Mentoring students in professional practice

When is mentoring not mentoring?

2011-11-18T04:38:00.001-08:00

My literature review of mentoring in nurse education has had a major reorganisation, from a structure based the on the headings 'Nurse education', 'Workplace learning' and 'Mentoring' to one based on the Lane and Clutterbuck model of mentoring competence structured by the headings 'Doing' (which includes 'relationship management' and 'knowledge transfer') and 'Being' (which includes 'personal characteristics' and 'experience'). I was quite excited by the new way of arranging the literature review under these conceptual headings. I thought it might facilitate greater synthesis of ideas and allow me to maintain a focus on the relevance of the chapter contents to mentoring.

However, this strategy seems to have backfired. I admit it was a struggle sometimes to make things fit under the headings, as so many research findings overlapped these categories. Nevertheless, I was able to create a narrative, or so I thought, to show that actually we know quite a lot about what mentors do, but understand much less about how they experience the role. However, my PhD supervisors complained that the narrative was missing and that perhaps I was trying too hard to speculate what this could all mean. Our discussion of the chapter concluded that perhaps it would be better to abandon the 'Being' and 'Doing' structure. But what to replace it with?

After spending many hours tossing ideas around, going back to basics (What is the purpose of a literature review? What are they supposed to contain?), and feeling totally deflated, I'm starting to think of a new story to tell. It concerns the fact that the role of 'mentor' in placement learning in the specific context of nurse education is very different to any other mentoring role, even in nursing, that involves providing collegial support. This role is much closer the the role of clinical educator in physiotherapy or fieldwork educator in occupational therapy or the mentors in teacher education than anything else.The term 'mentor' has been applied for want of a better one, but it somehow distracts from and conceals the reality of the role.

This takes me back to two pivotal past experiences. First, when I was working as a clinical placement facilitator, I and the network of colleagues I worked with invested a great deal of energy in finding an alternative term to 'mentor' that we could use as a generic term applied to all the clinical professions. We recognised that this was not mentoring in the sense that most people understood. However, we were unsuccessful in coming up with any replacement word that would be acceptable across the professions.The second experience was a brief conversation with David Clutterbuck following a lecture he had delivered on mentoring. I told him what I was planning to investigate for my PhD and he told me 'that's not mentoring'.

Maybe this is the key to unravelling my puzzle.

Mentors do it with a conscience

2011-08-12T05:38:00.000-07:00

The nurses in my research who mentored students in their workplace knew only too well what was at stake. They had a responsibility to their patients, colleagues, the health service and their profession to do a good job and make correct judgements about students. As they worked closely with students and befriended them to an extent (in order to help them to settle in and feel comfortable to ask questions, for instance), it could feel like a betrayal of trust tell them they weren't achieving. They did not hesitate to prevent a student from progressing in their training if they judged that to be the correct decision, but nevertheless their conscience could flood them with guilt feelings. The guilt could be associated with self-doubt - could I have done more to help them learn? It was also associated with anticipating the personal impact on the student, who had invested so much in their studies and in pursuing their nursing career. However, the guilt associated with making a decision that could potentially harm patients or the profession in the future was more persuasive.

However much the mentors could rationalise their judgements and decisions, they could not escape the 'call of conscience'. Philosopher Martin Heidegger proposed that humans are never fully at-home with themselves and constantly engage in anxious self-confrontation. To an extent, we can flee from this by inauthentically identifying ourselves collectively with a group, in which case we might tot up in a more detached way our 'good' and 'bad' actions. In being authentic, true to ourselves, we accept responsibility for our actions and there is always going to be some guilt, because we can never satisfy all needs. In taking one course of action, we cut off the possibilities for another. There is always something we didn't do.

Is this at all significant when coming to an understanding of the mentor experience? It is any more than an illustration of their humanity and a small window into the complexity of this and all human endeavours? I noticed that their conscience and their guilt would be formalised, at times when they softened the blow to a student by their careful construction of feedback, or in meticulous gathering of evidence to substantiate their decisions. It would be significant in less formal ways, such as in the way the mentors built allegiances with colleagues and used them as barometers for their mentoring judgements, or where they were 'looking over their shoulders' for anticipated student appeals against their decisions or fearing malicious gossip.

Maybe all I've done is to illustrate an aspect of human nature, but perhaps when we depend so heavily on mentors in the education of our student nurses, we need to be reminded that they are human and not simply commodities that feature in a numbers game.

Placement learning insights

2011-07-31T05:41:00.000-07:00

We have a good idea of how people can learn new skills and there's no shortage of information available about it. Established ways of learning include observation, asking questions to enable understanding, watching and then doing, receiving feedback from others as well as from the experience of actually doing it. And then, you need to practice until it becomes second nature so that you're no longer thinking about what you're doing and all the steps involved, but focused more on what you're using the skill for. A common example often used is that of learning to drive a car. You may start by learning what the different controls are, then how to coordinate your movements between the pedals and the gearstick, for instance, and before you know it, you're using the car to get from A to B rather than thinking what your hands and feet are doing. The rules of the road need to be learnt and adhered to, obviously, as part of being a competent driver, similar to a nurse using her knowledge to decide when to apply a skill and when to adapt her practice to a changing situation.

