Preceptership

Nursing and Midwifery Mentorship and Preceptorship Guide 12th September 2008 Status: Approved at August 2008 TNMC Review date: August 2010 Colette Laws-Chapman Head of Nursing & Midwifery Education GSTFT Mentorship & preceptorship guide. Final version CLC page 1 of 17 12th September 2008 Table of Contents Introduction Preceptorship Co-mentorship Mentorship Sign off mentorship Super Sign off mentorship Key Mentorship References Page 3 Page 4 Page 6 Page 6 Page 7 Page 8 Page 8 Page 9 Appendices • a) Preceptorship period checklist • b) Co-mentor workshop agenda • c) Mentorship course algorithm • d) Sign off mentorship process • e) Sign off mentor workshop agenda • f) Super sign off mentor workshop agenda • g) Key mentor role specification Page 10 onwards GSTFT Mentorship & preceptorship guide. Final version CLC page 2 of 17 12th September 2008 A Mentorship and Preceptorship guide for nursing and midwifery at Guys & St Thomas’ NHS Foundation Trust 1. Introduction This guide has been devised to support mentorship and preceptorship for nursing and midwifery staff and students at Guys and St Thomas’ NHS Foundation Trust (GSTFT). 2. Background The Trust is host to pre and post registration student nurses and midwives. The total number of full time pre-registration students commissioned per year from two universities, Kings College London (KCL) and London South Bank (LSBU) to undertake clinical practice placements at GSTFT is 277. Of these 40 are child branch (KCL), 40 midwifery (KCL) and 197 adult branch nursing students (157 KCL, 40, LSBU). In addition we also provide placements for overseas nursing and return to practice nursing programmes. We have over 3,000 nursing and midwifery staff and facilitate over 60 pre-registration placement areas over all clinical directorates across both trust sites and community placements for midwifery. In addition we commission and support our post qualifying workforce to undertake courses of study at varying universities across London who require post registration mentorship support. All of the students and learners require mentoring and support to enable them to be successful in their professional development and academic study. 3. Purpose To effectively facilitate this number of students and learners the Trust requires a robust system for supporting and developing our future nursing and midwifery workforce. In order for us to achieve effective pre-registration and post registration students we recognise that appropriate training and support is essential for all our qualified nurses and midwives. This document is designed to give staff a clear and practical guide to the preceptorship and mentorship development pathways at Guys & St Thomas’ NHS Foundation Trust (GSTFT). The pathway includes preceptorship, co-mentorship, mentorship, key mentorship, sign off and super sign off pathways for all nurses and midwives and is set against the Nursing and Midwifery Council (NMC) standards for mentors, practice teachers and teachers (NMC 2008). All mentors and preceptors will be registered on the Trust mentorship database (NMC 2008). This document will be produced into a format for placement on the Trust intranet and for use in mentoring training programmes. GSTFT Mentorship & preceptorship guide. Final version CLC page 3 of 17 12th September 2008 4. Preceptorship Preceptorship is designed to provide support and guidance for the newly qualified nurse or midwife enabling them to make the transition from student to accountable practitioner (NMC 2006 Circular 21/2006). Evidence has shown that preceptorship aids recruitment and retention of newly qualified staff and is effective in facilitating self confidence, competence and patient satisfaction (Leigh et al 2005). A preceptor and preceptee relationship should therefore be established in all areas that recruit newly qualified nurses and midwives. This should include new graduates, nurses successfully completing a return to nursing programme and those returning after qualifying on new parts of the register. For other areas, such as ICU or A&E who do not traditional recruit newly qualified nurses to their areas, a preceptorship relationship, as described in this document, may be useful to establish for on going support for new starters. Criteria and qualities of a preceptor: • NMC registrant for greater than twelve months • Qualified mentor holding an NMC approved mentorship programme • Practitioner working within the same field and speciality of the newly qualified practitioner • Effective communicator with skilled experience at feedback • Assertive and adaptive to individual styles of learners • Knowledge of the