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Nurse Education Today (2008) 28, 563571

Nurse Education Today


www.elsevier.com/nedt

Judgements about mentoring relationships in nurse education


Christine Webb
a b

a,*

, Pam Shakespeare

b,1

University of Plymouth, Exeter EX2 6AS, United Kingdom The Open University, Milton Keynes MK7 6AA, United Kingdom

KEYWORDS
Nursing students; Emotional labour; Mentors; Critical incidents

Summary Much has been written about the use of portfolios and mentoring in the clinical assessment of nursing students in the United Kingdom. Research reports have focused on difculties in using portfolios, mentoring relationships and mentor preparation. The aim of this study was to deepen understanding of how mentors actually make judgements about students clinical competence. Qualitative data were gathered in 2006 using a critical incident technique in interviews with a convenience sample of students and mentors from two different geographical regions in the UK. Thematic analysis generally conrmed previous ndings regarding the qualities of a good student and resource issues in mentoring. Good mentoring depended on students building a relationship with their mentors, and undertaking a great deal of emotional labour to convince mentors that they were good students in terms of attitudes as well as clinical competence. It seems clear that much of the burden of creating effective mentoring relationships falls on students. At the same time, many issues identied in previous research do not appear to have been tackled, including appropriate mentor preparation and support, the format of portfolios and competency statements, and ensuring that enough time is available for mentoring and student supervision. c 2007 Elsevier Ltd. All rights reserved.

Introduction
Many research and anecdotal articles have been written in recent years about the assessment of
* Corresponding author. Tel.: +44 0117 317 9329/078 3392 6052. E-mail addresses: christine.webb9@btinternet.com (C. Webb), p.r.shakespeare@open.ac.uk (P. Shakespeare). 1 Tel.: +44 01908 658166.

nursing students clinical competence. In the past 15 years, pre-registration nursing curricula in the United Kingdom (UK) have been changed from Project 2000 (UKCC, 1896) to making a difference (DoH, 1999) or competency curricula, while assessment systems have employed a portfolio in which students collect evidence of their learning and competence to demonstrate reective practice and integration of theory and practice.

0260-6917/$ - see front matter c 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2007.09.006

564 Our aim in the study reported here was to follow-up previous work suggesting that, rather than relying in a straightforward way on evidence in the portfolio and on their own direct observations of students at work, mentors formed a judgment of students and then translated this into the language of the portfolio through a process of deconstruction and reconstruction (Scholes et al., 2004). We wanted to explore in greater depth how this process of forming a judgement occurred, principally because we thought that this would assist in developing programmes for mentor preparation.

C. Webb, P. Shakespeare The qualities of mentors traced in the literature (e.g. Gray and Smith, 1999) include friendliness, patience, a sense of humour and being approachable and accessible. Spending quality time in individual face-to-face contact (p. 44) were valued by students, as were consistent, genuine feedback (p. 45). However, students in several reports (Bennett, 2002; Eby et al., 2004; Pearcey and Elliott, 2004) had potentially damaging experiences (p. 45), such as being ignored and being used as workers rather than supernumerary students. From a mentor perspective, Wilkes (2006) summarises the issues as competing expectations (p. 45) over patient care and mentoring, lack of time and support (including from higher education institutions), and difculties in dealing with failing students. Darling (1985) coined the term toxic mentors for those who do not form constructive relationships with mentees because they themselves are suffering from burnout. Despite now being carried out over 20 years ago, Darlings concept of toxic mentors still seems relevant when considering some of the negative reports of student experiences today. Thus, Gray and Smith (1999) describe such mentors as disliking their jobs and often being unpopular with their colleagues. Against this background we conducted a small qualitative study to explore these issues.

