CHAPTER 7. The Midpoint Interview
Chapter Aims
The purpose of this chapter is to explore the nature and function of the midpoint interview. After reading the chapter you will be able to:
• Explain the purpose of the midpoint interview.
• Identify the essential components of a successful midpoint interview.
• Successfully conduct a midpoint interview.
What is the purpose of the midpoint interview?
In Chapter 6 we discussed the importance of giving feedback to your student on the progress they are making towards achieving their learning outcomes. The chapter established that feedback is essential in helping the student to achieve competence. We also identified that feedback can be given both informally and formally. In this chapter, we will focus on one of the specific times when formal feedback, based on detailed assessment of progress, is given, that is, the midpoint interview.
The main purpose of the midpoint interview is to discuss with your student their progress and performance to date, identify strengths and weaknesses, outcomes achieved and those areas where further development is needed. The midpoint interview is a key step in the assessment process, allowing both you and your student the chance to look back on what they have achieved during the preceding weeks, and to plan for what still needs to be done. At this stage, both you and your student should have a clear idea of whether or not the required level of performance is likely to be achieved within the time remaining.
Chapter 6 also highlighted how you as a mentor will be continuously assessing your student’s level of competence, providing guidance, support and regular feedback to help your student achieve their outcomes. During this process, you will be recording your observations and informal discussions within the practice assessment document. In essence you will be continually monitoring your student’s progress. At some point however, you will need to take stock of how far you and your student have come on the learning journey. You will both need to take ‘time out’ to review progress made, reflect on the good bits and the not so good bits of the placement so far and plan for the ‘second half’. The midpoint interview represents half time. It is a time to evaluate, regroup and refocus. It is a time to review the initial learning plan and decide whether this has been effective. It is the time to ask questions such as:
• Have the goals you set at the initial interview been achieved?
• Have the different aspects of the learning plan worked in the way they were designed to?
• Were any changes made to the plan and why?
• What still needs to be done in order to achieve the desired goals?
• What are you and your student going to do now to get to where they need to be?
The midpoint interview is a time for you to re-energize, re-motivate and spur the student on to bigger and better things in the second half of the practice placement.
Purpose of the midpoint interview
Although the midpoint interview is a formal step in the assessment process, it is a formative rather than a summative component of assessment. The purpose of the midpoint interview is to identify and provide information that you can effectively use to improve your student’s learning rather than to test whether the specific learning outcomes have been achieved. At the midpoint interview, you are measuring how far your student has progressed towards achieving the set goals, identifying their successes and where they may be having trouble. You can then use this information to make necessary adjustments to their learning plan, such as changing your style of mentoring, identifying and/or offering alternative or further opportunities for practice. The feedback you give as part of the midpoint interview should help your student become aware of any gaps that exist between their desired goal and their current knowledge, understanding or skills and guide them through the actions necessary to achieve that goal. The purpose of formative feedback is to enhance learning not to pass judgement. The key function of the midpoint interview therefore is to inform both you and your learner about what has already been learnt and what has still to be achieved.
When should the interview take place?
Mentoring like all processes requires that each stage is completed at the proper time and in the proper manner if the whole system is to work successfully. A delay in any stage, skipping of any of the stages, or focusing too much on a single stage will lead to confusion and poor results. It is therefore important that the midpoint interview is carried out at an appropriate point in the student’s placement. So when should you carry out the midpoint interview?Case study 7.1 provides a possible midpoint interview scenario.
Case study 7.1
Gina’s midpoint interview
It is Gina’s sixth week of an eight-week placement to Disraeli ward. She has asked to see her mentor Carol.
Carol ‘Oh hi, erm, Gina? You said you wanted to see me! I’ve got a few minutes so what is it you want to see me about?’
Gina ‘We’ve got to sign something off in my practice book.’
Carol ‘Oh, right!’
Gina ‘I haven’t seen you since my initial interview. There is something in my book you have to sign off.’
Carol ‘Do you know where it is?’ (Takes the book from Gina.)
Gina ‘It’s nothing much. You just need to sign to say how I’m getting on.’
Carol ‘Oh yes! The midpoint interview’. (Reading from the practice book) ‘It says here this should take place during weeks three and four. How long have you been here now?’
Gina ‘Nearly six weeks!’
Carol ‘Oh dear! A bit late aren’t we? Ah well, it doesn’t matter, we can get something written down!’
There are clearly a number of concerns arising from this encounter but for the time being let’s consider the timing of this meeting. Gina has started her sixth week of an eight-week placement. Her mentor Carol has therefore had five weeks to monitor her progress, so in this respect should have a clear picture of Gina’s capabilities and areas requiring improvement. However, Gina has less than three weeks of her placement left. What happens if Carol decides Gina is not making adequate progress towards achieving the set learning outcomes? What if she identifies that Gina is struggling in several areas? Gina has less than three weeks left to work on any weak areas. Is this sufficient time for Gina to have the opportunity to work on these areas? If the purpose of mentoring is to facilitate learning and development, it is crucial that formative assessment is timely (try Activity 7.1).
Activity 7.1
Midpoint interviews in your area
If possible, try to complete a quick audit of when midpoint interviews are generally carried out in your clinical area. Try to find the data regarding the assessment process of some past (or present) students in your clinical area. For each student try to identify the following:
1. In which week should the midpoint interview have taken place?
2. In which week did the midpoint interview take place?
Try to include as many students as possible in your sample so you can get an accurate idea of the trends for your practice area.
