Developing mentors to support students in practice, supporting students in practice,

Part 10: Leadership (word count 4574)

Summary

There is a strong correlation between effective leadership in nursing and the provision of high

quality care to patients (Harris et al 2014). Recent revelations in relation to poor care

practices within the nursing profession, have highlighted the need for strong leadership in the

healthcare setting (Francis 2013). Mentors and practice teachers are required to demonstrate

leadership as part of both their nursing and facilitative role. In addition they are responsible

for developing effective leadership skills within their students who once registrants, will be

expected to demonstrate these skills in practice.

This article aims to provide guidance for both new and established mentors and practice

teachers in relation to the domain of Leadership, specifically stage 2 Mentor and stage 3

Practice teacher, (the specific outcomes can be found in Box 1). How mentors can foster

these skills will be discussed in relation to leading by example; the text will be interspersed

with these outcomes for mentors and practice teachers where they apply. The activities

indicated within this article will provide the opportunity for mentors and practice teachers to

generate evidence in order to map this on-going development against the NMC Standards to

Support Learning and Assessment in Practice (SSLAP 2008a).

Introduction

Although there are many definitions of leadership one which lends itself well to the mentor

and practice leadership standard, is that of Rafferty (1993) who suggests that leaders inspire,

facilitate, help and praise’. These are important facets of leadership when supporting student

nurses within the learning environment and are indeed integral to the role of mentors and

practice teachers. O’Driscoll et al’s (2010) study suggests that although other members of the

team have responsibilities in terms of student learning, the mentor/practice teacher is the one

who is primarily concerned with leading this on a day to day basis. Such skills involve

effective communication and interpersonal skills, self-awareness and being able to time

manage, prioritise and delegate appropriately (Craig and Smith 2015). Brimblescombe (2009)

suggests resilience, empathy and trustworthiness are important in developing leadership

skills. Moreover, these skills should be developed within students in order to enhance their

own practice when they become registrants and then mentors / practice teachers themselves.

More specifically students can observe and learn from those who facilitate their learning,

identifying certain attributes which are influential in effective leadership (Ousey, 2009).

Craig and Smith (2015) emphasise the need to equip students of healthcare with the skills to

recognise poor practice and to ensure good practice through change. Leadership is a skill

crucial to the role of the nurse/practice teacher in clinical settings in that they are responsible

for all aspects of the organisation of care; this organising of care allows the mentor/practice

teacher to demonstrate clear leadership skills and behaviours (Craig and Smith 2015). Ailey

et al (2015) assert that through the observation leadership skills in their mentor/practice

teacher and others, students are able to learn and practice such skills within the context of a

clinical environment. Furthermore, they are able to see how leadership can move from

leading on individual patient care to that of the nursing team. Indeed Lord Willis (2012)

identified the need to prepare future nurses for what would be expected of them in relation to

leadership once qualified. Certainly, beyond registration future employers expect leadership

qualities to have been already developed in newly qualified nurses (Foli et al 2014).

Why are effective leadership skills important?

The NHS’s forward view into action: planning for 2015/16 (2014) identifies effective clinical

leadership as a necessity in implementing new care models in response to the changing needs

of patients. Manley (1997 in Gopee 2010 pg 131) identifies a correlation between quality of

care and effective nursing leadership; in addition successful leadership can enable practice

development, and the empowerment of staff. In relation to practice teachers this applies to not

only the delivery of evidence based practice (discussed in article 9 in this series), but also

how practice teachers (and mentors) deliver and be a role model of best practice (Gopee

2010). The suggestion here is that leadership is not exclusive to leading teams in a managerial

capacity, but rather can exist on an individual level. This involves working effectively with

patients, being aware of and innovating to improve practice, and to also lead by example. The

Chief Nursing Officer Jane Cummings (2015) asserts the need for nurses and midwives to

work with and lead their patients in improving their health, by understanding what motivates

their patients as well as offering support and advice to achieve this. Ousey (2009) suggests

that through observation, students can learn the attributes of leadership as demonstrated by

their mentor or practice teacher

(Ousey, 2009). Students observing the application of leadership skills in this context can

provide a valuable learning opportunity. At this point is may be beneficial for the

mentor/practice teacher to undertake time out activity 1 below , in order to establish their

students’ thoughts and ideas about leadership.

