NMC Mentor and Practice Teacher Handbook

FACULTY OF HEALTH, SOCIAL CARE AND EDUCATION In partnership with local NHS Trusts and Organisations in London and Surrey NMC Mentor and Practice Teacher Handbook School of Midwifery and Child Health School of Nursing Dev

INTRODUCTION Section 1 General mentor information Introduction for all nursing and midwifery student mentors How the University allocates nursing and midwifery students to practice experiences Preparing students for learning experiences the role of the University Educational quality review summary of the audit cycle Facilitating learning and assessing students Support for students and mentors in practice key people Advice for mentors supporting a failing student Advice for mentors supporting a student who has failed Section 2 Pre-registration programmes BSc (Hons) Nursing (Registered Nurse: Adult, Child, Learning Disability and Mental Health) [2011 curriculum] PgDip Nursing (Registered Nurse: Adult, Child, Learning Disability and Mental Health) [2011 curriculum] BSc (Hons) Registered Midwife BSc (Hons) Registered Midwife for Registered Nurses PgDip Registered Midwife PgDip Registered Midwife for Registered Nurses Section 3 Mentor updating Overview of mentor updating Introduction to mentor and practice teacher passport Undertaking your triennial review Section 4 Roles and responsibilities of mentors Supervising pre-registration students in practice Insight learning experiences Nursing Outreach learning experiences Snapshot/episode of care practice assessments - Nursing Service users contribution to assessment Documenting the ongoing achievement record How your students evaluate practice Section 5 NMC sign-off mentors Accountability of sign-off mentors Support for sign-off mentors 2

Criteria for sign-off mentors How to become a sign-off mentor References Abbreviations Appendices 1. Mentor and Practice Teacher Passport (Version January 2015) 2. NMC Stage 2 Mentors checklist for triennial review (Version January 2015) 3

Introduction This handbook is produced for Mentors and Practice Teachers to use to assist them in supporting learning and assessment in practice. It outlines key information that will enable you to successfully undertake your role in supporting student s in their practice learning experience. The Schools of Midwifery & Child Health and Nursing offer a range of programmes of study that lead to registration as either a midwife or a nurse. Equally, the registered midwife or nurse can access a variety of modules in the Continuing Personal and Professional Development programme to enable the development of specialist or professional knowledge and skills. This mentor and practice teacher handbook relates the principles of mentorship and will enable you to support students from pre-registration and post-registration midwifery and nursing programmes. The Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Educators and Teachers. The Nursing and Midwifery Council introduced the Standards to Support Learning and Assessment in Practice: NMC Standards for Mentors, Practice Educators and Teachers in September 2007. The Standards: are a single developmental framework to support learning and assessment in practice describe the knowledge and skills Registrants need to apply in practice when they support and assess students undertaking NMC Approved programmes that lead to registration or a recordable qualification on the NMC Register designed f o r a p p l i c a t i o n w i t h i n c o n t e x t of i n t e r -professional learning and working in modern healthcare The Standards also known as SLAiP are the foundation for the way we support learning and assessment in practice. You can download a copy directly from the NMC website. http://www.nmc-uk.org/ All resources in the handbook reflect the professional role and responsibility of Mentors and Practice Teachers as outlined in the NMC Standards for Mentors, Practice Educators and Teachers (NMC, 2008). 4

1.1 Introduction for all nursing and midwifery student mentors The Standards to Support Learning and Assessment in Practice (NMC, 2008) include a number of underpinning principles for NMC Registrants who make judgments about pre-registration students. Mentors/practice teachers must: Have developed their skills, knowledge and competence beyond the point of registration to support their role Hold professional qualifications at an appropriate level to support and assess the student Been prepared formally to fulfill the role Keep records e.g. of students mentored, decisions made, actions etc. Be accountable and honest in their decision making and to seek support when necessary As a mentor or practice teacher, it is important for you to understand the programme that students in your practice area are undertaking. This means you will be able to: i d e n ti f y the academic level they are trying to achieve i d e n t i f y the learning and practice outcomes of the student s programme/ module i d e n t i f y how they relate to your practice area o f f e r practice learning opportunities to help the student to meet their outcomes. Unique identification number It is a requirement that all pre-registration students are mentored by a verified mentor or a verified practice teacher. On successful completion of either the mentor or practice teacher programme, you will receive a Unique Identification number (U.I.). This number, local to Kingston University: St. George s, University of London, is used to verify your right to practice as a mentor or practice teacher. You will be required to use your U.I. number on all student practice documentation. Your U.I. and a Mentor Resource Pack is issued to the person in your Trust/Organisation who is responsible for student placements. This person will forward your U.I. and Mentor Resource Pack onto you. 5

1.2 How the University allocates nursing and midwifery students to practice experiences Pre-registration nursing and midwifery students Practice learning opportunities for pre registration students undertaking NMC approved programmes are organised by the Placement Team within the Student Services and Programme Office. Kingston Hill. Practice experiences are organised in liaison with the Trust or Organisation Named Person. An annual forecast of student practice experiences is agreed between the Faculty and Trusts/Organisations, taking into account student capacity and range of experiences offered. Individual placements are notified at least six weeks in advance of student placements. If you have an issue that you wish to discuss regarding the allocation of pre registration nursing or midwifery students please contact your Trust or Organisation Named Person. If necessary, they will contact The Placement Team at the Faculty. Student numbers agreed by university and organisation University sends letter to nominated contact in practice area informing of students arrival Nominated contact confirms students can attend Nominated contact informs mentors to expect students Mentors plan off duty for students to ensure direct and indirect supervision Post-registration nursing and midwifery students In some cases the practice learning opportunities which are required for completion of a CPPD / Workforce Development module are arranged by the module leader in conjunction with the student and appropriate Trust/Organisation. Students are informed of this if this is the case and will be provided with contact details of the relevant module leader. Return to Practice programme (RTP) & Overseas Nurses Programme (ONP) Practice learning opportunities for these students are organised and supported by Trusts, Organisations or by an Independent Ag e n c y. If y o u a r e s eek ing i n f o r m a t i o n about t h i s programme or have an issue that you wish to discuss regarding student allocation please contact the named RTP/OMP/ONP Trust, Organisation or I n d e p e n d e n t Agency co-ordinator in the first instance. The course or module leader can also be contacted. 6