Trust competence assessment process • Completed own competency assessments • Aspiration to teach and undertake the preceptor role • Commitment to undertake the role for the six month period • Support from line manager to undertake this role • Have attended a local Preceptorship awareness briefing, or read through this and discussed with their line manager (available on the Trust Education pages) Responsibilities of a preceptor: Facilitation of the Preceptorship phase including: • Orientation and induction to the unit facilitation of the development of the preceptee • Assessing preceptees needs and organising opportunities to meet these including teaching / coaching / experiential learning sessions • Act as a role model and professional socialisation lead to the preceptee • Providing support and feedback to the successful or failing preceptee • Monitor and countersign the preceptees’ competencies and Preceptorship period checklist (appendix a) Preparation for Preceptorship: Assessment against criteria as above. Preceptorship programme The Guys and St Thomas’ Preceptorship programme will consist of: o a three week induction programme to include the full set of study days of corporate & nursing and midwifery induction and up to ten days of local induction followed by: o a six month supported period ending in the arrangement for the nurse / midwife to attend the two protected study day events, which include a co-mentorship preparation programme and the professional development at GSTT one day study day GSTFT Mentorship & preceptorship guide. Final version CLC page 4 of 17 12th September 2008 o A 12 month review meeting with preceptor Process: 1. Named preceptor identified on induction planning with line manager 2. Rostered meeting arranged (NB consider preceptors annual leave etc) Initial meeting:- to occur within two weeks of commencement on ward / dept. Agenda: • Meet & Greet • Review of induction programme • Introductions to Trust competency document • Identification of Trust, dept. and specific personal objectives Eight week interim meeting: – Agenda: • Agree action plans / educational /coaching support needed to meet competencies • Follow up on previous actions planned Three month midway meeting:- Agenda: • Review competency progress • Set date for appraisal with Line Manager at 5 months • Arrange application for placement on co-mentorship workshop at 6 months • Discuss ongoing professional development Six month meeting:- Agenda: • Review competency progress and sign off final six month comps • Follow up re appraisal • Ensure booked for placement on co-mentorship workshop • Arrange application for placement on the Professional development day • Complete Preceptorship programme checklist (appendix a Twelve month meeting:- Agenda: • Review competency progress • Follow up discussion on individual learning contract/ PDP • Review of Co-mentorship portfolio and experiences • Ensure application on mentorship preparation programme is completed • Ensure application on Professional development day has been made • Review Preceptorship programme checklist and file in staff file Preceptee protected learning time: Training: To attend two professional development days: 1) Co-mentorship preparation workshop 2) Professional development day (two centrally run study days per year). Contents: • Professional portfolios and reflective practice/ Clinical supervision • Future plans: o Continuing professional development o Careers and post qualification study advice GSTFT Mentorship & preceptorship guide. Final version CLC page 5 of 17 12th September 2008 5. Co-mentorship Staff nurses at GSTFT may become Co-mentors after completion of their 3 month core KSF competencies and should have completed 6 months of their preceptorship phase (or been qualified for a minimum of 6 months). Co-mentorship is designed to: • help the transition from being the assessed to being the assessor • improve the supervision of students in clinical placement areas • prepare staff with the fundamental skills and knowledge for Mentorship • meet clinical governance and educational support standards Applicable to all newly qualified staff or staff working at GSTFT who do not hold a Nursing and Midwifery Council (NMC) approved mentorship qualification. The co-mentorship framework includes: • attendance at the Trust induction session on Mentorship (for new starters) • attendance at a one day training workshop (September to May) • submission of a reflective diary relating to their development as a co-mentor Application is made to the Placement Development Manager, Education Offices, 2nd Floor, Gassiot House, St Thomas’ Hospital. See the education pages on GTi for an application form. For the full outline of the course programme see appendix b. Full study leave will be provided for the teaching components of this programme. Staff who are unsuccessful in completing a mentorship preparation programme will be encouraged to complete their study. In the interim period they will be asked to map their learning against the co-mentorship criteria and be placed on the database as a co-mentor on approval by their line manager. 