City, University of London Institutional Repository

Citation: Meier, Katharine (2012). A realistic evaluation of a tool to assess the interpersonal skills of pre-registration nursing students. (Unpublished Doctoral thesis, City University London)

This is the unspecified version of the paper.

This version of the publication may differ from the final published version.

Permanent repository link: http://openaccess.city.ac.uk/2097/

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Table 1 Questions on satisfaction with ISP

46($7*I""B")*".*'B><*2==J?*

*

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I think it’s too open to personal choice as some mentors want you to do extra work before they sign your book while others will sign it without checking if you have done everything. You can also have mentors who will grade you as excellent for everything and others who will just pass you!!

N.R$,$4g!./$!()-<$/)!5%4)'*-&%4&B!&'7$<!)2$!<.*-@$/)!(%B'/:!!

I like the levels of achievement [ISP] as it shows I am working well and above the level.

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Figure 9 Overview of the study

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6')$(!"!%/<!W!

Table 2 Research participants and data collected

!

3)!)..7!(.@$!)'@$!).!4$*4-')!@$/).4(!).!5%4)'*'5%)$!'/!)2$!()-<Bm!@$%/R2'&$!

'/)$4,'$R(!R$4$!*./<-*)$<!R')2!0.-4!+<-*%)'./!F2%@5'./(!S+F(T!k($*)'./!LEQEIlE!!

+F(!%4$!($/'.4!/-4('/:!0%*-&)B!R2.!@%/%:$!)2$!4$&%)'./(2'5(!)2$!N+3!%/<!*&'/'*%&!

5&%*$@$/)(!.,$4!%!R'<$!:$.:4%52'*%&!%4$%E!!12-(!)2$B!2%,$!%/!.,$4,'$R!.0!)2$!

*-44'*-&-@g!%(($((@$/)!54%*)'*$(!%/<!@$/).4(2'5E!!+F!5%4)'*'5%/)(!R$4$!4$*4-')$<!

04.@!(')$(!"!%/<!WE!!12$B!2%<!.,$4(':2)!.0!5&%*$@$/)(!04.@!%&&!0'$&<(!.0!/-4('/:E!!

>$)2.<.&.:B!

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6)4%)$:'*!N$%&)2!"-)2.4')BQ!S6N"T!.4!%)!)2$!N+3TE!

!

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.,$4!%!KJ9@./)2!5$4'.<E!12$($!R$4$!%&&!&'/7$<!).!6')$!"!%/<!R.47$<!R')2'/!)2$!

"<-&)g!F2'&<!%/<!H$%4/'/:!<'(%?'&')B!0'$&<(E!!

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k($*)'./!LEQEYlE!

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3/<-*)',$!%554.%*2 A$<-*)',$!%554.%*2 84$5%4%)'./!52%($

6$&$*)'/:!)2$!-/')!.0!%/%&B('(

>%7'/:!($/($!.0!)2$!<%)%!%/<!

R2.&$

M4:%/'('/:!52%($

M5$/!*.<'/:

F.<'/:!(2$$)(

O4.-5'/:

F%)$:.4'j%)'./

"?()4%*)'./

A$,$&.5'/:!%/%&B('(!@%)4'*$

A%)%!:%)2$4'/:!?B!*./)$/)

A$,$&.5'/:!()4-*)-4%&!%/%&B('(!

@%)4'*$

A%)%!*.<'/:!%**.4<'/:!)2$!*%)$:.4'$(

#$5.4)'/:!)2$!%/%&Bj'/:!54.*$((!%/<!)2$!4$(-&)(

>.<$&g!*./*$5)-%&!(B()$@g!*./*$5)-%&!@%5!.4!*%)$:.4'($

84$5%4%)'./g!.4:%/'('/:!%/<!4$(-&)'/:!52%($(!'/!)2$!*./*$5)!%/%&B('(!54.*$((

NB5.)2$('(!)$()'/:!*.44$(5./<$/*$!

*.@5%4'(./!).!$%4&'$4!()-<'$(!$)*

!

! KJY!

5%4)'*-&%4!()-<B!N+3!%/<!54$94$:'()4%)'./!/-4('/:!54.:4%@@$g!<%)%!R%(!%?()4%*)$<!

).!%!($*./<!&$,$&!%/<!*&-()$4$<!'/).!($,$/!*.<$!:4.-5(!.4:%/'($<!%4.-/<!F./)$a)!

k)R.!:4.-5(g!1%?&$!Ylg!>$*2%/'(@!k)24$$!:4.-5(g!1%?&$!Pl!%/<!M-)*.@$!k)R.!

:4.-5(g!1%?&$!QlE!F.<$!:4.-5(!*./('()$<!.0!0'4()9&$,$&!*.<$(!)2%)!2%<!%/!'@5%*)!./!%!

5%4)'*-&%4!%(5$*)E!12$4$!R%(!.**%('./%&!.,$4&%5!R')2!(.@$!*.<$(!5&%B'/:!%!4.&$!'/!

@.4$!)2%/!./$!:4.-5E!D.4!$a%@5&$g!)2$!*.<$!b@$*2%/'(@C!$a5&'*')c!($$@$<!).!

$/*.@5%((!%/!'@5%*)!./!0.4@%)',$!%(($((@$/)!.0!'/)$45$4(./%&!(7'&&(!'/!)2%)!

()-<$/)(!%/<!@$/).4(!7/$R!R2%)!R%(!$a5$*)$<E!12'(!?$*%@$!5%4)!.0!%!@$*2%/'(@!

:4.-5!b@$*2%/'(@C!0.4@%)',$!0-/*)'./cE!b>$*2%/'(@C!$a5&'*')c!%&(.!@$%/)!)2%)!

@$/).4(!R$4$!54.,'<$<!R')2!R.4<(!).!:',$!0$$<?%*7!'/()$%<!.0!2%,'/:!).!:$/$4%)$!

R.4<(!)2$@($&,$(E!12'(!%(5$*)!?$*%@$!5%4)!.0!)2$!@$*2%/'(@!:4.-5!b@$*2%/'(@C!

&$((!<%-/)'/:cE!!12$!)2'4<!&$,$&!.0!%/%&B('(!B'$&<$<!)2$!F>M!*./0':-4%)'./(!

(-@@%4'($<!'/!1%?&$!U!%/<!<'(*-(($<!'/!*2%5)$4!PE!

Q"#"#"!" A(&4%0-?(I(?-&4%.(R.-,'4/6*-

#$%&'()'*!+,%&-%)'./!<'()'/:-'(2$(!?$)R$$/!?%*7:4.-/<!'/0.4@%)'./!%/<!*./)$a)!

k($$!($*)'./!YEIlE!W%*7:4.-/<!'/0.4@%)'./!4$0$4(!).!<$(*4'5)',$!*./)$a)!.4!

*'4*-@()%/*$(!)2%)!54.,'<$!'/0.4@%)'./!0.4!4$%<$4(!.0!4$($%4*2E!12$!($*./<!

*%)$:.4Bg!*./)$a)(!@%7$!-5!)2$!F>M!*./0':-4%)'./(!?B!0%*'&')%)'/:!.4!'/2'?')'/:!

@$*2%/'(@(E!3/!)$4@(!.0!*-@-&%)'./!%/<!:$/$4%&'(%?'&')Bg!*./)$a)!4$0$4(!).!)2$!b0.4!

R2.@c!%/<!bR2$4$c!S8%R(./!p!1'&&$Bg!IJJYTE!!

! ;%@$!.0!:4.-5! F.<$(!'/*&-<$<!'/!*./)$a)!:4.-5!F./)$a)! >$/).4!,%4'%)'./! F./)$a)C!*&'/'*%&!&$%4/'/:!$/,'4./@$/)g!@$/).4!

54$5g!R%4<g!()-<$/)g!<.*g!54$((-4$g!@$/).4!,%4'%)'./!

F./)$a)! G/',$4(')B!%/<!5&%*$@$/)(!

F./)$a)C!G/'!*2%/:$(g!$<-*%)'./!*2%@5'./(g!6H"'8g!<.*g!(')-%)'./!54'.4g!*&-()$4!(7'&&(g!.4:%/'(%)'./!.0!5&%*$@$/)(g!8+D!,%4'%)'./g!'/)$44-5)\'/)$4@')!

Table 4 Context groups after second cycle of analysis

12$!)R.!:4.-5(!'/!1%?&$!Y!%<<4$((!<'00$4$/)!%(5$*)(!.0!)2$!?4.%<!*./)$a)(!'/!R2'*2!

)2$!()-<B!.**-44$<E!N.R$,$4g!%(!*./)$a)!'/!#$%&'()'*!+,%&-%)'./!0.*-($(!./!)2$!

(5$*'0'*!*./)$a)!(-44.-/<'/:!)2$!54.:4%@@$!.4!'/)$4,$/)'./g!0-4)2$4!%/%&B('(!

(-::$()$<!)2%)!(.@$!.0!)2$!*./)$a)(!'/')'%&&B!'<$/)'0'$<!R$4$!/.)!5$4)'/$/)!).!)2$!

368!)..&g!%/<!.)2$4(!:4.-5$<!)..!@-*2!).:$)2$4E!!12$!*./)$a)(!@%7'/:!-5!)2$!0'4()!

:4.-5!'/!1%?&$!Yg!b@$/).4!,%4'%)'./c!R$4$!7$5)!)24.-:2!)2$!)2'4<!*B*&$!.0!%/%&B('(!

!

! KJP!

%/<!%?()4%*)'./!%/<!%4$!<'(*-(($<!'/!F>MLC!F&'/'*%&!($))'/:!,%4'%?'&')B!k($*)'./!

PEYEKl!%/<!F>MYC!Z%4'%?'&')B!.0!@$/).4(c!$a5$4'$/*$!%/<!()-<$/)(c!$a5$*)%)'./(!

k($*)'./!PEPEKlE!!12$!*./)$a)(!'/!)2$!($*./<!:4.-5g!b-/',$4(')B!%/<!5&%*$@$/)(cg!

@%7$!-5!?%*7:4.-/<!'/0.4@%)'./!%/<!%(!(-*2!%4$!<$(*4'?$<!'/!)2'(!()-<B!k($$!

3/)4.<-*)'./!KEI!%/<!H')$4%)-4$!#$,'$R!IELEKEKl!?-)!<.!/.)!0.4@!5%4)!.0!)2$!F>M(!

<$(*4'?$<!'/!*2%5)$4!PE!!

Q"#"#"#" A(&4%0-?(I(?-1(&5)%+*1-,'4/6*-

>$*2%/'(@(!:$)!).!)2$!2$%4)!.0!R2%)!')!'(!%?.-)!)2$!)..&!.4!'/)$4,$/)'./!)2%)!'(!

2%,'/:!%/!$00$*)E!"(!8%R(./!%/<!1'&&$B!SKXXUm!IJJYT!'<$/)'0Bg!)2$!@$*2%/'(@!@%B!

/.)!?$!'@@$<'%)$&B!b*%-(%&cg!'E$E!')!<.$(!/.)!@%7$!)2$!'/)$4,$/)'./!R.47g!?-)!4%)2$4!

.00$4(!4$(.-4*$(!.4!.55.4)-/')'$(!).!)2.($!$/:%:'/:!R')2!)2$!'/)$4,$/)'./!(.!')!*%/!

R.47E!3)!'(!)2'(!54.*$((!)2%)!'(!'/,$()':%)$<!'/!%!#$%&'()'*!+,%&-%)'./g!%/<!%(!(-*2!)2$!

4$($%4*2!@-()!%&(.!'<$/)'0B!R2$/!)2$!@$*2%/'(@!<.$(!/.)!&$%<!).!%/!.-)*.@$!.4!

b<.$(!/.)!R.47cE!

! ;%@$!.0!:4.-5! F.<$(!'/*&-<$<!'/!@$*2%/'(@!:4.-5!>$*2%/'(@! D%*'&')%)$(! >$*2%/'(@(C!8&%*$!).!<.*-@$/)g!0%*'&')%)$(g!

54.@5)(g!_-'*7$4!>$*2%/'(@! D.4@%)',$!

D-/*)'./!>$*2%/'(@(C!0.4@%)',$!%(($((@$/)g!$a5&'*')g!(.*'%&'(%)'./g!?.4<$4&'/$!*.@@$/)(!!.-)*.@$(C!*./($_-$/*$(g!$%4&'$4!'@54.,$!%/<!$%4&'$4!0%'&!

>$*2%/'(@! H$((!A%-/)'/:! >$*2%/'(@(C!(-?i$*)',')Bg!&$((!<%-/)'/:g!'<$/)'0B!R2%)!%4$!%))')-<$(\?$2%,'.-4(g!$@.)'./%&g!<'()%/*$g!$a5&'*')!!M-)*.@$(C!<$0'/$!5%((\0%'&!%/<!*./($_-$/*$(E!!

Table 5 Mechanism groups after second cycle of analysis

12$!)24$$!:4.-5(!.0!@$*2%/'(@(!0.4@$<!<-4'/:!)2$!($*./<!*B*&$!.0!%/%&B('(!k1%?&$!

Pl!0.*-($<!./!(-55.4)',$!%(5$*)(!.0!)2$!368!%/<!R$4$!0.-/<!).!?$!./&B!5%4)!.0!)2$!

().4B!%0)$4!)2$!)2'4<!*B*&$!.0!%/%&B('(!k($$!*2%5)$4!PlE!12'(!($*./<!*B*&$!.0!%/%&B('(!

R%(!()'&&!_-')$!*&.($!).!)2$!<%)%!%/<!2%<!/.)!B$)!?$$/!%?()4%*)$<!).!-/<$4()%/<!

@$*2%/'(@(!)2%)!@':2)!?$!$00$*)',$!'/!%/B!)..&E!F4$%)'/:!./&B!)24$$!@$*2%/'(@!

:4.-5(!.?(*-4$<!<'00$4$/*$(!%@./:()!@$*2%/'(@(!%/<!2.R!)2$B!@':2)!2%,$!

