogative or judgemental. Ness (2010, p. 42) identifieskey points below when asking students in practice questions to assess their learning:

l Do my questions relate to the students learning outcomes?

l Are my questions clear?

l Do my questions help the student link theory to practice?

l Are my questions at the appropriate academic level for the student?

l Are my questions seen as threatening?

l Am I asking too many questions at once?

l Am I asking questions in an appropriate place?

l Am I asking questions at an appropriate time?

l Do I listen to the student’s response?

Activity 4 Acknowledging stages of learningAllow 20 minutes

In the case study below, what questions would you ask to assess learning if a student,Jo, is:

(A) AT THE INITIAL STAGE OF A PRE-REGISTRATION NURSING PROGRAMME?(B) COMPLETING THEIR FINAL PLACEMENT PERIOD OF A PRE-REGISTRA-

TION NURSING PROGRAMME ?

Week 6



Case studyJo, a student nurse, has been working with a Health Care Assistant for two hours caringfor Mrs X.

As Jo’s mentor, you have a planned meeting to discuss the episode of care for thirtyminutes before lunch. Jo states that Mrs X is complaining of headaches, feeling weakand just wants to go home. Jo has noticed that her skin is very dry.

DiscussionPossible interventions for scenarios A and B are described below.

Al You may have decided not to bombard Jo with too many questions at this stage.

l Ask about their understanding of Mrs X’s condition as a baseline.

l Can Jo think of any reasons why Mrs X’s skin could be dry?

l Ask about communication skills. How could Jo gather more information about MrsX’s headaches, feeling of weakness and wanting to go home?

l Consideration of the environment; ask Jo to consider noise levels, comfort andpositioning relating to how Mrs X could be sitting/lying.

l How did Jo feel about the episode of care? You may want to ask Jo to accompanyyou to the patient to role model how you would assess Mrs X.

l Ask Jo to reflect on this and read around a specific element of her care to discussfurther at your next meeting.

Bl You may want to ask more complex questions relating to Mrs X’s condition.

l What does Jo consider to be the causes of the above symptoms and how havethese been identified? What assessment tools did Jo use?

l Ask about current and potential medication, including their side-effects.

l What would Jo suggest in order to alleviate Mrs X’s symptoms? What relatedevidence and theory can be drawn upon to plan practice interventions?

l What information has Jo given to Mrs X and what interventions did she perform?

l You may want to ask Jo to write a critical reflection on this episode of care toinclude within her portfolio, which can be discussed at your next meeting.

All discussions relating to episodes of care need to be followed up with your ownobservation and assessment of the patient’s needs in order to ensure that appropriateactions are performed and plans of care are formulated.

Week 6



5 DocumentationWhen completing assessment documentation, you are accountable for the decisions youmake. Therefore, you should be detailed, systematic and comprehensive in collating theevidence that is required to inform your judgement. When assessing studentcompetencies, there may be just a signature box to complete within the assessmentdocument, an identified space to write a rationale for a particular decision or a generalcomment box following a set of competencies within a specific learning domain. Thesespaces should always be utilised fully to justify the decision you make.Assessment can be seen to be interpretive and somewhat subjective, so drawing onappropriate evidence when writing your comments can lead to increased confidence inyour assessment. This can be discussed openly and honestly with the student. Price(2012) suggests that there should be no surprises for the student when it comes to thefinal placement interview if effective continual assessment (including regular discussionsand constructive feedback) has been implemented.

Mentorship programmeIf you are completing these learning materials as part of an NMC mentor preparationprogramme, you should appreciate that from day 1 as a nurse mentor you must understandthe assessment process and student documentation. Discuss these with your clinicaleducational lead, university link tutor and supervisor to ensure that you fully understand thevarious requirements and processes for initial, intermediate and final assessment.

5.1 Validity and reliability of assessmentThe validity of an assessment is the extent to which it measures what it is supposed tomeasure. The reliability of an assessment is the extent to which it measures the skill,learning or competence consistently (Quinn and Hughes, 2007).

Activity 5 How reliable is your assessment?Allow 10 minutes

Think of a time when you have been involved in the assessment of a student. This canbe an initial diagnostic episode, or formative or summative assessment.

l How reliable do you think your assessment was?

l What do you think can affect the reliability of an assessment?

Click on ‘Reveal discussion’ to reveal possible factors that can affect the reliability ofassessment.

DiscussionReliability of assessment can be affected by:

l only being able to observe one episode of a particular skill or competence

l bias towards the student (both positive and negative)

l being unable to gather evidence from colleagues or service users

Week 6



l being unsure of documentation requirements

l using only one method of assessment (such as discussion)

l the readiness of the student

l adequate preparation

l your mood – a very busy or rushed day versus a calm, relaxed day.

Mentorship programmeIf you are completing this as part of an NMC mentor preparation programme, write this as acritical reflection for your portfolio of evidence. On completion of your mentorshippreparation programme, a subsequent reflection can be included relating to a recentassessment to demonstrate new learning.

A range of assessment methods should be utilised to give an overall picture of how thestudent is learning and progressing in practice. This will also increase the validity andreliability of assessment. The assessment documentation to be completed will have beenscrutinised as part of required quality assurance mechanisms, which may includeprofessional bodies such as the NMC and by the programme provider or university.However, a study by Fahey et al. (2011) suggests that the language of competencydocumentation can often be misinterpreted by both students and mentors, so you mustget clarity from the programme provider or practice link facilitator if there are anyuncertainties. A study by Brown et al. (2012) suggested that even experienced mentorslacked confidence in their assessment of students, in particular with failing students (thisis considered in more detail in Week 7), so always seek support from your own supervisor,mentor colleagues, educational lead and practice link tutor.Remember that your assessment of a student’s learning should be based on requiredcriteria, and not norm-referenced. Norm-referenced assessment is where the student isassessed against another student who is at a similar stage of their learning(Anderson, 2011).

Week 6



6 Feedback

Figure 2 Giving feedback

Feedback goes hand-in-hand with assessment as a successful strategy for learning andimprovement. Effective feedback is a priority for the mentor–student relationship in orderfor students to progress and learn from their experiences. Clynes and Raftery (2008)describe feedback in clinical practice as ‘an interactive process which aims to providelearners with insight into their performance’ (p. 405).Mentor feedback is also important for education providers and their external examiners,and also as part of regulatory body quality assurance and monitoring processes. Mentorsmay also be asked to give feedback on students who are being mentored by othercolleagues.

Activity 6 How do you give feedback?Allow 20 minutes

l Reflect on the last time you gave feedback to a learner. What strategies did youuse and how did it make you feel?

l How do you think the learner benefited from this feedback?

l Would you do anything differently next time?

DiscussionIt can be challenging to give feedback, in particular if it involves an identified area ofthe student’s practice that needs improving. It can seem much easier to give positivefeedback, although all feedback should be viewed as constructive in helping thestudent progress and improve. Clear feedback and direction in how to improve is vital,with studies suggesting that students do not want generalised or superficial feedbackthat does little to help them understand what they need to do to develop their practice(Murray et al., 2010; Aston and Hallam, 2014). It is important when assessing astudent that they receive feedback when applying quality standards to service users

Week 6



from a variety of backgrounds, including ethnic, religious, physical, learning or mentalability, and social class, to exclude bias or prejudice.You may have used terms such as ‘Well done’, ‘That’s good’, ‘That’s fine’, ‘That wasn’ttoo bad’, ‘That’s OK, just keep practising’ or ‘That’s not quite right yet’. These are allgeneral comments but do not provide specific, constructive feedback in how toimprove or know why particular interventions were good. Constructive feedback needsto give further detail and refer to relevant criteria so that the student clearlyunderstands how their practice is progressing. The ‘sandwich method’ is anestablished strategy for giving feedback, whereby a discussion relating to the need forimprovement is ‘sandwiched’ between two pieces of positive feedback that highlightstrengths and progression (Dohrenwend, 2002).

6.1 Delivering feedbackThere are various models to help you consider how you would like to deliver feedback.Examples of these are shown below. Figure 3 depicts the effective feedback cycle.

Figure 3 Effective feedback cycle

The four stages of feedback according to Duffy (2013) are:

1 Gauge the student’s expectations of feedback.2 Gather information on student practice.3 Act immediately.

Week 6



4 Be specific.

Jerome (1995) describes four other stages of giving feedback:

1 Provide a description of current behaviours that you want to reinforce and redirect toimprove a situation.

2 Identify specific situations where these behaviours have been observed.3 Describe impacts and consequences of the current behaviours.4 Identify alternative behaviours and actions that can be taken.

Activity 7 Giving feedbackAllow 30 minutes

Watch the video below, produced by the University of Plymouth, Faculty of Health, andanswer the following questions for each of the four student scenarios.

Video content is not available in this format.University of Plymouth, Faculty of Health

l What feedback would you give the student?

l What would you advise the student to do to overcome the situation?

l What are the consequences of not giving the student feedback or direction?

Write in your notebook or portfolio what your feedback would include and how youwould deliver this. Pause the video after each scenario to write down your answers.

DiscussionYou may have chosen to utilise one of the models above to structure your feedback tothe students in the video clips. Each situation will be different, as all students will haveindividual needs. You may be able to directly observe other colleagues and rolemodels in giving feedback to gain an overview of different approaches first-hand;however, with practice you will become more confident with your own style. It is alsouseful to ask the student how they felt about receiving your feedback, which cancontribute to your learning and influence how you give feedback in future.

Week 6



Below is an example ‘script’ for providing constructive feedback.

An example of constructive feedback‘How did you feel about that care episode today?’

Allow the student time to express their views and reflect on the care scenario, incorporatingthese points into your feedback as appropriate.

‘I felt the care you gave to Mr S was good, as you demonstrated care and compassion andmaintained his dignity throughout. There are a few things that you could try to incorporatenext time in order to improve your nursing care. You did introduce yourself and explainedthe procedure you were about to perform, but you could explain this further in terms that MrS would understand, as you did use some medical terms. You also need to check apatient’s understanding and give them time to ask any questions before commencing theprocedure. I was really pleased to see you ensured that Mr S was comfortable beforeleaving and asked him if he needed anything. It was also good to see you placed the callbuzzer within reach. How do you feel about the feedback I’ve given you …?’

Allow the student time to ask for clarification from the points you have raised and anydifferences of opinion. Be prepared to justify your assessment of the situation and feedbackgiven. Be open to learn about your own feedback mechanisms and encourage the studentto give feedback to you.

‘So, if you’re happy to move forward we can now agree some action points from thisdiscussion to give you direction in how to develop your nursing care.’

Mentorship programmeIf you are completing these learning materials as part of an NMC mentor preparationprogramme, use the protected learning time allowed to be observed giving feedback to astudent. Reflect on this process and discuss with your own supervisor, identifying areas ofstrength and any areas for improvement. This can be included within your portfolio ofevidence.

