Activity: The mentor-mentee relationship: teaching teachers through simulation

Transversal Skills:
Creative and critical thinking
Interpersonal and socio-emotional skills

Teaching- Learning Approach:

Simulation

   Miller Pyramid

Learning outcomes

By the end of the activity, students should be able to

  • Identify and use strategies to give constructive feedback in a teaching-learning environment
  • Explore and adapt to the students’ educational needs

As regards transversal skills, students should be able to:

Interpersonal and socio-emotional skills:

  • Express ideas clearly and fluently
  • Use precise and descriptive/content-specific vocabulary to enhance the topic or message
  • Share information in an organised and interesting way
  • Share an analysis of the main message to interpret, synthesise and/or evaluate the meaning of the content in order to draw a logical conclusion about the topic
  • Show empathy and use non-verbal communication and active listening
  • Self-reflect, evaluate one’s own actions and emotions, and take responsibility for own actions
  • Perform tasks efficiently and carefully
  • Persevere in the face of difficulties
  • Develop positive and emotionally safe interaction and develop and co-create teamwork
  • Reflect and manage emotional and self-regulation, and show empathy in professional relationships
  • Work cooperatively with others
  • Develop an empathetic leadership by understanding the needs of others and being aware of their feelings and thoughts, and to facilitate collaborative and participatory problem-solving
  • Create a non-discrimination atmosphere
  • Facilitate conflict resolution, remain calm under pressure, and control one’s emotions in conflict situations
  • Be willing and able to understand people from different backgrounds and embrace diversity

Critical and creative thinking:

  • Identify and deal creatively with unexpected, unforeseen, and complex situations that can be exploited, and to evaluate different solutions
  • Acquire, process, produce, and evaluate information critically and from the perspectives of different fields and decisions, taking into account both individual and community perspectives
  • Question norms, practices, and opinions, and to reflect on own one’s values, perceptions and actions
  • Develop innovative solutions to answer different questions and to create new and worthwhile ideas; elaborate and evaluate ideas in order to improve and maximise their creative efforts

Brief description of the activity

This is a simulation activity designed for teachers that mentor students during their bachelor’s final thesis. In this simulation case, a mentor will meet his/her mentee: Paul. He is an undergraduate student of a health sciences degree, undertaking his bachelor’s final thesis. He already submitted a midterm version of the manuscript, the mentor provided written feedback, and now they have a meeting together to talk about the feedback and set the next steps.

 

Activity plan: step by step

Before the activity

1. Definition of the case according to the learning outcomes: 

 

The description of the case must include, at least:

(1) Description of the initial scene and clinical features

(2) Challenge posed to the participant

(3) Narrative of the simulated character (especially if simulated with actors/actresses)

(4) Key moments that define the course of the case depending on the actions of the participant

 

For this activity, the following two cases are proposed:

 

CASE A: Paul is a final year undergraduate student of a health sciences degree. He is currently enrolled in the bachelor’s final thesis, as well as in the clinical practicum. He is a student with average grades. He works full-time while undertaking his studies to pay for tuition and other expenses. His boss already made him an upgrading job offer for when he obtains the bachelor’s degree, so he feels like the bachelor’s final thesis is pure formality and has no apparent interest in the course. He doesn’t seem to be interested in research, either. Accordingly, he proposed a very simple and broad topic for the thesis and is fine with getting the minimum grade to pass the course. What is actually important to him is to finish the thesis as soon as possible in order to obtain the degree and apply for the job offer. Today, he is meeting with his mentor, who already provided not very good feedback on his midterm version of the manuscript. 

 

CASE B: Paul is a final year undergraduate student of a health sciences degree. He is currently enrolled in the bachelor’s final thesis, as well as in the clinical practicum. He enjoys the degree and shows above average grades. It is very important for him to get the highest grades. He is a very ambitious and self-demanding student, which sometimes makes him over score his expectations and self-perception of the work he did. It is difficult for him to recognize his limitations or mistakes, and constantly looks for approval. Today, he is meeting with his mentor, who already provided not very good feedback on his midterm version of the manuscript. 

 

Participants of the simulation activity are asked to:

 

(a)  get into the room (Paul is already there, waiting for him/her). 

