Mastering Mentorship: A Practical Guide for Mentors of Nursing, Health and Social Care Students

The old adage of George Bernard Shaw suggesting those who can, do, and those who can't, teach, is undoubtedly challenged by the role of the mentor in professional practice. Mentors in health and social care practice must not only ‘do the do’ but must also be able to teach that ‘do’. Mentors along with colleagues in practice and the wider learning organisation require passion and enthusiasm for mentorship. They also need to value and have a belief in the merits of mentorship and an understanding of the evidence to underpin this fundamental role. We hope to demonstrate these qualities throughout this book. In it we will explore the complexity of the role of mentor, preceptor and supervisor, as well as celebrate the mastery required to perform this role well. At its heart is the desire to demonstrate that mentors utilise Master's level thinking skills in the advanced practice activity of mentoring in professional education. As health and social care professions negotiate their way through the second decade of this century they will continue to look for innovative and effective ways to teach the art of their professional practice.

The move to a degree-only preparation for nursing, the inclusion of social work within the Health and Care Profession's Council and increasing political and economic uncertainty have all contributed to a growing scrutiny of pre-qualifying professional programmes. The continuing professional development of qualified health and social care practitioners is also under examination. The ‘appalling suffering of many patients’ detailed in the Francis Report (2013: 3) highlights in stark terms the multitude of failings within the healthcare system. The role of mentors in supporting health and social care students to develop the professional curiosity and courage to always put their patients first is now more crucial than ever.

This book will define, contextualise and present theoretical explanations of mentorship and we hope its chapters will demonstrate both the art and craft of mentorship, supervision and preceptorship. We believe their content will resonate across health and social care professions and will also have value for health and social care practice education colleagues internationally. A unique feature of the book is the inclusion throughout of contributions by Master's level health and social care student mentors, who showcase the complexity of [Page xv]the integration of the theory and practice of effective mentoring. The chapters are divided using the Nursing and Midwifery Council (2008) domains described in the Standards to Support Learning and Assessment in Practice (NMC, 2008). These domains are establishing effective working relationships, the facilitation of learning, assessment and accountability, evaluation, creating an environment for learning, the context of practice, evidence-based practice and leadership. Although nursing led, these reflect the various skills, knowledge and values that are required to mentor regardless of the health and social care professional role and are widely acknowledged within professional practice education literature. These domains are implicit within the Health and Care Professions Council Standards for Education and Training (HCPC, 2012). In addition, The College of Social Work are in the process of phasing in new practice educator standards for social work (TCSW, 2012). Those standards detail four domains: to organise opportunities for the demonstration of assessed competence in practice; to enable learning and professional development in practice; to manage the assessment of learners in practice; and effective continuing performance as a practice educator. Throughout the book both the HCPC (2012) standards and TCSW (2012) standards will be directly referred to.

Each chapter is supported by a number of case studies which reflect the practical application of the key theoretical features discussed within that chapter. The case studies have been written by health and social care professionals who are currently actively involved in mentorship in its broadest terms. All of the case study contributors have successfully completed a Master's mentorship module delivered by the authors. Indeed it was the quality of this academic work that led the authors to consider writing this book. The case studies showcase key mentorship issues within contemporary health and social care practice and how our mentors, often through innovative approaches, demonstrated their mastery in mentorship.

Chapter 1 explores the current landscape of mentorship and links this to the qualities and knowledge mentors require to do this role well. The authors will demonstrate that the qualities associated with Master's level study and practice are essential to achieving excellence in mentoring. The complexities of mentorship in practice demand higher level thinking skills and particularly require mentors to deal with uncertainty and difficult decisions. The case study within this chapter provides a personal reflection regarding the experience and expertise that are necessary to mentor and links these to the academic level of study.

Chapter 2 discusses the nature of relationships within mentoring and the importance of an effective relationship between the mentor and mentee. The skill of facilitating effective learning in practice and assessing such learning [Page xvi]appropriately ultimately relies on the strength of that relationship. In the chapter three case studies are used to show the complexities of the mentoring relationship. The first of these reviews the use of a coaching model within a social work mentorship relationship and describes the ways in which the case study author has successfully implemented this approach with postgraduate social work students. The second case study takes the reader to the operating theatre and explores the effect of assessment on the mentorship relationship. The case study author here explores the skills required to unpick the delicate balance between mentor and assessor within the context of an effective relationship. The third case study author is a nurse in an accident and emergency department and demonstrates the important characteristics required within the mentor/mentee relationship.

