Practice Based Learning in Nursing, Health and Social Care: Mentorship, Facilitation and Supervision

Ian Scott, Jenny Spouse

• Publisher: Wiley-Blackwell
• Year: 2013
• Print ISBN: 9780470656068
• eBook ISBN: 9781118488195
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing Skills

Work-based learning facilitation, mentoring and coaching are all integral to the healthcare professions.

Practice Based Learning in Nursing, Health and Social Care promotes effective professional learning in the workplace and helps healthcare professionals to develop, enhance, reflect on and change their practice and perceptions of mentoring, facilitating, and supervision.

Aimed at the health and social care practitioner who is involved in facilitating learning, teaching and assessing learners in practice, this essential, comprehensive text explores several key themes, including:

• The nature of facilitating (coaching, supervision, mentoring) within professional contexts
• Learning in communities of practice
• Becoming an effective facilitator/mentor
• Understand and supporting work-based learning
• Managing the unusual, such as failing learners or those with special needs
• Giving and documenting feedback
• Managing workloads in busy environments
• Professional development issues

Special features:

• A clear, accessible guide for new and experienced practice educators/facilitators alike
• A comprehensive, applied text for practitioners of all levels of experience in facilitation and supervision
• Written by authors with extensive experience in the field
• Uniquely focuses on the professional development of the mentor/facilitator themselves
• Provides case studies throughout showing illustrating common issues and how to engage in formal theories of professional practice
• Multiprofessional focus - aimed at all health and social care practitioners

Chapter 1

Mentoring and supervision and other facilitative relationships

Ian Scott and Jenny Spouse

Introduction

In this chapter, we will be providing an overview to the text. We will discuss the origins of mentoring as a tool for personal development and its position within professional ­education from a macro- and micro-perspective. We will describe the increasingly ­important factors that are influencing the role, such as professional and national concerns, local and national policies. We will emphasise the critical importance of the person ­providing mentorship and who, in fulfilling their professional duty to protect the public, is both a gatekeeper to their profession and instrumental to the professional development of ­colleagues and visiting learners.

Throughout the chapter, we shall be exploring some of the vocabulary used across ­different professions to describe mentoring activities, and introducing and exploring some of the core concepts that are discussed in greater depth in later chapters.

This chapter includes the following:

• mentoring, coaching/supervision, the personal and professional implications of the role;
• what the different terminology means, for example, facilitator, mentor, supervisor, coach, sponsorship;
• introduction to the concepts of apprenticeship, communities of practice, sponsorship;
• the qualities of effective mentors to promote personal and professional development;
• the learner’s perspective;
• learning and teaching.

Exploring the role of the practitioner teacher

Since ancient times, vocations have been learnt through practice by the aspirational learner working alongside an established practitioner. This way of learning has stood the test of time; it has been developed and expanded, and exists in many forms; and it is known by many names, but at its heart is one individual facilitating the learning of another through an individualised relationship. In the health professions, several terms are used to identify such relations; it is common, for example, to find the terms mentor, supervisor and coach being used. In this book, will we commonly use the term ‘mentor’ or ‘­supervisor’ to describe the person supervising and facilitating learning. We shall use the term ‘learner’ to describe a pre-qualification student as well as a qualified member of staff who is also a learner.

The term ‘mentor’ refers to the person who is helping the other person in the ­relationship learn, although quite often, the mentor will also be learning. If you have been asked or volunteered to help someone to learn in this way, then the world has honoured you, for helping someone to learn is a great gift to give, brings pleasure, will no doubt lead to your own personal and professional growth, and is in recognition of your own professional value and expertise. At some time during your journey in this role, you will want to develop and hone your skills as a mentor. Many people in this role not only have the responsibility of helping someone learn but also may have to make the decisions that will determine whether or not their learner can enter their profession. Working in this way means you have become a gatekeeper of the professional standards for your area of ­practice. This book is intended to help you to become that kind of gatekeeper to your profession. Through this text, we will explore the different aspects and skills of being a work-place facilitator in a health care setting, and as we do so we will introduce different ways of developing these skills. In writing this book, and through our own experiences, we are keenly aware that the process of facilitating is felt both ways by both learners and facilitators, and thus throughout the text, we have introduced the ‘learner’s perspective’ often using real case studies from our experience and research.

