TEACHING IN THE CLINICAL SETTING

INTRODUCTION
The clinical teaching method in nursing is a type of group
conference in which a patient or patients are observed studied discussed
demonstrated and directed towards the improvement and further improvement of
nursing care provided by the nursing student.

Clinical teaching settings are environments where students learn about

patient care and problems through teaching methods. These settings can be inpatient,
outpatient, or community-based hospitals.

Clinical teaching is a form of interpersonal communication between a

teacher and a learner. The goal of clinical teaching is to help students apply theoretical
knowledge to develop the skills needed to provide patient-centered care.

Some say that clinical teaching is different from classroom teaching

because it involves patients and their problems. Others say that clinical teaching is a
human transaction that involves the teacher, learner, and learning group.

Provide feedback
Feedback is a crucial part of the learning process. It should be honest,
descriptive, and specific.
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Consider the learner
Consider the learner’s needs, learning principles, and expected outcomes
when choosing a teaching method.

Use an evidence-based model

Use the information that students already know to create teaching
interventions that improve their learning.

CHART OF PROCESS OF CLINICAL TEACHING

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DOMAINS OF CLINICAL TEACHING

Knowledge

OUTCOMES OF
CLINICAL
TEACHING

Skills Attitude

OBJECTIVES OF CLINICAL EDUCATION

 Individualized care with a systematic, holistic approach.

 Acquire Huge technical skills.
 Practice different procedures.
 Collect and analyse data.
 Do research.
 Develop communication skills.
 Develop interpersonal relationships.
 Maintain high standards of nursing practice.
 Become a professional member.
 Learn management skills.

CLINICAL LEARNING ENVIRONMENT

DEFINITION

A clinical learning environment (CLE) is essentially where students

(and other learners) learn about patient care . From the bedside to her team’s room,
From the emergency room to the operating room , clinics and wards.
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ATTRIBUTES PROPERTIES

The clinical learning environment contains four attribute traits that

influence the student’s learning experience.

 Physical space
 Psychosocial and interaction factors
 Organizational culture
 Components of teaching and learning.

FACTORS INFLUENCING THE CLINICAL LEARNING ENVIRONMENT

 Stressor in the learning environment

 Inclusion
 Teacher-colleague relationships
 Professionalism
 Mental health/well- being curriculum
 Hours/shifts
 Feedback systems
 Pedagogy.

IMPORTANCE OF CLINICAL LEARNING ENVIRONMENT

 Effective learning puts the student at the centre of the learning

experience
 Students are given the opportunity and space to take responsibility
for their own learning.
 The level of format of supervision may he changed or reduced as the
student gains confidence.
 An effective learning environment provides opportunities for
meaning learning experience that help students achieve learning
outcomes.
 Enhances different skills in different environments and situations.

FACTORS INFLUENCES CLINICAL LEARNING EXPERIENCE

SELECTION

CLINICAL ENVIRONMENT:
The setting where learning occurs can significantly impact the experience,
including its organization, resources, and patient population.

PRECEPTOR SUPPORT:
The guidance and support provided by clinical preceptors or mentors
greatly influence students’ learning and confidence.

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PATIENT DIVERSITY:
Exposure to a diverse range of patients and cases enhances learning by
providing varied experiences and challenges.

INTERPROFESSIONAL COLLABORATION:
Opportunities to work alongside professionals from different disciplines can
enrich learning by promoting teamwork and understanding of different
perspectives.

FEEDBACK AND EVALUATION:

Constructive feedback and regular evaluations help students identify areas
for improvement and track their progress.

TECHNOLOGY INTEGRATION:
Access to modern tools and technology in the clinical setting can enhance
learning through simulations, electronic health records, and telemedicine.

PERSONAL FACTORS:
Individual characteristics such as motivation, learning style, and prior
experiences also play a role in shaping the clinical learning experience.

CURRICULUM DESIGN:
The structure and content of the educational curriculum influence how
learning objectives are met and how experiences are integrated into
overall learning goals.

FACTORS INFLUENCES CLINICAL LEARNING EXPERIENCE SELECTION

 CLINICAL ENVIRONMENT

 PRECEPTOR SUPPORT

 PATIENT DIVERSITY

 INTERPROFESSIONAL COLLABORATION

 FEEDBACK AND EVALUATION

 TECHNOLOGY INTEGRATION

 PERSONAL FACTORS

 CURRICULUM DESIGN

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TEACHING MODELS IN CLINICAL USE:

Two clinical teaching models have been used successfully for

development by clinical teachers. Both models are behaviour based and can be
adapted by clinical teachers to any clinical situation. The first is the Stanford faculty
development model for clinical teaching and the second is the micro skills of teaching
model, also known as the one minute preceptor.

Stanford Faculty Development Model

Categories are:

• Foster a positive learning environment: The learning environment is

defined as the tone or atmosphere of the classroom environment. This includes
whether it is stimulating and whether learners can easily identify and address their
own limitations. It creates conditions for effective teaching and learning.

• Session control: This refers to how classroom inter- actions are focused and
timed, influenced by the teacher’s leadership style. It reflects the group dynamics that
influence the efficiency and focus of all classroom interactions.

• Targeted communication: This includes defining and articulating what

teachers and learners expect from learners. Goal setting provides structure for the
educational process, guides teachers in planning lessons, and provides a basis for
assessment.