6. Mentorship As described in the NMC standards (2008) an NMC mentor is a registrant, who following successful completion of an NMC approved mentor preparation programme, or comparable preparation that has been accredited by a university against the NMC mentor requirements, has achieved the knowledge, skills and competence to meet the defined outcomes. Mentorship is designed to: • foster professional growth and development • facilitate learning strategies to integrate theory to practice • enable the appropriate supervision of students in clinical placement areas • provide students with feedback from learning situations and assess levels of competence against criteria set by the NMC and university • support students in critical reflection to enhance further learning The mentorship framework includes: • attendance at the Trust induction session on Mentorship (for new starters) • successful completion of an NMC approved mentor preparation programme GSTFT Mentorship & preceptorship guide. Final version CLC page 6 of 17 12th September 2008 • or AP(E)L of previous experiences against the NMC approved mentor standards In order to facilitate progression, study leave and funding will be provided for this course in the first instance (see appendix c). All registered nurses and midwives at GSTFT, qualified for a minimum of 12 months are expected to obtain attend and complete an NMC approved mentor preparation programme, for example the preparation for mentorship course at KCL. Holders of previously approved qualifications such as the National board qualifications 998 or 997 are not required to repeat preparation but should map their experience and qualification against the NMC standards (2008) and through continuing professional development (CPD) ensure they meet any outstanding outcomes. Holders of qualifications that were previously not approved by a National board or NMC, such as the NVQ assessor, must use the AP(E)L processes to ensure they meet the standard. Support and advice on this can be obtained from the Head of Nursing, Education on 020 718 81645 or by contacting AP(E)L team at Kings College London. 7. Sign Off Mentorship Sign off mentors are required only for students on: o final destination placements including return to practice and overseas programmes o students on specialist practice programmes that lead to a recordable qualification on the nurses part of the register o all students on pre-registration midwifery programmes (NMC 2008) Sign off mentors are registered nurses and midwives who are mentors, as described above, who have met additional criteria (NMC 2008) as described below, who can make judgements about whether a student has achieved the desired standards for safe and effective practice for entry onto the NMC register. Sign off mentorship training is designed to: • enable the appropriate sign off of all nursing students in their final placement or midwifery students throughout their programme • provide staff with the skills and knowledge for sign off mentorship • meet clinical governance, NMC and Higher Educational institution standards For the full outline of this process see appendix d and for the full workshop programme see appendix e. Criteria to be sign off mentor • Line Manager approval • Recent experienced mentor for range of pre-reg students levels • Mentorship update within last 12 months • Senior Band 5 staff nurse & above • Attendance on the GSTFT Sign off mentor preparation day • Completion of a SOM portfolio of evidence • Work in area with need for SOM i.e. final destination or midwives GSTFT Mentorship & preceptorship guide. Final version CLC page 7 of 17 12th September 2008 Nurses and midwives will need to demonstrate and agree with their line manager when it is appropriate to undertake this development programme. Full study leave will be provided for the teaching components of this programme. Application is made to the Head of Nursing and Midwifery Education, Education Offices, 2nd Floor, Gassiot House, St Thomas’ Hospital; See the education pages on GTi for an application form. 8. Super Sign Off mentorship This is a unique process designed in partnership with the two linked HEI’s, LSBU & KCL, to