Sustainability Initiative in Nursing Essay.

Sustainability Initiative in Nursing Essay.

Evidenced-based nursing practice is used in this article to mean ‘‘practice in which nurses
make clinical decisions using the best available research and other evidence that is
feature article
reflected in approved policies, procedures, and clinical guidelines in a particular healthcare agency.’’4(p12) The use of evidence in nursing practice is often explained as the use of research in practice. Because much of nursing practice has not yet been tested or developed through research, nurses must make use of evidence such as chart reviews, infection control data, and clinical expertise.
The definition mentioned previously differs from those related to other disciplines because nurses often provide care in settings where a group of nurses provides care to a group of patients. In using approved evidence-based policies, procedures, and clinical guidelines, nursing staff has a consistent approach to patient care that results in less care quality variability. Moreover, individual nurses often lack the time, resources, and expertise to locate sources of evidence, read research and other literature containing evidence, translate the findings into interventions, and implement the interventions. Coaching And Teaching Clinical Essay Paper.
To facilitate the diffusion of evidence into practice, an
organizational model of EBP is recommended. The organizational model should support the development of interventions based on evidence and should lead to evidence
embedded in policies and guidelines. The process needed to
bring forth evidence is the responsibility of experts who
have the time to complete the needed work and keep
practice documents updated.4
EBNP or EBP is differentiated from research in several
key ways. Basing nursing practice on evidence entails
locating the latest research and other evidence, synthesizing
results, and translating the evidence into a protocol or
guideline that can be used to guide practice. Research is
systematic investigation aimed at generating new knowledge or refining existing knowledge.6 Although EBNP and
research involve some of the same tasks, such as searching
the literature, the purposes of these tasks are for achieving
different goals. The goal of research is generating new
knowledge and involves different skills than the application
of knowledge, which is the goal of EBP.
The need for the use of evidence in nursing practice has
been highlighted for several decades. However, implementing research and other evidence in practice has been shown
to take 20 years or more.7 Moving evidence more quickly
into nursing practice requires many strategies.
For EBP to be successfully implemented, a culture of
inquiry, or what Senge8 called the learning organization, is
necessary. A learning organization is one in which there is a
prevailing climate of continuous questioning and desire to
use the most recent evidence. Learning organizations are
‘‘where people continually expand their capacity to create
the results they truly desire, where new and expansive
patterns of thinking are nurtured, where collective aspiration is set free, and where people are continually learning
how to learn together.’’8(p3) Moreover, a culture of inquiry,
as one quality of professional practice, is critical to
institutionalize EBNP.4
CNSs have competencies for assisting nurses to develop
critical thinking and other skills for EBP. These competencies are described in the conceptual model of CNS
practice contained in the Statement on Clinical Nurse
Specialist Practice and Education.
9 This model includes 3
spheres of influence: patient/client sphere, nurses and
nursing practice sphere, and organization/system sphere.

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CNS outcomes for all 3 spheres are listed in the publication
and include 16 outcomes for patient/client, 13 outcomes
for nurses and nursing practice, and 13 outcomes for
organization/system. A specific outcome of CNS practice in
the nurses and nursing practice sphere is ‘‘evidence-based
practices are used by nurses.’’9(p31) In summary, CNSs
influence nurses to improve the quality of patient care and
increase the amount of evidence used in nursing practice.
Clinical coaching is a strategy that CNSs can use to help
assure that EBP is used by nurses.
In addition to the outcomes of CNS practice related to the nurses and nursing practice sphere of influence, CNSs are accountable for EBP outcomes in the other 2 spheres of influence. In their individual practices with patients/clients, CNSs are responsible for delivering EBP, and CNSs are responsible for assisting the organization/system to support EBP.9 To accomplish all the work needed to reach the goal of EBNP, CNSs work to develop a cadre of nurses who have the knowledge and skills to assist in the establishment and maintenance of EBNP. This article describes clinical coaching as a strategy for assisting nurses to develop critical thinking and other skills needed for practicing from a base of evidence.
DESCRIPTION OF THE STRATEGY
CNSs have positions in which they interact with nurses in
every day practice. CNSs are typically employed in staff
positions, instead of line positions; they do not usually have
supervisory responsibilities for employees.10 This organizational relationship may be capitalized on to assist individual nurses to improve their skills through the strategy of clinical coaching. In addition, CNSs may organize groups of staff nurses with whom they meet regularly to provide
clinical coaching. Coaching, along with teaching, is identified as an essential core content area in graduate preparation for CNSs.9 Although coaching and teaching
have some commonalities, coaching involves assisting others to improve skills rather than a focus on providing information, as teaching is often viewed and practiced.
The purpose of clinical coaching is to assist nurses to
strengthen areas of their practice that will result in improved
patient outcomes. Coaching is a relationship between
people for building skills toward the goal of performance
improvement. Techniques used in clinical coaching may
include observation of a nurse`s clinical care with feedback
provided; demonstration of skills such as leadership, conflict resolution, and problem solving; and review of a nurse`s written documentation to provide suggestions for improvement. In providing clinical coaching for groups of nurses, CNSs may also use techniques such as small group discussion of case studies and articles and demonstration of peer-review processes.
A well-developed plan for how clinical coaching can be
configured to best fit a specific organization is the first step
for the CNS to take. For example, the plan may include a
regularly scheduled meeting with each nurse on a unit. To
initiate the plan, scheduled individual coaching sessions
could be directed to areas that the nurse identified as
wanting to improve. Later sessions could focus on the
priorities of the unit for moving toward EBNP. These
individual coaching sessions may be as short as 10 minutes.

With a specific targeted focus on a very specific topic, such
as writing an accurate precise nursing note, 10 minutes can
be a very profitable use of time. Because coaching requires
the cooperation of both parties, the CNS should involve staff nurses in the planning as soon as possible. Staff will have ideas about what areas need to be addressed and timing for implementing aspects of the plan.
Clinical coaching involves the promotion of skills for
using processes such as those involved in critical thinking
and problem solving. Knowledge needed by staff nurses to provide evidence-based nursing care covers a variety of areas, such as knowledge of current literature and effective
communication skills. Clinical coaching for improving
readiness for EBNP should first be directed to enhancement
of basic knowledge and skills. This foundation will provide
the culture needed by CNSs to make the next step toward infusing the practice environment with evidence-based procedures, protocols, and clinical guidelines.
An expectation for EBP is necessary but not sufficient to
bring about the needed behavior changes. Much has been
written about the barriers to using research in practice including time limitations and lack of administrative support.11 Barriers such as these are numerous and still exist in
patient care settings. Barriers to the use of evidence in practice
cannot be entirely eliminated by enhancement of staff nurse
knowledge and skills, but CNSs provide support needed to
reaching the goal of EBNP.
CREATING AN ENVIRONMENT THAT
STIMULATES SELF-LEARNING
As a first step, the CNS needs to assess the environment
before beginning the work to create ‘‘an environment that
stimulates self-learning and reflective practice.’’9(p34) Clinical coaching will assist with creating a culture of selflearning while moving staff nurses and nursing practice
toward readiness for EBNP.

