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Facilitating Learning and Assessment in Registered Nurse Practice Essay

In this portfolio I intend to expose the requirement of PP0127 of the process of facilitating learning and develop the skills of assessment as a registered nurse in the clinical practice. Mentoring is a development skill that offers a chance to deliver skill and knowledge by educating new students without any expectations and fears as mention by Huang & Lynch, (1995). I have been in the nursing industry for the past 4 years as a registered nurse. I am working in dialysis unit department as well knows private hospital that has been established for 27 years in Southeast Asia. I has been completed my diploma in nursing in year 2010 as recognized by Malaysia Minister of Government and commenced profession in year 2011.

Being one of the senior nurses within my department, I am in charge of orientation of the dialysis department as well as the Environment Safety Health guidelines for the newly employed registered nurse in dialysis unit department. My nurse manager was assigned me to supervise a new registered nurse Miss Rina (pseudonym) in my department. She was graduated from nursing college in year 2013. Rina aged is 21 years old and originated from Malaysia (Appendix 1). Rina is under the mentorship of myself on the track for learning, new skill and establish better practical knowledge of the department. Rina was required to enhance her skills and knowledge in preparation of extracorporeal circuit for hemodialysis (Fresenius machine).

A learning contract was also signed by Rina for consent of monitoring assessment (Appendix 2). Identifying Learning Needs, Planning and Managing Students Experiences Honey and Mumford (1992) in their adaptation of Kolb suggested four learning styles which recognized as activist, reflector, theorist and pragmatist in accordance with four-stage learning cycle of having an experience, reflecting on it, drawing applying the lessons learned. Therefore, Rina’s performance was observed prior to the provision of the program period. Rina learns was identified as a reflector learning styles. It is mean reflectors learn through observation, and by thinking about what they have observed, and constructing meaning through the process of the reflection. Specifically, it is expected that at the end of this provision period Rina would be able to: Understand and explain about the procedure

Extracorporeal circuit is prepared under aseptic technique
Visible air and sterilant are completely removed from the extracorporeal circuit. To provide safe delivery of patients care by ensuring
This procedure shall be carried out by clinical staff who have successfully completed the ‘Introduction to Renal Dialysis’ course certified competent Learning outcomes
Outline the principles of prepared Extracorporeal circuit
Outline the roles and responsibilities of the learner in prepared Extracorporeal circuit Demonstrate competency in prepared Extracorporeal circuit

According to Furzard (1995), facilitator is reflected by coaching a learner in positive way to develop the process of teaching in their clinical placement. Mentors are being encouraged to use different way of technique to the learners, so that learners will more crucial and show interest to learn the procedure. It will also make learners to be systematically in the learning process Lister (1990). Fundamentally, as a mentor, I need to apply some theories and principles, to be able to plan and deliver a good lesson for Rina. Therefore, the knowledge will able to meet Rina’s needs and help her to achieve her goals. One of the most powerful theories is Maslow’s hierarchy of basic needs (1962) about motivation (Appendix 3). It is make me understand that my Rina will give up if learning is not take place in the appropriated manner without motivation.

Motivation in the work place is important for Rina to achieve her goals. Besides that, physical environment is also important area in facilitating of learning in clinical practice. The process of teaching environment will be arranged in the clinical practice to decrease barriers between mentor and learners (Quinn, 1995). Through these, explanations, discussions and questioning, discussions will be beneficial for Rina to extending her skill and knowledge to perform well in the clinical practice. In these situations both of feel more comfortable and freedom to ask questions and talk openly to clarify the doubts. According to Rogers (1969), the demonstration skills are important within the clinical practice, so that learners will be profession in their skills.

I also provided the method of how to prepared the Extracorporeal circuit, and demonstrate the procedure to Rina. Bloom’s Taxonomy was created in 1956 under the leadership of educational psychologist Dr. Benjamin Bloom in order to promote higher forms of thinking in education, such as analyzing and evaluating, rather than just remembering facts (rote learning). The committee identified three domains of educational activities or learning (cognitive, affective and psychomotor) (Bloom, 1956). This learning helps Rina to develop her knowledge, attitude and skills. According these principles, a learning plan was done in the four weeks’ time (01/01/2014 to 31/01/2014). This is guarantee that appropriate time is provided to Rina to learn and complete the procedure gradually in the due time (Appendix 4).

