In the any field of critical practice, the relationship between mentors and their students is said to be of vital importance, most especially in the development of the latter’s experience with regard to the said field (Mentor Information Pack 2008; Canham and Bennett 2001; Bastable 2008). Moreover, this relationship also becomes of great importance as it is during practice that the competence of the student is fifty percent assessed. Because of this, the mentor is now faced with the task to ensure that his or her students are fairly assessed at this particular stage (Mentor Information Pack 2008).
It is also then because of this that the Nursing and Midwifery Council developed the new Standards to support learning and assessment in practice (Lawson 2007; Burke and Saldanha 2005; Hansten and Jackson 2004). Basically, the goal of these set of standards is to strengthen the requirements for mentors as well as increase their accountability as they perform their two most important roles: (1) as facilitators of learning and (2) as assessors of their students’ competence.
More importantly, these standards aim to protect the public. The NMC then aims to ensure that the students of allied health professions comply with the standards with regard to their education, training, conduct, performance and ethics (NMC 2006). Accountability has been considered a very important part of the practice of both nursing and midwifery in the United Kingdom, as reflected in the agenda of the Nursing and Midwifery Council or NMC. Nurses were required to consider and observe many aspects as they fulfil their duties.
These include the ethical, psychological, ethnic and human rights dimensions in order to prove that these allied health professionals are really accountable for the actions that they are performing (Bastable 2008; Clemow 2006; Spouse 1996). Without a doubt, the necessity of these actions lies on the fact that the midwifery and nursing professions are considered to be something very important for all the members of the society. It is then because of this that the education of the students who are wishing to embark on the aforementioned professions are given paramount consideration.
As a result, their mentors during clinical practice are faced with the task of also being accountable in their roles as facilitators of learning and as assessors in determining the competence of their students (Burke and Saldanha 2005; Royal College of Nursing n. d. ). Considering the necessity and importance of the abovementioned, this paper’s discussion shall focus on the examination of the accountability that mentors have with regard to their role as the facilitators of learning. Likewise, their task in assessing the competence of their students would also be examined.
This paper shall focus on all the categories of learners in practice settings, but it would significantly look into the students who are in either the pre-registration or post-registration in allied health profession courses (Clarke 2007; Walsh, Crumbie and Reveley 1999; Wealsh and Swann 2002). Mentorship: A Definition Before going through the examination of the mentor’s role as facilitators of learning and in the assessment of competence, a definition of mentorship shall first be mentioned.
According to Carmin (1993), mentoring is a complex, interactive process, occurring between individuals of differing levels of experience and expertise which incorporates interpersonal psychosocial development, career, and/or educational development, and socialisation functions into the professional relationship. It is then because of this that the mentors must be accountable for their actions, considering that the mentors are the one that provides the students with the support and guidance that they need to ensure effective leaning and development (Bastable 2008; Guy 2001)).
The Framework to Support Learning and Assessment in Practice (NMC 2006) As it has been mentioned, the Nursing and Midwifery Council (2006) developed a set of standards in order to guide the education, training, conduct, ethics, etc. of the students. Aside from this, they also developed a framework to support learning and assessment in practice. This particular framework basically defines and describes the knowledge and skills that registrants need to apply in practice as the mentor support and assess their students who are taking programmes that are approved by the NMC (Clarke 2007).
Following these standards would eventually lead to the registration of the register. Moreover, the NMC (2006) said that this particular framework also listed outcomes for mentors, practice teachers and teachers so that there is clear accountability for making decisions that lead to entry to the register. Eight domains are identified in the framework developed by the NMC. Basically, each domain comes with identified outcomes at the four developmental stages.
These domains are the following (NMC 2006): (1) establishing effective working relationships; (2) facilitation of learning; (3) assessment and accountability; (4) evaluation of learning; (5) creating an environment of learning; (6) context of practice; (7) evidence-based practice; and finally, (8) leadership. As earlier defined, this particular paper would only focus on one domain, assessment and accountability, but it would still include, to some extent, the facilitation of learning (Bastable 2008). The Accountability of Mentors and their Role as Facilitators of Learning
According to Holloway (1985, in Stuart 2007) the mentor’s moral accountability to students emphasizes the need for a special relationship to exist between him or her and the student. This special relationship must be infused with empathy, trust and affinity which are then very important to the entire learning practices. As a result, the mentors must be able to develop good mentoring practices so as to ensure that they are developing a special relationship between them and their students. The Mentor Bulletin (2004) lists the different tasks that are required of mentors in fulfilling their role as facilitators of learning.
