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Becoming a Great Clinical
Teacher
Becoming a great CI means we must
become great at assessing our
students and helping them to
progress.
While clinical education is not an
evaluative process we use the tool of
evaluation to help our students
progress to entry-level clinicians.
Types of Evaluation
 Formative
– Feedback given to students during the course of

a clinical internship
– Primary purposes
To provide feedback during practice
 To determine how students are changing
 To identify additional work needed for mastery

Types of Evaluation
 Summative
– Feedback given to students during at the end of

a clinical internship
– Primary purposes

To evaluate overall effectiveness of a clinical course
 To determine whether a student is competent in a
procedure
 To evaluate the final achievement of objectives
 To gather data for determining grades

Types of Evaluation
PURPOSE

Formative
Process

Summative
Outcome

USE

Provides learning

Grading

TIMING

During

At the end

AUDIENCE

Internal

External

FUNCTION

Predicts

formative

Sets standards
summative
for
Evaluation-When do I begin?
 Evaluation

should begin as soon as the
student starts
 It should be ongoing and continuous
 It should reflect what the outcome will be –
no surprises at the end of the internship
Feedback is key
Providing

students with
formative evaluationFEEDBACK -during
the course of the clinical
internship is key to
achieving the primary
purposes.
What is good feedback?
 Specific

vs. Global

– “You need to keep your patients on track

during your interview.” vs. “Your interview
was terrible.”

 Positive

vs. Negative

– “Your hands are close to correct for that

mobilization, but you will have better results
if…” vs. “Your hands are not in the correct
place.”
What is good feedback?
 Useful

vs. Directed at something that cannot be
changed
– “Let’s problem solve how you are going to do that

technique because you seem to have difficulty.” vs.
“You can’t do that technique because your hands are
too small.”
 Supportive

vs. judgmental

– “Well, 2 hours is rather long to do an eval.” vs. “I have

never had a student who took 2 hours to do an eval.”
What is good feedback?
 Given

in private vs. in front of others

– This is generally true although having a

discussion like that described in the book on
page 275 (Thad) might be very effective and
appropriate.

 Based

on first hand information vs. based
on hearsay or conjecture
– Whenever possible feedback should be based

on what you have observed.
What is good feedback?
 Fair

vs. based on only one incident

– Safety is an exception to this. However, in

general you should based on several
observations.

 Honest

vs. Obscured by attempts to protect
feelings
– This person is going to be your colleague, you

need to tell them if they are not meeting the
competencies.
What is good feedback?
 Constructive

vs. Given without suggestions
for improvement
– “When you get Mr. Smith out of bed you

should support his right leg.” vs. “You used an
inappropriate technique for getting Mr. Smith
out of bed.”
– Feedback is all about change
What is good feedback?
 Current

and timely vs. Delayed by several
days or weeks
– It is tricky to find the time, but you should let

your student know how they are doing on a
regular basis.
– This is especially important with first rotation
students and early in any internship.
What is good feedback?
 Focused

on behavior vs. Focused on
personality traits
– “When you enter a patients room it is important

to smile and greet them.” vs. “ You are too
abrupt when you begin your treatments.”

 Checked

for clarity vs. Improperly
understood
– Always ask your student to repeat what you

said so you will know that they have heard
what it is you want them to hear and change.
If your student is not
progressing based on the
feedback…
Contact the school. It is
never too soon.
Being a good listener

What make someone a good listener?
Active listening
 The

skill of becoming involved with what
the other person is saying.

 Ability

to attend so closely to what the
other person is saying, that his/her response
generates your next question.
Active listening, cont.
 The

ability to wait patiently for a thoughtful
response.

 Ability

to attend to the emotional status of
the speaker.

 Ability

to create an atmosphere in which the
other person feels his/her contributions are
valuable.
Special Communication Skills
Maintain an environment for
open discussion
 Consider

the physical environment in which
you are going to discuss concerns.
 Consider your body language and how it
may impact the discussion.
 Encourage questions and suggestions from
the student.
 Use cooling off periods if the discussion
gets too heated.
Manage defensiveness
 Be

aware sensitive areas (both your
student’s and your own)
 Keep limits and non-negotiables in mind –
write them down if necessary.
 Focus on the behavior and the professional
requirements.
 Have a third party present, either someone
else at your facility or the ACCE.
 Practice what you are going to say.
Promote collegiality through
disclosure and sharing
responsibility
 Work

together to establish goals and
decisions.
 Sharing your own struggles or challenges
can encourage student sharing.
 This doesn’t prevent you from maintaining
clear roles. You are the clinical instructor
and are responsible to assure they meet the
professional competencies.
Guidelines for Summative
Evaluation
 Assessments

observations

should be based on definite

– If you haven’t observed the student doing

something write “not observed”

 Assessment

should be based on typical and
frequent performance
– If you have only observed a student doing

something once can you be sure they will do
the same thing again?
Guidelines for Summative
Evaluation
 Do

not “average” performance

– Assessment should be based on what the

student is doing today.
– We know students start at the novice level and
progress to entry-level. If we average their
performance they will never meet the entrylevel competency.
Guidelines for Summative
Evaluation
 Know

the tool you will be using to assess
your student.
– If you are unsure how to use the tool after

reading the instructions- ask.
 Use

explanatory remarks.

– ACCEs love to see lots of comments and more

importantly students need that type of feedback.
In summary…
 Students

need feedback to know how they
are doing and what they need to change
 If the student is not making progress,
contact the school ASAP.
 Formative evaluation should predict
summative evaluation – NO surprises!

