Describe about the Journal of Advanced Nursing for Nurses Perspectives.
This essay is to critically analyse few principles of constructive feedback impact on learning and teaching to both learner and mentor are critically analysed alongside how the feedback relates to the practice and how it brings development in the clinical area. Feedback is an information that is acquired comparing the observed achievement level of implemented activities and skills by a learner with a particular standard of evaluation to determine the areas of improvement and to assess learner progressive towards goals (Nicol&Dick, 2016).Feedback also mentioned as a process of significant other individuals the manner in which they are perceived (Bhardwaj, 2015).Whereas, constructive feedback basically means practical, helpful, valuable, useful or productive feedback. Assessment and feedback are interactive processes that promote learning by ensuring that the standards are met by providing the learner with an insight of the performance through critism (Gopee,2015).Constructive feedback important to both learner and mentor because it brings development in the clinical area (Schartel, 2012; Thomas & Arnold, 2011). In nursing, mentors are required to provide positive and negative feedback but not destructive feedback to enable learner to identify the area of development (Duffy, 2013).Without constructive feedbacks, the learner would feel that they lack of support from the mentor. An example of constructive feedback can be “You need to focus on achieving results with accuracy and precision therefore you should include interventions and respective rationales while writing a nursing care plan”. However, Walsh (2010) argues that feedback is essential in the support of healthcare learners. Oerman (2015) stated learner is a person who acquires knowledge, attitude and skills about particular subject or practise by studying, being instructed or through practical experience. By using gained knowledge and skills systematically, learner able to critically analyse and solve clinical problems. Despite, developmental feedback is important in the assessment of learners because it raises the standards that support assessment and learning within the nursing profession. Price et al., (2010) stated that feedbacks enables learner to evaluate aspects of their training that they require to work more, for instance if they poor in interpersonal skills, they will work on it to improve more. Developmental feedback can be formal or informal (Young and Steelman, 2014). The rate of formal feedback in practice placements is determined by the academic institutions from which the learners come from. Duffy (2013) argues that the more they are, the more beneficial they become. Price et al., (2010) mentioned mentors are required to assess learner’s current and future learning needs as it increase the productiveness of the feedback. Feedback in the clinical area is a highly valuable tool in the effort of developing professionalism and competence.Boud & Molloy (2013) expressed that feedback helps in the development of self confidence, self esteem, self awareness and enthusiasm by promoting effective learning. Through frequent motivation by their mentors, learners develop an insight of what is an expected in particular clinical situation, a factor that enables them to identify their personal strengths and weaknesses and work on it to enhance their skills and knowledge (Hattie&Timperly, 2007).Therefore, learner become autonomous in making clinical decisions through self-regulation within their scope. According to Blais and Hayes (2011), feedback can be used to provide positive reinforcement of the desirable practices in the clinical area by aligning the teaching and learning. Thus, the learners become sure of what is expected on them by receiving reassurance from their mentors.
Beside that, Needham, McMurray & Shaban, (2016) affirmed feedback also leads to improve clinical performance of the learners by supports the learner’s retention by enabling them to develop strategies to deal with their weaknesses and sustain their strengths. The experience gained through feedback helps learners to have a critical reflection on personal attributes about the professional characteristics hence leading to satisfaction. This feedback is important within the clinical area as it helps determine the missing aspects of the care being provided in a given facility. In order to provide what is missing, researchers within the clinics conduct studies and come up with recommendations that are necessary (Gray and Smith, 2000). Mentors and learners as well come up with new innovations that help in provision of the best quality care. Examples of feedbacks that mentors should provide include: you have done well; you handled the patient very well, even though you did not check with me before giving out that information; you did not do good enough; nice progress on your learning goals; maybe we expect too much from you; and you did not do much bad (Ferris et al., 2016). Every manner of feedback the given benefits the mentor in one way or another. For instance, a positive constructive feedback might make the mentor fulfilled while a negative one provides the mentor with an opportunity to teach the learner (Veeramah, 2012). According to NMC (2008), mentors are obliged to supervise students within learning institutions as well as providing them with feedback that is constructive in whatever they achieved. Aspects in which students are assessed on include safety, professionalism, psychomotor skills, interpersonal skills, applied knowledge base, motivation and attitude (Duffy, 2013). This feedback enables the learner to evaluate aspects of their training that they require to work more on. Some feedback benefits that enable learners to provide the necessary care includes teamwork development, improved interpersonal relationship and increased self-esteem. Duffy (2013) argues that mentors benefit from feedback by the enhanced interpersonal and communication skills they attain and mentors do not know how to give feedback in a way that is constructive and those that are aware of how to do it, enjoy mentoring their learners because of the benefits that they attain. Feedback is very essential in the clinical area. Mentors assess and provide developmental feedback to the learners themselves and to the health care management. Developmental feedback that mentors achieve provides them with a sense of satisfaction thereby enabling them to do their work efficiently (Walsh, 2010). This feedback ensures that health care facilities pick nurses who have attained all the necessary skills during their learning (Seppala and Cameron, 2016). Such nurses offer quality care to patients, their families and the larger community. Developmental feedback brings up individuals who are good at their profession to provide the necessary care. High quality care within clinics ensures that the purpose of existence of these facilities is achieved. Eventhough constructive feedback gives mentors a sense of satisfaction, regular constructive and developmental feedback impacts the same way to the learners. Some of the aspects in which mentors improve on as they provide feedback include psychomotor skills, interpersonal skills ,knowledge base motivation and safety and professionalism (Gray and Smith,2000).These are the same skills that learners achieve as the mentors keep improving them .When learners are provided genuine feedback ,they put much effort on how to improve themselves by approaching health professional colleagues, local practice facilitators, managers and lecturers(Knight&York, 2004).These mentors collaborate and come up with the best mentorship plans to help learners Wilkinson et al.,(2013).