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One foundation for creating an environment of selflearning is knowledge of current nursing and healthcare
literature. Nurses do not commonly read research journals
but depend on trade magazines and general nursing
journals for information.12 Thus, to the extent that general
nursing journals attempt to disseminate research findings
and evidence, nurses may be informed about the current
evidence base of practice. Most staff nurses have only
fundamental education about research.
Most positions do not allow the individual nurse time to
keep current with literature. A CNS could assist individual
nurses or groups of nurses to establish plans for review of
current literature and reading pertinent articles on a regular
basis. A plan for reading and thinking about nursing practice would provide for optimal use of limited time. For example, setting aside a half hour each week for scanning
current journals may be adequate for one to be broadly informed about the latest research and practice issues. To read
articles in depth, several additional hours may be needed.
Because every one has limited time for reading, especially
during work hours, CNSs may promote other approaches
for staff nurses to maintain current knowledge. For example, encouraging nurses to read professional literature outside work hours is part of establishing and maintaining an
environment that stimulates self-learning. Another approach is for a CNS to organize a group of nurses to
read a specific journal or journals each month and provide
written summaries to the total staff. Because much information is now available online, access to journals may be easier
than in the past. Based on specialty, CNSs should rotate
responsibility for consulting and assisting nurses who are
preparing written summaries.
Clinical nurse specialists assist nurses with developing
skills for examining literature. Not all information published in journals is accurate and current or meant to be
translated into practice. The CNS provides valuable input
when the content of specific articles is discussed even if the
CNS does not possess the specific body of knowledge
about a topic. The CNS asks targeted questions that guide
nurses` thinking about the implications of the information
for clinical practice within the context of patients in the
nurses` particular settings.
Clinical nurse specialists can be very instrumental in
helping nurses to hone their skills about use of literature.
When reviewing the literature, keep 2 things in mind. First,
keep an open mind about what constitutes the ‘‘right answer.’’ Discussion and open debate about issues are approaches for arriving at better answers and to helping create
an environment of intellectual stimulation. Accepting one
point of view may not be the best approach to treatment
and care, especially if the literature and the experts do not
agree. Second, any one person can be informed about only
a small portion of the current literature. This second point
is why it is important to include experts from other disciplines in the approach used to keep the staff informed about
current research and other evidence for nursing practice.
Clinical nurse specialists serve as role models and motivators for others to become interested in seeking answers
to complex questions or situations. Analyzing and synthesizing literature are approaches to addressing complex
problems and sharpening critical thinking skills. Nurses
constantly use critical thinking skills in their care of patients, so improved skills in this area theoretically contribute to improved patient care and better patient outcomes.
Clinical nurse specialists assist nurses to develop analysis and synthesis skills. Analysis refers to an intellectual
process of separating a concept or item into parts for study.
The synthesis process is meant to accomplish the combination of separate elements or parts into a coherent whole.13
Case studies and literature reviews can assist nurses in the
continued development of their analysis and synthesis
skills. Continuing education and in-service programs organized around case studies and other interactive learning
activities, such as problem-based learning, could contribute
to increasing nurses` critical thinking skills.
For example, CNSs can develop case studies about
particularly difficult patient situations with readings about
the evidence base provided to nurses before the case study
discussion is conducted by a CNS knowledgeable about
the particular patient condition. One area of patient care
that may provide challenges to nurses is smoking cessation.
In a review of studies to determine the effectiveness of
nursing-delivered interventions for smoking cessation, the
investigators concluded that nursing interventions can be
effective. They proposed that the challenge is to incorporate smoking-cessation intervention as part of standard
practice.14
CLINICAL NURSE SPECIALIST 298 A
Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
CNSs are instrumental in organizing unit-level in-service
programs that use case studies and other activities to
encourage active analysis and synthesis of literature. In
these programs, CNSs demonstrate and teach skills so that
nurses at the unit level could take over leading discussions
using analysis and synthesis techniques. One example of
case studies to improve analysis and synthesis skills is to
use the results of chart audits to compare the results of
literature syntheses about evidence-based care of patients
with specific conditions. This approach could be used with
groups of nurses but may also be effective in individual
coaching situations to demonstrate to specific nurses where
their care has not met standards of evidence-based care.
Another approach is to locate and provide literature
reviews that give summaries about specific clinical situations or problems. Such reviews save time and effort for the
staff when examining a well-defined area for discussion.
These discussions could be structured with a list of
questions that pertain to the specific situation faced by the
staff in the unit. For example, when and how often should
temperatures be taken on afebrile patients? A research base
is well defined to use for a discussion and decision about this
topic.15
Rubenfeld and Scheffer16 pointed out that critical
thinking and EBP are inextricably linked. The suggested
activities are aimed at assisting nurse to develop their critical thinking skills. Quest for knowledge, interest in learning
the latest nursing care, and demand for high-quality nursing care are nurse characteristics that will enhance the environment for establishing EBP. Sustaining the changes to
institutionalize EBP requires other CNS competencies.
APPROACHES TO SUSTAINING CHANGE
Creating lasting change is challenging. Consider the
example of pressure ulcer prevention and treatment, longstanding nursing care problems. In the last 20 years, several
studies have been conducted,17Y19 and an evidence-based
protocol was published by the Agency for Health Care
Policy and Research (now the Agency for Healthcare
Research and Quality).20 If a CNS found that the
prevention and/or treatment of pressure ulcers did not
meet the current care recommendations, what action
should she or he take? It is evident in the organization/
system sphere outcomes that the CNS is responsible for
creating and sustaining change throughout the system
sufficient to improve outcomes of nursing care, such as
with pressure ulcers.9
The first approach to creating lasting change is to assess
the organizational climate. In general, organizational
climate is viewed as an aspect of the internal environment
of an organization. Climate is a ‘‘result of the interaction of
the formal organizational policies, the personality factors,
and the stress created when individual and organizational
goals are integrated.’’10(p66) The organizational climate is
important because it may facilitate or hinder efforts to
implement and sustain EBP. The CNS`s efforts would be
improved by using the results of an assessment of the
organizational climate before implementation of EBNP is
attempted.
CNSs should coach staff nurses about how to be
involved in planning and implementing an assessment of
