Effective Clinical Teaching Methods

EFFECTIVE
CLINICAL TEACHING
METHODS
Dr. Esther John ,M.Sc (N), PhD
Principal,
Ganga College of Nursing ,
Coimbatore.

GANGA INSTITUTE OF HEALTH SCIENCES,
VATTAMALAI PALYAM ,
NGGO COLONY POST
COIMBATORE

INTRODUCTION
Nursing …..
• Knowledge based professional discipline.
Practice based professional discipline
• Skill based professional discipline

There is a deep gap between theory and practice

“ANY WEAPON IS A GOOD WEAPON AS
LONG AS YOU CAN USE IT WITH SKILL.”
SKILL ACQUISITION
Knowledge is gained by learning; trust by doubt; skill
by practice; and love by love.

• INFORMATIVE
• INSPIRATIONAL
• INTEGRATED
• EMPOWERMENT
TYPES OF LEARNING

TEACHER WILL BE
FACILITATOR AND CRITICAL
REFLECTIVE ENCHANCER
STUDENT WILL BE MEANING
MAKER AND KNOWLEDGE
CONSTRUCTOR

IDEAL LEARNING ENVIRONMENT
SAFE
ENVIRONMENT
LOW STRESS

FUN LEARNING
MOTIVATING
ENVIRONMENT

ALLOWS
PRACTICE
ACCESSIBLE
CONDUCIVE HEALTHY
LEARNING

BE
FAIR
BE
CONSISTENT
BE
UNDERSTANDING
SUSTAINING SAFE LEARNING
ENVIRONMENT

• RESPECT STUDENT’S TIME
• BE COGNIZANT OF STUDENT’S
OTHER RESPONSIBILITY
• MAKE RELAVANT DISCUSSION
• BALANCE PATIENT CARE WITH
TAKING THE TIME
TO TRAIN STUDENTS
ENVIRONMENT

• CLEARLY ARTICULATE
EXPECTATIONS
• ENCOURAGE STUDENTS
TO TAKE RISKS
• ENCOURAGE TEAM
WORK
• ENCOURAGE
QUESTIONS
ENVIRONMENT
ASK QUESTIONS

MATCH THE EDUCATIONAL GOALS TO THE
SETTING OF THE LEARNERS
EDUCATIONAL GOALS
SETTING OF THE LEARNERS

Clinical Teaching is a individualized or group teaching
to the nursing students in the clinical area by the
Nurses Educators , Staff Nurse and Clinical Nurse
Managers .

In preparation of
professional practice, the
clinical setting is the place
where the students come
in contact with patients or
consumers for the purpose
of testing theories and
learning skills.
CUFF SHOULD NOT
BE TOO TIGHT OR
LOOSE

CLASS ROOM TEACHING VS CLINICAL
TEACHING
CLASS ROOM TEACHING
• Large group
• No focus on patient
• Knowledge
• Theoretical framework
• Teacher/students ratio
is large
• Passive students
• Less interactive
CLINICAL TEACHING
• Small group
• Focus on patient
• Application of
knowledge
• Clinical reasoning
• Teacher/students ratio is
small
• Active students
• More interactive

• Time labelled curriculum
• Ward rounds
• Crowded curriculum.
• Junior nurse – Senior Nurse: endless menial
task
• Self directed learning.
TRADITIONAL METHODS

WHY CLINICAL EXPERIENCE?
• Teaching in clinical setting is
a challenge that is different
from those encountered in
the class room
• Like any other skill based
profession, nursing also
requires the development of
relationship between theory
and practice.
THEORY
PRACTICE

PRINCIPLES OF CLINICAL TEACHING
• Teaching is not equal to
learning.
• Adults learn differently
• Clinical education
should reflect the nature
of professional practice

Cont . . .
• Clinical teaching is supported by a climate of
mutual Trust & respect
• Clinical teaching & learning should focus on
essential knowledge, skill & attitude
PRINCIPLES OF CLINICAL TEACHING

• INDEPENDENT
• SELF DIRECTED
• EXPERIENCE- A RICH SOURCE
OF LEARNING
• PROBLEM CENTRED
APPROACH
• MOTIVATED TO LEARN –
INTERNAL DRIVES FOR
MOTIVATION MATRIX

PURPOSES:
 To provide individualized care in a
systematic ,holistic approach
 To develop high technical competent skills
 To practice various procedures
 To collect and analyze the data
PURPOSES OF CLINICAL TEACHING

 To conduct research
 To maintain high standard of nursing practice to
become independent enough to practice nursing
 To develop ,cognitive ,affective and psychomotor
skills

 To improve the standards of nursing practice
 To learn various diagnostic procedures
 To learn various skill in giving health education
techniques to the client and significant others.

