Facilitating learning in practice
Facilitating learning in practice

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Facilitating learning in practice

2 Open communication

The way in which you communicate with your students or mentees is fundamental to your mentoring relationship. You may already have well-honed communication skills developed through life experiences including your work role or roles – but if you haven’t thought recently about the factors that make for good communication, now is the time to review 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 all serve to support the meaning and clarity of our communication, it is often our non-verbal skills that will enhance or detract from this clarity.

Watch this short video from YouTube, created by About.com, to remind yourself about the various aspects of non-verbal communication.

Interactive feature not available in single page view (see it in standard view).

In case you need a prompt for future reference, the eight points are:

  1. facial expression
  2. hand gestures
  3. paralinguistics
  4. body language
  5. proxemics
  6. eye gaze
  7. haptics
  8. appearance.

Being aware of and deliberately using your non-verbal communication skills can make your relationship with your students much more rewarding for them and less stressful for you. In the video in Activity 1, Jane’s facial expressions and gaze are welcoming and indicate enthusiasm; she also uses gestures of positive reinforcement such as nodding and the pitch and rhythm of her voice to create a sense of calmness, suggesting there is ample time for discussion.

One of the mentors who participated in Wilson’s research study into the experiences of mentors 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 communication on their students’ emotions and deliberately employ strategies that encourage interaction. Consequently, their students feel comfortable to approach them for feedback or advice; this in turn reassures the mentors that their students are practising safely and appropriately, and that the patients/service users are therefore well cared for.

Activity 3 Delivering feedback

Allow 40 minutes

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 of feedback.

Drawing on your own experiences of giving or receiving feedback, and from reading these extracts from a paper by Clynes and Raftery (2008) [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] , answer the questions below and then read the suggested answers.

What is the purpose of giving feedback?

Answer

The aim is to offer the student insights into their performance. You can reinforce practices that are done safely and accurately, and behaviours that are productive. You can also highlight skills that need further development and conduct that is not yet sufficiently professional.

How might you give informal feedback?

Answer

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

What is formative feedback?

Answer

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

What is summative feedback?

Answer

This feedback usually takes place at defined points in a student’s practice learning journey. You will be providing a summary of all that has been achieved whilst the student 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 been achieved at the required level.

When is the best time to give feedback?

Answer

If your feedback is required to correct the student’s performance of a skill, it is best to do this as close to completion of the skill as is feasible. This will allow the student the opportunity 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 not supportive of the student’s development and could potentially put patients at risk. It is preferable not to correct a student in front of a patient, as this can be demoralising and undermine the student’s self-esteem. However, there can be occasions when the student’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 with a quieter interjection such as ‘Just before you do X, talk me through the possible options here’.

What factors can interfere with giving feedback?

Answer

As a nurse, your priority is always to your patients. In busy everyday practice it can be extremely difficult to find appropriate and sufficient time to provide meaningful feedback to the student. Finding time to give feedback can also be affected by periods when either the mentor or the student are on leave and so not available to either give or receive feedback.

When you consider the key components that contribute to effective mentoring relationships, it is clear that the mentor and the student may become close. As the mentor, this can make it difficult for you to give critical feedback, as you may feel that this will affect your ongoing relationship with the student.

How would you prepare to give formal feedback?

Answer

Allow sufficient time for delivering the feedback. Typically, more time is needed for summative feedback, as there are more elements to discuss. If you have to provide corrective formal feedback, arranging to do this at the end of the working day may raise anxiety in the student, who is then likely to be distracted throughout the day and therefore perform less well. Do think through how you will balance the negative aspects of the student’s performance with the elements that are done well. The student needs to leave the feedback session feeling that they have skills in place that can be built on, whilst recognising that there are particular actions that have to be taken forward immediately in order to become a safe, effective practitioner.

What elements contribute to high-quality feedback?

Answer

Asking the student to analyse their own performance of a particular intervention with a specific patient can prove to be fruitful to you and the student. The student may demonstrate to you an awareness of those elements of the skill that were delivered accurately and highlight areas where there was a lack of certainty or dexterity. This will allow you to concur with and reinforce the student’s perceptions, or suggest other factors 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 student insight into why you felt it didn’t go well and therefore what to focus on to make improvements.

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

Answer

Allow yourself sufficient time. Ensure the feedback can be given in privacy with no interruptions. You need to ensure that colleagues know that you cannot be interrupted for the next X minutes. Think through what you would like to say to the student, and also how the student might respond. Being prepared for particular types of response such 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 process first:

  • Aim to ensure that you have taken into account the place and timing of your feedback.
  • Make preparations that will help to ensure that the receipt of feedback is a positive experience, even if the feedback itself is negative.
  • Structure the feedback so that it is meaningful and can therefore support personal and professional growth, development and achievement.

Mentorship programme

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

  • Assessment and accountability.

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

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

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

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

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