the organizational climate with an emphasis on the climate
related to patient care. Areas for coaching nurses include
organizing literature searches, conducting interrater reliability studies in the use of assessment tools, and writing
reports. Knowledge of the organizational climate will help
nurses to be aware of the multiple factors that influence
organizational change. In addition, nurses will become
more skillful at working with the CNS in developing the
foundational pieces needed for EBNP, such as a professional practice environment.
To be able to assess an organizational climate, knowledge is needed about factors related to organizational
climate. Several tools for measuring organizational climate
factors are found in the literature.21Y23 Space constraints
prohibit an in-depth discussion of the factors, such as
management style and communication patterns, which are
assessed in an organizational climate. The CNS would
obtain the tools and assist the nurses to learn how to use
the tools. Readiness for EBNP could be viewed as a
continuum from totally not ready to completely ready.
Where an organization or part of an organization falls on
the continuum is the outcome of an organizational assessment.23 Key aspects of organizational readiness include a
mission and policies that support professional nursing
practice, administrative support for nursing participation
on committees and groups at all organizational levels, and
resources for maintaining nurse competence.10
Based on the results of the organizational climate
assessment, the next steps of the plan are developed to
address the areas needing to be changed or improved
before EBP is introduced for adoption. At this point, the
second approach to sustaining change should be part of the
CNS`s coaching plan.
The second approach to sustaining change is to develop
staff nurse skills as change agents. A change agent is a
leader who inspires others and guides the change process.
Skills needed to be a successful change agent include belief
that the change is needed, persistence to move the change
forward, leadership recognition within the group addressing the change, and effective communication skills.24 The
CNS could be very helpful in assisting nurses to assess their
change agent skills and providing coaching to improve
skills.
One process involved in developing change agent skills
is problem solving. The first step is to identify the problem
by collecting data, which may involve key individuals. By
including key individuals in this step, early buy-in may be
gained for whatever changes are eventually proposed. The
next step is to assess motivation and capacity to change.25
Coaching staff nurses about how to take steps that work
with existing organizational norms, and thus gain support
of key individuals, is a critical part of the approach to
sustaining change. Widespread and lasting change will
require the support of individuals in formal nursing
administrative positions.
ARTICULATING CONTRIBUTIONS TO CARE
AND OUTCOMES
CNSs are responsible for articulating and communicating
the outcomes of their practice and for assisting staff nurses
to also ‘‘articulate their unique contributions to patient
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Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
care and nurse-sensitive outcomes.’’9(p31) This particular
outcome is important for EBP because of the need to
demonstrate the economic value of nursing to an organization. Nursing is an integral part of a healthcare organization and, thus, is accountable for contributing to the
success of the organization.
Effective articulation requires effective verbal and written communication skills. As with other areas of knowledge and skills for EBNP, CNSs use clinical coaching to
assist nurses to improve their communication skills. A
beginning approach is to coach individual nurses in how to
conduct self-evaluations about areas of strength and areas
for improvement. Clinical coaching of groups may be used
to assist nurses to enhance their group process and leadership skills. Group activities such as listening exercises or
assertiveness training may be useful, but the use of specific
activities should be based on an assessment of nurses`
current skills.
Written communication is the public demonstration of
one`s thinking. Clearly stated ideas in writing show that
an individual has clear thinking about a topic. Because
most staff nurses are not often required to write reports or
documents, they do not have the opportunity to develop
writing skills. To help nurses develop writing skills, CNSs
use coaching through techniques such as critique of
written work, group process to assess accuracy of written
work, and conducting writing workshops. CNSs may
encourage nurses to coauthor articles for publication, to
present at professional conferences, and to assist with
development of written procedures and statements. Workshops are useful in the development of articles and
presentations. Coaching techniques for helping nurses to
develop writing skills include reviewing drafts of written
work, asking the nurse to read aloud a draft of a
document, and discussing how to develop an outline for
a report or an article.
CONCLUSION
Nursing education prepares nurses with basic knowledge
and skills, but the practice environment must nurture and
continue to assist nurses to expand their knowledge and
skills. The role of the CNS in assisting nurses to improve
their knowledge and skills is important for laying the
foundation for EBP.
Clinical coaching for EBNP should become part of a
supportive practice environment for professional nursing.
CNSs should be involved in helping others to develop the
knowledge and skills needed to enhance the use of evidence
in nursing practice within an organizational approach for
EBP. For an individual nurse to change practice based on 1
or 2 research studies is inappropriate. To encourage nurses
to use evidence without an organizational monitoring
system potentially places nurses in conflict with current
procedures or protocols. Moreover, using new evidence
without adequate confirmation of effectiveness could put
patients at risk for harm or adverse outcomes.
For all nurses to possess knowledge and skills for
promoting the use of evidence in nursing practice is a
necessity if nursing is to move the use of evidence forward
at a rate greater than currently occurring. The fact that it
takes as long as 20 years for some innovations to be
implemented7 is testament to the need for change in the
processes by which nursing practice is kept current. The
suggestions in this article are only a minute quantity of
what we could do in nursing to become more relevant,
timely, and cost-efficient if evidence was consistently and
routinely incorporated into all nursing practice settings.
IMPLICATIONS FOR NURSING PRACTICE
Implementing strategies such as clinical coaching may assist
nursing to move more quickly to EBNP. The role of the
CNS as key to establishing and maintaining EBP may be
able to demonstrate how such strategies over the long term
save money and improve care quality. These types of
outcomes need to be formally explored through research
and sound quality-improvement studies. CNSs may not
have the skills to do the large-scale research needed to
demonstrate such outcomes, but they need to assist in
defining the research questions, designing studies, and
participating in data collection. Multisite studies are often
needed to explore the large questions of the effectiveness of
strategies for increasing the use of evidence in practice.
The other side of EBNP is to discontinue using
interventions and care aspects that are not effective or
may be harmful to patients, as indicated in outcomes of
CNS practice.9 CNSs have a potentially great contribution
to make to this area because of their knowledge of the
evidence base for many nursing practices. Studies to
identify how to discontinue specific practices would
provide a great benefit to the nursing profession. Involving
nursing faculty in these types of endeavors would help to
reconnect the academic and practice parts of nursing that
have grown apart over the years. Any successful strategy to
speed up the process of getting evidence into practice will
be a victory for patient care.

