Huda AlrchedDr. Fatamah

Mofida AlbarrakEzdehar Jawaher

1.Introduction 2. Philosophy of clinical teaching 3. Define the term & concept 4. Clinical teaching is different from classroom teaching 5. Element of the philosophy of clinical teaching 6. Outcome in clinical teaching 7. Characteristic of an effective efficiency CI 8. Models of clinical teaching 9. What does the teacher need to be as a good teacher in the

clinical setting?10. Recommendation 11.Selecting a clinical teaching model

Every clinical teacher has a

philosophy of clinical teaching,

whether or not the teacher realizes it .That philosophy determines the

teacher's understanding of her role,

approaches to clinical teaching,

selection of teaching & learning

activities, use of evaluation

processes, & relationships with

learners & others in the clinical environment.

Because to change practice of clinical Because to change practice of clinical teaching, educator first must reflect teaching, educator first must reflect

on their fundamental beliefs about the on their fundamental beliefs about the value of clinical education, the roles & value of clinical education, the roles & relationship of teachers & learners, & relationship of teachers & learners, &

how desired outcomes are best how desired outcomes are best achievedachieved..

11..Clinical Clinical 2.CIin the college 2.CIin the college 3.CI in the hospital3.CI in the hospital

* *Clinical teaching is different from Clinical teaching is different from classroom teachingclassroom teaching

*Because nursing is a professional practice discipline, what nurses & nursing students do in clinical practice is more important than what they can demonstrate in a classroom.

*Clinical learning activities provide real-life experiences & opportunities for transfer of knowledge to practical situations.

*Some learners who perform well in the classroom cannot apply their knowledge successfully in clinical area

11..Clinical education should reflect the Clinical education should reflect the nature of professional practicenature of professional practice

2.Clinical teaching is more important 2.Clinical teaching is more important than classroom teachingthan classroom teaching

33..The nursing student in the clinical The nursing student in the clinical setting is a learning, not a nurse.setting is a learning, not a nurse.

4. Sufficient learning time should be 4. Sufficient learning time should be provided before performance is evaluatedprovided before performance is evaluated

winxp

29/12/1423many nursing students perceive that the main role of the clinical teacher is to evaluate, & many nursing faculty members perceive that they spend more time on evaluation activities than on teaching activities.

nursing faculty seem to expect students to perform skills competently the first time they attempt them, & they often keep detailed records of students' failures & shortcomings that are later consulted when determining their grades

55..Clinical teaching is supported by a Clinical teaching is supported by a climate of mutual trust & respect climate of mutual trust & respect

6. Clinical teaching & learning should 6. Clinical teaching & learning should focus on essential knowledge, skills, focus on essential knowledge, skills,

& attitudes& attitudes

77..The espoused curriculum may not The espoused curriculum may not be the curriculum-in-usebe the curriculum-in-use

8.Quality is more important than 8.Quality is more important than quantityquantity

the products of educational efforts

the characteristics is, * qualities, * attributes that learners * display at the end of an education program

* the enormous expenditure of resources * the enormous expenditure of resources

* on clinical education in nursing, teachers * on clinical education in nursing, teachers must have clear, realistic expectations of must have clear, realistic expectations of the outcomes of clinical learning the outcomes of clinical learning

What knowledge, skills, & values can be What knowledge, skills, & values can be learned only in clinical practice & not in the learned only in clinical practice & not in the

classroomclassroom??

Why we should consider our outcomes

OutcomesOutcomes

Intended outcomes Unintended outcomes

Knowledge Skills

Problem solving

Critical thinking

Decision making

Psychomotor skills

Interpersonal skills

Positive & negative

Organization skills

Attitudes & values

Cultural competence

knowledge

Problem solving Critical thinking Decision making

Clinical learning activities provide rich sources of realistic practice problems to be solved .Some problem are related to patients & their health needs; some arise from the clinical

environment & often required new mothers of resolving & problem solving strategies

knowledge

Problem solving Critical thinking Decision making

Provides direction for how critical thinking is

taught & how this outcome is evaluated.

Although most educators would classify critical

thinking as a knowledge out comes ,

CT characterize it as a composite of attitudes,

knowledge & skills

knowledge

Problem solving Critical thinking Decision making

The decision-making process

involves gathering ,analyzin

g, weighing & valuing information in order to choose the best course of action from among

a number of alternatives .

Skills

Psychomotor skills

Interpersonal skills

Organization skills

Attitudes & values

Cultural competence

Are purposeful, complex, movement oriented activities that involve an event physical response requiring neuromuscular coordination.Requiring neuromuscular coordination.They include the ability for perform proficiently, smoothly. & consistently, under varying conditions & with in appropriate time limits

Skills

Psychomotor skills

Interpersonal skills

Organization skills

Attitudes & values

Cultural competence

Used to assess client needs, to plan

& implement patient care. To

evaluate the outcomes of care, &

to record information

These skills include, communication,

therapeutic use of self, & using the teaching process

Skills

Psychomotor skills

Interpersonal skills

Organization skills

Attitudes & values

Cultural competence

Is important for the nurses to set

priorities manage confiding

expectations, & sequence their work

for perform efficiently .