Improving care may be borne out of poor or inadequate practice and leaders must be in

possession of the skills and confidence to initiate the required changes. Furthermore those

who facilitate student learning must demonstrate confidence as a leader in order to give

effective instruction and support to the learner (Craig and Smith 2015). It is expected that

students through observation of such behaviours in practice, will adopt these through

emulating the practitioners to whom they seek to be like (Perry 2008). Although students may

be taught leadership theory and skills within the academic setting by those with a clinical

background, the influence from the academic perspective is less well documented (Baldwin

et al 2014) , therefore emphasising the need for strong demonstration in the practice setting.

By undertaking Time out activity 2 below the mentor/practice teacher can provide evidence

for the following. Provide practice leadership and expertise in application of knowledge and

skills based on evidence

Time out Activity 1

Pause now and consider how students you support have thought of

leadership to date.

Do they see this as the remit of managers? Do they understand

that all registered nurses lead, for instance patients through an

understanding of their illness? What if anything needs

correcting in how leadership is thought about then?

Time out activity 2

Reflect on your leadership style and how you role model this

approach.

How might your style impact on students within the learning

environment ?

What makes the mentor/practice teacher an effective leader?

The literature presents a plethora of characteristics or traits within an individual which are a

prerequisite for the effective leader. Maxwell (1999) suggests there are 21 qualities including

positive attitude, charisma and competence, however Mullins (2002) argues there is not a set

or list of traits common to all effective leaders. He goes on to suggest that general

characteristics can be identified, such as self –confidence, intelligence and initiative as being

those which contribute to effective leadership. In terms of leadership style there is a broad

classification, examples being autocratic, democratic and lassez-faire. Mullins (2002)

describes these as follows:

Autocratic- The focus of power is with the leader who is the one who makes the

decisions and exercises authority.

Democratic- The focus of power is with the group, there is a greater interaction

within the group and the leader is much more part of the team. Group members

involved in the decision making process.

Laissez-faire-Focus of power is passed onto the group members; the leader will not

interfere but is available if help is needed.

Goleman (2000 cited in Gopee 2010 p 134) asserts that to be an effective leader one must be

able to adopt and combine any one of these styles depending upon the situation. However

mentors and practice teachers need to be aware of their own leadership style in terms of how

this may influence learning (Kinnell and Hughes 2010). Students therefore may benefit from

observing adaptable leadership styles in differing situations, which Sellgren et al (2006 p.

349) refer to as ‘situational leadership’ whereby a leader’s behaviour adapts to certain

situations.

In addition Gallagher and Tschudin (2009) suggest the leadership styles conveyed by staff

may, have a lasting impression on students in terms of the institution; it is therefore of some

importance that fairness and justice are interwoven whatever the leadership style. It is fair to

suggest that the leadership styles displayed in the practice setting by the mentor/practice

teacher can have an impact upon the learning environment and subsequently the students

learning. Kinnell and Hughes (2010) assert that an autocratic approach can convey an

environment which is controlled; students may feel at risk of feeling devalued in that their

opinions or suggestions are overlooked, similarly some students may well feel intimidated by

this approach. Furthermore a Laissez-faire style, although may present a relaxed atmosphere,

may lead to a disorganised placement area. This seemingly disordered approach potentially

could have a negative impact on student learning and give rise to anxieties about placement

and therefore not be conducive to learning. Finally the democratic approach is one which

could be viewed as one which is based on team decisions, can have a positive effect on

student learning (Kinnell and Hughes 2010). Here the student could experience being part of

the team and be involved in the decision making process, therefore feeling they have some

value within the team.

Having established the merits and pitfalls of each style of leadership there will be situations

where one style will be more effective than another. In the healthcare context, emergency

situations may require an authoritarian style, where risk and safety is not an issue a more

democratic approach may be just as effective (Gopee and Galloway 2009). Whichever

approach is adopted and in whichever circumstance, it is important for the mentor/practice

teacher to explore with their students the reasons for a particular leadership style, given that

some circumstances require a certain approach. As Craig and Smith (2015) assert, effective

leaders are able to justify their decision making as they are able to see the wider picture.

