1. Annual Mentor Update for Nurses and ODPs 2013

2. Clinical Learning Environment
What makes an effective learning Environment?
Ask the group members to discuss - 10 mins – then feedback 2 2

3. Clinical Learning Environment
The Mentor for Nurses or ODPs
The Student
The Ward/department
The University
Preparation for student:
mentor allocation
induction pack
orientation
duty rota
learning opportunities
appropriate support/meetings

4. What are the professional
requirements to remain on the ‘live’ mentor register as stated by the NMC (SLAIP 2008) or CODP(2009)?
Have successfully completed an NMC approved mentor preparation programme.
Have participated in an annual (12 months) Mentor Update.
Have an understanding of ‘due regard’
Participate in a Triennial Review process to ensure NMC standards are met/biannual review (CODP)
Support and summatively assess two students within the three year cycle
When the group respond ask them to further explain what a triennial review is and alert them to the triennial review document on the mentor portal for both Universities. (Triennial review is on next slide as well)
Ask the group do they know if they are on the live register for their organisation

5. NMC Mentor Standards (SLAIP 2008)
Have successfully completed an NMC approved mentor preparation programme
Have participated in an annual (12 months) Mentor Update
Have an understanding of ‘due regard’
Participate in a Triennial Review process to ensure NMC standards are met
Support and summatively assess two students within the three year cycle 5 5

6. CODP Mentor Standards ( 2009)
To be maintained on the local register the individual must have evidence of having:
1. Mentored at least two students within the two year period.
2. Participated in ODP specific update every two years.
3. Undertaken work based / informal learning relevant to their role as a mentor.
4. Undertaken professional activity
5. Develop knowledge and understanding of their role through formal education activity.
6. Undertaken the appropriate mentorship qualifications
College for operating department practitioners 6 6

7. Triennial Review (nurses)
Three yearly cycle of reflection of mentor practice against NMC standards
The process is a self assessment of your skills as a mentor
As a quality process a discussion will be held with your line manager or appropriate other
Will need to provide evidence of professional development
A checklist is available to support this process.
The Mentor Register is then updated
Triennial review document is in the handouts from the mentor update box. Triennial review is cyclical. Not all individuals will be at the same point in the process. For example if an individual completed the mentorship course in September 2009,they would then be due for TR in 2012.
Documentation used for verification that criteria has been met can be accessed on the mentor portal. Organisations across Essex and Cambs use this tool. However other documents are acceptable. The tool enables the mentor to provide evidence that they have attended an annual update and mentored 2 students in the three year period and have met the 8 domains of mentorship detailed in the standards, either through reflection and or documentation such as witness testimony, annonymised student documentation. Some mentors will have a portfolio for this purpose. TR has been built in to staff PDP/appraisal process in most areas. It is important that TR is completed in a timely fashion to avoid mentors dropping off the register.

8. Biannual review (ODPs)
Two yearly cycle of reflection of mentor practice against CODP standards
The process is a self assessment of your skills as a mentor
As a quality process a discussion will be held with your line manager or appropriate other
Will need to provide evidence of professional development
A checklist is available to support this process.
The Mentor Register is then updated

9. Due regard A mentor for nurses
has the specialist skills required to support the placement learning outcomes.
is from the same part of the register and field of practice as the student in the final year of the programme
has completed a mentor qualification
can mentor ODPs
A mentor for ODPs
has completed a mentor qualification
can only mentor ODPs not nurses
Ask if anyone knows what this means. For the first 2 years of the programme students can be assessed by other health care professionals as well as other fields e.g. mental health insights

10. Associate mentor Nurses No mentor qualification Cannot sign paperwork
ODP’s
Minimum 6 months experience
Attend mentor update
Complete biannual review
Performs formative assessment

11. Mentor Nurses Holds a mentor qualification: at level 2 or 3
Performs summative assessments
ODPs
Holds mentor qualification:
at level 3 (6) or
at level 2 (5) and completed level 3 (6) study
Performs summative assessments

12. Practice Educator Nurses Not required ODP’s Minimum 3 yrs experience
Holds a degree or working towards a degree
Has overall responsibility for students in placement

