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Nine studies explored student experiences of mentorship; six focusing on mentorship generally (2.3.1) and three on specific aspects of its delivery (2.3.2).

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2.3.1 Studies focusing on experiences of mentorship generally

This group included three studies from the UK and three from other countries.

UK studies of students’ experiences of mentorship

The three UK studies were each based on students drawn from one HEI. Spouse (2001 a, b) used a volunteer sample of eight first year students preparing for adult, child and mental health branches to explore the importance of mentorship in the acquisition of professional knowledge using successive interviews, complemented by observation and documentary analysis. Kilcullen (2007) interviewed a purposive sample of 39 third year diploma students in three focus groups to elicit their perceptions of the impact of mentorship on clinical learning. Second year students on community placements were the focus of Baglin and Rugg’s (2010) study in which semi-structured reflective diaries with a convenience sample of six students were used to explore experiences of the availability of learning activities and views about the value of the community placement.

The role of the mentor in facilitating students’ learning emerged from all three studies. Findings from Spouse (2000a) highlighted the importance of support and guidance from an approachable mentor in enabling students to gain professional knowledge. A second paper from this study (Spouse 2000b) indicated ways in which this acquisition was facilitated and included: helping the student to feel accepted in the clinical setting; assessment of capability and planning of educational experiences; working in partnership with the mentor during episodes of care-giving; and the

mentors sharing thinking about the processes they were deploying during care-giving. Respondents in Kilcullen’s study (2007) described ideal mentors as those who helped students socialise into the ward, assisted in the acquisition of clinical skills, gave constructive feedback during the placement, acted as a good role model, and had the ability to integrate theory and practice. Students reported that some of their mentors fulfilled these roles and that the majority were junior staff whom respondents perceived as having a good understanding of their own course. Experience of mentoring in community settings (Baglin and Rugg 2010) showed that working in a team and working closely with a mentor increased confidence and that students commented positively on support in this respect.

Findings from the three studies also revealed students’ perceptions of factors that could hinder their learning opportunities. These included: mentors having to provide mentorship for large numbers of students (Spouse 2000b); mentors feeling unsupported themselves (Kilcullen 2007); and having heavy workloads that led to competing priorities of patient care and student education (Kilcullen 2007, Baglin and Rugg 2010). Students in Kilcullen’s study (2007) reported not always having sufficient opportunity to develop analytic and problem solving skills while those in Baglin and Rugg’s study (2010) attributed a lack of opportunity to gain mastery of practical nursing skills in community settings to increasing delegation of these tasks to healthcare assistants.

Overseas studies of students’ experiences of mentorship

Similar findings in relation to positive and negative experiences of mentors emerge from the three studies in other countries which, like the UK studies, were all undertaken in one HEI. Ohrling and Hallberg (2000a, b) used in-depth interviews to understand the experience of 17 ward-based students selected from a sample of 30 students in the final year of a three year nursing programme in Sweden. A newly established mentoring programme in Hong Kong was evaluated by Chow and

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Suen (2001); expectations and experiences of the role of mentors were obtained from semi

structured interviews held with a volunteer sample of 22 second and third year students (40% of the student population). Likewise, the study by Van Epps et al (2006) was an evaluation of a new programme; in this case a hospital quality improvement initiative specifically set up for final year students. Thirty nine students opted to take part in the study and were paired with registered nurses who had also agreed to take part; data on their experiences were obtained via

questionnaires, focus groups, interviews and student diaries.

The Swedish study indicated students learn from being allowed to practise genuine nursing care and that contact time with the mentor, the use of reflection, provision of concrete examples and control were features of the process (Ohrling and Hallberg 2000a). The study by Chow and Suen (2001) in which responses were coded according to the five aspects of the mentor’s role originally specified by the ENB (assisting, befriending, guiding, advising and counselling) reported positive experiences of all of these. The programme evaluated by Van Epps et al (2006) showed that students appreciated the regular contact with their mentor and that benefits included: developing their clinical skills and gaining confidence from their increasing competence; integrating theory and practice; and a growing socialization into nursing. As with the UK studies, factors were identified that hindered the process of mentorship. Lack of physical space and time for students to reflect on learning either by

themselves or with their mentor emerged from the study by Ohrling and Hallberg (2000b) and mentoring expectations being unfulfilled due to mentors’ lack of training for their role and facing the competing demands of patient care and student education (Chow and Suen 2001).