launch the Sign off mentor processes at Guys & St Thomas for 2007/2008 only. Super sign off mentorship is designed to: • provide senior nursing & midwifery staff with the skills and knowledge for Sign off Mentorship preparation • meet clinical governance, Nursing & Midwifery Council and Higher Educational institution standards • assess sign-off for future sign-off mentors For the full workshop programme see appendix f. Criteria to be super sign off mentor • Line Manager approval • Recent experienced mentor for range of pre-reg students levels • Mentorship update within last 12 months • Senior Band 6 staff & above • Attendance on the GSTFT Super sign off mentor preparation day • Completion of a SSOM portfolio of evidence – obtaining signatures from managers and link lecturers once completed • Commitment to undertake the role and support mentors to achieve sign off mentor status within your clinical area • Work in an area that needs SOM i.e. final destination or midwife students Nurses and midwives will need to demonstrate and agree with their line manager if it is appropriate to undertake this development programme. Full study leave will be provided for the teaching components of this programme. Application is made to the Head of Nursing and Midwifery Education, Education Offices, 2nd Floor, Gassiot House, St Thomas’ Hospital. See the education pages on GTi for an application form. 9. Key Mentorship All registered nurses and midwives who hold an NMC approved mentorship qualification (for example the preparation for mentorship course at KCL, or its equivalent the 998) are eligible to become a Key mentor. Key Mentors may be responsible for one or more areas dependent on the local requirements. GSTFT Mentorship & preceptorship guide. Final version CLC page 8 of 17 12th September 2008 Key mentorship is designed to allow a mentor to act as a senior education resource in the clinical placement area and to liaise with the SDU Education Leads Group. Key mentors will act under the supervision of Ward Manager to develop the learning environment and to support mentors as a resource and role model. Applicable to all staff working at GSTFT who hold a Nursing and Midwifery Council (NMC) approved mentorship qualification with a strong commitment towards education, the development of students/learners, mentors and the learning environment within the clinical placement area. The key mentorship framework includes: • attendance at the Trust update session on Mentorship • attendance at a two hour coaching workshop (available all year round) provided by the Placement Development Manager . For the full outline of the key mentor role see appendix g. Full study leave will be provided for the teaching components of this programme. Criteria to be Key mentor • Line Manager support • Has been a qualified Mentor for at least 12 months • Recent experience as a mentor for the range of pre-reg students levels in area • Is knowledgeable of the current pre-registration curriculum and the practice assessment documents • Mentorship update within last 12 months • Band 6 staff nurse & above • Has a Trust email account Application is made to the SDU Education lead and approved by the Placement Development Manager, Education Offices, 2nd Floor, Gassiot House, St Thomas’ Hospital. 10. References Standards to support learning and assessment in practice. NMC standards for mentors, practice teachers and teachers. NMC (2008). NMC Preceptorship Guidelines NMC circular 21/2006 Leigh J, Douglas C, Lee K, Douglas M, A Case Study of Preceptorship in an Acute NHS Trust – using the European Foundation for Quality Management tool to support clinical practice development, Journal of Nursing Management (2005) 13, 508- 518 GSTFT Mentorship & preceptorship guide. Final version CLC page 9 of 17 12th September 2008 Appendix a Preceptorship period checklist Staff Name Date Directorate/Ward/dept. Assignment No. …./…./…. Comments Named preceptor identified on induction planning with line manager Rostered meeting arranged for initial meeting to take place Initial meeting:- to occur within two weeks of commencement on ward / dept. Agenda: • Review of induction programme • Introductions to Trust competency document • Identification of Trust, dept. and specific personal objectives Eight week interim meeting: – Agenda: • Agree action plans / educational /coaching support needed to meet competencies • Follow up on previous actions planned Three month midway meeting Agenda: • Review competency progress • Set date for appraisal with Line manager at 5 months Six month meeting: Agenda: • Review competency progress and sign off final six month comps • Follow up