Evaluation of Learning Environment for Facilitating Learning and Assessment

Introduction:

Nursing being a practice-based profession mandates the requirement of a good learning and assessment environment. Lynch (2009) states that the nursing profession has a commitment to constant development and improvement of clinical practice to ensure the highest standards of care and treatments are provided. As such, placements play a key role in the progression of student nurses as it provides a platform to expand their theoretical knowledge and gain practical skills from their exposure to real clinical environments (Moscaritolo, 2009). When a student nurse is introduced to a department, they require a lot of support and guidance to familiarise themselves with the day to day routine and operations of the role within the team. The support and guidance eventually become the building blocks for their careers. In fact, Walsh (2010) suggested that the creation of a positive learning environment is at the heart of mentoring.

Aim: This study evaluates the learning environment provided to students during their placement period.

Objective:

• Discuss the factors that influence learning in students.
• Assess the significance of effective feedback to students
• Analysis of the role played by the mentor for student development.
• Discuss and summarise the efforts taken by my placement area for facilitating student learning.

Literature review:

Factors that influence learning

Among the many factors which influence learning for a student nurse; time, tool and training stand out as the main are the foundational elements of learning. These three primary factors are essential for providing quality practical education and experience, thereby promoting the successful progression of a student nurse. Wilkes (2006) identified the lack of time as a major constraint to effective learning. Student nurses gain experience by being exposed to various individual approaches and ways of working. Thus, during their clinical placements individuals such as the registered and auxiliary nurses are crucial learning sources for a student nurse. This view is supported by Earnshaw (1995) who found that student nurses not only learn from their mentors, but also perceive all staff from auxiliary nurses to sisters as taking on many aspects of the mentoring roll. But the lack of time these individuals have due to the fast paced and busy nature of work creates a scenario, where only limited time is available to support the student nurses. This leads to the isolation and the consequent misguidance of student nurses.

Similarly, insufficient supplies of tools or equipment have an adverse effect on the learning experience of student nurses. The absence of equipment in any one department is often resolved by inter-departmental sharing, which can also become time consuming. On the other hand, if equipment is scarce it leads to a situation wherein the more senior and experienced staffs become solely exposed to them. This in turn, means that student nurses are minimally exposed to this equipment thereby impinging on a learning opportunity.

Thirdly, training is the other key factor that influences the learning of students. It aides in the development of skills in an area where confidence is needed or acquiring more knowledge. Therefore, the lack of training impedes the growth of student nurse. Training not only benefits the students by keeping them updated, but also renders to provide quality nursing care to the patients.

Significance of effective feedback

A good learning environment also integrates effective feedback as an essential tool in the development of student nurses. In fact, effective and constructive feedback will not only help the students but also benefits the patients (Gigante et al ,2013.). Constructive feedback paves way for good teamwork, identifying areas where work is needed, encourages career progression, increases communication between the senior staff and student nurses and enhances the productivity of the task performed. Hence, Duffy (2013) pointed out that constructive feedback was the best type of feedback. Conversely, providing negative feedback can also have an adverse effect on the confidence students and can discourage them to take on more responsibility. Darling (1986) pointed out that negative feedback based on the mentor’s power play can leave students with low self-esteem. Hence, it is essential that during the placement period a student nurse receives constructive positive feedback regularly to aid their growth as a nurse.

Analysis of the role played by the mentor

A mentor plays a decisive role for shaping the learning experience of student nurses. West et al (2007) describes the mentor as the key figure of respect and admiration that students can look up to. It is then by no coincidence that the mentors are essential in identifying existing skills, helping to develop new skills, reviewing documentation, encouraging taking on new responsibilities, supporting in the areas where help is needed and providing guidance throughout nurses’ training. Burns and Patterson (2005) suggested that apart from support in the development of clinical skills, mentors should also engage in critical thinking and refection on practice. As the actions of mentors are closely observed by students, it is necessary for them to perform professionally at all times according to the guidelines set by the NMC. This is also supported by Valentine (1997) who stated that unprofessional, unethical and inappropriate behaviours can easily be adopted by students, as role modelling relies heavily on observation.

Discussion

During the placement period, I ensured that the aforementioned factors were integral in my practice and role as a mentor. In my ward, there is a system whereby student nurses are able to shadow registered nurses. This provides timely guidance and support for the students. It proved beneficial as the students were not left alone and were constantly supervised. These shadowing periods were constructive for students as they were able to enhance their nursing skills by taking observation of patients, admitting patients on to the computers, supervise drug rounds and learn different techniques such as catheterisation. Being guided by the registered nurse in all these procedures, allows the student to build confidence while undertaking a new task. When it comes to providing exposure to new tools or equipment, preparations were made well in advance to ensure tools were at disposal for students to take advantage of and to learn from. For example, I was able to teach students under my care how to use the bladder scanner, BM machine, ECG machine and the observation machine to check vital signs such as blood pressure and heart rate. The NMC (2015) code of conduct states that nurses should keep knowledge and skills up to date, by taking part in regular and appropriate learning to develop professionally. I have constantly made effort to update my clinical skills annually in order to embrace any changes in practice, which in turn I have shared with my mentees thereby hoping that to provide better patient care, overall. For instance, I was able to teach about safe guarding of adults, basic life support, infection control and the use of aseptic techniques. Students were also provided with learning material through internet or notes to increase their awareness.