R.47$<E!3/!*2%5)$4!Pg!)2'4)$$/!)2'4<!&$,$&!@$*2%/'(@(!%4$!<'(*-(($<g!R')2!%/!

$@52%('(!./!b$a5&'*')/$((c!kPEIEIEKEl!%/<!b*&%4')Bc!kPEPEIEKl!%&)2.-:2!)2$!'<$%!.0!

b<'()%/*$c!kPELEIEKl!'/*.45.4%)$(!)2$!b&$((!<%-/)'/:c!:4.-5E!6.@$!.0!)2$!@$*2%/'(@(!

:4.-5$<!'/).!)2$!@$*2%/'(@!0%@'&B!b0%*'&')%)$(c!%4$!5-&&$<!.-)!%:%'/!%/<!$a%@'/$<!

!

! KJQ!

'/!b%!5&%*$!).!<.*-@$/)c!kPEIEIELl!%/<!b54.@5)c!kPELEIEIlE!12$!b0.4@%)',$!0-/*)'./c!

R%(!:4.-5$<!R')2!(-@@%)',$!%(($((@$/)!'/!)2$!b*./($_-$/*$(!.0!%(($((@$/)!

@$*2%/'(@c!kPEIEIEYl!%/<!(.@$!.0!)2$!'<$%(!)2$4$!R$4$!@.4$!4$&$,%/)!).!)2$!

.-)*.@$!.0!()-<$/)(!b*2%&&$/:'/:c!%/<!b*2%/:'/:c!k($*)'./(!PEPELEK!%/<!PEPELEIlE!

Q"#"#"9" A(&4%0-?(I(?-4/.&41(-,'4/6*-

W$*%-($!'/)$4,$/)'./(!%4$!'/)4.<-*$<!'/).!%!,%4'$)B!.0!(')-%)'./(g!.-)*.@$(!R'&&!?$!

@'a$<E!6.@$!@$*2%/'(@(!@%B!?$!)4'::$4$<!'/!(.@$!*./)$a)(!%/<!&$%<!).!(.@$!

.-)*.@$(g!(.@$)'@$(!)2$!*./)$a)!@%B!@$%/!)2%/!)2$!@$*2%/'(@!'(!/.)!%*)',%)$<!

%/<!)2$4$0.4$!/.!.-)*.@$!.4!%!<'00$4$/)!.-)*.@$!'(!($$/!k($$!($*)'./!LELlE!8%R(./!

%/<!1'&&$B!SKXXUm!IJJYT!%&(.!%*7/.R&$<:$!)2%)!<$(5')$!?$()!'/)$/)'./(g!(.@$!

.-)*.@$(!%4$!-/0.4$($$/g!)2$4$0.4$!%/%&B('(!(2.-&<!%&(.!&..7!0.4!/$:%)',$!.4!

$a*$5)'./%&!*%($(E!

! ;%@$!.0!:4.-5! F.<$(!'/*&-<$<!'/!.-)*.@$!:4.-5!M-)*.@$! F./0'<$/*$! >$*2%/'(@C!*./0'<$/*$!

M-)*.@$C!*./0'<$/*$!M-)*.@$! 3/)$45$4(./%&!

67'&&(!"(($(($<!F./)$a)C!.0!)2$!54'.4!(')-%)'./!>$*2%/'(@(C!0.4@%)',$!%(($((@$/)g!$%4&'$4!0%'&'/:!M-)*.@$(C!$%4&'$4!'@54.,'/:g!*./($_-$/*$(g!'/)$45$4(./%&!(7'&&(!%(($(($<g!$%4&'$4!0%'&!

Table 6 Outcome families after second cycle of analysis

!

12$!($*./<!&$,$&!.-)*.@$!0%@'&B!:4.-5'/:(!4$@%'/$<!0%'4&B!()%?&$!'/!)2$!D'/<'/:(!

k*2%5)$4!Pl!%4'('/:!04.@!%!)2'4<!*B*&$!.0!%/%&B('(!%/<!%?()4%*)'./E!3/!($*)'./(!PEIELEK!

%/<!PELEL!bF./0'<$/*$c!*./)'/-$<!).!?$!*%)$:.4'($<!%(!?.)2!%!@$*2%/'(@!%/<!%/!

.-)*.@$g!%/<!b'/)$45$4(./%&!(7'&&(!%(($(($<c!4$@%'/$<!%!@%'/!.-)*.@$!.0!)2$!()-<Bg!

R')2!)2$!4$0'/$@$/)!.0!.H*%(=I!%(($(($<!k($*)'./(!PEIELEIg!PELEL!%/<!PEYELlE!"/!

%<<')'./%&!.-)*.@$!:4.-5!$@$4:$<!<-4'/:!)2$!)2'4<!*B*&$!.0!%/%&B('(g!4$&%)'/:!).!

()-<$/)(c!.55.4)-/')'$(!).!*2%&&$/:$!-/0%'4!%(($((@$/)(g!'@54.,$!)2$'4!

5$40.4@%/*$!.4g!'0!%554.54'%)$g!0%'&!%/<!$a')!)2$!*.-4($!%)!%/!$%4&'$4!5.'/)!k($$!

($*)'./(!PEPELEI!%/<!PEPELEKlE!

?"#"4" 9HI+'./A)2-%&()./3+

D.&&.R'/:!)2$!<$,$&.5@$/)!.0!)2$!*.<$!:4.-5(g!<-4'/:!%!)2'4<!*B*&$!.0!%/%&B('(!%/<!

%?()4%*)'./g!)2$!F>M!*./0':-4%)'./(!R$4$!?-'&)E!!"(!)2$!*./)$a)(g!@$*2%/'(@(!%/<!

!

! KJU!

.-)*.@$(!R$4$!5-)!).:$)2$4g!0-4)2$4!<-5&'*%)'./!.0!*%)$:.4'$(!.4!4$<-/<%/*'$(!.0!

*.<'/:!?$*%@$!%55%4$/)E!"0)$4!($,$4%&!')$4%)'./(!0.-4!F>M(!R$4$!*./*$5)-%&'($<!

k($$!"55$/<'a!O!0.4!%/!$a%@5&$!.0!<'%:4%@@%)'*!4$54$($/)%)'./!.0!*./*$5)-%&'('/:!

F>M(!%/<!%/!$%4&B!$a%@5&$!.0!%!F>MlE!12$4$!'(!/.!:-'<%/*$!./!54$($/)'/:!0'/<'/:(!

'/!#$%&'()'*!+,%&-%)'./!%/<!@%/B!5-?&'(2$<!$a%@5&$(!0.*-(!./!)2$!@$*2%/'(@(!

-/*.,$4$<!Sf.&&B!$)!%&Eg!IJJXm!>$&)./g!IJJXm!8.@@'$4!$)!%&Eg!IJKJT!.4!54$($/)!)2$!

*./)$a)g!@$*2%/'(@(!%/<!.-)*.@$(!($5%4%)$&B!SH$./$g!IJJVm!H./:g!IJJXm!N.::g!

IJKJm!#B*4.0)9>%&./$!$)!%&Eg!IJKJTE!N.R$,$4g!'/!@B!-/<$4()%/<'/:!.0!#$%&'()'*!

+,%&-%)'./g!)2$!'/)$4%*)'./!.0!)2$!*./)$a)g!@$*2%/'(@!%/<!.-)*.@$!'/!%!

*./0':-4%)'./!R%(!'@5.4)%/)!%/<!)2$!)24$$!%(5$*)(!*.-&<!/.)!?$!54$($/)$<!

($5%4%)$&BE!12$!*./)$a)(g!@$*2%/'(@(!%/<!.-)*.@$(!0.4!$%*2!F>Mg!R2'*2!$@$4:$<!

04.@!)2$!%?()4%*)'./!%/<!)$()'/:!.0!)2$!)2'4<!*B*&$!.0!%/%&B('(g!%4$!&'()$<!'/!1%?&$!U!

k5E!KJVlE!3/!)2$!0.&&.R'/:!D'/<'/:(!*2%5)$4!$%*2!$&$@$/)!'/!1%?&$!U!'(!$a%@'/$<!%/<!

*2%&&$/:$<E!!

F>E> -'01+7&$%<%$&'(&"*"$6,.,&&

A%)%!%/%&B('(!%/<!%?()4%*)'./!*./)'/-$<!%0)$4!)2$!'/')'%&!0'/<'/:(!R')2!)2$!

<$,$&.5@$/)!.0!)2$.4$)'*%&!@.<$&(!k*2%5)$4!QlE!12$!'/)$4*.//$*)$</$((!%/<!

'/)$4<$5$/<$/*$!.0!*./)$a)g!@$*2%/'(@!%/<!.-)*.@$!R$4$!)2$.4'($<!'/!%!b(5'4%&!.0!

4%'($<!%R%4$/$((c!k($*)'./!QEKlE!124$$!@'<<&$!4%/:$!)2$.4'$(!R$4$!%?()4%*)$<!

k($*)'./!QEIlE!12$($!$/*%5(-&%)$!@$*2%/'(@(!R2'*2!%4$!&'7$&B!).!?$!5$4)'/$/)!'/!

.)2$4!*./)$a)(E!12$!)2$.4$)'*%&!@.<$&(!<$,$&.5$<!'/!)2$!0.-4)2!&$,$&!.0!%/%&B('(!

*./)4'?-)$!).!7/.R&$<:$!%(!<'(*-(($<!'/!($*)'./!VELE!

F>F> T"+"&8*"$6,.,&4'*4$0,.'*&

A%)%!%/%&B('(!'/!#$%&'()'*!+,%&-%)'./!'(!/.)!54$(*4'?$<E!12'(!()-<B!0.&&.R$<!%!

4$)4.<-*)',$!54.*$((!.0!'/<-*)',$!%/<!<$<-*)',$!*.<'/:g!*&-()$4'/:!%/<!)2$.4B!

:$/$4%)'/:!:-'<$<!?B!+&.!%/<!=B/:%(!SIJJVT!%/<!>'&$(!%/<!N-?$4@%/!SKXXYTE!12$!

'/)$4%*)'./!.0!*./)$a)g!@$*2%/'(@!%/<!.-)*.@$!'(!'@5.4)%/)!'/!#$%&'()'*!

+,%&-%)'./!%/<!0.-4!F>M!*./0':-4%)'./(!R$4$!<$,$&.5$<!%/<!)$()$<E!

!

!!

!

! KJV!

!

=$BC!F./)$a)(!%4$!-/<$4&'/$<g!1NXQJPHI\I!%4$!'/!]FLMD&L-('.8*3+%4$!'/++++)(&=)'3_+G"#9'%/-7W$,.#$7"*'(!'/*L$B&*'%&*/.'B/#-+

Table 7 Contexts, mechanisms and outcomes for each configuration after third cycle of analysis

& 3FPKNbK& 1NXQJPHI\& 'WKXF\N&F>MK! 3/)$45$4(./%&!(7'&&(!%4$!2%4<!

).!%(($((!+52$@$4%&g!/.)!(-4$!-/',$4(')B!R%/)(!)2'(!'/0.4@%)'./g!0$$&(!i-<:$@$/)%&\-/*.@0.4)%?&$!

%bSLHXHKV&R2%)\R2$/!).!%(($((!0NR\HIIHFP&KF&JIINII&e@$/).4(!%4$!%&&.R$<!).!%(($((!0LJXN&KF&MFXW\NPK&e)2$4$!'(!%!5&%*$!).!*%5)-4$!*.@@$/)(!3FPINcWNPXNI&FU&JIINII\NPKV!($$/!?B!@$/).4(!%/<!()-<$/)(!

J/(*%0*%3./&=+3?)==3+.H*%(=I+&33*33*,+>%B!2%,$!?$$/!<./$!?$0.4$!?-)!/.)!*&$%4!).!()-<$/)!.4!5.(('?&B!)2$!@$/).4!)2$@($&,$(!S@$*2%/'(@!0.4!F>MYT!

F>MI! >')':%)'/:!@$/).4!R$%7/$(($(!f-/'.4!()%)-(g!4$_-'4$<!).!@$/).4g!&%*7!.0!*./0'<$/*$g!'/%<$_-%)$!54$5%4%)'./g!./$9).9./$!%(($((@$/)!

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Figure 14 Outline of CMOs with intermediate mechanism/outcomes

mechanisms generated by the ISP. More than a weak or borderline mentor [see section 5.3.1], the disinterested mentor is uninterested in mentoring and unengaged with the student, and as key informant KI1 suggested, no tool would effectively support their assessments:

P31: KI1 (63:64) KI1: [!] I think if you’ve got a mentor who isn’t effectively fulfilling the role of mentor and they are letting things drift, they are giving students the benefit of the doubt, they’re not tackling issues I don’t think any practice assessment document would deal with that, I think that’s an issue for the mentor not the documentation!

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P31: KI1 (45:45) KI1: [!] if it’s not written down it may as well not have happened, so if a mentor hasn’t written those examples down, then the student on appeal will just say well they didn’t give me any examples and unfortunately if the mentor has presented them verbally but not written them down then, they don’t count really do they?

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P31:KI1 (17:17) KI1: [!] by letting it drift, it’s not even necessarily the issue that we’ve failed to fail a student that was unsafe it’s perhaps that we’ve missed an opportunity to get the absolute best out of a student.

D'/<'/:(!

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Figure 15 CM01: Interpersonal skills are hard to assess

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P31: KI1 (3:3) KI: one of the key reasons why we’ve got the interpersonal skills profile is mentors would say, ‘students are technically competent, they’ve got the underpinning knowledge but there is something I can’t put my finger on, that I can’t capture in the assessment document you know, something to do with their attitude or their manner’, maybe they were concerned about the way they interacted with the patients or visitors [!] so that’s what mentors would often say, it’s quite difficult to capture those things and I think they sometimes they felt they would end up passing a student without having had the opportunity to explore that, or also, not even just about pass and fail but about initiating discussion, that it’s quite difficult, it’s easy enough to say to somebody ‘oh you’re not really competent at taking a blood pressure this is something we need to set a goal for, something we need to address’ as saying to somebody ‘your manner with the patients isn’t particularly caring’ because it’s a more personal thing, it’s much harder to actually initiate that discussion so I think the mentors felt there was definitely a need for something to capture the things that the assessment documents weren’t capturing.

