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ПЕДАГОГИЧЕСКИЕ НАУКИ
ROLE OF THE MENTOR IN MOTIVATION OF STUDENTS FOR ACTIVE PARTICIPATION IN
PRACTICAL TRAINING
Vacheva Danelina Emilova
Doctor of Medicine, Associate Professor Medical University - Pleven, Bulgaria Kinesitherapist University Hospital - Pleven, Bulgaria
Paskaleva Ruska Vasileva Doctor of Medicine,
Associate Professor Medical Faculty - Thracian University
Stara Zagora, Bulgaria
ABSTRACT
An important point in clinical education is the joint work of students and mentors (working specialists in the respective healthcare facilities) who are in the role of supervisors in rehabilitation teams. This joint activity is important for improving the quality of practical training, for the personal and professional development of the students. The mentor is a central figure during the clinical practice and pre-graduate clinical practice of the students. The objective of this paper is surveying the opinion of the students - future specialists in the specialties Medical Rehabilitation and Ergotherapy and Physiotherapist as well as the opinion of the mentors at the training clinical facilities, on the joint work they do during the practical training. A questionnaire was prepared to conduct the survey, different for students and mentors, and answers to the questions were determined by a 5-degree scale. Good mentoring is a matter of the mentor's attitude towards the profession and the students; builds trust and makes training a fascinating challenge; explains complex cases in an accessible way; reveals the practical value of the theoretical material; devotes extra attention to students, who are experiencing difficulties; careful and is caring for the students.
Key words: mentor, motivation, professional training, clinical practice
INTRODUCTION
The medical colleges in Bulgaria (the former medical schools with three-year academic training) have been training specialists in Medical Rehabilitation since 1961. The education is focused mainly on mastering practical skills for work with the means of pre-formed physical factors, applying special kinesio-theurapeutic methods and various types of massage in accordance with procedures prescribed by a physician - specialist in physical and rehabilitation medicine [2, pp. 2-13]. During the recent years more and more evident becomes the need of professionals with wide range of skills, with knowledge in various sectors of life of people with disadvantages like social, economic, legal, hygienic, pedagogical knowledge, except the medical background.
The training of students in Medical Physiotherapist - Ergotherapist (Bachelor's Degree) and Physiotherapist (Professional Bachelor's Degree, three-year training) requires continuous improvement of lecturing, theoretical and practical background in compliance with the European requirements for quality health care for patients and their families. It determines the main priorities of the training, and they can be summed up as follows: setup of practical skills and professional competencies; stimulation of academic motivation in students as an important factor for setting up professional skills and competencies; life-long learning for the occupants in the sector of medical rehabilitation, and promotion of specific type of motivation - a motivation for learning. The motivation is one of the important factors that shall be used by the lecturers to improve the quality of education [7, pp. 1-
16; 8, pp. 955-958]. Proper and expedient organization of the training process favors building a positive motivation for academic activity, stimulates the development of cognitive interests that, once established, transforms into efficient internal factors for improved quality and efficiency of the training activity [5, pp. 184-189; 9, pp. 321-333]. Extremely important for the motivaton of the students are lecturers' personal qualities, contents of the training materials, methods of teaching and approach to students, impact of the working environment and facilities and equipment [1, pp. 80-88]. All these elements are in constant interaction: 1) Lecturer's role is to apply resourceful teaching techniques and to encourage the students to use innovative technologies; teaching shall be interesting and easy; communication with students requires enormous efforts, inside and outside the academic atmosphere; each student shall feel special. 2) Student's role in education is of a crucial importance and shall step out of the traditional concept for the student as a client or recipient of knowledge. 3) The most applied method for training is the suitable one to present the contents. Two are the basic approaches to support the motivation: to provide conditions for training in academic environment and engage the students, and to assist students in developing tools for self-regulation and self-training. 4) The contents for the training process shall be developed according to and in line with set objectives: students shall gain success and have options; to trigger formation of professional competencies, creative and critical thinking; implementation of innovative and modern methods. 5) The environment, which includes the role of the family
and the society in motivating the students, shall encourage students' willingness to not only educate, but to volunteer and provide mutual aid [4, pp. 295301].
