The Operating Department Practitioner Nursing Essay

Recently I have started to support student nurses and ODPs in their practice placements and this has made me look at my own practice to ensure I provide a good learning experience and evidence based practice. This in turn has prompted me to commence the Mentorship Preparation course in order to facilitate learning for future students.

The aim of this assignment is to provide evidence and analysis of my developing skills as a mentor by exploring the role dimensions of the mentor within the Standards, recommendations and guidance for mentors and practice placements (College of Operating Department Practitioners (CODP) 2009)) and Standards of Proficiency (Healthcare Professions Council (HCPC) 2008)).

The concept of mentoring and mentors (Neary, 2000) are not new, however, Hagerty (1986) informs us of the confusion over a precise definition caused by the lack of agreement concerning the role and function of mentors. Literally the term mentor means a wise and trusted friend (Barlow, 1991), Lane (2004) agrees as he reflects on the relationship that develops between master and apprentice. These literal terms prove too broad and complex to be used in the traditional professions that mentors are associated with such as business, finance and healthcare (Clutterbuck, 2004). The Department of Health (DOH) and the English National Board (ENB), 2001)) refer to the term mentor as someone who holds the correct professional qualifications to enable them to facilitate learning and to supervise and assess students in the clinical environment. It is therefore essential I am fully aware and understand what the current expectations are of me as a mentor as outlined in CODP Standards, recommendations and guidance for mentors and practice placements (2009) and HCPC Standards of Proficiency (2008) and that I am prepared to offer support and contribute to the students ongoing development. Ali and Panther (2008) inform us that good mentors are role models who students aspire to be through imitation so it is critical I ensure best practice for them to shape their future practice and that of future healthcare. Through my experience as a student I can now reflect as a qualified practitioner and realise I have evolved and shaped myself and my practice on my own mentors throughout my placements. This practice must also apply when integrating a student into the clinical team, shaping the relationship between mentor and mentee in the early stages of the placement and giving a sense of value to the student (West, 2007). Wilkes (2006) agrees enforcing that the student-mentor relationship is crucial to the student’s learning. The Clinical Learning Environment (CLE) is where students work directly with their mentor, other staff, patients and members of the public in order to gain experience towards qualification. The CLE is a truly multi-disciplinary environment where teamwork and collaboration are key actors to delivering patient care (Freeth, 2007). Boyd and Horne (2008) inform us that a team with common agreed goals who respect each others’ roles and functions and share knowledge and skills can influence the patient care to be provided. There is a vast amount of evidence that a failure of teamwork and collaboration can lead to devastating consequences for patients and their families (Quinney, 2006). It is therefore critical that the mentor integrates the student into the team as quick as possible to prepare for inter-professional working and to learn about the roles of other professionals. Inter-professional working will change negative attitudes and perceptions, encourage communication between professions, increase job satisfaction and ease stress to create a more flexible workforce with the shared belief of providing and improving patient care (Barr et al, 2005). As previously mentioned the mentor is the person who facilitates learning (Nursing and Midwifery Council (NMC, 2008)) and is responsible to ensure that the CLE is conducive to learning for students (Walsh, 2010). The student also has a responsibility to make sure that the placement experience is successful by engaging fully with the learning opportunities provided by the mentor. These learning opportunities will integrate theory with practice preparing the student to thoroughly learn about practice enabling them to work safely in real life clinical situations (Benner et al, 2009). It is essential that the mentor readily identifies all possible learning opportunities in the CLE whether they are everyday practice, rare or unusual events and spoke placements involving external departments affording the student maximum exposure. The multi-disciplinary team will offer the student a vast wealth of experience, knowledge and skills to interrogate, similarly, patients will be from a diverse cultural background with a plethora of medical conditions. This form of social learning will help the student observe what is being done, retain what is deemed useful, reproduce the skill and receive reinforcement or praise from their mentor to finally adopt the practice (Bandura, 1977). Each learning opportunity should be evaluated to gauge its benefit to the student and assess its worth for future use (McBrian, 2006). Veeramah (2012) voices concern regarding the quality of support offered by mentors in the CLE due to time constraints, staff shortages and illness and the number of students in the workplace leading to their clinical education suffering. The NMC (2008) stipulate a minimum of forty percent contact time between mentor and student highlighting the need for protected time for mentors alongside quality support and training for both (Gleeson, 2008). The Royal College of Nursing (RCN), 2007)) have produced a toolkit to provide guidance for mentors in practice in the facilitation of students in light of existing barriers. Evidence Based Practice (EBP) forms an integral part of the modern students’ education and development and as such the NMC (2008) state that mentors have a responsibility to support students when applying EBP. With more emphasis on applying EBP (Mohide, 2007) many mentors who received their nursing qualifications several years ago may lack the knowledge to recognise and understand best evidence and research to apply to practice, thereby invalidating that area of practice for their students. As registered practitioners mentors are required to keep their skills and knowledge up to date and therefore must be able to understand any research they are applying to practice thus improving teaching, learning and becoming good role models (HPC, 2008; NMC, 2008). As a mentor I must be able to make an informed decision on the quality of research before including it into any teaching. I must also be able to offer guidance and support to students in their task to filter through the vast amounts of research to identify which evidence base to apply to practice. According to Flemming (2007) qualitative and quantitative studies are held in high esteem in the hierarchy of best evidence and they provide a high proportion of all evidence published.