 

A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.

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18 M I D D L E E A S T J O U R N A L O F N U R S I N G MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4 • D e c e m b e r 2 0 0 9 / J a n u a r y 2 0 1 0 MIDDLE EAST JOURNAL OF NURSING VOLUME 8 ISSUE 4, NOVEMBER 2014
E D U C A T I O N A N D T R A I N I N G
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation ofnurse practitioner students: Articulating the wisdom ofexpert nurse practitioner faculty. San Diego: ClaremontGraduate University & San Diego State University.2. Ali, P.A., & Panther, W. (2008). Professionaldevelopment and the role of mentorship. NursingStandard, 22(42): 35-93. Andrews, M., & Wallis, M. (1999). Mentorship innursing: a literature review. Journal Of AdvancedNursing, 29(1), 201-207. doi:10.1046/j.1365-2648.1999.00884.x4. Bandura A (1977) Social Learning Theory. GeneralLearning Press, New York, NY.5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,R. (2005). The Value of Mentorship Within NursingOrganizations. Nursing Forum, 40(4), 134-140.doi:10.1111/j.1744-6198.2005.00026.x6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.(2000). Mentoring beginning teachers: guiding, reflecting,coaching. York, Maine: Stenhouse Publishers7. Brykczynski, K. (2012), Clarifying, affirming, andpreserving the nurse in nurse practitioner education andpractice. Journal of the American Academy of NursePractitioners, 24: 554-564.8. Burns I, Paterson IM (2005) Clinical practice andplacement support: supporting learning in practice.Nurse Education in Practice.5, 1, 3-9.9. Cant, r.p., & Cooper, s.j. (2010). Simulation-basedlearning in nurse education: systematic review. Journalof Advanced Nursing 66(1), 3-15.10. Clinard, L.M., & Ariav, T. (1998). “What mentoringdoes for mentors: A cross-cultural perspective”European Journal of Teacher Education 21 (1): 91-108.11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.(2013). Student feedback on teaching: Some issues forconsideration for nurse educators. International Journalof Nursing Practice 19:1, 62-6612. Daloz, L.A, (1986). Mentoring in education, (1st Ed),ISBN 155542001X, San Francisco, Calif.13. DeCicco, J. (2008). Developing a Preceptorship/Mentorship Model for Home Health Care Nurses.Journal Of Community Health Nursing, 25(1), 15-25.doi:10.1080/0737001070183631014. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.D. (2012). Survey of Experiences of an E-MentorshipProgram: Part II. Clinical Journal Of Oncology Nursing,16(1), 50-54.15. Gobet F, Chassy P (2008) Towards an alternativeto Benner’s theory of expert intuition in nursing: adiscussion paper. International Journal of NursingStudies. 45, 1, 129-139.16. Hallas, D., Biesecker, B., Brennan, M., Newland,J. A. & Haber, J. (2012). Evaluation of the clinicalhour requirement and attainment of core clinicalcompetencies by nurse practitioner students. Journal ofthe American Academy of Nurse Practitioners, 24: 544-553.17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). Theeffect of a peer-mentoring strategy on student nursestress reduction in clinical practice. International NursingReview, 58: 203-21018. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).Nurse Leader Mentor as a Mode of Being: Findings froman Australian Hermeneutic Phenomenological Study.Journal of Nursing Scholarship, 43: 97-10419. McGurk V (2008) Practice development within aneonatal intA clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.
16 M I D D L E E A S T J O U R N A L O F N U R S I N G MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4 • D e c e m b e r 2 0 0 9 / J a n u a r y 2 0 1 0
E D U C A T I O N A N D T R A I N I N G
MIDDLE EAST JOURNAL OF NURSING VOLUME 8 ISSUE 4, NOVEMBER 2014
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
M I D D L E E A S T J O U R N A L O F N U R S I N G • J U L Y 2 0 0 9 17 MIDDLE EAST JOURNAL OF NURSING February 2010 MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the
clinical reasoning of role models. This process is directly
relative to the methods and techniques demonstrated by
the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These
include reasoning which can be shared by the patient in
an ethical way, can be better considered once the event
has passed and which helps in the exemplification of the
best practice and is shown in an exploratory way. Some
healthcare decisions and patient care activities should
not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained
in depth to the patient due to its complexities. Weaver
(2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding
ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the
future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the
clinical reasoning of role models. This process is directly
relative to the methods and techniques demonstrated by
the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These
include reasoning which can be shared by the patient in
an ethical way, can be better considered once the event
has passed and which helps in the exemplification of the
best practice and is shown in an exploratory way. Some
healthcare decisions and patient care activities should
not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained
in depth to the patient due to its complexities. Weaver
(2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding
ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the
future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences. Coaching And Teaching Clinical Essay Paper.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the
clinical reasoning of role models. This process is directly
relative to the methods and techniques demonstrated by
the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These
include reasoning which can be shared by the patient in
an ethical way, can be better considered once the event
has passed and which helps in the exemplification of the
best practice and is shown in an exploratory way. Some
healthcare decisions and patient care activities should
not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained
in depth to the patient due to its complexities. Weaver
(2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding
ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the
future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of ExpeA clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
M I D D L E E A S T J O U R N A L O F N U R S I N G • J U L Y 2 0 0 9 17 MIDDLE EAST JOURNAL OF NURSING February 2010 MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.

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Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the
clinical reasoning of role models. This process is directly
relative to the methods and techniques demonstrated by
the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These
include reasoning which can be shared by the patient in
an ethical way, can be better considered once the event
has passed and which helps in the exemplification of the
best practice and is shown in an exploratory way. Some
healthcare decisions and patient care activities should
not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained
in depth to the patient due to its complexities. Weaver
(2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding
ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the
future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development. Coaching And Teaching Clinical Essay Paper.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250. Coaching And Teaching Clinical Essay Paper.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
M I D D L E E A S T J O U R N A L O F N U R S I N G • J U L Y 2 0 0 9 17 MIDDLE EAST JOURNAL OF NURSING February 2010 MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the
clinical reasoning of role models. This process is directly
relative to the methods and techniques demonstrated by
the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These
include reasoning which can be shared by the patient in
an ethical way, can be better considered once the event
has passed and which helps in the exemplification of the
best practice and is shown in an exploratory way. Some
healthcare decisions and patient care activities should
not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained
in depth to the patient due to its complexities. Weaver
(2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding
ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the
future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.
16 M I D D L E E A S T J O U R N A L O F N U R S I N G MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4 • D e c e m b e r 2 0 0 9 / J a n u a r y 2 0 1 0
E D U C A T I O N A N D T R A I N I N G
MIDDLE EAST JOURNAL OF NURSING VOLUME 8 ISSUE 4, NOVEMBER 2014
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
M I D D L E E A S T J O U R N A L O F N U R S I N G • J U L Y 2 0 0 9 17 MIDDLE EAST JOURNAL OF NURSING February 2010 MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the
clinical reasoning of role models. This process is directly
relative to the methods and techniques demonstrated by
the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These
include reasoning which can be shared by the patient in
an ethical way, can be better considered once the event
has passed and which helps in the exemplification of the
best practice and is shown in an exploratory way. Some
healthcare decisions and patient care activities should
not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained
in depth to the patient due to its complexities. Weaver
(2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding
ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the
future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.

