Clinical Teaching

PURPOSE OF CLINICAL TEACHING

Purpose of Clinical Laboratory

1. Where theory and practice come together

2. To perfect or master skills

3. To have an opportunity for observation

4. To refine problem-solving, decision-making, and critical thinking skills

Purpose of Clinical Laboratory

5. To gain organization and time management skills

6. To develop cultural competence

7. To become socialized in the clinical laboratory

Misuse of the Clinical Laboratory• Nursing students have been sent to the clinical setting to gain work experience rather than to achieve educational objectives.

•When novices are given too much responsibility for patient care.

•When learners are supervised and evaluated more than they are taught.

MODELS OF CLINICAL TEACHING

Models of Clinical Teaching

1.Traditional method– Instructors accompany groups (8-12 learners)

to a clinical agency and assign them to patients

2. Relies heavily on keeping nursing students in a skills laboratory until they are proficient with skills

3. More information about clinical practice should be taught in the classroom before learners go to the clinical area

Preceptorship Models

1.Traditional Preceptorship A student is taught

and supervised by a practicing nurse employed by the health care agency while an educator oversees the process and indirectly supervises the student

2.CTA Model Clinical Teaching

Associate and educatorwork hand in hand to

teach the students

Preceptorship

Increase clinical experience for students and expose them more of the realities of the work world, which should reduce reality shock

Allows students to learn from practitioners with a high skill level while still being guided by faculty who have a wealth of knowledge

PREPARING FOR CLINICAL INSTRUCTION

Preparing for Clinical Instruction• Clinical agency sites

must be chosen

• Clinical units within the agency must still be identified

• There should be enough role models for learners

• Contracts must be drawn up between the school and the clinical agency

Preparing for Clinical Instruction• Educator should set up

a meeting with the agency staff who will be involved with the education process

• Making specific arrangements for learners on a weekly or daily basis (for duty or actual patient care)

CONDUCTING A CLINICAL LABORATORY SESSION

Preconferences

Orientation occurs Instructors brief their

students Students ask questions

about their assignments Discusses and plans on

patient’s care

Practice Session

Follows the preconference

Combinations of strategies such as return demonstration with explanation, asking and answering questions, and coaching techniques are used

Like a checklist

Effective Teaching Techniques for Clinical Settings1. Observation

Assignments Supported by Social

Cognitive Theory Observing nurses as they

perform skills they usually cannot perform

2. Nursing Rounds Involves a group of learners

& their instructor visiting patients to whom they’ll be assigned

purpose is to expose learners to additional nursing situations and encourage them to consult each other in planning & evaluating care

Effective Teaching Techniques for Clinical Settings3. Shift Report

Being able to attend endorsements

A way for students to learn the uniqueness of nursing communication and is a means of professional socialization

4. Technology Use Students must learn how to

use varied technological tools required for patient care

PDAs, Nightingale Tracker System

Effective Teaching Techniques for Clinical Settings5. Learning Contracts

A written agreement between instructor and a learner, spelling out the learner’s outcome objectives

6. Journal Writing Clinical journals

promote active learning and reflective practice and are built on the theory of Constructivism.

Postconferences

Ideal opportunity for: pointing out

applications of theory to practice,

analyzing the different ways that patients with similar illness differ in their response to nursing care and treatment

Group solving Evaluating nursing care Learners to report what

they had done to their patients

Postconferences

Challenges: It is often unstructured

that allow for creativity but can dissolve into meaninglessness

It is usually held at the end of a physically and emotionally draining practice session

Few learners seem to believed that they learned everything they could have learned during their practice time

Learners thought postconference is just a boring post-mortem session

EVALUATING LEARNER PROGRESS

Why is Evaluation needed?

Learners need to hear the feedback and judgment of their work.

They need to know how they are doing at one level before progressing to the next.

To determine how well the objectives are met.

Choices to be Made Regarding EvaluationFormative and Summative

Evaluation Formative

...is the ongoing feedback given to the learner throughout the learning experience...helps identify strengths and weaknesses...prevents learners from being surprised at the end with the judgment of their performance

Summative ...summary evaluation given at the end of the learning experience...to assess whether the learner has achieved the objectives

Choices to be Made Regarding EvaluationNorm-Referenced and Criterion-Referenced Evaluation Norm-referenced

...learner is compared to a reference group of learners, therefore, evaluation and grading are relative to the performance of the group

Criterion-referenced...compares the learner with well-defined performance criteria rather than comparing him/her with other learners

Choices to be Made Regarding EvaluationGrading Systems

2 most common options for grading: Assigning letter grades Pass/Fail or

Satisfactory/Unsatisfactory approach

Behaviors to be Evaluated

Use of the nursing process

Use of health-promoting strategies

Psychomotor skills Organization of care Maintaining patient

safety Ability to provide

rationale for nursing care Ability to individualize

care planning and intervention

Behaviors to be Evaluated

Therapeutic communication

Ability to work with a professional team

Professional behaviors Written documentations

of care

Sources of Evaluation Data

Direct observation Broad questions asked to

the patients Learner self-evaluation Agency staff Written work and college

laboratory work performed by the learner

CLINICAL EVALUATION TOOLS

Clinical Evaluation Tools

1. The items should derive from the course or unit objectives

2. The items must be measurable in some way

3. The items and instructions for use should be clear to all who must use the tool

4. The tool should be practical in design and length

5. The tool must be valid and reliable

THE END