Clinical Mentoring Workshop for our Students
June 1, 2011
UNFPA Project Manager Sophia Griselda Nyame
Our partners in the Juba College of Nursing and Midwifery, the UNFPA, wrote the following report on a clinical mentoring workshop held on May 18th-May 20th, for a selection of the Nursing amd Midwifery students.
Background: Clinical Practice for students in training is essential in developing their skills and competences for effective patient care. Students in the clinical settings needs to be guided supervised and mentored by equally qualified staff to bring out these competencies. Most staffs are good in what they do but some find it difficult to transfer their knowledge to others. This may be as a result of lack of confidence, cultural issues, equipment and infrastructure, in-service training to update on current trends in the profession, etc.
As a result of the above, staffs fails to implement the ideal standards of patient management in the clinic setting and with time forget and or compromise these standards. In the Southern Sudan context, the above is true making teaching and learning in the clinical setting unfruitful (a supervisory follow up on students doing clinical practice revealed marked lapses between what is taught and what is actually practiced.) It is therefore of opt most importance to identify the right caliber of staff and equip them to mentor the junior (student) whilst in training to bridge these gaps.
- To build the capacity of the indentified Clinical Mentors/Ward In-charges on mentoring of students
- To equip the Mentors/Ward In charges with skills of mentoring
- To have effective and competent mentors
- To maintain a continues monitoring and supervision of students in the practical sites
- To help in the training the students
EXPECTED WORKSHOP OUTCOME/RESULT
- Effective and competent Clinical Mentors who will be able to guide students to acquire the needed skills in nursing and midwifery during the course of training
A three day non-residential training workshop sponsored by UNFPA was organized for some selected nurses and midwives acting as clinical mentors in the hospitals-Juba Teaching Hospital and Al Saba Children’s’ Hospital. A total of twenty-five nurses and midwives who were supervising the students in the various wards (Maternity and Gynae, Ante Natal ward and Clinic, Surgical and Medical units, Emergency and Pediatric units) were brought together during this training. Among the twenty-five participants, only three were midwives- this is as a result of the low number of midwives in the hospitals. The facilitators were tutors from the college, a doctor from the Juba Hospital and the project manager totaling six, the project assistant manager acted as the logistics officer during the training.
The workshop topic was “Basic Clinical Mentoring” and it was divided into 6 sessions to enable easy facilitation of the contents. Two sessions a day over an average period of two and a half to three hours each and each session had its learning objectives and key points at the end. There were two coffee and one lunch break in between the sessions. Lecture, discussion, demonstration and group assignment were some of the teaching methods used. An evaluation form was developed to enable participants assess the effectiveness of the overall workshop (workshop contents, facilitation, materials and logistics). As a way of actively involving the participants, they were divided into three groups; a leader was chosen to report on the day’s activities. Participants were encouraged to ask questions or made suggestions throughout the training.
Day 1 of the workshop:
Workshop began late on the first day due to transportation issues; it started at 9.25am as against the 8.00am proposed. Both participants and facilitators were registered totaling 30. After the introductions and training objectives, the Director General for Nursing and Midwifery-Mrs. Janet Micheal opened the workshop with some few remarks. She acknowledged and appreciated the importance of the workshop as according to her was the first of its kind for staff of the hospitals and would want them to take the training serious. She went on to suggest that the training should be in three phases so that those who do well and were interested could apply for sponsorship for training as tutors and with these remarks she declared the workshop opened.
The first session was Basic Clinical Mentoring facilitated by Mrs. Roslyn Owour, a tutor of JCONAM. She took participants through the definition of clinical mentoring, characteristics of a good mentor and the components of mentoring. At the end of her session she emphasized of these key points that:
- Clinical mentoring seeks to strengthen district health care systems by providing continuing education to HCWs, (most of the time students) and working towards creating more efficient clinical settings.
- Clinical mentoring involves relationship-building, identifying areas for improvement, coaching and modeling, advocacy, and data collection and reporting.
- Effective mentors are respectful, teach and learn, are adept at physical diagnosis, and enthusiastic about teaching.
- The next session was Relationship Building in Clinical Mentoring facilitated by Sophia Nyame. She explained the importance of a mentor building relationship with a mentee based on trust and mutual respect, Identifying potential barriers to relationship-building and some techniques for building rapport. Her closing key points were that:
- Relationships are the foundation of effective clinical mentoring.
- Strategies to build rapport include listening, patience, eye contact, use of affirming statements.
- There can be barriers to building mentorship relationships, based on cultural differences and expectations, as well as personal factors and Mentors can come prepared with strategies to overcome these barriers
Day 2 of the workshop:
The morning session began at 8.20am with arrival of participants and registration. Twenty-two Nurses, two midwives, seven facilitators and four observers from the Ministry and UNFPA. Total attendance was thirty-five.
The first group gave a recap of the previous day sessions and reminded participants of the ground rules set before the start of the training.
The day’s session began at 8.40am with Effective Communication and Feedback in Mentoring which was facilitated by Dr. Louis. In his session, he took participants through communication and feedback, its importance in mentoring, types of communication and the process, skills and barriers in communication and finally, the purpose of feedback in communication. His key points were that:
- Good communication—both verbal and nonverbal—is essential for an effective mentoring relationship.