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References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified
area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership grow into being mentors as a result of lifelong subjective experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact
on the learner. In a role modeling session, the difference
between learning from advice and learning from the role
model must be clearly defined.
Price (2009) also stated the importance of the ability of the practitioner to show understanding regarding the clinical reasoning of role models. This process is directly relative to the methods and techniques demonstrated by the role models. Price further explains three ways to plan
responses in advance to the patient’s questions. These include reasoning which can be shared by the patient in an ethical way, can be better considered once the event has passed and which helps in the exemplification of the best practice and is shown in an exploratory way. Some healthcare decisions and patient care activities should not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained in depth to the patient due to its complexities. Weaver (2007) explains how sometimes the need for reflection
is felt after the event has occurred. So the complexity of clinical reasoning can be reduced if questions regarding ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of representating situations which are helpful in carrying out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session will be effective, helping, understood in greater depth, and give an idea of what action to take next.
Practitioners are expected to formulate ideas for templates to deliver when they practice nursing in the future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and pre-test scores, the nurse educators who had taken part in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses in the sample population reported improvement in
assessment, education relating to patients and a better understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the mentorship program.
Gap Between Clinical Teaching and Clinical Practice Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application in a real scenario. Clinical practice has much relevance for students who learn to apply clinical theories and, simultaneously, practice their skills. Clinical practice acts as an evaluation tool for the clinical teacher to determine how much positive effect their teaching has had to support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the standard of teachers, as well as students, there are substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their future role. A second gap is due to the imparting of theory-oriented teaching rather than practice-oriented teaching. Theory which originates from practice is very different from theory which is taught in the classroom.
Since every human being is different from another, it is very difficult to predict how individuals will react, physically and mentally, to different interventions. This gap could be bridged by incorporating sufficient practical teaching. Students must be provided proper clinical supervision which helps in enhancing self-esteem as well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.

In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing implementation of standards to clarify the roles and responsibilities of the mentor”. They also suggest that there are many benefits to developing such standards in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as role models, both professionally and personally. It is the duty of clinical teachers, who are placed as mentors,to have specified strategies to use in these contrasting settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential aids the delivery of better health care. This then implies that the selected teaching methods must be effective, specific to each learner’s needs, and must incorporate every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional development and the role of mentorship. Nursing Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced Nursing, 29(1), 201-207. doi:10.1046/j.1365- 2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing Organizations. Nursing Forum, 40(4), 134-140. doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J. (2000). Mentoring beginning teachers: guiding, reflecting, coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and practice. Journal of the American Academy of Nurse Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S. (2013). Student feedback on teaching: Some issues for consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical hour requirement and attainment of core clinical competencies by nurse practitioner students. Journal of the American Academy of Nurse Practitioners, 24: 544- 553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is the students’ perception of clinical educators as role models. In order to fulfill these roles, that is, to provide higher education and to guide students regarding the implementation of theory in clinical environments, clinical teachers also need assistance and education. Within the nursing context, there remains a gap between the knowledge gained an application. So it is crucial for clinical teachers to learn effective skills that will facilitate the learning of students in ways that are then converted skillfully in the clinical setting (Brykczynski, 2012). This requires the use of effective methods of teaching. Such knowledge will help clinical teachers evaluate how effectively students are taught, recognize their own teaching weaknesses, and rectify or improve their teaching, based on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature review, and a discussion of teaching theories which are utilized in this important role. In addition, this paper examines the literature associated with the supervision of student nurses and focuses on the nature and practice of mentorship in practice settings. Also, a brief literature review regarding clinical teachers as mentors in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.

area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring, perceptoring and clinical supervision have all been
proven to be important for management in meeting the challenges offered in clinical nursing practice and are also vital tools for the future workforce planning process.
The success of mentorship is highly dependent upon the interaction and level of comfort between the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the patient as well as proper guidance to the mentee (Clinard & Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008) and provides them with the opportunity to build on their knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical setting, teaching by clinical teachers/mentors occurs by the following process. The student nurse carries out the
assessment of a patient and plans interventions after the diagnosis is established. The assessment is presented to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from the mentor. Later, the mentor reflects on the particular case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The mentor/clinical teacher plays an important role in the development of a qualified nurse. Clinical teachers impart knowledge and skills to a whole class, but the scenario differs when they teach and assist one single student. The behavioral theory of learning can be implemented by teachers/mentors and they can change
the learning environment for the student in either a positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student (McCloughen, O’ Brien & Jackson, 2011). Mentors may not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands the learning styles of the students and the leadership style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students learn quickly. This is often in contrast to classroom teaching where most of the time, it is assumed that the students have understood the topic well (Pastston et al., 2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership grow into being mentors as a result of lifelong subjective experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling can be more effective using a set of techniques to add both fun and efficiency in the process of clinical nursing mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
order to improve the process, a proper understanding of role modelling principles, the planning of clinical teaching is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by the student and the formation of practice template are essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author also describes the conditions which are essential for the role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the behavior of the role model and reward and recognition
from others regarding the learner’s behaviour in order to motivate the learner. It might provide a measure by which to determine whether modelling has been properly adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to practice their skills in appreciation of the strengths and abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact on the learner. In a role modeling session, the difference between learning from advice and learning from the role model must be clearly defined.
Price (2009) also stated the importance of the ability
of the practitioner to show understanding regarding the clinical reasoning of role models. This process is directly relative to the methods and techniques demonstrated by the role models. Price further explains three ways to plan responses in advance to the patient’s questions. These include reasoning which can be shared by the patient in an ethical way, can be better considered once the event has passed and which helps in the exemplification of the best practice and is shown in an exploratory way. Some healthcare decisions and patient care activities should not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable listening to the conversation, which can’t be explained in depth to the patient due to its complexities. Weaver (2007) explains how sometimes the need for reflection is felt after the event has occurred. So the complexity of clinical reasoning can be reduced if questions regarding ethical, professional, effective and efficient clinical reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of
representating situations which are helpful in carrying
out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session
will be effective, helping, understood in greater depth,
and give an idea of what action to take next.
Practitioners are expected to formulate ideas for
templates to deliver when they practice nursing in the future.
The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the

ORDER A CUSTOM-WRITTEN PAPER HERE


theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.A clinical learning environment forms an integral part of student
nurses’ learning experiences, both personally and professionally,
enabling them to move towards achieving a high level of
competence during their professional career. Nurse educators
aim to assist student nurses to integrate the theories learnt in
the classroom to relevant clinical situations, in order to enhance
the quality of health care delivery results (Ahren, 2000). Even if
technology advances beyond current imagination in the years to
come (which may happen with simulation teaching methods) the
authenticity and benefits derived from clinical teaching will still
be valued (Cant & Cooper, 2010). While students learn important
nursing skills in this process, teachers/educators gain knowledge
and skills as a result of extensive research on particular subjects.
Another aspect of the important role of the clinical teacher is
the students’ perception of clinical educators as role models. In
order to fulfill these roles, that is, to provide higher education
and to guide students regarding the implementation of theory in
clinical environments, clinical teachers also need assistance and
education. Within the nursing context, there remains a gap between
the knowledge gained and its application. So it is crucial for clinical
teachers to learn effective skills that will facilitate the learning of
students in ways that are then converted skillfully in the clinical
setting (Brykczynski, 2012). This requires the use of effective
methods of teaching. Such knowledge will help clinical teachers
evaluate how effectively students are taught, recognize their own
teaching weaknesses, and rectify or improve their teaching, based
on different theories of clinical teaching (Hallas, 2012).
This paper aims to highlight mentorship through a literature
review, and a discussion of teaching theories which are utilized in
this important role. In addition, this paper examines the literature
associated with the supervision of student nurses and focuses on
the nature and practice of mentorship in practice settings. Also,
a brief literature review regarding clinical teachers as mentors
in nursing is included along with a discussion of the advantages
and disadvantages of this. The clinical teaching method will be
related to behavioral theory and will be evaluated from a mentor’s
perspective. In the second part of this assignment, the gap between
clinical teaching and clinical practice will be identified.
Key words: Clinical Teaching; Mentorship teaching; Nurse; Nursing
Students; Knowledge; Learning.