Quiz - Week 6You’ve nearly reached the end of another week of study. Now it is time for the weekly quiz.This week's quiz won't count towards your badge, so only has five questions.



Week 6 SummaryThis week you have explored and reviewed your own attitudes to assessment, howvarious forms of assessment can be utilised to provide overall evidence of student

Week 6

100of 137

http://www.open.edu/openlearn/health-sports-psychology/facilitating-learning-practice/content-section-overview?LKCAMPAIGN=ebook_MEDIA=ol Thursday 25 February 2016



learning and subsequent decision making/action planning, and how effective feedbackstrategies can be considered when evaluating student learning.Next week you will explore the role of the mentor in supporting failing students.

Week 7In Week 6, you looked specifically at the processes of assessment and how to deliverconstructive feedback in the practice setting. You also explored various methods ofassessment and considered feedback strategies. The aim of this week is to discuss thestrategies and skills that will help you to identify the student who is either failing or hasfailed, and provide the appropriate opportunities and support for them to meet therequired competencies in order to successfully complete their placement.Most students of nursing achieve their required competencies in practice. However, thereare a few whose performance may be considered weak and who experience difficulty inmeeting the required standards. It will be necessary to provide extra support andsupervision for these students. Duffy’s (2003) study is a significant piece of research thathas contributed to the literature on reasons why mentors lack confidence in failingstudents, with more recent research replicating many of Duffy’s original findings. Forexample, a later study by Gainsbury (2010) found that a quarter of interviewees feltunconfident in managing students’ performance. Further evidence (Brown et al., 2012;Heaslip and Scammell, 2012) suggests that mentors find this aspect of their role mostchallenging and are reluctant to fail students when they do not perform as expected. Thismay occur because the student may display behaviours that can be hard to identify (Duffy,2004; Skingley et al., 2007; Black et al., 2014). In this context, as a mentor you need towork closely with students to provide support or opportunities as required.Watch Fiona introduce Week 7:


Week 7

101of 137



Mentorship programmeIf you are completing this session as part of a Nursing and Midwifery Council (NMC) mentorpreparation programme, the materials and activities relate to the following NMC domains:

l Establish effective working relationships

l Facilitating of learning


l Evaluation of learning.

You should have registered, or be planning to register, on KG006 Facilitating learning inpractice: mentorship portfolio assessment, which requires you to build a portfolio via a bodyof evidence that demonstrates achievement of NMC mentor competencies. You areadvised to consider using the learning activities included in this week’s study in yourportfolio as sources of evidence in demonstrating your achievement against the NMCcompetencies.


l consider the effectiveness of both formative and summative assessment strategiesused to assess the outcome of learning

l understand the importance of effective feedback to student learning and develop-ment

l identify and evaluate the sources of support and feedback for facilitating learning inpractice

Week 7

102of 137



l reflect on next steps if this learning is part of planned activities to meet the needs ofprofessional regulatory and statutory body requirements for supporting learners inpractice.

1 The underperforming student

Figure 1 The underperforming student

As part of the mentoring process, it is important that you identify why a student is notperforming or might be failing in practice, and when to take appropriate action. Activity 1enables you to consider this in more detail.

Activity 1 Underperformance in the workplaceAllow 40 minutes

Reflect on the discussions you have had with colleagues who report that they haveseen others underperforming in the workplace. Was this underperformance managedeffectively? Write your reflections in your notebook. In addition, discuss possiblestudent underachievement with others in your workplace to obtain their views on whatconstitutes effective management.

DiscussionYou may have discovered that colleagues underperform for a variety of reasons. Itcould be through failure to demonstrate a required level of competence in skillsassessment in delivering episodes of care, or demonstrating negative attitudes thatleave mentors to question the student’s developing professionalism. If you are workingin an area that supports nursing students, you need to assess what the issues are andinvolve the higher education institution (HEI) that is responsible for the individual andother senior colleagues from the university and service. You need to ensure that thesekey members are aware of your concerns and provide support to you in your role asmentor.

Duffy and Hardicre (2007b) and Black et al. (2013) list a range of issues that suggest whylearners fail to engage with practice. You may have noted similar issues from yourreflection and discussion with others. These include:

Week 7

103of 137



l a lack of insight, poor self-awareness and unresponsiveness to feedback

l a lack of interest, motivation, enthusiasm or commitment – not asking questions

l poor communication or interpersonal/interactional skills – insensitive interaction withpatients

l frequently late or absent

l exhibit poor preparation and organisational skills

l preoccupation with personal issues – poor health, withdrawn, sad and tired

l poor professional behaviour/boundary issues

l either overconfident or underconfident

l lack of theoretical knowledge and skill, and provides limited evidence to support theirlearning

l avoidance of working with the mentor and changing shifts

l unsafe practice and poor judgement.

It is important to raise and document your concerns regarding underperformance at theearliest opportunity and not to ignore problems as they occur. Evidence suggests that ifyou take time to explore the issues early and put an action plan into place, this mayenable the learner to rescue what may originally be considered a failing situation (Duffyand Hardicre, 2007a).In the next section you will focus on the importance of giving constructive feedback toothers. The emphasis within this feedback session is on being positive about learners’progress and highlighting areas that might require improvement.

2 FeedbackGiving regular, constructive feedback ensures that others have the opportunity to improvetheir performance in their workplace. The next activity presents a case study that givesyou the opportunity to reflect on why feedback is essential for a student of nursing who isfailing.

Activity 2 Case study: MaryAllow 20 minutes

Read the case study below.

Mary is a second year nursing student who works in an acute ward in a NHSFoundation Trust. She has been on placement for the past four weeks andher mentor has noticed her increasing lack of interest and motivation whenengaging with service users. Mary is often late for her shifts, requires a lot ofsupport when she is on duty to complete nursing assessments effectivelyand carry out particular procedures and observations. She is very unsure ofherself and has no confidence. At times the mentor feels she has to watchher all the time.

Now respond to the following:

Week 7

104of 137



l Give reasons why you think the mentor left it so late to provide feedback to Maryregarding her performance.

l What feedback would you give Mary?

l Identify what support and opportunities you would offer Mary.

l Suggest what practical advice the mentor needs?

DiscussionMentors sometimes leave it too late to inform the student that there is a problem(Webb and Shakespeare, 2008). Jervis and Tilki (2011) suggest that it is wrong toinform the student that they are failing when they do not have enough time to achievewhat is required. The reason this occurs is because the mentor finds it difficult to fail astudent, as they worry about the consequences that failure might bring. If feedback isrequired, then reflect on whether you want to give written or verbal feedback. It isimportant to avoid delaying feedback, to allow sufficient time for students to reflect onthe feedback received and for the student to change their behaviour. Feedback shouldalways lift out the positives, as well as being honest and objective. You always need togive the student time to respond to what you have shared.Heaslip and Scammell (2011) provide advice and basic principles for mentors givingfeedback to students:

l identify areas that need developing or improved

l arrange for all meetings with students to be held in a private area

l ensure that students have prior notification of the meeting

l avoid interruptions such as phone calls

l ensure feedback is immediate and not at the end of the placement.

Mentorship programmeIf you are studying this provision as part of an NMC mentor preparation programme, yourreflection on the outcome of this activity could be included as a source of evidence in yourKG006 portfolio.

You focus next on action planning with students who are experiencing problems. It is auseful strategy to adopt because it considers the difficulties that the students may befacing and together you can work towards mutually agreed goals.

Activity 3 Action planAllow 20 minutes

Read Mary’s case study again. Draw up an action plan that shows Mary’s areas fordevelopment, the actions required and support needed for improvement. Identifytarget dates and evidence needed for achievement. Your action plan may look like theexample in Table 1.

Table 1 Example action plan

Week 7

105of 137



Areas fordevelopment

Action neededby student

Support needed Target dates Evidenceneededachievement

Being late forwork

Explain reasonsfor lateness andpossiblesolutions

Exploreworkplaceoptions forimplementingsolutions

Set reasonabletarget datesdepending on thesituation

Arriving at workat the agreedtime

Mentor signature

Student signature

Date

Date

DiscussionIt is important in any action plan to include the educational provider in this discussion.Walsh (2014) provides some further guidelines for your action plan:

l identify the learning outcomes/competencies that have not been met

l identify the learning activities needed to reach the required targets

l identify what support is needed

l identify timescales and review dates

l specify what evidence of achievement is required

l document and sign and each take a copy.

The action plan must be regularly reviewed at specified and agreed dates. Actionplans are useful tools for documenting evidence of support because they highlight howevidence of competencies will be achieved.

Given support, a failing student has the opportunity to develop sufficiently to progress;however, you may find that you have to make the decision to fail the student. The nextsection looks at the challenges you face when you make that decision.

3 Failing the studentIt is possible that, despite an action plan, the mentor might have made a decision to failthe student if the required competencies for that particular placement had not beenachieved. The next activity is focused on a case study where you explore failing a studentin practice.

Activity 4 Case study: JeanetteAllow 20 mins

Read the following case study.

Staff Nurse Jeanette is the named sign-off mentor to a learner namedVeronica Barnes who has struggled to meet her learning outcomes.Jeanette has been reviewing her progress weekly. Veronica is at the end ofher placement, and is near the end of her programme of study, and has notachieved the required competencies. In Jeanette’s opinion, Veronica hasfailed.

Week 7

106of 137



Now respond to the questions listed below.

l What support will Jeanette need after making the decision to fail Veronica?

l How do you think Veronica will react to the failure?

l What support will Veronica require?

DiscussionIt is important to clarify the role of the sign-off mentor when assessing students inpractice nearing completion of their programme. The NMC (2008) requires eachstudent to be allocated a sign-off mentor for their last placement in their final year.Paragraph 2.1.3 of the NMC standards defines a sign-off mentor as ‘a nurse or midwifedesignated to sign-off proficiency for a particular student at the end of a programmeand must have been supervised on at least three occasions for signing off proficiencyby an existing sign off mentor’.As the sign-off mentor, Jeanette will find the decision to fail Veronica a challenging onethat needs to be managed sensitively. Documented evidence is crucial to establish apattern over a period of time. Jervis and Tilki’s (2011) research study examined thecomplexities that mentors encounter when failing students. The timing of fail decisionsshould occur earlier in the student’s programme rather than later: an early ‘fail’decision provides the student with an opportunity to receive focused support, whereasa ‘fail’ decision towards the end of a programme of study leaves little time for remedialaction to be taken.You are told that Veronica is nearing the end of her programme and that Jeanette hasbeen reviewing Veronica’s progress weekly, so she has invested time before reachingthis final decision. Robust documentation is crucial in demonstrating the integrity ofassessment decisions made so late in the programme.

Mentorship programmeYou can discuss your responses to Activity 4 with your supervisor if studying this as part ofan NMC Mentorship programme.