Nevertheless, it always has a magical feel for me, considering the transformation from a novice to a competent practitioner and onwards to expert. Patricia Benner, of course, did much to further our understanding of the transition from novice to expert, at least what the different levels look like in practice and how to help people make the transition. In her application of the Dreyfus and Dreyfus skill acquisition model, she stated that being a novice is contextual - an experienced nurse could be a novice in a novel situation (e.g. encountering premature babies for the first time) just as much as a student nurse would be a novice going into a practice area for the first time. However, in that case, there must be a difference between purely contemplating skill level and the 'being' of being a qualified nurse, because when a nurse reaches qualification stage they are not in the same place as a new student, even if they lack skills in certain specialised situations.

Student nurses are in a process of becoming a qualified nurse and need mentor support to get there. My research has been investigating the 'being' of mentoring, so not so much concerned with mentoring skills, but what it means to be a mentor for student nurses. Understanding this better can improve the way mentors are prepared, developed and supported. What is becoming clear is that there is no easy way of knowing when learning is happening, or to judge when a student is really competent.

According to Benner, the competent nurse is one who has typically been on the job in similar situations for two to three years. Given that student nurses might spend 8 weeks on a placement and continously move from one speciality to the other during their course, we must be using a different measure of competence for placement students.However, by the end of their three year course, they must be able to demonstrate that they can practise independently. Practising independently must be open to wide interpretation, because we know that nurses are part of a wider network of professionals and a nursing hierarchy, and it is recommended that they have a period of pereceptorship after qualifying. They are always part of a wider system.

The wider system, and what this means to any practising professional, is fascinating. Becoming a nurse means becoming familiar with the world of patients, treatments and care, the required attitudes and qualities expected in a nurse, the networks of professionals, nursing equipment and environments, and so on. All these things carry meaning to a nurse as part of a 'referential whole' to use one of Martin Heidgger's terms. Everything carries meaning to a nurse in a way that someone who isn't a nurse wouldn't see. A mentor's job is partly to enable a student to enter this world and see it with different eyes, as a nurse.

The mentor's journey

2011-07-25T01:00:00.000-07:00

The metaphor of journey is commonly applied to student learning. It is easy to conceive of a student on a journey from one preliminary state of being to another, more educated state. They arrive at their destination knowing more, seeing the world from a new viewpoint and with more nuanced understanding of the world. The journey changes them. A mentor's destination might not be as clearly articulated as that of a student, or even considered at all, but they are undisputedly on a journey of transformation - they cannot fail to be affected by their relationship with a student. Perhaps, though, the extent to which they are transformed depends upon opportunities to reflect. This might occur in the company of a critical friend, through flashes of insight during practice, or in conversation with their students.

Daloz (1999), drawing on his research with adult learners in higher education, suggested that mentors do three distinct things - they support, challenge and provide vision. Mentors make intuitive judgements of when to support and when to challenge so that they provide sufficient support to enable the student to trust them and to feel confident enough to try out new things. Too much challenge can destabilise a student and cause them to retreat into a 'safe' mode which stifles development. Providing vision can be achieved, for example, by modelling the endpoint of the learning journey (when students might have aspirations to become like their mentor), or offering students ways to see the practices and ways of working that make up the tradition they are entering.

In my PhD thesis, there appear to be several journeys - the student journey that mentors dip in and out of, the mentor journey and my own journey of transformation. Any journey of this sort can be hard and forces one to leave something of the old self behind. The people around you may also need support to recognise the journey you have travelled.

Daloz, L. A. (1999). Mentor: Guiding the Journey of Adult Learners, San Francisco, Jossey-Bass.

Why would nurses be interested in my PhD findings?

2011-04-09T06:09:00.000-07:00

Perhaps I need to answer this question before moving on. I'm doing this study because I think it is important to promote and extend understanding of the mentor experience. Mentors are such a crucial part of the whole enterprise of educating new nurses. Practice skills cannot be learnt in the classroom. However, the work of mentors seems precariously dependent on goodwill.

There are risks to being a mentor - students can challenge your practice in a slightly misjudged way through their lack of experience; you are vulnerable to gossip around the university; you open up your workplace to students who may slow the pace of work; you feel guilty when you have to tell a student they are failing; you feel responsible for letting someone through who you have doubts about and hope they improve in their next placement.

You give generously of yourself to help students - your time, energy, patience, enthusiasm for nursing. Mentoring is an integral part of being a nurse, and the challenge of passing on what makes a good nurse is never an easy one. Sometimes it is felt or sensed, part of who you are, rather than something that is easily taught. You want students to adopt the values and approaches that you have come to value in your work.