13. Sign Off mentors for nursing students (not required for ODP students)
Sign Off mentors are required for:
All student nurses in their final placement
Overseas Nursing programmes
Return to Practice students
A Sign Off mentor is a nurse who has met the additional criteria
Sign Off Mentors make judgements as to whether a student has achieved the required standards for entry on to the NMC register.
Sign off mentors need to be supervised by an existing sign off mentor. Trusts were required to identify a critical mass of sign off mentors by September 2009.These were automatically annotated on to the register and are therefore to be involved in the development of subsequent sign off mentors. Sign off mentors have 12 weeks in which to make a judgement. They are required to keep an audit trial of the decision they have made for QA purposes. The sign off mentor will have access to the students past summative assessments and any other resource which they reasonably consider necessary to inform their professional judgement 13 13

14. Prospective Sign Off Mentor
To become a Sign Off mentor you will need:
To be supervised by a qualified Sign Off Mentor on
3 occasions assessing a student
two via simulation
one with an actual student
annotated on to the Mentor register following review of evidence of above
(NMC 2008, NMC Circular 05/2010)
Discuss the importance of ensuring there are enough sign off mentors to support management students and the importance of forward planning regarding this

15. Sign Off Mentors for nursing students
Sign Off Mentors make the final decision
as to whether a student has achieved the required standards for entry on to the NMC register
Sign Off mentors are required for:
All student nurses in their final placement
Overseas Nursing programmes
Return to Practice students
A Sign Off mentor is a nurse who has met the additional criteria
A trainee sign off mentors need to be supervised by an existing sign off mentor. To become a Sign Off mentor you will need:
To be supervised by a qualified Sign Off Mentor on
3 occasions assessing a student
two via simulation
one with an actual student
annotated on to the Mentor register following review of evidence of above
(NMC 2008, NMC Circular 05/2010)
Trusts were required to identify a critical mass of sign off mentors by September 2009.These were automatically annotated on to the register and are therefore to be involved in the development of subsequent sign off mentors.
Sign off mentors have 12 weeks in which to make a judgement about a student. They are required to keep an audit trial of the decision they have made for QA purposes. The sign off mentor will have access to the students past summative assessments and any other resource which they reasonably consider necessary to inform their professional judgement.

16. RESPONSIBILITIES OF THE STUDENT16

17. Student responsibilities
To arrive on duty on time, smartly dressed.
To follow the stated sickness/absence procedure.
To take responsibility for his/her own learning by coming prepared to meetings with the mentor
Ensure that deadlines are met
To act professionally at all times
Work with their mentor
Work the shift patterns such as nights and weekends
Fixed annual leave 17 17

18. YOUR RESPONSIBILITIES WHEN WORKING WITH STUDENTS18

19. Francis report
Report commissioned by the Secretary of State for Health carried out by Robert Francis QC
Published 6th Feb 2013
209 recommendations:
Focus on developing the right culture in the NHS through leadership, training, information and transparency
What is the Francis report?
The Francis Inquiry report is the report of the full public inquiry into the failings at the Mid Staffordshire Foundation Trust. The Inquiry, led by Robert Francis QC, looks at the role of the Commissioning, Regulatory and Supervisory bodies and why serious problems were not identified and acted on sooner
What does the Francis report say?
The report delivers 290 recommendations to Government. The key message within the report is the need to develop the right culture of care within the NHS, through better leadership, training, information and transparency
What are these recommendations?
Some of these include:
A criminal offence for any doctor, nurse or health professional to mislead regulators
An obligation of candour to patients and relatives by health professionals
All health care professionals to be trained in compassion
A new register for health care support workers which would be able to ‘strike off’ poorly performing staff
The creation of a new set of ‘fundamental standards’ for care in the NHS which can be easily understood by patients, staff and the public
How does the Francis report affect you as a MENTOR?
It is important mentors discuss the findings of this report and its recommendations with their students. Many of these recommendations will be implemented over the coming months and years.
As mentors, preparing newly qualified health care professionals within the NHS, patient centred care, which focuses on compassion, dignity and respect must be at the heart of discussions with your students within practice.
Please talk to your students about this report and how you can draw on the findings within this report to develop your students to become the competent, compassionate, caring health care professionals of the future, highlighted within the Francis report. 19

