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Question:
Discuss about the Nursing for Learning and Cognitive Processes.
 
 
Answer:
Introduction:

Learning is a continuous process and learning occurs through interaction with the social and biological determinants of the environment. Learning makes an individual experienced. Mentor is a guide who bestows his knowledge and experience to his or her mentees during his learning process. Mentoring can be defined as the procedure of informal transmission of one’s knowledge, psychological support to a recipient as applicable to career, work or professional development. As discussed by Alligood (2014), a mentor is an adviser, master, and a perfect example who aids in the development of his mentee. Tutoring can be fruitful when both the guide and the mentee coordinately work through the process of learning. In the healthcare sector, a mentee is always placed under a highly accomplished medical attendant to function effectively in the clinical setting.

Clinicians play a significant role in assisting practice-based learning for the newly joined nurses or students. The utilization of mentoring processes in order to facilitate learning has gained momentum in the nursing practice since 1980s. According to Johnson and Gandhi (2015), the mentors of a clinical setting are registered and experienced nurses who guide their students in the professional development within the clinical setup through job-based learning opportunities. As stated by Esposito et al. (2016), there are our main roles of a mentor such as teaching, supervision, providence of emotional support and giving assessment feedback. This essay has the objective to discuss the key qualities of a mentor, recognition of the main behavior of an underachieving student, would give an outline for the application of learning styles and theories related to the topic, regarding the development of the mentee. In addition to this the essay would also highlight the importance of a proper clinical environment and its impact on learning process.

Although every mentee passes through a learning stage, successful learning outcome is not produced by every student. There are students who excel in the long run but certain students produce unsatisfactory results. Underachievers can be described as students who are disorganized, possess poor learning and performing skills and lack of interest in the work that they do.  According certain evidence, every mentor finds the learning approach for such underachieving student to be challenging responsibility related to mentorship. Therefore, proper guidance and timely assessment of such students is very important in the teaching process  (Vanlaar et al. (2016).

As discussed by Chan et al. (2015), the behavioral aspects of an underachieving student are distinctive of other students. Firstly, such students’ shows signs and symbols of unenthusiastic attitude like lack of personal interest in their clinical practice. Secondly, the underachieving students cannot to rely on due to their lack of confidence, high level of anxiety, poor attendance and punctuality. Thirdly, such mentees lack interpersonal skills, both clinical and theoretical knowledge and they tend to avoid working with their mentors. Fourthly, they show unreliable clinical performance due to lack of proper theoretical knowledge. Fifthly, their performance record reflects about their incompetence in the medical field and provides incomplete patient care. Additionally such underachieving students possess poor professional conduct, lack of reply to the received feedback and conflicts with their personal issues. Thus, a learning module and a clinical environment enhance the learning experience of the student and also their interest (Damber et al. 2012).

 

With regards to this case, a second year student during his placement was found to be underperforming and thus a proper learning module was required to be designed so that he achieves success in the future clinical practice. In this case study the student not only lacked clinical and theoretical knowledge, interpersonal skills but also lacked interest working with the mentor. Moreover, the techniques in terms of patient care used by the mentee were not in accordance with the nursing practice.  According to Butterwort & Faugier (2013), as a mentor it is key role to identify the main areas that needs improvement and also develop a learning style which can encourage the mentee to develop better clinical nursing practice.

By Daniel et al. (2015), as stated Mentors are an inherent part of any learning process. There are several roles associated with a mentor. A mentor plays an important role in identifying the complications and problems that encompass a mentee, evaluate the student’s weakness and strength, recognize the main goal of a learning module, design an action plan and then address the concerned issues relating to the underachieving student with a particular time frame. An effective mentor is one who has the capability to train students professionally so that they can achieve success as a registered practitioner and also prevent underachieving students from obtaining the registration so that the mentee should not reflect negative attributes in terms of patient care (Eddy et al. 2015).

As a mentor every individual experience a conflict between their position as a nurturer and a care giver, regarding failing of a mentee which is contrary to the learning objectives of development and facilitation. The consequences can be a personal failure in the future. Although there might be serious consequences for failing the student, it is very important for a mentor to judge a mentee before allowing the mentee to continue with the educational program. As discussed by Esposito et al. (2016), learning is the process of acquiring knowledge. A mentor is an individual who can develop a mentee’s learning curve and through his professionalism, effective communication, guidance and honesty enhance his teaching skills.

Adult learning occurs best through effective experiment and effectual practice placement where a student experiences the integration of theory into their own clinical practice. Therefore, it is very important for a mentor assess the men tee’s learning achievements and competencies. In order to improve the learning style a mentor should work with his or her emotional intelligence. According to Estes (2014), the ability to recognize an individual’s own feelings and also others, so that one’s own feeling and others feelings can be motivated and controlled is termed as “Emotional intelligence.” Emotional intelligence is a cognitive trait that can be measured by “intelligence quotient.” In a mentor the emotional intelligence can act as a framework for realizing the ways that an individual’s behavior can contribute to positive clinical setup (Jonassen and Land 2012).

