CLINICAL TEACHING METHODS Definition & Steps of Clinical Teaching
- 2. CLINICAL TEACHING • Introduction • Definition & Steps of Clinical Teaching • Philosophy / Principles of clinical teaching • Methods of clinical teaching » Nursing Clinic / Bedside clinic » Nursing care conference » Nursing Rounds » Demonstration » Nursing Care Study » Clinical Simulation » Virtual learning /Game based show » Mastery learning • Guidelines for best method • Evaluation of Clinical teaching • Conclusion S.Sujendran
- 3. INTRODUCTION In recent years, nursing education focused on theoretical education & deep gap between theoretical & clinical education created. Many nursing researchers reported that nursing students, in spite of good knowledge base, weren’t skillful in clinical settings. S.Sujendran
- 4. Theory practice gap; In result, with entrance of these unskillful students to the nursing care system, the quality of this system falls day to day. Clinical teaching of students and continuing education is vital for professional development. S.Sujendran
- 5. Clinical teaching (Definition) Clinical teaching is a individualized or group teaching to the nursing students in the clinical area by the nurse educators, staff nurse and clinical nurse manager. S.Sujendran
- 6. Steps in clinical teaching • Formulating objectives • Determining the student knowledge by conducting a test • Planning the content for ward teaching depending on the student’s knowledge • Organizing the programme • Implementing & evaluating the sessions. S.Sujendran
- 7. Philosophy / Principles of clinical Teaching • Clinical education should reflect the nature of professional practice • Clinical teaching is more important than class room teaching • The nursing student in the clinical setting is a learner, not a Nurse • Sufficient learning time should be provided before performance is evaluated S.Sujendran
- 8. Cont . . . • Clinical teaching is supported by a climate of mutual Trust & respect • Clinical teaching & learning should focus on essential knowledge, skill & attitude • Quality is more important than quantity S.Sujendran
- 9. Methods of clinical teaching » Nursing Clinic / Bedside clinic » Nursing care conference » Nursing Rounds » Demonstration » Nursing Care Study » Clinical Simulation » Virtual learning /Game based show » Mastery learning S.Sujendran
- 11. Bedside clinic • Bedside clinic always help to study the problems typically associated with a particular disease or disorder. • Always ensure the presence of the patient. • Either the group visits the patient or the patient is brought to the conference room. S.Sujendran
- 12. Cont . . . . . • Patients with Typical cases rather with unusual conditions are selected. • During the clinic the patient may be asked to speak something about the course of illness, symptoms and involves the family members and plan for discharge. • Brief history and therapy, nursing problems are presented along with the nursing care including physical, mental and social components. S.Sujendran
- 13. Cont . . . • Nursing clinic can be conducted by the head nurse or the clinical instructor. • Before the client entry the head nurse points out the group the observations which should made while he/she is present. • When the patient no longer needed should send back. S.Sujendran
- 14. Cont . . . • This is usually followed by a discussion and question and answer round. • The Material is summarized and the most important points are emphasized. • The clinic lasts for about 30 min finally it is evaluated by the head nurse and the group members. S.Sujendran
- 15. Advantages • The student nurse is getting an opportunity to observe, analyze & make decision in nursing care • The S/N remembers the nursing measures for longer time since directly they involved S.Sujendran
- 17. Nursing care conference • It is same like a bedside clinic but the patient is not usually present for the class. This may be a method of choice when the entire group is familiar with the patient. • Bedside clinic and nursing care conference can be used to evaluate the students. Both should be planned earlier if it is to be made more effective. But the nurse instructor can conduct it on the spot if she wishes to evaluate the students. S.Sujendran
- 19. Nursing Rounds • Nursing rounds is an excursion into patient’s area involving the students learning experiences. • In nursing rounds the patient history and the medical aspects of his/her care are included only as a background for understanding the nursing care. The registered nurse responsible for the patient should answer questions aroused in the group. Suggestions are made by the members of the group. • Suggestions discussed in the rounds will be recorded. Rounds may extend only up to one hour S.Sujendran
- 20. TYPES – Information giving rounds – Instructional rounds – Problem solving rounds S.Sujendran
- 21. Advantages • Increases the learning ability • Increases interest to share ideas & Knowledge with others for the benefit of the client • Response of the client is more natural • Students can select client with specific problem & plan for proper nursing care S.Sujendran
- 23. Demonstration method • Demonstration teaches by “Exhibition & explanation ”. • It trains the students in the art of careful observation a quality which is so essential to a good nurse. • To define "it is a physical display of the form, outline or a substance of object or events for the purpose of increasing knowledge of such objects or events. S.Sujendran
- 24. Advantages of Demonstration • Activates several senses • Provide opportunity for observation & learning • Clarify underlying principles • Commands interest by use of concrete illustration • It correlates theory & practice S.Sujendran
- 25. Types of Demonstrations 1. Planned demonstration: 2. Unplanned demonstration: S.Sujendran