Major moment in clinical training is the joint activity of students and mentors/advisers (specialists, who work in health institutions) who act as supervisors in rehabilitation teams. Such joint activity is important for improved quality of the practical training and for the personal and professional development of the students. The mentor is a central figure during clinical practice and pre-graduation clinical internship of the students. His/her main task is to support the trainees in mastering the medical profession, to introduce them to regularities and conditions that guarantee quality health care services, mistakes and omissions in the treatment process and options for their surpassing [3, pp. 31-34]. He/she shall assist the students in mastering habits and ethic approach to the patients and their relatives. The good mentoring is not a matter of some special methods, intentions or actions, primarily it is mentor's attitude to the profession and the students. The good mentor: Inspires credibility; Draws the attention of the trainees to abilities they are not aware of; Explains complicated matters in a simple language; Reveals the practical value of the theoretical material; Devotes additional attention to trainees who manage with
difficulty the material; Being a mentor means, above all, to be careful and caring [7, pp. 23-27].
OBJECTIVE
The objective of this paper is surveying the opinion of the students - future specialists in the specialties Medical Rehabilitation and Ergotherapy and Physiotherapist as well as the opinion of the mentors at the training clinical facilities, on the joint work they do during the practical training.
MATERIAL AND METHODS
An extensive anonymous questionnaire survey has been conducted, among 203 persons, 146 of which are students in the specialties Physiotherapist and Medical Rehabilitation and Ergotherapy at the Trakia University of Stara Zagora, and Medical Rehabilitation and Ergotherapy at the Medical University of Pleven, during their clinical practice and pre-graduation clinical internship. The survey included also 57 mentors/advisers, who work at the clinical facilities in the two academic institutions. The two categories of repondents have been separated into two subgroups. The students from Trakia Unievrsity are 77, the students from Medical University of Pleven are 69. The mentors from the clinical facilities in Stara Zagora are 31, and these from Pleven - 26. The surveyed period covers 2016-2017 academic year. The distribution of repondents per categories and groups is displayed in Tables 1 and 2.
Table 1
DISTRIBUTION OF INTERVIEWED STUDENTS GROUPS
Groups of respondents Total
Students from the Trakia University of Stara Zagora 77
Students from the Medical University of Pleven 69
Total: 146
Table 2 DISTRIBUTION OF INTERVIEWED MENTORS GROUPS
Groups of respondents Total
Mentors from the clinical bases in Stara Zagora 31
Mentors from the clinical bases in Pleven 26
Total: 57
Different questionnaires for the studenst and for the mentors have been developed for the survey; for the purpose of the analysis a mathematical and statistical processing of obtained results has been performed. Responses to questions are according to a 5-index scale (depending on the essence of the question) as follows: 1 - NO (very negative response); 2 - rather NO (negative reponse); 3 - cannot tell; 4 - rather YES (positive response); 5 - YES (definitely positive response).
> The questionnaire for the students includes the following questions:
1. How would you rate the clinical practice and the pre-graduation clinical internship?
2. What is mentor's attitude toward you during the practice at the clinical facility?
3. Does the mentor help you build skills and habits, of practical value for your work with patients and ethical attitude towards patients and their relatives?
4. What recommendations would you give for improving the quality of the practical training?
> The questionnaire for the mentors includes the following questions:
1. Are you satisfied with your work with the students?
2. Do you need a preliminary pedagogical training to support your work as a mentor?
3. What is the attitude of your peers, working at the clinical facility, toward your duties as a mentor?
4. What recommendations would you give for improving the quality of the practical training?
RESULTS AND COMMENTS
In the development and professional upgrade of specialists in medical rehabilitation the practical training and proper mastering of various methods and manual-theurapeutic techniques are of a great importance - like manual traction and peripheral joints mobilization, neuromuscular facilitation, post isometric relaxation of contracted muscles, muscle test
method, suspension treatment system and puli- therapy. Mastering and enhancing these skills by the students requires practical training, included in the curriculum as clinical practice training and pre-graduation internship, conducted at clinical facilities of physical and rehabilitation medicine. The mentors are clinical
specialists with long-term experience and rich practice in treatment, highly qualified and with practical knowledge and skills. The results from responses to the first three questions in the quiestionnaire are displayed in Table 3-4.