Through explanation students have a greater opportunity to not just explore the reasoning

behind a particular approach, but to also observe how this is delivered in practice.

Theories and models of leadership applied to the roles of mentors/ practice teachers

Leadership can be described as either transformational or transactional, Burns (1978) noted

that transactional leadership highlights the relationship between the leader and their

followers, and whereby there is a basis of authority, work tasks, outcomes and as a

consequence rewards and punishments for followers (Mullins 2002). An example is where

promotion or bonuses are exchanged for loyalty and effort in achieving objectives by the

followers; instilling self-esteem and personal fulfilment in followers is less of a feature in this

leadership style (Chemers 2009). Here the mentor/practice teacher, when working with

students and their specific learning objectives, they are in position to motivate the student

with the promise of reward (passing their outcomes) or censure depending on the students’

performance whilst in placement. Whilst we can see this approach to leadership may apply

according to Burns explanation, to adopt this approach in isolation could be detrimental to the

student’s development. Barr and Dowding (2008) highlight criticisms in that the transactional

approach to leadership is much less effective where there is a necessity for creativity in

complex working environments. Here alternative approaches to leadership would be more

effective in engaging followers in exceeding their own interests and undertaking more than

was expected (Hartley and Bennington 2010)

Transformational leaders in contrast are much more encouraging and motivating towards

their followers. Gopee and Galloway (2009) suggest that these leaders aim to engender in

their followers, commitment to an organisations ideals, as well as their own aspirations and

aims for the organisation. Furthermore Sellgren et al (2006, p.349) portrays transformational

leaders as a ‘gardener’, shaping a growing culture by empowering staff to think creatively

and giving them the freedom to grow and innovate. By both observing and engaging in this

dynamic process within teams, students are exposed to the values and behaviours associated

with this approach to leadership.

Transformational leadership therefore is seen as a desirable feature in healthcare where there

is a perpetual need for creative problem solving (Barr and Dowding 2008). This is in

response to perpetual change, some of which is stipulated by the Department of Health,

however ‘emergent’ change where, for example, reviews of nursing practice may identify

areas for change (Kinnell and Hughes 2010). Transactional and transformational theory of

leadership can seem less than concrete, however it becomes important when facilitating

learning as we consider what will best demonstrate the sort of leadership to be emulated in

our learners upon registration. Will they simply implement care, or will they attempt to work

with and lead on that care closely with the values and concerns of patients. If

transformational leadership is preferred in clinical practice, then it is necessary to discuss

with students and explore exactly why this is. We must also consider the style of leadership

that we use with the student when supporting them in practice. Transformational leadership

requires us to learn a great deal more about student values and beliefs than a transactional

style of leadership would. The transformational mentor/practice teacher would seek to work

closely with the student’s learning agenda, and blend this with what is professionally required

to achieve registration. Now consider time out activity 3.

Time out activity 3

Having read about transactional and transformational leadership

styles, decide where your strengths lie. How does (or would) it feel to

work very closely indeed with the students own beliefs and values

around learning, as well as what is required in terms of skill

acquisition? Have there been times when you have gone the extra

mile to help students make sense of their experiences, to ascertain

what can work best in a given clinical situation?

The transformational approach could be described as ethical leadership. Gallagher and

Tschudin (2009 p. 224) describe this approach as one which ‘aspires to good ends and to the

kind of change that contributes to the flourishing of other human beings, as well as towards

the good of other species and the environment ‘From a mentor/practice teacher perspective

this includes not only applying this assertion to work colleagues and the organisation, but to

that of facilitating student learning and development’.