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The midpoint interview therefore needs to take place at a point in the student’s placement that will allow plenty of time and opportunity for him/her to address any weaknesses. There has to be time for the student to participate in the necessary learning experiences, practise and refine skills if they are to gain competence. The ideal therefore is to time the midpoint interview at a point in the placement where progress can be properly established and advice given in a timely manner. Case study 7.2 provides an example of this.
Case study 7.2
Kelly’s midpoint interview
It is Kelly’s fourth week on Gladstone ward. Today she is meeting her mentor Daniel for her midpoint interview.
Daniel ‘Hello Kelly. Thanks very much for coming in. You will be pleased to know we have about a good half hour to go through your midpoint interview and then I’ve got to go to a meeting, but I’ve handed the keys over to Sarah and she’s going to hold the fort out on the ward. Is that your practice assessment book you’ve got there?’ (Daniel takes the book and starts to flick through it). ‘So how long have you been on this placement now?’
Kelly ‘It’s been three weeks. This is my fourth week now!’
Daniel ‘Right, excellent! So you’ve got another four weeks to go then? Great!’
The timing of Kelly’s interview is perfect! Her mentor has had four weeks to monitor her progress and there are still four weeks left for Kelly to work on any areas requiring improvement. Here the interview is truly a ‘midpoint interview’ as it is taking place exactly halfway through the placement. There has been time for her mentor Daniel to have supervised, facilitated, observed and assessed her learning. He will be able to draw on an adequate amount of data to review Kelly’s progress to date. There is also, more importantly, adequate time left on the placement for Kelly to continue to progress towards achievement of the set learning outcomes and to work on areas identified as requiring attention and improvement. This is essential. Your student must have the time and the opportunity to show improvement between the midpoint and final interviews. If the time between midpoint and final interviews is too short, as in Gina’s case, there will be few opportunities for the student to gain the knowledge and skills required and put these into practice. Without sufficient opportunity to try out new knowledge and skills in a variety of different settings, learning will not take place and your student will be unable to achieve the set outcomes. It is therefore crucial to schedule the midpoint interview to take place halfway through the placement.
Planning for the midpoint interview
The best way to ensure the midpoint interview is timely is to set the date for this during the initial interview. Setting the date well in advance provides opportunity for duty rosters to be organized to ensure that both you and your student’s off-duty coincide. Advanced planning may also make it possible to choose a date when you anticipate the clinical workload will be less. For example if one day of the week is generally quieter than others as there is no theatre list, or there is a day when clinics finish earlier. Perhaps on your ward there is a patient rest period when no planned clinical interventions are carried out. All of these would be good times to choose. Taking time to consider clinical down times in advance will reduce the chance of the interview having to be postponed or interrupted. Of course, healthcare is unpredictable and there will always be occasions when despite advanced planning interviews will need to be rescheduled. The likelihood however of this happening is greatly reduced with a bit of forward planning. Remember also, that interview opportunities are increased the more shifts that you and your student are rostered together (Activity 7.2).
Agree the date of the midpoint interview well in advanced, preferably during the initial interview. This will give plenty of time for off duties to be arranged and a target for your student to aim towards. Think about the clinical workload and try to identify periods when clinical activity is likely to be low.
Activity 7.2
Reasons for delayed midpoint interviews
Have a look again at the notes you took in Activity 7.1. If there were students who had a delayed midpoint interview then make some notes on why this happened. For example, were the mentor and student rostered together? Was the mentor on holidays? In doing this exercise you may be able to troubleshoot some of the common reasons that prevent timely midpoint interviews in your area.
Length of the midpoint interview?
We have established that the timing of the midpoint interview is crucial, but how much time should you expect to allocate to it? To answer this question you might like to refer back to Case studies 7.1 and 7.2. In Case study 7.2, Daniel has set aside 30 minutes for his interview with Kelly whereas in Case study 7.1 Carol appears to have been caught ‘on-the-hop’ and so no actual time has been set aside. It is therefore highly unlikely that Gina’s interview will last very long. Time is a precious resource within the healthcare environment so it is unlikely Carol, who is clearly unprepared for the encounter with Gina, will have time to spare. It is also obvious from the scenario that Carol and Gina have not planned the interview in advance so no time has been allocated to it.
Feedback sessions such as the midpoint interview are not effective if they are carried out hurriedly. If your student feels they pose an additional burden, in a busy clinical environment, they will be reluctant to approach you and their learning will suffer. We can see this in Gina’s approach and response to Carol. She diminishes the importance of the interview, desperately trying to reassure Carol that ‘It’s nothing much’, in other words it isn’t going to take up much of Carol’s precious time. ‘You just need to sign to say how I’m getting on.’ Gina obviously feels it is important to complete the assessment document. Perhaps she sees this as a way of keeping the university and her mentor happy. Her assessment book will have the required sections completed without making too many demands on her mentor’s time. In effect two people lose out as a result of this scenario. Gina will receive no feedback on her performance and therefore lose any opportunity to improve. Carol loses out in that she has undermined her professional credibility and competence as a mentor. By not valuing the midpoint interview both the mentor and student lose out.