According to the said article, the role of the mentors should be emphasized before, during and after the practice placement of their students. In fact, a national framework for health and social care education was developed in order to ensure that nurse educators are properly prepared and qualified in order to ensure that they could properly facilitate learning, the National Association of Educators in Practice (2007) discusses. This would also help in ensuring that effective educator roles, enriched by a partnership of service and education providers are developed.
Mentors in clinical practice play a very important role in influencing the experience, motivation and commitment of their students to their chosen profession (Friedman and Woodhead 2008). Basically, it is because of this that role modelling is always valued as a key component of education in practice. However, the National Association of Educators in Practice (2007) notes that the mentors’ example could not efficiently guarantee the proper learning that the students of allied health professions would receive.
It is because of this that mentors must be constantly guided in their fulfilment of educational roles (Hansten and Jackson 2004). Considering the fact that the mentors base their teachings on their experience and field of expertise, they must educate their students by using a problem-based approach to learning. According to the report entitled Guidelines for the Supervision and Assessment of Student Midwives during Clinical Practice (2003), problem based learning is capable of laying the foundations needed by students for a lifetime of continuing education.
It serves as a means by which students could gain the capability rather than just learning to acquire knowledge. It makes use of a structured process that would present the students the problems that they may eventually face once they formally practice. As a result, it is capable of providing a stimulus for learning. One of the advantages of using problem based learning is that it not only provides the educational conditions that are able to support learning in the cognitive and affective domain but it also helps students in mastering applied general principles to a range of competencies.
Basically, the mentors provide an avenue where students could learn, making use of past and present experience in order to promote reflection for future learning (Spouse 1996; Hansten and Jackson 2004; Humphris and Masterson 2000; Knowles 1984). It has been said that many problems that are usually associated with pre-registration programmes point to the lack of competence that nursing or midwifery students are exhibiting at the registration stage. Apparently, the students were seen to lack practical skills literacy and are still very much in need for a high level of support.
In this event, the government of the United Kingdom stressed on its need for health care professionals that are capable of rendering the best service possible to the modern National Health Service (NHS). Thus, the government called for the proper education of students of allied health professions in order to increase their practical skills while they are sill in the training programme. Moreover, it called on every practitioner to share the responsibility in supporting and teaching the next generation of nurses and midwives.
Because of this, the role of mentors as facilitators of learning and assessors of competence had been widely emphasized (Stuart 2007). The mentors, first of all are professionally accountable for the support, supervision of learners and the assessment of the standards of practice. Clause 6. 4. of the NMC Code of Professional Conduct states that mentors have a duty to the develop the competence of students of nursing, midwifery and others. The aforementioned clause is very important especially when the student nurse or midwife is still in his or her pre-registration stage and is only in clinical practice.
Once the work of a registered nurse has been delegated to them, the former must ensure that they are given appropriate support and supervision especially since they have not achieved full registration practices (Mentor Information Pack 2008; Stuart, 2007; Spouse 1996). In fact, they must be guiding their students at a very early age of practice. According to Stuart (2007), the mentors must exhibit special efforts in order to make students feel welcome during their early days of working in the clinical area.
Through this, the mentors would at least help in lessening the anxiety of the students, making them feel more relaxed and putting them into a better position order to start learning. Through this, the performance of the student is then affected positively (Clemow 2006; Neary 2000; Paliadelis and Cruickshank 2003). In their roles as facilitators of learning, the mentors must be able to first improve their own standard of practice before actually dealing with their students.
This is because according to Eraut et al (1995), the next generation of practitioners would suffer in the event that their mentors’ clinical practice are ill-defined, lacks quality and are making insufficient use of the scientific knowledge. In the same manner, much of the learning is said to take place in the practice setting. As a result, the mentors become a role model to their students, making role modelling a very important learning strategy in the clinical environment (Ewing 2007). Aside from this, the mentor, being a facilitator of learning, is responsible in ensuring that the learning environment is appropriate to the students’ needs.
