Mentors are lacking the time to both give and receive adequate feedback from students on placements despite the importance of the process in improving patient safety, an independent commission has found.
At the same time, a “hidden curriculum” is entrenched in organisations – where real-life practice undermines the theory students have been taught – which sends out “mixed messages” about standards, it said.
“The vocational nature of healthcare training means that mentorship is a significant contributor to a learner’s development and future practice”
The commission, set up by Health Education England, concluded that trainee nurses, midwives and other healthcare students were often not given any opportunity at all to give feedback to senior colleagues.
Meanwhile, students themselves sometimes only received feedback on their work at the very end of placements, said the report by the Commission on Education and Training for Patient Safety, which was chaired by Sir Norman Williams, former president of the Royal College of Surgeons.
Students contributing to the commission’s research also said there was often a gap between what they had been taught and the practice they actually saw on placements.
This so-called “illegal-normal” is often not discussed between students and senior practitioners, which sends “mixed messages” about the importance of high standards for safe patient care, said the report.
“The vocational nature of healthcare training means that mentorship is a significant contributor to a learner’s development and future practice,” said the report.
The commission called for Health Education England to work with employers to ensure mentors are supported to raise and respond to concerns.
Senior colleagues should also be trained to bring their knowledge up-to-date with what students are being taught on courses, said the commission.
“The system needs to learn from errors and embrace transparency”
A total of 12 recommendations were made by the commission for Health Education England and the healthcare system to improve patient safety through education and training over the next 10 years.
It noted major changes were needed in areas such as multi-specialty and team working and reporting systems to ensure the NHS has a culture of learning rather than blame.
Health Education England set up the commission to look at how education and training interventions can actively improve patient safety.
Wendy Reid, Health Education England’s director of education and quality, said the report was different to previous ones on patient safety because of this focus on training.
“We welcome this report and thank the commission for its work,” she said.
“The system needs to learn from errors and embrace transparency. Patients should be at the centre of care and we need to actively involve patients, carers and families in how we raise patient safety standards,” she added.