1.3 Preparing students for their learning experiences the role of the University Mentors can expect that students will be prepared for each practice learning opportunity. Preparation takes place in a variety of ways depending upon the stage of the programme and field of practice. Students in their first year of the programme will have minimal experience of learning in practice. For this reason, the university and local Trusts/Organisations will work together provide a comprehensive preparation programme. In later years of the programme students will be expected to take greater responsibility for their preparation for practice learning. Typically a preparation for practice programme includes advising students to make appropriate contact with a practice area at least 1 week prior to commencing the practice learning experience. A pre-practice visit is strongly recommended to ensure students are fully prepared to commence practice learning. Preparation for practice requires a student to engage with a range of learning experiences including tutorials, group work and practice visits. Mentors can expect that specific aspects of preparation for practice will change year by year according to relevant changes in practice learning opportunities. Examples of preparation for practice Guided tutorials Practice preparation checklists Explanation of practice assessment document Community study Practice visits Mandatory training Pre practice reading 1 ST YEAR 2 ND YEAR Explanation of practice assessment document Practice visits Planning of learning experiences Pre practice reading Explanation of practice assessment document Practice visits Planning of learning experiences Pre practice reading 3 RD YEAR 7

1.4 Education quality review summary of the audit cycle The NMC requires that all practice learning areas undertake a regular Education Quality Review. This is to ensure that the practice area meets the NMC Standards to Support Learning and Assessment in P r a c t i c e ( NMC, 2 0 0 8 ). The e d u c a t i o n a l q u a l i t y r e v i e w w i l l r e f l e c t t h e opportunities available for student learning in the area and the support mechanisms in place to facilitate student learning and assessment. The audit cycle takes place over a two year period. The cycle begins with an educational quality review, undertaken by a representative from the University, usually a Link Lecturer in partnership with the Trust/Organisation Named Person and senior member of the practice team e.g. Ward Sister, Senior Staff Nurse Community Team Leader etc. The educational quality review will involve the development of action plans that support the improvement of the practice learning environment. The action plan will indicate a plan for keeping the learning environment under review. The second stage of the educational quality review cycle will be focused primarily on a review of the action plans developed during the first stage of the cycle. Stage 1 Full audit and develop action plan Implement action plans Education Audit Cycle Implement action plans Stage 2 Review audit and action plans If there are any changes in the practice area between educational quality review the Trust/Organisation Named Person should be notified so the educational quality review coordinator within the Placement Office can be informed. 8

1.5 Facilitating learning and assessing students The NMC expects that mentors will facilitate a range of suitable learning experiences for a student during their practice experience. Facilitation of learning requires mentors to plan, supervise, guide, and provide feedback so that students are exposed to a wide range of opportunities relevant to the practice learning outcomes. Orientation and Initial Review This should occur within 48 hours of the student commencing a practice learning opportunity and at be completed within the first week of the placement. You should use this time to discuss the range of learning activities available to fulfill the designated outcomes. Dates for interim and final review should be agreed. The orientation should also include a plan for the total learning experience, including an initial discussion on any outreach learning opportunities that could be accessed. Interim Review The interim review should be held at the midpoint of the practice learning opportunity, and be documented for all students, regardless of whether they are on or off track. It provides the mentor and student an opportunity to discuss progress towards achieving indentified learning outcomes, reflect together on any areas that require development; document progress within the practice assessment document and develop action plans as required. Feedback from any outreach learning experiences, service users and members of the multidisciplinary team should also be discussed. If there are concerns with the student s practice or if it is considered that the student may not achieve their leaning outcomes, please contact your link lecturer who will need to be involved in the development of any action plan. Final Review and Assessment The final review and assessment of the practice learning opportunity should are normally conducted at the end the practice learning opportunity. The mentor and student should review the practice learning outcomes and any evidence that supports achievement of these outcomes. Feedback from outreach learning experiences, service users and members of the multidisciplinary team should be included in the discussion. The mentor is required to consider all evidence in deciding if the student has achieved the learning outcomes. If action plans have been developed, these should be reviewed in partnership with your link lecturer and student. If the student has achieved a learning outcome this should be documented by the mentor as a pass, if the student has not achieved this should be documented by the mentor as a fail. The student should have undertaken their self assessment and should be able to provide evidence to support this. The student and mentor should document a summary of the practice learning outcomes following the final review in the pages provided within the practice assessment document. Students should be encouraged to plan future activities and identify further needs for learning in practice. 9

Feedback Students should be given regular feedback ideally on a weekly basis - and the opportunity to reflect formally and informally on their progress. Feedback should be both verbal and written to ensure that information given is clear, factual and can be reviewed throughout the practice experience. Orientation To include review of feedback in Ongoing Achievement Record Verbal Feedback Verbal Feedback Final Review and Assessment To include documentation of feedback, OAR and review of action plan Interim review To include documentation of feedback and development of action plans if needed Verbal and written feedback Ongoing Achievement Record At the conclusion of every practice learning opportunity the mentor is required to provide a summary of the experience for the next mentor. The ongoing achievement record should include comments on the student s strengths, any areas that of concern and any developmental needs. The ongoing achievement record can be used to inform the discussion at the orientation to the practice learning opportunity. 10

1.6 Support for students and mentors in practice key people Prior to the commencement of the learning experience the Trust/Organisation Named Person will liaise with the university to ensure the student is allocated an appropriate practice learning opportunity. Lecturers and Clinical Placement Facilitators, Trust/Organisation Named Person will also coordinate mentor update events. Day to day support for the students practice learning opportunity is the responsibility of mentors, who are required by the NMC to facilitate student learning experiences and assess practice learning outcomes (NMC, 2008). Mentors are supported by link lecturers, who are available to discuss the student s progression through the practice learning opportunity, providing advice and support in relation to practice learning and assessment and support the development of action plans. Link Lecturer Organisation Named Person Student Mentor/ sign-off Academic Zone Lead (Nursing) The Link Lecturer This is a specifically allocated Academic member of staff from the School of Midwifery or Nursing. The link lecturer acts as a source of reference for mentors and students allocated to p r a c t i c e a r e a s. They a r e i n v o l v e d in organising s t u d e n t s u r g e r i e s, m e n t o r u p d a t e s, educational audits and visiting clinical areas and supporting mentors and practice teachers as appropriate. Link Lecturers will be able to advise on student s learning needs, provide help in dealing with learning issues and offer advice on strategies to enable the learning environment to develop Link Lecturers will keep practice areas informed of changes to the programme, including information about the student s practice assessment scheme. 11

