Welcome to the REGISTRANT AWARENESS STUDY DAY 2008-9 (Previously known as the Associate Mentor Study Day)

1. Welcome to the REGISTRANT AWARENESS STUDY DAY 2008-9 (Previously known as the Associate Mentor Study Day) 1 Registrant Awareness Study Day, October 2008.

2. Aims • To develop an understanding of the role and responsibilities of a Registrant (Associate Mentor). • To provide an outline of the contribution a Registrant (Associate Mentor) can make to teaching, assessing and the facilitation of students. Registrant Awareness Study Day, October 2008.

3. Objectives To identify the contribution the Registrant (Associate Mentor) can make to: • Teaching and the facilitation of learning. • Supporting students in practice. • Assessing students in practice. • Promoting an effective learning environment. • Outline the assessment process and the professional / legal responsibilities of those involved. • Identify the current programmes in Greater Manchester. Registrant Awareness Study Day, October 2008.

4. Objectives Cont’d Link to the NHS Knowledge and Skills Framework Core Dimensions (NHS 2004): • Communication. • Personal and people development. • Service improvement. • Quality. • Equality and Diversity. Registrant Awareness Study Day, October 2008.

5. Why Assess? • Assessment is a key component of every nurse’s role. • You have a duty to facilitate students of nursing to develop their competence. (NMC 2008a) • It is the role of Mentors and Registrants (Associate Mentors) to assess competence and confirm that students are capable of safe and effective practice. (NMC 2008b) Registrant Awareness Study Day, October 2008.

6. Clinical Pathway to Mentorship Maintain Portfolio Participate in supervision and assessment of pre-registration students Complete Mentor Preparation programme at L2, L3, L4 Preceptorship Registrant (Associate Mentor) Mentor Sign off Mentor Completion of preceptorship From September 2007 Prepare to make final assessment of fitness to enter practice Attend 1 day Preparation workshop Meet additional criteria Be on the same part or sub–part of the register 6 months Post qualified Registrant Awareness Study Day, October 2008.

7. Scenario 1 A qualified Mentor asks you to act as a Registrant (Associate Mentor) for a student nurse who starts her placement in 2 weeks time. What do you need to consider and what resources can you access: a) Prior to the student’s arrival? b) On the student’s arrival? Registrant Awareness Study Day, October 2008.

8. Role of the Mentor Work in conjunction with the Registrant (Associate Mentor) and hold regular meetings to: • Supervise, support and guide students in practice. • Contribute towards a supportive learning environment and quality learning experience for students. • Ensure completion of required assessment documentation. • Ensure a minimum of 40% contact between the qualified Mentor and student. Please refer to the Handbook for Mentors & Registrants (Associate Mentors) for more information. Registrant Awareness Study Day, October 2008.

9. Role of the Registrant (Associate Mentor) Work in conjunction with the qualified Mentor to: • Act as a role model. • Assist and support students in learning new knowledge, skills and attitude. • Help the student to identify their learning needs. • Ensure a minimum requirement of student / Registrant (Associate Mentor) contact 2 shifts (40%). • Arrange for others to work with and teach the student. • Make an assessment of the student’s progress and give feedback. • Assist with the student’s interview and help the Mentor to complete the assessment documentation. • Liaise with the Personal Tutor or Academic / Unit Lead where necessary. Registrant Awareness Study Day, October 2008.

10. Professional Responsibility These are required in order to fulfil your role as a Registrant (Associate Mentor) and to adhere to Trust and NMC requirements: Registration of Registrant (Associate Mentor) • Submit registration form and completed objectives to the Practice Education Facilitator (as appropriate). Maintaining competence • Attend an update or undertake the on-line Mentor / Registrant (Associate Mentor) update annually. • This is an interim role: The “NMC would expect that the majority of nurses and midwives would at least meet the outcomes of a mentor”. Registrant Awareness Study Day, October 2008.

11. Collection of Evidence Evidence of competency can be demonstrated through: • Observations, Discussion. • Research articles, appropriate literature searches. • Reflective written account. • Records of training and supervised practice. • Case studies and care plans. • Knowledge of relevant guidelines / assessment tools. • Clinical practice records and log sheets. • Supervised practical skills. In relation to the core dimensions linked to KSF: • Communication. • Personal and People Development. • Health, Safety and Security. • Service Improvement. • Quality. • Equality and Diversity. Registrant Awareness Study Day, October 2008.