20. NHS constitution
Working together to ensure students are supervised and assessed by mentors who support care that embraces the underpinning principles and values of the NHS Constitution and the 6 C’s in Nursing:
Care
Compassion
Competence
Communication
Courage
Commitment
Care – the public feel that we need to be able to measure the quality of nursing, midwifery and care giving to ensure that it is delivered on a consistent basis, first time, every time in the right setting and the right way.
Compassion – the public speak about the importance of recruiting nurses/midwives and care givers with compassionate values; measuring and assessing compassion; and the processes used to promote compassionate care, for example the use of annual appraisal and feedback
Competence – a high level of competence is required to deliver appropriate care, recognise a deteriorating situation, challenge poor practice or decision making of others
Communication – good communication involves better listening and shared decision making ‘no decision about me without me’ and making every contact count
Courage – many people felt nurses, midwives care givers might be afraid to speak up – it takes courage to stand up to poor care and to innovate, suggest and implement new ways of working
Commitment – commitment to take action together as a profession to unlock its potential
These 6C’s will be evident throughout the students’ practice assessment documentation.

21. It is important to ensure that all students:
Are supernumerary
Are on the duty rota for Health and safety reasons
Actively engage in hands on delivery of care as appropriate
Have a named mentor who is available for a minimum of 40% of the time
Participate in the 24 hour cycle of care
Discuss whether there have been any problems with this!
Also discuss role in supervising non-nursing students.

22. You may be supervising:
ARU nursing students on the September 07 nursing programme.
ARU nursing students on the all graduate programme which commenced in September’11.
ARU ODP students on 2 year diploma programme. 22

23. NURSES
This is an example of a September block plan. Talk to the group about the 50% theory 50% practice component. For the new curriculum students are assessed in the community and in acute therefore each year is broken up into 2 parts. The final year is a critical care type placement which is non assessed and the management module – students can choose whether community or acute in year 3
As you see from the block plan students come in to Uni from practice at various points for reflection etc

24. ODP student journey Trimester 1 Trimester 2 Trimester 3 Year 1
Anaesthetics
Surgery
Post-anaesthetic care
Trimester 4
Trimester 5
Trimester 6
Year 2
(critical Care/ED)

25. Supporting students What obstacles do you envisage?
What support is available?
Discuss in two groups, then feedback. 25 25

26. Assessing students Induction/Initial Meeting
Learning Contracts/Action plans
Interpersonal skills profile / core professional values
Service user views – why?
Cause for Concern
Fine Grading
Formative assessment
Summative assessment
This is an opportunity to go through the practice documentation with the mentors ,clarifying any queries and reinforcing the importance of timely initial meetings and assessments.
These documents can be found in the mentor update box, which needs to be collected prior to the session.
All the content on the slide should be discussed.
Ask a trigger question e.g. Do you know who is responsible for signing the summative assessment.
Important to remember that ARU currently has 2 curricula running
ARU has an interpersonal skills profile in the practice skills document
Need to consider what support is necessary for students with specific learning needs (see document on ARU mentor portal)

27. Grading in practice
When deciding the grade/score for the individual student assessment consider carefully;
How you are going to evidence/explain the reason for your decision 27 27

28. Supporting the failing student
Essential to have robust and transparent processes in place
Investigate why your student may be having difficulties
Clear action planning
Comprehensive documentation as evidence
Use of support networks
Pick up problems early!!!
Talk about why it may be difficult to fail students. 28 28

29. Learning Contracts /Action Planning
Use of Specific, Measurable, Achievable, Realistic, Timely, (SMART) objectives
Clear review dates
Use of support networks
It is essential that the mentor follows due process regarding this documentation to ensure that the student has been afforded the opportunity to address the identified area of concern.
PEFs are a good resource.
Students without clear action plans or formative feedback may well appeal through the HEI appeal system stating that they were not supported in practice and then may well be given a further attempt 29 29

30. Support in practice Remember
you are not expected to deal with student issues or concerns on your own
there is a network of support for mentors available from your own Organisation, the HEI and the Commissioning body
Here discuss the importance of partnership working and the need to use the support network to either discuss their decisions or to talk through difficult issues
For example – mentor colleagues, the education champion, the link tutors, the local practice education facilitator, the local education Trust lead

31. RESPONSIBILITIES OF THE HIGHER EDUCATION INSTITUTE31

32. To liaise closely with, and support, mentors and placement providers
To provide theoretical and practical teaching (skills lab) which will inform students in practice
To liaise closely with, and support, mentors and placement providers
With placement providers, monitor, develop and evaluate the quality of the learning environment eg audits
To respond to driving forces such as statutory bodies , placement providers and the public
Discuss points they have raised 32 32

