Debate: Mentors

The assessment of students undertaking a pre-registration degrees is made through placements in health care settings where the student is assigned a mentor. The role of the mentor is to support the student as mentor and assessor and they determine whether the student has achieved the right level of skills and competencies required.

A recent and rather shocking study led by Dr Louise Hunt from De Montford University, found that some students behave in a manipulative manner after receiving negative feedback in a practical assessment, in an attempt to avoid failing the placement. The study identified four patterns of behaviour that were used to influence the mentor. They were:

• ingratiating and emotionally exploitative activities to carry favour, such as bringing in cakes, hugging and crying
• diversionary tactics by citing factors not related to actual performance, such as personal circumstances or illness
• challenging the mentor by, for example questioning the competence of the mentor or accusing the mentor of bullying and harassment
• engaging in open hostility to the mentor including verbal and physical threats, and, in some cases, actual aggressive acts.

Responses to the study apparently suggests that tutors and practice educators have witnessed such behaviour, as have students of their peers but there is a reluctance to acknowledge it.

NHS Education for Scotland, in partnership with universities and service providers, established The National Approach to Mentor Preparation and the practice education facilitator and care home education facilitator roles. These support those mentoring pre-registration students and enhance the practice learning environment using the Quality Standards for Practice Placements.

Although this infrastructure is embedded across Scotland, the quality of mentorship and student experience continues to vary. This raises questions as to whether mentor and assessor is a role for all registered nurses and midwives. As a result, work is underway to introduce methods to select and recruit mentors with the appropriate skills and aptitude for the role and ensure their role is valued.

In Northern Ireland a quality assurance framework, is used to evaluate commissioned nursing education activity each year. The framework was updated in 2016 and contains seven criteria, against which activities are evaluated. The framework was designed with a particular focus on the contribution of commissioned education and development activities to the enhancement of patient and client care through improving the knowledge and skill base of participants.

The NHS Wales Workforce, Education and Development Service recently conducted interviews with Welsh Nursing HEIs (including mentors). It reported the All Wales approach is continuing to be successful and mentors feel well supported.

Mentoring is often absorbed into a mentor’s already full shift and they are responsible for supporting a student whilst facilitating their learning, while managing their own workload and ensuring patient safety. It needs to be acknowledged that time must be set aside for the support of students and that mentors should be given a reduction in their clinical workload.