By using hermeneutic phenomenology, I'm trying to interpret all these elements of being a mentor in a way that throws new light on the meaning of mentoring. Perhaps mentors are taken for granted a little too much. Perhaps we can learn a little more about the skill and personal involvement of mentoring that will help to enhance mentor preparation and support. Perhaps there are some answers to the perpetual puzzle of how people can be supported to learn in the workplace and how you should judge and assess workplace learning.

Fragments and hope

2011-04-08T10:58:00.000-07:00

I was recently re-working my two findings chapters on the themes 'working with fragments and having a sense of the whole' and 'having hope for the nursing profession'. Whereas the theme of being aware of high stakes was analysed according to 'being-already-in',the fragments theme is focusing on 'being-amidst' and the hope theme is focusing on 'being-towards'. At a distance, it has a very logical feel, but when digging into the data and vocative texts with these analytical filters it becomes a very hard task. Discussing narrative accounts of concrete events and more general dispositions towards mentoring relies on the use of data that is already spoken and representative of the experience. It is already removed from the actual experience. so, I have to consider whether a description of an event or of practice is really showing Dasein's falling, as in being-amidst or whether it is something else.

If working with fragments indicates being absorbed in coping, then it might also need to be linked to concepts of equipment use in terms of being ready-to-hand (in use) or present-at-hand (an object of contemplation). I think there are also things to be learnt from the differences in the different technologies, say, in the context of blood pressure measurements. What is the difference between taking manual blood pressures and using dynamaps and why does it matter so much?

Being on the edge of something

2011-04-08T10:39:00.000-07:00

I've written two sets of drafts of my findings chapters. First time around, I was approaching the writing from the perspective of being immersed in the data. Hence, there was not a strong narrative for the reader, even though when I was writing there was a perfectly logical flow of ideas. Second time around, I've made it more structured and added an interpretation of the findings through the lens of Heidegger's concepts of Dasein. However, I'm still struggling to nail down what makes this mentor study so special and so captivating for me. And, I haven't convinced my supervisors in my writing that the interpretations I've layered over the top, in terms of Dasein, are helpful. Still, I feel convinced that they are.

First, in terms of attunement, facticity, affectivity and mood, all these words can be used to represent the idea of 'being-already-in', that we have been 'thrown' into the world, so that we are 'always already' in a situation that is coloured by mood. I like the German word 'Befindlichkeit' that Heidegger used which can be translated as how you are finding things, or how it is with you. In terms of attunement, we are attuned to our world by mood. We cannot escape or manipulate these primordial moods, they are facitically part of our existence. There's another layer of mood, that might be more easily thought of as emotion, that we notice and can be acutely aware of. We clearly do have some control over these. The world that the mentors are 'thrown' into is a world of high stakes. For all the different participants in the world of the mentor - students, patients, colleagues, the university, employers and the professional body, the stakes are high. Whether or not they do a good job of educating their students matters greatly to everyone in different ways. The high stakes and mentoring mood combine into a potent mix.

Then, there is understanding, which is more about being capable, competent, having know-how, seeing the significance of situations, rather than a cognitive process that we commonly think of 'understanding' as. Understanding discloses our existence, which itself can only be understood in terms of potentiality-for-being. Existence is always ahead-of-itself in a process of becoming. One understands something when one can cope with it, so that mentors understand mentoring through their competence at mentoring. Mentoring is for-the-sake-of- something, which is to produce competent nurses for the future, which in turn keeps the profession strong and preserves the standards of care that the mentors value.

Being on autopilot - is this like inauthentic Dasein?

There's a jumble of ideas in the middle of all this. Mentors work with fragments of different sorts in a web of meanings, a referential whole. In their everyday engagement with their mentoring practice, when absorbed in coping, they assume a collective identity, or 'inauthentic self', a 'they-self', in which they are 'being what I am doing'. The role dominates, through accepted ways of practising, doing what you've learned to do in the role. Perhaps it is a kind of 'autopilot' in which you just get on and cope with things. This 'being-what-I-am-doing' covers up individual, authentic Dasein in a process of 'falling' away from itself. Equipment is 'ready-to-hand' most of the time, which means that it is used in context, but you might look right past the equipment to the work you're doing with it. I interpret 'equipment' quite loosely here, to refer to all the artefacts associated with nursing and helping a student learn the practice. If you stop to think about the equipment when it is not in use, or when you are not skilled at using it, it loses the direct meaningfulness that it had when you were using it. It then becomes 'present-at-hand', an object of theoretical contemplation. The implications for teaching and learning could be quite profound.

The use of language goes alongside all of these different ways of being-in-the-world. Language is used to signify meaning, allows one to articulate what one is doing. Sometimes, language can get in the way of the real Dasein, the who-I-am and how-it's-going-with-me, because it can only be a representation of Dasein's existence. We can understand at the level of the everyday talk, but this can hide, or put a veil over, the being underneath. However, we need to operate at this level in practice, or nothing would ever get done.

Working with fragments

2011-02-25T01:25:00.000-08:00

This image represents something of the nature of working with fragments from the mentor perspective.