Effective leadership for Mentors and Practice Teachers

In order to lead, a leader requires at least one other follower, and to lead effectively is to have

a greater influence on those followers (Stanton and Chapman 2010). Within the clinical

setting Stanley (2006) identified through his study into effective clinical leadership, a number

of attributes demonstrated by effective leaders. These qualities include clinical knowledge

and competence, an effective communicator and decision maker, and one who is

approachable. Hayes (2011) highlights some of the minimal attributes for an effective leader

including having a goal, having respect for others and being able to recognise and utilise the

resourcefulness within the team. Such resources may not just be found within the placement

area, but also external to the organisation, University Link Lecturers (ULL) can provide

valuable support to individual facilitators or the practice team as a whole. Their role is

primarily related to supporting placements with issues, but also to discuss and share good

practice. The opportunity arises here for the individual mentor and practice teacher to forge

stronger links with the university through the ULL (Demonstrate the ability to lead education

on practice, working across practice and academic settings -Practice Teacher). This function

may in some cases be exclusive to the person who tends to liaise with the university in

relation to completing the audit and receiving and disseminating allocations and student

evaluations. Now complete time out activity 4

Through observation students do not only learn tangible skills but also those which involve

the actions and reactions within their learning environment (Craig and Smith 2015). Bandura

(1977) in his early work suggested that the patterns of the behaviour of one person can be

copied by another, also known as role modelling. Most nurses and midwives can recall

encountering an individual with whom they have worked who values and behaviours have

impacted upon their own. Donaldson and Carter’s (2005) study into the value of role

modelling found that students expected to be able to identify a good nurse as a role model

and one which they would copy behaviour and attitudes from. Furthermore, students in

Watson and Harris’ (2000) study that good practice is reinforced by an effective role model.

The potential for student learning here is not to be overlooked. One mentor in Perry’s (2008,

p.40) study into role modelling in clinical practice commented ‘I am constantly reminded by

what the students say, that I am likely the most important textbook that they ever read.’ This

suggests students place a great deal of emphasis on their mentor for their practice learning.

As suggested this learning is not always formal learning as in nursing practice, mentors and

Time out Activity 4

If you don’t already know, find out who the ULL is for your

practice area. Are you aware of their role, as these may vary

depending upon the university they work in?

Consider the benefits of a strong partnership with the

university through the ULL, for example this could mean you

having a greater knowledge of the academic side of the

programme

practice teachers through role modelling and explanation can help as student make sense of

sometimes confusing situations where the way to proceed is less than obvious to the student.

Mentors and practice teachers when offering explanation and reasoning for certain actions

can demonstrate effective leadership. Now undertake time out activity 5 in order for you to

examine a situation where you may have been role modelling informally.

Managing the learning experience

Effective leadership skills can ensure an effective learning environment. The availability of

inspirational role models who can make a difference to and lead care, but who also influence

the learning environment is pivotal to student learning. However managing the learning

experience can be a challenge to a busy mentor or practice teacher; time constraints and

competing priorities have been well documented as barriers to effective mentoring. Pulsford

et al (2002) conducted a mentorship study and found some mentors experienced difficulty in

finding time to spend with students, whilst others felt they lacked link tutor support from

universities. The study however concluded that notwithstanding these challenges, mentors

carried out their role regardless. Although anecdotally, these issues remain in some practice

areas, the emergence of the role of the Practice Education Facilitator (PEF) has sought to

address some of the issues surrounding the demands of the practice area. The role is

Learning Activity 5

Examine your organisations values and identify areas where

you may have role modelled these to students.

Ask the student for feedback to establish how self-aware you

are/were in how this was delivered.

concerned with the capacity (number of students), quality and capability of learning

environments and can offer support to mentors/practice teachers or learning environments as

a whole in ensuring a quality learning experience for students. As such their advice and

support should be sought in such circumstances.

Other options may be available to individual mentors/practice teachers in that forward

planning could bear fruit, in terms of organising activities with other members of the team

within the department. The NMC (2008) stipulate that a minimum of 40% of a student’s time

in practice must be under supervision by a mentor or practice teacher. The guidance here is

that student can either work independently with indirect supervision or under the direct

supervision of others, thus being part of the students learning experience; it is the mentor /

practice teachers responsibility to plan this and should be commensurate to the student’s

stage in the programme. This applies to the following outcomes manage competing demands

of practice and education related to supporting different practice levels of students (Practice

teacher) and Prioritise work to accommodate support of students within their practice roles

(Mentor)

Kinnell and Hughes (2010) advocate planning a student’s learning experience on a week by

week basis during their placement and apply to mentor stage 2 ‘Plan a series of learning

experiences that will meet students’ defined learning need’. This allows the mentor/practice

teacher and the student to remain focussed on the tasks and activities to facilitate learning.

