Central Luzon Doctors’ Hospital Educational Institution

San Pablo, Tarlac City

Department of Graduate Studies
Master of Science in Nursing
TOPICS: CLINICAL TEACHING

REPORTER:

Purpose of Clinical Teaching

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.
5. To gain organization and time management skills
6. To develop cultural competence
7. To become socialized in the clinical laboratory

Models of Clinical Teaching

A. Traditional Model – the educator provides instruction and evaluation for a small groups of
nursing students and onsite during clinical experience.

The benefit of this model is the opportunity to assist students in suing the concepts and theories
learned in class through readings and other learning activities.

The disadvantage

Large number of students for whom the faculty member may be responsible.

Not being accessible to students when needed because of demands of other students in the
group.

B. Preceptorship Model
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 educator work hand in hand 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

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
 Educator should set up a meeting with the agency staff who will be involved with the education
process.
 Making specific arrangements for leaner on a weekly or daily basis (for duty or actual patient
care)

Conducting a Clinical Laboratory Session

 Preconferences
o Orientation occurs
 o Instructors brief their students
o Student ask questions about their assignment
o Discusses and plans on patient’s care
 Practice Session
o Follows the preconference
o Combinations of strategies such as return demonstration with explanation, asking and
answering questions and coaching techniques are used.
o Like a checklist

Effective Teaching Techniques for Clinical Settings

1. 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 and their instructor visiting patient to whom they’ll be
assigned
 Purpose is to expose learners additional nursing situation and encourage them to
consult each observation
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.
4. Technology Use
 Students must learn how to use varied technological tools required for patient care.
 PDAs, Nightingale Tracker System.
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.

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.

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

Evaluating Learner Progress

Why is evaluation needed?

 Learners need to hear the feedback and judgement 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.
Formative 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.

- to modify teaching and learning activities.

Summative refers to the evaluation done at the end of the learning experience.

- Focus on the outcome of the program.

Norm-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.

- Ranking of examinees.

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

- Pass or Fail.

Grading 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
 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

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