Before we start getting down to the detail, it is worth spending some time exploring how the terms ‘mentor’, ‘supervisor’, ‘facilitator’ and ‘coach’ are used and in particular how they are used differently by different health professions. This is important because if we do not understand different professional terminology, discussions between ­professionals can become difficult. It will also help you to place your own workplace into the situations described in this book. Before we start this discussion, we want to ­emphasise that all of the terms used are equally correct. We just need to accept that the meaning placed on these terms varies a great deal across different professional groups.

Mentor

The first term we will look at is that of ‘mentor’. The term ‘mentor’ is very widely ­recognised across organisations in the English-speaking world. It emerged largely in ­connection with large business organisations, where a ‘mentor’, normally someone ­successful at their business, would help another individual develop and succeed; the ­mentor’s role was to offer advice and guidance to help the mentee form networks, and would also often act as a role model. The ‘learning’ aspect of the relationship was ­informal, as was often the formation of the relationship itself. Notice that the informal nature of this form of mentorship meant that the relationship developed between ­individuals that had ‘attraction for each other’. For this reason, mentoring, although regarded as a route to success, was also considered to be a potential source of ­discrimination and potentially one of the reasons why certain groups within society (for example, women) are under-represented in the higher levels of top business.

Nevertheless, the role of the mentor as a significant person in an individual’s development within a company or organisation was recognised, and this led to many organisations developing formal systems of mentoring. Probably the most common types of ­mentoring to be seen in organisations are those connected with the induction of individuals into the organisation. Here, a newly appointed member of staff is ‘given’ a mentor that will help the mentee ‘find their feet’ during the first few months of their new employment. Normally, after the induction period, the formal mentor/mentee relationship discontinues; it may, depending on the individuals, continue informally. In some organisations, there have been attempts to develop formal more prolonged periods of mentorship that attempt to mimic the initial form of mentorship that we described. In general, all the mentors described in the relationships above will have very little or no training for their role.

The last form of mentoring that occurs is that which has formal structures and rigid controls over who can mentor and how they are trained for the role. The mentoring role is closely tied to formal education programmes, and the mentor may well have a significant involvement in the summative assessment of their mentees. Many professions would call this form of relationship ‘supervision’ This form of mentorship can be seen in its most extreme form in relation to pre-registration education programmes for nurses midwives and social work within the within the United Kingdom, although in social work, the term ‘mentor’ is not used.

The term mentor itself, comes from ancient Greek mythology. Odysseus placed his son, Telemarchus, in the care of Mentor and Eumaeus; their relationship with Mentor was akin to that of teacher but also carer. An interesting twist in this tale is that Athena, a ­goddess of wisdom and war in Greek mythology, masqueraded as Mentor when she was trying to persuade him to follow her ideas and suggestions. You may want to consider which version of the mentor described above best fits with your experiences of being helped to develop your clinical practices.

Supervisor

The term ‘supervisor’ in the context of developmental relationships is harder to describe and find consensus for. The word supervision implies to oversee, and thus one thing we can say about these types of relationship is that they should be asymmetric; that is, the supervisor is normally in a more senior position to the supervisee. Such a term is used, for example, in universities in relation to learners being ‘supervised’ while they undertake projects. In many health care professions, however, the term ‘supervisor’ is used to describe a relationship whereby clinicians meet to discuss their practice with the purpose of improving it. Normally, however, one of the clinicians is more senior to the others. In nursing and midwifery practice, this form of supervision is often referred to as ‘clinical supervision’, but their activities are clearly much more focused on facilitating learning than on oversight. In some professions such as social work, the ‘supervisor’ is responsible for both providing opportunities for learning in practice settings and assessing whether the supervisee is fit to practise. Use of the term ‘supervisor’ in this way is synonymous with the term ‘mentor’ as used in the Nursing and Midwifery profession.

Interestingly, for the medical profession in the United Kingdom, ‘supervised practice’ is also the term used to describe the period of training and development that newly ­graduated medics undertake before becoming fully registered. Subjecting a qualified practitioner to supervision can also be applied by the General Medical Council as a ­sanction to a practitioner who has been found not to be fully competent.

Coach

The term ‘coach’ can be applied to a facilitative role or to describe a process and has become popular to describe a ‘personal coach’ who is used to assist their ‘client’ to make a lasting change in their behaviour. They do this by helping their client to establish their goals and the ways they will go about achieving these goals. A coach is intently focussed on helping their client ‘find’ their own way, rather than showing them the way. In general this kind of coach relationship with a client is less close than that of a ‘mentor’ and they are unlikely to be present and work alongside their client. In addition, unlike many ­mentor/supervisor relationships, the coach’s career success does not tend to be linked to the success of their clients.