33. RESPONSIBILITIES OF THE PLACEMENT PROVIDER33

34. Local agreement to undertake triennial review
Works with the HEI to maintain an up-to-date register of current mentors, sign off mentors and practice teachers.
Local agreement to undertake triennial review
Supports mentors to access annual updates
Ensures mentor works 40% of time with their student
Ensure one hour protected time allocated for individuals acting as sign off mentors
Supports the triennial review process
Individuals acting as sign off mentors need to spend the equivalent of one hour a week with the student and this needs to be documented. Annual updating is mandatory 34 34

35. Monitoring the quality of the learning environment: Educational Audit
NMC require evidence of 2 yearly audits of the learning environment
The audit needs to provide evidence of:
Orientation/induction for students
Professional development of staff
Scope of the learning environment
Student evaluations and responses to these
Action plans in response to issues/concerns
Review of capacity 35

36. The good news: NMC visited ARU in November 2012 Nursing Times award
Student focus groups feedback
NMC – good collaborative working
Nursing Times award – shortlisted for collaborative working award.
Student focus groups (1st and 2nd year) –
Good points - felt well supported by mentors, good learning opportunities, “brilliant staff” “fantastic teaching” good induction to the hospital
Poor points – students not working with their mentors, “my mentor did not know I was coming”, “I felt like a burden”, “my book was an aferthought”

37. Thank you….
for attending today and for your continued support of students in practice.

38. On line information www.anglia.ac.uk/mentors
To support this presentation please access the link below for the information and guidance included in this presentation

39. Scenario For Discussion
1st year Student nurse Louise Martin approaches you and is very tearful. She says that her mentor is off sick and her second mentor is on annual leave. Her practice document is due to be handed in to the University in  three weeks time and she does not want to fail.
What should you do? 39

40. Find out who Louise’s mentor and co-mentor are and verify when they went off on holiday/sick leave and when they are likely to be back
Look at Louise’s practice document and establish how much has been completed/how much still needs to be completed 
Establish when the document is due be handed in and if the formative assessment is due
Depending on your seniority, take your findings to the ward manager/student link nurse to resolve the situation
Inform the Education Champion/Link Lecturer/PEF of the situation

41. Scenario For Discussion
As Julie’s mentor you have approached a patient anonymously to obtain feedback on the patient experience of being cared for by your student
The patient replies that she would ‘never want to be nursed by her again’

42. Sit down with the patient and ask her why she feels like this?
Will You
Decide to ask another patient for her views in the hope that they will be more positive?
Sit down with the patient and ask her why she feels like this?
Go straight to Julie and ask her why she thinks ‘a’ patient might have said this?
Ask Julie to reflect on the patient views and all the formative feedback given so far?
Fail Julie in this placement because of the effect she has had upon the patient?
It would not be productive to actively seek out a positive response as all patients under the student care should feel positive about the care given
It is important for the mentor to sit with the patient and clarify what the problem was and assure the patient this would be addressed with the student anonymously as it is important for the student progression and development
It would not be appropriate to ask the student to answer to this – it would be more productive to ask her to reflect on this along with all the formative feedback given by the mentor
It is important to consider all performance and progression before reaching a summative decision 42

43. Scenario For Discussion
You are mentoring a student nurse who is at the end of the second year of her course. It is the time for her formative assessment and you are very concerned about her attitude and her ability. When you try to discuss this with her, the student becomes very defensive saying that she has never received such negative comments before. This makes you feel very uncomfortable and you do not feel that you can proceed with writing the action plan. 43

44. E mail your PEF to discuss the problem
DO YOU:
E mail your PEF to discuss the problem
Seek support from your colleagues
Seek support from the HEI/link team
Decide to give the student the benefit of the doubt and write a more positive formative report.
Fill in a ‘cause for concern’ form.
Discuss the fact that E mails about a student’s performance should not be sent to any member of the support team without the student’s knowledge.
It is important that all discussions take place with the student and face to face or telephone if possible. Sending personal information over the web to PEF’s, link team etc is not respectful of the student data
It may well be that a statement has to be made and sent but numerous s complaining about the same student should not be happening
Filling out an ARU cause for concern form will mean that the education champion/link team can be asked to collect the form and read the issues on the form and will also mean the Director of Study will investigate and contact the link area 44 44