Week 7

107of 137



3.1 Breaking bad news

Figure 2 Breaking bad news

Breaking bad news is never an easy option, so informing a student near the end of theirprogramme of study that they have failed their placement will naturally upset theindividual. Walsh (2014) explains how students may react to the outcome of assessmentwith a feeling of:

l denial – they respond with disbelief and shock to a failed assessment

l betrayal – they may feel hurt that their friend has failed them (some students interpretthe supportive mentorship relationship as a close friendship rather than aprofessional one)

l sadness – some will cry, which can be upsetting for the mentor

l anger – some may react with aggression and/or denial, and may verbally abuse thementor

l disbelief – a student may place blame for their failure on a personality clash with theirmentor

l bargaining – they may react by blaming others, their placement, the HEI course ortheir mentors

l relief – some students may be relieved and willing to accept a failed assessment. Insome instances failure can have a positive outcome.

Support is crucial for students who perceive that this as a stressful experience. Anopportunity should be provided for them to repeat the experience when appropriate, and

Week 7

108of 137



to have access to a range of support services from the HEI, linked lecturers, moduleleaders, counselling and student union processes.This can be an equally stressful experience for the mentor, who will require support.Managing the process of underachieving or failing students must be made withconfidence (Brown et al., 2012). A decision to fail a student nearing the end of theprogramme can be a challenge, because the underperformance should have beenaddressed earlier. Jeanette’s decision could cause tensions within the team or theorganisation if it is perceived that some of the mentors assessing Veronica on herprevious placements did not fulfil their assessment obligations. However, failing to failstudents can have serious consequences for the service user, who may be put at risk.Mentors require support and guidance when they fail students, because they have todeliver difficult messages to the underperforming student. They need to developconfidence and must be clear about the roles and responsibilities in making thesedecisions. The next session focuses on these issues.

4 Support for mentorsMentors require support because they often find it difficult to fail students. This is due tolack of confidence in understanding the assessment process, interpreting the informationused by professional bodies and being able to differentiate between failing and competentstudents. They need to develop an in-depth knowledge and understanding of theiraccountability at every stage of the student’s programme, because they are accountablefor the decision made to either pass or fail a student.

Activity 5 Support for mentors in decision makingAllow 1 hour

The following video features Ros Moore, a practitioner who talks about the problems infailing students and acknowledges the need for mentors to have an in-depthknowledge and understanding of accountability for the decisions made. Sheemphasises the mentors’ professional responsibility as facilitators of learning,gatekeepers and the public representatives within the profession, and believes thatwhen mentors see a student struggling in practice, they should be willing to be thesupport and take action when required. Ros stresses the importance of their role asmentors in making valid judgements when assessing students’ competence in practiceto protect the service users and maintain good professional standing.

Video content is not available in this format.Ros Moore

Week 7

109of 137



As you watch, make a list of the factors that helped mentors to make confidentdecisions. Then reflect on what you have learned from doing this activity. Has it helpedor hindered you in making assessment decisions on knowing when to fail students?

DiscussionYou may have considered the importance of preparation for mentors when failingstudents. It cannot be underestimated that mentors need to be prepared to undertakethis aspect of their role. They need to be confident, assertive and skilled in assessingperformance. There is evidence that mentors are inconsistent when assessingcompetence and are hesitant when faced with students’ unacceptable performance(Fitzgerald et al., 2010). Being organised as a mentor is key, as you need to:

l keep accurate records of decisions made

l seek guidance

l encourage a network of support when required, such as peer supervision

l encourage a really strong mentorship network in and around your local area, orbetween trusts and other organisations.

If not, a lack of preparation and experience in not recognising when students areunderperforming may prevent the mentor from failing the student.You will be able to make a ‘fail decision’ with confidence if you have followed a plan ofaction for any student who is not progressing or failing. The student should not besurprised at being informed that they have failed.One of the key drivers for developing the role of ‘sign-off’ mentor was that moreexperienced mentors would be available to support assessment decision making notonly at the end of a course or programme but also on the journey to completion. As youcommence your mentoring role it is important that you establish what support isavailable to you through your colleagues, your employing organisation, educationproviders and national organisations.

Week 7

110of 137



Mentorship programmeIf you are studying this provision as part of an NMC mentor preparation programme, youshould discuss your reflections from this activity with your mentor and use your learning asa source of evidence in your portfolio.

Familiarising yourself with the NMC requirements for mentoring and keeping accuraterecords is discussed next. Accurate records will justify the decision made when assessingcompetence in students. It is therefore important to keep detailed notes of discussionsthat you have had with the student who has failed to meet the goals agreed.

5 Regulatory requirements for mentors keepingrecordsThe NMC’s Standards to Support Learning and Assessment in Practice (2008) states thatnurse mentors must keep sufficient records to support and justify their decisions onwhether a student is competent or not. Keeping accurate records and ensuring that dueassessment processes have been followed when mentoring is crucial. Mentors aretherefore accountable for their actions.

Activity 6 Assessment regulationsAllow 50 minutes

This activity is divided into three sections. You need to access the documentation onassessment regulations for a programme of study that either you or a colleague mayhave studied:

1 Familiarise yourself with the documentation and the process that a student wouldneed to follow.

2 Identify the strengths and limitations of the information reviewed.3 What are your areas of personal learning that you wish to explore before

supporting a student independently using this information?

Write your responses to the three prompts above, identify your new areas fordevelopment and ensure that you document these. Pay particular attention to the waythat student records are managed by the mentor.

DiscussionMentors need to familiarise themselves with students’ documentation and assessmentregulations, and must keep accurate records to support and justify their decisions onwhether a student is competent. They need to demonstrate that they have providedregular feedback and kept a record of this while mentoring students (Walsh, 2014).They can then make valid assessments on whether a student is competent or not. Inpractice, the consequences of not failing students are that we fail in our duty of care toprotect the safety of those whom we serve.

Week 7

111of 137



Mentorship programmeIf you are studying this as part of an NMC mentor preparation programme, discuss yourobservations with your supervisor and use this as evidence in your portfolio.

Quiz - Week 7Well done, you have completed the last of the activities in this week’s study before theweekly quiz.Complete the Week 7 quiz to assess your learning. By working your way through thequestions, you have made a great start in developing your knowledge and understandingof the complexities of failing students in practice. It is important to identify the sources ofsupport and skills required in making the decision when to fail students, as you areaccountable to the NMC for the judgements made when assessing students in practice.



Week 7 SummaryDuring this week you have been introduced to a range of strategies and developedknowledge and skills in recognising a student who may be failing or has failed their finalplacement experience. A majority of students achieve their competences in practice;however, there are a few whose performance requires support and guidance in meetingthe required standard. If they fail to reach that standard, then the student may be failed.Making valid assessments of student competence is challenging but essential, as you areaccountable to the NMC for the judgements you make when mentoring learners inpractice. Failure to do so can put your service users’ lives at risk.Next week you draw on your learning from the previous seven weeks, which should shapeyour thinking and understanding of mentorship as a concept and as a future role in whichyou will develop and foster the learning and development in others. The activities in thefinal week of learning will provide opportunities for you to consider potential challengesand support strategies, and to identify development needs.

Week 8Welcome to Week 8, the final week of Facilitating learning in practice. In the previousseven weeks of learning you have explored a range of topics relating to mentorship andthe processes involved in becoming an effective mentor. This has included learning andteaching strategies, facilitating learning in the practice environment, assessmentapproaches, relationships and collaborative working, and supporting failing students. Atthis point in your learning journey you should have reflected on the key points from eachof the previous weeks and developed your knowledge and understanding of the concept

Week 8

112of 137




of mentorship as the basis for becoming the sort of mentor you want to be in order toencourage and support learning in practice.This week will draw on this previous learning to focus on your role as a mentor in thefollowing ways:

l leading and evaluating practice learning

l exploring your future professional development as a mentor

l considering ways to disseminate areas of good practice.

Within this final week, it would be useful to revisit the standards to support learning andassessment in practice (NMC, 2008) to reiterate the requirements of a mentor. Thesestandards can be accessed at the Nursing and Midwifery Council (NMC) website.Fiona introduces the final week:




l Leadership

l Evidence-based practice.

Week 8

113of 137


http://www.nmc-uk.org/Educators/Standards-for-education/Standards-to-support-learning-and-assessment-in-practice/


Evidence of completion of the learning activities included in this session must be includedwithin your practice portfolio.


l reflect on your own potential competing demands

l understand ways of evaluating practice learning

l identify your personal areas for development

l consider how to disseminate areas of good practice.

1 Prioritising competing demands

Figure 1 Competing demands

Figure 1 is a photograph depicting a nurse mentor at a desk full of paperwork, taking atelephone call and reading a document. The student nurse is sitting beside her, readingnotes and waiting for the nurse mentor to finish her call.Health care organisations experience rapid and constant change that often involvesrestructuring or reorganising services. A study conducted by McIntosh et al. (2013)concluded that mentors report a number of challenges in relation to their roles, which isdominated by ‘the increasing complexity of healthcare services and by the diverse spreadof students’ learning needs’ (p. 364). These challenges need to be recognised andmanaged to ensure that the student is provided with opportunities to develop and achieverequired mentorship competencies.

Week 8

114of 137



The following activity will help you to consider potential demands and how these could bemanaged.

Activity 1 Identifying your potential demandsAllow 20 minutes

l Compile a list of potential demands that you feel may impact on a mentor role.

l For each demand, think about the ways in which you could address it.

DiscussionYou may have listed many or only a few demands, but it is important to be aware ofpotential demands so that strategies can be considered and implemented as andwhen issues arise.You may have identified some of the potential demands below:

l sufficient numbers of appropriately trained mentors

l staff shortages/sickness

l changes in placement dates for students

l completion of assessment documentation

l access to mentor updates

l workload (such as unplanned interventions, changes in patient/client care)

l needing to focus on competencies/ tasks

l access to supervision/support

l access to appropriate resources.

These are only a few of the demands that may impact on your role as a mentor, andyou will have identified areas that are particularly relevant to your practiceenvironment. Robinson et al. (2012) suggest that challenges to mentorship should beconsidered in a collaborative environment involving managers, educators, linklecturers, health care organisation education leads, mentors and students. Theresearch identifies the concept of a mentor ‘hinterland’ that consists of a partnership ofall of the above and the ‘availability of resources to fund posts, course fees, studyleave and staff time’ (Robinson, 2013, p. 25). However, it is evident that restructuringservices and changes to personnel can both impede continuity.

Mentorship programmeIf you are completing these learning materials as part of an NMC preparation programme,you should discuss your list and strategies from Activity 1 with your supervisor. As part ofyour protected learning time, write a reflection to be included within your portfolioconsidering an episode where competing demands challenged your role in helpingstudents to learn. Analyse the learning from this in order to compile an action plan for yourfuture mentor role.