area of clinical nursing. Andrews (1999) conducted a
review suggesting that the opportunities for practice
development are highly valued by student nurses.
Recently, the focus for mentorship has switched from
students to professional nurses. Block et al. (2005)
emphasized the advantage of mentorship in increasing
the retention rates of nurses in hospitals. Hospitals
face many challenges when it comes to retaining
nurses because many nurses are dissatisfied with their
jobs. Improving nurse retention rates, would, in turn,
increase patient outcomes. Research has shown that
the implementation of mentorship programs has been
proven to be effective in the retention of nurses.
The advantages and the role of mentorship in modern
practice related to nursing in the United Kingdom was
discussed by Myall et al. (2008), who aimed to identify
the impact of nursing education based on locality in
the United Kingdom. Their study also took into account
the academic staff and and examined similar situations
in Australia. The study concludes with a discussion
of the perceptions of mentors and student nurses.
For nursing students, mentorship is essential and has
attracted the interest of a great number of researchers.
Although a great deal of research has been conducted
on mentorship in the clinical nursing area, very little
attention has been paid to mentorship rules and
regulating bodies. The study aims to expand knowledge
on the regulatory bodies for clinical nursing mentorship
programs. The method used in this study is an online
survey and a questionnaire for clinical prequalifying
learners and for mentors in practice. The findings of
this research highlighted the need to provide mentors
who are adequately prepared and who can support the
mentorship process. Finally, the research concludes
with ways by which the gap between reality and theory
on mentorship can be bridged, such as identifying the
responsibilities and roles relating to the mentor. This
would also benefit the development of standards for
mentorship for clinical nursing, supporting students in
countries which run on similar systems.
The literature review suggests that dealing with problems
in rural areas regarding clinical nursing presents many
challenges for both managers and policy makers.
Hence, the use of programs, including mentorships,
perceptoring and clinical supervision are all helpful in
dealing with problems in these areas, and may also
help in nursing recruitment and increasing retention
rates. Furthermore, these programs are also helpful in
supporting relationships within organizations. Mentoring,
perceptoring and clinical supervision have all been
proven to be important for management in meeting the
challenges offered in clinical nursing practice and are
also vital tools for the future workforce planning process.
The success of mentorship is highly dependent
upon the interaction and level of comfort between
the person and the environment of the organization
where the mentorship is taking place. A mentor has far
more responsibility than the mentee. A mentor has to
undertake a dual duty, that is provide proper care to the
patient as well as proper guidance to the mentee (Clinard
& Ariav, 1998). This helps students learn the practice
standards in an individualized way (Ali & Panther, 2008)
and provides them with the opportunity to build on their
knowledge by putting theory into practice, while planning
the management of patient problems. In a typical clinical
setting, teaching by clinical teachers/mentors occurs by
the following process. The student nurse carries out the
assessment of a patient and plans interventions after the
diagnosis is established. The assessment is presented
to the mentor who validates the assessment and plan.
Then, it is implemented by the student with support from
the mentor. Later, the mentor reflects on the particular
case and discusses any future implications.
The mentor, being a teacher, provides constant feedback
and evaluates his/her student. The student refines their
practice on the basis of knowledge, skills and practice
by gaining assistance and support (Li et al., 2011). The
mentor/clinical teacher plays an important role in the
development of a qualified nurse. Clinical teachers
impart knowledge and skills to a whole class, but the
scenario differs when they teach and assist one single
student. The behavioral theory of learning can be
implemented by teachers/mentors and they can change
the learning environment for the student in either a
positive or negative way (Quinns & Hughes, 2007).
Due to varying degrees of responsibilities, a shortage
of time and increasing demand, it is very difficult for
mentors to address the individual needs of a student
(McCloughen, O’ Brien & Jackson, 2011). Mentors may
not be able to coordinate with the students due to a lack
of time. Also, it is essential that the mentor understands
the learning styles of the students and the leadership
style they most respect (Cleary et al., 2013). When a
student’s preferred learning style is catered for, students
learn quickly. This is often in contrast to classroom
teaching where most of the time, it is assumed that the
students have understood the topic well (Pastston et al.,
2010).
Nurse-leaders use mentorship to grow and develop
leadership potential in other nurses. Formal preparation
to be a mentor is not fundamental to all mentorship.
Some nurse-leaders who mentor others for leadership
grow into being mentors as a result of lifelong subjective
experiences.
Improved teaching learning recommendations
Price and Price (2009) described how role modelling
can be more effective using a set of techniques to add
both fun and efficiency in the process of clinical nursing
mentorship and also discuss the principles regarding
role modelling, as part of mentorship. They state that in
M I D D L E E A S T J O U R N A L O F N U R S I N G • J U L Y 2 0 0 9 17 MIDDLE EAST JOURNAL OF NURSING February 2010 MIDDLE EAST JOURNAL OF NURSING JULY 2012, VOLUME 6 ISSUE 4
order to improve the process, a proper understanding of
role modelling principles, the planning of clinical teaching
is an effective session for role modelling, revealing
clinical reasoning, discovering the understanding by
the student and the formation of practice template are
essential. The definition of the role modelling process,
in relation to healthcare, is the development of expertise
and competence (McGurk 2008). Bandura (1997)
observed that humans mostly learn from emulation and
observations of the individuals around them. The author
also describes the conditions which are essential for the
role modelling process to be successful. These include
sufficient attention of the learner towards the role model,
the learner’s retention of key information, the ability
of the learner to reproduce or effectively model the
behaviour of the role model and reward and recognition
from others regarding the learner’s behaviour in order
to motivate the learner. It might provide a measure by
which to determine whether modelling has been properly
adapted by the student.
Price (2007) emphasised the importance of experienced
professionals in planning the role modeling session. The
author explained the process of analysis of the nurses to
practice their skills in appreciation of the strengths and
abilities. This is an advantage because the nurses can
explain and share their knowledge and have an impact on the learner. In a role modeling session, the difference between learning from advice and learning from the role model must be clearly defined.
Price (2009) also stated the importance of the ability of the practitioner to show understanding regarding the clinical reasoning of role models. This process is directly relative to the methods and techniques demonstrated by the role models. Price further explains three ways to plan responses in advance to the patient’s questions. These include reasoning which can be shared by the patient in an ethical way, can be better considered once the event has passed and which helps in the exemplification of the best practice and is shown in an exploratory way. Coaching And Teaching Clinical Essay Paper.Some
healthcare decisions and patient care activities should not be discussed when the patient is within earshot.
This is because the patient might feel uncomfortable
listening to the conversation, which can’t be explained in depth to the patient due to its complexities. Weaver (2007) explains how sometimes the need for reflection is felt after the event has occurred. So the complexity of
clinical reasoning can be reduced if questions regarding ethical, professional, effective and efficient clinical
reasoning are considered.
Gobet and Chassy (2008) suggest templates as ways of representating situations which are helpful in carrying out decisions. Adapting the use of templates also
increases the chance that a particular mentoring session will be effective, helping, understood in greater depth, and give an idea of what action to take next.
Practitioners are expected to formulate ideas for templates to deliver when they practice nursing in the future.