The Academic Zone Lead (Nursing) This is a specifically identified person from the School of Nursing who co-ordinates the activities of the nursing link lecturers (student surgeries, mentor updates, educational audits) across a specific area of practice which includes a number of clinical placements. The Academic Zone Lead (Nursing) Works in partnership with the Trust/Organisation Named Person to ensure quality learning experiences are offered to students Provides in conjunction with the Trust/Organisation Named Person, a strategic communication link between the Health Care Provider and the Faculty. Assists in identifying new learning environments. Ensures quality of the learning environment. The Trust or Organisation Named Person This person is nominated by the Trust or Organisation to specifically maintain the quality of their practice learning areas. In some areas, the role of the Trust/Organisation Named Person is only part of their total role and function within their Trust/Organisation and for others, it is a dedicated role. Mentors should ensure that they are aware of the person who is undertaking this role in their Trust/Organisation and how to contact them. Liaison meetings between the School of Midwifery & Child Health and the School of Nursing and Trust or Organisation Named Persons Trust/Organisation Named Person and key staff (academic and professional support services) meet regularly at the University. These are planned meetings with specific agenda items related to student practice. If you have an issue that would be relevant for discussion at this meeting, please ensure you forward it to your Trust or Organisation Named Person. You may also wish to observe a meeting: your Trust or Organisation Named Person can also arrange this for you. 12

1.7 Advice for mentors - supporting a failing student A student can be considered to be failing during a practice learning opportunity if they are falling short of the standard set by the learning outcomes they are attempting. Learning outcomes printed in each practice assessment document are based upon NMC standards; therefore a failing student is defined as not meeting the NMC standard for their particular programme. Students must always be judged against these standards rather than your own expectations or personal criteria. Failure to meet the required standards may be noted by mentors or other members of the multidisciplinary team; perhaps during outreach experiences. It is important that any concerns regarding a student s ability to achieve the required competence are addressed with them as soon possible to allow the maximum time for help to be offered and improvements made. Concerns raised about students achievement of required NMC standard (Documented Feedback) Mentor and student discuss concerns (Documented Feedback) Mentor and student develop action plan to address key concerns Additional support offered to student and mentor by notifying link lecturer Feedback If a student is failing to meet the required standard then this should be documented clearly within their practice assessment document. This documentation should be undertaken in addition to the documentation of any action plans. In most cases, the interim review is a good opportunity for both mentors and students to reflect on progress and to clearly document achievements and areas for improvement. The review of progress should be supported by evidence from the practice experience. It may be that evidence has been witnessed by people other than the main mentor, for example, members of the multidisciplinary team, service users or other mentors. The source of the evidence and who observed the evidence should be clearly documented. Action plans An action plan should be put in place by the mentor and student as soon as possible after concerns regarding competence are acknowledged. An action plan should clearly state what concerns are being addressed and what strategies will be put in place to aid a student in developing competence. Link lecturers must always be involved in the development and review of any action plans. 13

Identified areas for development of practice Jenny is consistently failing to perform accurate drug calculations for oral medications Jenny will need to consistently achieve 100% accuracy in calculating oral medications The first review of this plan will take place in 2 weeks Plan of support Jenny will be provided with sample drug calculations to practice her calculations Jenny will be given 30 minutes protected time per day to practice her calculations Resources and activities required Protected time at 2pm every day Sample drug charts from some service users Contact the link lecturer Support for students and mentors This will obviously be a very difficult situation for the mentor and student so it is important that both feel supported throughout the practice experience. If a student is not achieving the required standard then a mentor should seek support as soon as possible. Support can be offered in a number of ways by different people. Senior mentors and managers can offer support by sharing their wealth of experience in dealing with similar situations and also offering to share the workload or offering second opinions. Link Lecturers and the Trust/Organisation Named Person can also offer support through helping to develop action plans and guiding the mentor and student in ensuring NMC competencies are fairly assessed. Senior Mentors Senior Managers Support for Mentors and Students Link Lecturers Trust or Organisation named person 14

1.8 Advice for mentors supporting a student who has failed If a student does not achieve the required NMC standard of competence by the final assessment and interview of a summative practice experience then they will have failed the overall experience. Whilst an action plan can address areas of weakness; it does not always follow that the provision of an action plan will ensure a student achieves the required standard. Feedback If a student has failed to meet the required standard then this should be clearly and carefully explained, with evidence provided to support the final decision. If clear feedback has been provided throughout the practice learning opportunity then this should not come as a surprise to the student. The reasons for the student not achieving the learning outcomes should be documented clearly within their practice assessment document. It may be that evidence has been witnessed by people other than the main mentor, for example, members of the multidisciplinary team, service users or other mentors. The source of the evidence and who observed the evidence should be clearly documented. Ongoing achievement record The NMC requires the mentor who assessed the student to provide a summary of the students strengths, areas for development and weaknesses for the next mentor. It should provide an accurate account of any areas which the student will need to focus on if there are any concerns related to proficiency. If a student has failed to meet the required NMC standard at the summative assessment then this should be clearly documented within the ongoing record of achievement. The main aim of the ongoing achievement record is to provide evidence of the student s progression throughout the programme. The sign-off mentor will be reliant on clear documentation within the ongoing achievement record to confirm that all practice competencies have been met and there are no ongoing concerns about a student s fitness for practice. Support for students and mentors This will obviously be a very difficult situation for the mentor and student so it is important that both feel supported during this time. Senior managers, mentors, the Trust/Organisation Named Person and Link Lecturers can all offer valuable support. A student fails to achieve required NMC standard Mentor and student document reasons for failure Mentor and student seek support regarding future options 15