Facilitating Learning and Assessment
An orientation program was conducted with Rina to make her feel comfortable and explain the plan about what are the expectations, responsibilities and attitude throughout the assessment. It is helps Rina to reduce her stress and anxiety. As a mentor, I will be providing her more confident and responsible to guide learners to avoid doing errors (Jeffery E.Auerbach). Rina has her basic knowledge on dialysis. Her requirements that she needs to achieved in her provision period was: To provide safe delivery of patients care by ensuring

Definition of priming extracorporeal
Why extracorporeal prepared under aseptic technique
Why visible air and sterilant are completely removed from the extracorporeal circuit Complications if present of sterilant in extracorporeal
According to Tomlinson, C. A. (1999), learners are will be act more effectively by visualize, perceiving and feel the sensations while performing procedure. Learners will be learning new things every day and gaining experience in daily activities. Visual learner is a learning style that easy to understand the contents from the aids and organizers. Rina was benefits from visual aid as a visual learner. Therefore, learning subjects like ideas, concepts, data, mind mapping and other information are related with images and techniques were presented via slide show to facilitate Rina’s learning.

The teaching methods described by Collins and colleagues in the ‘cognitive apprenticeship model’ (Collins et al. 1989) are highly specific and designed to foster situated learning and thus can be assumed to enhance learning in clinical practice. Collins et al. (1989) proposed six teaching methods promoting situated learning by helping students to acquire both cognitive and meta-cognitive skills and focus their observation of expert performance in practice so as to facilitate the development of their own problem-solving skills. Additionally, these methods foster the autonomy of students’ learning processes by encouraging students to formulate personal learning goals. In this study we will explore the use of the six teaching methods (modeling, coaching, scaffolding, articulation, reflection, and exploration) of the cognitive apprenticeship model as well as the role of the learning climate.

As mention by Albert Bandura, learning is a process of observing people’s attitude and trained to develop learners as a role model in future. Apart from that, learners will be captured by listening and observing of the performance in their clinical practice as a learning point to achieve their goals. Rina’s attitude was identified by visualized and perform the job skills before carried out a task. This learning method was given a positive perception for her because visual learners are expert at observing and perceiving details. During the assessment periods, Rina was required to observe my demonstrations of the procedure, how to prepare the correct technique of preparation of extracorporeal circuit (Appendix 5). The process of learning as a mentor will be develop by understanding and gaining information of the procedure before task has been performed to the learners.

Therefore, learners will be more confident and awareness to handle the procedure appropriately. Mentors are inspiring to be attentive to identify learners learning skills before guidance’s are being carried out, therefore difference types of learners has different type of learning skills that are be performed during working environment. Besides that, by observing learners performances through demonstration will be identify their understanding of the procedure. To be an effective mentor, mentors are encouraged to be prepared as a role model to a learner as suggested by Eric Parsloe, (1999). Rina was required to implement the procedure accurately after the demonstrations were given by me.

These demonstration practices will be emphasize to develop her skills. It is also encourage and motivate her with adequate knowledge, thought process and supportive environment. Scaffolding has been defined by Wood, Bruner, and Ross (1976) as an “adult controlling those elements of the task that are essentially beyond the learner’s capacity, thus permitting him to concentrate upon and complete only those elements that are within his range of competence. This method are supporting as well as providing comfort for Rina throughout the practice training. Learners are encouraged to think critical thinking and to clarify their doubt clearly in their professional as they will be prioritized on their learning practice and speak clearly to understand their needs. These critical thinking process will be enhance challenging for learners to interconnect their learning and procedure as they hands on with real equipment as mention by Chitty, (2001).

As a mentor I arranged some questioning section for Rina to stimulating and clear her doubts better understanding. According to Bulman & Schutz (2008), mentor and learners are reflected by experiences one other to evaluated their performance in daily and upcoming practices for improvement. Through reflection, I was identified Rina’s strengths and weaknesses. It will be beneficially for me to make effectively and competently to guide Rina to improve and develop her skills as a professional registered nurse during the training periods. Kolb’s experiential learning theory offers the career counselor a meta-model with which to structure career exploration exercises and ensure a thorough investigation of self and the world of work in a manner that provides the client with an optimal amount of learning and personal development.

