Enhancing the Placement Learning Environment:26th March 2009

INTRODUCTION
Quinn (1996) suggests that learning gained from placement experience is much more meaningful and relevant than that gained in the lecture room.This is supported by pedagogical writers such as Carl Rogers, Malcolm Knowles, David Kolb and Donald Schon. Thus it is clear that it must be of considerable importance for anyone who is going to be actively involved in helping to support learning in practice to understand the key factors that influence this learning environment.

KEY CHARACTERISTICS
Orton (1981), Fretwell (1983), Ogier (1982) and Pembury (1980) are regarded as seminal in relation to identifying the characteristics that students themselves identify as being key to an effective placement earning environment.Four key characteristics were highlighted.These were:

  • The use of a humanistic approach to learning;
  • A good working team spirit in the clinical team;
  • An efficient but flexible management style with teaching being recognised;
  • Teaching and learning support from qualified staff.

MOTIVATION AND NEED THEORY
A useful model to consider when thinking about supporting students in their placements is that of Abraham Maslow (1970).Maslow focussed on motivation and need theory and it seems relevant to explore this model as motivation and meeting learning needs are central to the mentor role.

(Adams, 2008)

At each level of Maslow’s hierarchical model the mentor has a very specific role to play in assessing individual student’s needs and helping them to meet these needs in as effective manner as possible.Maslow suggests that if any of the needs levels are not attended to then there will be some impairment to the learning process, in some cases, learning may in fact be totally blocked.

Being realistic about this model, it might be difficult to see how some of the needs can be fully met in students who spend sometimes very little time on a placement. For example, it may be difficult to imbue a student with something like a true sense of belonging in a short placement experience.However, such simple things as making a student feel valued and part of a functioning team can go some way to achieving this. Compromises may have to be made when the ideal proves to be unattainable.

MENTOR SKILLS IN CREATING A LEARNING ENVIRONMENT

Darling (1986) described a range of‘disabling’ types of mentor under the heading of “ A Galaxy of Toxic Mentors”.The table below summarises Darling’s findings

DUMPERS / Not available or accessible
Throw people into new roles
Leave them to ‘sink or swim’ strategies
BLOCKERS / Avoid meeting others needs by:
Refusing requests (the Refuser)
Controlling through withholding information (the Withholder)
Arresting development by oversupervising (the Hoverer)
DESTROYERS/
CRITICISERS / Set out to destroy others by:
Subtle attacks to undermine confidence (the Underminer)
Open approaches of verbal attack and argument to deliberately destroy confidence (the Belittler) constant put downs and questioning of abilities (the Nagger).

Disabling Traits: Central to the learning environment is the mentor who is assigned to support and guide the student throughout a placement.Their effectiveness in the roles required of them depends on a range of skills that they require to develop and hone through practice and experience.Anderson & Shannon (1995) report that successful mentors employ a range of enabling strategies and skills within mentoring relationships.

Some people become disablers in the learning situation because of their own experiences as learners, others adopt disabling behaviours as a defence in what they see as a threatening situation that they have not been adequately prepared for.Lack of self-awareness can compound the situation and it is unlikely that an individual will change their approach unless some intervention in the form of education and development is implemented.

Enabling Traits: There are a large number of mentors who have a very positive approach to learning and these people can be described as ‘enablers’.Morton-Cooper and Palmer (2000) suggest that enabling individuals display specific traits:

  • Accessible to those around him/her
  • Responsive to others needs
  • Easy to trust
  • Comfortable with him/herself and his/her abilities
  • Able to command mutual respect

They further expand upon this by identifying a range of ‘Core enabling characteristics’ and ‘Specific enabling characteristics’ that a mentor has to have to function effectively.These characteristics are as follows:

Core Enabling Characteristics
Motivates individuals to set their own agendas for working and learning
Provides safe opportunities for critical reflection
Advises, counsels and guides on personal, professional and career matters
Assists the mentee to learn through successes and failures
Is an effective role model
Recognises and supports the mentee’s strengths
Develops capabilities by offering constructive feedback.

Specific Enabling Characteristics
Is supportive and encouraging
Helps identify resources for learning and career socialisation
Is challenging and acts as a critical friend
Encourages creativity and risk taking in learning and working
Assists the mentee to critically reflect on his/her personal and professional capabilities

TEACHING/LEARNING STRATEGIES:

The clinical environment offers a challenge in relation to the choices of strategy available to facilitate learning.Oliver & Endersby (1994) suggest that most teaching in practice areas deals with skills, including interpersonal and management skills.Another way to look at this is to consider the elements of the educational taxonomy that considers that any learning topic has to be considered from three perspectives in relation to what a student has to learn.These elements are:

  • Psychomotor
  • Cognitive
  • Affective

Consider your own Learning Style and how best you approach a new situation. Consider what activities would promote this and what way you can promote wider learning utilising the other styles.

The list of strategies that can be implemented for supporting learning are many and varied and the choice of which to use is very much related to the preferences of the facilitator and the learning situation.Facilitators do tend to use strategies that they themselves have found useful in their own learning but must be conscious of the preferred learning style of the student.It is possible to alienate a student by involving them in a strategy that is perceived as threatening or irrelevant. Strategies to consider are:

Case conferences/studies; Discussions; Department reports; Critical incident analysis; Demonstration; Clinical demonstration; Experiential activities; Role play; Group work; Brainstorming; Simulations

SUMMARY
Clinical areas provide an absolutely vital professional learning environment and it is the role of qualified staff to ensure that that learning environment is maximised to its full potential for the students whose learning they are supporting.There are a large number of things to consider in relation to this including ensuring that the key characteristics are present, that the mentor possesses the appropriate enabling traits and is able to choose the appropriate strategies to facilitate learning.

REFERENCES
Anderson E & Shannon A (1995) Towards a conceptualisation of mentoring. Routledge
Darling L (1986) What to do about toxic mentors. Nurse Educator, 11(2).
Fretwell J (1983) Creating a ward-learning environment: the sister’s role. Nursing Times Occasional Papers, 79 (21&22)
Maslow A (1970) Motivation and personality. 2nd ed. Harper & Row.
Morton Cooper A & Palmer A (2000) Mentoring, preceptorship and clinical supervision. 2nd ed. Blackwell Science.
Ogier M (1986) An ‘ideal’ sister –seven years on. Nursing Times Occasional Papers,
82(2)
Oliver R & Endersby C (1994) Teaching and Assessing Nurses. Bailliere Tindall
Orton H (1981) Ward learning climate and student nurse response. Nursing Times Occasional Papers, 77(17)
Pembrey S (1980) The ward sister – Key to care, RCN.
Quinn F (1995) Principles and practice of nurse education. Chapman Hall