On the other hand, feedback entails communication which can be formal through written remarks or informal through conversations. Since this process involves interaction, it also enhances the interpersonal skills in both the learner and the mentor (Jansson & Ene, 2016). Lally (2013) mentioned that feedback promotes personal and professional growth. Formal feedback provided in the clinical practice forms part of the evidence-based practice. It helps the learners to appreciate the importance of feedback, constructive criticism and to assimilate the knowledge for application in their daily practice. It is also a practical advice for the learners that stimulate improved performance and competence. However, the mentor has to demonstrate effective communication skills while providing the feedback to learners. Ortlieb & Cheek (2013) mentioned that learning environment is a physical, contextual and cultural location with internal and external factors that promote the continuous process of acquisition and development of knowledge, skills, attitudes and habits that are desirable by both the trainee and the trainer. The conducive learning environment is some of the aspects that should be considered in providing an effective feedback that can serve the purpose it is meant for (Jansson & Ene, 2016).
Constructive feedback has lead to the adoption of five principles which help mentoring learners. The first principle requires that every mentor sets realistic goals before providing learners with feedback. Examples of realistic expectations by mentors to learners are arriving in shifts on time. This makes mentors to share their expectations in order to have a basis for their evaluations (Jones et al., 2015). Other examples of mentors providing realistic goals before evaluations include when a learner is told how a patient will respond to good treatment and also, when a mentor provides objectives of what learners should achieve after studying a certain chapter. These are realistic goals.
In the second principle, mentors are expected to gauge what feedback the learners expect as they could fail to have past experience on feedback (Pelgrim et al., 2012). For example, a learner who was previously in a placement that mentors always provided negative harsh feedback may have low self-esteem and might not be comfortable with the present placement (Dixon et al., 2015). Another example is when a mentor asks a learner what side effects he or she expects after administering a certain medication to a patient. A different example is when a teacher in a lab asks for the explanation of results before the experiment is done. Gauging helps the mentors create designs of providing the feedback. In the third principle, mentors have to gather more information on the practice of students (Price, 2012). Mentors keep advancing their knowledge in order to provide learners with the most accurate information. For example, since there are many health electronic systems being develop, mentors go for higher training before teaching their learners. This learning helps the mentors learn new innovations and new ways of providing health care to their patients(Barr and Conlon, 1994). Another example where this principle applies is when a mentor asks for more information from the previous teacher about the learners, to have a glimpse of what they have learnt. The other example is where mentors attend conferences or travel abroad to gain knowledge that they can use to teach the learners. As they pass this on, their students become even better mentors in future.
In order for mentorship to have impact on the learning of the student, the fourth principle urges mentors to act immediately (Weeks, 2015). For example, if a learner use inappropriate language on patient, the mentor should advised the learner and teach them the correct way to communicate with the patient immediately. Other examples include, when a mentor corrects a learner to follow the right aseptic technique during procedure (Boerboom et al., 2015) and in case the learner does not remember the step in a certain procedure, the mentor should reminds the learner. Constructive feedback that is timely mentors the learners as they work to improve their shortcomings before engaging in similar events. According to RCN (2007), feedback should be close to the event so that it can have the greatest effect. In the fifth principle, Duffy (2013) points out that mentors should be specific. For example, if a mentor tells the learner, “you did well “, that would not be specific. Being specific would be a feedback like, “the advice you gave Mary on contraceptives is based on the most recent evidence, and you did great job by explaining them very well (Knight, 2014). Others examples, include when a mentor tells a learner that he/she has missed the second step of diagnosing diabetes, or when the nurse tells the learner that he/she has arrived 20 minutes late for his/her shift. Mentorship is only effective if learners get to know the specific areas they need to improve on and which they should maintain (van der Rijt et al., 2012). As a mentor, accountability is the central element of giving feedback in nursing practice. Accountability has its roots in all the ways and all the levels of nursing. All the healthcare professionals including nurses are accountable to provide quality and lawful services to the clients. On the other hand, nurses are accountable for providing the feedback. Feedback can be about the client that is given while handover. This feedback must be accurate, as it may influence the actions and decisions of other nurses (Wilkinson et al, 2012). The accountability principle also includes that nurses must be committed towards supporting their teammates. For example, while providing the feedback to the student nurses, the senior nurse must be accountable for providing practical advice, for their performance enhancement (Clynes, & Raftery, 2008).
Nursing profession is evolving rapidly as years go by due to various factors such as the advancing technology. Therefore, every nurse should keep advancing their knowledge so that they can provide the best health care with the best. Health care providers and nurses can only understand the evolving technology only if they keep learning. Mentors are encouraged to keep on providing feedback to the learners for effective health care delivery. Feedback ensures that health care practice gets the best innovation for quality care. In conclusion, constructive feedback is very important to learners and mentors. However, evidence indicates that students usually find it difficult to find mentors who can provide them with constructive feedback. For those who are able to get this feedback, the timing, type and amount they get is inconsistent. It is important that learners get genuine and constructive and developmental feedback to keep them from constantly repeating the wrong thing. Feedback is only helpful if it addresses the negative and positive aspects of the students’ lives as they work hard to become better. Constructive feedback is important to mentors, learners and it makes the nursing profession to develop.
References
Gray, M. & Smith, L. (2000). The Qualities of an Effective Mentor from the Student Nurse’s Perspective: Findings from a Longitudinal Qualitative Study. Journal of Advanced Nursing, 32(6), 1542-1549. https://dx.doi.org/10.1046/j.1365-2648.2000.01606.x
Walsh D (2010) The Nurse Mentor’s Handbook: Supporting Students in Clinical Practice. Open University Press, Maidenhead.
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