As stated by Kendall and Hollon (2013), nursing profession is integrated with a lot of emotion and compassion. A successful mentor is the one who delivers his expression of love and emotion to his patient in form of knowledge and education distribution quality. At times it becomes a hindrance in mentorship in developing a positive and compassionate clinical environment regarding managing their own emotion and at the same time helping the mentees to adjust and adhere to the working environment. As discussed by Kim (2016), “Self-awareness and self-management” are the two important components of the “emotional intelligence framework.” A mentor should posses both the qualities in him or her. Self-awareness would help the mentor to understand and control his or her own emotional changes whereas, self-management would help would help him to construct strength in himself or herself.  

Several studies reveal the fact that nursing practice is a noble job and any individual who are in the path of mentorship should have effective knowledge related to the clinical approaches and techniques and should abide by certain norms related to nursing. In terms of providing feedback to the mentees, the feedbacks should be constructive, interesting, and innovative, in accordance with the mentees capability of accepting the feedback and this should be able to solve the student’s problem (Knowles et al. 2014).

 

 

A mentor should be able to hold up students poignant into precise part of practice or a height of practice further than first registration, recognizing their individual requires in touching to an altered level of practice. Waters (2009) discover the qualities which patients rate in professional nurses and establish these qualities to be as attentiveness, professionalism, caring, organized, kindness, sympathy, cheerfulness, advocacy, efficiency, thoughtfulness, selflessness, and politeness. Such qualities would thus include a precondition for shaping nurse-patient relationship achieved through clinical learning styles (Ashktorab et al. 2015).  

There are several learning styles that can be utilised during clinical learning practice. The most usually used learning styles are visual, kinaesthetic method and aural learning style implemented in various educational training. But in terms of the nursing practice it is more effective when the learning is practical based rather than only theoretical. An activist is the one who learns best through experimentation. As discussed by Merriam (2015), learning style promotes the assimilation of theoretical and practical knowledge. In the process of the assessment and evaluation learning style helps in understanding whether the teaching mode is efficiently transferred to the mentee or not in regards to the professional values and norms. According to Merriam and Bierema (2013), the external factors directly or indirectly influence the teaching and learning experience in nursing practice. Therefore, it is very important to have an interactive and influential clinical learning environment. This includes supportive staff, good team spirit, flexible teaching practice and effective management style. Learning of various theories is a part of the theoretical learning style.

One of the theories based on learning is andragogy theory which is also known as the adult learning theory, was developed by Malcolm Shepherd Knowles, which is reviewed on its assumptions, principles and practices  (Merriam and Bierema 2013). Andragogy is a method which promotes self-directed learning. There are six primary assumptions of Andragogy:

An autonomous self-concept and self-direction – this refers to the psychological need of a student or an individual to be treated as responsible or capable enough to handle their own tasks. This would provide a positive gesture to the student (Knowles, Holton and Swanson 2014).

A higher level of experience – No change in the basics, an attempt to impose on the background knowledge could lead to resistance or withdrawal from the procedure pf learning.

Identification of the reasons to learn something – To provide sufficient reason or information on why learning a particular topic could be useful. It is often not convincing for an adult to know that learning is good for them.

A learning motivation for personal need – In the case of an adult, the basic need of learning comes from the inadequacy of performance in a particular field. Identifying that particular reason in the student could help in convincing the need of learning a particular topic.

Pragmatic orientation – Individuals tend to learn things, which are useful in their daily life, or they would be able to utilise the information to a practical extent. This would help enhance the practical knowledge of the student.

Internally driven motivation – participation of an adult in a learning process is mainly driven by their personal requirements than superimposed by an external reason. Identifying the internal reason of the student would help in acknowledging the problems in a better way. Motivating the student would also help in enabling the student to focus on the topic (Merriam 2015).

The second theory is Cognition theory that alludes to mental action including considering, recollecting, learning and utilising dialect (Kendall and Hollon 2013). When we apply a subjective way to deal with learning and educating, we concentrate on the understanding of data and ideas. On the off chance that we can comprehend the connections between ideas, separate data and modify with logical connections, then our retention of material and comprehension will increase (Stevens 2013).

Since Cognitive, learning depends on one’s feeling and behaviour and thus relates to all forms of knowing, including thinking, memory, comprehension, motivation, perception and psycholinguistics. It is a more practical form of approach and requires an imaginative perception of the student (Estes 2014)

The third theory of learning is Behaviorism that reflects light on the impassively visible practices and rebates any independent movements of the mind. Scholars exemplify “learning” as the practice of securing new knowledge obtained natural condition, connections, then our retention of material and comprehension will increase (Seimens 2014).