As a mentor it is important to establish networks to help in developing strategies toovercome competing demands, remembering that a team approach generates more

Week 8

115of 137



ideas and has more influence than one person. Within previous weeks of learning youhave been encouraged to seek out other people, in practice, management, andeducation, who can help and inform your mentorship role. These relationships arefundamental to your progression as a mentor and helping to lead best practice in yourarea. Their importance means that it is important to maintain these key relationships. Inaddition, it is important that working relationships are established with newly appointedstaff to foster and facilitate mentoring

2 Evaluating practice learningAs a mentor you are involved in evaluating your student’s learning. The importance offeedback from students has been discussed in Weeks 4–7; however, it is also important toassess student evaluations that are completed at the end of a placement period. You mayhave a bespoke evaluation form within your practice area, one that is relevant to allplacement areas within your healthcare organisation, and/or the practice evaluationcompleted as a requirement of the relevant education provider.The following activity asks you to consider what we mean by ‘evaluation’ and what youthink are the important areas to evaluate.

Activity 2 Why evaluate?Allow 15 minutes

l What does the term ‘evaluation’ mean to you?

l In a notebook, write down your thoughts on how you see your role as a mentor inthe process of evaluating practice learning.

DiscussionEvaluation can mean different things depending on the context, and you may havelinked this to terms such as ‘assessment’ or ‘analysis’. Gopee (2011, p. 240) identifiesvarious types of evaluation that you may encounter within your mentorship role:

l public evaluation: open evaluation of an activity by others

l private evaluation: self-evaluation by the person who performed the teaching

l external evaluation: evaluation by others outside the organisation

l internal evaluation: evaluation by departments or individuals inside theorganisation

l continuous evaluation: ongoing evaluation

l episodic/intermittent evaluation: evaluation at set or specific times

l final evaluation: evaluation at the end of one or a series of activities

l case-specific evaluation: in-depth evaluation of a particular instance of an activity

l generalised or holistic evaluation: inviting and gaining overall impressions

l analytical evaluation: detailed evaluation that may include numerical data.

If discussed as a team, evaluating practice learning can be invaluable in identifyingissues and potential improvement strategies. This might include you and other mentorcolleagues, the link lecturer/tutor from the relevant education provider, the clinical

Week 8

116of 137



manager, and the organisation education lead. The evaluation process needs to behonest and transparent, with all parties having an opportunity to discuss findings andput forward suggestions for improvement. It is important that discussions be held in asupportive environment and that engaging in a blame culture is avoided at all times.Areas of strength need to be recognised and celebrated, with areas for improvementplanned carefully to achieve realistic targets. All resulting action plans need to bereviewed and re-evaluated. Kinnell and Hughes (2010) identify the process ofevaluation as the four stages shown in Figure 2.

Figure 2 Kinnell and Hughes’ (2010) process of evaluation

This model can be used to structure the evaluation process. Feedback is gatheredfrom all relevant parties and scrutinised to review all comments made. An in depthdiscussion of these comments is required to highlight focus areas for improvement.Action points are then identified and implementation for change can be planned.

Mentorship programmeIf you are completing these learning materials as part of an NMC mentor preparationprogramme, use the protected learning time allowed to discuss Activity 2 with yoursupervisor and formulate a new (or revise an existing) evaluation form for your practicearea. Present this at your next practice team meeting or mentor forum to seek views andopinions for its potential use in your practice area. This can be included in your portfolio ofevidence.

2.1 Educational auditYour role in evaluating practice learning in your area will include some involvement witheducational audit. This is a process that is required by the regulating body (the NMC) toassure standards are met in relation to student learning in practice. Education providersare responsible for organising and completing annual audits of all placement areas usedfor student clinical placements. This is done in partnership with placement providers andwill involve link tutors, clinical education leads and facilitators, healthcare managers,practice teachers, mentors, and students. Each education provider will have its ownformat, criteria, and audit process, so it is important that you are familiar with these andhave sight of the most current audit for your practice area, what are the areas of goodpractice, and what needs improving. In some areas of the UK, higher education instituteswill work together to share educational audit assessment. The following activity relates toa potential scenario in practice.

Week 8

117of 137



Activity 3 Case study: strategies for improvementAllow 20 minutes

You have commenced a new position within a health care organisation and feelconfident in mentoring students, as the practice area is similar to where you havepreviously worked. You access the most recent educational audit and notice identifiedareas for improvements relating to three areas:

l induction information

l educational and learning materials for students

l inter-professional learning opportunities.

You ascertain that no improvements have been discussed or implemented at this timeand have been asked to take a lead on this.List possible strategies for improvement you would consider for each area.

DiscussionYou may have identified strategies drawing from your learning in Week 5 in relation tofacilitating a practice learning environment. It is important that you recognise yourleadership role in this process in addressing the areas for improvement in the abovecase study. You would need to discuss these areas with the practice team andassociated personnel such as the educational lead, link tutor and your manager, totake suggestions and ideas forward that are agreed and owned by all stakeholders.Resources would need to be secured and this may involve seeking financial supportthrough appropriate departments or your line manager. Inter-professional learningopportunities would need to be negotiated across disciplines and reciprocalarrangements may need to be agreed. This may also be an opportunity to explore howpractice education and mentorship can be standing items on team meeting agendas.Sharing information with other placement areas may also give ideas on how toimprove student induction information, alongside suggestions from the link tutor oreducational lead. The currency of evidence-based literature and resources relating toyour area of practice should be maintained and owned by all team members to ensurethat students can access appropriate educational materials to improve their knowledgeand understanding.

3 Peer reviewYou may have been involved in peer review as part of educational processes relating toassessment, or as part of an appraisal process such as 360-degree feedback fromcolleagues. (Further information about 360-degree processes and tools can be found atthe NHS Leadership academy website.)You may also relate peer review to the role of a ‘critical friend’ who has the expertise togive constructive feedback on your performance. As part of your continuing developmentas a mentor, it is important to seek feedback on your own mentorship practices and alsocontribute to mentor colleagues’ development. This can be both informal and formaldepending on your practice areas’ guidance and requirements. However, the process ofpeer review can encourage and support mentors in continuous improvement. Peer reviewshould involve those of the same status or role, which in this context are your fellowmentors. Peer review should not be seen as a ‘pass’ or ‘fail’ activity, but should be seen as

Week 8

118of 137


http://www.leadershipacademy.nhs.uk/resources/healthcare-leadership-model/supporting-tools-resources/healthcare-leadership-model-360-degree-feedback-tool/


providing constructive feedback on performance and discussing areas for improvement.This is similar to the constructive feedback processes discussed in Week 6. Peer review,when conducted effectively, also helps to build confidence in the person being ‘reviewed’and ultimately embeds a culture of mentorship excellence in the ‘reviewer’ feeding back tocolleagues.Haag-Heitman and George (2011) identify the dimensions of nursing peer review(Figure 3).

Figure 3 Dimensions of nursing peer review

Activity 4 Engaging in peer reviewAllow 15 minutes

l Consider what skills, attitudes and knowledge are required to complete a peerreview. How confident would you feel in providing feedback to colleagues on theirmentorship role?

l In what areas do you feel you need further development?

DiscussionMany of your responses to this activity may relate to those you have previouslyconsidered in relation to giving constructive feedback to students. However, providingeffective feedback to other mentors who are colleagues may be a little daunting as anew mentor. Nevertheless, you have an important part to play within the mentor teamin providing opportunities for others to learn and improve from your observations. Peer

Week 8

119of 137



review will help you and your colleagues learn from each other and enhanceleadership responsibilities in promoting excellence in practice learning. Morby andSkalla (2010) suggest that peer review should be framed within the theory of humancare where nurses feel the process is safe and fair in order to fully engage and benefitfrom the process.

Mentorship programmeIf you are completing these learning materials as part of an NMC preparation programme,discuss your responses to Activity 4 with your supervisor. Use the protected learning timeallowed to complete a peer review for a willing mentor colleague. Write a reflection of yourrole as the ‘reviewer’ as evidence within your portfolio.

4 Maintaining contemporary practiceAs registered nurse, you are required to maintain a level of competence to maintain yourregistration with the NMC. This includes updating and recording your knowledge and skillsas required by NMC revalidation processes. “It will help to encourage a culture of sharing,reflection and improvement and will be an ongoing process throughout your career” (http://revalidation.nmc.org.uk/welcome-to-revalidation/).As a mentor, this also includes maintaining your knowledge, skills and competence to beincluded on the register of mentors for your local placement provider. As discussed inWeek 4, when you are included on the mentor register you will be reviewed every threeyears (triennial review) to ensure you continue to meet mentor requirements. As part ofthis triennial review, you will need to participate in annual updating that will give you anopportunity to discuss issues and share good practice with other mentor colleagues(NMC, 2008).Lawson (2011) stresses the importance of mentors maintaining a specific CPD portfolio ofevidence continually throughout their mentorship role. The following activity asks you toconsider how you might plan for this.

Mentorship programmeIf you are completing these materials as part of an NMC mentor preparation programme,you will be collecting evidence to meet the required eight domains associated with thementor role. However, you need to consider how you will remain a competent mentor onceregistered. This includes access to disability and equality training as advised by theNMC (2008).

Activity 5 Planning for CPDAllow 30 minutes

l Download a copy of Figure 4 and complete the SLOT analysis to identify thestrengths, limitations, opportunities and threats within your mentor role.

Week 8

120of 137


http://revalidation.nmc.org.uk/welcome-to-revalidation/



Figure 4 SLOT analysis

l What strategies can you employ to address the limitations, threats andopportunities that you have identified? Complete an action plan of your areas fordevelopment as a starting point. This can be revisited and reviewed as necessary,although should be updated at least annually. Table 1 shows an example of anaction plan that you could adapt to your own learning and development needs.

Table 1 Example of an action plan to record your developmentactivitiesArea for development Goal Actions required Review

date

New assessmentdocumentation beingimplemented for nextpre-registration studentcohort

To be confident in myassessment of studentsby having a goodknowledge andunderstanding of therequired assessmentdocumentation

1. Meet with link tutorand educational lead todiscuss requirements

2. Submit as an agendaitem for the next team/mentor meeting

4 weeks

2 weeks

Week 8

121of 137



3. Arrange for peerreview followingimplementation

3 months

Unsure ofresponsibilities whenmentoring students withdisabilities

To have knowledge andunderstanding of currentguidance relating to myresponsibility as amentor to enablelearning for students withdisabilities

1. Read guidelines anddiscuss implications andimplementation withcolleagues, educationlink tutor and manager

2 weeks

To be aware of resourcesavailable for students

2. Access organisationtraining in diversity anddisability

3. Disseminate informa-tion to mentor collea-gues

Placebooked 1month

Followingtraining (6weeks)

Leadership skills To demonstrateadditional leadershipskills within my mentorrole (I have been askedto set up a mentor forumfor my area)

1. Access nextleadership workshop

2. Meet with a colleagueto discuss their experi-ence of setting up amentor forum

2 months

1 month

3. Meet with linemanager to secure aleadership mentor

2 weeks

Share experiences andlearn from other mentors

To improve my networksof mentor contacts

1. Attend next localmentor forum

2. Ask education leadabout the possibility of abuddying system for newmentors

1 month

2 weeks

3. Explore internetforums for regional andnational mentor forums

2 months

DiscussionConsider keeping an ongoing action/personal development plan, as completion of thiswill help to demonstrate achievement of the required mentorship standards. The actionplan in Table 1 can be adapted to meet your own personal learning needs for CPD.