(b) break the ice with Paul and then talk about feedback

(c)  enable a trusting communication space in which Paul feels comfortable and non-judged: (i) explore Paul’s expectations and educational needs, (ii) perform emotional containment and regulation, (iii) conflict resolution and negotiation

(d) adapt own expectations and feedback to meet Paul’s needs while ensuring he acquires learning outcomes

 

Narrative of the character and cases development: 

 

CASE A

 

The mentor will enter the room and will find Paul waiting for him/her. He is sitting in a not very formal position and didn’t bring anything to the meeting, not even a printed version of the thesis. The mentor will sit in the empty chair in front of him and will start the conversation. While s/he is breaking the ice, Paul will sit a bit more correctly, but his attitude will still be dispersed and somehow distrustful. He may even start scrolling through his phone.

 

Once the mentor starts talking about the feedback, he will first ask if s/he can lend him a pen and blank sheet to take notes. He will rapidly start to make face signs of unconformity while writing what he is being told (rolling his eyes, raising his eyebrows, etc.). Anyway, he will not interrupt the mentor. He will only speak when he is asked to. If the mentor says something like “you need to work more on this”, “there are multiple things that you need to revise”… he will start being elusive and say that he has no time to devote to the thesis: he works full-time and, when he is not working, he needs to attend to the clinical practicum. If the mentor tries to talk to him about the importance of the bachelor’s final thesis and the benefits of doing a good thesis, he will totally lose interest in the conversation. He may even start drawing in the blank sheet or scrolling through his phone again. Paul will not move away from the “I don’t have time” position. 

 

After getting into this vicious circle, the mentor should try to focus more on Paul and less on the thesis. If s/he doesn’t do it, Paul will be more and more disconnected from the conversation. The following scenarios can emerge depending on the attitude adopted by the mentor: 

 

  • Confronting/preaching attitude: for instance, if the mentor says that scrolling through his phone or drawing while s/he is talking is a lack of respect. This will entail a tense situation. If the mentor keeps telling him about the importance of the thesis, Paul will remain elusive or even say something like “this university is elitist and doesn’t care about those of us who need to work”, “I will go talk to the headmaster”, etc. After that, Paul will stand up and try to leave the room and, if the mentor is not able to make him stay, the scenario will end. 
  • Paternalistic attitude: for instance, the mentor will respond to his words of “I don’t have time for this” being excessively empathetic, with words like “they demand too much of you”, “it is very difficult to balance work and school”, “I wouldn’t be able to do it”… If that is the case, Paul will start taking advantage of the situation by being more active in the conversation (sitting in a better position, paying attention to the mentor, maintaining visual contact, etc.) and will try to delve into how difficult his situation is. That is, he will start explaining particular situations in which it was impossible for him to focus on academic work, he could barely sleep, etc. Then he will build on that to make the mentor agree on reducing the work that he needs to do on the thesis, or even get him/her to do it (e.g. “maybe you could write a draft that I can draw on”, “maybe you could send me a good thesis of past years that I can follow”). If the mentor agrees to that, Paul will show gratitude to the mentor and leave the room under the premise that he needs to go to work but that he will wait for the new feedback and/or the work that the mentor committed to do for him. 
  • Assertive attitude: for instance, the mentor asks Paul what are his expectations with the thesis, as well as his needs related to these, and try to adapt his/her own expectations and feedback. That is, rather than providing feedback to get the highest mark, s/he will focus on the most important inquiries for Paul to pass the course while being able to balance all his other tasks. If s/he does it, Paul will start being more active in the conversation and even a bit enthusiastic. He will engage in what the teacher is saying and will show willingness to do the things that the mentor said he needs to do to pass the course, insofar as he will feel understood. Paul will set the next steps and leave the room gratefully and engaged. 

 

CASE B

 

The mentor will enter the room and will find Paul waiting for him/her. He placed several documents on the table, including the written feedback that the mentor provided prior to the meeting as well as scientific papers related to his thesis, and a couple of pens and blank sheets to take notes. The mentor will sit in the empty chair in front of him and will start the conversation. While s/he is breaking the ice, Paul will be very active in the conversation and say that he feels very enthusiastic about his thesis. He thinks it is going to turn into a great piece of work and will be graded the highest mark. However, he has some questions about the feedback he received from the mentor. 

 

Paul will start talking about items in the feedback that (as he says) peers, relatives and other teachers said were fine or even great. While saying this, he will start going through his manuscript (which he brought to the meeting) nervously and showing it to the mentor. When the mentor starts noting the aspects that were not so good in his manuscript, he will adopt a perplexed, incredulous or even defiant attitude. He may confront the mentor by saying that he followed his/her indications as well as what he learned at university and that there is no reason why now s/he (the mentor) would evaluate it negatively. He may also say that it is unjust to make such an extensive feedback at this point of the academic year, and that s/he should have responded to his emails faster. 