It is believed that through the provision of high-quality learning opportunities that the student would be able to achieve learning outcomes and competencies. Moreover, the mentors are accountable to ensure that their students receive the best instruction available. Failing to instruct the students properly then would be considered a negligent act on the part of the mentors (Stuart 2007; National Stakeholder Event 2007). The mentors must also ensure that their students would achieve the national NMC standards of proficiency so as to guarantee that their students possess the necessary competencies.
Thus, it is through this a proper education received from their mentors that the students would be able to ensure that they are of great quality once they become registered nurses (Clemow 2006; Crisholm and Blair 2006). Hence, the mentors must be responsible and accountable to what they are teaching, what their students are learning, what is being assessed by fully understanding the relevant aspects of the curriculum so as to ensure that their students will achieve the programme learning outcomes (Stuart 2007; Clemow 2006; Cox 1982). Bandura (1977) discusses the importance of role modelling from the perspective of social learning theory.
He suggests that learning takes place when one student copies the behaviour of his or her mentor, thereby emphasizing the importance of role modelling. In giving example to this, Stuart (2007) takes note of a study conducted wherein students were seen to have learned major concepts in nursing just by observing their role models that provided direct patient care. As a result, the mentors, as facilitators of learning must be accountable to their own actions in order to show good example to their students who learn so much just by observing them.
Without the mentor exhibiting good examples to their students, the latter would not be able to practice their profession properly (Mentor Bulletin 2004). The Accountability of Mentors and their Role as Assessors of Competence The mentors are also accountable to their roles as assessors of their students’ competence. Apparently, this assessment is very important since it generally serves as a quality control to the outcome of the educational process that the students have undertaken.
Basically, this educational and professional outcome reveals a nurse, midwife or any health professional who is able to apply the knowledge, understanding, and skills that are required of them as standards for their employment (Stuart 2007; Ewing 2007; Spouse 1996). Assessment then helps in measuring the theoretical and clinical learning achieved by the students. This entails the proper filling out and accomplishment of forms that serve as the means by which the competence of the students are measured. As a result, it is the moral responsibility of the mentors to fail their students who they deem as incompetent.
Because of this, assessment becomes a very important part of the health care programmes (Stuart 2007; Crisholm and Blair 2006). One must remember that the assessment of students’ practice is a continuous process which allows the reflection and planning of the future needs of students. The examination of the students’ portfolio to discuss their progress is very important. Moreover, the students must also be given feedback once they have completed a certain activity (Medical Officers of School Association 1998; Mentor Bulletin 2004).
Through this, the mentors would be able to determine the competence of the students and provide time in order to at least improve the performance of the latter (Cox 1982). The Parker’s Framework, developed in 2004 but remains unpublished, according to Dimmock (2006), lists six areas by which the students’ practice could be efficiently assessed; these are the following: (1) professional behaviour; (2) teamwork; (3) student interest, motivation and enthusiasm; (4) requests for help; (5) application of theory to practice; and finally, (6) communication.
Accountability and Assessment: The Practice of the Health Professionals Council The Health Professionals Council or HPC plays an active role in ensuring that the programmes of the different education providers throughout the United Kingdom meet their standards of education and training. In the same manner, they ensure that the graduates of the different programmes that they approve meet the standards of proficiency that the HPC developed before allowing them to be a part of the register.
Considering the importance of assessment, the council also gives special importance to the examination of programmes and other education providers in order to ensure the competence of its graduates (Walsh, Crumbie and Reveley 1999; Wealsh and Swann 2002). Because of the aforementioned, the council makes regular visits to the education providers and other institutions providing programmes relating to the health care professions regularly.
In these visits, they not only look at the programme being offered but also ask significant questions to the members of the staff, the senior managers and the placement providers in order to ensure, once again, the quality of the graduates. As a result, the duties pertaining to assessment and accountability of the mentors of the aforementioned educational institutions must be guaranteed in order to ensure that they remain accredited and recognized by the Health Professionals Council or HPC. References Bastable, S. B. 2008.
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