Mentorship in Healthcare

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• Publisher: M&K Publishing an imprint of M&K Update Ltd
• Year: 2012
• Print ISBN: 9781905539703
• eBook ISBN: 9781907830709
• Topic: Medicine
• Subtopic: Nursing

In healthcare settings, the term 'mentorship' is normally used to describe the supervision of a pre-registration student by a qualified practitioner. Mentorship can be very formal or relatively informal. It can also be practised differently in particular locations, settings and healthcare professions. This clear, concise book transcends professional and geographical boundaries in order to focus on the essential characteristics of effective mentorship. It will therefore be useful to a very wide range of healthcare professionals who are involved in mentoring and assessing junior colleagues. The book examines learning theories, teaching and communication skills and assessment methods. It also contains helpful advice on dealing with overseas students and students with special needs. Activities, reflection, quotes and tables enable readers to absorb the content and relate theory to practice.

1

Professional Development

Shelagh Keogh

The aims of this chapter are to familiarise the reader with:

• the case for engaging in professional development

• aspects of work-based learning

• the need for lifelong learning

• the sensitive or ethical issues which may arise.

Introduction

Since the early 1980s the term mentorship has been a word which is used with increasing frequency, and whilst there is a commonality in the usage of the term it does mean very different things to different professional groups. For example, it is used with socially excluded young people and refers to an older person who befriends them and assists with their integration in society, both in formal schemes and often in the more flexible sense of a young person assigned to an older person who will assist them in various aspects of their lives. As has been mentioned in the Introduction, within professional groups it can be used in a very specific manner, for instance, the role in nursing and midwifery education in the United Kingdom is one often more akin to a clinical supervisor who addresses a very specific and focused skill development. In other professional situations the term is perhaps used more loosely to describe a less prescribed and more informal relationship.

Whilst recognising the tensions in the use of the term mentorship, this chapter will focus on the notion of professionalism which underpins the concept of mentorship, and is common to all the health professions.

Activity 1

Reflect for a few moments on the concept of peer-to-peer mentorship. If you have engaged in this activity, what were the benefits for you and your peer? Consider also whether or not the process was easy or onerous. What made it so? If you have no experience of the process, can you consider what benefits it could bring to your practice?

Mentorship as a principle

Whether used in a formal or an informal sense, mentorship is one of the key tools in use to aid knowledge management, skills development, and team building across the workplace. The practice exists in many forms, some formal and some informal. A mentor can be defined as a person who listens and gives advice to us for our professional development. More commonly mentorship is conceptualised as a top-down process but it also exists in peer-to-peer mentoring in formal and informal settings.

Our first encounter with advice of this sort is with our parents or guardians (informal), who teach us how to do what is necessary or is acceptable, in accordance with their understanding and their experiences, to develop our competencies and improve our knowledge. Moving on from this we encounter teaching staff (formal) that teach both in accordance with their understanding of their experiences but also in accordance with best practice documented in literature. The difference between the two encounters is that the first expects nothing in return whereas the second expects something; this could be in the form of tested progress activities or at least some interaction with the teaching. That said, even those who do this as an altruistic activity expect some feedback that their words are not wasted.

In the healthcare world during training, a lot of mentorship is experienced with the expectation of receiving judgements of progress and development at points during its execution. Generally the principle behind all mentorship is about giving or getting support for progress and or development during your professional career, both the training and the lifelong learning.

Peer-to-peer mentorship is a means of obtaining support which is usually developed from a trust environment in order to offer mutual development between parties. Some occupations or roles within organisations are such that individuals in certain positions can feel isolated and having an opportunity to discuss issues and ideas with someone who understands the common practice can be very liberating, resulting in a solution or an understanding exploration process. From this strand of mentorship communities of practice have developed.

A community of practice is part of personal and group knowledge management. The initiative provides a platform for workers to share, learn and discuss their understandings. There are levels of successful community of practice; rarely does this informal and formal organisation sustain good practice without some kind of management support. Some studies have tried to objectively measure efficiency and rates of engagement (Yang and Wei, 2010). A prerequisite to sharing knowledge is the willingness to learn. This fundamental requirement is easier said than done, take for example ‘time management’. The majority of students have time management issues which cause great levels of stress, sometimes resulting in physical symptoms of illness, but do we learn from our mistakes? ‘Rarely’ would be the answer for most students and people generally.

Professional Development

As a principle, professional development is seen as a key feature of a truly professional person. Many professions such as nursing, law and teaching require the individual to demonstrate engagement with professional development as part of annual activity. Some of the professional bodies define mentorship as a feature within their requirements for continuous accreditation. As soon as one receives a requirement to do something, the shine of doing the activity may diminish slightly.

So why should we undertake professional development? One reason is that we spend a lot of time undertaking professional duties; therefore any contribution to the success of those activities will have direct impact on our lives, our job satisfaction and the lives of others. In order to achieve the best from ourselves, we will require a regime of reflection, by thinking things through, overcoming previous setbacks, capturing good practice and by benefiting from the experience of others. We are limited by the horizons of our experiences; as soon as we access others we can in principle double the knowledge captured. To access other people’s knowledge requires us to communicate our ideas and thoughts with them.

One could argue that by reading this book you are committed to professional development but, if we ask a book a question it will come up with the same answer each time. If we ask ourselves a question we may come up with an answer which meets our desires rather than our professional need. Ask a respected friend or colleague a question and they are more likely to give you a different response based on their knowledge of best practice, hence knowledge is expanded. One can conceptualise a mentor as a respected friend.

