CHAPTER 5. Orientation and the Initial Interview
Chapter Aims
The purpose of this chapter is to gain an understanding of the process and purpose of the initial interview. After reading this chapter you will be able to:
• Identify the main features, purpose and processes that should be considered when conducting an initial interview.
• Understand the importance of planning learning experiences that cater for a wide variety of student learning styles.
• Plan effectively for the initial interview event.
Meeting your student
In Chapter 3 we explored the preparation that should take place before a student arrives in your clinical area. The purpose of thorough preparation is to identify potential problems and ensure that the practice placement gets off to the best possible start for both you and your student. If you are properly prepared for your student’s arrival then the initial meeting should be a relaxed and friendly event. Ideally, you may have had contact with the student previously, either though a pre-placement visit or via the phone or email.
The first meeting is your opportunity to welcome them to the placement area and ensure they feel wanted and welcome. You only have one chance to get this right, so it is really important that this is handled well as this first meeting will set the tone for the rest of the placement. No matter how much information they may have about the placement, they will still be feeling very nervous about this first encounter, and will remember every detail about it. This is your chance to shine.
Orientation
One of the best ways to ensure that a student feels welcome to the practice placement is to orientate them to the placement environment as soon as possible. Ideally, orientation should be a staged process during the first day to ensure that the student is provided with all the information they require and that they are given the opportunity to ask questions that may be relevant to them.
Try to start the orientation by showing your student the essentials; where to put their bag/coat etc, and the location of staff lockers or changing rooms if relevant. If possible, arrange for this to take place within the first few minutes of them arriving in the placement. If you have got a student locker or locked cupboard available for valuables then make sure the student knows how to access this. Knowing where to put your personal property and how to access these items throughout the day will put them at ease very early on as it shows that you are interested in their welfare.
The next step in the orientation involves introducing your student to the other staff on shift that day. Let everyone know the student’s name and the year of the programme they are on. It’s a good idea to identify yourself to your colleagues as the student’s mentor, and let everyone know how long the placement is. If you can do this during handover then this is the best option as you don’t have to repeat the information throughout the day.
An introduction does not have to be long or complex, something simple will do such as:
‘Hi everyone, I’d like to introduce you to Jenny. She’s a third-year student and she is on placement with us for 6 weeks. Today’s her first day and just to let everyone know I’m her mentor during the placement.’
A simple and friendly introduction will allow greetings to be swapped. You can encourage your colleagues to introduce themselves and what their role is, or you can go around the group and do this yourself. If your practice area routinely does a handover, encourage your student to join in and ensure your student is provided with the same materials as other staff.
The second part of orientation will be to ensure that the student is orientated to the work area and that health and safety issues are addressed. Try to make this as informal as possible, without forgetting essential information. The types of information your student will need are:
• location of toilets/changing facilities
• location of fire exits and emergency equipment/evacuation procedures
• location of tea rooms, canteens, vending machines, etc.
• location of storerooms, treatment rooms, training rooms, etc.
Lastly, it is important that the student is aware of how to contact the placement, who to contact, and their off-duty for the placement. All these areas can be addressed throughout the first day to ensure that the student receives a thorough orientation without feeling overwhelmed.
If your placement area has a student folder try to include some of the orientation information in here. Phone numbers and key staff in the placement are very useful to include. On the first day you can ask them to read the information in the folder and then ask any questions they may have.
Initial interview
The initial interview is the first opportunity that you and your student will have to plan and discuss what is expected on the placement. Not only is it a chance to discuss each other’s expectations, it also marks the beginning of the student’s assessment. For this reason it is highly recommended that you do not try to schedule the initial interview for the first day of placement as your student will be taking in so much new information they will be unlikely to benefit (see Case study 5.1).
Case study 5.1
A student speaks about her first day of placement
‘I started placement with a community psychiatric nurse and within the first hour she was pushing me to sit down for the initial interview. I just felt so overwhelmed and disorientated. She treated the interview like a task she had to get out of the way. As soon as we started the interview I knew the placement was going to be a disaster. She told me a little bit about the clinic where we would be based and asked me what I wanted to learn and that was about it. The whole interview lasted less than 10 minutes. I wanted to talk about my learning outcomes and show her my assessment book but it was obvious she was in a real rush and I felt too nervous to stand up for myself. That was my worst placement experience. Over half the placement went by before my mentor actually realized what it was I should have been learning and bothered to look at my assessment book. By the time she understood what I was meant to be learning I had missed a lot of learning opportunities and as a result I got very little useful feedback. What a waste.’