Background
The international literature on supervision and assessment of pre-registration nursing students is confusing because of the use of different and sometimes interchangeable terminology, e.g. preceptor, mentor, assessor (UKCC, 1986). For example, van Eps et al. (2006) used the term to refer to a year-long quality improvement initiative in Australia in which nal year nursing students volunteered to take part in a programme with registered nurse mentors. Van Eps also notes that the majority of recent research on mentoring in nursing has emanated from the United Kingdom (p. 521). Because the study reported here was based on the current role in the UK, we relied mainly on UK-specic empirical research literature. Thus, the term mentor in this paper refers to a registered nurse who acts a supervisor, advisor and clinical assessor or pre-registration nursing students. The literature on mentoring in pre-registration nurse education in the UK was reviewed in 2006 by Pellatt, using a comprehensive electronic search strategy, and the report summarises the role of mentors in providing a supportive learning environment, clinical teaching and assessment. Pellatt (2006, p. 33) concludes that The role of mentor in the preparation or practitioners who are t for practice is paramount, but that better training, support and evaluation of their performance and an increase in their status are needed. Another recent literature review on The student-mentor relationship by Wilkes in 2006 was also based on a detailed electronic search. Wilkes identies the development of the mentor role with the changes in nurse education in the UK in the past decade, from Project 2000 (UKCC, 1986) to the present making a difference curricula (DoH, 1999), and considers its effects on student-mentor relationships. She sees a progression from mentor as advisor, through uncertainty of the role of mentor as assessor, to the current role as both teacher and assessor of competence.

Methods
Aim
The aim of the study was to explore how mentors make judgements about the clinical competence of pre-registration nursing students.

Design
A qualitative design was adopted as this was an exploratory study (Silverman, 2000). Data collection was inuenced by the critical incident approach used by Benner to explore how expert nurses made clinical judgements (Benner, 1984). We drew up an interview guide based on Benners, and asked participants to describe an incident that stood out for them as an example of a mentoring incident that was key in their mentoring relationships (see Fig. 1).

Participants
For this small exploratory study we aimed to recruit eight participants in each of the following catego-

Judgements about mentoring relationships in nurse education


A critical incident is one that stands out for you as an example of a mentoring incident that was key in your mentoring relationship: that went unusually well when there was a breakdown or things did not go as planned that was ordinary and typical that was particularly demanding an out of the ordinary mentoring event the piece of mentoring you are most proud of
Figure 1 Interview guide.

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ries: students with experience of being mentored, eight experienced mentors, and eight inexperienced mentors. Experienced mentors has supervised three or more students, while inexperienced mentors were either still training for the role or had only had one or two previous mentees. The rationale for recruiting these two kinds of mentors was to elucidate how mentors developed their skills in making judgements about students as they themselves gained experience in mentoring. The sample was one of convenience and the vicissitudes of securing appointments with staff in clinical practice meant that our sample did not quite match our original intentions. Thus, the nal sample was made up of nine third year students, 10 experienced mentors and ve inexperienced mentors (see Table 1).

Ethical issues
The study was approved by a university research ethics committee. Although the mentors were health service employees, they participated as university-authorised assessors, did so outside of their working hours and received an honorarium (see below). As there were, therefore, no implications for their employers, health service ethics procedures were not deemed appropriate. Participants were approached by a third party who was not involved in the study. This person gave them an information sheet and made interview appointments with those who agreed to take part. Before the interview, each participant received an oral explanation from the interviewer and signed a consent form. They were also given a claim form with which to claim 25 in expenses from the university.

Data collection
The data were collected at two educational institutions, one in the north and one in the south-west of England, and interviews were conducted by both authors. Again, because of the difculties of arranging and keeping appointments with busy clinical staff, the interviews took a variety of forms. Four of the nine students were interviewed as a group, the others being interviewed in individual face-to-face interviews. The ve mentors from Site A had telephone interviews. All other mentor interviews were face-to-face.
Table 1 Description of participants Total Study sample Experienced mentors Inexperienced mentors Third year students Total 10 5 9 24 Target 8 8 8 24

Data analysis
All interviews were fully transcribed and the data independently analysed thematically by both of us. We then discussed the themes identied and discovered that, while labeling them slightly differently, we had interpreted the data in a remarkably similar way.

Findings
Study limitations
This was a small study with a convenience sample. However, condence in the dependability and transferability of the ndings is enhanced by:  The use of two interviewers a nurse and a sociologist

566  The use of varying interview types  The wide geographical variation in study Sites  Replication of the ndings of other studies of mentoring It is also interesting to note that the interviews did not proceed in the way we had anticipated. Both students and mentors had difculty in reporting specic incidents of good or bad mentoring. Despite our re-phrasing the prompts in various different ways (e.g. could you tell me a story/give a particular example about a time when. . .), they tended to reply in terms of the kind of behaviour or attributes that made up a good mentor or student. This may be because, as found in previous research (Scholes et al., 2004) mentors particularly had a strong mental picture of a good student which they applied to specic instances of behaviour.