The exception to this would be the ‘sports’ coach. Use of the term ‘coach’ to describe a facilitative relationship is not commonly used within health care settings, but it is a term growing in popularity in the ‘personal development’ industry and so is likely to permeate the health care professions.

Obviously the terms ‘mentor’, ‘coach’ and ‘supervisor’ are used in different ways in differing context and have overlapping features. Unless your profession or your work place has adopted one of these terms and provided a clear definition, it is important that you qualify what you perceive your role to be, both for yourself and for the person you are working with. In this textbook, we will focus the discussion largely on the roles that relate to the descriptions of mentor and supervisor that we have given above. We will use the term ‘coach’ as a verb to describe some of the facilitative techniques used in ‘coaching’.

Professional statutory regulatory organisations (PSROs)

Some PSROs regulate who can and cannot act as mentors/supervisors. For example, in the United Kingdom, the Nursing and Midwifery Council and the General Social Care Council have clear requirements of those wishing to act as a mentor or practice educator. These include successful completion of a prescribed training programme, the curriculum of which is largely dictated by the PSRO. Professional organisations normally require mentors/supervisors who are involved in the formal assessment of learners ­preparing for professional qualification (sometimes called neophyte – literally new growth) to be formally registered. The PSRO may also require further education and additional qualifications if a professional is taking on an extended role such as advanced prescribing. It is the case, however, in most countries that when ever a qualified professional is supervising another individual that could be deemed to be a ‘learner’, the qualified professional has the legal and ethical responsibility for the patients or clients in their care. Before taking on the role of a supervisor or mentor, it is a good idea to ensure that you are aware of the nature of this relationship and your own legal and professional responsibilities.

Apprenticeship and its relationship to mentorship and supervision

The term ‘apprentice’ seems to have emerged in the middle ages and is used in relation to the right of craftsmen to employ (at very low cost) boys that would provide labour in exchange for being trained into a particular craft or skill. Apprenticeships were highly prized, since, in the Middle Ages, becoming a craftsman or a professional was a route to a more secure future (just as it is today). Recognition as a craftsmen or ‘professional’ was through membership of a Guild. As the Guilds became successful and powerful, they sought to protect their reputation by imposing strict rules and regulations on their apprentices and guild members such as protecting the use of certain titles such as ‘Stone Mason’. The Guilds regulated the terms of apprenticeships and controlled access to a wide range of professions. It is considered by some that the ‘Guild’ system led to the formation of Universities in the 12th century. Guilds covered a wide range of important economic activities, for example baking, brewing, weaving and carpentry. The authority of the Guilds was given to them by the monarch or the government of their respective nations. You can probably see in these Guilds similarities with modern professional regulatory organisations.

Interestingly, the Guilds system was largely abandoned by the 20th century. This is because they were seen as being highly protective, stifled innovation and were restrictive of free trade (Ogilvie 2004). Nevertheless many Guilds still have presence in modern times and are very influential in supporting charitable activities and promoting education.

An apprentice is thus someone who is learning a craft or profession through the process of watching and working alongside someone who is already fully capable with respect to that activity. The mode of learning would be best described as ‘reproduction’ learning or modelling. The apprentice would seek to mimic the actions of the master and thus acquire their skills. Modern forms of apprenticeship often include some form of formal study. Apprenticeships are often typified by apprentices having to practise and rehearse certain task over and over again, often irrespective of their actual level of competence (Singleton 1989).

Working and learning as apprenticeship

The nursing literature conta...

Table of contents

• Cover
• Title page
• Copyright page
• About the authors
• Chapter 1: Mentoring and supervision and other facilitative relationships
• Chapter 2: Personal and professional aspects of supervising others
• Chapter 3: The workplace as a learning environment: structures and sources of support and supervision
• Chapter 4: Practice settings as a learning resource
• Chapter 5: Identifying your learner’s needs and documenting a working learning plan
• Chapter 6: Facilitating professional development
• Chapter 7: Reporting on progress: assessing performance and keeping evidence
• Chapter 8: Giving feedback and documenting progress
• Chapter 9: Inquiring into personal professional practice
• Chapter 10: Personal and professional development planning
• References
• Index