Planning the initial interview
It is best practice to stage the initial interview in the first week of placement. If possible try to decide the date and time of the initial interview during the student’s first day of placement so that you can both plan for the event. If you are both working the same off-duty then scheduling the initial interview during a shift that you are both working together in the first week should not be difficult.
When scheduling the initial interview try to allow at least one hour of protected time. This is not to say that the interview will always take one hour; however, by identifying this time you are creating a fixed period of time that can be planned for within the workload of others. You may want to consider planning the initial interview for a day in the first week when you know there is a senior staff skill mix, or a day that is typically quieter than others (Case study 5.2).
Case study 5.2
Scheduling an initial interview
Jones ward is a very busy surgical unit. In the past it was common practice for students to miss out on their initial interviews with mentors as each shift left little time to sit with students. The staff on Jones ward have come up with a novel solution. When they know it is a student’s first week they ensure that the student and the mentor are rostered together on the Wednesday, as there is no elective surgery that afternoon. The student and the mentor then take an extended lunch together of 1 hour, starting at 2 pm once everyone else has returned and there is a good skill mix. As it is planned for in the off-duty, the other staff on shift that day can cover the lunch break without compromising patient care. It is now very rare for students on Jones ward to not have an initial interview in the first week.
It is important that both you and your student are prepared for the initial interview so that you can use the time constructively. Ensure that your student is aware they will need to bring the following to the interview:
• their practice assessment document
• their ongoing achievement record from the previous placement
• any supporting documents, for example, adjustments to be made for disabilities.
In addition, make sure you are fully prepared yourself by reading through the learning outcomes the student will be attempting on the placement in advance of the initial interview.
Staging the initial interview
The initial interview event will involve a mixture of discussion, writing down information and reading of materials. For this reason it should take place in a location where there is an opportunity to sit comfortably at a table where both you and your student can write. If possible arrange to hold the interview in a quite location away from the general hubbub of the clinical area so that interruptions can be kept to a minimum.
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Nurse’s stations, clinic rooms, cars and cafeterias are usually places to avoid for initial interviews. They are either not quiet, not comfortable, or not private (Case study 5.3). Ideally, you should be holding the initial interview in a meeting room, office, teaching room, etc.; somewhere that a door can be closed and noise kept out. If it is acceptable to put a sign on the door to stop interruptions then please do this. Just one hour of protected time at the beginning of a student’s placement is worth its weight in gold for both of you.
Case study 5.3
A mentor speaks about their experience of holding the initial interview
‘We used to conduct the student’s initial interview in the patient day room. I’m not sure how that started but it ended up being done there out of tradition I think. Anyway, it could not have been a worse possible place. First of all there was no door, so there was very little privacy. It wasn’t uncommon for patients and relatives to wander in half way through, wanting to watch TV or drink cups of tea. Eventually someone realized how ridiculous this was and now the students have their initial interviews in the manager’s office. They can close the door and have some privacy which is great for everyone.’
Beginning the interview
The initial interview is the first formal event that will begin the assessment process during the student’s placement. It does not however, need to be held in a formal style, in fact the more relaxed and informal this event is the better for both you and the student. It is formal in the sense that the purpose of the initial interview is to develop an agreed contract of learning and assessment that can be followed and referred to during a student’s placement. The initial interview is so important that there is little point in the student being on the placement until it has taken place. Without an initial interview, the student is essentially just working in your clinical area. After the initial interview, the work the student participates in is constantly contributing to their learning and your assessment of their competence.
It’s a good idea to have a checklist of issues that need to be covered at the initial interview so that you make the best use of time (Box 5.1). At the very least, the following will need to be discussed:
• learning styles
• reasonable adjustments for disclosed disabilities
• learning outcomes for the placement
• a plan of how learning experiences will be provided
• expectations of competence
• off-duty including confirmation of shift times
• additional learning experiences or goals the student would like to achieve
• an agreement regarding expectations of feedback.
Box 5.1
Best practice for the initial interview
The RCN provides specific advice for conducting an initial interview. Entitled Guidance for Mentors of Nursing Students and Midwives: An RCN Toolkit, they recommend the following should be considered during the initial interview
DO find out about the student’s stage of training.
DO help the student to form achievable objectives.
DO ask if they have any assignments or assessments.
DO introduce them to the placement learning opportunities.
DO find out if they have any specific anxieties.
DO encourage them to self-assess at every stage.
DO ask if they need any additional support.