Table 3
RESULTS OF THE TO STUDENTS ANSWERS FROM THE TRAKIA UNIVERSITY OF ST.
ZAGORA
Questions to students: gr. 1 gr. 2 gi\ 3 gr. 4 gr. 5
How would you rate the clinical practice and the pre-graduation clinical internship? 6 7,8% 9 11,7% 11 14,3% 16 20,8% 35 45,4%
What is mentor's attitude toward you during the practice at the clinical facility? 7 9,1% 8 10,4% 12 15,6% 19 24,7% 31 40,2%
Does the mentor help you build skills and habits, of practical value for your work with patients and ethical attitude towards patients and their relatives? 5 6,5% 7 9,1% 14 18,2% 23 29,9% 28 36,3%
Table 4
RESULTS OF THE STUDENTS ANSWERS FROM THE MEDICAL UNIVERSITY OF PLEVEN
Questions to students: gr. 1 gr. 2 gr. 3 gr. 4 gr. 5
How would you rate the clinical practice and the pre-graduation clinical internship? 12 17,4% 7 10,1% 12 17,4% 23 33,3% 15 21,7%
What is mentor's attitude toward you during the practice at the clinical facility? 11 15,9% 9 13,1% 14 20,3% 17 24,6% 18 26,1%
Does the mentor help you build skills and habits, of practical value for your work with patients and ethical attitude towards patients and their relatives? 8 11,6% 9 13,1% 13 18,8% 22 31,9% 17 24,6%
The difference between the results from the reponses of the students from the two academic institutions is seen on Diagram 1. Larger part of the students (66%) trained at the Trakia University of Stara Zagora rate positively the practical training conducted at the clinical facilities, unlike the student from the Medical University of Pleven, 36% of whom rate it
negatively. Most likely, this is because of the larger number of clinical facilities accessible for practical training for the students of the Trakia University, while the students at the Medical University of Pleven conduct clinical practice only at the clinics of the University Hospsital.
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Figure 1 Satisfaction of practical training students
Similar are the results form the responses to the next questions in the questionnaire, related to mentors' attitude to the students during the clinical practice and mentors' personal engagement with the training process. The analysis of received responses and the search of reasons for the more negative opinions of the students from the Medical University of Pleven we have established that the mentors in Pleven do not receive any financial support for their contribution to the training of the future specialists in medical rehabilitation and ergotherapy. The support they
provide in the practical work in most of the cases is a matter of personal qualities and good will for the successful realization of the students. At the Trakia University of Stara Zagora the subject is regulated and this explains the better results we have received.
At the same time, 63% (about 2/3) of all respondent students share that the Lecturer/Mentor -Student interaction is closer in hospital environment than in academic halls. Due to the specifics and nature of the specialty, the tutors may have to literally hold students' hands to teach them to manua techniques. It
creates friendly and peer relations between lecturers and students, especially during the pre-graduation internship of the graduating students.
Regarding the recommendations (question №4 in the questionnaire), 71% of the students recommend that the clinical practice shall be conducted in an actual clinical environment, at the bedside of patients or in immediate contact with outpatients, visitis to public institutions for childcare, daily centres for patients with psychic problems, nursing and care homes, homes of patients who are with permanent reduced mobility (paraplegia, cerebral paralysis, neuromuscle diseases). All respondents recommend that for improved quality of their education the training facilities and equipment shall be renewed and supplemented.
The correlative dependency between motivation and satisfaction of the students from the quality of the training is postitively significant (R=0,61; p<0,05). The good motivation of the students to educate in these
specialties is a factor that defines the quality of the training and their active participation in the practical work.
It is a main obligation of the lecturer at the clinical facility (the mentor among the working specialists in the clinical facilities) is to train the futire specialists how to build new motor skills in each patient by transforming theoretical knowledge into pratical skills [6, pp. 955-958]. To conduct such training, the relevant facility and equipment is required - visual aids, supportive products that assist walking in cases of impaired motor functions and others. The practical training where the specific relations "lecturer -student" and "future specialist - patient" are hard to accomplish, is an issue in the work with students [10, pp. 260-264]. The results from responses to the first three questions in the quiestinnaire are displayed in Table 5 and 6.
