Mentorship in Healthcare 2/ed
By Mary Shaw
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About this ebook
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 encourage reflection, and quotations and tables enable readers to absorb the content and relate theory to practice.
In this second edition, the text has been made even clearer and the authors have added further detail on learning theories such as social constructivism. Most importantly, they have added an Afterword written in the light of reports on the Mid Staffordshire NHS Foundation Trust Public Inquiry. This final section places new emphasis on the mentor’s role in helping to ensure that patients receive safe and effective care, which is provided with compassion as well as practical skill.
Contents include:
Introduction
Professional development
Teaching and learning
Optimising learning in the clinical environment
Skills for mentorship
Assessment
Challenging situations
Assessing care and compassion
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Mentorship in Healthcare 2/ed - Mary Shaw
students.
1
Mentorship and 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 used with increasing frequency. 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 in relation to socially excluded young people to refer 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 an older person assigned to assist them with various aspects of their lives. As mentioned in the Introduction, within professional groups the term can be used in a very specific manner. For instance, the mentor’s role in nursing and midwifery education in the United Kingdom is often more akin to that of a clinical supervisor, who monitors 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 these tensions in the use of the term, this chapter will focus on the notion of professionalism that underpins the concept of mentorship. This is common to all the health professions.
Activity 1.1
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
Mentorship is one of the key tools used to aid knowledge management, skills development and team-building across the workplace. The practice exists in many forms, both formal and informal. It can be defined as a person who listens and gives advice on professional development. Mentorship is most commonly conceptualised as a top-down process but it also exists as 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 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) who teach in accordance with their understanding and experiences and also in accordance with best practice, as documented in literature. The difference between the two encounters is that parents and guardians expect nothing in return, whereas teachers and tutors expect something – perhaps in the form of tested progress activities or at least some interaction with the teaching. Even those who do this as an altruistic activity expect some feedback – to assure themselves that their words have not been wasted.
In professional healthcare training, a lot of mentorship involves an expectation of judgement against a scale of desired progress and/or having your skills development monitored at various points. Generally, all mentorship is based on giving or getting support for progress and/or development in your professional career, both during initial training and while undergoing lifelong learning.
Peer-to-peer mentorship is a means of obtaining support that is usually developed within a Trust in order to offer mutual support between individuals. People working in some occupations or roles within organisations can feel isolated. Having an opportunity to discuss issues and ideas with someone who understands the common practice can be very liberating, often resulting in a solution and/or a very useful exploration process. From this type of mentorship, supportive communities of practice have been established.
A community of practice is part of personal and group knowledge management. This initiative provides a platform for knowledge workers to share and discuss their understandings. There are levels of successful community of practice; rarely does this informal and formal arrangement sustain good practice without some kind of management support. Some studies have tried to objectively measure efficiency and rates of engagement (Yang & Wei 2010).
A prerequisite to sharing knowledge is the willingness to learn. This fundamental requirement is easier said than done. Take time management, for example. The majority of students have time management issues that cause them a great deal of stress, sometimes resulting in physical symptoms of illness. But do we learn from our mistakes in this area of our lives? ‘Rarely’ would be the answer for most students – and people generally.
Professional development
Professional development is seen as a key feature of a truly professional person. Many professions, such as nursing, law and teaching, require practitioners to demonstrate that they have engaged with professional development each and every year; and some professional bodies make specific reference to mentorship in their requirements for continuous accreditation. However, as soon as we are officially required to do something, the appeal of the activity tends to diminish slightly.
So why should we undertake professional development? One reason is that we spend a lot of time undertaking professional duties; therefore anything that contributes to the success of those activities will have a direct impact on our lives, our job satisfaction and the lives of others. In order to achieve the best from ourselves, we require a regime of reflection: thinking things through, overcoming previous setbacks, capturing good practice and benefiting from the experiences of others. We are limited by the horizons of our own experiences. As soon as we access other people’s experiences, we can in principle double the knowledge captured; and accessing other people’s knowledge requires us to communicate 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 that meets our desires rather than our professional needs. 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; and thus your knowledge is expanded. One can therefore conceptualise a mentor as a respected friend.
Work-based learning
Health professionals are expected to learn and engage in professional development activities in clinical practice settings. On some programmes a mentor is prescribed, whilst at other times individuals may choose to interact with a mentor. Either way, the mentorship relationship offers a means of moving forward without having to re-invent how to map the progression pathway. If the engagement with mentorship is focused around your work activities, the term currently used for this approach is ‘work-based learning’. Work-based learning (WBL) involves learning in and from the workplace, where work (rather than a set curriculum) is the focus of the learning programme (Durrant, Rhodes & Young 2009).
Many organisations have incorporated WBL into the formal professional development opportunities they offer. Some university courses bring together universities and work organisations to create new learning opportunities in workplaces (Boud & 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. WBL 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 & Little 2006).
Activity 1.2
•List the people who have helped you in your development.
•In each case 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 the question arises: 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 disagree with the advice given, you will have changed, in that you will have added to your personal body of knowledge, in relation to that particular piece of advice.
Reflecting on practice can be quite a challenging process. Our understanding of our own experiences may be limited by the difficulty we may find in accepting our weaknesses. Accepting our strengths can also be difficult, and this may be influenced by cultural and social development. (For instance, modesty and humility are highly valued characteristics in some cultures, and may make it difficult for people to accept praise.) Having a mentor who can ‘stand outside the experience’ and offer objective critical feedback and advice can therefore be very beneficial, even if that advice is sometimes hard to accept.
Stakeholder involvement
Mentorship is not a one-way street, in that the student is not the only one who gains from it. There are many stakeholders involved in such a relationship, the most obvious being the mentor and the student (or mentee). When talking to individuals who have mentored others, you quite often hear, ‘I think I got more out of the relationship than the mentee’. You frequently develop your own knowledge as a result of giving advice to others. In giving advice, you have to reflect on your own experiences. The reflection is in itself one interaction with the experience; and the giving of advice based on that experience is a second interaction with it. Therefore it is not surprising that mentors gain a lot from the