2. Philosophical Approaches to
Clinical Instruction
• Role of the Clinical Instructor
• Foundations for Selection of Clinical
Activities
• Clinical Activities and Clinical Reasoning
• Student-Centered Learning
• Faculty Development
3. Philosophical Approaches to
Clinical Instruction
• The purpose of clinical instruction is to
give the student opportunities to bridge
didactic information with the realities of
practice.
• Students blend theoretical knowledge
and experimental learning.
• Clinical learning is directed by a nurse
educator.
4. Philosophical Approaches to
Clinical Instruction
• Clinical instruction in all health professions has
become more challenging because of changes
in the healthcare environment.
• Instructors need to examine their personal
philosophy about teaching.
• The need for clinical judgment requires
content-specific knowledge and an ability to
use the information in clinical practice and
decision-making.
5. Role of the Clinical Instructor
• The goal of the clinical learning
experience is for the instructor to guide
the novice in what constitutes safe
practice and to develop clinical
judgment.
• Planning and selecting clinical learning
activities tends to be instructor driven.
• The teacher guides the students in
applying theory to health care.
6. Role of the Clinical Instructor
• The instructor is expected to be
competent, experienced, knowledgeable,
patient, and energetic.
• The instructor must be aware of didactic
information the students are studying, in
order to provide parallel opportunities
for application.
7. Role of the Clinical Instructor
• Nursing students have indicated that
their most successful clinical experiences
are ones in which the instructor uses
strategies to improve self-confidence,
foster learning of responsibility, and how
to think critically.
8. Role of the Clinical Instructor
• Two Approaches to Clinical Instruction
– Task mastery
– Professional identity mentoring
9. Role of the Clinical Instructor
• Two Approaches to Clinical Instruction
– Task mastery
• Based on the instructor’s decisions about
what behaviors and ways of thinking are
important for nurses.
• Clinical instructors are gatekeepers,
allowing students to enter the profession
once they have demonstrated their
ability.
10. Role of the Clinical Instructor
• Two Approaches to Clinical Instruction
– Professional identity mentoring
• The instructor serves ad a mentor,
guiding students in decision making and
the principles of professional practice.
11. Role of the Clinical Instructor
• A Successful Student Clinical Experience
– Measured in terms of learning outcomes and
an internalized sense of fulfillment.
– Selection of activities and teaching are
value-laden and reflect the instructor’s
philosophical approach to clinical learning.
– Roles in which instructors see themselves
include interaction with students, being a
role model, and functioning as an expert
reference.
12. Role of the Clinical Instructor
• A Successful Student Clinical Experience
– Roles students see as important for clinical
instructors include being knowledgeable
and professionally competent, encouraging
and supportive, being able to provide
helpful feedback, and being respectful of
students.
– An effective clinical instructor is one who
has the knowledge and practice experience
while understanding students’ learning
preferences and educational needs.
13. Foundations for Selection of
Clinical Activities
• Purpose of Clinical Learning Experience
– Apply theoretical concepts
– Experience actual patient situations
– See and implement professional roles
14. Foundations for Selection of
Clinical Activities
• Goals of Student Assignments
– Learn the patient: provide one-to-one
patient care
– Learn the content area: practice a variety of
care activities in one setting
– Learn roles: function as a staff or team
member, as a practitioner, administrator,
etc.
15. Foundations for Selection of
Clinical Activities
• Selected Empowerment Activities
– Analytic nursing: use actual experiences to
define and solve problems
– Change activities: develop planned change
and identify resources to effect this change
– Collegiality: professional interactions to
solve problems and promote optimal care
– Sponsorship: collaboration and interaction
with preceptors, administration
16. Foundation for Selection of
Clinical Activities
• Instructor must make decisions about
which activities enhance learning
outcomes.
• The process reflects the teacher’s values,
beliefs about how learning takes place,
and how teacher role fulfillment will
influence this learning.
17. Foundation for Selection of
Clinical Activities
• There are clear advantages for students
to be engaged in more than one type of
learning experience from one clinical day
or week to the next.
• Students who experienced multiple
clinical placements described themselves
as more adaptable in new environments.
18. Foundations for Selection of
Clinical Activities
• Feedback
– Periodic, timely feedback is necessary.
– Feedback should be evaluative and should
also bolster confidence and independence.
– Students felt the need for personal feedback
from the instructor until they were certain
what the instructor wanted from them.
19. Clinical Activities and Clinical
Reasoning
• Discovery learning is one way in which student
autonomy and problem solving can be
enhanced.
• These discoveries boost self esteem when
students see what they have learned on their
own.
• Discovery learning has been found to increase
student motivation, interest, and retention.
20. Clinical Activities and Clinical
Reasoning
• Another approach to promoting problem-
solving abilities is by placing emphasis on the
clinical, or patient problem, rather than on the
clinical setting.
• In addition to learning how to deal with clinical
problems, students in new or unexpected
settings also experience professional
socialization.
21. Student–Centered Learning
• Reciprocal learning usually takes the
form of peer teaching, or student-to-
student instruction.
• Students feel more individualized,
empathetic instruction and may feel
more relaxed with a peer than with a
faculty teacher.
22. Faculty Development
• Individual teachers need to cultivate an
appropriate self-image as a teacher.
• The clinical instructor should indulge in
periodic self-reflection.
• Self reflection by the instructor brings
about a synthesis of the experience and
an evaluation of successes and failures.
23. Conclusion
• The philosophical approach to teaching is the
foundation by which the instructor
operationalizes his or her own practical
knowledge.
• Much of the instruction that takes place is
related to how the instructor has internalized
professional values and developed a self image
as a practitioner and role model.
