As the paramedic profession continues to move away from its vocational approach to training to the academic route of education, I agree wholeheartedly with the statement by Jones et al (2012) that paramedic practice mentors are, and will continue to be, pivotal in the success of this transition. It is therefore vital as a profession that we fully embrace the whole concept of mentorship and realise the importance of developing individuals who have a full understanding of the skills and qualities required to enable them to become truly effective mentors. It is also vitally important for us to understand how an ineffective mentor can have a catastrophic effect on an individual just beginning their career.
In February 2013, I enrolled on a Level 6 15 credit mentorship module at the University of Surrey (fully funded by my trust) to begin my journey to become a mentor/practice placement educator. The following article uses Gibbs’ Reflective Cycle (developed by Graham Gibbs in 1988 from Kolb's ideas in educational theory (Jasper, 2003)) to refect on my personal journey through this experience.
Description
Throughout my entire working life I have had a passion for training and education and greatly enjoy mentoring and developing the skills of others. As I did not have any specific training, teaching or mentorship qualifications, however, this has always been in an “informal” capacity. Due to my professional experience and the knowledge I have acquired and developed I consider myself to be “profcient” (Benner, 2001) as a specialist clinician working within my area practice, but a “Novice” (Benner, 2001) in the area of mentorship. I always strived to be a “good mentor”, but realistically, had a limited understanding of what this actually meant and had no understanding about learning styles, learning theories, or learning domains. I had also never written a teaching plan or undertaken any formal assessment of learners.
I began my journey on the mentorship module with high expectations that it would provide the underpinning knowledge and theory to bridge this chasm in my understanding and allow me to progress from “novice” through to “advanced beginner” and then on to become “competent” as a mentor (Benner, 2001).
Feelings
This was my second voyage into the higher education environment and even though I thoroughly enjoyed my first experience and felt more prepared due to a degree of familiarity, I still felt quite anxious about the journey I was about to begin.
As described, I was expecting to acquire a high volume of knowledge about learning styles, theories and domains whilst undertaking this module, but was very surprised about how much I also learnt about myself. I found the four main learning styles fascinating to investigate and after completing Honey and Mumford's Learning Styles Questionnaire (LSQ) (Honey and Mumford, 1992), I was intrigued to find that I have a strong preference as a reflector, a moderate preference as both a theorist and activist, with a low preference as a pragmatist. I found writing a teaching plan very constructive due to the clarity it brought and thoroughly enjoyed the whole teaching experience. I was, however, very apprehensive about the assessment element, as I had no experience of formally assessing learners.
Evaluation
I thoroughly enjoyed my journey through the module and it has reinforced my passion for teaching.Even though it was a positive experience, overall it did have its ups and downs. It was a very emotional and exhausting time for me personally due to a sudden unexpected family bereavement, but this also coincided with an unusually high additional workload that I had to try to manage. I considered withdrawing from the module due to these pressures, but as I was able to attend all the lectures, I did not want to miss the opportunity. I did, however, have to request an extension due to extenuating circumstances as I was unable to complete the teaching session and essay in the time provided and to my relief this was granted.
Due to the fact I always work alone and spend a very limited time “on base”, it was very difficult to organise an opportunity for the teaching session, but when I finally achieved it I was thrilled that it went well. I also overcame my apprehension about the skill of assessing a learner, as the objective approach I took as suggested by Gopee (2011), was more straightforward than anticipated. I also really enjoyed the multidisciplinary nature of the cohort and the opportunities it generated for sharing thoughts and ideas.
Analysis
Sibson and Mursell (2010a) discuss that it is important to understand the learning styles of a student and the domains adults actually learn in, as understanding this enables a mentor to grasp how best to support and assess them. Initially I found my personal results from Honey and Mumford's Learning Styles Questionnaire (1992) very surprising, as on surface value I have always considered myself as a practical down-to-earth person who likes making practical decisions and solving problems; character traits that Honey and Mumford (1992) suggest are indicative of a “pragmatist”. However, when I began digging beneath the surface, analysed the results and studied the general descriptions of learning styles identified by Honey and Mumford (1992), I concluded that overall my learning style was actually a mix of all four. As a “refector” I ‘like to stand back and ponder experiences and observe them from many different perspectives.’ As a “theorist” I tend to ‘adapt and integrate these observations into complex but logically sound theories,’ and as an “activist” I am ‘open-minded, not sceptical….and thrive on the challenge of new experiences’ (Honey and Mumford, 1992). It is reassuring that this appears to be quite normal, as Gopee (2011) argues that research on learning styles indicates that students do not choose and use only one style of learning, but almost always use a combination of styles.
‘…mentorship is a key element of professional life that underpins student development and supports qualified staff as they advance their own clinical and professional practice.’