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P7: M07 (129:129) M07: Yes I would still [comment on interpersonal skills without the ISP] but I think it doesn’t make it as formal and I think it is good to have it quite formal in this way still because it is!it makes it more constructive and I think!I don’t know as a student you might think that it is less of a judgemental thing.

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P29: PEF07 (173:173) PEF07: I think mentors are always have a problem with failing people, I think the interpersonal skills is probably more difficult really, because nurses, from a skills point of view I think they are clear cut and make assessment on that and I think that interpersonal skills in terms of they have to struggle and make a judgement on people’s attitudes, personalities and I think they do feel uncomfortable about it.

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P15: M15 (245:249) M15: [!] generally speaking and this is a very general statement, I just think as a rule nurses like to be nice don’t they? And it’s very, very uncomfortable to fail somebody or even mark them low just a pass or something and it’s just an uncomfortable position to be

D'/<'/:(!

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P20: PEF01 (156:156) PEF01: Yes, you would get the how on earth did the student get here syndrome? Because it wouldn’t be until [final placement] that their attitude would actually contribute to fail them really.

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P6: M06 (87:89) M06: No I think this tool is very useful because otherwise, yes it helps us how to think about what we are looking at as opposed to just making up something if you know what I mean. It gives guidance and I think that has been very useful. It helps us to know what the University is looking out for and what they are wanting to see.

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P3: M03 (103:111) M03: !I think these [items] can be used because they seem to be the approved sentences. It is not going to be a shock when it is written because they are in their booklets

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P6: M06 (105:105) M06: Because we have got this added responsibility of having to pass or fail them, whereas before we didn’t, nothing that we really said made a huge amount of difference in their progress of their course KM: As a staff nurse working with students on a daily basis your feeling was that what

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you said wasn’t going to decide whether they passed or failed? M06: Yes, that was then, but I think now it has very much changed and I think that is a good thing

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P29: PEF07 (223:223) PEF07: there are still some mentors out there who still don’t see that it is their role to fail a person, and I think that has been a shock to me, and the other facilitators and to some of the mentors as well, well what did you think your role was? It is assessment!

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KM: And before you had it [the ISP] did you talk about those kinds of things [interpersonal skills]? M04: Not necessarily so overtly, does that make sense? Because sometimes, ! I would say ‘once you have had more placements you will develop more confidently in doing’ things. Indirectly I must have been addressing it but I wonder and it’s difficult because I can’t remember. If someone didn’t communicate very well, if I –not avoided that—but it [communication] wasn’t one of the things I identified, almost, you would look at a different aspect maybe of what you have picked out. You wouldn’t say ‘you don’t communicate well in a team’. It is difficult, I can’t remember.

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P9: M09 (71:71) M09: [!] I personally think a lot of what nursing is about is on [the ISP]. So I think yes you are looking at clinical signs and symptoms but you are also thinking of what the patient needs, you are thinking about how you treat them, how you talk to them, how you act, how you respond to others. I think it gives you chance to look at people holistically as well as looking at what clinically they are doing.

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P30: PEF08 (71:71) PEF08: [!] yes you can document your reason for saying it, but it does all appear very subjective whereas I think with this you’re being asked to make objective choice of these statements and I think these are much more objective assessments than you had previously [!] and then you have to justify what you’ve said, you can’t just make something up you’ve got to justify what decisions you’ve made, what your choices were, but I think it’s a much easier way, much more objective way of dealing with it

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P29: PEF07 (201:201) PEF07: I think it probably highlights that it is just as important for mentors and students to be aware that students that can equally fail on clinical skills as well as interpersonal skills whereas before I think 95% mentors really focused on clinical skills and I think they forgot about the interpersonal [!] so I suppose it just makes people aware, and raises the profile, and I think that it has gotten them to question their own opinions and interpersonal skills as well, of their own personal judgement really

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P22: PEF02 (86:86) PEF02: [!] because I think as I said at the very beginning when you see [the ISP] in black and white, it gives people permission to identify what the issue is

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P30: PEF08 (69:69) PEF08: !they are the ones who are very, very good generally, generally pretty good clinically, not ones you’re going to fail because of clinical skills and academically they are good they pass their academic skills but there is still something about them that you can’t quite put your finger on but you know that there is!.they aren’t somebody you want to nurse you, they aren’t somebody you want to nurse your family because of attitude, like the ones you ask to do something they roll their eyes all the time or! (KM so you think this allows those issues!) to be addressed it does,

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P5: M05 (61:65) KM: Do you feel like you tried to talk to her about things like her motivation and her initiative? M05: Oh yes. KM: But you didn’t have a...did you have a place to document those issues? M05: No, that was when we had the...I was doing it all on A4 paper. I wanted a record, I have still got all of the emails, I have kept them now (KM: just in case), my ward manager had a student on the placement before who she had lots of problems with, not problems but she hadn’t passed because she didn’t feel that she was up to the standard, so she had had lots of meetings and I remember her saying to me that she had kept a file on everything, even if it was just a bit of scrap paper. [...] I did that, I wrote it on - not secretly I did it in front of her - I wrote it down and stuck it in a file with all of the emails between the tutor and myself about it all. I don’t know how long I will keep it for.

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P19: EC4 (41:45) EC4: I think before the documentation we had was that if you’re not assessing something in a way it’s hard to address it, so in the previous documentation that we had was that there would be spaces for the mentors to write about how they had progressed but really, it was sort of a generic progression rather than perhaps identifying any particular areas, so there were students who would turn up late, those students who would be off sick a lot, there would be students who were quite negative, but there was no way sort of purposively for mentors to write it and so in a way not having to raise it they didn’t.

D'/<'/:(!

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[!] EC4: although those things area quite important to anybody who’s a trained nurse there was nowhere of putting it in our previous documentation where now that we’ve got it, it makes it a very real issue now, that actually as a mentor it is about professionalism as well as delivering clinical care

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P17: EC2 (139:139) EC2: yeah I think the whole!.you can actually do it in a very kind way because it doesn’t mean that because somebody has adopted this attitude they can’t be put back on track, I think this is a tool at formative assessment to actually say, did you know that sometimes you’re really rude and arrogant to patients and staff? P5: M05 (68:69) KM: Do you think you would have had a formative use for this? That if you had been able to say to her early on “this is where you are” do you think she would have taken it as a judgement, ‘that’s it you lack confidence, and it’s over?’ Or do you think you could have turned it into ‘you lack confidence and I’m going to help you develop?’ M05: I think the latter, the lacks confidence I’m going to help you develop. I think it is not necessarily about the documentation, this is a useful tool, but some of it is about how you say it. If I had gone along and said to her “I think you’re all Fs...and I’m not sure how we are going to get along with this, I’m not passing you” I think that would have knocked her confidence. I think it is a combination between the two. I think this would have been, at the time, so much more helpful, definitely

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P20: PEF01 (63:71) PEF01: yes, it’s also made a huge difference I think to the students as well KM: why is that? PEF01: because before you couldn’t!if they could do the competencies you couldn’t fail them because of their behaviour, because there was no way of doing it, you could only write it, you couldn’t actually fail them because of it, but now a student can fail purely on personal profile alone. And I think the students are more aware of that KM: ok, so do you think that’s caused any changes in their behaviour? PEF01: I think it’s made it more positive behaviour; we’re not getting as many behavioural problems. We do [have more problems] when they first come in but they soon settle, when it seems to be they actually realise they can fail on their behaviour alone

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P4: M04 (106:106) M04: I usually use it as a tool to start up a conversation about...right, this is what I am going to look at, and this is why I am going to choose these particular!

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P29: PEF07 (147:157) KM: do you think even now mentors are comfortable commenting on interpersonal skills? PEF07: I think they probably are based on the grid [the ISP] KM: so this [the ISP] has increased their confidence? PEF07: I think it has yeah KM: you think before they might not have felt confident in saying! PEF07: I think they didn’t know how to say it before, I think how do you start that conversation with somebody? Especially when the document you are using doesn’t actually say you have to assess the student on interpersonal skills

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P19: EC4 (61:61) EC4: it’s a two way, it’s the student’s document, but to pass it they need to have the cooperation or the collaboration of the mentor but equally I think that the practice document can help the mentor in terms of them perhaps managing a student that is having difficulties, so it’s not just about tick box because now it’s competencies it’s very easy to go pass, pass, pass whatever but actually if there is a student who is having difficulties then it’s the mentor can almost use it as a tool to say ok, you’ve done all this, you’ve done really well on but actually on these competencies you’re not doing so well on, lets think about how we can tailor your placement to deal with these ones or actually I’ve noticed when it comes to communication you’re very withdrawn you don’t initiate, let’s use that

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P1: M01 (34:34) M01: So actually to use this document is saying yes you can do those tasks that are required by a nurse, actually you have got really good skills and attributes that are valuable to nursing on this end of the scale, which will make you an excellent, kind, safe, caring nurse

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P4: M04 (115:118) KM: Do you think get students that are borderline sometimes? [...]

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! KII!

M04: I haven’t had one yet [!] I think maybe that is where this [the ISP] would pick [it] up because you can have technically brilliant nurses who are hopeless at talking to people.

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P31: KI1 (23:23) KI1: !But the real value of this I see is to use it as a way of increasing insight and self awareness by saying to learners, actually, ‘you know you come across as’!because often the learner will say ‘that’s not what I feel’, ‘but actually this is how you come across and why might that be and what can we do about it?’ and it’s a real tool to facilitate that discussion and to encourage them to step back.

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P24: PEF03 (149:149) PEF03: [!] some staff really like [the ISP] they really like it they think it’s great, they’re halfway through they get to pick 5 categories and!other people find it very difficult to make that kind of judgement call and they tie themselves up in knots and they make a judgement call. Other people need some interpretation,

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P6: M06 (77:77) M06: I find [the ISP] quite useful but like with all these things I find it quite limiting in the sense that I know that mentors have said to me that once they have done the first interview, got your first, you have chosen five, then you do it again later on towards the end of it, I find they say that they are not sure that they can find another five. They looked further in those first five. I think they feel that they need a new lot because they have already said that. I think that is about the only area that people have struggled with. Once they know how they can use it I think we have found it to be quite useful. It is a good guide.

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P24: PEF03 (210:210) PEF03: !it slightly worries me that there is real variation! KM: are there any you could say offhand that! PEF03: lacks maturity [item 13], always a problem KM: because what you were saying about age? PEF03: people get maturity against age and I think the other one that they have problems is the lack of confidence inhibits effective performance [item 9] they confuse confidence with competence, and taking responsibility appropriate for this level [item 8] especially for third years they didn’t know what was appropriate responsibility and it was the specialism taking over

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P21: PEF01 F-up (17:20) PEF01: They tend to use those [slow to settle, has not achieved full potential, needs to be more assertive] rather than lack of confidence because if they put lack of confidence in the second and third year then they fail. KM: So they find another way to say it? PEF01: They find other ways round that doesn’t fail them. That has been some of their comments that one or two of them that would fail them in the second and third year that it is possibly a little bit harsh because some people do lack confidence longer than just one year. They lack confidence in the first half of every placement so there are interpretations problems there and there are issues around the double assessment on those ones that have got the pass/fail on them.

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P10: M10 (146:151) KM: You’re saying she does need more experience because she has been out of the hospital, would you pick that one? Or would you focus on something else do you think? Do you know what I mean? M10: Yeah, yes I tend to, I try to use sort of a selection of them to try and cover! because they sort of fall into different categories on there, the time management and there’s confidence ones, and there’s ones sort of working above and beyond and that kind of thing. I try and select a variety of them but I wouldn’t hold the fact that she has been out in the community against her, I would probably! KM: You’d pick something else. [!] M10: Yes, I don’t want to fail her as a student so I wouldn’t pick anything that failed her.

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MENTOR: [The student] has worked with various members of the team identifying learning needs, working towards them and evaluating/reflecting on her experiences in a very mature fashion and has shown good theoretical understanding underpinning her practice. She has fitted in exceptionally well and been handing over to other members of the team also.

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MENTOR: [!] although confidence has grown immensely during this placement, it is an area for her to continue to work on, a little self-belief is required- a very capable student.

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P3: M03 (58:59) KM: You said you used this to give them [qualified nurses] feedback, how does that come up for the ones that are [qualified] because it is not in their documentation? M03: No it’s not, but I kept a copy of it because I perceived these as being approved sentences whereas when you are giving less than positive feedback it is quite hard for me to find the words. I can say it, because I think tone gives an element of compassion. Even if it is not perhaps the nicest thing you want to hear, maybe your tone and body language can make it less damaging.

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Table 8 Use of each ISP item per module in first and second year

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P31: KI1 (97:97) KI1: I guess it’s where you’ve got a combination of a borderline student who’s had borderline mentors, because if you’ve got good mentors they will respond to borderline students, if you’ve got good students then it won’t matter that they’ve got borderline mentors, it’s that combination with a student who’s on the edge who hasn’t encountered a mentor with the confidence to actually deal with it.

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P31: KI1 (65:65) KI1: yeah I suppose if we talk about students being on the cusp, I suppose it’s mentors that are on the cusp as well and the ones that aren’t really!there are some mentors who are absolutely fantastic, there are some to be honest, who I think are really not fulfilling the role effectively at all and probably shouldn’t be mentors and then there are some that are probably doing their best and bumbling along a little bit and again and again I think the bumbling along ones this [the ISP] probably guides them and directs them in a positive way, it gives them more scope and more guidance on how to effectively fulfil the role.

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P10: M10 (51:51) I think you only learn through seeing a failing student and having seen one I think if I got one I think I would be a lot more confident to address it, having seen how they [more senior staff] managed it.