 

The following scenarios can emerge depending on the attitude adopted by the mentor in view of Paul’s behaviour:

 

  • Confronting attitude: the mentor sticks to his/her feedback and starts justifying them to Paul. Paul will be more and more angry and defiant (yet always respectful). He may accuse him/her of not understanding his thesis. He will keep on reproaching the mentor for not having been more available and having put a greater effort in understanding his thesis. Every time the mentor tries to explain limitations of his thesis or manuscript, he will say that s/he does not get the point of his thesis. He may even say that he talked about the thesis to other people, and they said it is a great idea and very well-developed. If the tension between the two rises, Paul will leave the room saying that he will contact the headmaster to ask for a mentor replacement, since he feels like he will not be able to learn with this mentor. 
  • Paternalistic/doubtful attitude: in view of Paul’s arguments, the mentor starts to question his/her initial feedback. If that is the case, Paul will adopt a more active and powerful role in the conversation, arguing that other teachers said the thesis is great and very well-developed. Paul will insist that the mentor takes a look at his manuscript again and reevaluates his/her feedback. If the mentor agrees on re-reading the manuscript for a new feedback, Paul will ask her to be fast, since he wants to finish the thesis as soon as possible to take additional courses and improve his CV. Paul’s goal is to leave the meeting with the fewest revisions possible and green light to keep with what he is currently doing. 
  • Assertive attitude: the mentor will ask Paul to explain his idea again, for him/her to understand it better and provide more tailored feedback. If that is the case, Paul will calm down and start to explain his (too complex) thesis. Paul’s ideas will not be organised, and he will jump from one issue to another. The mentor will have to make an effort in understanding what he is saying and trying to organise the conversation. S/he will get back to his/her initial feedback but linking every comment with what he said was his idea. If Paul refuses his/her comments, s/he will get back to him with what he learned at university (e.g. “tell me the study designs that you learned at university; which of these would suit your idea best”). Paul will then be confronted with his own mistakes or knowledge limitations and will start to listen to the mentor’s suggestions and comments. The mentor will then try to keep Paul motivated by stating that the thesis is indeed very interesting and that the work that he put in it so far is not lost. Paul will leave the room grateful, self-confident, and willing to revise his work. 

 

 

So far, the cases should not take much longer than 10 minutes. If these do not seem to come to an end, facilitators of the simulation activity can end the scenarios by knocking on the door of the room and telling the mentor that s/he has another student waiting for him/her. 

 

2. Preparation of the physical setting

 

Simulation room equipped as an office or a teaching room (at least two chairs, a table, and some pens and blank sheets). If a room of these characteristics, equipped so that participants in the debriefing room can see and hear live what is happening, it can be performed within the debriefing room in an area reserved specifically for the performance of the simulation. While the simulation is taking place, however, observers need to be very aware that they cannot make any noise or source of distraction to make the scene as realistic as possible. 

Debriefing room separated from the simulation room. It has to be equipped with enough resources to be able to see and hear live what is happening in the simulation room. If a simulation room is not available and the performance of the simulation occurs within the debriefing room, this needs to be roomy. For the debriefing phase of the simulation, the room must allow all participants to be immersed in the conversation, avoiding physical barriers that prevent everyone from seeing each other face to face. 

Simulation control room from which the development of the case is controlled, and the case is broadcasted. It is important that the teaching staff or simulation technicians know the computer equipment that is being use

d. This is not necessary if the simulation takes place in the debriefing room.

3. Definition of the roles of participants

 

Role of the students. Participants will be divided into two groups: those who get into the simulation room and try to solve the case (i.e. enact the role of health professional), and those who observe their peers trying to solve the case. All students will participate both in the pre-briefing and debriefing phases of the activity. The group will decide who gets into the simulation room and who stays at the observation room. 

Things to take into account prior to the activity:

 

  1. Context. You should make sure that the activity is appropriate for the number of students you have, as well as for the learning objectives of the subject in which it will be implemented
  2. Materials necessary for its implementation. Make sure that you have a proper primary care simulation room with a proper camera/microphone system. The observation room should have a screen to watch and listen to the development of the case real-time and big spaces to perform the pre- and de-briefing phases. Check whether you have all the consumable and non-consumable materials that will be used during the activity, from printed sheets with the description of the case to the materials of the primary care simulation room. Finally, make sure that you provided students with all the necessary information about the case.
  3. Human resources necessary for its implementation. In simulation activities, at least two teachers should be available with knowledge of how to perform simulation activities. You may also need to hire an actor to perform the role of Paul.

