Mentorship - The Learning Environment

The Learning Environment

Within your own area what positive aspects contribute to the learning environment?

French (1992) in an evaluation of pre-registration preparation of nurses in the 1980's indicated that the clinical setting and the practitioners within were the most influential factors in the development of nurses.

Researchers in higher education (Ramsden 1987; Ramsden & Entwistle 1983; Entwistle & Tait 1990 and Trigwell & Prosser 1999) have generally agreed that a learning climate which involves respect for students, freedom to learn and enthusiasm on the part of the teacher encourages a deep approach to learning, while departments with heavy workloads, high assessment demands and lack of freedom encourage a surface approach to learning.

In the clinical learning environment much of this research is supported with similar conclusions. Studies from nurse education (Pembrey 1980; Orton 1981: Fretwell 1982; Ogier 1982) suggest that a sound learning climate is one in which there is team work, consideration, empathy and support of the learner as an individual.

Fretwell (1982) identified the characteristics of a 'good' learning environment as one in which the sister and staff nurse show interest in the student when they begin on the ward; establish good relationships with the student; are approachable and available; pleasant yet strict; promote good staff patient relationships and focus on the quality of care; give support and help to learners; invite questions and give answers; and work as a team.

Ferguson's study (2000) concluded that the diversity and complexity of clinical areas and the implications for student learning must be acknowledged. One of the most anxious times for a learner was entering a new clinical situation. The participants in her study identified the primary concern was 'to be accepted' or to 'fit in' to that new environment. Although Ferguson's study supported the work done by Melia (1987) in the 80's she did discover the importance of the mentors role at this time as she/he played an important role in assisting the student to 'fit in'.

Ferguson's study also emphasises the need for structure on the process of learning. The availability of structured programmes in placement helped the student to focus on learning. Having structure in the placement allows the student to recognise the experience available and to some extent relate it to achieving specific goals. Gray and Smith (2000) highlight how student needs change at different stages of the programme. For example, a level of supervision that is very reassuring in first year may be difficult later on.

More recent work has re-emphasised all of the themes identified above. Percy and Elliott (2004) in their small study of student nurse impressions of clinical nursing noted three main themes; the influence of ward culture, learning from the negative and mentors. Experiences of ward culture had sometimes been negative (for example, staff not taking the time to talk to patients) but one good experience of a ward with high staff morale, with staff development encouraged, persuaded two students to stay in nursing who might otherwise have left.

A study by Ip and Chan (2005) of Hong Kong nursing students reported that “In essence, students see human relationship in the clinical learning environment as their top priority while on clinical placement”. Midgely (2006) in her study in Leeds, using the same assessment tool as Ip and Chan, suggested that “it appears students are seeking respect, support and acknowledgment from their mentors during clinical placements”.

How might the practice learning environment be managed?

A useful guide to Managing the Placement Learning Environment (Congdon et al., no date) is available from the Making Practice Based Learning Work website, Learning Materials page. Click on the Mentorship Resources button to the right here, and follow the link. The booklet takes you through how to complete a SWOT (strengths, weaknesses, opportunities and threats) analysis.

In the Introduction to Practice Education booklet (Burrill et al., no date: 10-11) there is an exercise that explores the differences between learning in the University and learning in a practice setting. This booklet is also available from the Making Practice Based Learning Work website.

Making Practice Based Learning Work

Understanding of learning theory on the part of mentors, to promote a desirable approach to learning, is important (see, for example, Tiwari et al. 2006 re problem-based learning promoting deep learning. Burgess 2006 has an interesting discussion of PBL, available on the internet). A responsive mentor, who both adjusts to and challenges the student’s learning style, is also important. All these issues are dealt with in other sections in these notes.