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P14: M14 (101:101) M14: yeah, probably, because before that when I first started mentoring there was a student who was rubbish basically and I didn’t have the confidence to fail him then, he did

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actually go on and fail in another placement but I wouldn’t have had the confidence then whereas I would definitely would now, having gone through the experience

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P19: EC4 (61:61) EC4: [!] but I think also those skills come with mentoring more and more!. (KM: confidence!) yeah, I think with mentoring it’s like caring for patients, if you have one of those patients where everything is going very easily and you love it, it’s great, when you have challenging patients or challenging students you realise there is actually a lot more to the role and you have to pull on different skills but then when you discharge those patients or the students moved on, then when you have your next student or your next patient you realise what you’ve learned, so it’s an ongoing process too

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P23: PEF02 F-up (21:23) PEF02: No, I mean more basic than that [mentor’s ability to give feedback] ok, I mean do I know how to complete the booklet? I mean, do I know how to fail a student? Have I been shown? Do I know what the paperwork looks like? Do I know which bits I have to complete on what date? I’m not talking about high-faluting assessment strategies at all, I’m talking basics. KM: Okay, and have you been noticing in the past nine months then that there are mentors who are struggling with this? PEF02: I wouldn’t say I have been noticing it in the last nine months, I’d say I’ve been noticing it in the last [many] years since I have been doing this job.

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P13: M13 (36:36) M13: she was just very quiet and in fact, after that [incident where student tried to get her practice document signed off by other mentors] she’d sort of stare at me in the staff room, I’d be sitting there eating my lunch and she’d be there eating her lunch and I’d just feel that she was looking at me, !it was really uncomfortable

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P1: M01 (48:48) M01: [!] it would be interesting to compare because I think as a mentor we get so much more support now in failing students, that it doesn’t feel so scary. I think that because of the new mentorship course and the fact that when you have to submit your essay you have to put in about failing students and it is one of those things as a mentor that is being raised. Maybe the future mentors may feel more comfortable because it is not as alien to them

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P15: M15 (176:177) [!] (249:249) !KM: so you’re comfortable to raise those [issues like professionalism, attitude, appearance mentioned by M15], you don’t need this to support you in raising them? M15: no, not um!when it comes to attitude and behaviour then yes I would need this because trying to say to somebody that their attitude towards the doctors or the patients or whoever isn’t correct is quite difficult because it’s a personal attack isn’t it, saying to someone you’re not allowed to wear a watch, that is hospital policy, that is fine that doesn’t upset anyone, it’s when you’re talking about personal values, behaviours and professionalism [!] I think so because rather than, obviously it’s my opinion but it’s not my exact comment [the ISP], whereas if I was to write a comment saying, ‘difficulty with this that and the other’ it would feel that I was personally attacking them, where that way it’s still personal but it takes a little bit of the personal edge away

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P20: PEF01 (324:328) PEF01: it seems to! I don’t know if it takes the personal out, because obviously nobody likes to fail anybody and there is still that feeling but I think it’s the but I didn’t actually write it, (KM it was the paper not me) yeah, the it’s the university’s statement [!]

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P30: PEF08 (89:89) PEF08: I think it gives them support but it also gives them a prompt, whereas they might have just kind of let things slip before, they are not able to as such here, they’ve got to do this assessment!

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P12:M12 (180:180) M12: I think now I’ve used it [the ISP], I think it’s a good idea because it does prompt you, not necessarily for attitude but for various other things as well.

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KI1 (61:61) KI1: yeah, I think so, I certainly think it would make them think about it because they would look at what’s a fail and what’s a pass and if they were uncertain then they would go to someone else so yeah, I think it’s making them question what they’re doing rather than putting a tick in the box, and because this isn’t a tick in the box, you’ve actually got to pick the statements out, I think it does make you challenge it a bit more and question it, I mean the cluster skills, to be honest, it’s quite easy to literally go down and just initial it and they can’t do that with this [the ISP] which I think is really positive.

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P14: M14 (152:156) M14: yeah, probably, but I’ve seen some of the more junior mentors wouldn’t, they don’t feel like they should criticise people and especially if they’ve not long qualified themselves [!] they still know what it feels!well I still know what it feels like to be criticised but have your confidence chopped down when you think you’re doing alright is! KM: so you think this might be useful for some of those mentors in that situation who need a little bit of...something to back them up M14: yeah yeah

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P17: EC2 (179:179) EC2: [!] it gives them a guide for what sort of things we’re looking at, because if you said to maybe an inexperienced mentor, how does your student lack maturity? Would they have thought of putting that before? I guess not, do they think maturity is important? Especially in the young students, can you see that they? It gives them an idea of what they’re looking for in a nurse really, in a qualified nurse.

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P30: PEF08 (83:83) PEF08: they love it, for the same reason I do, it’s that you’ve always had these students

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who are borderline and you know, yes, if you are a very strong person you can do something about it but I think on the whole people aren’t experienced enough, a very small percentage of mentors would actually be experienced enough and mentally strong enough to deal with it

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P9: M09 (115:117) M09: Yes, some of my girls [referring to colleagues] are pretty tough. Yeah they will [give critical feedback]. I don’t mean tough in a mean way but I would look at the positive things and I would say “this is very positive but you need to work on this” whereas some of my girls would handle it in a different way but much better than I would because they would maybe say “what does being professional mean to you?” and explore it through that way whereas I am not quite so clever at that. KM: Because you say that you are quite positive in a sense does that tool allow you to give a little more critical feedback than you would if you didn’t have those words there? M09: Oh definitely I think it does yes.

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P1: M01 (64:64) M01: But it comes with confidence and I think that this [the ISP] does help nurses to develop their confidence because if you are saying to somebody “you appear to lack motivation” you can’t just say it, you have got to drill down and find out why that might be and it will tie in with other things as well

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P30: PEF08 (69:69) PEF08: !the other thing I particularly use this for when I get these comments about

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students in the first couple of weeks students are in practice, “I have a student here, she’s pretty good however, I’m a little bit concerned about her attitude because of this, this and this” and what I always say to them is “right, get out your attitude and behavioural skills profile [ISP] and go through it with them now, because it’s much easier to use this as an objective criteria and face that student and go now look, I have seen that in the last couple of weeks your attitude has not been very good with me and this way of behaving blah blah blah in two weeks time we’re going to have a formative assessment and at the moment I would select this particular statement about you, so if you don’t want me to be failing you in three weeks time, this is what you need to work on” and then you write and action plan based on that

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P17: EC2 (191:191) EC2: !very difficult and particularly you know some of the mentors, I know they have to have at least a year to qualify but they’re still quite junior, in terms of nursing hierarchy, they may never have been in supervision, managerial roles, having to deal with difficult staff, difficult situations so they’re sort of on that little ladder aren’t they where they are just realising they might have dealt with a few patient complaints, they might have dealt with a few issues but really the majority of them haven’t been up that managerial step or ladder, dealing with behaviour or performance, they haven’t been dealing with that a lot of them

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P4: M04 (14:14) M04: No I think supporting student nurses and mentoring is quite an important role that is very much underplayed as part of the registered nurse role. From what I have seen, although it is highlighted in the band five [junior staff nurse], which is a nursing band in the job description, it is actually not highlighted as an actual essential until you are a band six. By the time you have got to a band six which is a junior sister role, [!], you are very often one step away from the actual hands on.

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P7: M07 (110:113) KM: Could you imagine!how do you think you would feel being assessed by it? M07: I think it is quite horrible to be honest. KM: What do you think would be horrible? Have the students said anything to you about it? Have they said it is horrible? M07: They haven’t no, I think they are quite chuffed when they get something quite good when they get something higher up the scale so that is nice, it obviously boosts their confidence as well but I can imagine if you are not very confident it could knock your confidence, it could do the complete reverse. If you would get a poorly and I think if you have personality clashes with your mentors and you perhaps might have issues because I used to think they might then mark you lower.

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P17: EC2 (155:155) KM so do you think they’re angling for the higher end? [items on the ISP] EC2: I do. It’s quite astounding really that they’re waving them saying look at this one! Look what I’ve got on this one! KM: so giving them some self-esteem? EC2: yeah, they’re very proud of when they get the higher numbers, extremely proud

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P17: EC2 (173:173) KM: ok, so your students seem mostly to accept it? EC2: they like it KM: because they are doing well? EC2: and even the ones that are doing not so well!

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S030801 mod 3 [second half of first year] Formative ISP: 24p, 27g, 28g, 30g, 32g16 Mentor evidence: Shows professional attitude in how she talks to patients and communicates with others. She highlights areas of concern to her, e.g. anything that may be seen as a risk to patients, e.g. pt [patient] needing an air mattress due to pressure sores. S030801 mod 3, Summative ISP [completed the same day as formative]: 24p, 27g, 28g, 30g, 32g Mentor evidence: as before [written by mentor] Further development: is making good progress but would benefit from more exposure to ward rounds and MDT meetings

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S030801 mod 4 Formative ISP: 19p ,22p ,23p ,27g ,30g 17 Mentor evidence: 1) 19 Practice makes perfect 2) 22 able to work in whatever team, she is in 3) 23 self explanatory 4) 27 is able to identify in which field she lacks more, e.g. Admission, transfer, discharge 5) confident in what she is doing. [30 implied but not written next to the comment] S030801 mod 4 Summative ISP, same day as formative: 17p, 19p, 23p, 27g, 28g18

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Mentor evidence: 17) always asking/interested in new learning opportunities 19) will become more confident with practice 23) good attitude at work and within a team 27) able to identify areas where she lacks knowledge 28) works well within a team, good team player.

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P29: PEF07 (133:133) PEF07: yeah, that is an issue because they sometimes feel that they might have actually decided on that [item of the ISP] but they look and they say ‘oh no this student is in second year and I don’t want to fail them’, they have been honest and said ‘well actually I changed my mind’

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P29: PEF07 (173:173) PEF07: I kind of, I don’t know why they say that, it doesn’t sit, I mean if they wouldn’t know the outcome, they make the statements and it goes back to the university!I don’t if it’s the ownership of it, I didn’t know that you’d fail, I just picked out the statements, if that was one of the reasons why or whether it was just a kind of maybe it was too much of a,

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maybe it hindered their judgment because it was there in front of them!?

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P20: PEF01 (108:108) PEF01:[!] needs more experience is also being used, particularly where they are having to fail an outcome, they are using it to back that up. [!]

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Child field faculty 1: On a few occasions some of the Interpersonal statements do not accurately reflect what the Mentor wishes to say. For example a Mentor scored a student as no.10 [needs more experience at this level]. Unfortunately this related as a fail for a second year and this was not intended by the mentor. Child field faculty 2: I think the concept of Interpersonal development is excellent, however I feel there needs to be less criteria and I have found some of the criteria rather ambiguous in application. For example: 'Needs more experience at this level ' (10) was used to describe a very competent 2nd year student but constitutes a 'fail'. This was discussed with mentor and was an error although clearly they felt that this was not a negative statement.

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P21:Pef01b (3:3) PEF01: [!] There has also been a bit of confusion with them around some of the statements meaning different things depending on the stage of the student’s training. That has also caused some problems as in they have given a statement in the second year which has actually failed the student when they interpreted it as being a development thing which it would have been in the first year. There have been a couple of errors because of some of the statements having two possibilities

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P24: PEF03 (69:69) PEF03: [!] the staff themselves have this idea that automatically people know what is expected of people and it’s a real difficulty I’m working on at the moment, on welcome packs, to uniform those so that all students have the expectations of the areas articulated clearly beforehand, so you know where you are at, because students find different variations, they are not standardised the quality

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P29: PEF07 (205:205) PEF07: I mean, sometimes because of the time frame, it is a forced relationship and the student is obviously there to learn [!] they don’t know the student for very long they have to make a comment or judgement, maybe not always working with the student as much as they’d like having to rely on other people’s comments as well! and [community] mentors can find that difficult because they are then relying on colleagues to feedback and sometimes they’re not very good at feeding back verbally or in the document and it’s a huge responsibility then for the mentor because they can only go on the information that is provided to them or what they saw themselves I think people do feel uncomfortable and unless there is any major concerns really I think most of them, from a district nurse point of view, will feel as though if they haven’t heard anything, well the student will pass [!]

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P7: M07 (75:75) !M07: I think it is very difficult especially when they perhaps haven’t been here for a long period of time and you have got to assess that. Yes but at the same time I think it is a good thing to do definitely. I think it is very helpful because obviously just because you

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! KYK!

have!you can do certain tasks doesn’t mean you have the skills that you really need.

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P8: M08 (19:19) M08: Every day it is completely different. One day it can be very busy, we don’t get much time to spend with the students to teaching them or even to showing them because you are always in a hurry to do things. Like you have got loads of things but you find sometimes!like days like this today, it has been a very nice day, I managed to take one of my students with me to do her [inaudible] drugs. She came along with me, she observed me, what I was doing [!] So I got lots of opportunities there, as I told you, when you are busy it is very difficult to look after the students but they are very good actually. Well they just carry on doing!they just get along with the things that they want to do.

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P15: M15 (233:233) M15: about 50/50 really if I have the time and they haven’t done it [referring to getting the student to do the self assessment before she does her assessment] then I say you do it first then I will do it, but 9 times out of 10 we’re so short of time that it’s their last day or second to last day and I’m trying to get their last few done and I’m like well it has to be done, I can’t send them away to do it because I don’t have the time after to do it with them

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P12: M12 (47:47) M12: She has picked up a lot since then and I think that you’ve always got that in the back of your mind with regards to!if you have a problem student, you always think “okay when she comes back!” So I think a few weeks before she came back for this term, because she’s been off doing other ward placements and I sort of said “okay, we have to try and do!this, this and this” [!]