2.3 BSc (Hons) Nursing (Registered Nurse: adult, child, learning disability and mental health) (2011 curriculum) Throughout this three year programme students undertake both generic modules and field specific modules (adult field, child field, mental health field, learning disability field) Structure and content of programme Year Semester Theory Practice Year 1 Focus: This year introduces students to nursing and enables them to actively engage in developing their knowledge and skills in the principles and practice of nursing Year 2 Focus: Students engage in reasoned and evidenced based practice. The academic focus is on service users, their families and carers and establishing effective partnerships in practice. Year 3 Focus: Students will develop professional attributes enabling engagement in, and recognition of social and political, academic and healthcare challenges that shape nursing care. Semester 1 14 weeks 5 weeks Semester 2 12 weeks 10 weeks split 4 weeks and 6 weeks Semester 1 12 weeks 9 weeks Semester 2 9 weeks 9 weeks Semester 1 4 weeks 14 weeks Semester 2 6 weeks 14 weeks 16

Practice outcomes Students on this programme are required to achieve all eight practice outcomes by the end of their three year programme plus essential skills clusters. Students demonstrate these practice learning outcomes through undertaking practice learning opportunities, snapshot/episode of care assessments and assessment of key skills. All outcomes to be achieved are documented in the students practice assessment document. Year 1 8 Practice Learning Outcomes Snapshot/Episode of care assessment 1. Communication Year 2 8 Practices Leaning Outcomes Snapshot/Episode of care assessment 2. Individualised Care Year 3 8 Practice Learning Outcomes Snapshot/Episode of care assessment 3. Medicines Management 4. Management of Care Key Skills Assessment Including field specific assessment of competence Key Skills Assessment Including field specific assessment of competence Key Skills Assessment Including field specific assessment of competence Assessment in practice BSc (Hons) Nursing programme Students will be assessed throughout their three years of practice. On the BSc (Hons) programme the NMC requires that the mentor undertaking the assessment must: Be a registered professional and be listed on the local mentor register (1 st year) Be a registered nurse and be listed on the local mentor register (2 nd year) Be a registered nurse on the part or sub-part of the NMC Register that the student is intending to enter (3 rd year, first practice experience) Be a sign-off mentor, on the part or sub-part of the NMC Register that the student is intending to enter (3 rd year, final practice experience) Be available to directly or indirectly supervise the student for 40% of the time they are involved in delivering patient care 17

2.4 Postgraduate Diploma in Nursing (Registered Nurse: adult, child, learning disability and mental health) (2011 curriculum) Throughout this two year programme students undertake both generic modules and field specific modules (adult field, child field, mental health field, learning disability field) Structure and content of programme Year Semester Theory Practice Semester 1 Developing Knowledge and Skills for Nursing practice 10 weeks 17 weeks 1 (generic) Therapeutic Pharmacology in Nursing (field specific) Semester 2 Applying Clinical Reasoning and Decision-making in Nursing (field specific) 8 weeks 11 weeks 1 Implementation and Evaluation of Nursing (field specific) Evidence for Effective Nursing (generic) 2 Semester 1 Leadership, Management and Team working (generic) Personal and Professional Development in Nursing (generic) Complexities in Nursing (field specific) 7 weeks 12 weeks 2 Semester 2 Complexities of Service provision in Nursing (field specific) Health Improvement in Nursing (generic) Developing Nursing through Research and Innovation (generic) 11 weeks 16 weeks 18

Practice outcomes Students on this programme are required to achieve all eight practice outcomes and NMC Essential Skills Clusters by the end of their programme. Students demonstrate these practice learning outcomes through undertaking practice learning opportunities, snapshot/episode of care assessments and assessment of key skills. All outcomes to be achieved are documented in the students practice assessment document. Year 1 8 Practice Learning Outcomes Year 1 8 Practice Leaning Outcomes Year 2 8 Practice Learning Outcomes Snapshot/episode of care assessment 1. Communication Snapshot/episode of care assessment 2. Individualised Care Snapshot/episode of care assessment 3.Medicines Management 4.Management of Care Key Skills Assessment Including field specific assessment of competence Key Skills Assessment Including field specific assessment of competence Key Skills Assessment Including field specific assessment of competence Assessment in practice the postgraduate diploma in nursing programme Students will be assessed throughout their practice programme. The NMC requires that the mentor undertaking the assessment must: Be a registered nurse and be listed on the local mentor register (1 st year) Be a registered nurse on the part or sub-part of the NMC Register that student is intending to enter (2 nd year, first practice experience) Be a sign-off mentor, on the part or sub-part of the NMC Register that student is intending to enter (2 nd year, final practice experience) Be available to directly or indirectly supervise the student for 40% of the time they are involved in delivering patient care 19

3.1 Overview of mentor updating As a mentor/practice teacher, the NMC requires you to: attend a mentor/practice teacher update at least ONCE per annum keep a record of your mentoring activities in your Mentor Passport that will be issued to you along with your U.I. number. Further copies of your mentor passport are available on The NMC requires that practice/ placement providers maintain a record of current/live [verified] mentors and practice teachers and in partnership with local education providers, make provisions for annual face to face updating of mentors and practice teachers. These are normally delivered by a link lecturer with a representative from your Trust/Organisation. Face to face mentor updates Annual face to face updates Sign-off mentor update Mentor workshops/briefings Practice Assessment Document Audit event In addition, mentors/practice teachers should prepared to demonstrate to their employer and NMC quality assurance agents how they have maintained and developed their knowledge, skills and competence as a mentor/practice teacher. Self-directed Discussion with link lecturer Review of Kingston University Mentor Website Reading of mentorship articles / NMC circulars Mentors should inform their Trust / Organisation named person when they have attended a mentor update so this can be recorded on the live mentor register. 20

3.2 Introduction to the mentor/practice teacher passport The NMC requires that you maintain a record of your role and activities as a mentor/practice teacher. A mentor/practice teacher passport has been provided for you in order to maintain these records. A copy of the mentor passport is available for you to download on the Faculty of Health, Social Care and Education website. Mentor resources can be accessed at http:/// Your passport should be reviewed annually and available at your triennial review. Completion of the passport will help you to demonstrate that you have facilitated students in your role as a mentor/practice teacher and have also assessed their performance either formatively and/or summatively. Mentor/practice teacher passport sections The following sections are available in the passport to allow for clear documentation. Your organisation will consider this and other evidence of updating and student support as part of your triennial review. RECORD OF STUDENTS MENTORED MENTOR /TEACHING AND ASSESSING QUALIFICATIONS TRIENNIAL REVIEW ANNUAL MENTOR/ PRACTICE TEACHER UPDATE SESSIONS MENTORING INFORMATION/R ESEARCH REVIEWED OTHER MENTORING EVENTS/ MEETINGS 21