A key feature of the mentoring role is the effective and creative facilitation and structuring of the learning experience. Chapter 3 explores the ways in which learning can be facilitated across a range of health and social care settings. It offers practical examples of the integration of learning theories to ensure the effective facilitation of learning. There are four case studies presented within this chapter. Two of the case study authors look at reflection as a means of facilitating learning: the first case study explores the difficulties associated with moving from the role of expert to novice within professional practice (examining the strategies used within a Children's Centre to assist staff in this transition and to build confidence and expertise within a new set of skills); the second looks at the application of key learning theories to the facilitation of learning in practice (using a district nursing setting). The third case study describes an innovative Practice Guide role (created within a pre-registration mental health nursing programme). A key feature of the Practice Guide role is to undertake structured, facilitated clinical supervision sessions with student mental health nurses in order to facilitate the linking of mental health nursing theory and practice. A final case study examines the merits and challenges of using reflection to facilitate learning in a community-based drug and alcohol team.

Chapter 4 goes on to highlight innovative ways in which practice can be assessed across health and social care and the role and accountability of the mentor within the assessment process. The three case studies within this chapter take a wide-ranging view of assessment. The first case study highlights the merits of reflection within the assessment process: it is set within a health visiting team and explores the ways in which reflection can be used to aid assessment. The second case study author describes some of the issues involved in assessing the ongoing competence of registered professionals. The final case study considers the use of service user feedback to inform the personal and [Page xvii]professional development plans of staff: the author looks at the challenges of doing this in a district nursing practice setting.

Chapter 5 details the importance of the evaluation of the learning experience and the various methods used to evaluate learning in practice. Evaluation is embedded in the quality processes of both practice and academic institutions, and in the case study for this chapter the author will address some of the inconsistencies for nurse mentors in evaluating their own mentorship practice.

The impact of the learning environment on the mentee's learning is explored in Chapter 6, in particular the need for mentors to organise the environment to ensure it is conducive to learning. The concept of the learning organisation is also reviewed within this chapter. The three case studies presented reflect a range of themes connected to the learning environment. The first of these takes the theme of reflection and considers whether reflective practice can enhance the learning environment within a health visiting team. The next two case studies explore the importance of the practice learning environment in pre-registration nursing: the first is within a school nursing team and the second is situated within a multi-professional community mental health team. Both look at the appropriateness of the learning environment for the student nurses allocated to their respective teams.

Chapter 7 reviews the various practice contexts in which learning takes place and examines especially the ways in which learning happens in practice and the potential barriers to this learning. The first case study highlights some of the tensions and challenges faced by the mentor when supporting a reluctant learner. The second considers the skills involved in health promotion and relates these skills to those of a mentor, with the similarities between the two roles also being discussed. The third case study explores the impact of inter-professional working and learning within a multi-professional community drug and alcohol team and the ways in which a social work student can engage fully in this learning environment. Finally, the challenge of transforming ‘ordinary’ practice situations into a meaningful learning opportunity is considered. The author in this fourth case study describes how the daily morning meeting in a Children's Centre has incorporated a reflective approach to encourage critical reflection within the team.

Chapter 8 examines the role of evidence-based health and social care and the implications of this for practice mentors. It also explores the notion of values-based practice and the ways in which both evidence- and values-based practice are essential for the development of health and social care students. The case study in this chapter considers the barriers to learning in relation to continuing professional development and the ability to engage in evidence-based practice.

[Page xviii]Chapter 9 explores the nature of leadership within health and social care practice and professional education. It examines the skills required by mentors to lead both practice and practice education. The first case study within this chapter describes the challenges inherent in being the leader of a team, a manager and a mentor. The second case study considers the most appropriate leadership style for mentorship.

The final chapter draws together key learning from the previous chapters and discusses the future of mentorship within health and social care professions. The case study is written by the two authors of this book and describes their successful efforts to deliver mentor preparation modules at academic levels six and seven only. The rationale for this is explored and the implications for the future delivery of mentor preparation programmes are examined.

The reader is encouraged to use the Chapter Link boxes found throughout the chapters to review their current understanding of each topic. These Chapter Links act as signposts by indicating the key chapters which discuss a topic further. Each chapter ends with a series of questions to help the reader in applying the contents of that chapter to their own practice setting. The reader is encouraged to use this checklist to consolidate their learning and also to begin to apply it to their own practice as a mentor.