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P24: PEF03 (69:71) PEF03...I picked up on this on the children’s ward, where the Adult branch move every six months, people kind of know what level they [the students] are at but on the children’s ward there is!it’s more seamless, there is much more of a continuum because that’s their core area [!], the expectation [of the students’ ability to fit into the ward] is higher, quicker in that area, ‘the slow to settle’ and all that shouldn’t be a problem because you’re [the student is] not going to a different area, [!] [The mentor has] seen them for three

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years, [!] KM: so you’re saying that in the children’s areas because they see them constantly over three years that they have a hard time sometimes distinguishing between what they’d expect from a first year, second year and third year? PEF03: yes

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P25: PEF03 f-up (9:9) PEF03: I actually did a session for a Mental Health group which is practitioners that I don’t usually support and we discussed the interpersonal skills profile as part of that and their comments were very interesting in that it is an extension of their normal assessment skills and they felt very, very comfortable using it and didn’t feel it was at all judgemental because they are using that as part of their professional toolkit all the time. PEF07: I do feel that the Mental Health nurses do really put a lot of value on interpersonal skills, I don’t know if that’s because in Mental Health nursing, communication and forming a relationship with your client group is so important and as a student nurse coming in that they also assess you on that, yeah I would agree with that actually, they are probably more likely to be more strict on the interpersonal because it is such a critical part of the role really

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P25: PEF03 f-up (11:11) PEF03: Yes absolutely, so when we were talking about asking them [Mental Health field] to give me examples that they had observed in practice that would actually support the interpersonal skills profile, they tripped off the tongue and they didn’t have any discomfort in making judgements on behaviour whereas the acute [Adult field] staff, the Child branch really struggle with it still in that they are quite happy to verbalise it but they are less comfortable putting it down on paper.

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P13: M13 (150:150) M13: yeah then you know it might be difficult, but clearly it shows and then everybody can be reading from the same song sheet and you know what’s unacceptable and what’s acceptable and the grey in between!

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P4: M04 (102:102) M04: [!] As it stands you can see why it has come out and yes it does give you a yard stick I guess.

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P16:EC1 (101:101) EC1: It [the ISP] makes it much easier, it makes it able to really document it so it can be seen whereas before it was just a comment in a comment box, now, well there is a scale to it as well, this person is very low numbers instead of higher numbers, it gives them [mentors] a tool! P22: PEF02 (127:127) PEF02: I think probably it's like a, it's easy isn't it, writing a learning contract you've got to have the time. The ward staff are phenomenally busy, when you've got a failing student and it's phenomenally hard, especially some of the ones we've had recently so to be able to write a number and just write a brief thing kind of gives a nice segment section to be able to do it, so yes they say they like it they find it easy they find it useful.

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P1: M01 (90:90) M01: it is almost like a prompt as well because you think you haven’t got to think so hard about “what am I going to write about [!]” it is all there in a summary and you are picking out the key aspects and then you are elaborating on them, I think it makes it quicker.

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P05: M05 (93:93) M05: [!] I think it is going to be harder and harder to make the time and the documentation tends to get more detailed or precise, it is not going to be done either one, as thoroughly or two, as often [!],

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P8: M08 (117:117) M08: I don’t know, what is the purpose? Why does this [the ISP] have to exist? Why can’t you just write it okay this is what have been observed, why can’t we just write a general feedback? Like saying that if they can just ask okay, just say something, what do you think about a student? That includes everything. Okay she is quite confident, she is well motivated or she is proactive, you can just write like say about your student. Not to say about your student, something, have a brief explanation.

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P8: M08 (37:37) M08: Yes, picking things is quite easy like you can read and think “oh yes, she is quite good” you know that because when you read that you come to know what about the students, “okay yes she does this” or “yes she is like this and she is quite mature” you come to know.

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P1: M01 (53:54) KM: What did you do before that existed? Presumably you had students with the same lack of motivation and all that kind of stuff, how did you address that before? M01: You would meet with them and say to them about it. On their documents you have a bit about comments and you put summative, I’d write a spiel about you need to be more

D'/<'/:(!

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assertive or you need to look at prioritising, identifying and prioritising and you would have the opportunity to then review the learning contract and maybe put something in there that they needed to work towards as part of their behaviour but there wasn’t ever a tool in which to measure it.

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P16: EC1 (79:81) KM: And the [!] ward, were they pleased that they had this ISP? EC1: Very much so, I think all the wards see it as a way of articulating the way the student behaves, whereas before they didn’t have that.

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P25: PEF03 f-up (13:13) PEF03: Even with the numbers [the ISP], we have had an occasion in the last six months where this girl’s [student] behaviour!they would not move forward from “she’s odd, she’s not safe” and they really had problems quantifying it, even though that tool was available, to such an extent that even when we actually had her removed from the site such was their concern about the things she had done, the audit trail was appalling and yet we had had four quite experienced mentors verbalise their concerns about this girl, and so we have actually had to go back and do some specific documentation sessions about using the documentation although these are staff who have been mentoring for considerable amounts of years they were not seeing this as advantageous.

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P7: M07 (97:99) M07:[!] I mean the interpersonal skills profile, I suppose it is quite hard sometimes when students have just started and are settling in to be able to mark them along that scale really. KM: How much!is it because the mid-point has to come so quickly? M07: Yes definitely. I mean when they are out of placement and in college it just makes it really difficult and obviously I don’t work every day so!to be able to assess them accurately I think is quite difficult and I think it is maybe slightly unfair sometimes.

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P15: M15 (221:221) M15: I think it’s useful in the ones that are failing or struggling to!because as you said you can use it to highlight or demonstrate where they are struggling, the ones that are really good, that as I said, because of the setting they can’t,! I’m kind of marking them as a pass or a good but my instinct says they are better than that but because it’s this area they are not doing informed decision making [item 34] because they can’t so I’m having to mark them down.

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P24:PEF03 (121:121) PEF03: [!] this is a girl [mentor] working in a [specialist area], ‘if you had to pick five categories today about this student, what would you pick?’ [!] And interestingly she picked lack of confidence inhibits effective performance [tem 9, would be fail for student in 3rd year] so I said ok, [!], ‘is that because she’s not familiar with the specialist area or is that because she’s truly ineffective?’ And she went, ‘well she doesn’t know enough about the specialism’!’but is the rest of her nursing knowledge and the rest of her skills consistent with somebody in the third year of the course?’ She said ‘yeah’, so actually, this is about her working in the specialist area and being ineffective in the specialist area, not having enough specialist knowledge that wouldn’t expect a pre-reg[istration] student to have! and I said ‘if you picked that category you would be effectively failing your student who you’ve said is good’, and at this point the mentor became completely panic stricken that she was effectively failing the student, something that she didn’t actually feel reflected! and that was the difficulty for the specialty area, they couldn’t actually separate what would be the expectations of somebody in the specialism and what was truly ineffectiveness!.

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P14: M14 (117:121) M14: I don’t really like it personally, I think it’s very subjective, because as I say different people respond differently depending on which placement they’re in and who the mentor is, whether they create some kind of rapport with them or not! KM: so the response of the student varies M4: yeah, I think, the way you have to tick off that list and say that pass well at that or pass excellently at this is, it’s just, I don’t know, I just think there could be a definitely be a better way of measuring their abilities…like, interpersonal skills, good verbal communication with the MDT and you give them a score of 1-5, 1 being pretty useless and not very animated to 5 being proactive, really autonomous, able to communicate effectively, I just think there should be some kind of scale like that rather than just the! because they’re not even all the same in that list are they, they are very all over the place

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really, it’s not like can do it at this level, can do it at this level, it’s just like can do it or can’t do it.

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P14: M14 (160:160) M14: [!] I trained in another city and I think my practice paperwork was really quite good because it was graded like that, you got a score and you could see yourself progress over that year, and the criteria changed depending on what year you were in but you could see yourself !beginning of your first year you’d get 1s and 2 s by the end of the first year you were getting 4s and 5s so you felt like you were progressing!

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P17:EC2 (155:155) EC2: And in actually fact I did have a student who came to me last week to say they’d all been crossed out and signed, dated by her mentor, because when she came to have her summative she had scored her quite low and she said ‘I don’t believe you’ve scored me accurately’ which is a very, challenging, which is good, so the mentor quite rightly said ‘well ok what do you think you should have for this?’ And she said ‘well I think this and that’ and the mentor quite rightly said ‘well can you tell me why? Can you recall an event?’ And of course the student could, and she said ‘yes actually I remember a time when ‘dedadeda’ and you told me that I had great initiative’ etc. so the mentor crossed out all of her first rating score and signed and dated it and increased the student’s!. KM: and did her comments reflect that as well? EC2: yes she did and she said ‘maybe I was rushed and I didn’t take the time’, but the student was quite concerned because it’s very important for the student to get the higher end!.

!

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P25: PEF03 f-up (59:59) PEF03: [!]I think now people are saying ‘oh bloody hell there are thirty five of them that I

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P20: PEF01(200:200) PEF01: [!] the potential is that this mentor would have ignored it, that mentor wouldn’t. And you’ve still got the difference in mentor situation, which we’ve tried very hard to improve and I think we’ve achieved it to a certain extent, but you’re always going to get some!

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P25: PEF03 f-up (39:39) PEF03: [!] there is a sort of a continuum of ideas about what constitutes unprofessional behaviour, and it actually seems to be related to when people trained. [!] So nursing has gone through such a cultural shift and quite, you know, over only a thirty five year period but we have got mentors who will have trained anywhere from ’79 their own culture but people have trained in the last five years, people’s expectations are really different. You are asking people to make a judgement against something that is very different.

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P4: M04 (4:4) M04: [!] I came into nursing via the NVQ [national vocational qualification] route and trained slightly older than straight from sixth form which gave me a completely different

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perspective and I am curious as to how students that come in directly from education find it. I think it is a bit of a culture shock to be honest, from experience!

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P5: M05 (129:129) M05: I was lucky because I had worked as a healthcare assistant before I did my training so with the basics I was all right with all of that and I had done enough clinical work. I wasn’t above my station and that I knew everything but I was keen to learn. The thing that I felt was a shame was that if someone had taken the time to teach me I could have probably helped them out a lot more on their shift.

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P14: M14 (160:160) M14: I think it also depends because a lot of the people who work on our ward have all been trained within the trust, so they’ve never ever known anything different, but I trained in another city and I think my practice paperwork was really quite good! I’ve worked in four trusts in total and I’ve seen a variety of different ways of doing things

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P25: PEF03 F-up (35:35) PEF 03: Yes and the thing is it is very difficult because obviously it is more cultural I think, it has a lot to play in what the students behaviour and attitude will be in practice and if the students are astute and can work out the culture of a particular environment and play to the strengths of that culture they will be successful and they will be judged favourably on that, but if they are very questioning or if they are [!] It is almost, not their behaviour, but the way they phrase the way they talk, their body language, even the way they are at coffee breaks will all contribute to that and I guess!looking at this and working through these problems over the last six months I didn’t realise how much playing the game was important and I think you know, if students are having a problem now they are not going to go to their mentors because they are going to be judged on them.

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P22: PEF02 (178:178) PEF02: even if [the ISP] wasn't there, we went back to the old system, like learning contracts that we're so used to, that could still be discriminatory, doesn't have to be just this particular tool, it could just be you don't like me whatever the document [is], it's a load of rubbish. It could be anything.

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P15: M15 (141:141) M15: oh my god no!I would have dragged myself in [reference to calling in sick], and if the ward was busy I would stay late to help them out and I used to bend over backwards to get the most out of what I could!

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P17: EC2 (45:45) EC2: [!] the mentor who had been qualified for many years, I guess like a lot of us, our expectations are different, you know, maybe 15, 20 years ago, you know you always hear you know the older nurses say, oh we were running a ward and we were, you know we’d done 52 catheterisations, we’d done all this and we’d done all that and [the mentor’s] expectations were that the student should have done this particular thing, now it was coming to a mutual agreement, which we did, that the student hadn’t been able to gain those skills in the areas where she’d been, [!], but she hadn’t had the opportunities

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P24: PEF03 (49:49) PEF03: I think the biggest feedback I get from staff is that when students were part of the workforce, students automatically behaved because they actually saw a direct consequence of their actions, when I was a student I was a student of that hospital, if somebody reprimanded me we knew that had a direct bearing on my reference and everything else. Students tend to behave now like they’re a university student and they’re doing you a favour by turning up [!] not all of them but some of them the shifting balance means that they don’t have as much reference if you like, to the trust experience as some generations of mentors, so when mentors meet a problem, they say, ‘I can’t understand it, why when I’ve spoken to her about time keeping she doesn’t amend her behaviour’ or ‘I can’t understand when I challenge her about her uniform she seems to think it was

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acceptable.’

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P22: PEF02 (166:166) PEF02: !last time at the induction [in the early part of first year] I had complaints from the academic building we used on the attitude of these individuals, it was appalling. But, the same week I had the third year students in, completely different. Almost like there had been an!institutionalised. They were polite and friendly, they weren't all trying to go home at a time, no one asked me if they could go early, they knew what the rules were.

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P4: M04 (110:114) M04: !but I’m not convinced about the pass, fail and which bits you have to pick. KM: So you don’t like the fact that it is graded? M04: No, but then!you could say it is a judgement call isn’t it? KM: I am interested in that, what is it about the fact that it is graded that is less appealing? M04: I don’t know. It’s one of those strange things, I look at it and!I think it probably is that you have got this borderline on all of them, it’s unclear, it’s almost murky but then I suppose dependant on where they are in their training it is going to reflect on how they are going to manage.

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P10: M10 (122:125) KM: What do you think of the fact that you can pass or fail it in different year? M10: I think that’s useful actually because it gives you as a mentor a guideline of what they are looking for as well. KM: And do you think that is fair enough that they should be passing in the first year with some things and failing later because I’ve heard some suggest that it is a bit harsh, or are you okay with that? M10: Well they need to improve don’t they? So what is acceptable at year one from interpersonal or a clinical skills point of view is not necessarily acceptable at year two, they need to progress. They do need a progression on it.