Work-based Learning

Health professionals are expected to learn in clinical practice settings and engage in professional development activities. Whilst on some programmes a mentor is prescribed whilst others may choose to interact with a mentor, the mentorship relationship is a way to move forward without having to reinvent how to map the progression pathway. If the engagement with mentorship is focused around work activities then the term currently popular for this approach is work-based learning. Work-based learning (WBL) focuses on learning in and from the workplace where work, rather than a set curriculum, provides the focus for the learning programme (Durrant et al., 2009).

Many organisations have incorporated WBL as part of their formal development opportunities. Some university courses bring together universities and work organisations to create new learning opportunities in workplaces (Boud and Solomon, 2001). Such programmes meet the needs of learners, contribute to the longer-term development of the organisation and are formally accredited as university courses. Work-based learning is seen as a means by which to support the personal and professional development of students who are already in work and the focus of the learning and development tends to be on the student’s workplace activities (Brennan and Little, 2010).

Activity 2

List the people who have helped you in your development. Identify whether this was formal or informal.

For each of the persons above list the outcomes (learning) that you personally gained as a result of the mentorship experience.

If you have listed nothing above against the mentorship experience then one has to ask, were you an active participant or a passive passenger in the process? A prerequisite for gain in any circumstances has to be that the participants are willing to change as a result of the engagement. Even if you are in disagreement with advice given you have changed in that you have added to your personal body of knowledge in relationship to that particular piece of advice.

Reflecting on practice can be a challenging activity. Our understanding of our experience can be limited by our difficulty in accepting our weaknesses. Accepting our strengths can also be difficult for some people; this can be influenced through our cultural development. Hence having someone who can stand outside of the experience and return critical advice can be very beneficial, even if sometimes that advice is hard to accept.

Stakeholder involvement

Mentorship is not a one-way street in that the student is not the only one who gains. There are many stakeholders involved in such a relationship, the most obvious being the mentor and the student. In talking to individuals who have mentored others you quite often hear, ‘I think I got more out of the relationship than the mentee’. Lots of knowledge development is in existence as a result of giving advice to others. In giving advice one has to reflect on one’s own experiences. The reflection in itself is one interaction with the experience then the giving of the advice is a second pass on that experience, therefore it is not surprising that mentors gain a lot from the process.

Informal arrangements

It could be that students you have previously worked with request mentorship, so for example in my own practice people tend to look for those whom they have admired for the way they achieve outcomes and the type of achievements accrued. It has been usual to have encountered such an individual in striving for personal development, hence the commonality between the two parties. The potential mentor is usually very happy to provide this kind of support. How this works in practice depends on the efforts of the mentees to facilitate the arrangements. This type of mentorship falls under the label of informal arrangements; it could also be encompassed in the term coaching. In seeking out these types of mentorship arrangements one is also building up a network of advice givers to support future decision making processes.

Formal arrangements

With more formal arrangements, as in the case of UK nursing and midwifery education, mentors are usually allocated by management or by some formal process. This process is driven by procedures and requirements of the parties concerned. For example in nursing, mentorship is a prerequisite to obtaining fundamental qualifications.

The formal arrangements differ from the informal in that the agendas of each participant will be slightly different. In the informal arrangement the agenda is to explore opportunities for reflection and development only, whereas in the formal agenda there are many more stakeholders to consider, such as the following:

• student mentor

• mentor’s manager

• clinical setting manager

• educational course tutor

• educational course management

• professional body

• Department of Education and Health (which pays for the training)

• the public who experience the results of the mentorship arrangements (more indirectly).

All the above would have an interest in the mentorship arrangements and would at some point want to know how the arrangements are impacting on practice and on the use of resources, be that time, people, places and money.

In order to be a formal mentor in an arrangement which covers professions which have compulsory membership of the professional body, an individual would have to satisfy the professional body that they have the competence to be in such a position. This is usually achieved by completion of an approved course as set out by the professional body.

Both the informal and formal arrangements have benefits as well as drawbacks. For example in the informal arrangements participants should consider conflicts of interest, limitations of participation in terms of time and areas of discussion, duration of interaction and many other issues. In the formal arrangements, whereby the mentor may have an assessment role, these informal issues become even more important. Bray and Nettleton (2007) concluded that there was confusion in describing formal arrangements under the umbrella of mentorship. The following example will clarify this point, and the principles apply both to the formal and the informal aspects of mentorship.

Imagine you are a student radiographer and you are about to go into a clinical practice workplace where you will be given a mentor who will assess your competencies during and at the end of your placement practice.

Student radiographer – the student would see the mentor in a power relationship and as part of the management structure. The student’s main objective would be to successfully pass the competency assessment and to achieve a good report.

Mentor/Mentor’s Managers/Clinical Setting Managers – All these participants would see the student as a responsibility to look after but also as an aspect of professional duty, to ensure they meet fundamental requirements set out by professional bodies, institutional management and educational demands. The main objective would be to ensure that the student had a meaningful experience and conducted themselves in a manner expected of a professional person without taking up too much time or creating problems for other people.

Educational course tutor – this person would be responsible to the professional body, educational institution, and medical institution but also responsible for the student. The main objective would be to ensure the student was working in a safe environment which meets the st...

Table of contents

• Cover Page
• Title Page
• Copyright
• Contents
• About the Authors
• Introduction
• Outline of the Book
• Chapter 1. Professional Development
• Chapter 2. Teaching and Learning
• Chapter 3. Promotion of an Effective Learning Environment
• Chapter 4. Skills for Mentorship
• Chapter 5. Assessment
• Chapter 6. Challenging Situations
• References
• Index