C. Webb, P. Shakespeare I just felt immediately that she didnt want a student, although she had been assigned. She just didnt want me working with her. . . I would try and join in with her and say, What are you doing? What do we do now? and she would say to me, Oh, why dont you just go and work with the HCAs? . . . It made me feel awful - I used to come off the shifts and cry. Experience versus recent qualication Mentors who were experienced nurses brought this wealth of knowledge and skills to the relationship, whereas there were also advantages in having mentors who had been through the process themselves. One student had had the ideal co-mentoring by an experienced nurse and a recent graduate: Having a mentor who was so newly-qualied, she knew exactly how (the assessment documentation) needed to be done... And then I had the other mentor who had more experience and more background nursing because she had been qualied for quite a few years. . . That was probably the best set of mentorship that I have had.

Overview of ndings
In this paper we present the data on three themes: good mentor, good student and the mentoring relationship, and our discussion focuses on the concept of emotional labour. Whereas this has been discussed previously in relation to nurses and patients, we draw attention to the emotional labour required of students to develop relationships with their mentors which are likely to lead to productive and satisfying placement experiences and getting signed off at the end of the placement. The ndings are considered below in terms of the themes and categories. Although we expected to nd differences resulting from varying lengths of experience as a mentor, we did not nd these.

Being there Students valued mentors who prepared them for new experiences and then, when they thought that they were ready, stood by while students put what they had been taught into practice. In this situation, it was important just tobe there: I was doing his discharge. . . So it meant making loads and loads of calls and sometimes drawing blanks and stuff. I did it all myself but the mentor was there, just, you know. . . if there was a little problem and I would ask her, but she didnt ever at any point take over she just gave me tips if I needed them. . . and that made it more satisfying because I sorted the problem out for myself.

Good mentors
Enthusiasm For students, good mentor were those who were enthusiastic about their own work and about passing on their knowledge to students: I had a fantastic mentor in A and E. She was actually quite young but she has had really good experience. . . of CCU, ITU and she was just so enthusiastic and it just made me feel so much more condent. Attitudes Mentors attitudes towards students were crucial, and having a poor experience was undermining and could ruin the entire placement:

Good students
Enthusiasm Enthusiasm was also an attribute of good students, and this might be in evidence even before the placement started. It was also important motivator for mentors: They are willing to learn. . . nothing is too much trouble. They want to get on, they want to learn every little bit of why you are doing this, what is this medicine for. . . it really stimulates one as a mentor. . . these are the ones I get the most thrill out of working with.

Judgements about mentoring relationships in nurse education Attitudes As with mentors, attitudes were important and non-verbal cues could give these away. Mentors would observe students: Watching their attitudes, how they look if a patient is incontinent when theyve gone to them the facial expression. All these experiences. . . just mannerisms, how they approach people. Inappropriate attitudes were the hardest thing for mentors to deal with: I felt honestly that I was talking to a brick wall and, although I tried several different ways of trying to get through, I didnt feel that she was improving at all. And I was getting feedback from other members of staff that she was unprofessional in her manner and even if they asked her to do things she did it with bad grace, and that was quite difcult to deal with. I tried to talk it through with her, by trying to guide her by working closely with her so that I could lead by example, but I didnt feel that I was getting through, which was quite difcult.

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They can be too assertive, too condent they miss things. . .. She was questioning what I did, and I did not mind that at all because that was good for me, and if she picked up on something that didnt bother me. But she got that she was so assertive that she would start to argue with things you were saying and it was frightening the patient. . . she was over-assertive. Again, this seemed to require judgment on the part of students and the ability to strike the right balance between positive and negative assertiveness, as in the following example: (A good student is) very assertive and they are able to think for themselves and they work quite safely. You have to be able to see an opportunity and take it, and there are some students who dont see that. And you are constantly having to say, Why dont you go with that patient and go and see this? . . . there are just some that sit back on the top of the bed and just want to watch all the time.