Often, the mentor’s efforts were directed towards making sense of and giving form to the fragments in their lived experience. They applied their selves as creative beings, seeing patterns in the project of mentoring. It was not possible or even desirable to know the student as a whole entity in one moment of perception. They needed to build their knowledge of the student from the fragments that presented themselves piece by piece over time and in relations with others.

They came to know the student by observing their practice, having conversations, working alongside them, gettng to know them as individuals. As nursing requires practical as well as academic skills. the hands in this image are meaningful. Mentors find it very important that students learn the hands-on skills early on, even though as nurses they are often delgating this work to health care assistants. Many of them feel the tensions of wanting to carry out the direct nursing care, while at the same time being pulled towards the equally important management tasks.

Sometimes, students are welcomed in to the workplace as an extra pair of hands, or sometimes students have been reported as saying they feel like a spare part. There are many ways in which fragments feature in mentoring.

The will

2011-01-14T10:45:00.000-08:00

The will to be a mentor has been occupying my thoughts for a long time. It shows clearly in my research participants, but I haven't paid much attention to the best way of conceptualising it. Returning to Roberto Assagioli (1973) recently, I realise he might be able to provide a conceptual structure for relating my research sub-themes to the concept of the will.

Assagioli describes four aspects of the will that represent the different facets. They are:

The strong will - strength is only one aspect, and it is sometimes misleadingly thought to be all there is to it
The skillful will - the ability to obtain desired results with the minimum expenditure of energy
The good will - will can be a harmful weapon, but to be fulfilling, and for our welfare, the will must be good
The transpersonal will - this is the realm of metaneeds, essence, ultimate meaning and so on.

A study of the phenomenology of the will has revealed certain characteristics: energy, mastery, concentration, determination, persistence, initiative, organisation. There should be a lot of potential for overlap with my themes in the mentor experience.

Plenty of food for thought!

Assagioli, R. (1973). The Act of Will, London, Wildwood House.

The body in mentoring

2010-12-07T09:44:00.000-08:00

It is sometimes said that the body is invisible in nursing. The dominant western perspective that knowledge and theory are supreme has tended to push the body into the shadows. Ideas take preference to embodiment as a way of understanding human agency and culture (Rudge 1997). Even though the scientific body is very much the focus for nurses, the lived body, which is how patients experience their bodies, often takes back stage.

In mentoring, another meaning of bodies shows through. The patient's body becomes a site of teaching and learning. It is a teaching and learning space - for showing a student how to do eye drops, insert a catheter, take blood pressures, apply dresssings and bandages and so on. There is, therefore, commonly a patient as third party present to mentors and students in workplace teaching situations. Mentors also use their bodies as teaching tools, physically showing practice or guiding a student's hands.

Florence Nightingale rocks!

2010-09-24T09:41:00.000-07:00

Who would have thought that Florence Nightingale could still be so current?

"I use the word nursing for want of a better. It has been limited to signify little more than the administration of medicines and the application of poultices. It ought to signify the proper use of fresh air, light, warmth, cleanliness, quiet, and the proper selection and administration of diet—all at the least expense of vital power to the patient."

"The everyday management of a large ward, let alone of a hospital—the knowing what are the laws of life and death for men, and what the laws of health for wards—(and wards are healthy or unhealthy, mainly according to the knowledge or ignorance of the nurse)—are not these matters of sufficient importance and difficulty to require learning by experience and careful inquiry, just as much as any other art? They do not come by inspiration to the lady disappointed in love, nor to the poor workhouse drudge hard up for a livelihood." (Florence Nightingale 1898, 2004 )

What did the Nursing Times survey tell us?

2010-06-02T11:06:00.000-07:00

The Nursing Times survey (reported on 27th April) seemed to reveal some quite shocking statistics about mentors passing students who they wanted to fail. Then, on the 11th May it was reported that the Nursing and Midwifery Council (NMC) will take "immediate action" to address the concerns the survey raised.

The front line of this action entails writing to the directors of nursing in all NHS trusts and all deans in the universities and the commisioners of the education programmes to take immediate action and remind everyone involved of their responsibilities. While this is a useful first step, one wonders whether this will have the desired effect, which is presumably to ensure that students receive adequate support in their practice placements and have a fair and accurate assessment of their achievements.

The job that mentors have to do to support and assess students is incredibly complex and in my opinion is severely underestimated when you consider the lack of time they have in which to do the work and the lack of formal or informal recognition they seem to have from their employers of the difficult job they do.
Those who do it very well can contribute a lot to our overall understanding of just what it takes to be a skilful facilitator of learning and a fair and just assessor who can really tell who you can trust to progress towards entry to the professional register and who you can't.

Trust is like paper

2010-05-07T09:38:00.001-07:00

Compassion in nursing

2010-04-25T06:24:00.000-07:00

There has been a lot recently in the nursing press about the compassion in nursing agenda, especially since the final report of the Prime Minister’s Commission on the Future of Nursing and Midwifery has called for all nurses and midwives to make a pledge to provide high quality, compassionate care. This week, it was annnounced that the first national batch of nursing students to be tested and tracked on their ability to show compassion will be arriving at Welsh universities this September. Some nurses are indignant that anyone should assume that compassion can be measured in tick-box fashion, and some suggest that keeping cool and making hard clinical decisions in an emotionally detached way is preferable to getting too emotionally involved. Others think the problem lies in the lack of compassion that nurses feel they are offered by those in power.

