Facilitating learning in practice
Facilitating learning in practice

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Facilitating learning in practice

1 Establishing effective mentoring relationships

Recent research involving students, mentees and mentors has explored and identified various elements that contribute to or undermine successful mentoring relationships (Teatheredge, 2010; Straus et al., 2013; Eller et al., 2014). The findings highlight factors that 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, it suggests that you should be able to identify many of the components of successful mentoring relationships by drawing on your own life experiences, which may include being a student, mentee or mentor.

Activity 1 Recognising factors that contribute to effective mentoring relationships

Allow 15 minutes

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

Download this video clip.
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Transcript

Narrator:
Student nurse, Paul Lawrence had been in training for the past two years. Today, hes working for the elective surgery ward in the Alexandra Hospital in Redditch. He supervised by experienced nursing sister Jane Gascoigne who as is mentor is supporting his learning.
Jane Gascoigne:
Speaking to patient: How's your day Mr, Dry? I'm a sister nurse mentor, and I'm just observing Paul today, taking some blood pressures of patients on the ward.
Mr Dry:
OK.
Paul Lawrence:
Hello, Mr Dry. How are you?
Mr Dry:
I'm good, thank you.
Paul Lawrence:
My name is Paul I'm one of the student nurses. I need to check your blood pressure, if that's OK? Let me just clean this blood pressure cuff, for you.
Jane Gascoigne:
It's quite important, from an infection control point of view, that Paul is cleaning the cuff in between each patient. He's already gelled his hands and he's gained consent, as well, from Mr. Dry.
Paul Lawrence:
Have you had any nausea, Mr Dry?
Mr Dry:
No.
Paul Lawrence:
No? That's lovely.
Paul Lawrence:
So, it's gonna get a little bit tight around the arm, OK?
Mr Dry:
Yes, OK.
Jane Gascoigne:
During this time, Paul is assessing the patient, as well. checking he hasn't got any nausea or pain, and that he is comfortable. Paul is assessing the patient; having a rapport with him, watching his face; any sort of grimace that he might have, experiencing any pain or nausea. It's a crucial time that a nurse has with a patient.
Jane Gascoigne:
So, now Paul has taken Mr Dry's observation chart and he needs to know record this, accurately, making sure he's got the time and the date in the right place. It's important that he is aware that he can take a manual pulse, as well, so he is, hopefully, feeling the strength of the pulse, to make sure it is a regular pulse.
Paul Lawrence:
That's a good, strong, regular pulse.
Mr Dry
Good
Jane Gascoigne:
Paul has reassured his patient that everything is fine. Sometimes, if there isn't feedback, they might be a little bit concerned.
Paul Lawrence:
I'm happy with that, thank you, I'll pass everything on to sister.
Jane Gascoigne:
That was good. How do you feel about it?
Paul Lawrence:
I should have really taken the gentleman's arm out of his sleeve, rather than rolling it up.
Jane Gascoigne:
It would have been easier, but at least you realised. You did your observations, very well. You've checked the patents details are correct, you put the date in, you've timed it, correctly. You've observed that all your parameters are within normal range, for him. You spoke to him while you were taking a manual pulse, as well.
Paul Lawrence:
The pulse was quite strong, and regular.
Jane Gascoigne:
So you're aware of that, that's good. You also looked back at the previous observations so you had an idea of what their climbing at. You signed it at the bottom, as well, so that's very good.
Narrator:
For Jane, being able to inspire students is something she finds very rewarding.
Jane Gascoigne:
I absolutely love it. and I've been quite like, for a long time, so I want a student to appreciate that love, as well. It sounds a bit corny, but I want them to enjoy the job as much as I do.
Narrator:
Mentoring boosts students' reflective learning and encourages best practice.
Paul Lawrence, speaking to a patient:
I can get you some Paracetamol, now, but I'll go check with sister to make sure that's correct, for you.
Narrator:
There's also a mandatory requirement for all pre-registration nursing students.
Jane Gascoigne:
So did you establish, Paul, on what kind of pain level he had?
Paul Lawrence:
No, I didn't, sister.
Jane Gascoigne:
So, you might want to think about what level his pain is, and obviously, what scale it is. Have you checked his wound?
Jane Gascoigne:
No, I haven't, sister.
Jane Gascoigne:
He needs to observe the patients wound because there are lots of complications he needs to be aware of. He also needs to access patient pain threshold.
Paul Lawrence, speaking with the patient:
It doesn’t look inflamed and it's a clean dressing. On a scale of 1 to 3, how painful would you say it is?
Patient:
I'd say it's a 2.
Jane Gascoigne:
I’m glad you went back and talked to him about his level of pain because you just need to be aware of the fact that when a patient says they're in pain you need to establish what threshold of pain he has, does it require morphine.
Paul Lawrence:
That's why I thought I would speak to you first and make sure.
Jane Gascoigne:
Great, that's good. He says that it's not extreme pain, so that's good. Obviously, if the Paracetamol doesn't work, we could perhaps decide later whether he needs an alternative.
Paul Lawrence:
Yes, OK, no problem.
Narrator:
As an experienced mentor, Jane's up to speed with the latest NMC standards to support learning and assessment in practice; something Paul Lawrence is thankful for.
Jane Gascoigne:
No problems there, at all. Good interaction.
Paul Lawrence:
Thank you, sister.
End transcript
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Eller et al. (2014) conducted an extensive research study with students and their mentors from various academic disciplines, including natural sciences, nursing/health sciences, engineering, and technology. Using a defined technique for achieving consensus through twelve focused group discussions, the behaviours considered helpful for effective mentoring relationships were organised into eight themes, termed key components (see Figure 1).

