CHAPTER 3. Preparing for Students
Chapter Aims
The purpose of this chapter is to gain insight into the preparation that may be required prior to mentoring a student. After reading this chapter you will be able to:
• Identify the key elements of a learning environment.
• Evaluate strengths and weaknesses of your own student preparation.
• Plan effectively for a student’s arrival.
Before the student arrives
The fact that students spend 50% of their programme on practice placements can result in some areas having a constant flow of students through the door. For many mentors, having students in your practice area on a regular basis can end up feeling like it’s part of the routine, especially if new students are arriving almost weekly. However, spare a thought for the student in all this. While you may tend to see them as ‘just another student’, they will arrive in your practice area with all the fears and anxieties that are entirely normal when entering a foreign environment. From the student’s point of view, the first day of placement is vitally important.If a student feels welcomed straight away, this is the best possible start and they will be more likely to maintain a positive outlook throughout the entire placement. There is just no substitute for a student going home after the first day thinking ‘I love my ward/unit/clinic/day centre’. However, if a student gets off to a bad start they will feel very let down, and even more anxious about the weeks to come.
Student expectations
Every student that commences placement in your practice area will arrive with a certain set of expectations. These expectations will be based partly on previous experiences, partly on the information they may have received from other students and/or the university, and partly on any previous contact they may have had with your practice area. This may have been in the form of a pre-placement visit or by looking at on online profile of the placement. If a student’s expectations are not met they may begin the placement with a negative mindset. On the other hand, meet these expectations and the placement can begin on a high note.
Likewise, you will also have expectations about the student. If your student meets these expectations on the first day this will no doubt influence your opinion regarding them. If they do not meet your expectations then no doubt you may feel let down and frustrated. Yet the expectations that students and mentors may have for each other may be based on unreasonable or unrealistic assumptions or misunderstandings that can only be resolved through honest and open communication. This type of communication must take place before the placement begins, and as such, is a vital part of pre-placement preparation. This means that before a student arrives in your practice area you will need to have prepared specifically for their arrival. You should not rely on the hope that everything will just magically fall into place; it will take planning, co-ordination and communication throughout your whole team.
In this chapter we will explore issues you should consider when preparing for a student’s arrival, how to identify potential problems, and specific aspects of preparation such as information packs and off-duty considerations. It is only once these preparations are considered that you will be fully prepared for accepting students into your learning environment.
Is your practice area prepared?
Let us assume that a student nurse is starting their placement in your practice area next week. Now stop and think for a moment. Would you be prepared? Before you consider the answer, have a look and reflect on the following two questions:
1. Is there any particular preparation that is routinely done by your clinical area before a student arrives?
2. Is there a system in place that ensures that the staff in your area are prepared for students’ arrival?
Time for honesty
If you have answered yes to both of these questions, then this is great, your practice area is well on the way to preparing for students. You will be able to use this chapter to identify ways that you may be able to develop and improve on your current practices. However, if you have answered no to either or both questions then the fact is that your area is not at all prepared for students.
Without specific preparatory systems in place the truth is that students will be faced with a ‘lucky dip’ of experiences on their first day. They may get lucky and have a positive experience and be welcomed, however they are just as likely to be ignored, forgotten or made to feel unwanted. Consider the scenario in Case study 3.1.
Case study 3.1
A student speaks about her first day of placement
‘My worst experience was in my second year when I started a placement in a day-care clinic. I had already done a pre-placement visit the week before and met the manager who was lovely, so I turned up on my first day feeling really confident. It was just awful, because the manager was off sick and hadn’t told anyone I was coming. The nurse in charge was new herself and was really rude. She said I must be in the wrong place because the manager had not said anything about expecting a student. I had to call the university to prove that I was meant to be there, and even then she didn’t apologise. I just felt in the way the whole day, as if it was my fault that I had turned up when the manager was off-sick. No one knew who my mentor was meant to be and I was just told to wait until the manager returned the next day. It was just the worst day ever.’
Quite obviously the events outlined in Case study 3.1 are just unacceptable, and from a mentor’s perspective, highly unprofessional. However, without an identified plan, a student’s first day can easily become a horrible experience for them. Sometimes it goes wrong due to unforeseen circumstances such as low staffing numbers due to sickness; however, often it reflects poor preparation or inexperienced mentors. Unfortunately this is a reality that is all too common, and while it is rarely the result of deliberate actions, this does little to rectify the situation. If a student’s first experience of practice is of feeling unwanted and rejected, you will find yourself in the unhappy position of having to salvage the placement by re-establishing trust before you can move on.
What can go wrong?
Crossing your fingers and hoping that the first day of a student’s placement just works out is not the way to ensure a student has a satisfactory placement in your clinical area. You will need to accept therefore that quite a bit of planning and preparation needs to go into your clinical environment before a student arrives.
Obviously the best-case scenario in Activity 3.1 represents what would be the ideal first day for any student. However, the reality is that very often it is the opposite of this that actually takes place (see Activity 3.2). We must therefore identify what potential problems might occur, so systems can be put in place to prevent problems before they arise.
