1. Return-Demonstration
TEACHING STRATEGY
Demonstration and
Return-Demonstration
Karen Micale, RN, BSN, NCSN

2. DEFINITION Demonstration Return-Demonstration
shows the learner how to perform a skill by the teacher (Bastable, 2008)
Return-Demonstration
Carried out by the learner to perform a task with cues from the teacher (Bastable, 2008)

3. Why demonstration?
“A demonstration provides a concrete, realistic learning experience. It has the advantage of using visual as well as oral perceptions. Other senses may be used such as smell or touch. The emphasis is on what to do, rather than on what not to do.” (Cooper, S., 1982)
“Ensures that learning and comprehension have occurred. This method can increase the opportunity for the learner to understand and apply the skill that is taught. Verbalizing what they are doing, in their own words, will also increase the likelihood of patients’ retention.” (Burkhart, J.A., 2008)

4. DESCRIPTION Models- Replicas: constructed to scale:
models of the heart, kidney, DNA helix, resuscitation dolls, breast models
Analogues: has the same properties and performs like the real object:
Dialysis machines, computer model of the brain
Symbols: used in teaching situations:
Traffic signals, words, mathematical signs, stick figures, international signs. (Bastable, 2008)

5. Domains of Learning Primarily effective in teaching psychomotor skills
Examples: teaching self-injections, breast self-exams, testicular exams using anatomical models
May enhance cognitive and affective learning
Examples: assisting developing interactive skills for crisis intervention, grief counseling, interviewing, history taking (Bastable, 2008).

6. Cognitive Learning Theory by Robert Gagne
Reception-gain learner’s attention
Expectancy-inform learner of objectives
Retrieval-stimulate learner’s recall of prior learning
Selective- perception
Semantic encoding-facilitate learner’s understanding
Responding-learner demonstrates the new skill or information
Reinforcement-give feedback to the learner
Retrieval-assess the learner’s performance
Generalization-enhance retention and transfer through application and varied practice.
(Bastable, 2008, p )

7. Uses of Demonstration and Return Demonstration
CPR
Insulin self-injections
Dressing changes
Self-catheterization
Glucose monitoring
Testicular/Breast exams on models
Preparing medications
How to use an asthma inhaler
Tube Feedings
Colostomy irrigation
Epi-pen self-injections
Monitoring blood pressures
Taking patient histories
Crisis intervention skills

8. Appropriate Settings Inpatient Outpatient, clinics, doctor’s offices
Community centers, Senior centers, Wellness centers
Classroom and other academic settings
One-on-one
Nursing schools, medical schools

9. Advantages Especially effective for learning in the psychomotor domain
Actively engages the learner through stimulation of visual, auditory, and tactile senses
Repetition of movement and constant reinforcement increases confidence, competence, and skill retention
Provides opportunity for over-learning to achieve the goal (Bastable, 2008).
Increased ability to control the environment and simulate clinical practice (Billings, D.M.& Halstead, J.A., p. 309, 2009)
Effective teaching method for low literacy, can increasing health literacy

10. Disadvantages Requires plenty of time for teaching as well as learning
Audience size must be kept small to ensure opportunity for practice and close supervision
Equipment can be expensive to purchase and replace
Extra space and equipment is needed for practicing certain skills
Competency evaluation requires 1:1 teacher-student ratio (Bastable, 2008)

11. Methods of Adaptation Encourage students to learn at their own rate
Adjust teaching time to meet individual needs
Accommodate a variety of learning modes: visual, auditory, kinesthetic, tactile
Address any cultural needs
Be aware of any learning disabilities
Provide more time for elderly patients to practice

12. Evaluation Evaluation of learning and retention is a complex task.
Learning is defined as a change in cognitive, psychomotor and/or affective behavior.”
Activities used for teaching are only effective to the extent that they result in a change in one or more of the 3 learning domains (Dougal, J., Gonterman, R., 1999)

13. Methods of Evaluation Formative:
Can my teaching be improved to enhance learning?
Am I giving the learner enough time to practice?
Is the demonstration material appropriate for the learning objectives
Do I need more opportunities for return demonstration?

14. Methods of Evaluation Summative: Was the overall goal accomplished?
Were the behavioral objectives met?
Was the level of competency increased?
Was the skill learned-is the patient able to perform return-demonstration with 100% accuracy?
Likert scales, questionnaires, pre-test and post-test comparisons, Return demonstration checklists (performs independently, performs with minimum verbal clues, unable to perform)

15. References
Bastable, S.B. (2008). Nurse as educator: Principles of teaching and learning. 3rd Ed. Boston: Jones & Bartlett.
Burkhart, J.A. (2008). Training nurses to be teachers. The
Journal of Continuing Education in Nursing. 39,
Billings, D., & Halstead, J. (2009), Teaching in nursing; A guide for
faculty. St. Louis: Saunders Elsevier.
Cooper, S. (1982) Methods of teaching-revisited the demonstration. The Journal of Continuing Education in Nursing, 3, p
Dougal, J., Gonterman, R. (1999) A comparison of three teaching methods on learning and retention. Journal for Nurses in Staff Development, vol. 15, 5,