Facilitation of learning is a process of helping learners to achieve self-growth through self-evaluation and cooperation with others. It is a learner-centred approach, where learners direct and control their own learning. This will only occur when learners are encouraged and eager to take part on the learning process. I commenced in my career as a staff nurse ten years ago, and now I am attached to Haemodialysis Unit in one of the District Hospital in Sabah. My workplace consists of six Haemodialysis machine, where we have eighteen patients who came for dialysis three times per week.
As one of the senior renal trained staff nurse in our unit, one of my responsibilities is to orientate and guide all new health care who are posted to our unit. This task was given by my ward in charge. I agree to be the mentor of a new staff member name Alice (this is pseudonym). She is a newly qualified staff nurse posted in our unit and it is my responsibilities to educate her in the learning process and until she develop to be mature and confident enough to adapt and practice her knowledge in our clinical area.
After one week of observation on my mentee, I found out that she look worry, stress and not confident in doing her job. She opts to remain silent, unwilling to share her problems and worries with me. It is apparent that if this situation continues, facilitation of learning could be impossible. Within this study I intend to explore and describe the organisation of teaching and assessing to a new staff member in my workplace. IDENTIFYING LEARNING NEEDS, STRATEGIES & PLANNING AND MANAGING NEW STAFF Case study:
As a senior staff nurse and the one that had been assigned by the Hospital Nursing Manager and Hospital Nursing Professional Education Committee to orientate and guide all new staff within our unit, I am aware of my responsibilities and the need to always be up to date and upgrade my knowledge and skills. My Hospital will receive new nurses twice a year. So I choose one of the new staff nurse to be my mentee. Her name is Alice (this is pseudonym). As a mentor of her, it is my responsibility to guide and educate her. Learning Needs
New staff nurse who graduated from nursing schools or nursing colleges, can either perform to be good or poor nurse. This may also depends on whether their facilitators during clinical placement, performed a positive or negative attitude towards their role in facilitating the new staff nurse. Therefore, it is important for senior staff nurses who were assigned to orientate and guide all new staff to understand facilitation, thus help to assist new staff nurses to gain and develop their skills which are vital in nursing. In this study, I have chosen one of the new staff nurses, Alice to be my mentee.
The people to be studied should be informed in advance about the research in accurate way, they should give their unconstrained consent (Hammersley & Atkinson 1995:264). With this in mind, on the first meeting (see appendix A) I explained to Alice about my study in my degree of nursing program and I need her consent being my mentee. After discussing this situation with her, she agreed to be the mentee in my study. In my unit, Haemodialysis Unit, there is plenty routine procedure which includes care of temporary vascular access for Haemodialysis, priming procedure, blood transfusion and medication.
Out of all the topic, I have choose one particular topic for Alice that is ‘Care of Temporary Vascular Access’. My mentee agreed with the topic and willing to sign the learning contract (see appendix B). A learning contract is an agreement between educator and leaner concerning issues of assessment. It is made up of learning goals or objectives and methods of evaluation. As agreed by Cranfield School of Management (2005), using a learning contract and individualized learning plan will be advantageous because it helps learner to have sense of ownership of the objectives they will pursue.
Since Alice is a new staff nurse and never had experience working as a trained staff, I am aware that she really needs a planned managing learning need. In identifying the learning need, I have used interview and discussion method. By this I discovered that my mentee: Have lack of knowledge and skills on the routine procedure carried in haemodialysis unit. Have lack of self confidence Have lack of communication skills Teaching Strategies and Planning As a mentor for Alice, I have to plan my strategies of facilitating her learning in caring her new task as a nursing staff in haemodialysis unit.
The goal we need to achieve here is to: Increase her knowledge and skills Promote efficiency and effectiveness Being able to be independent in performing everyday task and routine Become a competent and confident nurse. This is quite a mandate for me and I have to plan my strategies of facilitating her teaching. The strategies includes: Orientation Mentoring Role modelling Collaborative learning – Simulation Readings or computer knowledge Teaching Feedback Orientation Orientation is important for all staff who appointed in new unit. All newly appointed staff will be expose on physical and safety environment.
