Words By Hannah Gray BParamed, GradCertEd
Within the Paramedic profession, mentoring is often utilised as a capacity building strategy to assist students and experienced paramedics to further progress their clinical and social workplace capabilities. Commonly within the Australian system, mentoring relationships within paramedicine in contemporary professional programmes are between a university student and a qualified Paramedic. However, mentoring can occur when any more highly skilled or more experienced clinician provides guidance to assist another individual’s development (1). Additionally, post goal completion the mentoring relationship is often not terminated, and instead continues to develop and adapt (2). Within paramedicine, specifically for university students, the mentoring relationship generally has a duration of 2-8 weeks whilst the student is undertaking clinical placement (11). Post placement completion, many students remain in contact with mentors to enable ongoing feedback and development, further progressing their clinical and social capabilities. These mentoring relationships may allow student paramedics to continue to develop their fundamental skill set to effectively and efficiently make decisions, utilise acquired knowledge to justify clinical reasoning and improve their ability to articulate an appropriate management plan (1). With these outcomes in mind, it is important to consider appropriate and effective frameworks on which to scaffold these learning objectives. One such framework is: Kram’s Mentoring Model.
The model in which mentoring within paramedicine best relates to is ‘Kram’s Sponsoring Model of Mentoring.’ This model utilises a 4-stage approach (3):
- - Initiation- Cultivation - Separation - Redefinition
Typically, this model is utilised over a period of up to 36 months, however in Paramedicine, university students are faced with an accelerated version over a period of up to 8 weeks. While the time difference is significant, the processes of mentoring in paramedicine still closely relate to those presented in the model.
Stage 1 This phase involves the initiation of the relationship, founded on trust (4). After the trust relationship has been established, the participants can begin discussing their goals and objectives for the relationship (9). To ensure communication is clear, both parties must listen and be understanding of each other’s goals and be able to share and reflect on how these goals can be accomplished within the relationship (10). This initial discussion can assist in strengthening the trust relationship, as it allows participants to become more confident and comfortable with each other’s goals and enhances mutual trust and respect for one another and the mentoring process (9). For paramedicine students, this stage involves sitting down with their mentor/s and discussing goals and objectives for their duration on placement. This may include highlighting weaknesses, to ensure clarity regarding the intended mentee learning objectives and ways in which they may be achieved.
Stage 2 The cultivation stage is where trust and confidence within the relationship continues to grow between the mentor and mentee (3). During this stage, it is crucial that the mentor is able to assess and identify the mentees weaknesses, then offer feedback and assistance towards overcoming limitations. Mentors should facilitate alternatives for the mentee to assist them with overcoming challenges and barriers (4). An example could be, if the student was struggling with their interpersonal communication. An effective mentor could identify this limitation, and then actively engage with the student to discuss some techniques and skills to overcoming this. The mentor should then continuously monitor how the student is performing and provide ongoing feedback and assistance. This stage can include the completion of goals however the mentoring relationship should continue to develop despite goal completion.
Stage 3 The separation stage of Kram’s mentoring model (3) generally takes place prior to the conclusion of a mentoring relationship. This stage incorporates the formulation of an ongoing learning and development plan, to ensure the mentee understands how they are currently performing, and the steps required to achieve the performance level they desire (5). For mentoring relationships in Paramedicine, this stage takes place at the conclusion of a student’s time on clinical placement and is often in the form of a supervisor report. This report specifically targets the assessment of the student’s performance, and feedback of their progression throughout their time on placement. It is also suggested to mentors that they provide some suggestions for the students ongoing development and learning post placement, to ensure they continue to enhance their abilities in between placements and their evolution to qualified Paramedic.
Stage 4 The final stage of Kram’s mentoring model is redefining (3). This stage generally occurs at the conclusion of the relationship, where the mentor and mentee begin a professional peer friendship (10). Whilst still maintaining mutual trust and respect for one another, this change in relationship status allows for an ongoing mutual friendship that enables participants to share experiences and ongoing developments (9). This is not always possible for paramedicine students, as occasionally the mentoring relationship was unsuccessful and neither party wish to stay in contact, however it is encouraged by tertiary institutions where appropriate. The continuation of a professional peer friendship allows the student to express new experiences with their once formal mentor, and ask for ongoing feedback and advice as they progress through their studies and towards course completion.
