Interpersonal Issues in Clinical Nursing EducationLorainne Evanenne B. Rubio, RN
The Instructional Role • The role of the clinical instructor is MULTIFACETED, requiring shifts in the nature of interactions with learners as the instructor recognizes and responds to learners’ needs in the various situations that evolve both in the clinical setting and in encounters outside that setting. • Can be best described as involving a continuum of interactions that begin with a student-teacher relationship in which the learning situation is largely teacher-controlled and move toward a collegial relationship in which learning involves a mutual encounter between two nurses.
3 Principles that guide the evolvinginstructional relationship with students: 1. The instructor must maintain boundaries while fostering trust and communicating caring. 2. The instructor must immerse herself in the instructional role. 3. Continual performance as a role model of professional nursing.
The Clinical instructor as a: Teacher – Provide great deal of structure and focus for students,deliberately guiding their activities. Functions: • As coach, expresses her belief in the capacity of students to succeed and instills in them an expectation of their own success. • As preceptor, involves more watchful listening.
Supervisor • Clinical supervision keeps the instructor aler to each student’s progress in the clinical area, both in executing the assignment and demonstrating competence and skill in performing nursing functions with patients. • Functions: • As safety officer, “walking around” is done to detect student practices that might affect patient safety. • As disciplinarian, she must act in ways that protect the patient and maintain the dignity of the student.
Evaluator• in two important and distinct ways: – Formative evaluation • Requires a lot of openness and interaction between instructor and students as each communicates their observations and experiences in the clinical setting. – Summative evaluation • Process of applying judgements to evaluative data to determine the grade each student will receive in the clinical component of the course.
Nurse • Functions: – As Role model • able to demonstrate aspects of the nursing role that are difficult to articulate to students. – As Future Colleague of students • Should strive to communicate her enthusiasm for nursing and the joyful aspects of this professional career. – As mentor
Communicating Caring • Knowledge and experience are assumed to contribute to learning nursing. • Caring as involving authentic presence and connectedness with the other, characterized by active patterns of helping and enabling. • The essence of caring interaction between faculty and student was recognition (involved attending), connection and affirmation/confirmation. (Hanson and Smith 1994)
3 ingredients contribute to the instructor’ssuccess in communicating caring to students:• Is to be “being in” the instructional role rather than “playing” the role.• Knowing the content (that is, feeling confident and comfortable in th clinical setting)• Instructor needs to value people.
Conveying Enthusiasm• It is the instructors leadership skills that enable her to motivate and inspire students as they engage in learning.• The instructor can communicate her enthusiasm by highlighting the unique possibilities contained in the students assignments.• The instructors sense of passion about nursing- and about teaching nursing to others- encouraged and inspires students to emulate her high standards.
Conveying Enthusiasm• Nursing can be a source of delight and fun, and students should be encouraged to recognize the humor in many of the situations they encounter.• Enjoying the work of nursing and learning contributes to emotional health,uplifts staff and can be a source of comfort and reassurance to patients.
1. Setting Goals – Establish the instructor’s expectations for student performance. – The focus is to address both goals for patient care and goals for student learning. – General goals (related to the objectives for the clinical experience) – Specific goals (develop in relation to past performance or experience)2. Communicating Values – Once value has been incorporated into once practice, it is seldom articulated; the action accord with the value speaks for itself.
3. Motivating Perfomance– Students’ enthusiastic engagement in activities can be promoted by an explanation as to why the activity is important and how it contributes to futur nursing practice.4. Praising– Positive feedback on performance is an important component of formative evaluation contributes to students’ motivation.5. Providing Corrective Feedback– Instructors must focus on the behavior and its effects.
6. Preventing Unsafe Practice– Important factor in alleviating stress and focusing students’ attention on situations that could result in error or jeopardize patient safety.7. Describing Performance deficits– Focus on patterns of behavior rather than on isolated episodes, and its consequences rather than on the students and her adequacies.8. Disciplining a student– Identify the behavior in a matter-of-fact manner.– Cite any prior instances of the same or similar behavior.– Outline the consequences of continued episodes of similar behavior and the rationale for these.