Strengths and limitations of the UK and overseas studies

These six studies have various strengths and limitations, some of which are discussed by the authors. Detailed accounts of data analysis procedures were provided and in some instances verification of analysis with participants; some studies were strengthened by triangulation of data from different sources (e.g. Spouse 2001a, Van Epps et al 2006). Sources of bias include motivation of respondents taking part in volunteer samples and participants being potentially vulnerable to a ‘power

relationship’ when studies take place in the researcher’s institution. Generalisation from a study undertaken in one institution is limited but considered in conjunction with other similar studies contributes to building up an overall picture of factors facilitating and hindering the process of mentorship from the perspective of students.

2.3.2 Studies focusing on a specific aspect of students’ experiences of mentorship

Three studies focused on a specific aspect of the delivery of mentorship: contact time with mentor and students’ changing needs for mentorship at different stages of the course.

Lloyd-Jones et al (2001) found considerable variation in the extent to which students and their named mentors worked together. A sample of students across all branches of nursing (n=270) and their named mentors from 14 NHS trusts in three geographical areas were asked to complete activity diaries for one week as part of a larger cost-benefits analysis study of clinical placements. Among the student respondents (n=125, response rate 46%) and the mentor respondents (n=117, response rate 45%) there were 81 student-mentor pairs. Data from these pairs showed that 31 worked on the same shift every day, 48 a mixture of the same and different shifts, with just two pairs not working together at all. Lack of working together was partly a function of differences in shift patterns.

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Findings suggested that the students who did not work with their named mentors spent less time in educational activities and adopted a more passive role in clinical care. However, patient-related activities were separated from educational activities in the analysis, suggesting that patient-related activities were perceived as having no educational component.

Students’ changing needs for mentors emerged from a longitudinal study in one HEI by Gray and Smith (2000). Data were obtained from a volunteer sample of 10 adult branch students who were interviewed on five occasions throughout the course and from a further seven volunteers who kept diaries only. Findings charted the changing role for mentors at different points of the students’ education; thus they were vital to the students at the start of training but diminished in importance towards the end. Similarly, dependency on the mentor reduced once the students had settled into placement and knew what was expected of them. By the end of the foundation programme, students articulated the qualities they associated with good mentors and these included: being approachable and friendly; being good role models (professional, organised, confident in own ability, and enthusiastic about their job); ability to pace their teaching to student need; and provide

constructive, critical feedback. Having a good mentor coincided with perceptions of having a good placement.

The importance of mentorship for final year students in one institution emerged from a study by Ross and Clifford (2002) focusing on the transition from student to newly registered nurse. Thirty students from a total of 177 students in the third year of a diploma course volunteered to take part and were asked to complete a questionnaire about their experiences and expectations (19 did so) and of these 13 completed a post-qualification questionnaire. In between these two time-points, four of the 19 responded to a request to be interviewed. One of the key findings was that more positive and directed support was wanted from mentors during the final year alongside

acknowledgement that mentors were not sufficiently supported themselves at times to do so. The authors report that these findings were discussed at mentor workshops.

In terms of strengths and weaknesses of these three studies, two share characteristics with studies in Section 2.3.1 in that they were volunteer samples in one institution. The study by Lloyd-Jones et al (2001) has the strength of including 14 trusts and all branches of nursing, although it is not entirely clear from the paper how some components of the sample were selected. Findings from these studies amplify some of the findings from those reviewed in 2.3.1 such as perceived

characteristics of good mentoring and factors that limit the process such as mentors lacking support themselves and the impact of shift patterns on contact time.