Mentoring relationship
Self-condence Mentors wanted students to be condent, and saw this as an aspect of competence. However, students also needed to be able to exercise judgement and know when to ask for help: I have got a very condent student at the moment and she is very good. She does know when to step back . . . and she is able to take a bay and a side room obviously under my supervision. . . she is able to prioritise what needs doing and, you know, she assists on ward rounds and she does any dressings that are needed. If a student lacked condence but showed potential, then staff could work on this: I had a very good third year student who was a little bit under-condent in her own abilities and she was a very, very good student: her theoretical knowledge was at a good level, she related it really well to practice, she had a lovely disposition about her, got on with everybody, all the multidisciplinary team, all the patients. But the one thing that she lacked was self-condence, really, and that was something that we kind of worked on through her placement. Positive feedback Receiving feedback on their performance is essential if students are to be able to reect on progress and make action plans to move forward. However, the following moving comment from a student is very telling of the extent to which this was done: We dont get awful lot (of positive feedback) but when we do it is, like, it brings tears to your eyes. Another student said: I would have liked more opportunity for feedback . . . it is difcult to get that time to do that, because by the time you have nished one thing you have moved on to the next and your mentor is also doing the next thing. It is very difcult. An inexperienced mentor, talking of her own student experience, said: She (the mentor) reassured me and everything that I did correctly, she said, That was brilliant, that was excellent. However, none of the data from mentors included examples of the need to give positive feedback to students. Nevertheless, mentors themselves were gratied to receive positive feedback from students: The student actually gave me a card to say, Thank you for helping me with my report. . . and so thats what I felt proud about.

Assertiveness Assertiveness and self-condence were similar, but over-assertiveness could be a problem:

568 Negative feedback When mentors had to give negative feedback to students, they found this difcult: Negative (feedback) is the most difcult one to give. . .it can be a bit overpowering if there are two senior people with a student. We do it informally over coffee and biscuits, get their point of view, and we (tell them) how they are getting on, whether they are achieving, what we expect them to achieve. Mentors might feel guilty if a student was not succeeding, and wonder if they themselves could have done better: Having to give somebody that news and tell them that they are not coming up to expectations I think that is quite difcult to do. I suppose to a certain extent you feel it is your fault. Sometimes students would indirectly receive negative feedback, as in the following example: I feel like I am a bit of a burden, so they dont have time for the students. And sometimes, if the student did not get something right or was taking time over something, you would have the mentor standing saying, Oh, for goodness sake, I will take over.

C. Webb, P. Shakespeare are just dropped into it to pick it up as you go along.

Mentoring relationships
As many of the quotes already given indicate, many mentoring pairings were highly rewarding for both partners. This was particularly so when students showed enthusiasm and the appropriate degrees of condence and assertiveness, as in these examples: The mentor that I have is fantastically supportive and absolutely brilliant, and most of the time when I do something we reect on it afterwards. I just loved getting into it. Thats why I enjoyed it, because I was allowed to do stuff. . . Normally, we would meet, make sure that we met up and had our coffee together and just checked everything was going OK. Normally, we had lunch together as well. However, in other cases students had to do emotional work to make the relationship function: And sometimes, working with lots of different people, it is really difcult because you need to know how they. . . do I do it that way or do I do it that way, and that can be a bit confusing. . . now I am my third year, I just say OK and then I do it like that (person wants me to).. I just try to adapt to the person that I am withYou just try and nd a common link with my mentor, almost make that bond, and then I think you get more from (the placement). As a result, students sometimes had to work hard on themselves, too: I am normally quite a condent person, but it really took a lot of resolve to get through that placement and I used to dread going into the placement every day. . . I tried to talk to (my mentor) but again she did not want to discuss it with me.

Being treated like a gofer Another process through which students were given negative messages was that their supernumerary status was ignored: I did say to my mentor once I feel like a gofer because its constantly, Jo, can you go for that, go for this. And she looked at me and I think she took it on board, what I was trying to say, because I said it nicely. Another way in which this gofering might be manifest was explained by another student: It was, Get the student to do that or The student needs a break, and they dont call you by your name. On other occasions students felt that they were being used as health care assistants (HCAs) to get the work done: Sometimes you do look back and think, I have just spent a whole shift being an HCA, really, and didnt really get involved in any what I call educational things. It is difcult to be supernumerary, so that you get some built-in tuition at the start rather than you

Making a judgment
As the previous themes illustrate, both mentors and students emphasized relationships as the fundamental element in making decisions about student competence. A mentor put it this way: Its just how you feel yourself, while a student said, I think that probably comes down to, you know, judging you

Judgements about mentoring relationships in nurse education This illustrates the focus on judging the person as much as or perhaps more than their performance. This impression was given by a mentor, who said that she assessed a student by: . . .her presentation of herself. Some of the examples would be that every time you turned around she was sitting down. No matter what was going on, she would be slouching on the furniture instead of being alert and taking notice of what was going on around here. This compared with a student who: . . .does not just stand and wait she is off, she is looking in, she is just very capable and she likes to get on with it. Other examples from mentors were She changed from being timid to being outward, She had a lovely disposition and She was a youngish girl, referring to the way they perceived that students presented themselves.