Furthermore, this can help ensure that the three formal interview stages, initial, midpoint and

final take place at the required junctures in the student placement, in relation to timely

feedback and action planning, thus Providing feedback about the effectiveness of learning

and assessment in practice (Mentor). McNair et al (2007) stress the importance of a student

always needing to know how they are performing throughout the placement, as well timely

actions pans for underachieving student. Feedback and action planning has been discussed in

much greater detail in article 6 Assessment. In terms of planning student activity, undertake

time out activity 6 below,

Part of the planning process in relation to the students learning experience could involve the

‘mentorship team’. Kinnell and Hughes (2010) describe this as a team of a number of

individuals working together in facilitating students and enhancing the learning environment.

Moreover, involving other members of the team in the learning experience of students has

benefits which are twofold. There could be positive effects in terms of team dynamics and

team cohesion; in addition the student can link with any one of these other team members if

their mentor is not available. Although this may present a challenge for a number of reasons,

consider the activity below in exploring possibilities within your area of practice. In addition

to other stage one registrants, who would be supporting student learning by ‘sharing

experience and knowledge’ (NMC 2008b) others within the team could offer valuable

support and guidance. Here the mentor would be undertaking the following, be an advocate

for students to support them accessing learning opportunities that meet their individual

needs, involving a range of other professionals, patients, clients and carers

Time out activity 6

Devise a weekly plan for a student you are about to support

and consider what you as a mentor/practice teacher will

undertake each week to enable them to meet their learning

needs.

Ensure you try to map them to the student outcomes so that the

student can see that the activity is meaningful. Also reflect

upon which other professionals work in your area of practice

who might enhance the students learning though their

Some universities offer peer support or peer mentoring schemes whereby third year students

are involved in the more junior student learning experience. Indeed there are potential

benefits, studies undertaken have identified reduced anxiety in clinical settings where junior

students have been provided with support and guidance from more senior students (Aston and

Molassiotis, 2003; Sprengel and Job, 2004). Furthermore senior students would start to

develop the skills required in facilitating students, skills very much a feature of a Stage One

Mentor within SSLAP (2008a) Other members of the team are not to be overlooked in terms

of their contribution to the student learning experience. Health Care Assistants (HCAs) can

prove to be an invaluable source of fundamental knowledge with the placement and are seen

as a ‘vital linchpin’ in the orientation process (Kinnell and Hughes 2010). Moreover in

O’Driscoll et al’s (2010) study into who leads and contributes to the student learning

experience, the evidence suggest that in terms of acquiring bedside care skills, the HCAs play

a significant role. Now complete time out activity 7

In order of the student to see the patient journey through health care services, opportunities

for them to spend time in other areas should be seized upon. These opportunities allow the

student to learn about the roles of other professionals who form part of the multidisciplinary

team, which serves to go some way to preparing students for their future role within that

team. Modernising Nursing Careers (DH 2006) states ‘nurses will take responsibility for care

co-ordination, standards of care and leading the nursing workforce as part of

Time out activity 7

Consider who you could ask to be involved in the mentorship team

and the role they may play in supporting your student. You may want

to include this in the plan undertaken in the previous activity

multidisciplinary teams (MDT)’, it would be advantageous therefore for mentors and practice

teachers to consider supporting students to take up these opportunities. The benefits also

extend to other members of the MDT to contribute to the assessment process whilst they are

supervising the students and this approach is acknowledged within SSLAP. Indeed as

Anderson (2011) suggests the contribution of other practitioners in the assessment process

can ensure a limit of bias as well as transparency and equity.

Maintaining the quality of the learning environment.