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P31: KI1 (17:17) KI1: And it’s the ones that you think ooh (groan) on a good day maybe they’re ok and then on a bad day maybe they’re not so ok? I think they’re the ones that drift, the ones, you couldn’t say they were unsafe as such, but you know if you were lying in the hospital bed they wouldn’t be the first choice of a person you’d want looking after you. And that’s the ones I think the mentors struggle with, the ones that are really bad are very few and far between, everybody sees what needs to be done and it is done. I don’t think we have students who get through who are clearly unsafe and inappropriate but I think it’s the ones that are, that 40% it would be in theory, 39%, 40%, 41% [40% is the pass mark for theory] and I think they’re the ones the mentors don’t know what to do with and often they do bumble along, I don’t think there are huge amounts of them but! KM: it was a comment that did come up? KI1: yeah. I think so, it’s those ones who are sort of right in the middle and you don’t know quite what to do so the mentors often do nothing.

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P32: KI2 (20:20) KI2: [!] some of these students will then, they don’t just fail practice, they’ll have either personal issues or be failing assignments and will just be generally be struggling a bit, struggling a bit academically [!] so it’s not a huge surprise when something goes wrong in practice

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P1: M01 (16:16) M01: When I meet with the students initially and we go through the induction process and we look at what learning objectives they can achieve, I go through and say to them “do you understand the books?” Because it is surprising the amount who come and don’t really understand, I mean the students, what they are supposed to do.

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P15: M15 (145:145) M15: what it feels like is, this is a very judgemental thing to say (KM: go on) it feels like the students are arriving at us going you give me everything, you teach me, you tell me what I need to know and I will sit here and take it and be along for the ride where when they get here we’re like, now it’s you to do the hard work, you need to go and look that up or find out about that, we will help you and we will give you the seed but you need to grow it, [!]

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P1: M01 (58:58) M01: Actually this tool can be used in a way to reflect [interpersonal skills] and because it is in black and white students are more likely to accept it I guess and be aware of it. You are going through it and because they need to achieve this it makes them more aware. Do you know what I mean?

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P13: M13 (182:182) M13: yeah!it makes it easier for the student as well because they can see what things they need to improve on

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P5: M05 (79:79) M05: I think it’s good when you can sit down and say “well...” what am I trying to say? I think it is useful because of this section here going down so they can look at it and see what they need to achieve, where they need to get and I suppose in the case of my challenging student I should say really, I think it would have been helpful if she could have seen where she was at.

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P18: EC3 (154:154) EC3: I think the students, when these tools changed, they seemed to up their game a little bit more, they’re more aware of what their requirements are

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P29: PEF07 (137:145) PEF07: [!] and I think maybe because the student is aware of the actual grid and what’s in there, the student needs to prove otherwise then really because they know that the mentor is assessing against those things [!] PEF07: whereas now all mentors are using the same tool, the same grid whereas before it was very woolly, very generic, you could read from it what you wanted, and perhaps not every mentor was as explicit in using [the previous] tool, and that actual tool is statement after statement give it a lot more clout to the mentors to say this is you because of x, y and z

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P4: M04 (46:46) M04: No because it is her first year and plus the fact, this is a formative. [!] she needs to be more assertive but that is more to do with confidence and finding her feet still. At that point there was no way I would have seen her as a fail, it was more of a case of this is a very inexperienced, very young student who needs a lot, who does need more support. Okay this early on that is not going to be a fail but if it is still the same...then you would have issues.

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P 7: M07 (99:101) M07: I know that personally I might not be that confident to start off with so I might score really low on something like that. KM: If you were going to score someone low on confidence for instance but you thought as the mentor that it was partially because of the timing, how would you incorporate that into your feedback? M07: Obviously use the part where you can write about evidence and the notes, I would put that something with time that they would be able to develop.

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P4: M04 (142:146) M04: Yes, that’s the only thing. I don’t know how you would, if you were working with someone you are going to form some opinions and get to know them. KM: The fact that you have to evidence what you say, does that reassure you to some degree? M04: I think so because it means that!I suppose it is justifying the assessment. You can say “well I have got evidence that they have done this, I know they’ve done that and I haven’t just pulled it out of the air.”

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P18: EC3 (104:104) EC3: [!] it gives you an opportunity to discuss and with the student all the way through, maybe in some ways it could be too prescriptive but then you’ve got commentary [place to provide evidence] for that element, ! P19: EC4 (49:49) EC4: [!] and I think what’s good about it is we’re not just asking them to be assessed and we’re not just asking them to pick 5 things, we’re asking the mentors to say, for the evidence in why they picked those 5 things, so it’s not good enough to say oh you always turn up late, you don’t seem to care, you’ve been very slow to settle, it’s about giving examples, so why perhaps they’ve been slow to settle, why we’re thinking this, why, or this is how you come across to others and this is why we think it so I think it’s much more constructive to the students, [!]

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P8: M08 (33:35) M08: That is fine to write the evidence, this is quite good but when you are writing the evidence I find that I can try! KM: You find that kind of tricky? M08: Yes. If it is quite clearly understood okay, just mention about like what do you think about her? Otherwise because you write this and you need to relate that one. You are not going to write, say for example you are not going to pick only one point and write it, you are going to need to write five different things, so it is quite difficult. When you write you have to choose your five points right and in that small space just to write everything, it is quite confusing.

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P5: M05 (79:79) M05: Actually as a progressive thing as well, if someone sees that they are improving and going up the scale that is more motivational. So it can be more motivational as well.

!

P10: M10 (79:81) M10: It’s really useful actually because I think [the ISP] is assessing something, because [for clinical skills] you can tick the boxes, can they do a blood pressure, tick, can they sort out feeds, tick, but I think it [the ISP] sort of is a different aspect to them. I find that’s really useful, especially when!a few of them we have had almost working above and beyond what you would expect of a second year student so you can sort of explain that with those interpersonal skills rather than just what they have to achieve. KM: Right and how do they respond to that? M10: I think they quite like it, I think they like getting positive feedback and hearing that we’re pleased with them is always good

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P18: EC3 (82:82) EC3: there is better demarcation on what, where they are, the student is more aware of it and the student can reflect back on these as well and think, well, I got this on that one and that on that one

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P1: M01 (60:60) M01: You have got something that you can talk to them about and drill down. Sometimes it could just be that they are under a lot of stress; there could be underlying issues, which as a manager I have to manage within my workforce anyway [!] We’re all human; we all suffer from stress or hormones, whatever it may be. Then you might have somebody who is really willing to try [item 17] and has developed in confidence [item 18] after being, a lacking self-awareness [item 7] so it is really good. Because it is on bit of a scale when I am giving feedback I can say “you were here and now you are here, well done” and it spurs people on. KM: So you find it a very formative tool. M01: Absolutely whereas before it was very much pass, fail, tick all the boxes, but actually this enables mentors to give much better feedback I think.

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P12: M12 (107:113) M12: [!] maybe it’s just me but I don’t think you should be getting excellents until maybe the end of the second year, third year. I don’t know if it’s just the novice to expert type thing really. KM: Have you ever had a student who seemed to be doing excellently for a first year? Do you see what I mean? M12: My other first year. KM: Are you giving her higher ones? M12: She’s got goods at the moment, she’s sort of got a couple of G’s and E’s at the moment. KM: So you are reflecting that you see she is working at a higher level.

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P14: M14 (125:133) M14: yeah, the only benefit of them are, if you have got a poor achieving student, that you can pick things that are very, sort of woolly and just put them down for things like that rather than make them feel too bad you’re still giving some positive feedback KM: so are you saying you can pick some of the more serious ones to point out a problem but then you can pick out some woolly more positive ones? M14: yeah, just to make them feel like they’re not absolutely pathetic! KM: do you think that works? Do you think a student would understand that you’re giving them some critique but they still!do you think it gives you some space then so you can tell them you’ve got some problems [M14: yeah] but this is ok? M14: yeah, critical positive!constructive feedback is what they say P22: PEF02 (186:186) PEF02: yes, definitely. Slow to settle is quite a good one because it is nice and woolly, don’t change it, it’s quite a good one, useful, people use that quite a bit

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MENTOR: [!] thus admit that at this point she still has not developed confidence which makes her stand back rather than involve herself. Encouraged to be more proactive i.e.

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STUDENT: I feel that I do lack confidence but I am working hard to address this and to actively participate in areas where my confidence is lacking. I am constantly reflecting on my abilities and feel that I am beginning to overcome the confidence problems which I had. I have learned an awful lot so far in this placement and feel that I am able to put the skills learned to good use.

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KM: So how did you give them the feedback? M08: Well basically I told them “do you realise, I know you are a very good nurse, you still can do lots of things and still need a little bit of development because nursing, as you know, it is very difficult, it is not that easy doing nursing, you’re going to look after the patient and you are going to deal with the life and the death and it is a huge responsibility as a nurse okay”, so that is the reason I will tell them “you are a very good nurse, you can definitely be a very good nurse, at the moment you are doing this many things which is very good but we all need development at some stage because we all have to improve. So if we show a little bit of interest, [!] it will be easy for you an easy for me so that we don’t waste much time and you don’t need to come back and do lots of time [...]”

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MENTOR: She needs to believe she has the ability to become a confident and competent nurse. Just having a try is better than standing back and watching though sometime it can be better to stand back and assimilate information. Is conscientious and listens as well as asking questions a good quality in a nurse

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P30: PEF08 (71:71) PEF08: I’ve have been encouraged to see [formative use of the ISP], because as I said it is very difficult to be completely objective about students and to be transparently objective, you know you might have been objective but the students still see that as being subjective and that you’re picking on them, students always blame mentors for whatever goes wrong, I’ve learnt that in life so I think with this, now you can pick up problems early on and say look, I think at the moment you’re not behaving in a very professional way because of this, this and this, this is what I’ve got to assess you on and in order to meet this requirement this is what I want you to do and you can write out your action plan and the student nurse will know what is expected of them. You can review it and review it a few weeks later and say actually this is the way you were a few weeks ago when we had our conversation, this is where I put you at now, there is still some work to be done but you are edging towards a pass and keep up the good work and it’s encouraging to the

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student as well!

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P32: KI2 (20:20) KI2: ! if you are relatively bright and can read between the lines you can see that it is relatively damming but! KM: damming with faint praise? KI2: yeah exactly you can see well, you can tell from the comments that but the student doesn’t see that KM: they take it at face value KI2: yeah they totally take it at face value as opposed to thinking well what are they actually saying here? And that can be an issue, I don’t know a way around that, because unless you tell mentors to be brutal in what they write like Simon Cowell23, then you’re not going to get that type of feedback, some will, some will be harsh or the students will see them as harsh but in fact they’re being very fair.

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P 4: M04 (142:146) KM: Has a student ever, if you have given them example, has a student ever said well, ‘that’s not what I’... M04: No they haven’t, in fairness no and I have always said ‘if there is anything you don’t agree with or are not sure of ask me’ I do qualify what I’ve said, so I don’t assume that it is written in stone because all I would do is write down that the student hadn’t agreed necessarily with this and yes I could see where they’re coming from.

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P13: M13 (194:198) M13: I asked her [to do self assessment before the final assessment] twice and she kept forgetting her book and not bringing it in, then she brought it in she hadn’t done it and said well I’m not going my bit until you do yours and then she brought it in again and then she said ‘it needs to be handed in’ I said, ‘oh ok’ so I did my bit under duress and then she must have gone off and done her bit but!when I got the book back, the second time, because they give you the old assessment book and the new one and she’d written things like, ‘I don’t agree with!’ so it was sort of a very passive thing, rather than telling me, I don’t agree with that, she’d write it KM: ok, so she wrote down in her comments that she didn’t agree with you but she never told you that [M13: no] and the tutor never got in touch with you based on that? M13: no!and I think she would’ve been mortified if she thinks that I’d have seen it

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P18: EC3 (142:142) KM !and in that case they think it was that the mentor didn’t understand the student’s communication, so the student wasn’t necessarily aggressive but perceived of as aggressive [referring to story of cultural gap between student and mentor]? EC3: yes, and that’s what happened, the colleague [from the HEI] went out and had a three way with the mentor and the other staff hadn’t perceived that at all from this student, but this particular staff member, who was unfortunately her mentor, [!] there was absolutely no problem at all with this student anytime and then right at the very end this has happened, this has kicked off, so [now] it’s all sorted

!

P31: KI1 (33:36) KI1: I did have one student actually who’d been marked down as a fail on her formative on her interpersonal skills and that got really messy [!] and I ended up going in and intervening and actually sitting down and managing the summative assessment for them because they’d reached a point where they couldn’t do it together and then ultimately the student did pass it but it was quite interesting to see, I guess it’s an example of how it wasn’t used effectively and actually it caused more trouble then because then it did get very personal and heated KM: and do you think that’s partially because the mentor didn’t have the skills to give the feedback but also the student wasn’t willing to accept the criticism KI1: both, the student!and I think they just got off on the wrong foot but the student was then on the defensive, what was quite interesting was that it was a recently qualified mentor [!] it made all three of us stop and think about actually and at the end of it, it was successful, the student passed and they sort of kissed and made up and everybody felt that they’d learned something really valuable from it [!]

D'/<'/:(!

! KQP!

KM: that’s really interesting so that’s a case where it didn’t really help KI1: well it depends which way you look at it, if it hadn’t have been there, I mean at the end of the day that student learnt a lot about herself, the mentor learnt a lot about herself as well, the mentor will have been a better mentor from that experience, the student then went on and did really well in her next placement, I think they gained from it.

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STUDENT: I agree with the above, however, I am confident and assertive where I know that my actions are both safe and appropriate. If I am slower and more careful sometimes it is because I want to do the right thing for my patients whilst maintaining proper dignity and safety. I feel that as my skills grow so will my confidence.

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STUDENT: I have ostensibly developed in confidence since beginning here, but lack of confidence has never been an issue with me, it was a question of the staff getting used to me and trusting in my abilities as a mature student nurse. I have learnt to develop strategies for getting what I need from this placement, there have been some staff willing to help. Initially I did not know what I needed to achieve from this placement setting, but now I do know and will extract what I need from here and hopefully it will assist me towards becoming a nurse.