• To help in integration of theoretical knowledge into
practice
• To develop communication skills and maintain
interpersonal relationship
• To develop proficiency and efficiency in carrying out
various nursing procedures
• To learn managerial skills

The instruction
and valuation of
student is done
by the academic
faculty member
who is in the
clinical setting.
TRADITIONAL MODEL

An experienced and
expert nurse in the
clinic, work with the
student on a one-to-
one basis in addition
to the ongoing patient
care responsibility.
PRECEPTOR MODEL

Partnership Model
Here a staff nurse instructs a small group of
students in the clinical setting
collaboratively with the lead teacher
ASSOCIATE MODEL

CLINICAL
KNOWLEDGE
CLINICAL
SKILL
PRACTICAL
PROCEDURES
CLINICAL
REASONING
OUTCOMES OF CLINICAL TEACHING

OUTCOMES OF CLINICAL TEACHING
DATA INTERPRETATION
AND RETRIEVAL
COMMUNICATION
PATIENT
INVESTIGATIONS

PROBLEM SOLVING
KNOWLEDGE
CRITICAL THINKING
DECISION MAKING

2. Skills SKILLS
PSYCHOMOTOR SKILLS
ORGANIZATIONAL SKILLS

WHAT IS THE DIFFERENCE BETWEEN YOUR
DOSAI AND AMMA SUTTA DOSAI?

CHALLENGES IN CLINICAL TEACHING

• LIMITED CONTROL OVER
TIME
• UNPREDICTABLE CASE LOAD
• EMERGENCIES
• CLIENT DEMANDS
• DEPENDENCE ON OTHERS

• NO TIME FOR ELABORATE TEACHING
• TEACHER CANNOT FOCUS ON ONE
PROBLEM TO TEACH
• TEACHER SHOULD BE A GUIDE OR
FACILITATOR THAN INFORMATION
PROVIDER
• DIFFICULTY IN TAKING LEARNING AND
SERVICE SIMULTANEOUSLY

•Difficult to set teaching goals , unanticipated events
occur frequently
•Patient too sick or unwilling to participate in teaching
encounter
•Teachers feel insecure about admitting errors in front of
patient
•Engaging all learners simultaneously can be difficult

STEPS IN CLINICAL TEACHING
FORMULATING
OBJECTIVES
DETERMINING
KNOWLEDGE
PLANNING
CONTENT
ORGANIZINGIMPLEMENTINGEVALUATING

Ethical and legal
issues in clinical
teaching

• Patient’s Privacy rights.
• Competent teaching
• Academic dishonesty

LEGAL ISSUES
• Students with disabilities
• Patient safety
• Breach of duty
• Injury
• Negligence
• Liability
• Unsafe clinical practice
• Documentation and record keeping

STRENGTHS OF CLINICAL EDUCATION
• Problem centered approach
in the context of professional
practice
• An experience-based learning
model and
• A combination of individual
and team learning

FACTORS INFLUENCING CLINICAL
TEACHING

TEACHING
•Group interaction skills
•Clinical supervision skill
•Clinical competence and professionalism

TEACHING
•Knowledge and analytical ability.
•Organization and clarity of presentation
•Enthusiasm and stimulation of interest

PITFALLS IN CLINICAL TEACHING
• Revert to comfort zone
• Information does not fits
learners need
• Inappropriate techniques
• Blaming the system
• Doing attender's job

SELECTION OF CLINICAL
TEACHING METHODS
• Appropriate to objectives and
desired behavioural changes
• Based on Principles of learning
• According to the capacity of the
student
• Availability of resources

PROCESS
RECORDING
BEDSIDE
CLINIC
CASE METHOD
LABORATORY
METHOD
NURSING
CONFERENCES
NURSING
ROUNDS
TYPES OF CLINICAL TEACHING METHODS

GROUP AND INDIVIDUAL CONFERENCE
DEMONSTRATION
NURSING ASSIGNMENT
MORNING AND EVENING ROUNDS
ROLE PLAY
FIELD TRIP

LOGBOOK AND
PORTFOLIO
NURSING RECORD
WRITING
SHADOWING A
JUNIOR NURSE

Process recording is a written account
or verbatim recording of all that transpired
during and immediately following the
nurse-patient interaction.

FEATURES
Written during or immediately following
the interaction
Can be used for Educational and Teaching,
purpose.
 Can be used as Therapeutic tool .