As part of your development as a mentor, you might also consider your position as a rolemodel for others. Turnbull et al. (2014) acknowledged that not everyone wants to be amentor, but that all nurse registrants have a responsibility to engage in learning inpractice. As a mentor you can help to foster a culture of evidence-based supportivelearning within your area of practice and encourage colleagues to help plan and deliverlearning opportunities for students. Alongside this you will act as an enabler, innovatorand exemplar of professional standards, and hopefully you will inspire others to becomementors. As previously discussed, it is important to share good practice, so you may wantto think about this within your areas for development and is discussed further within thefollowing section.

Week 8

122of 137



Watch the following video in which mentors describe how their practice relates to the NMCMentor (Stage 2) domains.

Video content is not available in this format.NMC Mentor (Stage 2) domains

5 Your next steps

Mentorship programmeIf you are completing this OpenLearn course as part of an NMC mentorship preparationprogramme, then you will need to additionally register and undertake the portfolio aspect ofmentorship (KG006 Facilitating learning in practice: mentorship portfolio assessment) if youhave not already done so. Details of this element of learning were discussed in the NMC-approved mentorship programme .

Following your learning and development as a mentor, it is important to disseminate goodpractice within your practice area. You will also have the opportunity to add to the body ofmentorship knowledge on a wider scale. There are many instances where good practiceand lessons learned from mentor challenges are restricted to a particular event at aparticular time, with the understanding gained never being shared. The following activityasks you to reflect on your learning so far and any changes that you hope to propose.

Week 8

123of 137



Activity 6 Ways of sharing good practiceAllow 30 minutes

l Reflect on your learning so far. What do you hope to achieve in your future role asa mentor? As well as referring to required mentor standards and short-term goals,think big! Ideals should be aspired to.

l Consider and write a plan of ways you might disseminate your experiences andshare areas of good practice.

DiscussionIt can be difficult to imagine yourself disseminating your own knowledge and expertisewhen you may only be at the early stages of a mentor role. However, everyone has tostart somewhere, and it is useful to draw on accomplished role models who inspireyou. Simply sharing how it feels to be a ‘new’ mentor would be a great start.Below are some examples of how you might share good practice. Remember you donot have to do these alone – you may be able to collaborate with others who would bewilling to contribute and give guidance.

l Being an excellent role model for both students and other mentors.

l Sharing good practice and proposals for change within team meetings.

l Discussions and evidence provided for triennial review.

l Sharing experiences within local and national mentor forums.

l Arranging regular meetings with link tutors and educational leads to discussexperiences, ideas and potential plans for improvement.

l Write an editorial or commentary for your organisation’s newsletter/staff briefing.

l Write an article for publication within a professional journal after discussing ideaswith the editor.

l Presenting your implementation of improvements at a local, regional or nationalconference.

l Developing a mentoring blog.

l Arranging to deliver a seminar to mentor students.

Quiz - Week 8Well done – you’ve not only come to the end of this week’s study, but you've also almostcompleted the final week in Facilitating learning in practice.You can now take the Week 8 quiz.

Week 8 compulsory badge quiz.


Week 8

124of 137




Week 8 SummaryThis week you have been encouraged to draw on learning from the previous seven weeksof this course. This will have shaped your thinking and understanding of mentorship bothas a concept and as a future role in which you will foster the development of others. Theactivities within this week of learning have also provided opportunities for you to considerpotential challenges, possible available support strategies and identification of develop-ment needs.We hope you have enjoyed this course as part of your learning journey.Remember, this material is based on an Open University badged course. In order togain a badge you must access and enrol on the full course on OpenLearn.Now you've completed the course we would again appreciate a few minutes of your timeto tell us a bit about your experience of studying it and what you plan to do next. We willuse this information to provide better online experiences for all our learners and to shareour findings with others. If you’d like to help, please fill in this optional survey.

Keep on learning

Study another free courseThere are more than 800 courses on OpenLearn for you to choose from on a range ofsubjects.Find out more about all our free courses.

Take your studies furtherFind out more about studying with The Open University by visiting our online prospectus.

Keep on learning

125of 137



https://www.surveymonkey.com/r/FLP_End

http://www.open.edu/openlearn/free-courses?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OL

http://www.open.ac.uk/courses?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OU


If you are new to university study, you may be interested in our Access Courses orCertificates.

What’s new from OpenLearn?Sign up to our newsletter or view a sample.

For reference, full URLs to pages listed above:

OpenLearn – www.open.edu/openlearn/free-courses

Visiting our online prospectus – www.open.ac.uk/courses

Access Courses – www.open.ac.uk/courses/do-it/access

Certificates – www.open.ac.uk/courses/certificates-he

Newsletter –www.open.edu/openlearn/about-openlearn/subscribe-the-openlearn-newsletter

ReferencesClutterbuck, D. (n.d.) ‘Twelve habits of the toxic mentor’ (online). Available athttp://www.coachingnetwork.org.uk/information-portal/Articles/ViewArticle.asp?artId=41(Accessed 5 March 2015).Darling, L.A. (1986) ‘What to do about toxic mentors’, Nurse Education, vol. 11, no. 2,pp. 29–30.Kay, D. and Hinds, R. (2009) A Practical Guide to Mentoring, HowtoBooks, Oxford.LearningFromWOeRK [YouTube user] (2011a) ‘Mentoring skills: what is mentoring?’(online), 28 September. Available at https://www.youtube.com/watch?v=_f2JD5V2vh0(Accessed 5 March 2015).LearningFromWOeRK [YouTube user] (2011b) ‘Mentoring skills: qualities and skills of amentor’ (online), 28 September. Available athttps://www.youtube.com/watch?v=Ss_PO5knp0Q (Accessed 5 March 2015).MentorSET (n.d.) ‘What is mentoring?’ (online). Available athttp://www.mentorset.org.uk/what-is-mentoring.html (Accessed 21 April 2015).Nursing and Midwifery Council (NMC) (2015) The Code: Professional Standards ofPractice and Behaviour for Nurses and Midwives, NMC, London.Nursing and Midwifery Council (NMC) (2008) Standards to Support Learning andAssessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers,NMC, London.Royal College of Nursing (2009) Guidance for Mentors of Nursing Students and Midwives(online). Available athttp://www.rcn.org.uk/__data/assets/pdf_file/0008/78677/002797.pdf (Accessed 6March 2015).

References

126of 137


http://www.open.ac.uk/courses/do-it/access?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OU

http://www.open.ac.uk/courses/certificates-he?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OU

http://www.open.edu/openlearn/about-openlearn/subscribe-the-openlearn-newsletter?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OL

http://www.open.edu/openlearn/free-courses?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OL

http://www.open.ac.uk/courses?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OU

http://www.open.ac.uk/courses/do-it/access?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OU

http://www.open.ac.uk/courses/certificates-he?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OU

http://www.open.edu/openlearn/about-openlearn/subscribe-the-openlearn-newsletter?LKCAMPAIGN=OLSU_KeepLearning&MEDIA=_OL

http://www.coachingnetwork.org.uk/information-portal/Articles/ViewArticle.asp?artId=41

https://www.youtube.com/watch?v=_f2JD5V2vh0

https://www.youtube.com/watch?v=Ss_PO5knp0Q

http://www.mentorset.org.uk/what-is-mentoring.html

http://www.rcn.org.uk/__data/assets/pdf_file/0008/78677/002797.pdf


TheFuzzfree [YouTube user] (2009) ‘What not to do when mentoring’ (online), YouTube,19 September. Available at https://www.youtube.com/watch?v=C1j0beTn8_U (Accessed5 March 2015).Andrew, N., Tolson, D. and Ferguson, D. (2008) ‘Building on Wenger: communities ofpractice in nursing’, Nurse Education Today, vol. 28, no. 2, pp. 246–52.Ausubel, D.P. (1968) Educational Psychology: A Cognitive View, New York, NY, Holt.Bruner, J.S. (1961) Toward a Theory of Instruction, Cambridge, MA, Belknap.BullyingNewsVideos [YouTube user] (2008) ‘Classical conditioning – Ivan Pavlov’(online), YouTube, 13 September. Available athttps://www.youtube.com/watch?v=hhqumfpxuzI (Accessed 10 February 2015).Coffield, F., Moseley, D., Hall, E. and Ecclestone, K. (2004) Learning Styles andPedagogy in Post 16 Learning: A Systematic and Critical Review, London, Learning andSkills Research Centre.Harvard University [YouTube user] (2011) ‘Reinforcement theory’ (online), YouTube, 13October. Available at https://www.youtube.com/watch?v=YIEt6TrjJXw#t=26 (Accessed 10February 2015).Hinchliff, S. (2004) The Practitioner as Teacher, 3rd edn, London, Elsevier.Honey, P. and Mumford, A. (2006) Learning Styles Questionnaire and AssociatedCategories, Peter Honey Publications.Janet Finlay [YouTube user] (2010) ‘Andragogy (adult learning)’ (online), YouTube, 17May. Available at https://www.youtube.com/watch?v=vLoPiHUZbEw (Accessed 10February 2015).Keating, S.B. (2006) Curriculum Development and Evaluation in Nursing, Philadelphia,PA, Lippincott Williams and Wilkins.Kelly O’Dowd [YouTube user] (2010) ‘Maslow’s hierarchy of needs’ (online), YouTube, 14November. Available at https://www.youtube.com/watch?v=dmtmxYbDhKA (Accessed 10February 2015).Knowles, M. ( 1990) The Adult Learner: A Neglected Species, 4th edn, Houston, TX, GulfPublishing.Kolb, D.A. (1984) Experiential Learning: Experience as the Source of Learning andDevelopment, Englewood Cliffs, NJ, Prentice Hall.Martin, S. (2010) ‘Teachers using learning styles: torn between research andaccountability?’, Teaching and Teaching Education, vol. 26, pp. 1583–91.Maslow, A. (1987) Motivation and Personality, 3rd edn, New York, NY, Harper and Row.McLeod, S. (2007) ‘Skinner – operant conditioning’ (online), SimplyPsychology. Availableat http://www.simplypsychology.org/operant-conditioning.html (Accessed 10 Feb-ruary 2015).Nursing and Midwifery Council (2008) Standards to Support Learning and Assessment inPractice, 2nd edn, London, NMC. Available athttp://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learn-ing-assessment.pdf (Accessed 11 February 2015).Pavlov, I.P. (1927) Conditioned Reflexes: An Investigation of the Physiological Activity inthe Cerebral Cortex (translated and edited by G.V.Anrep), London, University Press.Quinn, F.M. (2001) Principles and Practice of Nurse Education,4th edn, Cheltenham,Nelson Thornes.Rogers, C. (1983) Freedom to Learn for the 1980s, Columbus, OH, Merrill.