I'm not so sure that being compassionate excludes calm, somewhat emotionally detached decison-making. I think that nurses need to find a balance between being able to empathise with patients and be responsive to their emotional needs alongside the more fact-based clinical reasoning. Surely, in the end, it's about knowing how to treat people as people and not "conditions in a bed". Some of the best nurses I know do this juggling act incredibly skilfully and seemingly without effort, but no doubt they are paddling furiously under the surface. Then, there are some nurses who are incredibly compassionate with patients but pay less attention to the emotional needs of their colleagues.

In my recent work on trust as revealed by the mentors in my PhD study, I had a glimpse into just how complex all of this is. Trust is essential for cooperative teamwork. Nurses want and need to be trusted both by their patients and their colleagues - and although trust judgements are partly made in terms of cold facts ( can I rely on this person to do the job properly?), trust is also about emotional connections with people (if I reveal my personal or professional vulnerability, will this person respect that and respond appropriately?). Psychological safety is crucial if nurses are to maintain a no-blame culture and learn from clinical mistakes. The less trust there is in the workplace, the more errors and near-misses will be swept under the carpet and the system will struggle to improve.

The meanings of place and time

2010-03-15T02:37:00.000-07:00

Spring is late this year. The snowdrops are still in full bloom and the daffodils are yet to grace us with their show of bright yellow, even the early ones, so St David's day came and went in a more subdued way, botanically speaking, than in recent years. The waxing and waning of the seasons provides an anchor, a way of grounding human experience. Today is the "ides of March", the thought of which fills me with a tiny sense of forboding, but not being superstitious, I don't attach any real significance to this.

The idea of place and time as being meaningful is often uppermost in my thoughts as I work with my research data. The different environments in which nurses work have an enormous impact on how they experience their work and their mentoring. A busy surgical ward presents a range of opportunities, challenges and constraints to a mentor that are quite different from a rehabilitation unit or a community nursing team. Whatever the setting, they all experience certain things that frustrate their efforts to be a good mentor and can strain their relationships with students and colleagues, along with the things that make their work worthwhile and that they feel passionate about sharing with students.

The work context dictates the pace of the work. The experience of time is very different in the different contexts and time dictates the rhythms of the work, the priorities that are constantly juggled and the affordances available to mentors to be with and support their students. Physical space is also significant - whether they can physically see the student at any time; whether there is a space for a private conversation; or how close is too close when working together. How these mentors feel about being a nurse, and nursing, in the context of their own lives is often an overarching driver for how they approach mentoring.

Reflections on discussion with HSC Practice learning research group

2010-01-26T02:25:00.001-08:00

I thought a useful way to start talking about my more recent considerations of mentoring and learning styles was to introduce the different mentoring styles (and the metaphors) that I had identified. I could then steer it to what people think of the concept of learning styles, and/or to the idea of “do mentors teach” depending on responses.

There was initial interest in the hierarchy I had created (low-high intervention) and some discussion about what values should be placed on this. Low intervention isn’t necessarily a negative. This is interesting for me in the sense that I hadn’t said that low intervention was necessarily of lower value than high intervention, but there seemed to be an immediate sense around the table that I was saying that, and perhaps the way I described the mentors reinforced this impression. This may well reflect my own feelings that the mentors I placed at the high intervention end seemed to have more energy for the role and seemed to have thought in great depth about how they can support students. This could, of course, be more a case of being more able or willing to talk about what they do and find the words to describe it. People often do think that doing more is better. Perhaps it shows greater motivation and greater application to the task or role.

What is the “right” disposition to be a mentor? Can mentors intervene too much and become “toxic”? One type of toxic mentor described by Lou Ann Darling (1985) is the “hoverer” who blocks development by too close supervision. The idea of “too close supervision?” was discussed in the Trust Chapter, and very specific explanations were given by the mentors concerned as to why they were supervising closely at those times. In fact, the reasons were very different and the mentors felt very differently about them. I didn't get any sense that these participants were toxic in any way, and the circumstances for close supervision were quite appropriate. We did agree, though, that working as co-workers needs to be valued as a valid way of supporting workplace learning.

We tried to come up with a metaphor for the mentor who I’d labelled as the person who was team oriented and offered a menu of experiences rather than see herself as a direct source of learning for the student. “Quality Street” was one offering. I like this, as I do think she offered quality to students.

Another way of articulating what mentors do is to say that they are negotiating and brokering a learning contract with students. The idea of mentors as brokers of learning is an interesting one, and may offer another way of thinking about what the role is and how mentors experience it.