The success of the e-mentorship program for clinical
nurses is discussed by Faiman et al. (2012) who used
a survey which showed that, according to the post- and
pre-test scores, the nurse educators who had taken part
in the e-mentorship program demonstrated improved
knowledge. In addition, more than half of the nurses
in the sample population reported improvement in
assessment, education relating to patients and a better
understanding and communication with the patients.
The research also concluded that the outcomes of
management were also improved after using the ementorship program.
Gap Between Clinical Teaching and Clinical Practice
Clinical practice is as important as clinical teaching.
Theories acquire value only when they find application
in a real scenario. Clinical practice has much relevance
for students who learn to apply clinical theories and,
simultaneously, practice their skills. Clinical practice acts
as an evaluation tool for the clinical teacher to determine
how much positive effect their teaching has had to
support better quality nurses. Coaching And Teaching Clinical Essay Paper.
Research suggests that, irrespective of the numerous
teaching models devised, in order to improve the
standard of teachers, as well as students, there are
substantial gaps between clinical practice and teaching.
One reason for this is the setting. While a classroom
setting doesn’t have the pressure of performance with
time constraints and risk to life, students may fail to cope
with the real, stressful situations of the clinical setting.
This can give rise to anxiety and clinical errors. The real
environment of the clinical setting must be imitated in the
classroom, or bedside teaching must be implemented
in teaching models in order to prepare students for their
future role. A second gap is due to the imparting of
theory-oriented teaching rather than practice-oriented
teaching. Theory which originates from practice is very
different from theory which is taught in the classroom.
Since every human being is different from another,
it is very difficult to predict how individuals will react,
physically and mentally, to different interventions. This
gap could be bridged by incorporating sufficient practical
teaching. Students must be provided proper clinical
supervision which helps in enhancing self-esteem as
well as assisting them in the learning of practical skills.
The bridge between teaching and practice is not very
wide; by careful analysis and formulation of strategies, it
can be addressed.
Conclusion
In a study conducted by Myall, Levett-Jones and
Lathlean (2008), it was stated that “the results provide
new evidence of a narrowing of the gap between the
theory and practice of mentoring and for the continuing
implementation of standards to clarify the roles and
responsibilities of the mentor”. They also suggest that
there are many benefits to developing such standards
in countries with similar systems of support for nursing
students. Students frequently perceive their mentors as
role models, both professionally and personally. It is the
duty of clinical teachers, who are placed as mentors,
to have specified strategies to use in these contrasting
settings. It is the clinical teacher/mentor’s role and
responsibility to nurture future nurses whose potential
aids the delivery of better health care. This then implies
that the selected teaching methods must be effective,
specific to each learner’s needs, and must incorporate
every aspect of the student nurse’s development.
References
1. Ahern-Lehman, C. (2000). Clinical evaluation of
nurse practitioner students: Articulating the wisdom of
expert nurse practitioner faculty. San Diego: Claremont
Graduate University & San Diego State University.
2. Ali, P.A., & Panther, W. (2008). Professional
development and the role of mentorship. Nursing
Standard, 22(42): 35-9
3. Andrews, M., & Wallis, M. (1999). Mentorship in
nursing: a literature review. Journal Of Advanced
Nursing, 29(1), 201-207. doi:10.1046/j.1365-
2648.1999.00884.x
4. Bandura A (1977) Social Learning Theory. General
Learning Press, New York, NY.
5. Block, L., Claffey, C., Korow, M. K., & McCaffrey,
R. (2005). The Value of Mentorship Within Nursing
Organizations. Nursing Forum, 40(4), 134-140.
doi:10.1111/j.1744-6198.2005.00026.x
6. Boreen, J., Johnson, M. K., Niday, D., & Potts, J.
(2000). Mentoring beginning teachers: guiding, reflecting,
coaching. York, Maine: Stenhouse Publishers
7. Brykczynski, K. (2012), Clarifying, affirming, and
preserving the nurse in nurse practitioner education and
practice. Journal of the American Academy of Nurse
Practitioners, 24: 554-564.Coaching And Teaching Clinical Essay Paper.
8. Burns I, Paterson IM (2005) Clinical practice and
placement support: supporting learning in practice.
Nurse Education in Practice.5, 1, 3-9.
9. Cant, r.p., & Cooper, s.j. (2010). Simulation-based
learning in nurse education: systematic review. Journal
of Advanced Nursing 66(1), 3-15.
10. Clinard, L.M., & Ariav, T. (1998). “What mentoring
does for mentors: A cross-cultural perspective”
European Journal of Teacher Education 21 (1): 91-108.
11. Cleary, M., Happell, B., Lau, S.T., & Mackey, S.
(2013). Student feedback on teaching: Some issues for
consideration for nurse educators. International Journal
of Nursing Practice 19:1, 62-66
12. Daloz, L.A, (1986). Mentoring in education, (1st Ed),
ISBN 155542001X, San Francisco, Calif.
13. DeCicco, J. (2008). Developing a Preceptorship/
Mentorship Model for Home Health Care Nurses.
Journal Of Community Health Nursing, 25(1), 15-25.
doi:10.1080/07370010701836310
14. Faiman, B., Miceli, T. S., Richards, T., & Tariman, J.
D. (2012). Survey of Experiences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139. Coaching And Teaching Clinical Essay Paper.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p
202.riences of an E-Mentorship
Program: Part II. Clinical Journal Of Oncology Nursing,
16(1), 50-54.
15. Gobet F, Chassy P (2008) Towards an alternative
to Benner’s theory of expert intuition in nursing: a
discussion paper. International Journal of Nursing
Studies. 45, 1, 129-139. Coaching And Teaching Clinical Essay Paper.
16. Hallas, D., Biesecker, B., Brennan, M., Newland,
J. A. & Haber, J. (2012). Evaluation of the clinical
hour requirement and attainment of core clinical
competencies by nurse practitioner students. Journal of
the American Academy of Nurse Practitioners, 24: 544-
553.
17. Li, H.C., Wang, L. S., Lin, Y.H. & Lee, I. (2011). The
effect of a peer-mentoring strategy on student nurse
stress reduction in clinical practice. International Nursing
Review, 58: 203-210
18. McCloughen, A., O’ Brien, L. & Jackson, D. (2011).
Nurse Leader Mentor as a Mode of Being: Findings from
an Australian Hermeneutic Phenomenological Study.
Journal of Nursing Scholarship, 43: 97-104
19. McGurk V (2008) Practice development within a
neonatal intensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.
20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).
Mentorship in contemporary practice: the experiences
of nursing students and practice mentors. Journal of
Clinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-
2702.2007.02233.x
21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.
& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.
22. Price B (2007) K823 Developing Skills for Practice.
(Course Study Guide). The Open University, Milton
Keynes.
23. Price, A., & Price, B. (2009). Role modelling practice
with students on clinical placements. Nursing Standard,
24(11), 51-56.
24. Quinn, M. & Hughes, S. (2007), Quinn’s Principle
and Practice of Nurse Education, (5th Ed). Cheltenham
Nelson Throne, p 202.ensive care unit. Innovation or expectation.
Journal of Neonatal Nursing. 14, 2, 52-55.20. Myall, M., Levett-Jones, T. & Lathlean, J. (2008).Mentorship in contemporary practice: the experiencesof nursing students and practice mentors. Journal ofClinical Nursing, 17: 1834-1842. doi: 10.1111/j.1365-2702.2007.02233.x21. Patston, P., Holmes, D., Maalhagh-Fard, A., Ting, K.& Ziccardi, V. B. (2010). Maximising the potential of parttime clinical teachers. The Clinical Teacher, 7: 247-250.22. Price B (2007) K823 Developing Skills for Practice.(Course Study Guide). The Open University, MiltonKeynes.23. Price, A., & Price, B. (2009). Role modelling practicewith students on clinical placements. Nursing Standard,24(11), 51-56.24. Quinn, M. & Hughes, S. (2007), Quinn’s Principleand Practice of Nurse Education, (5th Ed). CheltenhamNelson Throne, p 202.References1. Horsley JA, Crane J, Crabtree MK, Wood J. Using Research
to Improve Nursing Practice: A Guide. New York: Grune and
Stratton; 1983.
2. Stetler CB. Refinement of the Stetler/Marram model for
application of research findings to practice. Nurs Outlook.
1994;42(14):15Y25.
3. Taylor-Piliae RE. Utilization of the Iowa Model in establishing evidence-based nursing practice. Intensive Crit Care Nurs.
1999;15(6):357Y362.
4. Ervin NE. Evidence-based nursing practice: are we there yet?
J N Y State Nurses Assoc. 2002;33(2):11Y16.
5. Goode CJ. What constitutes the ‘‘evidence’’ in evidence-based
practice? Appl Nurs Res. 2000;13(4):222Y225.
6. Burns N, Grove SK. The Practice of Nursing Research:
Conduct, Critique, and Utilization. 4th ed. Philadelphia, Pa:
Saunders; 2001.
7. Brooten D, Youngblut JM, Roberts BL, et al. Disseminating
our breakthroughs: enacting a strategic framework. Nurs
Outlook. 1999;47:133Y137.
8. Senge PM. The Fifth Discipline: The Art and Practice of the
Learning Organization. New York: Currency Doubleday;
1990.
9. National Association of Clinical Nurse Specialists. Statement
on Clinical Nurse Specialist Practice and Education. 2nd ed.
Harrisburg, Pa: Author; 2004.
10. Simms LM, Price SA, Ervin NE. Professional Practice of
Nursing Administration. Albany, NY: Delmar; 2002.

