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CLINICAL TEACHING

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Purpose of Clinical Laboratory

1. Where theory and practice come together


2. To perfect or master skills
3. To have an opportunity for observation (Infante, 1985)
4. To refine problem-solving, decision-making, and critical
thinking skills (Roche, 2002)
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Purpose of Clinical Laboratory

5. To gain organization and time management skills (Oermann


& Gaberson, 2007)

6. To develop cultural competence (Oermann & Gaberson,


2007)

7. To become socialized in the clinical laboratory (Chan, 2002)

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Misuse of Clinical Laboratory

1. Nursing students have been sent to the clinical setting to gain


work experience rather than to achieve educational objectives.

2. When novices are given too much responsibility for patient


care.

3. When learners are supervised and evaluated more than they


are taught
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Models of Clinical Teaching

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Models of Clinical Teaching

1. Traditional method

Instructors accompany
groups (8-12 learners) to a
clinical agency and assign
them to patients

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Models of Clinical Teaching

2. Relies heavily on keeping


nursing students in a skills
laboratory until they are
proficient with skills

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Models of Clinical Teaching

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

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Preceptorship Models

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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

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Preceptorship Models

2. CTA Model

Clinical Teaching Associate and educator work


hand in hand to teach the nursing students

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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

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Preparing for Clinical
Instruction

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Preparing for Clinical Instruction

1. Clinical agency sites must be chosen


2. Clinical units within the agency must still be
identified
3. There should be enough role models for
learners
4. Contracts must be drawn up between the
school and the clinical agency
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Preparing for Clinical Instruction

5. Educator should set up a meeting with the


agency staff who will be involved with the
education process
6. Making specific arrangements for learners on
a weekly or daily basis (for duty or actual
patient care)

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Conducting a Clinical
Laboratory

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Preconferences

• Orientation occurs
• Instructors brief their
students
• Students ask questions
about their assignments
• Discusses and plans on
patient’s care
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Practice Sessions

• Follows the preconference


• Combinations of strategies
such as return demonstration
with explanation, asking and
answering questions, and
coaching techniques are used
• Like a checklist
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Effective Teaching Techniques for
Clinical Settings

1. Observation Assignments
• Supported by Social Cognitive Theory
• Observing nurses as they perform skills they
usually cannot perform

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Effective Teaching Techniques for
Clinical Settings
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
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Effective Teaching Techniques for
Clinical Settings
3. 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
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Effective Teaching Techniques for
Clinical Settings
4. Technology Use
• Students must learn how
to use varied
technological tools
required for patient care
• PDAs, Nightingale
Tracker System
• OpenMRS, Open-NIS
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Effective Teaching Techniques for
Clinical Settings
5. 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.
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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
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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
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Evaluating Learner Progress

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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.

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Choices to be Made Regarding 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
Usually non-graded
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Choices to be Made Regarding Evaluation

Summative

Summary evaluation given at the end of the learning


experience
To assess whether the learner has achieved the
objective and is ready to move on to the next experience

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Choices to be Made Regarding 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

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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
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Behaviors to be Evaluated
Therapeutic communication
Ability to work with a professional team
Professional behaviors
Written documentations of care

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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

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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

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Reference
• Deyoung, S. (2009). Teaching Strategies for Nurse
Educators (Second ed.).

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