PURPOSES
Improve the quality of nurse-patient
interaction.
Assist the student nurse to plan, structure &
evaluate the interaction.
Gain competency in interpreting and
synthesizing raw data under supervision.

PURPOSES
To identify thoughts and feelings in
relation to self and others
To increase observational skills
Ability to identify the problem and
gain problem solving skills.

PRE-REQUISITE FOR PROCESS
RECORDING
Physical setting: Calm and
quiet environment
Obtaining consent
Maintaining confidentiality

• Bedside clinic - To study problems
associated with a particular disease or
disorder.
• Always ensure the presence of the patient.
• Either the group visits the patient or the
patient is brought to the conference room.
BEDSIDE CLINIC

• Patients with typical diseases are selected.
• Brief history and therapy, nursing problems
are presented along with the nursing care
including physical, mental and social
components will be included.
BEDSIDE CLINIC

• Nursing clinic conducted by Head Nurse/Clinical Instructor.
• Before the client enters, the head nurse points out the
group the observations to be made. This is usually followed
by a discussion and questions and answers round.
• Summarization done at the end.
• Duration: 30 min
• Evaluation: Head Nurse and Group members
BEDSIDE CLINIC

The student is getting an opportunity to
• Direct observation
• Analyze &
• Make decisions in nursing care.
BEDSIDE CLINIC -ADVANTAGES

Bedside Clinic and Nursing Care Conference
can be used to evaluate the students
Similar to bedside clinic but in the absence of
the patient.
Method of choice when the entire group is
acquainted with the patient.
Planning to be done earlier.
Conducted by the Clinical Instructor.
NURSING CARE CONFERENCES

 Involves student’s learning experiences.
 Patient history and medical aspects of his/her care are
included as a background for understanding the
nursing care.
 The registered nurse responsible for the patient should
answer questions aroused in the group & encourage
active discussion.
NURSING ROUNDS

Share the clinical expertise.
Suggestions are made by the members of the
group.
Avoid telling them everything from the book
Suggestions discussed in the rounds will be
recorded.
NURSING ROUNDS

NURSING ROUNDS - TYPES
INFORMATION
GIVING ROUNDS
INSTRUCTIONAL
ROUNDS
PROBLEM SOLVING
ROUNDS

NURSING ROUNDS - ADVANTAGES
INCREASING
• LEARNING
ABILITY
INCREASING
• INTEREST –
SHARE
KNOWLEDGE
SELECTING
• CLIENT WITH
SPECIFIC
PROBLEM
&PLAN CARE

DEMONSTRATION
• Demonstration teaches by “Exhibition &
explanation ”
• It trains the students in the art of careful
observation

• Planned Involves preliminary
preparation, introductory conference,
performing the procedure and follow
up.
• Unplanned When uncommon
treatment occurs in the ward, this can
be demonstrated to the students if it
is not emergency.
DEMONSTRATION - TYPES

DEMONSTRATION - ADVANTAGES
ACTIVATES
SENSES
OPPORTUNITY
FOR
OBSERVATION &
LEARNING
CREATES
INTEREST BY
USE OF
ILLUSTRATION
CORRELATES
THEORY &
PRACTICE

CASE METHOD - DEFINITION
METHOD WHICH FOCUSES ON INFORMATION AND FACTS
ABOUT PATIENT, HIS DISEASE CONDITION, AND HIS SOCIAL
AND PERSONAL HISTORY AND THE APPLICATION OF THIS
KNOWLEDGE IN RENDERING NURSING CARE.

CASE METHOD - TYPES
TYPES
CARE STUDY
CASE
ANALYSIS
CASE
INCIDENT
TECHNIQUE

• Student selects one patient for intensive study.
• Student decides nursing measures to solve
problems.
• Student to be given opportunity to take care of
patient, to gain his/her confidence, to learn the
real nature of his/her problems, and to evaluate
her nursing measures.
NURSING CARE STUDY

• Concentrated effort of students to solve problems
arouses interest in patients & result in better
nursing care.
• The students learn to recognize the effect of
personal and social factors on illness and recovery,
to organize the information and identify the
problems
NURSING CARE STUDY -
ADVANTAGES

• Students learn problem-solving approach.
• Report acts as reference material for students.
• Report to be evaluated in terms of content,
organization, clarity of thought and interest.
• The oral presentation helps the student to
speak in front of the group.
NURSING CARE STUDY -
ADVANTAGES

• An analysis of a case or a condition is done by nursing
students.
• Comprehensive information presented to the students
to aid them make judgment of a problem or situation.
• No background information is given students.
• The instructor will have facts about case; can be given as
requested by the students.
CASE ANALYSIS

