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

2. 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

3. 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).

4. 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)

5. 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

6. 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

7. 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

8. 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

9. 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

10. References
Bastable, S. B. (2008). Nurse as educator (3 ed.). Sudbury, MA: Jones and Bartlett.
Cirone, N. (2010). Documenting return demonstration. Nursing Retrieved May 24, 2010 from
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.

11. 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.