These activities will help and provide new staff nurse with information that will smooth their transition into the new work setting (Bastien, Glennon and Stein; 1987). Being provided with adequate orientation on clinical setting, ward management, ward routine and other unit that associated with the unit, I believe that my mentee will be more confident in handling the everyday task in our unit. Mentoring Mentor is someone of equal status who assists a new graduate nurse who teaches, facilitates, assesses or supervises a nursing student.
Mentors are responsible for : Organising practice learning activities Supervising students and providing constructive feedback Assessing total performance Setting and monitoring realistic objectives Providing evidence that a student has achieved or not achieved competence Mentee is a new staff nurse who establishes goals with the mentor to obtain knowledge, skills and abilities to perform everyday task or routine that she were assigned. The mentee engages in mentoring by preparing for meetings with the mentor, taking advantage of appropriate resources and give feedback
appropriately. Mentoring is a process where mentor will pass along knowledge, skills, behaviours and values to mentee (NLN, 2006). By sharing information and insights with mentee, mentor contribute in improving patient care and ultimately strengthening the profession of nursing. In order for mentoring to be successful, mentor and mentee must be willing to devote time and energy as well as building trust with each other. Role Modelling Role modelling is ‘teaching by example and learning by imitation’ (Dake and Taylor, 1994).
It occurs when new staff nurse observe senior or more experienced nurses perform a task that they are attempting to learn. Thus help new staff nurse to have ideas on how to perform their daily routine and enhance their confidence. Bandura (1997) describes role modelling as a continually reciprocal interaction between a person and the environment. It occurs when an individual learns by observing another, and is influenced by: The relationship between role model and student The usefulness of what is modelled The student’s ability to undertake the role The student’s motivation
Role modelling is not always a passive event; it can be an active procedure for an example senior staff nurse giving a demonstration on performing a procedure to a patient. Positive role-modelling will shows when the senior staff nurse encourage the new staff nurse participate in performing the procedure, thus help to develop their problem-solving capabilities. The benefits of role modelling includes development of the new staff nurse knowledge , skills and effectiveness. It also inspired new staff nurse when they notice the success of others in performing the task they attempted to learn.
Collaborative Learning – Simulation Collaborative learning through simulation can be very effective, especially for new staff nurse (Gibbons et al. , 2002). Through this learning, preceptor will selects a task and works with the student in discussing, evaluate a strategy or possible diagnose and recommendations. Both preceptor and students share in the decision making. This strategy is suitable for beginners, its rather a collaboration and brainstorming exercise than telling them that they are wrong. Thus help to build confidence among new nurses. Reading or computer knowledge
This strategy is good for new nurses who have limited experience with certain kind of task. New nurses will be given a specific topic or the topic that was chosen and asked to do research, read article or research and write a short synopsis. Teaching Teaching is where preceptor guides the new staff nurse verbally over a procedure or routine. New staff nurse will follow the preceptor work schedules and therefore they may see how the routine or daily tasks were carried out in the unit. This helps new nurses to learn and familiarized with the routine they not yet mastered.
Feedback This final strategy is very important, because if there is no feedback from preceptor, new nurses will think that they have not performed well and make it difficult for them to make appropriate change with their work and performance. Feedback from preceptor should be specific, reinforce what is positive, discuss any errors or mistakes and demonstrate new staff nurse where they can improve. With this strategies, I believe that it will help Alice as well as me in meeting up the goal and thereby help to enhance the development of Alice.
FACILITATING AND ASSESSMENT According to the Readers’ Digest Oxford Dictionary (1993:29), to facilitate denotes to make easy or less difficult or more easily achieved. Therefore, facilitation means to ease, assist, help or further promote. Furthermore, White & Ewan (1991:112) explained facilitation as guiding and developing student nurses’ skill of critical thinking and self-directed learning by constantly challenging their knowledge base, their ability to identify learning needs and to assess their own performances accurately.