References

127of 137


https://www.youtube.com/watch?v=C1j0beTn8_U

https://www.youtube.com/watch?v=hhqumfpxuzI

https://www.youtube.com/watch?v=YIEt6TrjJXw#t=26

https://www.youtube.com/watch?v=vLoPiHUZbEw

https://www.youtube.com/watch?v=dmtmxYbDhKA

http://www.simplypsychology.org/operant-conditioning.html

http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learning-assessment.pdf



Skinner, B.F. (1938) The Behaviour of Organisms, New York, NY, Appleton CenturyCrofts.Slow Media [YouTube user] (2010) ‘Cognitive learning theorists’ (online), YouTube, 10May. Available at https://www.youtube.com/watch?v=_Sy8n5DRa7A (Accessed 10February 2015).Tennant, M. (1997) Psychology and Adult Learning, 2nd edn, London, Routledge.Walsh, D. (2014) The Nurse Mentor’s Handbook, Buckingham, Open University Press.Wenger, E. (1998) Communities of Practice: Learning Meaning and Identity, 6th edn,Cambridge, Cambridge University Press.Wenger, E., McDermott, R. and Synder, W. (2002) A Guide to Managing KnowledgeCultivating Communities of Practice, Boston, MA, Harvard Business School.Anderson, L.W. and Krathwohl, D.R. (eds) (2001) A Taxonomy for Learning, Teaching,and Assessing: A Revision of Bloom's Taxonomy of Educational Objectives. New York,NY, Longman.Atherton, J.S. (2013a) ‘The learning curve’(online), Learning and Teaching. Available athttp://www.learningandteaching.info/learning/learning curve.htm (Accessed 23 Feb-ruary 2015).Atherton, J.S. (2013b) ‘Bloom's Taxonomy’ (online), Learning and Teaching. Available at:http://www.learningandteaching.info/learning/bloomtax.htm#ixzz3NxhuUgGv (Accessed23 February 2015).Chapman, A. (2015) ‘Conscious competence learning model’ (online). Available at:http://www.businessballs.com/consciouscompetencelearningmodel.htm (Accessed 23February 2015).Clark, D. (1999) ‘Bloom’s Taxonomy of learning domains’ (online), Big Dog & Little Dog’sPerformance Juxtaposition. Available at:http://www.nwlink.com/~donclark/hrd/bloom.html(Accessed 23 February 2015).Dave, R.H. (1975) ‘Psychomotor levels’ in Armstrong, R.J. (ed.), Developing and WritingBehavioural Objectives, Tucson, AZ, Educational Innovators Press.Nursing and Midwifery Council (NMC) (2008) Standards to Support Learning andAssessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers,London.Nursing and Midwifery Council (NMC) (2010) Standards for Pre-registration NursingEducation, London.Reynolds, B. (1965) Learning and Teaching in the Practice of Social Work, 2nd edn, NewYork, NY, Russell and Russell.Baranik, L.E., Roling, E.A. and Eby, E.T. (2010) ‘Why does mentoring work: the role ofperceived organizational support’, Journal of Vocational Behaviour, vol. 76, no. 3,pp. 366–73.Clynes, M.P. and Raftery, S.E.C. (2008) ‘Feedback: an essential element of studentlearning in clinical practice’, Nurse Education in Practice, vol. 8, no. 6, pp. 405–11.Dow, R.S. (2014) ‘Leadership responsibility in mentoring organization newcomers’,Journal of Management Policy and Practice, vol. 15, no. 1, pp. 104–12.Eller, L.S., Lev, E.L. and Feurer, A. (2014) ‘Key components of an effective mentoringrelationship: a qualitative study’, Nurse Education Today, vol. 34, no. 5, pp. 815–20.Ensher, E.A. and Murphy, S.E. (2011) ‘The mentoring relationship challenges scale: theimpact of mentoring stage, type and gender’, Journal of Vocational Behaviour, vol. 79, no.1, pp. 253–66.

References

128of 137


https://www.youtube.com/watch?v=_Sy8n5DRa7A

http://www.learningandteaching.info/learning/learning%20curve.htm

http://www.learningandteaching.info/learning/bloomtax.htm#ixzz3NxhuUgGv




Foster, H., Ooms, A. and Marks-Maran, D. (2015) ‘Nursing students’ expectations andexperiences of mentorship’, Nurse Education Today, vol. 35, no. 1, pp. 18–24. Availableat: http://dx.doi.org/10.1016/j.nedt.2014.04.019 (Accessed 11 February 2015).Gagné, R.M. (1985) The Conditions of Learning, 4th edn, New York, NY, Holt, Rinehartand Winston.Health Education West Midlands (n.d.) ‘Developing your career in healthcare’ (online).Available at http://learning.wm.hee.nhs.uk/resource/nurse-mentoring-ward (Accessed 11February 2015).Huybrecht, S., Loeckx, W., Quaeyhaegens, Y., De Tobel, D. and Mistiaen, W. (2011)‘Mentoring in nursing education: Perceived characteristics of mentors and theconsequences of mentorship’, Nurse Education Today, vol. 31, no. 3, pp. 274–8.Keller, J.M. (2008) ‘First principles of motivation to learn and e learning’, DistanceEducation, vol. 29, no. 2, pp. 175–85.Lisa Johnson, Ph.D. [YouTube user] (2013) ‘ARCS motivation model - learning design’(online), YouTube, 20 September. Available athttps://www.youtube.com/watch?v=RpjVprPeSo0 (Accessed 11 February 2015).Locally Healthy [YouTube user] (2010) ‘Nurse mentoring on the ward’ (online), YouTube, 1July. Available at https://www.youtube.com/watch?v=lzyVbUOlH5s (Accessed 11 Feb-ruary 2015).Nursing and Midwifery Council (2008) Standards to Support Learning and Assessment inPractice, 2nd edn, London, NMC. Available athttp://www.nmc-uk.org/Documents/NMC-Publications/NMC-Standards-to-support-learn-ing-assessment.pdf (Accessed 11 February 2015).Straus, S.E., Johnson, M.O., Marquez, C. and Feldman, M.D. (2013) ‘Characteristics ofsuccessful and failed mentoring relationships: a qualitative study across two academichealth centers’, Academic Medicine, vol. 88, no. 1, pp. 82–9.Teatheredge, J. (2010) ‘Interviewing student and qualified nurses to find out what makesan effective mentor’, Nursing Times, vol. 106, no. 48, pp. 19–21.Thomas, I. (2012) ‘Improving suturing workshops using modern educational theory’, TheClinical Teacher, vol. 9, no. 3, pp. 137–42.Thomas, S.P and Burk, R. (2013) ‘Junior nursing students’ experiences of verticalviolence during clinical rotations’, Nursing Outlook, vol. 57, no. 4, pp. 226–31.Vivienne Hall [YouTube user] (2013) ‘8 types of nonverbal communication YouTube’(online), YouTube, 18 February. Available athttps://www.youtube.com/watch?v=csaYYpXBCZg (Accessed 11 February 2015).Wilson, A.M.E. (2014) ‘Mentoring student nurses and the educational use of self: ahermeneutic phenomenological study’, Nurse Education Today, vol. 34, no. 3, pp. 313–18.Anderson, L. (2011) ‘A learning resource for developing effective mentorship in practice’,Nursing Standard, vol. 25, no. 51, pp. 48–56.Brennan, G. and McSherry, R. (2007) ‘Exploring the transition and professionalsocialisation from health care assistant to student nurse’, Nurse Education in Practice,vol. 7, pp. 206–14.Brugnolli, A., Perli, S., Viviani, D. and Saiani, L. (2011) ‘Nursing students’ perceptions oftutorial strategies during clinical learning instruction: a descriptive study’, Nurse EducationToday, vol. 31, no. 2, pp. 152–6.

References

129of 137


http://dx.doi.org/10.1016/j.nedt.2014.04.019

http://learning.wm.hee.nhs.uk/resource/nurse-mentoring-ward

https://www.youtube.com/watch?v=RpjVprPeSo0

https://www.youtube.com/watch?v=lzyVbUOlH5s



https://www.youtube.com/watch?v=csaYYpXBCZg


Chesser-Smyth, P.A. and Long, T. (2013) ‘Understanding the influences on selfconfidence among first year undergraduate nursing students in Ireland’, Journal ofAdvanced Nursing, vol. 69, no. 1, pp. 145–57.Dent, M. and Whitehead, S. (2002) Professional Identities, London, Routledge.Hatmaker, D.M., Park, H.H. and Rethemeyer, R.K. (2011) ‘Learning the ropes:communities of practice and social networks in the public sector’, International PublicManagement Journal, vol. 14, no. 4, pp. 395–419.Houghton, C. (2013) ‘“Newcomer adaption”: a lens through which to understand hownursing students fit in with the real world of practice’, Journal of Clinical Nursing, vol. 23,no. 15–16, pp. 2367–75.Houghton, C., Casey, D., Shaw, D. and Murphy, K. (2013) ‘Students’ experiences ofimplementing clinical skills in the real world of practice’, Journal of Clinical Nursing,vol. 22, pp. 1961–9.Jokelainen, M., Turunen, H., Tossavainen, K., Jamookeeah, D. and Coco, K. (2011) ‘Asystematic review of mentoring nursing students in clinical placements’, Journal of ClinicalNursing, vol. 20, no 19–20, pp. 2854–67.McIntosh, A., Gidman, J. and Smith, D. (2013) ‘Mentors’ perceptions and experiences ofsupporting student nurses in practice’, International Journal of Nursing Practice, vol. 20,no. 4, pp. 360–65.Masters, K. (2013) Role Development in Professional Nursing Practice, London, Jonesand Bartlett Learning.Moscaritolo, L.M. (2009) ‘Interventional strategies to decrease nursing student anxiety inthe clinical learning environment’, Journal of Nursing Education, vol. 48, no. 1, pp. 17–23.Nursing and Midwifery Council (2008) The Code: Standards of Conduct, Performanceand Ethics for Nurses and Midwives, London, NMC.Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education,London, NMC.Ousey, K. (2009) ‘Socialisation of student nurses – the role of the mentor’, Learning inHealth and Social Care, vol. 8, no. 3, pp. 175–84.Passmore J. (2006) Excellence in Coaching – An Industry Guide, London, Kogan Page.RCNonline [YouTube user] (2012) ‘This is nursing’ (oniline), YouTube, 13 May. Availableat https://www.youtube.com/watch?v=URlKV0ewrhM (Accessed 20 February 2015).Rejon, J.C. and Watts, C. (2013) Supporting Professional Nurse Socialisation: Findingsfrom Evidence Reviews, London, RCN.Robinson, S. (2013) ‘Sustaining mentorship for student nurses’, Nursing Times, vol. 109,no. 16, pp. 24–5.Roy, C. and Andrews, H.A. (2008) Roy Adaptation Model, 3rd edn, Upper Saddle River,NJ, Prentice Hall.Ruth-Sahd L.A. (2011) ‘Student nurse dyads create a community of learning: proposing aholistic clinical education theory’, Journal of Advanced Nursing, vol. 67, no. 11,pp. 2445–54.Spouse, J. (2000) ‘Supervision of clinical practice: the nature of professional develop-ment’ in Spouse, J. and Redfern, L. (eds) Successful Supervision in Health Care Practice,Oxford, Blackwell Science.This is Nursing, http://thisisnursing.rcn.org.uk/ (Accessed 10 March 2015).Willis Commission (2012) Quality with Compassion: The Future of Nursing Education,report of the Willis Commission, London, RCN.

