Clinical Coach Standardisation Meeting August 2011

Aims Define Practical Skills How can practical skills be learnt? How can practical skills be taught Why is assessment important? How can this be done in a robust way?

What are practical skills? Doing! BUT Require underpinning knowledge & understanding Require ability to perform a dextrous task Can be simple or complex May require fine or gross motor skills Acquisition is a life long process: child adult

Practical Skills in Veterinary Nursing Technical Animal care and welfare First Aid Preparation & administration of medication Diagnostic procedures Clinical Care Procedures Equipment prep & maintenance Professional Communication Team Working Teaching Conduct Business Staff Management Stock Control Reception Duties Payments Estimates Health & Safety

How do we learn?

Kolb’s Experiential Learning Cycle Concrete Experience (Doing) Reflective Observation Abstract Conceptualisation (Learning from experience) Active Experimentation (Putting into practice what has been learned)

Blooms Taxonomy Imitation Manipulation Precision Articulation Naturalisation Psychomotor (Practical Skills)

Skill Aquisition Dreyfus (1980) proposed a model of how to acquire skills Applied to nursing by Benner (1984) Progressive level of skill based on experience Novice Advanced Beginner CompetentProficientExpert

Conscious Competence Model and its Professional Application Reflective Competence Unconsciously Incompetent Consciously Incompetent Consciously Competent Unconsciously Competent Expert Confidently Incompetent

What Concepts can be used to guide our teaching? Activity aids learning Repetition and practice aids learning Small steps aid learning Reinforcement aids learning Behavioural Therapy Learning comes from understanding Organisation and structure of teaching aid learning Perceptual features need attention Cognitive feedback aids learning Individual differences need to be taken into account Cognitive Theory Learning is a natural process Motivation, purposes and goals are important Choice, relevance and responsibility aid learning Anxiety and emotion affect learning Humanisation and Adult Learning Theory

Teaching a skill Stage 1 Demonstration of skill at normal speed with little/no explanation. Stage 2 Repetition with full explanation and encouraging learner to ask questions. Stage 3 Demonstration again with learner explaining each step and teacher questioning and correcting. May need to be repeated multiple times. Stage 4 Learner performs skill under close supervision describing each step before performing it.

Acquisition of skills in Veterinary Nursing College Work- based

Why is work based learning important?

Workplace teaching & learning - Limitations Time and clinical constraints Effect on smooth running of a business Ability and willingness of staff whose main role is not teaching Availability of teaching opportunities Variability in technique Non compliant patients

Simulations Allows learning to be in a safe & controlled environment Lots of opportunities to practice Standard techniques can be taught Less time constrained BUT Experience NOT real Not possible for all tasks May result in poor application in practice

Assessment – Why? Have learning outcomes been met? Are learners - Competent, Reliable, Safe. Can knowledge and practical skills be used together in a problem solving context? Important for public confidence and professional registration

Assessment formats Does NPL Shows How (College & Practice) Practical exams Knows How (College) Written assessment - assignments Knows (College) Written assessment – MCQ’s

Assessment of practical skills must be……. Feasible Credible Have educational impact Defensible Supported by body of evidence in the literature Acceptable to all stakeholders

Any Questions?