Skills

Psychomotor skills

Interpersonal skills

Organization skills

Attitudes & values

Cultural competence

Which represent the humanistic &

ethical dimensions of

nursing

Skills

Psychomotor skills

Interpersonal skills

Organization skills

Attitudes & values

Cultural competence

in the ability to provide care that first the

cultural beliefs & practices of

patients .

Unintended outcomes

Positive Negative

Include career choices that students & new

graduates nurses make when they have clinical experience in

various setting

Unintended outcomes

Positive Negative

That when nurses learn body practice

habits from observing other

nurses in the clinical

environment .

Characteristics of an effective & Characteristics of an effective & efficiency CIefficiency CI

22 . .Clinical competenceClinical competence

demonstrate expert clinical skills & judgment.

They know how to function in clinical practice &

can guide students in developing clinical competencies.

**has emerged in some studies as the has emerged in some studies as the most important characteristic of an most important characteristic of an effective teacher, at least from the effective teacher, at least from the

students' point of viewstudents' point of view..

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3. Skill in clinical teaching3. Skill in clinical teaching Skill in clinical teaching includes* the ability of the teacher to assess learning needs, *plan instruction that meets these needs within the context of the goals & outcomes of the clinical experience, *guide learning so students gain essential clinical knowledge & *develop requisite clinical competencies, & evaluate learning fairly.

In the traditional model of clinical teaching, *the clinical instruction & evaluation of a group of students are carried out by an academic faculty member who is on-site during the clinical experience.

*Academic faculty is directly responsible for guiding student learning in the clinical setting.

11..The opportunity to assist students in using The opportunity to assist students in using the concepts & theories learning in class, the concepts & theories learning in class, through readings, & through other learning through readings, & through other learning activities in their patient care. activities in their patient care.

2.The teacher can select clinical activities 2.The teacher can select clinical activities that best meet the students' need & are that best meet the students' need & are consistent with course goals & objectivesconsistent with course goals & objectives . .

3.Since the clinical teacher is involved, to varying degrees, with the nursing curriculum overall, the clinical activities may be more carefully selected to reflect the concepts & theories that students are learning in the course the faculty member, in addition, is a member of the educational system & may be more committed to implementing the philosophy of the nursing program than preceptors.

The large number of students for whom The large number of students for whom faculty may be responsible, not being faculty may be responsible, not being accessible to students when needed accessible to students when needed because of demands of other students because of demands of other students in the group,in the group,

the time commitment for faculty who the time commitment for faculty who may have other teaching may have other teaching

responsibilities & research goalsresponsibilities & research goals..

1. The clinical teaching associate [CTA] model involves a staff nurse who instructs a small group of nursing students in the clinical setting collaboratively with the lead teacher from the nursing program.

2. The CTA assumes clinical teaching responsibilities for the students. The faculty member, as lead teacher, works with the CTA to coordinate the overall clinical practicum, design the clinical experiences, assist in the evaluation of student clinical performance, & serve as a resource in

22..undergraduate clinical teaching & undergraduate clinical teaching & mentor for the CTA.mentor for the CTA.

Similar to the preceptor model, faculty Similar to the preceptor model, faculty may not be on site during the actual may not be on site during the actual

clinical activities. clinical activities.

In return for the CTA's time, the faculty In return for the CTA's time, the faculty may conduct teaching for staff, may may conduct teaching for staff, may provide consultation in the clinical provide consultation in the clinical

setting & may assist with discharge setting & may assist with discharge planning or case managementplanning or case management . .

1.The clinical teaching partnership model varies with the academic institution but is generally a collaborative relationship between a clinical agency & nursing program involving the sharing of an advanced practice nurse & academic faculty member.

2.The advanced practice nurse teacher's students in the clinical setting, often on an individualized basis, with the faculty member serving as course coordinator.

33 . .The faculty member works closely The faculty member works closely with the advanced practice nurse to with the advanced practice nurse to ensure adequate clinical activities for ensure adequate clinical activities for

studentsstudents..

Benefits of this model are Benefits of this model are

1.the opportunity to acquire advanced knowledge 1.the opportunity to acquire advanced knowledge for practice, develop clinical & technological for practice, develop clinical & technological skills, & gain an understanding of the role for skills, & gain an understanding of the role for which the student is preparing by working closely which the student is preparing by working closely with a person in that role. with a person in that role.

For these reasons, this is often the model of For these reasons, this is often the model of choice for graduate clinical educationchoice for graduate clinical education . .

The model benefits students by pairing The model benefits students by pairing them with an expert in clinical them with an expert in clinical practice. practice.

With this model, the advanced practice With this model, the advanced practice nurse collaborates more formally with nurse collaborates more formally with academic faculty in research & academic faculty in research & scholarly activities & also may be scholarly activities & also may be involved in classroom teaching in her involved in classroom teaching in her area of expertisearea of expertise . .