11. Carroll DL, Greenwood R, Lynch KE, Sullivan JK, Ready
CH, Fitzmaurice JB. Barriers and facilitators to the utilization of nursing research. Clin Nurse Spec. 1997;11(5):
207Y212.
12. Estabrooks CA. Will evidence-based nursing practice make
practice perfect? Can J Nurs Res. 1998;30(1):15Y36.
13. Bloom BS. Taxonomy of Educational Objectives. Handbook
1. Cognitive Domain. New York: David McKay; 1956.
14. Rice VH, Stead LF. Nursing interventions for smoking
cessation. Cochrane Database Syst Rev. 2004;(1):CD001188.
15. Beaudry M, VandenBosch T, Anderson J. Research utilization: once-a-day temperatures for afebrile patients. Clin
Nurse Spec. 1996;10(1):21Y24.
16. Rubenfeld MG, Scheffer BK. Critical Thinking TACTICS for
Nurses. Sudbury, Mass: Jones and Bartlett; 2006.
17. Bergstrom N, Braden B. A prospective study of pressure sore
risk among institutionalized elderly. J Am Geriatr Soc. 1992;
40:747Y758.
18. Bergstrom N, Braden BJ, Laguzza A, et al. The Braden
scale for predicting pressure sore risk. Nurs Res. 1987;36:
205Y210.
19. Braden BJ, Bergstrom N. Predictive validity of the Braden
scale for pressure sore risk in a nursing home population. Res
Nurs Health. 1994;17:459Y470.
20. Panel for the Prediction and Prevention of Pressure Ulcers in
Adults. Pressure Ulcers in Adults: Prediction and Prevention.
Clinical practice guideline, no. 3. Rockville, Md: Agency for
Health Care Policy and Research, Public Health Service, US
Department of Health and Human Services; 1992. AHCPR
publication no. 92-0047.
21. Coeling HV, Simms LM. Facilitating innovation at the
nursing unit level through cultural assessment, part 1. J Nurs
Adm. 1993;23(4):46Y53.
22. Coeling HV, Simms LM. Facilitating innovation at the
nursing unit level through cultural assessment, part 2. J Nurs
Adm. 1993;23(5):13Y20.
23. Jones KR, DeBaca V, Yarbrough M. Organizational culture
assessment before and after implementing patient-focused
care. Nurs Econ. 1997;15(2):73Y80.
24. Lancaster J. Nursing Issues in Leading and Managing
Change. St Louis, Mo: Mosby; 1999.
25. Melnyk BM, Fineout-Overholt E. Evidence-Based Practice
in Nursing and Healthcare. Philadelphia, Pa: Lippincott
Williams and Wilkins; 2005. Coaching And Teaching Clinical Essay Paper.