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STUDENT: I thought I was giving mitigating circumstances as opposed to making excuses!! [exclamation marks in the original]

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P31:KI1 (17:17) KI1: And I don’t know whether all those students have necessarily failed or if they need to fail but I think when they’re on the borderline, by not doing anything about it we’ve lost that opportunity to bring them up to standard, because actually, if you tackle those students and you do an action plan, then they are often the ones where you can see a vast improvement, by letting it drift, it’s not even necessarily the issue that we’ve failed to fail a student that was unsafe it’s perhaps that we’ve missed an opportunity to get the absolute best out of a student. They could perhaps be better than they end up being if someone had gone, you know what, this student just needs a little bit more!

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P21: PEF01 F-up (34:34) PEF01: [!] What I’ve noticed is that any behaviour issues that are flagged up and potentially failed on this are early in the first year. Very few, I think I can recall one in the last that has progressed beyond the first year. So once it is dealt with and they failed on this because of their behaviour they seem to improve.

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P1: M01 (50:52) M01: But this, I do feel that this document does help, but it also helps to motivate as well. It is nice to get feedback about how you are doing. KM: So you think the students who are at the better end feel motivated. M01: Definitely, even those who aren’t the fact that I have seen an improvement in their performance because of this...(taps ISP)

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P22: PEF02 (85:85) PEF02: [!], possibly I have seen some improvement, but whether or not that would be sustained improvement I wouldn't like to say, there might be able to do it for the three months while they're on the ward to pass, whether or not they would then do it on other placements....

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P16: EC1 (61:65) EC1: !they failed her formative but she passed on the summative KM: and has she changed any of those behaviours? EC1: yeah, for that ward, but then when she went on the next ward I saw her mentor and they said she’d come in wearing bellbottom trousers and trainers, so it’s almost as if she changed her behaviour to pass the ward and then has gone back again

D'/<'/:(!

! KQU!

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P16: EC1 (13:13) EC1: !so the mentor was not going to sign the student off because she felt she couldn’t leave the student alone with a group of patients. That the student didn’t have the motivation, they didn’t have the organisational skills to be able to do this! KM: so was she circling things in the fail or this part here? (I point to the lower scored items) EC1: things like displays a negative attitude [item 3], appears to lack motivation [item 5], does not define own learning needs [item 6] things like that, but these are all the same things that the student failed on the last ward

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P21: PEF01 F-up (12:12) PEF01: Okay it is the ones with 9, 10, 11 and 1224 next to them, they find that bit confusing because in the first year it is a pass and in the second and third year it is a fail. There have been some errors there but most of those do tend to be the commonest one they use. They certainly use the confidence one and the experience, they do use the one about how they react to criticism, they sometimes use the slow to settle and sometimes use the maturity.

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P12: M12 (193:193)

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D'/<'/:(!

! KQV!

M12: I guess if you have got a problem student who is borderline it is a good idea because you can say “well look we’ll pass you this time but you are borderline and you have to remember that in the second year this would be a fail.”

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P12: M12 (87:89) M12: [!], she’s [a student who is unable to sustain enthusiasm for areas she is not interested in] still quite young. She still lives at home. My first year’s completely different, she is a bit more of a mature student and we were saying this with a couple of other mentors. We’ve got some very young first years and we’ve got some sort of older first years and we find that they work completely differently [!] compared to my first year who’s got a background in social work, she’s got a three year old daughter, she’s a bit more of a mature person, she works completely differently whereas this other first year!she’s new, it’s her first time away from home, she’s only eighteen so I think it’s maturity [!]. And we’ve got another first year who is the same as the!she’s about eighteen, nineteen but her parents are both nurses. They’re Mental Health nurses but it doesn’t really matter. She’s got some more of an idea of what’s expected of her I think.

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P30:PEF08 (137:137) PEF08: I think in my experience of many years of students I don’t think maturity has got anything at all to do with age, I think maturity is a state of mind, it’s to do with the life experience students come across, I’ve had very a young student nurse who come straight out of school/college/a-levels whatever, straight into nursing had lost her mother at a very young age and brought up her younger sisters and so she was 19-20 but had got a huge amount of life experience and I’ve had ‘mature’ students who are incredibly childish and you know throw the toys out of the pram at the first opportunity so I don’t think maturity is anything to do with age I think it’s more of a state of mind, it’s more to do with your personality than anything else..

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P4: M04 (48:48) M04: Yes you can explore because in some ways it doesn’t disadvantage people who haven’t been in [a healthcare setting] before but I think they feel that they have got a lot more ground. Equally it is about being confident on the ward in practice. They are learning all the routines almost, or the how the ward works, the basic day to day...This goes over there...What does this do?

D'/<'/:(!

! KUJ!

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P8: M08 (25:25) M08: When I meet the student for the first time I try to get a bit more information like why you want to do nursing? Why didn’t you fancy doing something else? What made you [inaudible] any inspiration or anything, why you have to do this? So things like this, so as you speak to them or as asking them in your family has anybody been nurses, anything about nurses or before you come in. [!] They used to come in “oh I’m really scared, this is my first hospital experience and I haven’t got a clue.” So you can support them more, once you come to the student, come to know them how much support they need so depending on that we can spend more time with them you see.

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P9: M09 (87:87) M09: My last, my girl [student] who was a week in!I can remember I put that she!something about confidence, needs to gain confidence but I said “you are a week in so you know!” and her mentor after me said exactly the same thing so she came back to me, I said “you’re very new you know, you’re eighteen, you’ve just come in fresh, the confidence will come the more that you learn” and it did, it did come a little bit while she was with me but I said “you just need a little bit more to trust your instincts and kind of do what you think you need to do because you know how to do it and you are trying to do it, you just need to get!” Yes, so, it is difficult

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P4: M04 (56:56) M04: [!] Equally you might have someone who is very confident that you almost then want to kind of...right okay. We have had people who have been quite, not over-confident but they come across as really...not in your face but almost... “I can do that, I can do that”. Okay then, this is what we are going to do, you go and do that admission, I want you to do all the paperwork, all the observations, I want you to tell me what you think is going on and see how they go. By the time they come back and they say “how much of this paperwork do I have to do?” “Well you’ve got half an hour and you’ve got to complete all of that, I want to see a set of obs [vital signs], and if you have done an ECG before carry on with that as well, what are you going to do for this patient now?” Actually I don’t quite know where I am now, and at this point this student had done it ! was kind of like she said “I hadn’t realised what was going on” and I said “no that’s fine, you’re learning”. That’s why sometimes you need to sit back and say I need to sit back and see it from a different perspective.

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MENTOR: “[!] and is able to reflect on her practice in a useful and valuable way.”

D'/<'/:(!

! KUK!

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MENTOR: [!] she is very aware of own limitations and is happy to perform new tasks under appropriate supervision i.e. removal of [device].

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P31: KI1 (45:45) KI1: [!] well certainly the ones that I’ve seen the evidence tends to be, I don’t know that I’ve ever really seen evidence, what I would call evidence. I would say to mentors, like at a mentor update or if a mentor asks me about it, if you’re saying the student has problems with time keeping, list down the dates on which they were late for work so when the student comes to you and says no I’m always on time you can say well no actually it wasn’t 20 past seven it was half past seven, when we’re saying evidence, that’s what we mean, you need to be able to give the student examples so if you say to the student oh your manners with the visitors can be a bit abrupt for example, on such and such a day when Mr. Smith’s relatives asked for a cup of tea and you said they couldn’t have one they had to go to the canteen and what I try to say to mentors is the evidence is more examples really, it’s being able to say to the student, this is what I’m thinking, let me give you an example so you can see what I mean, so the student can’t say, oh your just saying that, I’m never late for work and I’m always lovely. The mentor can say actually no, these are the occasions I’m referring

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P24: PEF03 (194:194) PEF03: [!] I think that’s why we need to actually work on improving evidence to support the subjectivity of picking a category and I’d like to see people have better examples to support, more examples of why they’ve got a problem [!]

D'/<'/:(!

! KUI!

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S090709 module 5 Formative ISP 17p. 19p, 21p, 23p, 25p29 MENTOR: He is willing to try and skills will come with development of practice. He is willing to accept responsibilities when needed. He is pleasant and appropriate in manner. He is well motivated. S090709 module 5 Summative assessment 17p, 21p, 23p, 26p (p/g), 27p30 MENTOR: He is willing to try new skills. He is willing to accept appropriate responsibility. He is pleasant and approachable in manner. He is able to reflect on his outcomes. He is able to identify his own learning needs.

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! KUL!

P32: KI2 (10:10) KI2: yeah, they are relatively positive or if they do pick up on something negative it’ll be something that’s almost mundane, like I tested them on one medicine and they didn’t know the side effects and it’s obvious that wasn’t the issue, ok, maybe that’s true but there is also the student was late, made mistakes and they haven’t mentioned those things, they’ll mention something that the student can achieve in a day, they can go and read a book and come back and answer the question but it’s missing the point because that’s not really, because someone really shouldn’t fail for that, but if you assess them and they don’t know, fine, but they can sort that out really quickly and you think well what about the other things? How is their care? The knowledge will come and yeah it is important they know those sort of things but if you’re just highlighting that as an issue then why have you ticked these other boxes and that’s what I see? KM: so you’re seeing mixed messages coming from the mentors? KI2: yes, that’s exactly what it is, well certainly documented. Maybe it’s not when they’re face to face, maybe they get told [!] I’ll ask them [the ECs] to go in to sort it out to ask the mentors to have a chat and then hopefully that’ll give it enough time for it to be documented properly and for the student to know where they stand because the student might not realise that they’re failing, they might think that if the mentor is telling them they need more time, they might not see that as a problem, and when I tell them that is a problem it comes as a shock!

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P1: M01(80:80) M01: [!] if you need to chivvy somebody up a bit [motivate] you could say “well you are here at the moment; I need to really see you up here.” Because you’re here!

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P29: PEF07 (117:117) PEF07: !I think if it’s the interpersonal skills that they’ve actually identified there is already the grid there, so I think that’s where they kind of yeah so all through the placement they’re actually picking them out [KM: right] there is a box where they then make comments so they comment in there rather than using the action plan for that KM: so when they give the examples about why they chose them (PEF07: yeah) that’s telling the student this is where the deficit in your behaviour is PEF07: yeah, so it is documented but not documented from what I can see in the learning contract

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Item 8 [needs to take responsibility appropriate for this level]. MENTOR Needs to exhibit more motivation in selecting learning opportunities and learning outcomes. STUDENT I felt I was learning about my learning outcomes by reading up on the resources available, i.e. catheter care worksheet and wound care books, I will try and be more motivated in asking for more opportunities

Item 15 [could have made more use of available resources]. MENTOR For example in the mornings could be looking at visit book, reading relevant journal articles rather than reading a novel STUDENT At the start I was reading a book as I felt ‘out of place’ I realise now that it may have appeared like I was disinterested so I will take this on board

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P30:PEF08 (69:69) PEF08: [!] from my perspective as a district nurse when it came into practice I

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jumped for joy, I love it, and talking to mentors in practice they love it too. The reason they love it is because they’ve always had this grey area where you’ve had students who were very good clinically or and were very good academically but you just know that there is something not quite right, [!], it isn’t something that you can really pick up easily without seeming very subjective in the documentation but this scale gives you the perfect forum for it.

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P18:EC3 (66:66) EC3: It’s quite interesting actually, because attitude and the way they socialised into nursing is in my opinion being picked up earlier, these things are being ironed out a lot sooner, people are more comfortable now, whereas before it was a bit of a pass on things, I think this has been, mentors working with us has made them more accountable and at the first formative if there is an issue that is flagged up then they sometimes contact us but invariably they try and work it out

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P25: PEF03 F-up (35:35) PEF03: [!] I didn’t realise how much playing the game was important and I think you know, if students are having a problem now they are not going to go to their mentors because they are going to be judged on them. [p.151]

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P31: KI1 (36:36) KI1: well it depends which way you look at it, if it [the ISP] hadn’t have been there, I mean at the end of the day that student learnt a lot about herself, the mentor learnt a lot about herself as well, the mentor will have been a better mentor from that experience, the student then went on and did really well in her next placement, I think they gained from it.

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Coates, V.E. & Chambers, M. (1992) Evaluation of tools to assess clinical competence. Nurse Education Today, 12, 122-129.!F.:2&%/g!"E1Eg!84$(7'&&g!NE!p!F%)(%@?%(g!1E1E!SIJJLT!"/!.,$4,'$R!.0!%554$*'%)',$!'/_-'4B!'/!$,%&-%)'./E!E*7+W)%*'()./3+D.%+NH&=-&()./g!IJJLg!P9IIE!

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! ILQ!

Donoghue, J. & Pelletier, S.D. (1991) An empirical analysis of a clinical assessment tool. Nurse Education Today, 11, 354-362. A.R/R%4<g!8Eg!D'/*2g!fENE!p!#%@(%Bg!fE!SIJJIT!F4')'*%&!4$%&'(@g!$@5'4'*%&!@$)2.<(!%/<!'/0$4$/*$C!%!*4')'*%&!<'(*-(('./E!<&8G%),2*+o.-%/&=+.D+N'./.8)'3g!IQg!YVK9PJJE!

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Fitzpatrick, J.M., While, A.E. & Roberts, J.D. (1997) Measuring clinical nurse performance: development of the King's Nurse Performance Scale. International Journal of Nursing Studies, 34, 222-230. Flin, R., Yule, S., Paterson-Brown, S. et al. (2006) The Non-Technical Skills for Surgeons (NOTSS) System Handbook v.1.2. available www.abdn.ac.uk/iprc/notss D.(($Bg!+Eg!N%4,$Bg!FEg!>*A$4@.))g!DE!p!A%,'<(./g!HE!SIJJIT!G/<$4()%/<'/:!%/<!$,%&-%)'/:!_-%&')%)',$!4$($%4*2E!F-3(%&=)&/+&/,+E*7+q*&=&/,+o.-%/&=+.D+$3I'A)&(%Ig!LQg!UKU9ULIE!