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Becoming a Great Clinical Teacher

  • 1. Becoming a Great Clinical Teacher
  • 2. Becoming a great CI means we must become great at assessing our students and helping them to progress. While clinical education is not an evaluative process we use the tool of evaluation to help our students progress to entry-level clinicians.
  • 3. Types of Evaluation  Formative – Feedback given to students during the course of a clinical internship – Primary purposes To provide feedback during practice  To determine how students are changing  To identify additional work needed for mastery 
  • 4. Types of Evaluation  Summative – Feedback given to students during at the end of a clinical internship – Primary purposes To evaluate overall effectiveness of a clinical course  To determine whether a student is competent in a procedure  To evaluate the final achievement of objectives  To gather data for determining grades 
  • 5. Types of Evaluation PURPOSE Formative Process Summative Outcome USE Provides learning Grading TIMING During At the end AUDIENCE Internal External FUNCTION Predicts formative Sets standards summative for
  • 6. Evaluation-When do I begin?  Evaluation should begin as soon as the student starts  It should be ongoing and continuous  It should reflect what the outcome will be – no surprises at the end of the internship
  • 7. Feedback is key Providing students with formative evaluationFEEDBACK -during the course of the clinical internship is key to achieving the primary purposes.
  • 8. What is good feedback?  Specific vs. Global – “You need to keep your patients on track during your interview.” vs. “Your interview was terrible.”  Positive vs. Negative – “Your hands are close to correct for that mobilization, but you will have better results if…” vs. “Your hands are not in the correct place.”
  • 9. What is good feedback?  Useful vs. Directed at something that cannot be changed – “Let’s problem solve how you are going to do that technique because you seem to have difficulty.” vs. “You can’t do that technique because your hands are too small.”  Supportive vs. judgmental – “Well, 2 hours is rather long to do an eval.” vs. “I have never had a student who took 2 hours to do an eval.”
  • 10. What is good feedback?  Given in private vs. in front of others – This is generally true although having a discussion like that described in the book on page 275 (Thad) might be very effective and appropriate.  Based on first hand information vs. based on hearsay or conjecture – Whenever possible feedback should be based on what you have observed.
  • 11. What is good feedback?  Fair vs. based on only one incident – Safety is an exception to this. However, in general you should based on several observations.  Honest vs. Obscured by attempts to protect feelings – This person is going to be your colleague, you need to tell them if they are not meeting the competencies.
  • 12. What is good feedback?  Constructive vs. Given without suggestions for improvement – “When you get Mr. Smith out of bed you should support his right leg.” vs. “You used an inappropriate technique for getting Mr. Smith out of bed.” – Feedback is all about change
  • 13. What is good feedback?  Current and timely vs. Delayed by several days or weeks – It is tricky to find the time, but you should let your student know how they are doing on a regular basis. – This is especially important with first rotation students and early in any internship.
  • 14. What is good feedback?  Focused on behavior vs. Focused on personality traits – “When you enter a patients room it is important to smile and greet them.” vs. “ You are too abrupt when you begin your treatments.”  Checked for clarity vs. Improperly understood – Always ask your student to repeat what you said so you will know that they have heard what it is you want them to hear and change.
  • 15. If your student is not progressing based on the feedback… Contact the school. It is never too soon.
  • 16. Being a good listener What make someone a good listener?
  • 17. Active listening  The skill of becoming involved with what the other person is saying.  Ability to attend so closely to what the other person is saying, that his/her response generates your next question.
  • 18. Active listening, cont.  The ability to wait patiently for a thoughtful response.  Ability to attend to the emotional status of the speaker.  Ability to create an atmosphere in which the other person feels his/her contributions are valuable.
  • 20. Maintain an environment for open discussion  Consider the physical environment in which you are going to discuss concerns.  Consider your body language and how it may impact the discussion.  Encourage questions and suggestions from the student.  Use cooling off periods if the discussion gets too heated.
  • 21. Manage defensiveness  Be aware sensitive areas (both your student’s and your own)  Keep limits and non-negotiables in mind – write them down if necessary.  Focus on the behavior and the professional requirements.  Have a third party present, either someone else at your facility or the ACCE.  Practice what you are going to say.
  • 22. Promote collegiality through disclosure and sharing responsibility  Work together to establish goals and decisions.  Sharing your own struggles or challenges can encourage student sharing.  This doesn’t prevent you from maintaining clear roles. You are the clinical instructor and are responsible to assure they meet the professional competencies.
  • 23. Guidelines for Summative Evaluation  Assessments observations should be based on definite – If you haven’t observed the student doing something write “not observed”  Assessment should be based on typical and frequent performance – If you have only observed a student doing something once can you be sure they will do the same thing again?
  • 24. Guidelines for Summative Evaluation  Do not “average” performance – Assessment should be based on what the student is doing today. – We know students start at the novice level and progress to entry-level. If we average their performance they will never meet the entrylevel competency.
  • 25. Guidelines for Summative Evaluation  Know the tool you will be using to assess your student. – If you are unsure how to use the tool after reading the instructions- ask.  Use explanatory remarks. – ACCEs love to see lots of comments and more importantly students need that type of feedback.
  • 26. In summary…  Students need feedback to know how they are doing and what they need to change  If the student is not making progress, contact the school ASAP.  Formative evaluation should predict summative evaluation – NO surprises!