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Discussion
The aim of this study was to explore how mentors make judgements about the clinical competence of pre-registration nursing students. It emerged that the linchpin in this process was the mentoring relationship. As discussed earlier, many previous writers have discussed this relationship, what denes a good mentor and a good student, and the resource constraints that condition the relationship. What has not been little considered before, however, is how much work students have to do to make this relationship a productive one. The concept of emotional labour has become part of the discourse of nursing since the early PhD studies of James (1989), who collected her data using participant observation in a hospice, and Smith (1992), who focused on how nursing students learn to care. In a follow-up study, Smith and Gray (2001) identify mentors as the main providers of emotional labour and support (p. 235) for students as they in turn learn to use emotional labour in their work with patients. Smith draws on the work of Hochschild (1983) with ight attendants, who dened emotional labour as: The induction or suppression of feeling in order to sustain an outward appearance that produces in others a sense of being cared for in a convivial safe place (p. 7). It seems legitimate to conceptualise the role of mentors with nursing students as caring, and that this should take place in a safe place, since

their role is to support and nurture these future practitioners and increase their self-condence (Tracey and Nicholl, 2006). This certainly happened in the good mentoring pairings in our study. However, what seems to stand out in our data is how much emotional labour students had to put into their relationships with mentors. For these to be effective and rewarding, students needed to portray themselves as appropriately enthusiastic, condent, assertive and competent. If they succeeded, and were not seen as overcondent or too assertive, this was likely to lead to a productive and enjoyable placement. If they did not succeed, either because they did not display these qualities to the appropriate extent or because they had an unwilling mentor, the placement could be emotionally draining and ineffective as a learning experience. It is not satisfactory to say that such placements allow students to learn how not to practice, as suggested by Eby et al. (2004) and Pearcey and Elliott (2004). The effects of this kind of socialization are shown in the recent focus on bullying in nursing in the UK. Parallels between bullying and negative emotional labour can be seen in their shared features, reported by Hume et al. (2006) as being ignored, personally criticised and abused. The effects of this are likely to be low self-esteem and ultimately to poor clinical care and increased student dropout. The conicting demands of patient care and student mentoring underlie some of the problems we and others have identied. For example, Hunter (2004) in a focus group study with UK midwives and students, also found the conicting ideologies of client care and institutional demands to be a major source of emotion work. The conicts of mentoring found in our study seem to parallel Hunters institutional demands in that they conicted with mentors occupational ideology of high quality care. Ehrich et al. (2002) carried out a review of 159 research reports of mentorship in education and also found that the most common problem for mentees (not necessarily pre-registration nursing students) was lack of time for mentoring. What denes a good nurse does seem to be changing with developments in nurse education. In the past, a good nurse was a good woman (Gamarnikow, 1978) and was expected to be quiet, kind and compassionate (Mackay, 1993, p. 163). In contrast, Project 2000 (UKCC, 1986) and making a difference (DoH, 1999) emphasized students responsibility for their own learning

570 and thereby legitimized the use of independence and assertiveness in realising this learning in clinical settings. The inclusion of reection as part of this process encourages students to take a more critical view of what happens both to patients and to themselves. However, these processes expose students more than previously to what Foucault (1997) called the gaze and result in them having to exercise more self-discipline or emotional labour through opening themselves to scrutiny.

C. Webb, P. Shakespeare  paying greater attention to mentors reservations about unsatisfactory students  supporting mentors to fail students who are not achieving.