12. Programmes Leading to Registration The University of Manchester / MMU: • Diploma: multiple exit - Diploma, Diploma with 40 degree level credits, Degree. University of Salford: • Diploma: multiple exit - certificate, Diploma, Diploma with 60 degree level credits (Ordinary Degree). All Universities: • Degree: multiple exit – certificate, Diploma, Degree, Degree (RN). • Fast Track: Assistant Practitioner, Graduate Entry, AP(E)L – over two or two and a half years. Part Time Programmes: • University of Salford – over four and a half years. NB: Nursing should work towards becoming an all graduate profession (NMC, 2008). Registrant Awareness Study Day, October 2008.

13. Partner Higher Education Institutions • The University of Manchester • University of Salford • Manchester Metropolitan University • Bolton University Registrant Awareness Study Day, October 2008.

14. Placement Regulations Pre-Registration Student Nursing University Rules & Regulations Varies across programmes and HEIs See handout and University Websites for details 14 14

15. Curriculum Core Components 1 year Common Foundation Programme and 2 year Branch Programme. Equal weighting for the accreditation of theory and practice. An outcomes based standards of proficiency approach. Portfolio of evidence to demonstrate fitness for practice, award and purpose. Use of PBL, blended learning, VLE Registrant Awareness Study Day, October 2008.

16. Curriculum Core Components • Clinical Skills Teaching. • Students are supernumerary • Essential Skills Clusters (NMC 2007). • Longer clinical placements with 12 weeks consolidation at the end of the programme. • Requirement to be exposed to other branches (EU Directives). Registrant Awareness Study Day, October 2008.

17. Points to Consider for the Facilitation of Learning • Stage in training. • Previous experiences. • Hubs & Spokes. • Learning styles. • Students with a disability. • Maintain equality and diversity. • Practice based learning opportunities. Registrant Awareness Study Day, October 2008.

18. Rotational Placements • HUB = base placement. • SPOKE = holistic view of patient care. • Spoke placements are to be negotiated between the student and Mentor. • Rotational placement is a programme of rotation set up within a Hub placement (often a unit base). • Group Spokes. NB: SeePolicy in relation to Hub and Spoke Placements Registrant Awareness Study Day, October 2008.

19. Hub and Spoke Registrant Awareness Study Day, October 2008.

20. Example of Spoke Placements Registrant Awareness Study Day, October 2008.

21. TWO HUBS THEATRE A & E POSSIBLE SPOKES Palliative Care / MacMillan Outreach Team Two Hubs – Same Spokes Registrant Awareness Study Day, October 2008.

22. Learning Styles • Our attitude and behaviour can determine our preferred way of learning. • It is well known that people learn in different ways. • Honey & Mumford (1982) identified 4 preferences or styles of learning: • Activist; Reflector; Pragmatist; Theorist • Flemming (2007) formulated VARK; • Visual; Aural; Reading/writing; Kinaesthetic Registrant Awareness Study Day, October 2008.

23. The Activist • Tends to act first and consider the consequences later. • Learns best when involved in new activities, but can get bored with implementation or long explanations. • Learns less well listening to lectures or following precise instructions. Registrant Awareness Study Day, October 2008.

24. The Reflector • Likes to stand back and look at situations from different perspectives. • Learns best from observing others at work or when given the opportunity to review what has happened. • Learns less well when rushed or when they are asked to lead in a situation. Registrant Awareness Study Day, October 2008.

25. The Theorist • Tends to be perfectionists who like to think problems through step by step. • Learns best in structured situations where they have prior knowledge or can ask questions. • Learns less well in unstructured situations, or situations where they have no prior knowledge or have to deal with emotional issues. Registrant Awareness Study Day, October 2008.

26. The Pragmatist • Wants concepts that can be applied in practice. • Learns well when they can practice techniques or can see an obvious link with their job. • Learns less well where learning is all theory or when there is no apparent pay back for them. Registrant Awareness Study Day, October 2008.

27. Learning Styles • I learn best when I am able to try new activities and can see the benefits for my patients / students, team or myself. • I learn less well from formal lectures and tend to get bored if learning is repetitive or does not seem relevant. Registrant Awareness Study Day, October 2008.

