1. Teaching a clinical skill Anne Pegram March 2014

2. Aims and objectives Identify theory associated with learning a clinical skill Discuss approaches to teaching a clinical skill Identify the importance of feedback in clinical skills acquisition

3. Identify theory associated with learning a clinical skill How do you learn a skill?

4. Skills Domains COGNITIVE / KNOWLEDGE AFFERENT / ATTITUDE PSYCHOMOTO R / SKILLS

5. Theory associated with learning a clinical skill Repetition/practise Hughes S & Quinn F M (2013) Quinn’s Principles and Practice of Nurse Education.6 th edition. London: Stanley Thornes (Publishers) Ltd Visualisation Wrigth C, Hogard E, ellis R, Smith D, Keilly C (2008) Effect of PETTLEP imagery training on nursing skills: pilot study. Journal of Advanced Nursing. 259-265 Blended learning Bloomfield J G & Jones A (2013) Using e-learning to support clinical skills acquisition: Exploring the experiences and perceptions of graduate first-year pre-registration nurses - A mixed methods approach. Nurse Education Today. http://dx.doi.org/10.1016/j.nedt.2013.01.024 accessed 28th January 2014 http://dx.doi.org/10.1016/j.nedt.2013.01.024

6. Approaches to teaching a clinical skill psychomotor

7. http://www.faculty.londondeanery.ac.uk/ e-learning/teaching-clinical- skills/teaching-and-learning-practical- skills

8. Approaches to teaching a clinical skill psychomotor Repetition is with a purpose Duvivier R J et al (2011) The role of deliberate practice in the acquisition of clinical skills. BMC Medical Education. http://www.biomedcentral.com/1472-6920/11/101 accessed 11th February 2014 http://www.biomedcentral.com/1472-6920/11/101 Knowledge Skill and Attitude Bloom B S (1972) Taxonomy of educational objectives. London. Longman. Feedback Macleod Clark, J., Maben, J., Runciman, P., Dewar, B., Wallace, L., Herbert, R., Adams, J., Doyle, C., Gate, J., 2001 Clinical Skills Development. An exploratory study to examine the impact of laboratory based learning on the acquisition of the nursing and midwifery competencies. National Board for Nursing, Midwifery and Health Visiting for Scotland.

9. Feedback - stages of skill development Benner (2004) novice (first year of education), advanced beginner (new graduate), competent stage 1 to 2 years in practice), proficiency ( transitional stage), expertise (practical wisdom). Bondy (1983) accuracy 0r acceptability of behaviour – including professionalism, qualitative aspects – including use of time, equipment and energy, amount of assistance needed

10. Approaches to teaching a clinical skill - feedback Pass Demonstrates knowledge and understanding of the procedure as evidenced by: Fluent and co-ordinated Organised approach to the skill Skilful and accurate performance of key steps Safe and sensitive practice Professional attitude Confident Timely (performs skill within recommended time limit) Borderline pass Lack of fluency and/or co- ordination Organised approach in parts of the skill Skilful in part but occasional inaccuracies Safe and sensitive practice Professional attitude Lacks confidence Does not complete skill within recommended time limit Needs development Lack of fluency and/or co- ordination Disorganised in most parts of the skill Lacks skilfulness and accuracy in most parts of the skill Lack of safe and sensitive practice Lacks professional attitude Lacks confidence Does not complete skill within the recommended time limit

11. Application to own teaching Preparation – knowledge underpinning skill Practise with a purpose what outcomes are students and you wanting to achieve Feedback level of skill acquisition

12. Conclusion Identify theory associated with learning a clinical skill – practise, visualisation, blended learning. Discuss approaches to teaching a clinical skill encompasses methods to achieve theory of learning a skill. Identify the importance of feedback in clinical skills acquisition purposeful taken from stages of skills development.

13. References Benner P (2004) Using the Dreyfus model of skill acquisition to describe and interpret skill acquisition and clinical judgement in nursing practice and education. Bulletin of Science, Technology & Society. Doi:10.1177/0270467604265061 ACCESSED 11 TH February 2014 Bondy K N (1984) Clinical evaluation of student performance: the effects of criteria on accuracy and reliability. Research in Nursing and Health. 7 25-33