What does ‘Mentoring’ mean for Paramedics?A mentor is defined as an “artist of enlightenment” and “trusted and experienced advisors who have direct interests in the development and education of other individuals” (6). Specifically in paramedicine, mentoring has been defined as an admirable figure providing guidance to assist the development of other individuals (1). Together these definitions allow for an understanding of the founding principles of mentoring relationships, based on the sharing of knowledge between experienced and less experienced persons. Mentors in the field of prehospital medicine are those that demonstrate desirable qualities and characteristics (2). A mentor is to act as a role model and assist the mentee in achieving professional and personal goals, while sharing experiences and knowledge to enhance the mentees experience within the relationship.
In the majority of jurisdictional ambulance services and paramedic industry positions, “students are reportedly mentored by staff who do not understand the underpinning theory of their profession sufficiently to fully support their students’ development” (7). Clarke (7) then discusses that together with the apparent deficits of knowledge, “the nature and level of the professionalism and attitude of supervisors has also been shown to impact on the ability of students to develop as independent practitioners” (7). One suggested framework to correct these recognised issues is that of the Practice Educator Model, actively utilised in the mentoring practice of the London Ambulance Service (LAS). The model utilises a holistic approach that encompasses the ideal roles and values of a successful practice educator. Paramedics of LAS that wish to be a practice educator for university students must complete the paramedic practice educator course, designed and delivered by the College of Paramedics (8). As demonstrated in the College’s course overview, aspiring educators are provided with the opportunity for understanding of the founding roles and values of an educator, together with an understanding of experiential development and the importance of the ability to utilise previously acquired knowledge, the ability to apply this knowledge to new experiences, and to allow for further learning opportunities. Outcomes demonstrate the significant enhancement of a paramedic’s ability to provide adequate mentoring actions and values, and overall improved the university students experience whilst completing clinical placement (8). As a result, Lecturers from the University of Hertfordshire’s Paramedicine faculty observed an overall improvement in their students’ capabilities and confidence as an independent practitioner (8). The utilisation of this structured education process within Australian state ambulance services has the potential to provide paramedics and university paramedicine students with similar improvements and enhanced professional development.
1. Queensland Ambulance Service. Clinical Governance Framework. 2017. pp. 14-15.2. Defining Mentorship in Prehospital Care: A Qualitative Analysis of the Characteristics of Prehospital Mentors. Cameron, C. 2, 2018, Irish Journal of Paramedicine, Vol. 3.3. Phases of the Mentor Relationship. Kram, K. 4, 1983, The Academy of Management Journal, Vol. 26, pp. 608-625.4. RECONCEPTUALIZING MENTORING AT WORK: A DEVELOPMENTAL NETWORK PERSPECTIVE . Higgins, M and Kram, K. 2, 2001, Academy of Management Review, Vol. 26, pp. 264-288.5. Lambright, T. The adult mentoring relationship: A philosophic inquiry. s.l. : ProQuest Dissertations Publishing, 1999. pp. 56-92.6. Mentoring Medical Students in Academic Emergency Medicine. Garmel, G. 12, 2008, Academic Emergency Medicine, Vol. 11, pp. 1351-1357.7. Clarke, V. The Theory-Practice Relationship in Paramedic Undergraduate Education. 2018. pp. 143-197. 8. Mentoring and Preceptorship supporting staff to a National Standard. Fellows, Bob. 2018, College of Paramedics. 9. The Mentoring Experience: Leadership Development Program Perspectives . Lamm, K, Sapp, R and Lamm, A. 2, 2017, Journal of Agricultural Education, Vol. 58, pp. 20-34. 10. Mentoring in Higher Education Should be the Norm to Assure Success: Lessons Learned from the Faculty Mentoring Program, West Chester University, 2008–2011. Bean, N, Lucas, L and Hyers, L. 1, 2014, Mentoring & Tutoring: Partnership in Learning, Vol. 22, pp. 56-73. 11. O'Meara, Peter, et al. Paramedicine clinical placment duration and quality variance: An international benchmarking study. s.l. : Health Workforce Australia, 2014. pp. 16-20.