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Becoming a Great Clinical Teacher

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Becoming a Great Clinical Teacher

  1. 1. Becoming a Great Clinical Teacher
  2. 2. Becoming a great CI means we must become great at assessing our students and helping them to progress. While clinical education is not an evaluative process we use the tool of evaluation to help our students progress to entry-level clinicians.
  3. 3. Types of Evaluation  Formative – Feedback given to students during the course of a clinical internship – Primary purposes To provide feedback during practice  To determine how students are changing  To identify additional work needed for mastery 
  4. 4. Types of Evaluation  Summative – Feedback given to students during at the end of a clinical internship – Primary purposes To evaluate overall effectiveness of a clinical course  To determine whether a student is competent in a procedure  To evaluate the final achievement of objectives  To gather data for determining grades 
  5. 5. Types of Evaluation PURPOSE Formative Process Summative Outcome USE Provides learning Grading TIMING During At the end AUDIENCE Internal External FUNCTION Predicts formative Sets standards summative for
  6. 6. Evaluation-When do I begin?  Evaluation should begin as soon as the student starts  It should be ongoing and continuous  It should reflect what the outcome will be – no surprises at the end of the internship
  7. 7. Feedback is key Providing students with formative evaluationFEEDBACK -during the course of the clinical internship is key to achieving the primary purposes.
  8. 8. What is good feedback?  Specific vs. Global – “You need to keep your patients on track during your interview.” vs. “Your interview was terrible.”  Positive vs. Negative – “Your hands are close to correct for that mobilization, but you will have better results if…” vs. “Your hands are not in the correct place.”
  9. 9. What is good feedback?  Useful vs. Directed at something that cannot be changed – “Let’s problem solve how you are going to do that technique because you seem to have difficulty.” vs. “You can’t do that technique because your hands are too small.”  Supportive vs. judgmental – “Well, 2 hours is rather long to do an eval.” vs. “I have never had a student who took 2 hours to do an eval.”
  10. 10. What is good feedback?  Given in private vs. in front of others – This is generally true although having a discussion like that described in the book on page 275 (Thad) might be very effective and appropriate.  Based on first hand information vs. based on hearsay or conjecture – Whenever possible feedback should be based on what you have observed.
  11. 11. What is good feedback?  Fair vs. based on only one incident – Safety is an exception to this. However, in general you should based on several observations.  Honest vs. Obscured by attempts to protect feelings – This person is going to be your colleague, you need to tell them if they are not meeting the competencies.
  12. 12. What is good feedback?  Constructive vs. Given without suggestions for improvement – “When you get Mr. Smith out of bed you should support his right leg.” vs. “You used an inappropriate technique for getting Mr. Smith out of bed.” – Feedback is all about change
  13. 13. What is good feedback?  Current and timely vs. Delayed by several days or weeks – It is tricky to find the time, but you should let your student know how they are doing on a regular basis. – This is especially important with first rotation students and early in any internship.
  14. 14. What is good feedback?  Focused on behavior vs. Focused on personality traits – “When you enter a patients room it is important to smile and greet them.” vs. “ You are too abrupt when you begin your treatments.”  Checked for clarity vs. Improperly understood – Always ask your student to repeat what you said so you will know that they have heard what it is you want them to hear and change.
  15. 15. If your student is not progressing based on the feedback… Contact the school. It is never too soon.
  16. 16. Being a good listener What make someone a good listener?
  17. 17. Active listening  The skill of becoming involved with what the other person is saying.  Ability to attend so closely to what the other person is saying, that his/her response generates your next question.
  18. 18. Active listening, cont.  The ability to wait patiently for a thoughtful response.  Ability to attend to the emotional status of the speaker.  Ability to create an atmosphere in which the other person feels his/her contributions are valuable.
  19. 19. Special Communication Skills
  20. 20. Maintain an environment for open discussion  Consider the physical environment in which you are going to discuss concerns.  Consider your body language and how it may impact the discussion.  Encourage questions and suggestions from the student.  Use cooling off periods if the discussion gets too heated.
  21. 21. Manage defensiveness  Be aware sensitive areas (both your student’s and your own)  Keep limits and non-negotiables in mind – write them down if necessary.  Focus on the behavior and the professional requirements.  Have a third party present, either someone else at your facility or the ACCE.  Practice what you are going to say.
  22. 22. Promote collegiality through disclosure and sharing responsibility  Work together to establish goals and decisions.  Sharing your own struggles or challenges can encourage student sharing.  This doesn’t prevent you from maintaining clear roles. You are the clinical instructor and are responsible to assure they meet the professional competencies.
  23. 23. Guidelines for Summative Evaluation  Assessments observations should be based on definite – If you haven’t observed the student doing something write “not observed”  Assessment should be based on typical and frequent performance – If you have only observed a student doing something once can you be sure they will do the same thing again?
  24. 24. Guidelines for Summative Evaluation  Do not “average” performance – Assessment should be based on what the student is doing today. – We know students start at the novice level and progress to entry-level. If we average their performance they will never meet the entrylevel competency.
  25. 25. Guidelines for Summative Evaluation  Know the tool you will be using to assess your student. – If you are unsure how to use the tool after reading the instructions- ask.  Use explanatory remarks. – ACCEs love to see lots of comments and more importantly students need that type of feedback.
  26. 26. In summary…  Students need feedback to know how they are doing and what they need to change  If the student is not making progress, contact the school ASAP.  Formative evaluation should predict summative evaluation – NO surprises!

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