 

 

This particular hypothesis is moderately easy to understand since it based on just detectable behavior and portrays several general rules of conduct. Its affirmative and pessimistic support strategies could be extremely effectual. On considering an example, in drugs designed for human use comprising autism a type of psychological disorder, tension concern and reserved behavior. Behaviorism is regularly exploited by trainers who either punish or reward such students (Jonassen and Land 2012).

Learning satisfaction is a term that can be represented as an individual’s emotional affordance of the measure at which the nursing students’ learning experiences match his or her expectations on a course. According to Knowles et al. (2014), andragogy theory teachers direct the apprentices to their own understanding rather than providing them with details. This approach differs with pedagogy where students depend on the instructor to instruct the learning. On the basis of the pedagogical approach, a mentor will be able to act as a facilitator in order to deliver instructions and assist the mentees in pursuing self-directed learning. According to the cognitive theory, an individual's acquisition can be achieved y observing others through social interactions and experiences.  If a mentor examines his or her belief in a student's behaviour or reason of failure then, through interaction behaviours can be changed. Teacher's role becomes easy with an understanding of the student's behaviour and action. Thus, innovative approaches should be used to recognise the strength and weakness of the student. One of such effective approach is the SMART goal approach (Siemens 2014).

The SMART approach is an effective learning approach. In this case, the use of the SMART approach would be involved during the interview. Firstly, understanding of the student’s complications to specify a goal would be required. Secondly, the measure would involve the mentor’s communication with the mentee, in order to provide feedback and helping him or her to realise his areas of improvement and clinical learning practice. Thirdly, the aim of the interview is achievable through a set of questionnaire which would help to recognise the mentee's strength and weakness. The communication during the interview is relevant since the interview is conducted to get a note of the initial requirements of the learning process. The time duration of the interview is one hour (Olson 2014).

The effect of a good environment is necessary for the success of the learning process. According to the literature if a student feel detached with the clinical setting and feel anxiety during his or her placement might experience less educational opportunities and this might lead to student attrition in the near future (O'Brien et al. 2014).

According to Padfield & Knowles (2014), the role of induction is very significant in the student learning and professionalism. It creates a good impression on the student’s mind. As discussed by Papaioannou et al. (2016), induction helps in imparting necessary safety and health management information and also gives and obligatory training of the internal facility of the clinical settings. It also provides the mentees important data related to their job and also mentions the norms. "In the context, the setting mentioned have several clinical aspects that would motivate and encourage the student learning. Firstly, there are numerous mentors that might be available to seek help. Highly improvised technical equipment is available to help the students to cope up with every situation. Audio and visual tools are available for clinical teaching. Moreover, the student has the access to the library in order to gather theoretical knowledge, and it also promotes evidence-based practice."

In order to understand the drawbacks as well as the positive attributes of the clinical setup, it is very significant to use the SWOT analysis in the practice. The SWOT analysis is in accordance with the clinical setup mentioned in the context. The strength of the setting is a friendly environment which believes in sharing, openness and commitment to boost the student's moral. The weakness is the restriction in student’s work and performance so that it does not lead to any personal or ethical issues. The opportunities involve direct practice using the patients to improve the clinical practice. The threats involve the loss of the confidentiality (Robinson & Niemer 2010).

The SWOT analysis can only be identified using an action plan. An action plan involves identification of the student’s strength and weakness. Then data should be recorded through observation daily, feedback should be provided as an improvement technique and preparation of the mock documents.    The data should be reviewed on weekly basis in order to identify the student’s progress rate. The last and crucial part of the action plan is the conduction of examination and entry of the results of the examination in the form data and documentation (Scanlan et al. 2001).

 

 

One of the most important parts of learning is feedback. As a mentor it is very important to provide a sandwich feedback which begins and ends with a good note. It has been observed that verbal feedback is more effective than written feedback. The reason behind this is a verbal feedback develops an opportunity to get back an immediate student response. A feedback therefore, provides an opportunity to the students to analyze and rectify their own mistake (Siemens 2014).

Assessment or examination plays another important part in the field of learning. Assessment is a technique of understanding the mentee’s capability and understanding level. In clinical setup assessment has high significance, since the health care sector deals with the life of human beings. Any mistake can cause major health related complications. Thus, it becomes essential to conduct short term called formative assessment and long term called summative assessment (Siemen 2014).

Thus it can be concluded that the role of a mentor is very important part of a learning process, I believe that promoting the new models of mentorship, the sharing of education can be more effective. A mentor should use good learning style in order to improve his own skills and develop the interest of a student in the clinical practice. In addition to this the nature of clinical environment is also important in the learning process. I feel that promotion of more evidence based practice can demonstrate the inter-personal relationship more between the student and the mentor. Moreover, facilitation of social networks would promote community practice mentorship.

