1. Session Two Facilitation of Learning in the Clinical Environment 03/09/2015Facilitation of learning in the clinical environment 1

2. UNIVERSITY Teacher directed What is to be learned is often decided for the student Planned Information presented is logical and ordered Student may be relatively passive Transfer of information largely based on word Learning experience only part of student environment 03/09/2015Facilitation of learning in the clinical environment 2 Teaching and Learning in University and Practice? PRACTICE Student has to find out things for self Decided by student or patient needs Often unplanned Information comes from many sources in a random manner Student actively engaged with experience Information gathered through action, discussion or observation The whole environment is a source of learning

3. Roles in student learning University Lecturer/link lecturer: responsible for university teaching and ensure quality and standards in practice Practice Education Facilitator; Support mentors in the practice and ensure NMC SLAiP standards are met Mentor/|Sign off mentor: Teaching and assessment of student in practice and ensuring competence 03/09/2015Facilitation of learning in the clinical environment 3

4. Why are students sent to your clinical placement? What are the learning opportunities and what preparation is required? How is learning managed? How would you support a student with dyslexia / dyscalculia? How do you evaluate student progress in relation to their learning outcomes? 03/09/2015Facilitation of learning in the clinical environment 4 Group Work

5. The purpose of clinical placement is to allow acquisition of professional skills and attitudes, the theorising of practice, the practising of theory, the formation of professional identity and adoption of the professional culture. “That special part of a professional educational programme in which students gain “hands – on” experience working with clients under the supervision of a qualified practitioner (Alsop & Ryan, 1996, p.4) 03/09/2015Facilitation of learning in the clinical environment 5 The Practice Learning Environment

6. What to expect from the student Come prepared and informed, behave and dress in accordance with the service setting Engage in the placement and take advantage of the learning opportunities it offers Notify you of e.g. any health related problem which might have an effect on their placement with you, sickness absence protocol Take responsibility for their learning, making good use of learning opportunities 03/09/2015Facilitation of learning in the clinical environment 6

7. Students must develop in an environment and culture conducive to learning where: Students are well prepared for practice learning experiences Practice learning settings are well prepared for students A range of feedback systems influence student progression and enhance practice experience Learning resources in practice support evidence based practice 03/09/2015Facilitation of learning in the clinical environment 7 Ensuring a positive learning experience

8. Students learning time in practice is protected Students practice learning opportunities build on previous experience and are adaptable to individual learning needs Students are supported to take increasing responsibility for their learning as they progress and develop. (NMC 2004, p.3) 03/09/2015Facilitation of learning in the clinical environment 8

9. Engage in reflection on their own performance and be open to constructive criticism and apply guidance / feedback Work in accordance with the professional code of conduct Take responsibility.. but acknowledge limits to knowledge and experience so as not to endanger him/herself or other people Aim to achieve a balance in their work and social/personal life Provide you with feedback at the end of their placement experience (Adapted from Alsop and Ryan, 1996, p. 59) 03/09/2015Facilitation of learning in the clinical environment 9

10. Statutory Proficiencies – within an evidence based framework Key Skills Caring, Communication, Technical, Numeric, Documentation ICT and Information management Knowledge, related to nursing assessment, intervention or management of patients/ clients care Teamwork Reflection, decision making, problem solving Leadership, delegation Career management 03/09/2015Facilitation of learning in the clinical environment 10 Identifying Learning Needs and Opportunities “what the students need to achieve”

11. 1. Learning is concerned with individual responses to stimulus - Behavioural 2. Learning is concerned with gaining insight and understanding, making sense of the whole experience and includes feelings and context - Cognitive 03/09/2015Facilitation of learning in the clinical environment 11 Learning Theories- how can you help students to Learn..

12. Know what is required of the student, what have they been taught Know Learning outcomes or what are the required proficiencies Learning in sequential stages, break complex skills down into component parts The importance of immediate feedback & intermittent positive reinforcement ( Praise achievements) Regular evaluation, Discuss strengths, limitations, anxieties and expectations Stresses the importance of repetition – skills should be practised often. Skinner (1953) & Gagne (1983) 03/09/2015Facilitation of learning in the clinical environment 12 Using Behavioural Learning Theories in Practice some practical hints

13. Stresses the importance of “mind pictures”, i.e. observing the expert practitioner, seeing the skilful performance in context. Modelling skilled behaviours Discovery learning very important- the student needs to be active in learning and the learning process is as important as the outcome Problem solving - practice helps with recognition of patterns and relationships. Refers to previous experiences. Understands principles, and becomes more flexible in behaviours. Bruner (1964) & Bandura (1977) 03/09/2015Facilitation of learning in the clinical environment 13 Using Cognitive Learning Theories in Practice some practical hints

14. We all have preferred learning styles… Honey and Mumford (1986) suggest that there are 4 main learning styles: Activist (enjoys the experience itself) Reflector (spends a great deal of time and effort reflecting) Theorist (good at making connections and abstracting ideas from experience) Pragmatist (enjoys the planning stage) 03/09/2015Facilitation of learning in the clinical environment 14 Individual differences in learning

15. Other differences which affect learning… Previous experience, motivation, gender, health or age all may affect what we learn and how we learn but learning should be enjoyable, stimulating and inspirational. “ Learning without thought is labour lost, thought without learning is perilous” Confucius The reflective practitioner is thoughtful.. “ thinking about what you are doing and why turns experiences into meaningful learning to increase professional knowledge and skills to the benefit of patients and yourself” (NIPEC 2004) 03/09/2015Facilitation of learning in the clinical environment 15

16. What is Reflection? “Reflection is a process of reviewing an experience in order to describe, analyse, evaluate and so inform learning about practice” (Reid, 1993 p. 305) Key Stages of the Reflective Process An awareness of interesting, uncomfortable or thought provoking situations Critical analysis including attending to facts and feelings Development of a new perspective on the situation 03/09/2015Facilitation of learning in the clinical environment 16 Reflection

17. Plan time with student to discuss areas of practice or specific situations or events Have in mind a simple framework for reflection Ask critical questions related to above Encourage students to demonstrate reflection in their portfolio 03/09/2015Facilitation of learning in the clinical environment 17 Promoting Reflective Practice

18. Will be known to School and University Come under the Disability Discrimination Act and hence “reasonable adjustment” has to be made Have to self-disclose to mentor(s) Link Lecturer will complete short report at end of placement. Assessed as thoroughly as any other student Dyslexia, dyscalculia, epilepsy, ME, MS, Ulcerative colitis, mental health issues etc etc 03/09/2015Facilitation of learning in the clinical environment 18 Students with a Disability

19. Fitness for Practice 03/09/2015Facilitation of learning in the clinical environment 19 Knowledge Performance Professionalism Fitness for Practice is dependent on students being able to demonstrate the integration of theory and practice within the context of professional behaviour.