28. VARK (2007) Further methods of aiding teaching and learning: • Visual – use pictures, posters and equipment to explain and demonstrate new skills. • Aural – use discussion and explanations. Some students may record information given in teaching sessions. • Read / Write – use notes, definitions and flow diagrams to remember information. • Kinaesthetic – need to experience the skill to be able to understand and internalise it. 28 Registrant Awareness Study Day, October 2008.

29. Challenge for the Mentor • Appreciate that your own learning style may not suit your student. • Consider how to adapt your placements learning opportunities to meet all the learning styles. • Ultimately try to achieve a mix between theory, practice, structured teaching and experiential learning. Registrant Awareness Study Day, October 2008.

30. Action Plan for Learning Consider how you could adapt your teaching / mentoring style to suit each of the following student types: • Activist student. • Reflective student. • Theorist student. • Pragmatist student. Registrant Awareness Study Day, October 2008.

31. How to Evaluate Effectiveness of Learning • Questions and answers. • Observation. • Performance to achievement of outcomes or standards of proficiency. • Feedback from placement team. Registrant Awareness Study Day, October 2008.

32. Scenario 2 Part 1: The student has been in placement for 3 weeks and you will be assisting the qualified Mentor in undertaking the mid-point interview in 2 days time. Registrant Awareness Study Day, October 2008.

33. Supporting Students Why should Mentor / Registrant (Associate Mentor) support students? Students must be supported in identifying their learning needs and making the best of the learning opportunities provided. Placements must provide adequate support and supervision for students. (DH 2001) Registrant Awareness Study Day, October 2008.

34. What Makes a Good Placement? Registrant Awareness Study Day, October 2008.

35. The Good Placement A good placement should include the following: • Consistent support and supervision. • Appropriate preparation and orientation. • Appropriately qualified Mentors / Registrants (Associate Mentors). • Assistance to link theory and practice. • Help to match learning needs against learning opportunities. • Regular feedback on progress given to student. • All placements meet quality standards. NB: This list is not exclusive. Registrant Awareness Study Day, October 2008.

36. What Makes a Good Mentor / Registrant(Associate Mentor) ? Registrant Awareness Study Day, October 2008.

37. The Good Mentor / Registrant (Associate Mentor) A good Mentor / Registrant (Associate Mentor) requires the following skills: • Coaching. • Supporting. • Instructing / developing. • Listening. • Inspiring. • Encouraging. • Managing risks. • Opening up avenues of opportunity. • Giving constructive and timely feedback. • Being a good role model of professional behaviour. NB: This list is not exclusive. Registrant Awareness Study Day, October 2008.

38. Giving Feedback to Students • Giving timely feedback is the backbone of good supervision. • In order to develop students must receive regular feedback about their progress – positive and negative. • A feedback sandwich consists of constructive criticism “sandwiched” between 2 examples of praise or positive feedback: i.e. positive / negative / positive. • To be effective feedback must be as precise as possible and suggest solutions for how negative practices can be changed. NB This list is not exclusive. Registrant Awareness Study Day, October 2008.

39. Assessment Support Student and Mentor / Registrant (Associate Mentor) support should come from the whole nursing team plus: • The Academic in Practice / Directorate Liaison Teacher. • The Personal Tutor. • The Unit / Module Lead. • The Academic Tutor. • The Programme Leader. • The Practice Education Facilitator. Registrant Awareness Study Day, October 2008.

40. Guidelines for Dealing with Issues Relating to Clinical Placements Issue/problem identified within a clinical placement Joint discussion to take place between Student, Mentor and Placement Educational Lead (PEL) Further action required No Issue resolved Yes Lessons learnt & changes made as required, preventing future reoccurrence Personal Support Issue Student/Mentor to contact Personal Tutor (Programme Support Team if sickness/absence issue) Personal Tutor to liaise with Mentor & PEL to support Student/resolve issue Placement Issue Student or Mentor to liaise with Academic in Practice from relevant University and inform the Placement Education Facilitator. The Student must document the issue and forward to the AiP or Personal Tutor. Academic in Practice / Practice Education Facilitator to liaise with Mentor and PEL and support placement area to resolve issue Academic/Student Progression Issue Mentor to liaise with Personal Tutor from relevant University and inform the Placement Education Facilitator Personal Tutor /Practice Education Facilitator to liaise with Mentor and PEL to support placement and Student Disciplinary/Conduct Issue Mentor to liaise with PEL, Academic in Practice and Personal Tutor AiP/Personal Tutor to inform Practice Education Facilitator and refer the issue to the appropriate Programme Leader and Trust Senior Manager Programme Leader to liaise with the Head of School/Department & Trust Senior Manager for further action Registrant Awareness Study Day, October 2008.