Described image
Figure 1 The key components of effective mentoring relationships (adapted from Eller et al., 2014, p. 817)

Activity 2 Linking your observations to the key components of effective mentoring relationships

Allow 30 minutes

Refer to the eight key components identified by Eller et al. (2014) in Figure 1 and decide whether the factors that you identified from the video clip can be associated with these components. Copy out Table 1 (or download a copy [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] ) and add your observations.

Table 1 Linking your observations to the key components of effective mentoring relationships

Key components of an effective mentoring relationship Observed factors from the video clip
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

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

Discussion

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

Table 2 Possible observations to the key components of effective mentoring relationships

Key components of an effective mentoring relationship Observed factors from the video clip
Open communication and accessibility Jane, the mentor, is available throughout the time the student, Paul, is carrying out the observations. Jane encourages open communication by asking how Paul felt the intervention had gone. There is good eye contact between Jane and Paul during the post-observation discussion, and she uses positive prompts such as nodding and smiling.
Goals and challenges Jane sets Paul a new set of goals when she explores with him whether he has sufficient information to make a decision about appropriate pain relief for the patient. She indicates the need to establish the patient’s reported level of pain and to check his wound.
Passion and inspiration Jane highlights her considerable experience as a registered nurse and her real desire, even though it might sound ‘corny’, to inspire her students so that they enjoy nursing as much as she does.
Caring personal relationship Paul is unsure about the best way of managing the second patient’s pain. He has no hesitation in seeking his mentor’s advice, suggesting that he values the relationship and feels supported by it.
Mutual respect and trust Paul appears to be comfortable when discussing aspects of care that he has initially missed. This indicates that he believes Jane will not respond in a punitive way. Instead, she will enable and encourage him to find solutions to his patient’s pain problem. Jane gives Paul pointers as to his next actions, but she trusts him to know how to assess the patient’s pain level and to check his wound. She trusts and respects that he will carry out the interventions correctly.
Exchange of knowledge Jane discusses the process of recording observations with Paul, which enables him to highlight what he knows – for example, the importance of a strong, regular pulse, and that removing the patient’s arm from his sleeve rather than rolling up the sleeve might have been a better alternative.
Independence and collaboration Jane allows Paul to carry out taking the blood pressure without interruption, encouraging independence. They work closely together to determine the best approach for managing the second patient’s pain.
Role modelling Jane explains to the first patient that she is there to observe the student, thus role modelling the importance of offering explanations to patients. Paul mirrors this approach by explaining to the patient the outcome of taking his pulse manually. Jane consistently presents herself in a professional manner, both in appearance and behaviour. She demonstrates a calm, assured approach that reassures the students she supports.
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