This technique requires immediate
decision and action from a case and
presented to the students for their
analysis and decision
CASE INCIDENT TECHNIQUE

CASE INCIDENT TECHNIQUE -
ADVANTAGES
INDIVIDUAL
DIFFERENCES
FOR
STUDENTS
OPPORTUNITY
FOR SELF-
EXPRESSION
OPPORTUNITY
FOR SELF-
EXPRESSION
SCIENTIFIC
PAPER
WRITING
CORRECT
ERRORS OF
INFORMATION
DIRECT STUDENT
THINKING

• BETTER PERSONAL UNDERSTANDING
• TIME SAVING
• OPPORTUNITY FOR PUBLIC SPEAKING EXPERIENCE
• SOURCE OF MOTIVATION
• FEELS ACHIEVED BY PRESENTING HER STUDY TO
OTHERS
ADVANTAGES

SELF DISCIPLINED
GOAL ORIENTED
MOTIVATED PERSISTENT
INDEPENDENT
SELF
CONFIDENT
ADVANTAGES

• No opportunity for new ideas
• Requires more time
• No opportunity for writing and for other
creative expressions
• Leaves no record for future reference
DISADVANTAGES

“Nursing Conference is defined as the
process in which group discussion is
made using problem solving techniques
to determine the ways of providing
care for the patients to whom students
are assigned as part of their clinical
experience”.
NURSING CONFERENCE - DEFINITION

GROUP CONFERENCE
NURSING CONFERENCE - TYPES
INDIVIDUAL CONFERENCE

GROUP CONFERENCE
• Is a small group teaching method
• The students are allowed to participate
actively in the discussion, explaining their
own experiences in the clinical area
• This helps the students to develop problem
solving skills, team building skills and the
ability to express themselves assertively
GROUP CONFERENCE

• Focuses on the overall development of the
individual student.
• The focus is more directed towards the
development of clinical skills.
• It mainly deals with the student nursing care
ability, level of performance achievements and
assignments related to the clinical experiences.
INDIVIDUAL CONFERENCE

• To focus on the overall development of the
individual student with a special emphasis
to the clinical skills.
• To help in communicating ideas and
viewpoints of students regarding problems
pertaining to their clinical posting.
NURSING CONFERENCE - PURPOSES

• To provide opportunity to the students to
refine their clinical skills.
• To encourage innovative and creative ideas
among students.
• To recognize the ability and limitation of
various team members.
NURSING CONFERENCE - PURPOSES

OPENING
WORKING
CLOSING
NURSING CONFERENCE - PHASES

OPENING PHASE
• The students are informed prior so
that discussion is meaningful
• Patients selected should have typical
signs and symptoms

WORKING PHASE
• Focus is made on patient information such as bio data,
family background, past and present medical history, signs
and symptoms, line of care and nursing management.
• The teacher motivates the students to come forward with
innovative and creative ideas suiting the problem or
situation.

CLOSING PHASE
Suggestions derived from various group
conferences, relevant to the ward
situation is put into the notice of the staff
working in the same area in a friendly
manner.

• Develop problem solving skills
• Develops team building skills
• Ability to express oneself assertively
• Makes clinical area more interesting place for
teaching and learning.
• Provides opportunities for the students to express
innovative ideas and to refine clinical skills
NURSING CONFERENCE - ADVANTAGES

•Sharpens the critical thinking
•Helps the students to know about their
progress and hence boosts their self confidence.
•Boosts the sense of security
•Helps the teacher to identify the students
attitude and insight regarding the problems of
their clients.

•May not be very beneficial if the students are not
accustomed to the clinical setting
•It requires a careful planning
•It is a time consuming process
•It portrays the personal problems of the patient
which should be maintained confidential
•Patient involvement is less in this method of
teaching and learning

Laboratory method is planned
learning activity dealing with
original data in the solution of a
problem
LABORATORY METHOD - DEFINITION

• To provide experiences with actual situation such as
nursing laboratory and hospital ward
• To make students to become skillful in manipulation
apparatus , practicing laboratory technique
• To help the student to acquire scientific attitude and
scientific approach to problem solving
• To provide first hand experiences with materials.
LABORATORY METHOD - PURPOSES

PREPARATION
WORK PERIOD
EVALUATION
LABORATORY METHOD - TECHNIQUE

BUDGET
POOR
PLANNING
TIME
CONSUMING
LACK OF APPARATUS
LACK OF DIRECTION
LABORATORY METHOD - LIMITATIONS

NURSING ASSIGNMENT
• NURSING ASSIGNMENT

It is the part of learning experiences
where the students are assigned with
patient or other activities concerning
to patient in clinical laboratory .
NURSING ASSIGNMENT

