Presentation on theme: "Creating a Learning Environment in Clinical Education Partners in Teaching January 8, 2004 Pat Ceri RN, MN."— Presentation transcript:
Creating a Learning Environment in Clinical Education Partners in Teaching January 8, 2004 Pat Ceri RN, MN
What is Learning Environment The conditions, forces and external stimuli which affect the individual; a network of forces and factors which surround and affect one (Bloom, 1965) Basic ideas and principle of teaching and learning in a clinical area Context of nursing care –Unit staff & culture –Clinical instructor
Cahn, D. (2002) J. of Nsg Educ. 41:2:69-75. Aspects of Environment Affecting Student Learning Quality of student preparation Characteristics of instructor Characteristics of unit/unit staff Peer support Past clinical experiences
Gaberson, K. & Oermann, M. (1999). ClinicalTeaching Strategies in Nursing. NY: Springer. Clinical Education Critical thinking development Problem-solving abilities Specialized psychomotor & technological skills Professional value system
Chan, D. J. of Nsg Ed. (2002) 41:2:69-75 Expectations of Clinical Placements Application of knowledge Development of skills Development of attitudes & values inherent in the profession of nursing
Paton, B. (2003)Unready-to- hand as Adventure: Knowing within the Practice Wisdom of Clinical Nurse Educators. Clinical Practice Opportunity to learn how to learn in a continually changing and complex organization Handle ambiguity, complexity, uncertainty, conflict and instability, to think like professionals, develop personal responsibility and accountability, problem-solve, and make decisions
Chan, D. (2002). J. of Nsg Ed. (2002) 41:5:69-75 Expectations of Clinical Teachers Monitor students’ needs Monitor clients’ needs Monitor clinicians’ needs Respond to unplanned activities Practical teaching Assessing students Supporting students Facilitating students’ learning
Gillespie, M. J. of Adv. Nsg. (2002) 37:6:566-576 Expectations of Clinical Teachers Coach & Guide Assisting students to plan care Assisting students to deliver care Developing relevant nursing skills Assessing student understanding of patient status
Characteristics of Good Clinical Teachers Interpersonal aspects: –Role modeling –Relationship: rapport, genuineness, respect –Enjoys nursing and teaching Competence: –Theoretical and clinical –Attitude to profession Teaching ability: –Knowledge of philosophy of school & curriculum –Evaluation practices
Scanlan, J.M. Nsg & Health Care Perspectives, (2001), 22:5:240 How do we become clinical teachers?
The Student Experience Anxiety Vulnerability Change in role from classroom thinker to “real-world” doer Competing demands
Paton, B. (2003). Unready-to hand as Adventure.... The Experience of Clinical Practice Envisaging oneself as a nurse Coping with technology Negotiating with physicians Facing suffering and death Learning skills of involvement Learning to cope with ones feeling of inadequacy
Betz, C. J. of Nsg Educ. (1985) 24:301-302 in Chan, 2001 Supportive Aspects of Clinical Experience Strengthen students’ independent professional growth and encourage peer- level interactions with other health care professionals Autonomy & recognition Role clarity Job satisfaction Quality of supervision Peer support Opportunity for learning
Saarikoski, M. & Leino-Kilpi, H. (2002) Int. J. of Nsg Studies. 29:3:259-267 “Good” Clinical Learning Environments Non-hierarchical structure Teamwork Good communication Positive atmosphere Good team spirit Working together Motivated staff Supportive of students High quality nursing care
Crawford, MW & Kiger, AM (1998) JAN 27:1:157-164 Phases of Adaptation to Clinical: Adaptation Description –New area, anticipated characteristics of pt/needs –Reputation of unit –Physical orientation –Getting to know the staff –Insecurity, lack of knowledge, anxiety Strategies: –reading ward objectives, observing, practising new procedures, seeking role models, questioning, seeking reassurance Barriers: excess anxiety, insufficient support, unrealistic expectation.
Crawford, MW & Kiger AM (1998) JAN 27:1:157-164 Phases of Adaptation to clinical: Stabilization Strategies –Beginning awareness of gaps in knowledge More probing questions –Increased discrimination of performance against standards Able to cope with most situations –Helping others –Aware of increasing knowledge
Crawford, MW & Kiger AM (1998) JAN 27:1:157-164 Phases of Adaptation to Clinical: Consolidation Strategies –Expertise the goal, managing complexity –Minimal supervision –Application of theory to practice –Evaluation against standards Barriers: –Perception of not meeting expectations
Strategies The teacher The unit/clinical area The student The faculty
An experienced instructor says: I try to eliminate as many of the stressors for the students as possible through making feedback & expectations clear, applying the rules equally, gradual immersion of the student into the clinical workload, a welcoming greeting from the unit manager,
dealing with concerns promptly, negative feedback given in a confidential manner & location, not correcting a student in front of a patient.
I ensure that I have credibility with the unit manager and clinical staff and health team members through current knowledge regarding the area, sharing my resources with staff, familiarity with the equipment in use and the policies and procedures on the unit.