re appraisal • Arrange for placement on o co-mentorship workshop o professional development day o Complete Preceptorship programme Twelve month meeting Agenda: Individual review Preceptee signature NA Preceptors signature NA GSTFT Mentorship & preceptorship guide. Final version CLC page 10 of 17 12th September 2008 Appendix b Co Mentor workshop agenda GSTFT Hosted event Venue: Various (see dates advertised on education pages on GTi) Capacity: 20 Facilitators: 2 minimum Time: 7.5 hours Resources: Power point projection/ flip chart & pens/sign off documentation/ mentoring guide/ PADs/ portfolios/ evaluation sheets Welcome and introductions Mentorship framework – standards for learning in practice The student journey Signing off – the process overview Co mentorship – what does it mean & accountability Coffee Staff Student relationships & the link lecturer role o Boundary Settings Things Students do – problem solving Lunch Practice Assessment Documents 2008/09 o LSBU & KCL Panel Giving feedback: o Interviews, documentation and dynamics o Dealing with a difficult student o Failing to Fail Tea Break Completing your reflective diary Evaluation & close Pre-course information • • Reading list Course workbook GSTFT Mentorship & preceptorship guide. Final version CLC page 11 of 17 12th September 2008 Appendix c GSTFT Mentorship Module algorithm No mentorship course Consider: Band / role or Co-mentor options Apply for & complete mentorship course level 5 or 6. Web based or full module or accreditation Complete Trust external study leave & funding form (07/2006) First Attempt Fail Line management meeting • Identify cause Pass Non submission • • Identify cause Discuss o Support needs o Consequences of 2nd fail Academic fail • • • • • Identify cause Discuss support needs Student to obtain KCL tutor feedback Consider level of study for 2nd attempt Consider deferring / extension Re-submit Second Attempt Fail Pass • Line management meeting Identify cause Mitigating circumstances Appeal NO mitigating circumstances • If successful take 3rd attempt at KCL • • • • • Unsuccessful appeal at KCL Appraisal & set clear objectives & support Mgr to contact HoN Ed, possible re-appeal Consider alternative university Consider self funding Consider • • Capability Procedure Withhold KSF gateway Pass Fail Pass Fail GSTFT Mentorship & preceptorship guide. Final version CLC page 12 of 17 12th September 2008 Appendix d Sign off Mentorship Process 1) NMC approved mentorship preparation programme Criteria to be nominated as a potential sign off mentor • Line Manager approval • Recent experienced mentor for range of pre-reg students levels • Mentorship update within last 12 months • Senior Band 5 staff nurse & above • Work in an area with final destination/post reg/ midwives • Attendance at GSTT SOM day • SOM portfolio 2) Annual Mentorship update in date 3) Selected for sign off mentor development (against criteria) 4) Attend sign off mentor development workshop 5) Complete sign off mentor portfolio (within 3 months of workshop) 6) Complete 3 practice sign offs under supervision 7) Portfolio and practice sign offs – manager verification within 1 month of completion 8) Register on local and trust sign off database (held by Matron & HoN for Education) 9) Maintain reflective diary of sign off experiences for Triennial review (with University Lecturer & at IPR) 10) Continues to undertake annual mentorship update (sign off mentorship & mentorship status revoked if not updated) GSTFT Mentorship & preceptorship guide. Final version CLC page 13 of 17 12th September 2008 Appendix e Sign off Mentor workshop agenda GSTFT Hosted event Venue: TBC Capacity: 24 Facilitators: 2 minimum Time: 3.5 hours Resources: Power point projection/ flip chart & pens/sign off documentation/ mentoring guide/ portfolios/ evaluation sheets Welcome and introductions Practice Assessment Documents 2007/08 – overview Mentorship news & Sign off overview Giving feedback – Activity based session Coaching to competence – developing your coaching skills Tea Break Failing to Fail – Discussion & Group work Signing off – scenarios Dealing with a difficult student Completing your portfolio Evaluation & close 15 mins 15 10 30 20 20 20 20 40 20 15 GSTFT Mentorship & preceptorship guide. Final version CLC page 14 of 17 12th September 2008 Appendix f Super sign off Mentor workshop agenda GSTFT Hosted event Facilitated by holder of an NMC approved teacher qualification Venue: tbc Capacity: 24 Facilitators: 2 minimum Time: Resources: Power point projection/ flip chart & pens/sign off documentation/ mentoring guide/ portfolios/ evaluation sheets Welcome and introductions NMC standards – overview Fitness to Practice – failing to fail & accountability Portfolio work – Evidence to support role Making a Valid assessment focus on the register Giving effective feedback– developing your coaching skills Tea Breaks & lunch plans to be included Writing action plans – focus on effective evidence Support required for the super sign off Evaluation & close 15 mins 45 45 105 60 60 60 15 15 GSTFT Mentorship & preceptorship guide. Final version CLC page 15 of 17 12th September 2008 Appendix g Key Mentor Role Key Mentor Role Specification Role Profile The role of the Key Mentor is to act as an education resource in the clinical placement area and to liaise with the SDU Education Leads Group. Key mentors will act under the supervision of Ward Manager to develop the learning environment and to support mentors as a resource and role model. Person Specification In order to fulfil the aspects of the role, the key mentor should: Be a Registered Nurse / Midwife committed to education, the development of students/learners, mentors within the clinical placement area Have been a qualified mentor for at least 12 months Have experience in conducting student assessment in a clinical practice setting Be knowledgeable of the pre-registration curriculum and the practice assessment documents Have a Trust email account Scope of the Key Mentor Role To help create and maintain an effective learning environment which ensures the safety of patients and the growth of learners. The expectation is that each clinical placement area will have at least one key mentor. The key mentor role will be undertaken alongside the clinical practitioner roles and responsibilities Responsibilities Be the named link between their clinical placement area and the Placement Development Manager, SDU Education Leads and University link lecturer Liaise with the Ward Manager of the clinical placement area with regard to the implementation of education issues In conjunction with the Ward Manager act as a resource person for staff concerning education related problems in the clinical placement area Participate in the writing, reviewing and updating of education policies, procedures and standards in relation to their own speciality, as required by the Trust education team Inform the Placement Development Manager of student issues, adverse incidents and any other issues affecting placement in a timely fashion Support new co-mentors and mentors to aid them in developing through the process of facilitating and assessing learners in practice Support mentors who are assessing students as having difficulty meeting the minimum standards expected in practice (‘failing students’) In partnership with the link lecturer, ensure the education audit is completed regularly (Quality Review completed as a minimum once every two years and Practice Environment Profile completed annually). Maintain a live register of all staff – stating the mentors, sign-off mentors and any mentor who has ceased supporting students due to lack of capability Local mentor registers to be updated quarterly and forward to the SDU Education Lead and the Placement Development Manager Work collaboratively with ward manager and link lecturer to ensure that staff receive annual mentor updates that meets the NMC Standards Plan the student experience (rota) to reflect 24 hour and seven-day cycle of care for patients GSTFT Mentorship & preceptorship guide. Final version CLC page 16 of 17 12th September 2008 Ensure all members of staff take part in supervising students as stated in NMC Code of Professional Conduct and to fulfil the Knowledge and Skills Framework Core Dimension of their role Ensure a well resourced clinical placement area with learning opportunities clearly stated/documented for students at all levels and conduct local audits to evaluate effectiveness on a twice yearly basis Establish interprofessional learning as part of the student nurses practice placement experience Take part in student recruitment (at HEI’s) and GSTFT newly qualified nurse staff nurse recruitment processes Attend the student forum a minimum of twice per year Support, distribute and where possible contribute to the Student Nurse and Mentor Newsletter Professional Responsibilities Attend key mentor and university led mentor educational updates twice a year Promote a conducive learning environment within the clinical placement area Liaise with other key mentors and SDU Education Lead for their Service Delivery Unit Update their professional knowledge and competency in maintaining clinical competency and capability GSTFT Mentorship & preceptorship guide. 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