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2. BASICS OF CLINICAL INSTRUCTION Sikha Chatterjee, MSN RN Amy Hayes, MSN RN October, 2008

3. Objectives  Discuss the roles of clinical educator  List the multiple components necessary to organize and implement a clinical experience  Describe methods of effective clinical instruction  Note to reader: Please view under “normal” view to see additional notes on slides 5,7,9,10.12,13,14,15,16,17,18,19,21,22,23,and 24

4. What is Clinical Instruction?  Components identified: –Holistic –Active –Intellectual –Values –Development of nursing identity »Headlines of NLN Survey

5. Definitions of Clinical Education “An exchange between practicing professional to enable the development of professional skills” – Butterworth 1992 “A term used to describe a formal process of professional support and learning which enables individual practitioners to develop knowledge and competence, assume responsibility for their own practice and enhance consumer protection and safety of care in complex clinical situations” -- Department of Health 1993 “Clinical Supervision is a practice focused professional relationship that enables a clinician to reflect on their practice with the support of a skilled supervisor. Through reflection the clinician can further develop their skills, knowledge, and enhance their understanding of their own practice” – Nursing and Midwifery Council 2004

6. Purpose GOAL OF NURSING EDUCATION: “The ultimate goal of nursing education is to prepare the student to think critically, communicate accurately, and perform indicated therapeutic nursing interventions in patient care..” – Andrea B. O’Conner

7. Characteristics of Clinical Faculty  Attributes of successful nursing practice translate well into faculty role –Coordination/Facilitation –Negotiation –Supervision –Conflict Resolution –Teaching

8. Personal Characteristics of Faculty  Willingness to share knowledge and skill  Let someone see nursing through your eyes, hands, and mind  Use empathy to support the learner  Recognize individuality of the learner

9. Characteristics of Adult Learners  Adults prefer to know why they need to learn something before undertaking to learn it  Adults invest considerable energy to something that they want to learn and perceive value in learning  Adult learners wish to be treated with respect and they are capable of self-direction  Adults bring with them a volume of past experiences, including experiences with learning. These past experiences can be positive or serve as a barrier  Adults want to learn materials that have practical application. They want to learn in real-life situations »Knowles, 1990

10. Competencies  NLN has identified core competencies for nurse educators –Facilitate learning and learner environment –Utilize assessment and evaluation –Act as change agent and leader –Function within the educational environment –Practice continuous positive improvement »NLN 2005

11. Components of Teaching a Clinical Experience

12. 12 Planning a Clinical Experience  Review syllabus  Choose proper clinical site ***  Communicate to clinical site; orient if necessary  Plan student orientation (see packet)  Make a student schedule

13. Student Clinical Orientation  See checklist in packet example  Review with students –Syllabus –Methods of instruction –Written assignments –Evaluation process

14. Considerations  Facility limitations  Staff role  Patient participation  Educator role  Observational or “special experiences”

15. Planning a Clinical Day  Arrive early  Select patient assignments for students –Consider student needs –Confer with the staff –Post the assignment with student activities  Pre and Post Conference

16. Time Management During Clinical Day  Establish a routine  Schedule student interaction  Round  Meds and treatments  Assessments and documentation

17. Constructing the Experience  There is no one way or method to teach clinical skills.  This is a process of choosing from a repertoire of methods depending on the learner and practice setting.  This must involve active participation in learning. POSSIBLE METHODS:  Experiential Learning  Problem Solving  Observation

18. Tools to Help Make the Methods Work  Asking questions  Answering questions  Facilitating discussion  Explaining everything  Demonstrating new or unfamiliar procedures  Providing feedback

19. POINTS TO REMEMBER:  You are responsible for the actions of the learner  Always develop a clear and specific plan of what aspects of nursing care you are responsible for, and what the learner is responsible for  Continuously communicate with the learner  Share responsibility  Evaluate the learner’s performance with both positive and constructive feedback [www.chamberlain.edu/HealthcareEmployers/Precep torship/Clinica…..]

20. Evaluation

21. FEEDBACK SHOULD BE:  Specific rather than general  Factual rather than opinionated  Descriptive rather than judgmental » (Alspach, 2000)

22. Student Preferences  Timely feedback  Recognition of positive, not just problems  Clear understanding of expectations  Respectful environment and methods  No surprises

23. Specifics of Evaluation  Verbal feedback  Evaluation tools  Refer to course objectives/evaluation criteria  Focus on the action or performance in relation to criteria  Keep good notes!

24. How to Address Performance Problems  Verbal discussion  Written description of incident  Consult with supervisor  Disciplinary tract  Student Contracts

25. Rewards to Expect  Satisfaction in seeing student progress  Increasing student confidence  The beauty of the “aha!” moment  An opportunity to impact the future of nursing  Personal growth

26. Questions and Sharing  What are your concerns?  What can we clarify?  What about?...

27. References  Giddens, J., Brady, D., Brown, P., Wright, M., Smith, D., and Harris, J. (2008), A New Curriculum for a New Era of Nursing Education, Nursing Education Perspectives, 29(4), 200-204  Headlines from the NLN: Summary of the Survey on Clinical Education in Nursing (2008), Nursing Education Perspectives, 29(4), 238-245  Kalb, Kathleen A., (2008) Core Competencies: Inspiring Excellence in Nurse Educator Practice, Nursing Education Perspectives, 29(4), 217-219

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