References
Andrews, G.J., Brodie, D.A., Andrews, J.P., Hillan, E., Thomas, B.G., Wong, J., Rixon, L., 2005. Professional roles and communications in clinical placements: a qualitative study of nursing students perceptions and some models for practice. International Journal of Nursing Studies 43, 861874. Andrews, G.J., Brodie, D.A., Andrews, J.P., Hillan, E., Thomas, B.G., Wong, J., Rixon, L., 2006. Professional roles and communications in clinical placements: a qualitative study of nursing students perceptions and some models for practice. International Journal of Nursing Studies 34, 861874. Benner, P., 1984. From Novice to Expert. Excellence and Power in Clinical Nursing Practice. Addison-Wesley, Menlo Park, CA. Bennett, C., 2002. Making the most of mentorship. Nursing Standard 12 (3), 29. Darling, L.A., 1985. What to do about toxic mentors. Journal of Nursing Administration 15 (5), 4344. DoH, 1999. Making a Difference. Strengthening the Nursing, Midwifery and Health Visiting Contribution to Health and Health Care, Stationery Ofce, London. Eby, l., Butts, M., Lockwood, A., Simon, S.A., 2004. Proteges negative mentoring experiences: construct development and nomological validation. Personal Psychology 57 (2), 411. Ehrich, L., Tennent, L., Hansford, B., 2002. A review of mentoring in education: some lessons for nursing. Contemporary Nurse 12, 253264. Foucault, M., 1977. Discipline and Punish, Allen Lane, London. Gamarnikow, E., 1978. Sexual division of labour: the case of nursing. In: Kuhn, A., Wolpe, A. (Eds.), Feminism and Materialism. Routledge and Kegan Paul, London, pp. 96 123. Gray, M., Smith, L.N., 1999. The professional socialization of diploma of higher education in nursing students (Project 2000): a longitudinal qualitative study. Journal of Advanced Nursing 29, 639647. Hochschild, A., 1983. The Managed Heart: Commercialisation of Human Feeling. University of California Press, Berkeley, CA. Hume, C., Randle, J., Stevenson, K. 2006. Students nurses experience of workplace relationships. In: Randle, J. (Ed.), Workplace Bullying in the NHS, Radcliffe, Abingdon, pp. 63 76. Hunter, B., 2004. Conicting ideologies as a source of emotion work in midwifery. Midwifery 20, 261272. James, N., 1989. Emotional labour, skills and work in the social regulation of feeling. The Sociological Review 37 (1), 1542. Mackay, L., 1993. Conicts in Care. Medicine and Nursing. Chapman and Hall, London. Pearcey, P.A., Elliott, B.E., 2004. Student impressions of clinical nursing. Nurse Education Today 24 (5), 382387. Pellatt, G.C., 2006. The role of mentors in supporting preregistration nursing students. British Journal of Nursing 15 (6), 336340. Scholes, J., Webb, C., Gray, M., Endacott, R., Miller, C., Jasper, M., McMullan, M., 2004. Making portfolios work in practice. Journal of Advanced Nursing 46, 595603.

Conclusions
Our ndings seem to conrm earlier research (Scholes et al., 2004) that judgements of student competence are made on a relatively subjective basis, negative outcomes often being described as arising from personality clashes. However, more fundamental aspects of nursing culture rather than individual personalities underpin the problems identied in our study and many of its predecessors. Implementation of oft-repeated recommendations (see, for example, Darling, 1985; Watson, 2000; Andrews et al., 2005) would undoubtedly help, such as better mentor preparation and support, recognition and appropriate resourcing of mentoring by managers, closer liaison between service and education staff but this will not solve the cultural issues in nursing. A greater contribution may result from initiatives to develop leadership skills in ward managers, which are intended to contribute to promoting facilitative leaning environments, as well as improving standards of care (Andrews et al., 2006). The emphasis in pre-registration education on developing assertiveness, self-condence and reection should have similar longer-term benets. In the short term, these may need to be backed by stronger quality assurance of mentoring systems, including:  making attendance at mentor preparation and update sessions compulsory  not allocating students to mentors who have not attended these sessions  emphasizing to students the importance of body language and other non-verbal forms of communications in self-presentation  taking more seriously student evaluations of placement and mentoring quality  not allocating students to mentors who have received negative evaluations and addressing issues of burnout through clinical supervision and staff development

Judgements about mentoring relationships in nurse education


Silverman, D., 2000. Doing Qualitative Research. A Practical Handbook. Sage Publications, London. Smith, P., 1992. The Emotional Labour of Nursing. Macmillan, Basingstoke. Smith, P., Gray, B., 2001. Reassessing the concept of emotional labour in student nurse education: role of link lecturers and mentors in a time of change. Nurse Education Today 21, 230 237. Tracey, C., Nicholl, H., 2006. Mentoring and networking. Nursing Management 12 (10), 2832.

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UKCC, 1986. Project 2000: A New Preparation for Practice, UKCC, London. van Eps, M.A., Cooke, M., Creedy, D.K., Walker, R., 2006. Student evaluations of a year-long mentorship program: a quality improvement initiative. Nurse Education Today 26 (6), 519524. Watson, S., 2000. The support that mentors receive in the clinical setting. Nurse Education Today 20, 585592. Wilkes, Z., 2006. The studentmentor relationship: a review of the literature. Nursing Standard 20 (37), 4247.

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