The discussion has made me think about role modelling. I gave one of my mentors the label “role model” because she stood out as being very aware of how people viewed her and thoughts about how she came across to others seemed uppermost for her. She also had very definite views on the nursing profession and how it is viewed, and that it was important that students were made aware of this. However, it is probably true that all mentors recognise their role model potential and some of my participants talked about influential role models for them in the past. Another of the participants struck me as, if anything, a “reluctant role model” because she felt uncomfortable being observed by students and couldn’t see the point of learning by observation, as it was something that had never worked for her. Whether or not you are a role model for someone else is something you have little control over. Also, you can pick a role model for yourself without making that person aware, but perhaps you are even sometimes unaware yourself that you are doing it. “Role modelling” is a mentoring strategy that has been described recently by Bob Price in the Nursing Standard (Nov 2009). He talks about “role modelling sessions” as defined, planned activities that end with guided reflection. It is clear that I need to be aware that when using the term “role model” there is a range of meanings and activities that are associated with it and I’ll need to be explicit about what I mean by it.

I needed to explain about the data collection, the questions I asked or didn’t ask and why. It goes to show how pivotal the data collection process is - something to remember when writing up.

Trust and interdependence

2009-11-25T11:08:00.000-08:00

Trust relationships in the world of the mentor seem to feature a marked interdependence. I'll consider this with respect to the relationships between mentor-student, mentor-university link, mentor-colleague and mentor-patient.

In the mentor-student relationship, the interdependence is concerned with the mentor depending on the student to practise in a responsible and reliable way (do no harm to patients) and to report back to peers and university staff in a way that is fairly representative of the experience they have had on placement, and that is respectful of some of the difficulties and subtleties of professional practice. The student depends on the mentor to show them good practice, open doors to learning experiences (make them available, e.g. access to patients and other professionals), and to assess their performance fairly.

In the relationship between the mentor and the university link person, the mentor depends on the university link person/people to provide the right information and training/updating when needed, and support and back-up in cases of difficult student-related issues. They also depend on the university sending students in manageable numbers and appropriately, in terms of matching learning needs to the practice area. Mentors rely on the university to prepare students appropriately for their forthcoming practice experiences. The university depends on mentors to provide the appropriate practice experience, communicate with them as necessary, and assess students appropriately.

In the relationship between the mentor and their immediate colleagues, the mentor depends on colleagues to show goodwill, cooperation and support towards the student, and to deputise in their absence. Mentors often depend on the opinions of and evidence provided by colleagues in assessing the capabilities of students. As having a student may be seen as competing or interfering with day-to-day practice, the mentor also relies on colleagues to be tolerant and accepting of their position and responsibility. There is probably less dependence in the other direction, unless colleagues are also mentors, in which case giving support can be reciprocated mentor-to-mentor. In some senses, then, the relationship between mentors and close colleagues could be unbalanced or unidirectional in terms of dependence.

With patients, mentors depend on patients allowing students to take part in their care. Patients depend on the mentors to delgate and supervise appropriately to deflect risk of harm.

Where there is obvious interdependence, this must be different to situations where the mentor is more dependent, for example, on colleagues to provide support. Where does trust come into this? Is it easier to make yourself vulnerable, knowing that the other can also be vulnerable?

How do nurses negotiate multiple trust relationships in their mentoring roles?

2009-11-24T13:49:00.000-08:00

Trust exists in relationships with patients, colleagues, managers, and relevant professional bodies. Indeed, the first item in the Nursing professional code of conduct is that “The people in your care must be able to trust you with their health and wellbeing” (Nursing and Midwifery Council, 2008). The code further stipulates that nurses have an obligation to work collaboratively in teams and behave in such a way as to uphold the reputation of the profession.

Trust is thought to be important for cooperative behaviour. Workers are said to trust others when they have optimistic expectations of them and are willing to be vulnerable and take a risk with regard to the other fulfilling their expectations (Rousseau, Sitkin, Burt, & Camerer, 1998; Whitener, 1997). The relationships between mentors and students and with their work colleagues seem to call for a consideration of collegial trust. Collegial trust operates on an interpersonal level and carries an expectation of the other person working with professional integrity and doing what is expected (Jackson, 2008; Sullivan, Francis, & Hegney, 2008).

The data in my study reveals a complex web of relationships that mentors negotiate. With their work colleagues, they sometimes need to advocate for their mentoring activities and the presence of students in the workplace, or they may need to confide in colleagues about aspects of their mentoring practice, or delegate to them for supervision of and judgements about their student. With the partner university, it is important to them that their judgements and concerns about students are taken seriously, but also that their goodwill in taking students and making the effort to support students is recognised and not taken for granted. With students, they make efforts at befriending in order to put students at ease, and to foster a sense of trust that enables disclosure by the student. Such disclosures can be seen as essential for supporting reflection on practice. However, this befriending must be tempered by the requirement of mentors to assess students' practice, determining their eligibilty to progress in their training, or even to progress onto the professional register. With regard to patients, mentors are protective, seeking to reduce any risk associated with students providing care. They also require patients to cooperate with the student, and accept that some patients will refuse care by a student.

