Purpose of Clinical Laboratory 1. Where theory and practice come together 2. To perfect or master skills 3. To have an opportunity for observation 4. To refine problem-solving, decision-making, and critical thinking skills
Purpose of Clinical Laboratory 5. To gain organization and time management skills 6. To develop cultural competence 7. To become socialized in the clinical laboratory
Misuse of the Clinical Laboratory• Nursing students have been sent to the clinical setting to gain work experience rather than to achieve educational objectives.• When novices are given too much responsibility for patient care.
Models of Clinical Teaching1.Traditional method – Instructors accompany groups (8-12 learners) to a clinical agency and assign them to patients2. Relies heavily on keeping nursing students in a skills laboratory until they are proficient with skills3. More information about clinical practice should be taught in the classroom before learners go
Preceptorship Models1.Traditional Preceptorship A student is taught and supervised by a practicing nurse employed by the health care agency while an educator oversees the process and indirectly supervises the student2. CTA Model Clinical Teaching Associate and educator work hand in hand to
Preceptorship Increase clinical experience for students and expose them more of the realities of the work world, which should reduce reality shock Allows students to learn from practitioners with a high skill level while still being guided by faculty
Preparing for Clinical Instruction• Clinical agency sites must be chosen• Clinical units within the agency must still be identified• There should be enough role models for learners• Contracts must be drawn up
Preparing for Clinical Instruction• Educator should set up a meeting with the agency staff who will be involved with the education process• Making specific arrangements for learners on a weekly or daily basis (for duty or actual patient care)
Preconferences Orientation occurs Instructors brief their students Students ask questions about their assignments Discusses and plans on patient’s care
Practice Session Follows the preconference Combinations of strategies such as return demonstration with explanation, asking and answering questions, and coaching techniques are used Like a checklist
Effective Teaching Techniquesfor Clinical Settings1. Observation Assignments Supported by Social Cognitive Theory Observing nurses as they perform skills they usually cannot perform2. Nursing Rounds Involves a group of learners & their instructor visiting patients to whom they’ll be assigned purpose is to expose learners to additional nursing situations and encourage them to consult each
Effective Teaching Techniquesfor Clinical Settings3. Shift Report Being able to attend endorsements A way for students to learn the uniqueness of nursing communication and is a means of professional socialization4. Technology Use Students must learn how to use varied technological tools required for patient care PDAs, Nightingale Tracker System
Effective Teaching Techniquesfor Clinical Settings5. Learning Contracts A written agreement between instructor and a learner, spelling out the learner’s outcome objectives6. Journal Writing Clinical journals promote active learning and reflective practice and are built on the theory of Constructivism.
PostconferencesIdeal opportunity for: pointing out applications of theory to practice, analyzing the different ways that patients with similar illness differ in their response to nursing care and treatment Group solving Evaluating nursing care Learners to report what they
PostconferencesChallenges: It is often unstructured that allow for creativity but can dissolve into meaninglessness It is usually held at the end of a physically and emotionally draining practice session Few learners seem to believed that they learned everything they could have learned during their practice time Learners thought
Why is Evaluation needed? Learners need to hear the feedback and judgment of their work. They need to know how they are doing at one level before progressing to the next. To determine how well the objectives are met.
Choices to be Made RegardingEvaluationFormative and Summative Evaluation Formative ...is the ongoing feedback given to the learner throughout the learning experience ...helps identify strengths and weaknesses ...prevents learners from being surprised at the end with the judgment of their performance Summative
Choices to be Made RegardingEvaluationNorm-Referenced and Criterion-Referenced Evaluation Norm-referenced ...learner is compared to a reference group of learners, therefore, evaluation and grading are relative to the performance of the group Criterion-referenced ...compares the learner with well- defined performance criteria rather than comparing him/her with other learners
Choices to be Made RegardingEvaluationGrading Systems2 most common options forgrading: Assigning letter grades Pass/Fail or Satisfactory/Unsatisfactory approach
Behaviors to be Evaluated Use of the nursing process Use of health-promoting strategies Psychomotor skills Organization of care Maintaining patient safety Ability to provide rationale for nursing care Ability to individualize care planning and intervention
Behaviors to be Evaluated Therapeutic communication Ability to work with a professional team Professional behaviors Written documentations of care
Sources of Evaluation Data Direct observation Broad questions asked to the patients Learner self-evaluation Agency staff Written work and college laboratory work performed by the learner
Clinical Evaluation Tools 1. The items should derive from the course or unit objectives 2. The items must be measurable in some way 3. The items and instructions for use should be clear to all who must use the tool 4. The tool should be practical in design and length 5. The tool must be valid and