References

130of 137



http://thisisnursing.rcn.org.uk/


Anderson, L. (2011) ‘A learning resource for developing effective mentorship in practice’,Nursing Standard, vol. 25, no. 51, pp. 48–56.Aston, L. and Hallam, P. (2014) Successful Mentoring in Nursing, 2nd edn, London, Sage.Atkinson, S. and Williams, P. (2011) ‘The involvement of service users in nursing students’education’, Learning Disability Practice, vol. 14, no. 3, pp. 18–21.Baxter, P. and Norman, G. (2011) ‘Self-assessment or self-deception? A lack ofassociation between nursing students’ self-assessment and performance’, Journal ofAdvanced Nursing, vol. 67, pp. 2406–13 .Brown, L. (2012) ‘What influences mentors to pass or fail students’, Nursing Management,vol. 19, no. 5, pp. 16–21.Brugnolli, A., Perli, S., Viviani, D. and Saiani, L. (2011) ‘Nursing students’ perceptions oftutorial strategies during clinical learning instruction: a descriptive study’, Nurse EducationToday, vol. 31, no. 2, pp. 152–6.Carlson, E., Wann-Hansson, C. and Pilhammar, E. (2009) ‘Teaching during clinicalpractice: strategies and techniques used by preceptors in nursing education’, NurseEducation Today, vol. 29, no. 5, pp. 522–6.Casey, D. and Clark, L. (2014) ‘Involving patients in the assessment of nursing students’,Nursing Standard, vol. 28, no. 47, pp. 37–41.Clynes, M.P. and Rafferty, S.E. (2008) ‘Feedback: an essential element of studentlearning in clinical practice’, Nurse Education in Practice, vol. 8, no. 6, pp. 405–11.Dohrenwend, A. (2002) ‘Serving up the feedback sandwich’, Family Practice Manage-ment, vol. 9, no. 10, pp. 43–9.Duffy, K. (2013) ‘Providing constructive feedback to students during mentoring’, NursingStandard, vol. 27, no. 31, pp. 50–56.FacultyofHealthUOP’s channel [YouTube user] (2010) ‘Describe yourself on a placement’(online), YouTube, 2 March. Available athttps://www.youtube.com/watch?v=job59GG2bR4 (Accessed 24 February 2015).Fahy, A., Tuohy, D., McNamara, M.C., Butler, M.P., Cassidy, I. and Bradshaw, C. (2011)‘Evaluating clinical competence assessment’, Nursing Standard, vol. 25, no. 50, pp. 42–8.Jerome, P.J. (1995) Coaching through Effective Feedback, London, Kogan Page.Murray, C., Rosen, L. and Staniland, K. (eds) (2010) The Nurse Mentor and ReviewerUpdate Book, Maidenhead, Open University Press.Ness, V. (2010) ‘Supporting and mentoring nursing students in practice’, NursingStandard, vol. 25, no. 1, pp. 41–6.Nursing and Midwifery Council (NMC) (2008) Standards to Support Learning andAssessment in Practice: NMC Standards for Mentors, Practice Teachers and Teachers,London, NMC.Nursing and Midwifery Council NMC (2010) Standards for Pre-registration NursingEducation, London, NMC. Available athttp://standards.nmc-uk.org/PublishedDocuments/Standards%20for%20pre-registration%20nursing%20education%2016082010.pdf (Accessed 24 February 2015).Price, B. (2012) ‘Key principles in assessing students’ practice-based learning’, NursingStandard, vol. 26, no. 49, pp. 49–55.Quinn, F.M. and Hughes, S.J. (2007) Quinn’s Principles and Practice of Nurse Education,5th edn, Andover, Cengage Learning.

References

131of 137


https://www.youtube.com/watch?v=job59GG2bR4




Black, S., Curzio, J. and Terry, L. (2014) ‘Failing a student nurse: a new horizon of moralcourage’, Nursing Ethics, vol. 21, no. 2, pp. 224–38.Brown, L., Douglas, V., Garrity, J. and Shepherd, C.K. (2012) ‘What influences mentors topass or fail students’, Nursing Management, vol. 19, no. 5, pp. 16–21.Duffy, K. (2003) Failing Students: A Qualitative Study of Factors that Influence theDecisions Regarding Assessment of Students’ Competence in Practice. Glasgow:Caledonian University. Available athttp://www.nm.stir.ac.uk/documents/failing-students-kathleen-duffy.pdf (Accessed 18March 2015).Duffy, K. (2004) ‘Mentors need more support to fail incompetent students’, British Journalof Nursing, vol. 13, no. 10, p. 583.Duffy, K. and Hardicre, J. (2007a) ‘Supporting failing students in practice 1: assessment’,Nursing Times, vol. 103, no. 47 pp. 28–9.Duffy, K. and Hardicre, J. (2007b) ‘Supporting failing students in practice 2: management’,Nursing Times, vol. 103, no. 48 pp. 28–9.Fitzgerald, M., Gibson, F. and Gunn, K. (2010) ‘Contemporary issues relating toassessment of pre-registration nursing students in practice’, Nurse Education in Practice,vol. 10, no. 35 pp. 158–63.Gainsbury, S. (2010) ‘Nurse mentors still “failing to fail” students’ (online), Nursing Times.Available athttp://www.nursingtimes.net/nursing-practice/specialisms/educators/nurse-mentors-still-failing-to-fail-students/5013926.article (Accessed 18 March 2015).Heaslip, V. and Scammell, J.M.E. (2012) ‘Failing underperforming students: the role ofgrading in practice assessment’, Nurse Education in Practice, vol. 12, no. 2, pp. 95–100.Jervis, A. and Tilki, M. (2011) ‘Why are mentors failing to fail student nurses who do notmeet clinical performance standards’, British Journal of Nursing, vol. 20, no. 9, pp. 582–7.Nursing and Midwifery Council (NMC) (2008) Standards to Support Learning andAssessment in Practice, London, NMC.Placement Connect (n.d.) ‘Sign off mentors’ (online). Available athttp://placementconnect.coventry.ac.uk/index.php/nursing/sign-off-mentors (Accessed 18March 2015).Skingley, A., Arnott, J., Greaves, J. and Nabb, J. (2007) ‘Supporting practice teachers toidentify failing students’, British Journal of Community Nursing, vol. 12, no. 1, pp. 28–32.Walsh, D. (2014) The Nurse Mentor’s Handbook, Buckingham, Open University Press.Webb, C. and Shakespeare, P. (2008) ‘Judgements about mentoring relationships innurse education’, Nurse Education Today, vol. 28, no. 5, pp. 563–71.Gopee, N. (2011) Mentoring and Supervision in Healthcare, 2nd edn, London, Sage.Haag-Heitman, B. and George, V. (2011) ‘Peer review’ in Nursing: Principles forSuccessful Practice, Sudbury, MA, Jones and Bartlett.Kinnell, D. and Hughes, P. (2010) Mentoring Nursing and Health Care Students, London,Sage.Lawson, L. (2011) ‘CPD for mentors: creating a portfolio’, Nursing Times, vol. 107, no. 21,pp. 15–18.McIntosh, A., Gidman, J. and Smith, D. (2014) ‘Mentors’ perceptions and experiences ofsupporting student nurses in practice’, International Journal of Nursing Practice, vol. 20,no. 4, pp. 360–65. Available at http://onlinelibrary.wiley.com/doi/10.1111/ijn.12163/pdf(Accessed 4 March 2015).

References

132of 137


http://www.nm.stir.ac.uk/documents/failing-students-kathleen-duffy.pdf

http://www.nursingtimes.net/nursing-practice/specialisms/educators/nurse-mentors-still-failing-to-fail-students/5013926.article

http://www.nursingtimes.net/nursing-practice/specialisms/educators/nurse-mentors-still-failing-to-fail-students/5013926.article

http://placementconnect.coventry.ac.uk/index.php/nursing/sign-off-mentors

http://onlinelibrary.wiley.com/doi/10.1111/ijn.12163/pdf


Morby, S.K. and Skalla, A. (2010) ‘A human care approach to nursing peer review’,Nursing Science Quarterly, vol. 23, no. 4, pp. 297–300. Available athttp://nsq.sagepub.com/content/23/4/297.full.pdf+html (Accessed 4 March 2015).Nursing and Midwifery Council (NMC) (2008) Standards to Support Learning andAssessment in Practice [Slaip], London, NMC.Nursing and Midwifery Council (NMC) (2011) Post Registration Education and Practice[Prep], London, NMC.Robinson, S. (2013) ‘Sustaining mentorship for student nurses’, Nursing Times, vol. 109,no. 16, pp. 24–5.Robinson, S., Cornish, J., Driscoll, C., Knutton, S., Corben, V. and Stevnson, T. (2012)Sustaining and Manging the Delivery of Student Nurse Mentorship: Roles, Resources,Standards and Debates, London, National Nursing Research Unit, Kings College London.Turnbull, P., Francis-Wright, M., Wetherall, C. and Corrin, A. (2014) Report on theExploration of the Influences on Developing and Maintaining a Successful MentorshipProcess: An Investigation of Mentorship from Multiple Perspectives, Anglia RuskinUniversity and University of Essex. Available athttp://www.essex.ac.uk/hhs/documents/research/mentorship-heee-2014.pdf (Accessed 4March 2015).