During the third week of Rina’s training program, Rina was required to assist the senior registered nurse in preparing extracorporeal circuit. By this way encouraging Rina to implement her skills and providing safe deliver care. Rina’s performance was observed by me and another senior registered nurse to determine if she is able to handle and solve problem independently. While assessment, both formative and summative assessment were completely to assess the outcomes of learning skill of Rina. Instantly, competency checklist is important for learners to evaluate their level of understanding of the procedure so that learner will be more conscious on what they have being thought to perform according to the procedure as suggested by Yorke, (2003). Formative assessment is a feedback process of given an opportunity to demonstrate Rina’s learning. It is because to determine me to evaluate her response of the knowledge and skills that she received, and make adjustments in learning plans for Rina in identifies areas need improvement (Appendix 6).

Through the assessment, Rina will be observed to see whether she successfully complete and was able to perform the required responsibilities by performing correct procedures (Appendix 7). Summative assessment is to finalize the feedback and evidence based of learning for learners to complete their assignments which has been thought in their learning process by Hanna & Dettmer, (2004). Summative assessment is evaluation of Rina at the end of the training program to identify the outcome of the program. By this summative assessment, I know the level of Rina understands about performing the procedure. These assessments include an exam (Appendix 8). That examines to grade Rina’s skill on preparing extracorporeal circuit, as well as her ability in the knowledge. Rina will repeat the assessment that she failed to make sure the important skills and knowledge are required at the end of the training program.

Providing Ongoing Support and Guidance
The Vygotsky, (1978) suggested that, zones of proximal development (ZPD) are identified that, real development progress by each and individually in their career. Mentor will be encouraging to involved learners to resolve problem solving by independently when learner occurs difficult time so that learner will be have a chance to experiences in their lesson. Besides that it also enhances to be a team work among colleagues and proficient on career. Furthermore, by using these techniques of learning Rina will be developing skills and approach through effective ways. Hereafter, it is comfort for Rina to be more confident to proceed the procedure of preparing extracorporeal circuit without any nervous or anxiety throughout the training and after the provision period also.

During the provision period, I and Rina meet twice a week for discuss about the problems that she encounter and need further help to improve herself in performing the procedure. On this meeting time, the things of discussion were recorded as mention above (Appendix 4). Additionally, a senior registered nurse Dolly (pseudonym), with 10 years’ experience in dialysis unit department was assigned as Rina’s co-mentor, for the reason that Rina can look for her assistance when I am not around. In Kimble’s original definition he states that behavioral potentiality in learning occurs as a result of reinforced practice (Olson & Hergenhahn, 2009). Learning is a difficult definition to state because learning is only observable through behavioral changes.

Because learning cannot be observed if there is no change in behavior, the definition must contain and emphasize the need for behavioral change and in the textbook’s definition it stresses the importance of experience but leaves the theorist to specify the kind of experience he deems necessary to his research (Olson & Hergenhahn, 2009). Behavior is a key component when discussing the learning process. Without changes in behavior it is nearly impossible to document or record that learning has taken place. Olson and Hergenhahn claim that, the change, based on the definition given, must also be relatively permanent and must result from experience (2009).

Thus, I believe that Rina will be able to learn from Dolly by observing how she performs the procedure by her way. Rina also had some discussion with Dolly to clarify her doubts. Through these Rina can improves her skills and perform well with confident. Furthermore, Dolly and I support and guide Rina in the practice area by assessing, evaluating and give positive feedback whenever she do the mistakes in her procedure to encourage her to achieved the knowledge, skills and to make improvements to promote her progress. This is one the framework to support learning and assessment in practice for Rina.

Summary of Personal and Professional Development in Mentorship In the conclusion, I have confidence in that I and Rina have benefited throughout the assessment period. Rina was successfully accomplished her target to developing skills and knowledge in the assessment. According to David A Stoddard (2009), “mentoring involves helping others to discover and pursue their passions, recognize and deal with their pain and sort out their priorities. More than a sound business practice, mentoring is really a stewardship issue. It’s an opportunity to give of ourselves – our experiences, our expertise, and our gifts- and take advantage of opportunities to help someone be all that they can be.” I understand that mentoring is a challenging process for both of us, me as a mentor and for Rina as a learner to teaching and assessing her throughout the provision period.

These mentoring processes identify my strength and weakness to progress my personal and professional development in career. Throughout the assessment period I have extended my knowledge and understand how to become a good mentor and has confident to guide learners in different methods for my future students. I have also known various assessment and teaching strategies through the aspects of NMC standards. Further that, being a mentor is a good opportunity for me to identify my skills and knowledge in my department. It is helps me to developing my skills and knowledge as mentor role. In future, I as a mentor will be more confident in teaching my learner.

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