A development of mentoring styles

2009-11-06T07:30:00.000-08:00

Mentoring styles could be seen as approaches to mentoring that can be fluid and adaptable according to characteristics of the mentee or the demands of any particular work situation. They can also be seen as more stable aspects of a mentor’s practice that relate, for example, to their own personality, values and preferences for learning. In reality, there is good reason to suspect that there is a combination of forces at work. Hence, one would expect to see mentors adjusting their repertoire according to any situation, while constrained to an extent by their own preferred style of being with students. I'm adopting the term “mentoring style” to denote a more personal attribute, and “mentoring approach” as a behaviour that can be adapted. I have also tried to attach an interpretation of the relationship style based on what I know about transactional analysis (TA).

In the following list, I’ve ordered the latest style classiifications roughly in a hierarchy of passive-active intervention.

1) Providing a link between the learner and the practice

chef with menu TA Adult-Adult)

co-worker to an apprentice (TA Adult-Adult)

taxi driver (TA Adult-Child)

2) Role model

Role model(TA Adult-Adult)

3) On a mission

Crusader

personal trainer or coach (TA Parent-Child)

4) Actively supporting, probing, monitoring and nurturing

nurturing parent or gardener (TA Parent-Child)

shepherd and trail guide (TA Parent-Child)

Probing parent or advocate/ mediator (TA Parent-Child)

responsible parent (TA Parent-Child)

5) Creative mentoring

scientist or pedagogue (TA Adult-Adult)

nurturing, intuitive parent (TA Parent-Child)

Mentoring styles

2009-10-03T03:27:00.000-07:00

I've done some thinking recently on the different styles of mentoring that are coming out of the accounts of my participants. I think that probably they are adapting their styles according to the situation, but as time goes on I expect that there will be some consistency of style showing through. This list is just an initial run through, considering possible metaphors that could guide the thinking.

"Probing parent"

"Team and menu approach" or "chef" (try it and see)

"Crusader"

"nurturing parent" or "gardener"

"personal trainer" or "coach"

"Role model"

"Expedition leader"

"Taxi-driver" (service on demand only)

"Pedagogue"

"Advocate, mediator"

"Lone ranger" (independent, in control but rather exposed personally)

"Goosegrass" (stick to my side)

The will to be a professional or to be a mentor?

2009-07-19T08:31:00.000-07:00

Ron Barnett gave a keynote speech at the 2009 SCEPTrE conference, unpacking the notion of the will to be a professional. He posed the challenge that the basis of the formation of the professional will is unclear and that this creates opportunities to re-think how we as educators can help students develop the necessary dispositions and qualities that maintain the professional will. He drew parallels with themes from his book "A Will to Learn", which has provided me with extra insights into what it means to be a student in the journey through processes of learning.

I’d like to be able to add something to this knowledge. My PhD research is partly driven by the desire to discover the will to be a mentor for students on placement. It's a role that isn't enjoyed by all nurses and some seem to have a greater propensity than others for supporting and educating students in the workplace. Also, I wonder if there is a relationship between the strength of their professional will and their will to be mentors.

As Barnett pointed out, there can be tensions in the doctor-patient repationship when the doctor has the ideal patient in mind and the patient has the ideal doctor in mind and between them the relationship is worked out. I can see parallels here with the mentor-student relationship. Some of the mentors in my research have described characteristics of their "ideal student", and there is plenty reported in the literature from the student viewpoint of ideal characeristics of mentors. According to Barnett, the will has to be continually nurtured and re-nurtured (possibly because of these tensions?), but we don’t have a theory of what professionals do to maintain the will to be or become professional in the present, in the here and now. The educational challenge is of helping to form this professional will in such a way it will be durable. For nurse mentors, this nurturing of a professional will needs to take place at different levels:

the mentor as a nurse has to sustain a professional will to be a nurse and also to be a mentor.

Not only that, but they also need to find a way to nurture a professional will in the students.

Occasionally, they see that there is no professional will in a student

The will exists in knowing, acting and being. Mentors are challenged to devise a space or spaces in which the acting and the knowing and the being relate to each other, both for themselves and their students.

Teasing out the relationship between what it means to be a professional and the life around the professional, it's clear that the professional is part of a wider community, but you have to question whether their own interior spaces provide resources for going on, amongst turbulence and uncertainty. Because, according to Barnett, the professional is able to critique the profession and move it forward, standing apart from the profession as well as part of it, it isn't sufficient to rely only on a community of practice to nurture the professional will. It will be useful to look out for signs of critiquing the profession in the themes and accounts that emerge in my data, and as I'm delving into thoughts and feelings, I may have some insight into the interior spaces of the mentors in my study.

To end this entry, I'd like to share this list of sources of the professional will that Barnett presented:

Delight – something keeps us going, we look into a classroom, we see a little event that students put on in an evening, all by themselves

The language, the poetry of the moment – something happens, something is said, something is done with care

Recognition – a moment of affirmation

Humour

Graciousness

Perceived value – we have to perceive value in what we’re doing in order that that will be nurtured

Perceived effect – a sense that what we’re doing has some kind of valuable effect

Faith? Hope? (I’ve already identified hope as something that features in the mentor experience)

I think there is a lot of this coming through in my data from the mentors, so it will be exciting to see the parallels.