FUNCTIONAL
CASE
METHOD
TEAM
METHOD
PRIMARY
CARE
NURSING ASSIGNMENT - METHODS

• Students are to be informed of the objectives of their
assignment
• Students are to be oriented to the clinical area.
• Select the area based on the learning experiences of the
student needed
• Proper guidance and supervision
• Provide sufficient time for giving care to the patient
• Evaluate the students performances and give corrections
NURSING ASSIGNMENT - CRITERIA

ROLE PLAYING IS A DISCUSSION TECHNIQUE
THAT MAKES POSSIBLE TO GET MAXIMUM
PARTICIPATION OF A GROUP THROUGH ACTING
OUT AN EXAMPLE OF SOME PROBLEM OR IDEA
UNDER DISCUSSION
ROLE PLAY

ROLE PLAY - PURPOSES
• TO PROVIDE REAL LIFE SITUATIONS FOR
FIRST HAND INFORMATION
• TO SUPPLEMENT CLASS ROOM
INSTRUCTIONS

DEFINE THE PROBLEM IDENTIFY THE CHARACTER
CONDUCT DISCUSSION
PARTICIPANT PLACEMENT
LENGTH DEPENDS UPON
THE TOPICS
CONDUCT SHORT CONFERENCES
ROLE PLAY

A report summarizes the services
of the nurse and or the agency.
Reports may be in the form of an
analysis of aspects of a services
MORNING AND EVENING REPORTS

REPORTS - TYPES
ORAL REPORT
WRITTEN REPORT

• Report between head nurse and her assistant
• Report between nurse who assigned to
bedside care
• Report to the clinical instructor
• Report of charge nurses to the physician
• Day , evening and night reports
FORMS OF REPORTS

• Clear , concise , complete
• clearly stated and well organized for easy
understanding
• Good oral report are expressed and
presented in an interesting manner and
important points are emphasized
CRITERIA FOR GOOD REPORT

• IF IT IS WELL WRITTEN ALL PERTINENT
IDENTIFYING DATA, TIME PEOPLE
CONCERNED, THE SITUATION, SIGNATURE OF
THE PERSON MAKING THE REPORT ARE
INCLUDED
CRITERIA FOR GOOD REPORT

• The field trip must be planned to meet
specific educational objectives rather than
merely a picnic activity.
• Have list of all candidates, contact numbers
of people to be contacted in case of
emergency & special needs.
• Submit report on field visit and analyze.
FIELD TRIP – GUIDELINES

• Plan field trip with a specific checklist
(permission, transport, booking boarding,
parental notification, safety & emergency
arrangements).
• Plan a schedule & route plan for the field trip.
Identify leaders & sub leaders.
• Assign responsibilities to individuals and make
them understand their role.
FIELD TRIP – GUIDELINES

• Field trip enriches the classroom learning
• Field trips provide an opportunity to the
learners to get first hand information from
natural settings.
• It provides an opportunity to solve the
individual's problems by interacting with a
group in a natural setting.
FIELD TRIP – ADVANTAGES

• The monotony and boredom of classroom
teaching is eliminated through field trips.
• Field trip gives natural stimulation and
motivates the learner to be more interactive
and creative.
• Field trips help learners learn things very
quickly and remember them for longer of
time.
FIELD TRIP – ADVANTAGES

• If the field trip is not planned well with
specific learning objectives it will result in
wastage of teaching learning resources.
• Field trips are expensive.
• Safety and security of the students is a real
concern.
• If the sought permission is not got, the
scheduled plan of the curriculum suffers.
FIELD TRIP – DISADVANTAGES

PRACTICAL TIPS TO IMPROVE CLINICAL
TEACHING
• Incorporate teaching into your every day
activities
• Teaching can be inextricably integrated with your
patient care activities
• Don’t wait for thinks to just get better on their
own
• Plan teaching activities ahead of time

NO CLINICAL SUPERVISION WITHOUT
CLINICAL TEACHING.
TREAT YOUR WEAKEST STUDENT AS YOUR BEST
STUDENT.

TRAITS THAT EVERY STUDENT NURSE
SHOULD HAVE
STRESS
TOLERANCE
EMOTIONAL
STABILITY

TRAITS THAT EVERY STUDENT NURSE
SHOULD HAVE
PHYSICAL ENDURANCE HARD WORK

HONEST RELIABLE
SINCERE COMPETE

KNOWLEDGE
PASSION
DEDICATION
SKILL
LEADERSHIP

Effective Clinical Teaching Methods

Effective Clinical Teaching Methods

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