In order for Practice Teachers and indeed mentors need to be aware of how students perceive

their placement experience, they will need to examine and respond to recent evaluations of

practice. Evaluations which students undertake are a collection of information about a

particular part of a programme which is subject to analysis; this insight allows those

facilitating students, to establish areas for improvement (Neary 2000). However, on a positive

note it also highlights what is right. The specifics of evaluation are discussed in further detail

within another part of this series of articles. However within stage 3 practice teachers are

expected to lead and contribute to the evaluation of the effectiveness of learning and

assessment in practice. This may be from a personal perspective by reflecting upon your own

performance as facilitator, but also by examining the evaluations students undertake, usually

at the end of the placement and via the university. Evaluation will be examined in more detail

in part 11 of this series. This should be an ongoing process and Elcock and Sharples (2011)

advocate that asking your student for feedback throughout the placement, allows the student

to raise concerns which can be addressed at the time rather than at the end of the placement.

Furthermore by asking for student feedback throughout is good practice and ensures the

students feel they are being listened to. Now go to time out activity 8

Summary

Effective leadership is important within a healthcare setting which dictates constant change in

order to keep abreast of the developments within contemporary health care. Mentors and

practice teachers are required to both lead within their own practice as part of a clinical, lead

on the student learning experience, also to make visible and inspire such skills within the

student. As such, the element of leadership is multifaceted and potentially complex, given the

diversity of both team members and situations requiring leadership. It is vital that student

learning is managed effectively by the mentor/practice teacher, with the involvement of other

members of staff as a resource demonstrating effective leadership skills. Similarly, through

role modelling it is key that students can identify leadership styles and skills within a variety

of situations, allowing for the process of reflection for further development.

Learning Activity 8

Think about a student whose learning you have recently facilitated

and reflect upon the experience in relation to:

What went well and what did not go so well. What do you think

were the reason/s for this?

What could have been improved upon and how?

What have you gained from this experience and how might this

improve your skills as a facilitator?

References

Ailey, S. Lamb, K. Friese, T. Christopher, B.A. (2015) Education student nurses in clinical leadership. Nursing Management 21(9) 23-28

Anderson, L. (2011) A learning resource for developing effective mentorship in practice.

Nursing Standard. 25, 51, 48-56.

Aston, L. Molassiotis, A. (2003). Supervising and supporting student nurses in clinical placements: the peer support initiative. Nurse Education Today 23 (3), 202–210.

Baldwin, A. Bentley, K. Langtree, T. Mills, J. (2014) Achieving graduate outcomes in undergraduate nursing education following the yellow brick road. Nurse Education in Practice. 14 9-11

Bandura, A.(1977) Self-efficacy: toward a unifying approach of behaviour change.Psychological Review. 84, 191–215.

Barr, J. Dowding, L. (2008) Leadership in Health Care. Sage. London.

Bass, B.M. (1985) Leadership and Performance Beyond Expectations. The Free Press. New York

Brimblecombe, N. (2009) Leadership and Management in Callaghan, P. Playle, J. Cooper, L. (eds). Mental health nursing skills. Oxford University Press. Oxford, pp 232-238.

Burns, J.M. (1978) Leadership. Harper & Row, New York.

Chemers, M.M. (2009) An integrative theory of leadership. Psychology Press. New York.

Craig, K. Smith, B. (2015) The nurse mentor’s companion. Sage. London.

Cummings, J. (2015) As leaders we must show we can work on our own lifestyles. Nursing Times. 111, 3, 7.

Department of Health (2006) Modernising Nursing Careers: setting the direction. DoH. London.

Donaldson, J, Carter, D. (2005) The value of role modelling: Perceptions of undergraduate and diploma nursing (adult) students. Nurse Education in Practice. 5, 353–359.

Elcock, K, Sharples, K. ( 2011) A nurse’s survival guide to mentoring. Churchill Livingstone. London.

Foli, K. J, Braswell, M. J, Kirkpatrick, Lim. E. (2014) Development of Leadership Behaviors in Undergraduate Nursing Students: A Service-Learning Approach Nursing Education Perspectives. 35: 2 p.76-82.

Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry. The Stationery office, London. Retrieved from http://www.midstaffspublicinquiry.com/report on 20 August 2014.

Gallagher, A. Tschudin, V. (2009) Educating for Ethical Leadership Nurse Education Today 30 224–227.

Gopee, N. Galloway, J. (2009) Leadership and management in healthcare. Sage. London.

Gopee, N. (2010) Practice teaching in healthcare. Sage. London.