Table 5
RESULTS OF THE TO MENTORS ANSWERS FROM THE TRAKIA UNIVERSITY OF ST. ZAGORA
Questions to mentors: gr. 1 gr. 2 gi\ 3 gr. 4 gr. 5
Are you satisfied with your work with the students? 2 6,5% 1 3,2% 4 12,9% 10 32,2% 14 45,2%
Do you need a preliminary pedagogical training to support your work as a mentor? 3 9,7% 5 16,1% 4 12,9% 8 25,8% 11 35,5%
What is the attitude of your peers, working at the clinical facility, toward your duties as a mentor? 3 9,7% 2 6,5% 6 19,3% 8 25,8% 12 38,7%
Table 6
RESULTS OF THE MENTORS ANSWERS FROM THE MEDICAL UNIVERSITY OF PLEVEN
Questions to mentors: gr. 1 gr. 2 gr. 3 gr. 4 gr. 5
Are you satisfied with your work with the students? 4 15,4% 5 19,2% 7 26,9% 4 15,4% 6 23,1%
Do you need a preliminary pedagogical training to support your work as a mentor? 3 11,5% 5 19,2% 4 15,4% 6 23,1% 8 30,8%
What is the attitude of your peers, working at the clinical facility, toward your duties as a mentor? 2 7,7% 4 15,4% 3 11,5% 8 30,8% 9 34,6%
Figure 2 is a graphic of received results from reponses of the mentors that show predominantly negative responses of the mentors from the Medical Unievsity of Pleven. Larger part of them (54%) state their dissatisfaction from participation in the practical training of students without financial arrangements with the University which inevitably impacts their motivation for a fulfilling, active and responsible
mentoring work. It is being relied only on the personal engagement to training of students, entrusting only to mentors' good will and cimmittment to the profession. Opposite of this tendency are the results of the mentors in Stara Zagora - 3/4 of them (77,41%) rate positively their satisfaction from the duties they have as mentors at the clinical facilities used for training by the Trakia University.
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Figure 2 Satisfaction of mentors from their work with students
The correlative dependency between motivation and satisfaction of the mentors from their work with the students is postitively significant for the mentors from Stara Zagora (R=0,77; p<0,05), and significant (R=0,54; p<0,05) for the mentors from Pleven. The good motivation of the students to educate in these specialties is a factor that defines the quality of the training and their active participation in the practical work.
Regarding the question "Do you need a preliminary pedagogical training to support your work as a mentor?", more thn 67% (2/3) of all mentor respondents state a necessity from a special pedagogical training, corresponding to the modern conditions and new didactical methods and means.
A very large part of all mentors (more than 85%) rated positively the attitude of the other people working in the clinical facilities towards their mentor duties. It explains the good tuning of all peers in the field of medical rehabilitation and their understanding of the need of training of specialists in this sector.
CONCLUSIONS
From all that the respondents shared in the interview and after analysis we can formulate the following conclusions:
> Approximately 2/3 of all students repondents express satisfaction from the practical training at the clinical facilities;
>The material and technical base of the Clinics of Physical and Rehabilitation Medicine is crucial for enhanced level of the professional practical training;
>Free training courses shall be conducted, organized by the lecturers of Physical and Rehabilitation Medicine Department, to improve the qualification of the staff at the clinical facilities in order to synchronize theoretical knowledge and practical skills during the clinical practice of the students;
>In order to improve the quality of the practical training of the students from the Medical University of Pleven, it will be appropriate if the management of the Clinic of Physical and Rehabilitation Medicine and the University jointly discuss a mode of financial stimulation of specialists in the clinical facilities who are committed to mentoring and who participate in the practical training of the students from the specialty Medical Rehabilitation and Ergotherapy.
IN CLOSING
The complex knowledge, skills and training obtained by the specialists in medical rehabilitation during their education contribute to a better medical, social and domestic, psychological, legal and ledagogical services, facilitate daily activities and improve the quality of life of patients with special needs. Main task of the lecturers/mentors is to continuously improve their professional qualification
and to teach the students in a much accesbile language and with high quality.
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