Further readingGray, M.A. and Smith, L.N. (2000) ‘The qualities of an effective mentor from the studentnurse’s perspective: findings from a longitudinal qualitative study’, Journal of AdvancedNursing, vol. 32, no. 6, pp. 1542–9Kings College London (2013) ‘Should all nurses be mentors?’, Policy+, no. 41 (October).Available athttp://www.kcl.ac.uk/nursing/research/nnru/policy/By-Issue-Number/Policy–Issue-41-FI-NAL.pdf (Accessed 6 March 2015).Walsh, D. (2010) ‘The effective mentor’ in The Nurse Mentor’s Handbook: SupportingStudents in Clinical Practice, Buckingham, Open University Press. Available athttp://nursing.iugaza.edu.ps/Portals/55/effective%20mentor.pdf (Accessed 6March 2015).Browne, S., Clarke, D., Henson, P., Hristofski, F., Jeffreys, V., Kovacs, P., Lambert, K. andSimpson, D. (2009) ‘How does the acquisition of skill affect performance?’ (online) inPDHPE Application & Inquiry Second Edition HSC Course, 2nd edn, Oxford UniversityPress. Available athttp://lib.oup.com.au/secondary/health/PDHPE/HSC/Student%20Book/PDHPE_HS-C_e_chapter_Ch8.pdf (Accessed 23 February 2015). Note that this focuses on sportsperformance using Bloom’s model, but content is transferable.Heer, R. (2009) ‘A model of learning objectives, based on “A taxonomy for learning,teaching, and assessing”: a revision of Bloom's Taxonomy of educational objectives’(online) Center for Excellence in Learning and Teaching, Iowa State University. Availableat http://www.celt.iastate.edu/pdfs-docs/teaching/RevisedBloomsHandout.pdf (Accessed23 February 2015).Self Awareness (2013) ‘Understanding the Johari Window model’ (online), 10 November.Available at

Further reading

133of 137


http://nsq.sagepub.com/content/23/4/297.full.pdf+html

http://www.essex.ac.uk/hhs/documents/research/mentorship-heee-2014.pdf

http://www.kcl.ac.uk/nursing/research/nnru/policy/By-Issue-Number/Policy--Issue-41-FINAL.pdf

http://www.kcl.ac.uk/nursing/research/nnru/policy/By-Issue-Number/Policy--Issue-41-FINAL.pdf

http://nursing.iugaza.edu.ps/Portals/55/effective%20mentor.pdf

http://lib.oup.com.au/secondary/health/PDHPE/HSC/Student%20Book/PDHPE_HSC_e_chapter_Ch8.pdf

http://lib.oup.com.au/secondary/health/PDHPE/HSC/Student%20Book/PDHPE_HSC_e_chapter_Ch8.pdf

http://www.celt.iastate.edu/pdfs-docs/teaching/RevisedBloomsHandout.pdf


http://www.selfawareness.org.uk/news/understanding-the-johari-window-model (Ac-cessed 23 February 2015).Benner, P. (2000) From Novice to Expert: Excellence and Power in Clinical NursingPractice, Upper Saddle River, NJ, Prentice Hall.Cant, R., McKenna, L. and Cooper, S. (2013) ‘Assessing pre-registration nursingstudents’ clinical competence: a systematic review of objective measures’, InternationalJournal of Nursing Practice, vol. 19, no. 2, pp. 163–76.Gopee, N. (2011) Mentoring and Supervision in Healthcare, London, Sage.Joghin, G. (ed.) (2009) Assessment, Learning and Judgment in Higher Education,Wollangong, Australia, Springer.Ali, P. and Panther, W. (2008) ‘Professional development and the role of mentorship’,Nursing Standard, vol 22, no. 42, pp. 35–9.Availble athttp://www.uwplatt.edu/files/tlc/Mentoring/Role%20of%20Mentoring.pdf (Accessed 4March 2015).Myall, M., Levett-Jones, T. and Lathlean, J. (2008) ‘Mentorship in contemporary practice:the experiences of nursing students and practice mentors’, Journal of Clinical Nursing,vol. 17, no. 14, pp. 1834–42.Robinson, S., Cornish, J., Driscoll, C., Knutton, S., Corben, V. and Stevenson, T. (2012)Sustaining and Managing the Delivery of Student Nurse Mentorship; Roles, Resources,Standards and Debates, National Nursing Research Unit, King’s College London.

AcknowledgementsWeek 1 of This free course was written by Julie Messenger.Week 2 of This free course was written by Ann Mitchell.Week 3 of This free course was written by Julie Messenger.Week 4 of This free course was written by Fiona Dobson.Week 5 of This free course was written by Kay Norman.Week 6 of This free course was written by Kay Norman.Week 7 of This free course was written by Ann Mitchell.Week 8 of This free course was written by Kay Norman.Except for third party materials and otherwise stated (see terms and conditions), thiscontent is made available under aCreative Commons Attribution-NonCommercial-ShareAlike 4.0 Licence.The material acknowledged below is Proprietary and used under licence (not subject toCreative Commons Licence). Grateful acknowledgement is made to the following sourcesfor permission to reproduce material in this free course:Course image: © Istockphoto.com

Week 1

TextSection 1.2: extract from: Clutterbuck, D. (n.d.) ‘Twelve habits of the toxic mentor’ (online).© David Clutterbuck.Images

Acknowledgements

134of 137


http://www.selfawareness.org.uk/news/understanding-the-johari-window-model

http://www.uwplatt.edu/files/tlc/Mentoring/Role%20of%20Mentoring.pdf

http://www.open.ac.uk/conditions

http://creativecommons.org/licenses/by-nc-sa/4.0/deed.en_GB


Figure 1: Shutterstock/Wavebreakmedia.Figure 2: © unknown.TablesTable 4: extract from Section 2.1.2 of the NMC (2008) document Standards to SupportLearning and Assessment in Practice, entitled ‘Competence and outcomes for a mentor’.VideosActivity 1: ‘What is mentoring?’, Jane Stubberfield, University of Plymouth (and JISC),released under a Creative Commons NC Sharealike Licence.Activity 2: ‘What not to do when mentoring’, courtesy of School of Education andUniversity of Hertfordshire.Activity 3: ‘Qualities and skills of a mentor’, Jane Stubberfield, University of Plymouth (andJISC), released under a Creative Commons Non-Commercial Sharealike licence.

Week 2

TextActivity 7: extract from Walsh, D. (2014) The Nurse Mentor’s Handbook, Chapter 4,pp. 84–110, Open University Press. © Danny Walsh.Activity 9: extract from Andrew, N., Tolson, D. and Ferguson, D. (2008) ‘Building onWenger: communities of practice in nursing’, Nurse Education Today, vol. 28, no. 2,pp. 246–52.ImagesFigure 1: courtesy of Saul McLeod (http://www.simplypsychology.org/pavlov.html).Figure 2: courtesy of Saul McLeod )http://www.simplypsychology.org/pavlov.html).Figure 4: http://www.studentlifenet.co.uk/.Figure 6: adapted from Kolb, D.A. (1984) Experiential Learning: Experience as the Sourceof Learning and Development, Englewood Cliffs, NJ, Prentice Hall.Figure 7: http://npstc.org/images/Home/COPs.jpg.VideosActivity 1: ‘Classical conditioning’ video courtesy of Scot Webb (http://www.simplypsychology.org/pavlov.html).Every effort has been made to contact copyright owners. If any have been inadvertentlyoverlooked, the publishers will be pleased to make the necessary arrangements at thefirst opportunity.

Week 3

ImagesFigures 1 and 2: adapted fromhttp://www.learningandteaching.info/learning/learning curve.htm.Figures 3–5: adapted fromhttp://www.learningandteaching.info/learning/bloomtax.htm#ixzz3NxhuUgGvFigure 6: adapted from Dave, R.H. (1975) ‘Psychomotor levels’ in Armstrong, R.J. (ed.),Developing and Writing Behavioural Objectives, Tucson, AZ, Educational InnovatorsPress.Tables

Acknowledgements

135of 137


http://www.simplypsychology.org/pavlov.html


http://www.studentlifenet.co.uk/

http://npstc.org/images/Home/COPs.jpg


http://www.learningandteaching.info/learning/learning%20curve.htm

http://www.learningandteaching.info/learning/bloomtax.htm#ixzz3NxhuUgGv


Table 2: adapted from Chapman, A. (2015) ‘Conscious competence learning model’ (http://www.businessballs.com/consciouscompetencelearningmodel.htmTable 4: adapted from Clark, D. (1999) ‘Bloom’s Taxonomy of learning domains’, Big Dog& Little Dog’s Performance Juxtaposition (http://www.nwlink.com/~donclark/hrd/bloom.html).

Week 4

TextActivity 3: extracts from Clynes, M.P. and Raftery, S.E.C. (2008) ‘Feedback: an essentialelement of student learning in clinical practice’, Nurse Education in Practice, vol. 8, no. 6,pp. 405–11.Section 5: pages 12, 16, 17, 27 and 28 from: Nursing and Midwifery Council (2008)Standards to Support Learning and Assessment in Practice, 2nd edn, London, NMC.VideosActivity 1: Locally Healthy [YouTube user] (2010) ‘Nurse mentoring on the ward’ (online),YouTube, 1 July. Available at https://www.youtube.com/watch?v=lzyVbUOlH5s. Courtesyof NHS Local.

Week 5

TextSection 1: list from Jokelainen et al. (2010)Section 5.1: list from Spouse (2000)ImagesFigure 1: top left, Wikipedia Commons; middle left, http://en.wikipedia.org/wiki/Paramedicmade available under http://creativecommons.org/licenses/by-sa/3.0/; bottom left, ©unknown; top right, © Helenecandade/iStockphoto.com; middle right,http://hee.nhs.uk/work-programmes/health-visiting/, NHS Education England; middleright, © unknown; bottom right, © unknown .Figure 3: adapted from Passmore J. (2006) Excellence in Coaching – An Industry Guide,London, Kogan Page.VideosActivity 5: https://www.youtube.com/watch?v=URlKV0ewrhM

Week 6

ImagesFigure 1: © Shironosov/iStockphoto.com.Figure 2: https://www.youtube.com/watch?v=1kXHhZK_lv0.Figure 3: © unknown (for illustrative purposes only).

Week 7

ImagesFigure 1: © unknown.Figure 2: bowdenimages/iStockphoto.com.

Acknowledgements

136of 137




https://www.youtube.com/watch?v=lzyVbUOlH5s

http://en.wikipedia.org/wiki/Paramedic

http://creativecommons.org/licenses/by-sa/3.0/

http://hee.nhs.uk/work-programmes/health-visiting/


https://www.youtube.com/watch?v=1kXHhZK_lv0


Week 8

ImagesFigure 1: Dreamstime.com.Every effort has been made to contact copyright owners. If any have been inadvertentlyoverlooked, the publishers will be pleased to make the necessary arrangements at thefirst opportunity.Don't miss outIf reading this text has inspired you to learn more, you may be interested in joining themillions of people who discover our free learning resources and qualifications by visitingThe Open University – www.open.edu/openlearn/free-courses.

Acknowledgements

137of 137


http://www.open.edu/openlearn/free-courses?LKCAMPAIGN=ebook_&MEDIA=ol