Activity 3.1
Best-case scenario of a student’s first day
Let’s look at planning your clinical environment from the student’s perspective. Imagine you are about to walk through the door on your first day of a new placement. What is the best-case scenario for what you would like to happen next? There are some ideas listed to get you started, however you might like to add in your own ideas based on your own experiences. As you were a student once too, you could even use this opportunity to reflect on your own experiences when you were training to be a nurse.
Best-case Scenario
• You are met by your mentor and welcomed by name – it is clear you are expected.
• Your mentor introduces you to the staff on duty that day.
• You are shown where you can store your bag/coat, etc.
• You are welcomed into the team working that day and encouraged to join in on handover/team meeting.
Activity 3.2
Worst-case scenario of a student’s first day
Once again imagine you are about to walk through the door on your first day of a new placement. However, this time you are required to reflect on the following. What is the worst-case scenario for what might happen next? Just like Activity 3.1 there are suggestions to get you started and you are able to add in your own ideas based on your own experiences.
Worst-case Scenario
No-one greets you, no one can find your name on any list – it is clear that you are not expected.
No-one introduces you to anyone, and no-one seems to know who your mentor should be.
You are told that there is nowhere for students to put their belongings as all lockers and cupboards are full.
You sit in on handover/team meeting but feel as if you are in the way.
The best- and worst-case scenarios represent the two extremes of a student experience. No-one is expecting your clinical area to be perfect; however, as a mentor you should be striving to create a positive experience and enable students to feel welcomed on their first day. Without planning how to achieve this, the student is more than likely to experience elements of the worst-case scenario rather than the best-case scenario.
Creating a learning environment
Before any student arrives in your clinical area you must ensure that you have prepared a learning environment that is suitable for them. Students are not just with you to complete a set amount of hours. The purpose of a practice placement is for students to learn while they are with you, through practising skills, increasing their knowledge and role modelling the professional behaviours of staff. It is your responsibility therefore to ensure that your area as a practice placement is a suitable environment for students to learn in and through.
Learning opportunities
Start by asking yourself these questions:
1. What opportunities are there for students to learn in my area?
2. What activities do we undertake that students might learn from and through?
No doubt you will be able to identify a number quite quickly. For example, drug rounds, wound dressings, patient assessment and observation, to name a few. The term used to describe these activities is learning opportunities. A learning opportunity is any event or activity that exists in a placement area that a student might learn something from either by taking part or observing. Now try Activity 3.3.
Activity 3.3
Learning Opportunities
Take some time to note down the learning opportunities that students may have in your clinical area. Try to think of as many as you can. You might like to separate these into categories, for example medicines management activities, assessment activities, communication activities, etc.
Hopefully, you will have identified a large number of learning opportunities for students. It is likely that there will be opportunities that are suitable for students at different stages of their programme, for example first year, second year and third year students. It would be worthwhile to indicate in your list the level of the student that opportunities are most applicable for. This will help you decide the different groups of students that can and should be encouraged to undertake their clinical experience in your area.
The non-learning environment
It is not uncommon for mentors to facilitate students on placement without thinking through the learning opportunities that are available for them and how appropriate they all may be. If your placement area has been supporting students for a number of years then it is best practice to regularly reconsider whether any of the learning opportunities have changed. Given that healthcare is in a constant state of change, it is not unreasonable to assume that the learning opportunities available to students will also be likely to fluctuate.
By undertaking Activity 3.3 you should have identified the majority of learning opportunities that are available for students in your practice area. However, it may be that there are not as many learning opportunities as you assumed, or perhaps the opportunities are more suitable to a particular group of student. For example, the learning opportunities you have may be best suited to third year students; however, you may be currently supporting first year or second year students. If this is the case then you must discuss this with your manager and/or contact the university to discuss appropriate student allocation. It benefits no-one if students are inappropriately placed in your area where there are limited learning opportunities available or the learning opportunities are not applicable to the level of the student.
Personal preparation
Assuming that you work in a practice area that is suitable for students to achieve their learning outcomes, the next step is to ensure that you are personally prepared for your role and responsibility as a mentor. Once again, you cannot assume that this will all just fall into place once a student is allocated to you, and being personally prepared is your own responsibility – no one can or should be expected to do this for you.
Am I competent?
In the UK it is the NMC that sets the professional standard that is expected of a mentor. As part of this professional accountability you are required to undertake a self-assessment of your competence to be a mentor on a yearly basis. If you fall short of the standard expected of a mentor the NMC would expect you to take measures to rectify this prior to you undertaking a mentorship role. This has already been discussed extensively in Chapter 2. Take the time now to review these standards if you have not already done so (see Appendix).
Remember that maintaining an up-to-date record of your mentoring experiences and record of your attendances at mentor updates is all part of the evidence required by the NMC to demonstrate that you have adequately prepared for your role as a mentor. In essence, all these measures are there to ensure that mentors are competent to undertake their role of facilitating and assessing students on clinical placement. These standards therefore are an integral part of your pre-practice preparation for a student.
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