3.3 Undertaking your triennial review Once on the local register, mentors and practice teachers are required to undertake a triennial review. This involves a review of your mentorship practice over a three year period. The mentor/practice teacher passport allows you to document the evidence to show that you have met the NMC requirement to remain on the local register. Evidence required for triennial review Mentored at least two students (for practice teachers one student) within a 3 year period Participated in annual updating Explored the validity and reliability of judgements made when assessing in challenging circumstances Mapped your role against the NMC Mentor or Practice Teacher standards (NMC 2008) Meet all requirements to remain on the local register of Mentors & Practice Teachers Triennial review event This would normally take place as part of appraisal/ipr process. You can expect that the following will take place: Discussion and evidence to support personal reflection of mentoring role/responsibility Review of mentor/practice teacher passport Confirmation of continuation as a mentor/practice teacher signed/authorised within your annual appraisal/ipr system Once your triennial review has taken place, please inform your local Trust/Organisation Named Person responsible for maintaining the local Register of Mentors and Practice teachers who can update the Register accordingly. 22

4.1 Supervising pre-registration students in practice The NMC is very clear regarding the need for supervision of pre-registration students whilst they are undertaking their practice learning opportunities. At all times students must be directly or indirectly supervised in the practice setting. The mentor s responsibility is to plan and coordinate the student s whole learning experience, determining the amount of direct supervision required by the mentor, and what experience may be through indirect supervision (student working independently). Some experience may be supervised by others, (other professionals, mentors or practice teachers). The named mentor is accountable for their decisions to let the student work independently with others. (NMC, 2008, p. 31) Direct Supervision Mentor is directly observing and supervising the care the student is delivering. Indirect Supervision Mentor is not physically present for all aspects of the care episode Directly watching or listening to care being delivered The mentor is aware of the care the student is providing and can be readily contacted. Indirect supervision can also mean that a mentor is available, rather than physically present. Being available can include telephone, Skype, email or bleep. This means that a student can undertake a range of learning experiences with other healthcare professionals with a mentor available for contact if required. 23

Insight learning experiences Nursing Practice learning opportunities are an essential element for developing registrants who are competent to practice in primary, secondary and tertiary care settings in all fields across all providers and within very diverse populations. A variety of practice learning opportunities will provide students with the experiences they need to relate theory to practice; develop skills and achieve their required competencies in their chosen field of nursing. The NMC requires all pre-registration nursing students who commenced their programme after September 2011 to have learning opportunities that provide contact with a range of client groups. (NMC 2010a) These client groups include: Babies Adults Children Older people Young people People with acute conditions Pregnant women People with mental health problems Postnatal women People with learning disabilities People requiring end of life care People with long term conditions In order to facilitate this learning some students may have an opportunity of undertaking a practice learning opportunity in a field of practice that is different to their own field. Where this occurs, it may be referred to as an insight learning experience. In addition, some students may gain insight into other fields of practice through outreach learning experiences. Mentoring students during insight learning experiences Initial interview Midpoint review Final review Establish the field of nursing in which the student is enrolled Discuss the learning opportunities available for the student to gain insight into your field of nursing Plan together how learning outcomes can be met during the practice experience Reflect with the student on their progress in meeting learning outcomes Use the interim review action plan to highlight any learning needs and plan for specific learning experiences that will aid the student to gain insight into your field of nursing Final assessment and documentation of learning outcomes Document comments related to summative assessment Document in the ongoing achievement record indicating any areas of future development 24

4.3 Outreach learning experiences In order to achieve learning outcomes and to engage with a wide variety of practice learning opportunities it is expected that students will be encouraged to undertake a range of outreach learning opportunities during the practice learning opportunity. Outreach learning experiences should be relevant to their overall learning outcomes and expose students to a wider range of learning opportunities than they would otherwise achieve by staying in one practice area. Benefits of outreach learning experiences Students experience different fields of practice Students can work with a wider range of healthcare providers Students exposed to opportunities for interprofessional learning Students are able to follow the patient / service user journey Students are able to pursue particular areas of interest related to their learning outcomes The type, number and location of any outreach opportunity will be dependent on the type of practice experience and the local opportunities available. Mentor indirectly supervises Outreach learning experience Mentor indirectly supervises Outreach learning experience Base learning experience Mentor directly and indirectly supervises 25

Examples of outreach learning experiences Practice learning experience - adult student Base experience - Surgical Ward in Hospital Outreach One day in theatre working with operating department practitioners in the anaesthetic room Outreach One week working with acute pain team, assessing inpatients and attending outpatient follow-up clinics Outreach Three days of working with occupational therapists, undertaking home visits for patients being discharged Practice learning experience - child student Base experience - Paediatric Community Team Outreach One week in Children's Outpatient A&E working with triage nurse Outreach Three days of working with London Ambulance Service attending emergency calls Outreach One day working with NHS Direct nurses Practice learning experience - mental health student Base experience - Acute Mental Health Service Outreach One day of working with 'Mind' art facilitators and service users Outreach One week working with Community Psychiatric Nurses Outreach Three days of working with Practice Nurses undertaking 'new patient' assessment in GP practices Practice learning experience - learning disability student Base experience Service Users home Outreach One day working with local adult education services Outreach One week working with social workers or care managers Outreach Three days of working with local 'Mencap' drop-in service 26

Mentoring students on outreach learning experiences Outreach learning experiences expose students to a wider range of learning opportunities than they would otherwise achieve by staying in one practice area. The type, number and location of any outreach opportunity will be dependent on the type of practice experience and the local opportunities available. As the mentor of a student undertaking outreach learning experiences you will need to adopt a flexible approach to how you stay in touch with your student and ensure that you are able to indirectly supervise them. One day outreach experience with mental health art facilitator at MIND Three days outreach experiences with occupational therapists based in hospital One week outreach experiences with social workers in local council services Mentor aware of where student is for the day and able to contact Mentor and student on the same shifts Mentor aware of where student is and able to contact Mentor and student on the same shifts Mentor aware of where student is for the week and able to contact Mentor and student on the same shifts Student and art facilitator able to contact mentor by phone if needed Student and occupational therapists can phone or return to ward to contact mentor Student and social workers contact mentor by phone at midpoint in the week At the completion of the outreach learning experience the student and facilitator should document the details of the experience within the practice assessment document. There is a section available for the student to reflect on the experience and the facilitator to write comments related to the students performance and learning. Staying in touch For short outreach experiences the student and mentor may not need to contact each other directly, especially if the student is being supported by another healthcare professional during the learning experience. For longer outreach experiences, it is good practice for the mentor, supervisor and student to agree a pre-arranged time to make contact, either in person or by phone. 27