- 26. Planned demonstration: Involves preliminary preparation, introductory conference, performing the procedure and follow up. S.Sujendran
- 27. Unplanned demonstration: when uncommon treatment occurs in the ward, this can be demonstrated to the students if it is not emergency. Patient’s feeling is given due consideration. It can be explained in the follow up conferences S.Sujendran
- 29. Case method Types – Case Study – Case Analysis – Case incident Technique S.Sujendran
- 30. Nursing Case Study • The student with the help of the clinical instructor selects one of her patients for intensive study which she finds interesting. • The student tries to solve the problems through the study, consultation and experimentation and decides the nursing measures which will meet the patient’s individual needs and solve nursing problems. S.Sujendran
- 31. Nursing case study • The student must be given opportunity to take care of the patient over a long duration of time, to understand his/her behavior, to gain his/her confidence, to learn the real nature of his/her problems, and to note the effect of nursing measures and the results of the care. S.Sujendran
- 32. Advantages of nursing care study • The effort of the student to define and solve the problems in the patient care arouses interests in him and results in better nursing care. • The students recognize the effect of personal and social factors on illness and recovery. • Useful to organize the information and identify the problems. S.Sujendran
- 33. Cont . . • The student also learns about the problem solving approach to nursing. The report may act as a reference material for the student. • The student can present the report in front of the group and it should be evaluated in terms of content, organization, clarity of thought and interest. • The oral presentation helps the student to speak in front of the group. S.Sujendran
- 34. Clinical Simulation Simulations are “activities that mimic reality of clinical environment and are designed to demonstrate procedures, decision- making and critical thinking through techniques such as role play and the use of devices such as interactive videos or mannequins ” S.Sujendran
- 35. Types of Clinical Simulations • Low fidelity (reliablity) (Less precise reproduction) • Moderate fidelity (Provide some feedback) • High fidelity (Pharmacological / physical manipulation) S.Sujendran
- 36. Clinical simulation Low fidelity Simulators Moderate fidelity simulators S.Sujendran
- 39. Virtual learning • A book can hardly be described as a learning environment. But, reading a book in a seminar, discussing with other students, writing a summary for the tutor, ... do constitute a learning environment. • Similarly, a set of Web pages does not constitute a virtual learning environment unless there is social interaction about or around the information. S.Sujendran
- 40. Virtual learning • This includes synchronous (e.g. chat, MUDs...) versus asynchronous (e.g. electronic mail, forums,) communications. • one-to-one versus one-to-many or many-to-many, text-based versus audio and video, ... • This includes also indirect communication such as sharing objects. S.Sujendran
- 42. Mastery Learning • In Mastery learning, "the students are helped to master each learning unit before proceeding to a more advanced learning task“ (Bloom 1985) in contrast to "conventional instruction". S.Sujendran
- 43. Principles of mastery learning • The concept of mastery learning can be attributed to the behaviorism principles of operant conditioning. • According to operant conditioning theory, learning occurs when an association is formed between a stimulus and response (Skinner, 1984). • In line with the behavior theory, mastery learning focuses on overt behaviors that can be observed and measured (Baum, 2005). S.Sujendran
- 44. advantages • Higher achievement in all students as compared to more traditional forms of teaching S.Sujendran
- 45. CLINICAL REASONING • Clinical reasoning is “the thought process that guides practice” -(Rogers, 1982). S.Sujendran
- 46. TYPES OF CLINICAL REASONING S.Sujendran
- 47. Guidelines for best method • Identify the barriers • Consider learning style • Plan activities collaboratively • Create learning environment • Effective clinical teaching • Extend evaluation possibilities • Designate • Encourage experts S.Sujendran
- 48. Principles of evaluation – Documented – Valid – Reliable – Objective – Comprehensive – Useful S.Sujendran
- 49. Principles of selecting evaluation methods • Evaluation should be based upon first-hand (Observed) or Objective (written) information • It should match with the clinical skill or knowledge being assessed • Complex skill may require multiple sources of evaluation before promotive / certification • It should consider feasibility in terms of time, money, space, trained observers / raters S.Sujendran
- 50. Conclusion • Learning by doing is the most effective method of teaching. The laboratory of the nursing students is the clinical field. The nursing students get the practical experience and skill doing procedures by taking care of the patients. S.Sujendran
- 51. • The nurse manager manages and controls the practical field of nursing students. The clinical teaching should well organized to provide the needed experience to the students. The nurse manager plays a dual role, she is aware of the practical problems, and she should use each and every opportunity to teach the nursing students. S.Sujendran
- 52. References • “Clinical Teaching Strategies in NURSING”, Kathleen B. Gaberson, Marilyn H.Oermann, 3rd edition, Springer Publishing Company. • “Fast factors for the clinical nursing instructors”, Eden Zabat Kan, Susan Stabler-Hass, Springer Publishing Company, New York. • “Virtual Learning Environments”, Pierre.Dillenbourg, University of Geneva, EUN Conference 2000. • Education for Health, Vol.17, No.2, July 2004,236-39 S.Sujendran