According to Blooms Taxonomy, cited in and discussed by Sibson and Mursell (2010a), there are three main domains of learning: cognitive, focused on the knowledge and development of intellectual skills; affective, which focuses on the way emotional concepts such as feelings and attitudes are managed; and psychomotor, which focuses on the development of physical skills.
When planning my teaching and assessment, I endeavoured to develop a session that encompassed all these elements. Providing the underlying theory of percussion fell within the cognitive domain, creating the opportunity for the student to interact with the patient acted within the affective domain and learning a physical skill operated within the psychomotor domain. I also used a variety of teaching styles to appeal to a varied mix of learning styles.
The Nursing and Midwifery Council's (NMC) Standards to Support Learning and Assessment in Practice (NMC, 2008) are the accepted framework by the Health and Care Professions Council (HCPC), but it is interesting to note that any specific reference to “mentorship” is conspicuous by its absence in the HCPC's standards of proficiency for paramedics (HCPC, 2012). This is disappointing as Sibson and Mursell (2010b: 206) highlight that mentorship is a key element of professional life which underpins student development and supports qualified staff as they advance their own clinical and professional practice.
The NMC (2008) suggests a mentor is a registrant who facilitates learning and supervises and assesses students in the practice setting, and who is accountable for confirming if students have, or have not, met the competencies of practice. Gopee (2011) stresses that this ability to assess students is one of the most fundamental functions of the mentor. I was very apprehensive about how you assess an individual's level of competence, but Gopee (2011) advises that assessments should be as objective and fair as possible. Sibson and Mursell (2010a), however, argue that there is no such thing as an objective assessment as there is a degree of subjectivity involved in all assessment. They do suggest, however, that objective assessments should ideally have a single correct answer. This information assisted me to make a decision to teach a physical skill as it would enable me to physically observe and assess the skill and allow me to determine the underlying knowledge using objective criteria that generated single correct answers.
Conclusions
As the paramedic profession moves away from the vocational route to training that mainly operates within the psychomotor domain, to an academic route to education with a far greater focus on learning within the cognitive and affective domains, I agree wholeheartedly with the suggestion by Jones et al (2012) that paramedic practice mentors are, and will continue to be, pivotal in the success of this transition. Even though established mentorship programmes for paramedic practice are in their infancy (Sibson and Mursell, 2010c), Jones et al (2012) highlight that paramedics acting as mentors have generally been providing constructive support and learning experiences that compare well with other health care providers.
I had a good understanding of my strengths and weaknesses before commencing the module and therefore had high expectations about the knowledge and understanding I wanted to achieve. When I began my journey and took those first cautious steps into the styles domains and theories of learning, and investigated the role of the mentor, I felt it confirmed that I was indeed a “novice” (Benner, 2001). Undertaking the module, however, provided me with the underpinning knowledge to bridge the chasm in my understanding, and I feel that the journey so far, and my refection on this journey, has equipped me with the skills to allow me to progress from “novice” through “advanced beginner” and has enabled me to become “competent” (Benner, 2001) as a mentor. I look forward to continuing the journey as I strive to become “profcient” (Benner, 2001) in this role, which will then allow me to contribute to the success of this educational transition.
Action plan
As mentioned in my evaluation, I thoroughly enjoyed the journey and it has reinforced my passion for mentorship and teaching. It was disappointing, however, to find out that I will not be given the opportunity to solely or jointly mentor student paramedics “full time” through the duration of their studies, as my area of practice is considered to be too specialist to provide the all-round pre-hospital experience that a student paramedic would need. I do understand and accept this but find this very frustrating on a personal level. I am determined, therefore, to make sure I make the most of the occasional opportunities for formal mentorship that I am afforded.
‘…paramedics acting as mentors have generally been providing constructive support and learning experiences that compare well with other health care providers.’
Travelling this journey also reinvigorated me to continue to search and apply for lecturer practitioner positions within Higher Education Institutes and also ignited an enthusiasm around the importance of the whole concept of clinical leadership in my profession. As a result, in June 2013 I applied to the NHS Leadership Academy for a place on the Mary Seacole Clinical Leadership Programme. To my delight (and surprise!) I was successful in my application and am looking forward to commencing this new leg of my professional journey in October 2013.
A final comment
As Sibson and Mursell (2010b: 206) suggest, mentorship is a key element of professional life that underpins student development and supports qualified staff as they advance their own clinical and professional practice. In addition, Jones et al (2012) highlight the fact that mentors are and will continue to be pivotal in the transition from vocational paramedic training to academic paramedic education, should mentorship be specifically included in the HCPC's standards of proficiency for paramedics. Does a national standard and associated register of paramedic mentors need to be developed?