 
References:

Alligood, M. R. (2014). Nursing theorists and their work. Elsevier Health Sciences.

Ashktorab, T., Hasanvand, S., Seyedfatemi, N., Zayeri, F., Levett-Jones, T. and Pournia, Y., 2015. Psychometric testing of the Persian version of the Belongingness Scale–Clinical Placement Experience. Nurse education today, 35(3), pp.439-443.

Butterworth, T., & Faugier, J. (2013). Clinical supervision and mentorship in nursing. Springer.

Chan, A.W., Yeh, C.J. and Krumboltz, J.D., 2015. Mentoring ethnic minority counseling and clinical psychology students: A multicultural, ecological, and relational model. Journal of counseling psychology, 62(4), p.592.

Damber, U., Samuelsson, S. and Taube, K., 2012. Differences between overachieving and underachieving classes in reading: Teacher, classroom and student characteristics. Journal of Early Childhood Literacy, 12(4), pp.339-366.

Daniel, S., Switzer-McIntyre, S. and Evans, C., 2015. Clinical practice facilitator: an innovative mentor role for Internationally Educated Physical Therapists in a Bridging Program. Physiotherapy, 101, p.e290.

Eddy, L.D., Dvorsky, M.R., Molitor, S.J., Bourchtein, E., Smith, Z., Oddo, L.E., Eadeh, H.M. and Langberg, J.M., 2015. Longitudinal Evaluation of the Cognitive-Behavioral Model of ADHD in a Sample of College Students With ADHD. Journal of attention disorders, p.1087054715616184.

Esposito, G., Manuel, J., Lavié-Martínez, D.F.S. and Iorga, E.M., 2016. 7 Underachieving student experiences in the INSTALL programs. Working with Underachieving Students in Higher Education: Fostering Inclusion Through Narration and Reflexivity, p.85.

Estes, W.K., 2014. Handbook of Learning and Cognitive Processes (Volume 4): Attention and Memory. Psychology Press.

Jonassen, D. and Land, S. eds., 2012. Theoretical foundations of learning environments. Routledge.

Kendall, P.C. and Hollon, S.D. eds., 2013. Cognitive-behavioral interventions: Theory, research, and procedures (Vol. 21). Academic Press.

Kim, N.Y., 2016. An Analysis of English Learning Style of Underachieving Student in High School: Based on Factor, Regression and Cluster Analysis.현대문법연구, 88(단일호), pp.81-97.

Knowles, M.S., Holton III, E.F. and Swanson, R.A., 2014. The adult learner: The definitive classic in adult education and human resource development. Routledge.

Merriam, S.B. and Bierema, L.L., 2013. Adult learning: Linking theory and practice. John Wiley & Sons.

Merriam, S.B., 2015. Adult Learning Theory: A Review and an Update.Culture, Biography & Lifelong Learning, 1(1), pp.59-71.

O'Brien, A., Giles, M., Dempsey, S., Lynne, S., McGregor, M.E., Kable, A., Parmenter, G. and Parker, V., 2014. Evaluating the preceptor role for pre-registration nursing and midwifery student clinical education. Nurse education today, 34(1), pp.19-24.

Olson, J.M., Herman, C.P. and Zanna, M.P., 2014. Relative deprivation and social comparison: The Ontario symposium (Vol. 4). Psychology Press.

Padfield, B., & Knowles, R. (2014). Development of learning facilitation roles for unregistered practitioners. Nursing Standard, 29(16), 35-40.

Papaioannou, S., Mouzaki, A., Sideridis, G.D., Antoniou, F., Padeliadu, S. and Simos, P.G., 2016. Cognitive and academic abilities associated with symptoms of attention-deficit/hyperactivity disorder: a comparison between subtypes in a Greek non-clinical sample. Educational Psychology, 36(1), pp.138-158.

Robinson, E., & Niemer, L. (2010). A peer mentor tutor program for academic success in nursing. Nursing education perspectives, 31(5), 286-289.

Scanlan, J.M., Care, W.D. and Gessler, S., 2001. Dealing with the unsafe student in clinical practice. Nurse Educator, 26(1), pp.23-27.

Siemens, G., 2014. A cognitive theory of inquiry teaching. Instructional design theories and models: An overview of their current status, p.247.

Siemens, G., 2014. Connectivism: A learning theory for the digital age.

Vanlaar, G., Kyriakides, L., Panayiotou, A., Vandecandelaere, M., McMahon, L., De Fraine, B. and Van Damme, J., 2016. Do the teacher and school factors of the dynamic model affect high-and low-achieving student groups to the same extent? a cross-country study. Research Papers in Education,31(2), pp.183-211.

Waters, D., Crisp, J., Rychetnik, L. and Barratt, A., 2009. The Australian experience of nurses' preparedness for evidence‐based practice. Journal of Nursing Management, 17(4), pp.510-518.

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