4.4 Snapshot/episodes of care practice assessments As part of the practice assessment strategy some students may be required to undertake a snapshot /episode of care practice assessment during their practice learning opportunity. Snapshot/episode of care assessments generally focuses on one aspect of competence where the student must demonstrate a range of related skills. Example of snapshot/episode of care assessment Communication with a service user Establishes rapport Effective communication Engaging and responsive Closes interaction Effective introduction Gains consent Demonstrates compassion, dignity etc Maintains confidentiality Appropriate verbal and nonverbal communication Demonstrates empathy Responds to, and poses questions Attentive, warm and kind Responds appropriately Listens and watches for verbal / nonverbal clues Asks appropriate questions Confirms what has been said Summarises conversation Takes leave in caring way Maintains professional boundaries Role of the mentor in snapshot/episode of care assessments A snapshot/episode of care assessment will be pre-printed for mentors in the students practice assessment document. Mentors should discuss with students at the initial interview the most appropriate time for the assessment to take place. This should include opportunities for the student to gain experience in relation to the assessment criteria and obtain feedback on their performance. Mentor and student agree to undertake snapshot/episode of care assessment Mentor and student familiarise themselves with assessment criteria Mentor directly supervises student undertaking snapshot/episode of care assessment Mentor judges if student has demonstrated assessment criteria Mentor writes justifying comments to support assessment decision Mentor judges if student has passed or failed snapshot/episode of care assessment 28

4.5 Service users contribution to practice assessment The NMC requires service user and carers to contribute to the assessment process of preregistration students (NMC, 2010). This means that students who began their programme after September 2011 need to obtain comment from service users during each practice learning opportunity. The term service user includes clients, patients, relatives, carers and significant others. It is recommended that mentors discuss with the student how service user feedback will be obtained during the practice experience. This is best done at the practice orientation. The service user feedback can be recorded in the Service Users Comments pages in the Practice Assessment Document. Before obtaining feedback the mentor should ensure that the service user consents to having their comments recorded in the practice assessment document. The service user should be advised that they will remain anonymous and any discussion held in confidence by the student, mentor and university. Initial Interview Mentor and Student discuss how service user feedback will be obtained Mentor gains consent from service user Service user documents feedback following explanation from mentor Mentor gains consent from service user Mentor documents feedback obtained from service user. Final Interview Mentor reflects on user/carer feedback to inform Ongoing Achievement Record. 29

4.6 Documenting the ongoing achievement record The NMC requires the mentor who assessed the student to provide a summary of the students strengths, areas for development and weaknesses for the next mentor. It should provide an accurate account of any areas which the student will need to focus on if there are any concerns related to proficiency. The main aim of the ongoing achievement record is to provide evidence of the student s progression throughout the programme. The sign-off mentor will be reliant on clear documentation within the ongoing achievement record to confirm that all practice competencies have been met and there are no ongoing concerns about a student s fitness for practice. Strengths Mentors should provide a documented overview of learning outcomes that have been achieved Specific examples of particular strengths should be included Issues and areas of concern Mentors should provide a documented overview of learning outcomes that have not been achieved Specific examples of particular areas of concern should be included Developmental needs Mentors should provide advice to the student and next mentor of what areas require development Specific examples of where improvement are needed should be included 30

4.7 How your students evaluate practice Students evaluate their practice learning opportunities in a number of ways. Students and mentors should evaluate the overall practice learning opportunity at the final interview. This will give mentors/practice teachers first hand feedback on the students experience and assist with planning learning opportunities for future students. This could be undertaken verbally and/or by completion of a written evaluation. Evaluation can also take place in a student support group and may involve the Trust/Organisation Named Person. This allows the organisation to gain an understanding of students learning experience. Students are required to formally evaluate their practice learning opportunity once they return to the university. Students are asked to respond to a series of questions that relate to the NMC Standards to Support Learning and Assessment in Practice (NMC, 2008). The results of this survey are collated by the university and shared with the Trust/Organisation Named Person. Student completes University evaluation including multiple choice and free text responses Evaluation results collated by University and shared with the Trust/Organisation Named Person Trust/Organisation named person shares results of student evaluation with individual practice areas Evaluation results Practice areas should use evaluation results to develop the practice learning opportunity for students in their areas. Individual student feedback and overall evaluation results can be a useful way for mentors to gauge their own mentoring performance and indentify changes that could be made in the practice area to improve the student learning experience. Evaluation results will also be reviewed within the Educational Audit for each practice learning area. Improving the practice learning opportunity - example following student evaluation Student evaluates they did not know who their mentor was on first day Students identify they would like to attend MDT meetings Practice area identifies mentor allocated to student in orientation pack and off-duty Dates, times and location of MDT meetings identified on student notice board 31

5 NMC Sign-off mentors In order to safeguard the health and wellbeing of the public, the NMC must be assured that preregistration nursing and midwifery students have been assessed and signed off as capable of safe and effective practice at the end of a programme. Accountability of NMC sign-off mentors Consider evidence from students practice Judge if all competencies have been met If proficient sign off practice part of programme Consider evidence from students practice Judge if all competencies have been met If not proficient do not sign off practice part of programme Accountable to the NMC Nurse mentors make sign-off decisions at the end of the programme Midwife mentors make sign-off decisions at a progression point and end of the programme Accountable to the NMC Support for NMC sign-off mentors As a sign off mentor, as part of the role, you should have protected time of one hour per week to perform the role. Protected Time Protected Time Protected Time Reflection on student s competence Feedback to student on their competence Documentation of feedback given in assessment document Additional support from link lecturers, Trust/Organisation Named Person and other mentors is also available to assist you in decision making. 32