Both the above definitions support that facilitation in clinical area mean assisting and encouraging the student nurse or new staff nurse to perform their nursing skill in an easier manner. Referring to Van Rooy (1997:4) outline of facilitation, as a mentor to Alice, I expect her to be: Actively involved in the teaching events by participating in discussion, problem solving and sharing her point of views and experiences. Responsible in finding, learn and adapt necessary information on procedure or routine in our unit. This will empowers her to be responsible for her own learning and achievement while being mentored by me.
Actively giving regular feedback. Actively involves sharing the responsibility for learning between me and her, by mean both of us is responsible for the success or failure of the facilitation events. This means that, in practicing facilitation, me as the mentor will give Alice more control over her own development. However I am still aware and committed in sharing the responsibility in her learning, thus makes it less difficult in achieving the goals of this study which are to enhance her knowledge specially in ‘Care of Temporary Vascular Access’ and help her to be more confident and competent in performing the daily routine in our unit.
Facilitating Strategies Learning styles are particular to an individual, everyone have different ways of interacting and processing information. Therefore, teaching methods also should differ according to the individual learner. I have designed facilitating strategies for Alice to encourage her to apply the real-life situations working in our unit which includes: discussion questionnaires demonstrating continuous medical education reading, case management, books, journal video and other literature internet access
I have provided Alice with work process procedure which related to the topic that we have chosen, ‘Care Of Temporary Vascular Access for Haemodialysis Patient’ (see Appendix…). Work process will help her to be more confident in performing the routine by herself. I also encourage her to ask question and discuss her needs with me. Through the discussion, I can see that Alice shows positive feedback and willing open up to me. Thus I encourage her to record all the unsure question, reflection and answer that we obtained during the discussion.
I also adviced her to participate in continuous medical education(CME) which related to our topic once a week. CME help her to enhance her knowledge specifically in performing the routine in our unit. I also suggested her to refer the appropriate literature and surfing the Internet, and Alice had no problem in doing so. Assessment Assessment is a sequence of teaching as it measure how well the teaching and learning process results. As for Alice, I observed and rate her performance twice, mid evaluation and at the end of the program.
The reason why I conducted a mid evaluation is to review and indentify my facilitating strategies, whether it is successful or not. This may also help me in determining areas where there is a need to improve and corrected. As for Alice, problems that had been identified were lack of work skills and lack of self confidence. To overcome these problems, I continued with the facilitating and teaching strategies that I had discussed earlier. Dealing with lack of skills is easier, as my strategies will only require to give additional teaching, demonstration and coaching.
As for the behaviour problems like lack of self confidence, it is quite challenging to overcome where I have to discover the needs of my mentee. Mentor should discuss more and details on the improvement plan designed to eliminate the undesired attitude or behaviour. In self assessing, I observed that Alice is a fast learner and was quite happy with her performance and knowledge obtained. She was assessed during discussion and during performing the task or procedure. From the feedback given, Alice shows her willingness to learn more on the routine in our unit.
I also observed on her intellectual skill and how she applies the knowledge and skill in performing the daily task. Overall, Alice shows a positive feedback where she will discuss problems with other new staff nurse and refers to me. This shows that learning has taken place. PROVIDING ONGOING SUPPORT AND GUIDANCE Support and guidance is essential for new staff nurse in order for them to embark on their career. It is the mentor role in preparing support and guidance which will encourage development and growth of a new nurse.
As stated by Soulwork Systematic Couching (1996-2006), one of the roles of a mentor is to provide emotional encouragement and reassurance needed to allow learner to develop confidence. Thus shows that ongoing support and guidance is also vital for new nurses so that they can continue to perform at their best in everyday routine. Throughout this programmed I discovered that motivation has been a great help in improving Alice overall performance, so I decided to continue on motivating her as well as continue delivering this method to new mentee.
During the meeting with Alice, we will discuss on problems that she encountered and I will provide her with adequate help such as giving notes, related article and other supportive guidance. CONCLUSION Throughout conducting this study, my conclusion is facilitation is essential for new new nurses to help them perform at their best in providing health care. Facilitation is also beneficial to all senior staff nurse because its help to broaden knowledge, increase their skills and competencies in assisting, guiding and involving new nurses in gathering information and depending on themselves for lifelong learning, and to be a competent nurse.
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