- Communication techniques such as appropriate body language, active/ reflective listening, and summarizing can aid communication.
- Feedback is integral to adult learning, and is a vital component of the clinical mentoring relationship
Before and after lunch break, Learning Theories in Mentoring was facilitated by Mr. Khamis.In his introduction; he explained the application of these theories to clinical mentoring. He taught about Principles of Adult Learning and how that people learn differently, the three domains of learning-cognitive, affective and psychomotor; the three basic learning styles as visual, auditory and kinesthetic. Relating this to mentoring, he said adults are self-directed learners who bring experience to their learning and are motivated by tasks they find meaningful. His closing key points were.
- Adult learning theory should guide mentor instructions.
- All learning is added to past knowledge, which can influence how learners learn.
This session ended with questions and comments from the groups. The 2 Midwifery Specialists, Mrs. Butts-Garnets and Ms. Rehnstrom from UNFPA were at the workshop to encourage and support both facilitators and participants. The day’s activities were closed at 4.00pm.
Day 3 of the workshop:
The third day began at 8.30am with arrival of participants and registration-2 Registered Midwives,23 Registered Nurses and 6 facilitators summing up to31 in attendance. A recap of the previous sessions was done by the second group after which Mrs. Judith Apondo facilitated on Clinical Teaching Skills. She said teaching moments were opportunities to share a piece of information, demonstrate a technique, or expand on the implications of a clinical observation. She also emphasize on the use of bedside teaching, side-by-side teaching, and case presentations as teaching strategies in mentoring. Steps to bed side teaching, strategies of side by side teaching, their benefits and disadvantages were not left out. She closed her session with these key points:
- Teaching moments are opportunities to improve clinical skills of a health care worker.
- It can take place in a variety of settings, and mentors should maximize the number of teaching moments.
- Bedside and side-by-side teaching reinforce classroom learning, and allow the mentor to model clinical technique, as well as attitudes and behaviours.
Addressing System Issues was the last session and was facilitated by Mr. Gitonga. He said identifying common systems issues that exist in health care facility and developing strategies to address them was one of the qualities of a good mentor. He also said that mentoring was not just about teaching health care workers how to better administer care, but also about strengthening systems in the health care facility that support care and treatment. He categorized the system issues as-Patient capacity, supplies, confidentiality, record/organization and quality of care at the health care facility and strategies to mitigate these issues. As a closing point he said that:
- Strengthening systems in the health care facility to support care and treatment is an important aspect of clinical mentoring
- Participants were also taken through the Log Book that has been introduced by the Ministry of Health to be used as guide by the clinical mentors as well as the Student Evaluation Forms. Time was given for questions and comments following which the third group gave a recap of the day’s activities.
Closing of the Workshop:
The Head of Office of UNFPA, Dr. Ramiz Alakbarov, the DG of HR and Professional Development-Dr. Margaret Itto, the DG of Nursing and Midwifery-Mrs. Janet Micheal graced the workshop with their presence and to give their closing remarks.
Dr. Ramiz in his closing remarks said he was happy with the collaboration that existed between the Ministry and the organization (UNFPA) and how important they see training clinical mentors as a means of reducing maternal morbidity and mortality in the nation. Because, he said, given the right knowledge and information, it will affect attitude and way of giving attention and care to patients.
The DG of Nursing and Midwifery was please with the turn up of the staff for the training and laid emphasis on her opening remarks that the training was very crucial to the staff as this was the first of its kind. She appealed to the participants to ensure effective mentoring of the students any time they are at the clinical settings. She asked participants to be good role models for the students who will effect change in the profession. She finally appealed to the facilitators and organizers of the program to organize two more phases for similar workshop as the 3 days was not enough in equipping the staff for the tasks ahead.
Dr. Margaret, the DG of HRT and Professional Development in her remarks was please and express her gratitude to UNFPA for the continues support given to the Ministry. She highlighted training as one of the key priorities in human resource development and trainings that is geared towards upgrading knowledge is very much appreciated. The government as she made known has plans of opening five more Diploma training schools in the country and therefore appealed to the organizers to develop training materials and manuals for training mentors which will serve as tool to all the health institutions.
She encouraged the participants to enroll in English classes to enhance their confidence and command of the English language and also as a way of upgrading their professional competencies. She wished the best of achievements for the mentors and declared the workshop closed at 4.30pm.
SUGGESTIONS AND RECOMMENDATIONS
From the workshop analysis and the views solicited both from participants and the Ministry, Similar trainings should be organized within a period of five days touching different contents .Participants felt they were far behind the current trends in nursing and midwifery therefore constant training workshops were a means of upgrading their knowledge and skills.
The staff of JCONAM and the project management sincerely appreciates and acknowledge UNFPA for the support given in funding and organizing this workshop. We also acknowledge the officers from the Ministry of Health for their guidance and suggestions from planning to execution of this workshop. The hospital administrator of the Juba Teaching Hospital and Al Saba Children’s Hospital cannot be left out-for arranging and releasing their staff for the workshop. Finally, we would like to appreciate the nurses and midwives, all the facilitators who worked very hard to make this dream come through.