41. Concerns Regarding Student Progression Mentor may wish to discuss progression issues with Practice Education Facilitator, prior to meeting with the student. Mentor discusses concerns with the student, clearly stating specific areas of concern and relating them to the learning outcomes. An action plan is negotiated between the mentor and student. A review date is agreed. Discussion and plan documented in student placement documentation. * In placement areas where there is no Practice Education Facilitator, mentors would contact the Academic Tutor directly. Mentor to inform Practice Education Facilitator and Academic Tutor about concerns and action plan. Review of action plan. Satisfactory progression. Partial or no improvement. Mentor to inform Practice Education Facilitator and Academic Tutor. Mentor to have clear discussion with student about progression, highlighting which learning outcomes may not be met by the end of the placement. Continue with or amend action plan. Student may wish to discuss the situation with their Academic Tutor. Mentor to inform Practice Education Facilitator and Academic Tutor. An individual action plan/learning contract will be required, tailored to the nature of the concerns and carried over to the next placement area. This will be developed by the Unit Team and the Academic Tutor, and Examinations Office informed. Registrant Awareness Study Day, October 2008.

42. Scenario 2 Part 2: At the mid-point interview the student indicates that he / she has settled in well to the placement area and is meeting his / her Learning Objectives. However, you have been approached by several members of the team voicing concerns regarding the student’s ability to perform essential nursing skills when delivering nursing care. Registrant Awareness Study Day, October 2008.

43. The Purpose of Assessment is to: • Recruit to academic programmes and / or careers. • Maintain professional standards. • Motivate students. • Provide feedback on performance / progress to students, mentors and HEI’s. • Prepare students for their professional career. 43 Registrant Awareness Study Day, October 2008.

44. What to Assess? These are measured against the NMC outcomes and proficiencies: • Knowledge and understanding. • Skills. • Attitudes and behaviour. • Direct patient care. • Indirect aspects of patient care. • Communication / interpersonal skills. • Competence. Registrant Awareness Study Day, October 2008.

45. Nursing Assessment Criteria NMC Outcomes / Proficiencies Professional / Ethical: • Code of Conduct. • Legislation. • Equality. Care Delivery: • Communication. • Health promotion. • Nursing process. • Evidence Based Practice. • Clinical judgement. • Care Management: • Maintaining safe environments. • Inter-professional working. • Management skills. • Key skills. • Personal & Professional Development: • Safe and effective practice. • Enhancing practice. • Nursing Process. • Evidence Based Practice. • Clinical Judgement. Registrant Awareness Study Day, October 2008.

46. Indicators of Achievement YEAR 1 YEAR 2 YEAR 3 POST-REG ADVANCED BEGINNER COMPETENT NOVICE EXPERT Adapted from Benner (1984) Registrant Awareness Study Day, October 2008.

47. Indicators of Achievement Novice / Safe Practitioner: • Performance is guided by rules and objectives. • Lacks a strategy for practice. • Whole situation is not understood. • No experience of the situation. • Inability to discuss reasons for practice. Registrant Awareness Study Day, October 2008.

48. Indicators of Achievement Advanced Beginner / Emerging Practitioner: • Has prior experience of the situation. • Can identify overall important aspects of a situation. • Unable to sort out priorities in a situation. • Compares, contrasts and discriminates aspects of the situation. • Beginning to develop a strategy for practice. Registrant Awareness Study Day, October 2008.

49. Indicators of Achievement Competent / Effective Practitioner: • Has a long-range view of practice. • Develops a strategy for practice. • Practice informed by analysis and problem solving. • Identifies own practice goals and formulates plans for achieving these. • Can manage many aspects within a situation. Registrant Awareness Study Day, October 2008.

50. Methods of Assessing Students in Practice • Observation. • Testimony. • Explanation. • Role play (tutorial sessions). • Written evidence. • Questioning. • Demonstrating application of prior knowledge / skills. Registrant Awareness Study Day, October 2008.