As mentioned above, feedback is essential for the learning of a student. My students are unrestricted and encouraged to ask questions, to promote healthy psychological learning. West (2009) states a stimulating and encouraging environment lessens students’ feelings of remoteness and isolation, which is key in their learning. As such, I made sure that I asked my colleagues feedback on my mentees performance when I was absent. I was then able to collate this with my own perception of the students to provide my students with constructive feedback. Jarvis (2000) noted that “practice is the basis not only for or reflective learning, but also on the basis on which we construct our own theory”. I always made sure that at the end of our shifts together, to ask my students to reflect on what they had learnt from the day and what possible changes they could bring into practice; this I hope aides in the consolidation of their learning.

The clinical environment can be strange and stressful (Walsh 2010). Hence, students look for inspiration to those role models who portray positive, caring and compassionate attitudes and behaviour. In my opinion to be a good role model it is extremely vital to be compassionate. Therefore, I have made sure that I remained approachable and supportive to any student coming for help and guidance. I have strived to provide them with constructive feedback, encouraging them to take on new tasks or responsibilities and training them in areas which are usually challenging. Taking teaching sessions for my students, has helped me to identify gaps in my own theoretical knowledge and has promoted learning in me.

Conclusion

In conclusion this study has outlined the importance of different factors that influence learning in students’, such as to promote a culture of positive learning environment for the development and improvement of the students. The procedures and guidelines which are adopted by my placement area have proved to be working and beneficial to the students. This study also illustrates the influence of providing constructive feedbacks as the most evitable aspect of mentorship to promote confidence and self-esteem in students. As mentioned above, regular constructive feedback has demonstrated to be fundamental as it helps students as well as me as a mentor. Furthermore, it has highlighted the role played by mentors in shaping the nurses of tomorrow. Thereby, exploring the key attributes a mentor should possess to make the learning process of the student in the placement period more productive and successful.

References

• Burns, I. and Paterson, M.I. (2005) Clinical practice and placement support: supporting and learning in practice. Nurse Education in Practice5(1): pp 3-9
• Darling, L.A. (1986) cited in Duffy, K. (2013) Providing constructive feedback to students during mentoring. Nursing Standard 27(31): pp 50-56.
• Duffy, K. (2013) Providing constructive feedback to students during mentoring. Nursing Standard 27(31): pp 50-56.
• Earnshaw, G.J (1995) cited in Andrews, M. And Roberts, D. (2003) Supporting student nurses learning in and through clinical practice: role of the clinical guide. Nurse Education Today 23(7): pp 474-481.
• Gigante, J. Dell, M and Sharkey, A. (2011) Getting beyond “good job”: how to give effective feedback. Paediatrics 127(2): pp 205-207.
• Jarvis, P (2000) Adult and Continuing Education: Theory and Practice. London: Routledge Falmer.
• Lynch, Lisa. (2009) Clinical Supervision for Nurses, John Wiley &sons Ltd McIntosh, Annette (2010) Key Concepts of Healthcare Education, Sage production.
• Moscaritolo. (2009) L.M. Moscaritolo Interventional strategies to decrease nursing student anxiety in the clinical learning environment. J. Nurs. Educ., 48 (2009), pp. 17-23

• Nursing and Midwifery Council (2015) The code-standards of conduct, performance and ethics for nurses and midwifes. NMC London.
• Valentine, K. (1997) cited in Twentyman, M., Eaton, E. and Henderson, A. (2006) Enhancing support for nursing students in the clinical setting. Nursing times.net. Available from: www.nursing times.net/enhancing-support-for-nursing-students accessed on 12/08/2018.
• Walsh, D. (2010) The Nurse Mentor’s Handbook. Maidenhead: Open University Press.
• West, Sue., Clark, Tim., & Jasper, Melanie, (2009) Enabling Learning in Nursing and Midwifery Practice, London: John Wiley & Sons Ltd.
• West, S. Clark, T. and Jasper, M. (2007) Enabling Learning in Nursing and Midwifery Practice. Chichester: John Wiley and Sons, Ltd.
• Wilkes, Z. (2006) The student-mentor relationship: a review of the literature. Nursing Standard 20(37): pp 42-47.