Learning to be professional

2009-03-11T01:03:00.000-07:00

I'm preparing a paper for a conference organised by the University of Surrey's Centre for Excellence in Professional Training and Education (SCEPTrE). The main theme is 'learning to be professional' and I think my research has a lot to contribute, in that it provides the part of the story that depicts the experiences of the professionals who directly support learners in the workplace. They have their own idea of what it is to be professional and go to some length to instill professional skills and behaviour in their students.

Although it feels like early days yet (last data was collected at the end of January), interrogating the data with both the research question and the conference theme in mind has brought out some intriguing themes: working with fragments of experience; being aware of high stakes; having hope for the profession. Both mentors and students work with fragments of experience. The mentor sees a fragment of a student’s learning journey and has to imagine where and how it fits with their image of a professional nurse, in addition to helping the students connect their experiences. The stakes are high for mentors and their students. There is urgency about learning, and mentors can be subject to persistent questioning or find themselves striving to ‘unlock’ a quiet student. The accounts reveal how when a relationship is under tension, there is a range of emotional responses. Underlying a decision about a student’s aptitude to become a nurse is a poignant reality-check: would I want this person caring for me or my family? Hope for the profession extended to concern and optimism for the future and recognition of the importance of the mentor role.

I'm looking forward to the conference and to having some fruitful discussions about how what I'm doing complements some of the excellent work already done in the field of work-based and professional learning, such as by Stephen Billet and Michael Eraut.

Empathy in nurse mentors

2008-06-15T07:28:00.000-07:00

One of the things that has really struck me as I carry out the initial interviews with mentors is the high level of empathy that mentors have for student nurses, patients and colleagues. The people I have interviewed so far are very experienced nurses who seem instinctively tuned in to other people and their feelings. I would like to find out more about what this means for mentors. How much of their empathy-led behavour are they conscious of labouring over, and how much is it authentic caring behaviour? Is it related to their identities as members of a caring profession? The notion of 'being-with' a student mentee is worth exploring in some depth. Sometimes, it is not about teaching or providing learning opportunities or other such actions; it is simply that they spend time together and may be inhabiting the same space at these times.

I am also interested in exploring further how mentors orient to colleagues. For instance, what are the emotional display rules amongst their colleagues with regard to mentoring? Mentors do seem to spend energy on complex interactions with colleagues, getting feedback on students, being mindful of the impact on the team of having a student, and so on.

How much of the time do mentors have to work hard at showing the 'right' emotion to students? If they are battling between heart and head when having to fail a student, how much of that do they let the student or others see? If they are relieved that a student has carried out a difficult procedure safely, does that show? I think these are all fascinating aspects of the 'hidden' lifeworld of the nurse mentor that I hope to discover.

Emotion as a social construct in the lifeworld

2008-03-19T02:11:00.000-07:00

I've always started from the premise of studying thoughts and emotions and because they are not accesssible to a researcher by observation (although emotions can be but they can also be masked), I wanted to find out about them in dialogue with mentors. However, if I am assuming that emotion is socially constructed within the life world of a mentor, and if my focus is on the life world (as it is), then I can't really assume that emotions are internal to a person. A mentor's experience of emotion in carrying out the role will be in the context of social interactions, rationalisations and perceptions that are shaped by cultural, social and professional context. In dialogue, emotion and thoughts are mediated by language which imposes limitations on how they are and can be expressed.

I wonder how easy it is going to be for the mentors in my study to share with me how they experience their lifeworld. What other sources of data can inform my knowledge and understanding of the mentor's lifeworld? Could they capture their experience in a drawing or in some of the records they keep in the process of doing the job? Would it be feasible to ask mentors to reflect on the naturally occurring data that make up the lifeworld of mentoring and what would this add to the study?

Thoughts and feelings of mentoring

2008-03-07T03:48:00.000-08:00

There are some psychosocial perspectives that I am interested in exploring with regard to mentoring in the context of supervising and assessing students in professional practice. These include the emotional experiences of supporting learners (who themselves have to contend with the emotions associated with learning), inducting students into the 'emotional display rules' of the workplace and the profession, managing time constraints and the rigours of 'getting assessment right' as one of the gatekeepers of the profession. I am interested in the emotional impact of all these perspectives. There is also a cognitive element, in terms of perceptions and understandings of events and the role generally. Thoughts and feelings, then, are what I'm hoping to explore.

Starting out

2008-03-03T02:02:00.000-08:00

I'm starting out on my PhD in the UK, exploring the experiences of mentors for students in pre-registration nurse education. However, there are many potential overlaps with other professions, so I would hope that this blog may be read by mentors and students in a range of professions. There's a lot written about the role of mentors, but not so much about the "lived experience" - thoughts and feelings and perceptions of the experiences. I would love to hear from people who mentor students in their professions, to get a feel for the range of experience and some of the features of mentoring that make it different from other roles at work.