Criteria for NMC sign-off mentors The NMC requires that mentors or practice teachers who make the final decision regarding a student s competence for registration must fulfill additional criteria to be a sign-off mentor. Be on the same part of the register and in the same field of practice as the student Clinical currency and capability in the field of practice in which the student is being assessed In-depth understanding of accountability to the NMC Understand the NMC registration requirements and the contribution they make to meet these requirements. Meet the NMC requirements to remain on the local register Working knowledge of current programme requirements, practice assessment strategies and relevant changes in education and practice How to become a NMC sign-off mentor From 2007, the NMC stipulated that midwives will complete their sign-off mentor development as part of their mentorship preparation programme. Nurses complete their sign-off mentor development (normally) outside of their mentor preparation programme via their employing Trust/Organisation. To become a sign-off mentor a mentor or practice teacher needs to assess 3 final placement students (nursing) or 3 midwifery students at progression points under the supervision of a mentor or practice teacher already designated as a sign-off mentor on the mentor register. The NMC has stated that u p t o t wo of these sign-off s can be done as simulated learning. but the final signing off must be with a final placement/progression point student. Local Trusts and Organisations are responsible for the identification of suitable sign-off mentors. Download the NMC sign-off criteria (NMC Circular, 26 March 2010 - NMC 2010b) Frequently asked questions Who decides if I am a sign-off mentor? Your Trust/Organisation will let you know if you are required to undertake this role, it will not be your decision to opt in or out. Can I mentor students while I am undertaking the additional sign-off mentor training Yes, as long as you are a qualified mentor you can continue to mentor and assess students. If I leave my organisation can I be a sign-off mentor elsewhere? Yes, however you may need additional evidence to support your competency for this role within the new organisation. 33

The role of the NMC sign-off mentor As a sign-off mentor you will be expected to review all of the student s previous practice assessment documentation to ensure that any concerns raised earlier in the programme by previous mentors have been appropriately addressed. You must be satisfied that all appropriate practice assessments have been undertaken with any concerns or issues followed up/addressed. If you are a nurse sign-off mentor you will also undertake the final practice assessment of the student and complete the required documentation. If you are a midwife s ig n - o f f mentor you will also undertake assessment at the progression point and also the final practice assessment of the student and complete the required documentation. You should use the protected time of one hour per week that you are allocated to perform this role to reflect on the overall performance of the student, provide written and verbal feedback in the student s assessment document / ongoing record of achievement and maintain records in your mentor passport. Example Sign-off mentor reviews students practice assessment document Previous mentor noted a weakness in communication with service users Sign-off mentor develops action plan with student to address communication Sign-off mentor arranges learning experiences that support developing communication skills and provides feedback Sign-off mentor makes final decision related to practice competency Communication learning outcome, and all current learning outcomes are achieved Learning outcome related to communication not achieved Sign-off mentor continues to assess all current learning outcomes and provide feedback Sign-off mentor decides required practice proficiencies have been achieved If you consider that the student has not reached the desired level of proficiency; you must not sign the student as proficient. In this case you should provide the student with clear feedback, document your reasons clearly and seek support from your link lecturer and the Trust/Organisation Named Person responsible for student support and placements Becoming a sign-off mentor If you are not a sign-off mentor and wish to become one. Please contact your local Trust or Organisation Named Person who can advise you attending and completing a sign-off mentor development programme. 34

NMC Sign-off mentor checklist NURSING - Is the preregistration student in their final practice placement? MIDWIFERY - Is the preregistration student at a progression point or in their final practice placement? Is the sign-off mentor in the same field of practice as the student? Ye s allocate a sign-off mentor Yes allocate a sign-off mentor Yes no action needed No sign-off mentor not required, allocate a mentor No sign-off mentor not required, allocate a mentor No check with your Trust/Organisations Named Person to identify a suitable verified sign-off mentor Is the sign-off mentor available for 40% of the student s time in practice Yes no action needed No ensure the student is rostered to be at work with the sign-off mentor for 40% of the students time Has the sign-off mentor been allocated an hour of protected time a week Yes no action needed No address with Trust/Organisation Named Person and manager for action plan/allocation of time Is the sign-off mentor available to assess all the final practice requirements of the student and document the outcome? Yes no action needed No inform manager and contact the link lecturer and Trust/Organisation Named Person to discuss action plan. Is the sign-off mentor available to review all of the students practice documents Yes complete documentation and declaration as such No contact your link lecturer and Trust/ Organisation Named Person to discuss concerns. Document these also. Does the sign-off mentor have any concerns about the students practice? Yes - contact your link lecturer and Trust/Organisation Named Person to discuss concerns document these. No no action needed Does the sign-off mentor need any additional support? Yes seek support from colleagues and contact your link lecturer and Trust/Organisation Named Person No but reflect on your experience with colleagues and other mentors/sign-off mentors 35

References Nursing and Midwifery Council (2010a) Standards for pre-registration nursing education London: Nursing and Midwifery Council Online Available at http://standards.nmcuk.org/pages/welcome.aspx (accessed 10 January 2015) Nursing and Midwifery Council (2010b) Sign-off mentor criteria London: Nursing and Midwifery Council Online Available at http://www.nmcuk.org/documents/circulars/2010circulars/nmccircular05_2010-1.pdf (accessed 10 January 2015) Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice NMC Standards for Mentors, Practice Educators and Teachers (2 nd edn.) London: Nursing and Midwifery Council Online Available at http://www.nmc-uk.org/documents/nmc-publications/nmc- Standards-to-support-learning-assessment.pdf (accessed 10 January 2015) Abbreviations CPPD IPR MDT NMC OAR OMP ONP RTP U.I. Continuing Personal and Professional Development Individual Performance Review Multi Disciplinary Team Nursing and Midwifery Council Ongoing Achievement Record Overseas Midwifery Adaptation Programme Overseas Nursing Adaptation Programme Return to Practice Unique Identification Number 36