The faculty member responsible for the The faculty member responsible for the clinical course benefits greatly from this clinical course benefits greatly from this close interaction with an expert clinician; close interaction with an expert clinician; through this relationship the faculty through this relationship the faculty member has a direct link to new member has a direct link to new interventions & technologies in practice, interventions & technologies in practice, fosters learning by pairing the student fosters learning by pairing the student with an expert who is in the intended role, with an expert who is in the intended role, & has more time to pursuer scholarly & has more time to pursuer scholarly activitiesactivities..

In the preceptor model of clinical teaching, an expert works with the students on a one-to-one basis in the clinical setting.

Preceptors are staff nurses & other nurses employed by the clinical agency who in addition to their ongoing patient care responsibilities provide on-site clinical

instruction for the assigned students. In addition to one-to-one teaching, the

preceptor guides & supports the learner & serves as a role model

*A registered nurse employed in a *clinical setting who serves as a role model & clinical resource person for* a specific period of time to an individual enrolled in an approved nursing education program

As a role model, the preceptor *demonstrates effective leadership & interpersonal skills, is clinically competent, is skilled in the use of the nursing process, & demonstrates the ability to apply the nursing process in both routine & complex nursing situations.

**Decision making by the preceptor is based Decision making by the preceptor is based on scientific & behavioral principles. on scientific & behavioral principles.

*Clinical expertise also includes patient *Clinical expertise also includes patient teaching, knowledge & use of resources, & teaching, knowledge & use of resources, & expertise in both basic & advancedexpertise in both basic & advanced nursing nursing skillsskills..

As an educator, the preceptor must be

familiar with principles of adult learning.

*Integration of these principles into the educational process help meet the needs of the learner.

*The preceptor, faculty liaison, & student will collaborate to identify the expected outcomes & to design experiences to meet individual learning needs.

As an advisor, the preceptor is a helping role.

*The preceptor provides support by creating an environment to facilitate a sense of psychological safety.

*The student is guided toward self-direction using the strategies of collaborative goal-setting.

*The preceptor facilitates the social & professional transition of the student into the clinical practice setting.

As an evaluator, the preceptor is to provide formal & informal feedback to the learner that is objective & based on achievement of expected outcomes.

*The preceptor participates in the evaluation process, providing feedback which motivates learning by validating that the student is achieving the expected out comes

Or by identifying additional needed Or by identifying additional needed knowledge or skills. knowledge or skills.

*A achievement of goals is reviewed *A achievement of goals is reviewed periodically. Evaluation conferences are periodically. Evaluation conferences are held on a regular basis final evaluations held on a regular basis final evaluations will be completed by the preceptor & will be completed by the preceptor & reviewed by the faculty liaison. reviewed by the faculty liaison.

*The preceptor may make written *The preceptor may make written recommendations for future learning recommendations for future learning experiences. experiences.

We found an examples in We found an examples in the internet of college who the internet of college who implement the preceptors implement the preceptors

modelsmodels

11..Expertise in the selected area, as Expertise in the selected area, as demonstrated by above average demonstrated by above average performance ratings as reported by performance ratings as reported by supervisor supervisor

2. A minimum of two years experience 2. A minimum of two years experience in the clinical setting chosen for the in the clinical setting chosen for the clinical preceptor experienceclinical preceptor experience

33..A commitment to profession A commitment to profession 4. Ability to develop collaborative 4. Ability to develop collaborative relationships with faculty & students relationships with faculty & students 5. A willingness to share project ideas 5. A willingness to share project ideas & assist students In selecting & assist students In selecting experiences experiences 6. A willingness to supervise & assist 6. A willingness to supervise & assist students in meeting course objectives students in meeting course objectives 7. A baccalaureate or master's degree 7. A baccalaureate or master's degree in nursing is preferredin nursing is preferred . .

1.1. Assists the student in developing a Assists the student in developing a plan which meets the student’s plan which meets the student’s personal professional objectives, personal professional objectives, course objectives, & unit project course objectives, & unit project priorities. priorities.

2. Plans with the student for selected 2. Plans with the student for selected clinical experiences which facilitates clinical experiences which facilitates learning & meets specified objectives. learning & meets specified objectives.

33..Assumes responsibility for determining Assumes responsibility for determining which experiences are appropriate for which experiences are appropriate for student involvement student involvement

4. Agrees with student contract4. Agrees with student contract

5. Supervises the patient care provided 5. Supervises the patient care provided by the student & other activities by the student & other activities necessary to accomplish objectivesnecessary to accomplish objectives

66 . .Maintains communication with the student Maintains communication with the student & faculty as agreed& faculty as agreed 7. provides guidance & feedback to the 7. provides guidance & feedback to the student as agreed student as agreed

8. Participates with faculty & the student in 8. Participates with faculty & the student in evaluation of the student’s performance in evaluation of the student’s performance in the clinical settingthe clinical setting

There is no one model that meets the need of every nursing program, clinical course, or group of students. The teacher should select a model considering these factors:

* Educational philosophy of the nursing program* Philosophy of the faculty about clinical teaching;* Goals & intended outcomes of the clinical course & activities; * Level of nursing student; * Type of clinical setting; * Availability of preceptors, expert nurses, & other people in the

practice setting to provide clinical instruction; * Willingness of clinical agency personnel to participate in

teaching students.