 

During the activity

Step 1. Pre-briefing. The pre-briefing phase is devoted to generating an emotionally-safe space, wherein participants feel comfortable to perform the activities they are required to without being judged, show their emotions as these emerge, and rely on the group for any source of support. The facilitator(s) should be perceived by participants as part of the group. To know more information about how to organise this phase, see the Methodological guide. 

Step 2. Case development. For the case development phase, the facilitator(s) will briefly present the case (A or B) to the whole group of participants. Then they will choose the participant that gets into the simulation room and tries to solve the case. The other ones will stay at the debriefing room and observe their peer throughout the development of the case. 

While the case is developing, there are two key moments to which you should pay special attention: 

(a)   How the participant (i.e. mentor) breaks the ice with Paul and starts to provide feedback

(b)   How the participant (i.e. mentor) reacts to Paul’s response to the provided feedback

 

Step 3. Debriefing. In the debriefing phase, the participant that was in the simulation room gets back to the debriefing room with his/her peers and facilitator(s). This is a moment for common reflection in which performing participants offer an internal point of view of the simulation and observing participants offer an external point of view of what happened and what could have been done differently. Therefore, it will probably be the phase that lasts the most. Topics that should be addressed are: 

(a)   emotions that emerged during the case

(b)  reasons that guided the decision-making: whether, why and how performing participants adopted a certain attitude;  how they tried to redirect Paul; how did they manage Paul’s expectations and needs; how did they get to negotiate with Paul.

(c ) transfer of what they learned to professional reality

 

After the activity

After the debriefing, it’s time for evaluation. Below, you can find a rubric to evaluate their socioemotional and interpersonal skills (both of students that performed in the simulation and those who observed it). You can also give it to them for self-evaluation in order to stimulate self-reflection. 

 

Role of teacher(s)

The teacher(s) will facilitate the pre-briefing and debriefing activity. In both parts of the activity, an emotionally-safe space should be guaranteed. They will not get into the simulation room unless they play a role in which they make the simulation end realistically (e.g., the unit coordinator gets into the room for a check-in with the patient and offers to solve the situation). 

Following the recommendations made by studies in simulation methodology, it is preferable to have two teachers in this type of simulation. One of them, the “instructor” and who will have accomplished a specific training in simulation methodology, will take the role of moderating and facilitating the session and debriefing, while the other, an expert in the content of the cases, will handle content clarification and questions.

 

Evaluation tool

Transversal skills are difficult to evaluate, particularly among big groups of students. Therefore, in this section we propose a tool for students to self-assess the development of these skills. The tool is divided into three dimensions: suitability of the learning activity, level of achievement of learning outcomes, and transferability to professional settings. You can adapt the dimensions and/or indicators that you use according to your teaching-learning context and needs. 

 

Evaluation tool to self-assess the development of skills during the activity

For each of the following statements, select the best answer on a scale from 1 to 4, where 1 means “Not at all” and 4 indicates “Yes, totally”. N/A means “not applicable”.

  1 2 3 4 N/A
DIMENSION 1. Suitability of the learning activity
I found this learning activity adequate in terms of time          
I found this learning activity adequate in terms of resources (material resources, physical space, etc.)          
I found this learning activity adequate in terms of content          
I found this learning activity engaging          
I found this learning activity challenging          
I found this learning activity disruptive in comparison with other learning methodologies          
I found this learning activity useful to learn [add the subject]          
I found this learning activity useful to retain knowledge          
This learning activity motivated me to deepen my knowledge of [add subject or hard skill]          
This learning activity allowed me to feel emotions that would be rather difficult to experience with other learning methodologies          
I would recommend this learning activity to others          
DIMENSION 2. Level of achievement of learning outcomes
This learning activity helped me to improve… 
…my ability to [add a row for each learning outcome of the activity that you performed, both related to hard and transversal skills]          
DIMENSION 3. Transferability to professional settings
After this learning activity…
…I will be better able to apply what I learned to my reality (everyday life, classroom, professional life)          
…I feel more capable to perform in a professional setting          
…I feel I can make better choices regarding professional situations          
…I feel more prepared and self-confident to address professional situations          

OPEN QUESTION – Use this space to explain whatever you think is remarkable from the learning activity, including strengths, weaknesses, improvements, potential uses, feelings or dilemmas you encountered during the activity. 

 

 

 

Download evaluation tool in pdf here.

 

 

 

Some images of the content
           
Our Score
           Author / Creator

      Ariadna Graells

      agraells@esimar.edu.es

      Eva Padrosa

      epadrosas@esimar.edu.es

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