Harris. R, Bennett J, Ross F. (2014) Leadership and innovation in nursing seen through a historical lens. Journal of Advanced Nursing. 70, 7, 1629-1638.

Hartley. J. Benington, J. (2010) Leadership for healthcare. The policy press.Bristol

Hayes, P. (2011) Leading and coaching teams to success; the secret life of teams. Open university Press. Maidenhead.

Kinnell, D. Hughes, P. (2010) Mentoring Nursing and Healthcare Students. Sage. London.

McNair, W. Smith, B. Ellis, J. (2007) A vision of mentorship in practice.Journal of Perioperative Practice.17, 9, 421-430.

Mullins, L. J. (2002) Management and Organisational Behaviour (6th ed) Pearson Education. Harlow

Maxwell, J. C. (1999) The 21 indispensable qualities of a leader. Thomas Nelson. Nashville

Neary, M. (2000) Teaching, assessing and evaluation for clinical competence. A practical guide for practitioners and teachers. Nelson Thornes. Cheltenham.

NHS England (2014) The forward view into action: planning for 2015/16.Available at http://www.england.nhs.uk/wp-content/uploads/2014/12/forward-view-plning.pdf ( accessed 24 January 2015)

Nursing and Midwifery Council. (2008a) Standards to Support Learning and Assessment in Practice. Second edition, NMC. London.

Nursing and Midwifery Council. (2008b) The Code- standards of conduct. Performance and Ethics for Nurses and Midwives. NMC, London.

O’Driscoll, M.F. Allan, H. T. Smith, P.A. (2010) Still looking for leadership – Who is responsible for student nurses’ learning in practice? Nurse Education Today 30 (2010) 212–217.

Ousey. K, (2009) Socialization of student nurses: the role of the mentor, Learning in Health and Social Care, 8, pp.175-184.

Perry, B. (2008) Role modeling excellence in clinical nursing practice Nurse Education in Practice 9, 36–44.

Pritchard, E. Gidman, J. (2012) Effective mentoring in the community setting, British Journal of Community Nursing, 17, pp.119-124.

Pulsford. D, Boit. K. Owen. S. (2002) Are mentors ready to make a difference? A survey of mentors' attitudes towards nurse education. Nurse Education Today 22, 439-446.

Rafferty, A. (1993) Leadership questions: a discussion paper on the issues of nurse leadership. Kings fund Centre .

Sellgren, S. Ekvall, G. Tomson, G. (2006) Leadership styles in nursing management: preferred or perceived. Journal of nursing management.14 348-355

Sprengel, A.D. Job, L. (2004). Reducing student anxiety by using clinical peer mentoring with beginning nursing students. Nurse Educator 29 (6), 246–250.

Stanley, D. (2006) Recognising and defining clinical nurse leaders . British Journal of Nursing 15, (2) 108-111.

Stanton, E. Chapman, C. (2010) Team working and clinical leadership. In Stanton, E. Lemer, C. Mountford, J.(eds) Clinical Leadership Bridging the Divide. Quay books. London, pp 51-66.

Watson, H.E., Harris, B.( 2000) Supporting students in practice placements in Scotland. Glasgow Caledonian University andNational Board for Nursing, Midwifery and Health Visiting for Scotland, Glasgow.

Willis Commission on Nursing Education (2012) Quality with compassion: the future of nursing education. RCN on behalf of the Willis Commission. London.

Box 1.

Nursing and Midwifery Council (2008a) ‘Standards to

Support Learning and Assessment in Practice’

Domain 8 Leadership- Stage 2- Mentor

Plan a series of learning experiences that will meet students’ defined learning need

Be an advocate for students to support them accessing learning opportunities that meet their individual needs, involving a range of other professionals, patients, clients and carers

Prioritise work to accommodate support of students within their practice roles

Provide feedback about the effectiveness of learning and assessment in practice

Domain 8 Leadership- Stage 3- Practice Teacher

Provide practice leadership and expertise in application

of knowledge and skills based on evidence

Demonstrate the ability to lead education on practice,

working across practice and academic settings

Manage competing demands of practice and education

related to supporting different practice levels of

students

Lead and contribute to the evaluation of effectiveness

of learning and assessment in practice