Teaching Strategy: Return Demonstration Lori Couch RN, BSN, CDE Christina Jilek, RN, BSN, CNOR

Broad overview of strategy Return demonstration is effective strategy when learning a psychomotor domain This strategy is effective when combined with a demonstration, the learner should return demonstration as close to demonstration as possible Gives the learner an opportunity to show what they have learned in a comfortable non-intimidating environment

Educational theories Self Efficacy theory: theory based on performance accomplishments. The learner is taught a skill and then given the opportunity to demonstrate the skill learned. According to Albert Bandura, self-efficacy is “the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations” (Bandura, 1994).

Educational Theory: Self Efficacy Defined People with strong self efficacy View challenging problems as tasks to be mastered Develop deeper interest in the activities in which they participate Form a stronger sense of commitment to their interests and activities Recover quickly from setbacks and disappointments (Bandura, 1994) People with weak self efficacy Avoid challenging tasks Believe that difficult tasks and situations are beyond their capabilities Focus on personal failings and negative outcomes Quickly lose confidence in personal abilities (Bandura, 1994)

Usages of the strategy Demonstration of blood glucose testing, explained and the learner is given the opportunity to demonstrate this to the instructor. Best used with individualized instruction. Other examples: Dressing Change Injections Blood Pressure Measurement Medication Administration Hand washing Donning Sterile Gloves

Pros of strategy Effective for learning in the psychomotor domain Engages the learner using visual, auditory and tactile senses Repetition of movement and constant reinforcement increases confidence, competence, and skill retention Provides opportunity for over learning to achieve goal

Cons of strategy Best completed with 1:1 instruction Can be costly Need to limit the size of instruction Requires plenty of time to be set aside for teaching and for learning Extra space and equipment may be necessary for certain skills

Evaluation Return demonstration is beneficial in making patients comfortable with new skills. This strategy permits the nurse to document patient’s progress and any areas they need improvement. Evaluator/Coach can use a checklist to make sure the learner is mastering each step, and which steps require more practice

Summary Can increase the knowledge base for health promotion practices. Accurately reflects both what was taught and how the patient is able to demonstrate the skill. Teacher should remain silent except for offering cues Practice should be supervised until the learner is competent

References Bastable, S. B. (2008). Nurse as educator (3 ed.). Sudbury, MA: Jones and Bartlett. Cirone, N. (2010). Documenting return demonstration. Nursing 2010. Retrieved May 24, 2010 from www.journal.lww.com. Finkelstein, E., Wittenborn, J. & Farris, R. (2004). Evaluation of public health demonstration programs: The effectiveness and cost effectiveness of wise woman. Journal of Women’s Health. Retrieved May 24, 2010 from ebscohost. London, F. (1997, February). Return Demonstration: How to validate patient education. Nursing 97, 32.

References Continued Bandura, A. (1994). Self-Efficacy. New York, New York: Academic Press. Bastable, S. (2008). Nurse as educator: principles of teaching and learning for nursing practice. Sudbury: Jones and Bartlett. Mantik Lewis, S., & Heitkemper, M. (2004). Medical-surgical nursing: assessment and management of clinical problems. Mosby.