Mentors must be able to recognise and appreciate the current curriculum (NMC, 2010) for pre-registration nursing students in order for them to develop their skills in facilitating learning. As the emphasis moves from the traditional didactic approach, promoting passive learning, to self directed learning, students will be encouraged and empowered to becoming active learners (Howkins, 2008). The current NMC (2010) curriculum is based on four domains, all of which increase in depth and complexity over the three year program. Students are continually assessed on their achievements of all learning outcomes and standards of proficiency in all domains, the latter for registration to ensure fitness for practice, for purpose, for award and for professional standing (NMC, 2010). All healthcare governing bodies set standards and requirements for their student programs of education throughout the United Kingdom. As a mentor I must be prepared appropriately to facilitate the diversity of students in order for them to achieve their goals (Warren, 2010) and they must maintain their supernumerary status to focus on learning. Warren (2010) continues and makes it apparent that this preparation should be done on a bespoke basis as students will have their own individual learning style and needs depending on personality and stage of learning. Learning is more likely to be achieved if learning needs and outcomes are recognised by mentor and student at the earliest stage providing the student with a valid purpose and providing the mentor with an invaluable assessment on their own learning needs (Grant, 2002). Students should maintain a record of ongoing achievement (NMC, 2008) which should be readily available for mentors at the beginning of new placements to assess strengths and areas for improvement. I have found in practice it is useful to complete a SMART (Specific, Measurable, Achievable, Realistic, Timely), (Doran, 1981) learning objective for each student to maximise their time in placement. This SMART document should be constantly reviewed by mentor and student offering them both the opportunity to reflect on practice (Johns, 2000). A peer review through critical analysis will identify any learning needs for the mentor (Grant, 2002). Honey (2006) informs us of four learning styles, activists who tend to enjoy the experience and are open minded and try anything, reflectors are cautious and consider the situation, theorists will think things through in a logical manner and pragmatists will tend to be impatient problem solvers. Honey (2006) continues to emphasise the importance of determining a preferred style to support and encourage a student orientated approach to mentoring. The VARK questionnaire is a helpful analysis tool to help determine how individuals learn best and allows mentors to work with a students’ dominant style while allowing the option to encourage learning outside their comfort zone (VARK, 2012). Walsh (2010) advocates that there are three basic models of learning, the behaviourist which includes role modeling, the humanist where students learn by participation and is student centered and the cognitive approach which utilizes experiential learning, with no one being correct but dependant on the student, the subject to be learned and the setting in which it is taught. As an ODP the majority of my work is with elective patients so I know where, when and what I will be doing for several weeks in advance. This offers an ideal setting in which to create lesson plans to facilitate my students learning and afford time to make any changes to working patterns, service requirement permitting. At my first meeting with my mentee’s I always take my work rota and elective lists to help in producing quality time and lesson plans to address the underpinning knowledge and skills and to meet my students learning outcomes, however it must be remembered that not all learning opportunities are planned but they can be questioned and reflected on later. The student can be guided to refer to policies and documents and how they are applied to clinical practice and introduce further relevant evidence based material to promote knowledge and skill development. During orientation emphasis should be made to other resources for practice education, at my trust we have an excellent library, e-learning suites and internet café and students have their own notice board. Learning can also take place through observation, research and through socialisation or tacit learning (Channel, 2002) consolidating the need for mentors to be good role models. According to Steineker and Bell (1979) the mentor must determine what level of behaviour and skills are required for their student to become more proficient in the practical environment. Whether they should be observing practice, assisting their mentor or colleague, performing under supervision, consistently sustaining a skilled performance or maintaining their competence and enabling others, bearing in mind any delegation I make to an un-qualified student remains my responsibility as I am accountable to my professional body (HCPC, 2008).