Appendix 1 Mentor and Practice Teacher Passport (updated January 2015) 37

FACULTY OF HEALTH, SOCIAL CARE AND EDCUATION In partnership with local NHS trusts and organisations in London and Surrey Mentor and Practice Teacher Passport Name: Trust/Organisation Base: Mentor Unique Identification no: Passport valid From: To: KSF Dimensions: Core 1 and 2, G1 Mentors/Practice Teachers must develop their own knowledge, skills and competence beyond that of registration and be formally prepared for the role. (NMC 2008) A record of training and development undertaken should be kept and made available for triennial review: the Mentor/Practice Teacher Passport has been designed to aid this. A Mentor is: A registrant who has met outcomes of NMC Mentor stage 2 and who facilitates learning, and supervises and assesses students in a practice setting (NMC 2008) A Practice Teacher is: A registrant who has gained knowledge, skills and competence in both their specialist area of practice and in their teaching role, meeting the outcomes of NMC Practice Teacher stage 3, and who facilitates learning, supervises and assesses students in a practice setting (NMC 2008) Reference: Nursing and Midwifery Council (2008) Standards to support learning and assessment in practice NMC Standards for Mentors, practice educators and teachers 2 nd edn. London: Nursing and Midwifery Council Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2015

Mentor/teaching and assessing qualifications Date obtained Place of Study Course/Programme Annual mentor/practice teacher update sessions to include sign-off mentor development, mentor updates etc. Date Where attended Facilitator - name/signature Other mentoring events/meetings e.g. Mentor Link Group Date Event Facilitator - name/signature Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2015

Mentoring information/research reviewed e.g. articles read, web-based learning, moderating committees etc. Date Activity/Evidence Date of annual review and discussion with Manager Triennial review Signature/Name of Manager Comments NMC Eight Domains Self assessment competency statement completed: Date: Date of Triennial Review: Has the Mentor/Practice Teacher evidence of: Yes/No Signed Manager Mentored two students with due regard in last 3 years (Practice Teachers one student)? Participated in annual updating? Explored the validity and reliability of judgements when assessing practice? Mapped role development against current NMC Mentor/Practice Teacher standards? Met all NMC requirements to stay on local register? Please note: All points above must be met to remain on the local register Outcome: Remain on the local register? Yes / No Signature/Name of Manager Mentor Register co-ordinator informed of the decision of the Triennial review Name of Mentor Register co-ordinator Date informed Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2015

Record of NMC Pre-registration or NMC Workforce development students mentored Date from: Date to: Name of pre-registration student / ID no: Signature of student Cohort/Course Developed in partnership between local Trusts/Organisations and Practice Partners and The Faculty of Health, Social Care and Education, Kingston University/SGUL For review: January 2016

Appendix 2 NMC Stage 2 Mentors checklist for triennial review (Updated January 2015) Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2012

FACULTY OF HEALTH, SOCAL CARE AND EDUCATION AND PARTNER TRUSTS AND ORGANISATIONS Developmental framework for a standard to support learning and assessment in practice Nursing and Midwifery Council Standards to support learning and assessment in practice 2 nd edition NMC 2008 Name of Mentor/sign-off mentor Date completed Mentor/sign-off mentor to map their on-going development in their role as a mentor against the NMC Stage 2 Mentor Standards (NMC 2008 p11) Domain NMC Mentor Stage 2 List of evidence to support achievement provided Demonstrate effective relationship building skills sufficient to support learning, as part of a wider interprofessional team, for a range of students in both practice and academic learning environments 1. Establishing effective working relationships Develop effective working relationships based on mutual trust and respect Demonstrate an understanding of factors that influence how students integrate into practice settings Provide ongoing and constructive support to facilitate transition from one learning environment to another Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2012

Facilitate learning for a range of students, within a particular area of practice where appropriate, encouraging self-management of learning opportunities and providing support to maximise individual potential 2. Facilitation of learning Use knowledge of the student s stage of learning to select appropriate learning opportunities to meet individual needs Facilitate the selection of appropriate learning strategies to integrate learning from practice and academic settings Support students in critically reflecting upon their learning experiences In order to enhance future learning Assess learning in order to make judgments related to the NMC standards of proficiency for entry to the register or for recording a qualification at a level above initial registration 3. Assessment and accountability Foster professional growth, personal development and accountability through support of students in practice Demonstrate a breadth of understanding of assessment strategies and ability to contribute to the total assessment process as part of the teaching team Provide constructive feedback to students and assist them in identifying future learning needs and actions, manage failing students so that they may enhance Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2012

their performance and capabilities for safe and effective practice or be able to understand their failure and the implications of this for their future Be accountable for confirming that students have met or not met the NMC competencies in practice and as a signoff mentor confirm that students have met or not met the NMC standards of proficiency and are capable of safe and effective practice Determine strategies for evaluating learning in practice and academic settings to ensure that the NMC standards of proficiency for registration or recording a qualification at a level above initial registration have been met 4. Evaluation of learning Contribute to the evaluation of student learning and assessment experiences, proposing aspects for change resulting from such evaluation Participate in self and peer evaluation to facilitate personal development and contribute to the development of others Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2012

Create an environment for learning, where practice is valued and developed, that provides appropriate professional and interprofessional learning opportunities and support for learning to maximise achievement for individuals 5. Creating an environment for learning Support students to identify both learning needs and experiences that are appropriate to their level of learning Use a range of learning experiences, involving patients, clients, carers and the professional team, to meet defined learning needs Identify aspects of the learning environment which could be enhanced negotiating with others to make appropriate changes Act as a resource to facilitate personal and professional development of others Support learning within a context of practice that reflects health care and educational policies, managing change to ensure that particular professional needs are met within a learning environment that also supports practice development; 6. Context of practice Contribute to the development of an environment in which effective practice is fostered, implemented, evaluated and disseminated Set and maintain professional boundaries that are sufficiently flexible for providing interprofessional care Initiate and respond to practice developments to ensure safe and effective care is achieved and an effective learning environment is maintained Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2012

Apply evidence-based practice to their own work and contribute to the further development of such a knowledge and practice evidence-base 7. Evidencebased practice Identify and apply research and evidence based practice to their area of practice Contribute to strategies to increase or review the evidence base used to support practice Support students in applying an evidence base to their own practice Demonstrate leadership skills for education within practice and academic settings 8. Leadership Plan a series of learning experiences that will meet students defined learning needs Be an advocate for students to support them accessing learning opportunities that meet their individual needs involving a range of other professionals, patients, clients & carers Prioritise work to accommodate support of students within their practice roles Updated January 2015 tg Developed in Partnership with Kingston University & St Georges, University of London and Practice Partners Mentorship Resources 2012