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Gauger, P.G., Gruppen, L.D., Minter, R.M., Colletti, L.M. & Stern, D.T. (2005) Initial use of a novel instrument to measure professionalism in surgical residents. The American Journal of Surgery, 189, 479-487.!O$44'(2g!=E!SIJJJT!6)'&&!0-@?&'/:!%&./:d!"!*.@5%4%)',$!()-<B!.0!)2$!/$R&B!_-%&'0'$<!/-4($h(!5$4*$5)'./!.0!)2$!)4%/(')'./!04.@!()-<$/)!).!_-%&'0'$<!/-4($E!o.-%/&=+.D+F,H&/'*,+E-%3)/2g!LIg!YUL9YVJE!

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Irvine, A. (2010) Using telephone interviews. Realities Toolkit, #14

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Sargeant, J., Mann, K.V., van der Vleuten, C. & Metsemakers, J. (2008) "Directed" self-assessment: practice and feedback within a social context. Journal of Continuing Education in the Health Professions, 28, 47-54.!6%()4Bg!1E!SIJJPT!12$!$<-*%)'./!%/<!)4%'/'/:!.0!@$<'*%&!%/<!2$%&)2!54.0$(('./%&(!'/!2':2$4!$<-*%)'./!'/()')-)'./(E!

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=V> 855%*;.K&8&&LEVELS OF ACHIEVEMENT IN THE INTERPERSONAL SKILLS PROFILE This Interpersonal Skills Profile is an essential element of the Practice Assessment and all students must achieve a Pass grade if they are to progress with the course. However, we recognise that there needs to be an opportunity to progress and that student’s early in the course should not be expected to show the same maturity of approach as students nearing qualification.

Please select FIVE comments from the list below which most closely describe the performance of the student.

1. (F) Behaves in an unprofessional manner. 2. (F) Unsafe to practice. 3. (F) Displays a negative attitude. 4. (F) Blames circumstances for difficulties encountered. 5. (F) Appears to lack motivation. 6. (F) Does not define own learning needs. 7. (F) Lacks self-awareness and the effect of behaviour on others. 8. (F/P) Needs to take responsibility appropriate for this level. 9. (F/P) Lack of confidence inhibits effective performance. 10. (F/P) Needs more experience at this level. 11. (F/P) Reacts adversely to constructive criticism. 12. (F/P) Slow to settle. 13. (F/P) Lacks maturity. 14. (P) Needs to be more assertive. 15. (P) Could have made more use of available resources. 16. (P) Has not achieved full potential. 17. (P) Willing to try. 18. (P) Has developed in confidence. 19. (P) Skills will develop with practice. 20. (P) Assimilates new information. 21. (P) Accepts appropriate responsibility. 22. (P) Fits well into the team. 23. (P) Has a pleasant and approachable manner. 24. (P) Displays a mature attitude. 25. (P) Well-motivated and adaptable. 26. (P/G) Is able to reflect on outcomes. 27. (P/G) Identifies own learning needs. 28. (P/G) Has made a useful contribution to the work of the team. 29. (P/G) Shows a good understanding of the concepts of nursing/midwifery. 30. (G) Displays confidence. 31. (G) Analytical in approach, drawing from a wide range of sources. 32. (G) Offers informed and considered opinions. 33. (G) Realistically evaluates performance. 34. (G/E) Capable of informed decision-making. 35. (G/E) Shows a mature understanding. 36. (G/E) Valued team member who has gained respect. 37. (E) Innovative, develops fresh ideas. 38. (E) Consistently works at a higher level than expected. 39. (E) An excellent performer in all areas.

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Key: The Profile affords a number of levels of achievement, which will be used in the following manner: Fail (F) This grade applies in all three years of the course. The inclusion

of this grade in the student’s profile constitutes a Fail for that module.

Fail/Pass (F/P) This grade denotes a Pass in Year 1, but a Fail in Years 2 and 3. Pass (P) This grade denotes a Pass in all years of the course. Pass/Good (P/G) This grade denotes a Good profile in Year 1 and a Pass in Years 2

and 3. Good(G) This grade denotes a Good profile in all years of the course. Good/Excellent (G/E) This grade denotes an Excellent profile in Year 1 and a Good

profile in Years 2 and 3. Excellent (E) This grade denotes an Excellent profile in all years of the course.

Source: University of Northampton FORMATIVE ASSESSMENT OF INTERPERSONAL SKILLS PROFILE (Mid point of placement) MODULE 11: Preparation for Professional Practice

Write in the boxes below the numbers of the interpersonal skills comments that have been selected from page 25.

No:

No: No: No: No: Mentor’s signature

Date

Mentor Assessment: Summary of evidence to support the interpersonal skills comments selected: * How might the student improve their interpersonal skills? * Student reflection on above comments * Mentor signature / Date………………………………………………………………………....... Student signature / Date………………………………………………………………………….

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P28: PEF06 (48:48) PEF06: they like the way it’s all for example in one book, you know it’s quite handy, it’s well laid out from the point of view of its progression through the placement, the initial interview, the formative, the summative, so they enjoy that, the information is all there, it’s in the book, it’s like a one stop shop which I think they appreciate.

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Demographics

How long have you been a PEF?

Semi-structured schedule:

Why do mentors contact you? What brings you into support them?

What is your role in supporting mentors and/or students?

Does this build on your own experiences as a mentor?

In your opinion, are mentors using the ISP in practice?

For what reasons?

What feedback are you getting around the ISP

How do you think the ISP is being used for students in practice?

Have you seen mentors use comments from 8 to 16? What do these types

of comments indicate?

Are mentors aware of prior assessments?

Is the ‘passport’ being used after the first placement?

Is there anything else you would like to tell me?

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particular Trust or setting as this varied.

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Demographic information: closed questions for quick info

How long have you been nursing? In the clinical area?

How long mentoring?

Any preparation? Courses?

Semi-structured schedule:

Is there a student in particular that you wanted to speak to me about?

How have you used the interpersonal skills profile? [will include ISP in

information pack for mentors and suggest they have it so we are both looking at

one for conversation]

Has it been useful?

What types of issues does it address?

If discuss which categories used – WHY and what did the category mean

to this mentor?

What are the types of issues that flag up a struggling student?

What issues are there for you?

If you’ve got a student and you’re not sure if they should pass or fail, what issues

do you weigh up?

Who do you go to for support?

Is there anything else you would like to tell me?

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Questions on context:

EC: role of ec, perceived need? Mentorship preparation and ability

PEF: role of PEF, perceived need? Interaction with mentors, type of

support (same as before, why get called in etc.)

Mentor: own setting, types of student etc.

All: older/younger students # maturity issues

where are students perceived to belong (college/clinical) and does

that matter?

Eg. of behaviour/attitude/professionalism problems

Questions for mechanisms:

All: how was attitude and behaviour assessed?

does ISP support mentors in assessing students?

How? In what way?

What do you think of statements 6-14?

Does it matter that they are pass in first year and fail in 2nd

and 3rd?

probe in interviews left about student self assessment: do they

bring it in rough, transcribe if agree or change it if don't

Questions for outcome:

All: what do you think the impact of the ISP has been?

What is the impact of having items that fail in first year and not in

2nd and 3rd?

does this assessment help delineate a passing student from a

failing student?

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Study Number

session 1 f ! mod 1 0308

session 1 s ! mod 1 03/08

module 2 f module 2 s module 3 f module 3 s module 4 f module 4 s

S030801 18,14,22, 26,27 21,23,28,18,19 24,27,28,30,32 24,27,28,30,32 19,22,23,27,30 17,19,23,27,28

S030802 25,28,29 31,34 24,29,22,23,18 18,23,27,15,19 14,19,23,26,21 26,31,35,38,39 37,32,33,28,38 19,23,25,27,29 19,23,25,27,29

S030803 26,27,28,29,33 22,23,30, 21,33

S030804 18,19,20,22,25 21,23,24,27,17 18,19,22,23,33 20,24,25,28,31 17,21,22,25,27 17,22,23,33,39 18,20,23,27,39 19,21,22,35,30

S030805 18,21,27,35,26 26,28,32,35,36 22,23,20,21,26 18,21,22,23,26 27,21,23,25,28 20,31,32,28,29

S090701

S090702 12,17,21,25,27 17,18,19,36,27 17,22,25,30,23 18,25,28,30,20 28,30,25,21,23 28,29,21,30,36

S090703 18,20,21,24,25 26,27,28,29,30 10,17,19,20,23 10,18,20,22,26

S090705 30,33,32,28,23 27,30,28,29,36 17,27,22,24,35 28,33,26,29,21 36,35,28,25,24 21,36,35,30,26

S090705 9,12,14,17,23 18,20,33,26,29 17,18,14,12,24 19,23,22,17,21 17,19,22,23,18 16,17,19,21,23

S090706 14,19,22,23,27 17,20,22,23,27 8,17,21,23,27 18,21,27,28,33

S030806 28,30,32,33,38 29,31,34,27,36 23,25,28,38,39 22,24,27,29,30 21,17,22,25,29 30,35,38,27,39 23,18,28,29,36 38,35,33,26,25

S030807 19,21,23,25,17 21,23,25,26,28 18,25,29,36,38 21,35,32,31,39 18,19,22,23,35 26,27,28,32,35 24,25,28,30,32 24,25,28,30,33

S030808 10,18,19,20,22 21,22,23,24,25 18,25,22,23,27 22,28,25,30,24 26,27,28,36,38 17,20,23,25,22 18,22,28,30,24

S090707 39,38,37,36,35 39, 38,37,36,35 26,27,31,36, 38 20,28.30,34,35 34,35,36,38,39 34,35,36,38,39

S090708 22,24,25,23,27 25,28,36,33,29 27,20, 23,32,30 26,31,33,38,35 25,27,24,28,30 25,27,24,28,30

S090709 18,22,23,25,26 30,27,33,35,36 27,30,33,35,29 35,30,28,26,23 27,30,32,31,33 18,25,26,32,24

S090710 17,18,19,20,22 23,24,25,27,28. 18,27,28,35,38 18,21,29,30,34 22,23,27,30,36 18,22,27,28,30

S090711 9,14,17,19,20 18,19,20,21,22 9,17,27,29,35 18,19,20,26,31 18,17,27,28,20 19,29,27,18,24

S090712 23,24,28,22,27 29,30,32,36,35) 17,19,23,25,27 33,35,38,21,20 8,9,21,22,35 18,19,20,26,29

!!

(Study Number

module 5 f !3 for adult field

module 5 s ! 3 for adult field

module 6 f module 6 s module 7 f module 7 s module 8 f module 8 s

S030801 22,26,27,33,25 28,33,27,26,22 10,11,16,17,4 10,11,16,15,4 9,10,12,14,16 4,17,18,8,19

S030802 26,23,35,32,30 28,32,25,24,34 17,21,26,32,35 3,29,35,36,37 19,20,24,27,35 21,23,24,31,35

S030803 23,24,25,30,26 37, 22, 25,34,26

21,24,26,27,19 28,29,30,32,34 23,25,26,30,35 20,21,24,28,33

S030804 20,22,23,19,18 24,26,27,30,35 22,23,24,25,27 34,35,36,38,39 30,25,32,24,28 34,35,36,38,39

S030805 19,24,27,25,20 24,26,31,33,27 18,25,352628 20,21,23,31,38 18,21,22,25,27 25,29,32,34,36

S090701 17,18,21,33,28 34,32,30,29,35

S090702 8,13,16,15,18 28,30,33,36,25 27,29,35,34,21 26,27,29,31,33 26,36,29,34,31

S090703 19,25,26,22,30 30,26,32,33,35 19,21,23,24,30 19,22,23,28,30 17,19,21,22,23 25,15,22,30,29

S090705 19,17,22,24,27 25,26,27,30,35 21,22,26,27,32 23,24,25,28,30 30,33,35,36,38 30,32,33,36,38

S090705 18,23,22,19,26 20,22,26,27,33 22,24,27,30,35 36,34,33,30,27 34,26,38,30,35 24,27,30,32,35

S090706 25,27,30,32,33 26,17,29,30,39. 22,23,24,25,27 28,29,30,26,36 22,30,23,20,25 21,30,24,22,23

S030806 25,39,28,38,29 39,38,36,35,30 30,33,35,36,38 32,35,36,38,39 23,25,30,38,29 33,35,36,38,39

S030807 20,24,26,27,32 29,31,21,25,36 25,28,33,36,23 36,38,32,23,22 18,31,24,38,27 18,22,24,28,38

S030808 30,31,27,32,39 21,22,23,24,25 23,25,27,28,30 24,29,30,33,36

S090707 21,22,23,30,37 21,22,24,25,30 34,35,37,38,39 36,30,31,38,39 30,33,34,35,37 35,36,37,38,39 27,30,31,35,33 28,30,32,23,39

S090708 18,24,27,29,36 33,29,36,38,34 27,28,29,33,36 27,35,33,32,26 18,23,27,28,25 38,34,36,32,39

S090709 17,19,21,23,25 17,21,23,26,27 30,31,35,36,32 34,35,36,37,38 31,25,32,18,35 38,36,34,21,30 36,35,31,32,33 39,38,37,36,34

S090710 17,19,20,21,23 14, 19,25,26,28 22,23,24,25,28 17,18,24,25,27 18,20,22,24,27 25,26,28,30,36

S090711 17,20,22,24,26 26,29,27,28,35 31,33,34,35,38 30,32,35,36,38 14,31,19,24,33 26,28,31,20,36

S090712 21,25,26,27,28 22,23,26,27,28 19,25,27,28,30 20,26,32,33,36 21,22,24,25,27 27,30,31,35,36

! (Figure 26 ISP numbers selected in documentary analysis

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Figure 27 Example of early development of CMO1

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Figure 28 Example of early development of CMOs

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Figure 29 Coventry University (2012) Interpersonal Profile

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Figure 30 University of Western England (2012) Interpersonal Skills Profile

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