Throughout my student years and since being a qualified ODP I have continuously reflected on my own practice and experiences enabling me to critically analyse my own beliefs and practice. The NMC (2010) expects nurses to be autonomous critical thinkers maintaining an open mind. Ghaye and Lillyman (2006) suggest this continuous process of questioning why we do things inevitably shapes future clinical practice. Reflective models offer a structured approach to thinking and writing about practice following a logical sequence to avoid premature assumptions and conclusions resulting in a developmental approach to professional practice (Johns, 2000). Students must be encouraged to try each model and decide which one is right for them. Students can be encouraged to reflect by maintaining a learning journal serving as a point of focus for the student to look back on, in turn becoming an integral part of their graduate portfolio of development and commitment to life-long learning (Moon, 1999). Moon (1999) also advocates introducing a series of reflective writing exercises which will allow the student to identify areas for improvement in their practice by questioning their decision making. This will underpin theory and practice and introduce critical thinking in turn encouraging autonomy whilst providing written proof of development. The mentor should be approachable in all aspects of teaching and should be willing to demonstrate the worth of reflection by discussing their own personal experiences and how they affected their practice and development (Johns, 2000).

Assessment is a continuous process (Gopee, 2008) and as such for the student starts from the initial meeting with their mentor. It is used to measure against the learning outcomes to provide evidence to determine if the student has reached an acceptable standard of competency (Hand, 2006). Gopee (2008) affirms that assessments are in place to protect the public and maintain the standard of the profession. Continually assessing a student allows the mentor to closely monitor their progress highlighting any learning needs and providing valuable feedback to the student (Walsh, 2010). Quinn and Hughes (2007) also report that assessment can be used to evaluate and promote quality learning and mentoring. Informal assessments are made on a ad-hoc basis developing the mentor student relationship while formal assessments are planned and organized and can form part of a summative assessment which takes place at the end of a placement. Formative assessments focus on the students’ development and are planned well in advance to enable the student to be prepared and lessen anxiety (Price, 2007). Walsh (2010) asserts for an assessment to be valid it must be relevant to the subject and situation so the mentor must select the most appropriate method which may include getting the student to think aloud by describing what they are doing and why or reflecting on a situation. Prior knowledge of the students’ learning outcomes, competencies to be achieved and previous clinical experience are critical to assessments being deemed fair. These details along with dates and times for mid-point and final assessments should all be agreed and documented at the initial meeting circumstances permitting. As a mentor I have high expectations of my students so using Benners’ (1984) model of Novice to Expert assists in guiding my assessment process in practice to reach a fair and un-bias result. There should be no surprises for the student at the final assessment as feedback, action plans and any concerns documented at the mid-point assessment should have been reviewed and given the student ample time to develop the knowledge and skills required. Brookhart (2008) recommends that feedback must be given as soon as possible after an event to promote student learning and offer support. Students should be encouraged to self-assess to turn negative points into learning objectives, must understand what is expected of them and agree on an action plan if required (Brookhart, 2008) Mentors must inform the students’ Personal Link Tutor and Practice Education Facilitator (PEF) at mid-point if the student is failing. Support for both mentor and student is critical to enable a positive outcome towards final assessment (Gurling, 2011). The mentor must document all student achievements against learning outcomes and identify any issues that may arise at the final summative interview. Once again mentors must inform the students’ Personal Link Tutor and PEF if the student has failed. As a mentor I have a responsibility and must be prepared to fail a student if they are not capable of safe and effective practice (HCPC, 2008). I also have a responsibility to be able to identify a failing student and to manage it appropriately. Duffy (2007) reports of several indicators that may alert mentors to a possible failing student including inconsistent clinical performance and not responding appropriately to feedback. Others may include unsafe practice with no regard for professional behavior, bad time keeping and poor attendance. As a mentor and ODP I must use leadership skills to supervise, delegate and manage others and have the ability to provide constructive feedback to students in order for them to understand their failings and to support them in improving their development (HCPC, 2008; NMC, 2008).

Since qualifying as an ODP I have completed my pre-ceptorship programme, consolidated my practice and supported student nurses’ and ODPs’ as an associate mentor. Upon qualifying as a mentor I must ensure I am regularly updated through my Higher Education Institute on current assessment procedures and documentation and complete any mentorship updates and continue with my own Continuous Professional Development (HCPC, 2011).

In conclusion through completing the Mentorship Preparation Module it has become evident to me that the role of the mentor is complex and critical in the development of students aspiring towards qualification. It is a role I will be privileged to take on with more focus and knowledge in helping students’ link theory to practice in the clinical learning environment. I am committed to my own CPD as an ODP, assessor and teacher in the perioperative area and eager to pass on my knowledge and skills to future students. Research into learning styles, theories and assessment has identified lack of knowledge in my own practice and given me confidence to plan and prepare meetings, lesson plans and timely assessments. Deeper understanding of the NMC, CODP standards and that of the mentor student process has prepared me to develop my knowledge and skills within the mentor role. I will endeavor to make sure that all future students I mentor and assess will be competent safe practitioners who are fit for practice (CODP, 2009; HCPC, 2008; NMC, 2008).