• Encourage comprehension and memorization: Comprehension is the

ability to analyze, synthesize, and correctly apply; memorization is the process of
memorizing facts or concepts. This category looks at the approaches teachers can use
to describe the content being taught and interact with it in meaningful ways so that
learners can understand and retain it.

• Assessment: This is the process by which teachers assess learners' knowledge,

skills, and attitudes against pre- established educational goals. Teachers can see where
learners are, which helps them plan future lessons and assess lesson effectiveness.
Assessment can be formative to assess the learner's continued progress towards
educational goals or summative for final assessment to measure the learner's
achievement of the goals.

• Feedback: Feedback is the process by which teachers provide learners with

information about their performance and potential improvements. It provides a
teaching loop where teachers can guide learners to reassess their goal achievement
using performance assessments.

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The One-Minute-Teacher

Teaching “microskills”, also known as the one-minute teacher due to the

short amount of time available for teaching in a clinical setting provide a framework.

The original microskills model used a five-step approach.

Step 1-make a promise:

 Teachers encourage learners to articulate their opinions regarding

differential diagnosis and treatment, rather than stating their own
conclusions or plans. Teachers need to create a safe learning
environment so that learners feel safe enough to risk their
commitments, even if it is wrong.

Step 2-seek supporting evidence:

 Teachers should encourage learners to “think out loud” and give

reasons to focus on the diagnosis, treatment, or other aspect of the
patient’s problem. Teachers should either validate the learner’s
commitment or gently reject it if it falls short.

Step 3-teach general rules:

 Teachers can help learners understand how what one patient is learning
can be applied to other situations. Learners are prepared for new
information applicable to both specific patients and future patients. If
the learner is doing well and the teacher has nothing to add, this
microskill can be skipped.

Step 4-reinforce:

 What you do well whenever a trainee does well in a patient care

situation, it is appropriate to use this microskill. Effective reinforcement
must be concrete and action-based, not vague. Positive feedback also
boosts the trainee’s self-esteem.

Step 5-right wrong:

 Negative or constructive feedback is often avoided by clinical teachers,

but is essential for good patient care. Encouraging self-assessment is a
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 good way to get learners to identify their own mistakes, and once they
do, they can receive positive feedback on their self-reflection skills. If
any, it should be timely and fully action based.

CHARACTERISTICS OF EFFECTIVE CLINICAL TEACHER

Responsibilities of clinical teacher

1. Plan and implement the clinical learning experiences through most effective
methods of clinical teaching
2. Plan and prepare required clinical area and needed resources for effective
clinical experiences.
3. Orient the new group of students to the clinical environment to promote their
adaptation to the new clinical setting .
4. Facilitate in arranging all the essential resources required for the clinical
learning.
5. Demonstrating clinical nursing skills and motivating the students to carryout
return demonstrations to ensure that they acquired the required clinical
learning.
6. Helping the students to gradually become independent in performing the
learned clinical knowledge and skills.
7. Assessing the students to ensure that they have achieved optimum level of
desired learning in the particular clinical Field/area.
8. Keep himself/herself updated with most advanced and effective methods of
clinical teaching.

Qualities of a good clinical teacher

1. Available, approachable and nonthreatening.

2. Resourceful.
3. Clinically competent.
4. Non-judgmental.
5. Enthusiastic and passionate in clinical teaching and learning.
6. Empathetic and tolerant.
7. Three ‘A’ for qualities of clinical teacher are Ability (attitude, knowledge and
clinical skills). Availability (physical presence of teacher in clinical
setting/bedside). Affability (approachable, affectionate, gentle, gracious and
friendly).

Clinical instructor functions:

 Set practice goals.

 Develop evaluation tools.
 Laboratory approval must be sought
 Prepare a master rotation plan.
 Store equipment readily accessible for care.
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  The clinical instructor has primary responsibility for planning the direction of
the educational program within the clinical area of student’s experience.
 Clinical trainers must adhere to standards of nursing practice.
 Clinical instructor has to direct and supervise the students in providing
client’s care.
 Assist in patient care and role model.
 Demonstrate nursing procedures on patients and ask the students to re-
demonstrate procedures to develop skill and confidence.
 Improve research understanding for better patient care.
 Analyse difficulties and guide students accordingly.
 Maintain high standards of patient care.
 Encourage motivate and inspire students.
 Supervise and evaluate the performance of students.
 Conduct one-to-on-one interviews with students to resolve issues that arise
and address their professional and personal needs.
 Attend scheduled lectures (by physicians) for students and arrange
presentations on the subject. Bring in customers and have them ready
overhead? Projectors and more.
 Must attend faculty meetings.
 Draws the student’s attention to the medical and nursing problems of the
client to whom he or she is assigned.
 Help students develop the ability to tailor general care plans to individual
patient needs.
 Help students develop lesson plans.
 Skilfully indicate which nursing procedures are of particular importance in
each area.
 Help students learn new skills.
 Direct students to create and prepare their clinical assignments using library
resources.
 Guide students in conducting nursing research activities.
 To develop the potential of each student.

DESCRIPTION OF CLINICAL LEARNING OUTCOMES/PRACTICAL

SKILLS

Writing effective learning outcomes is essential for clinical practice skill. A

learning objective is a specific, clearly formulated statement about a learner's
observable behaviour, which can be measured after completion of an educational
activity. They form the basis of instructional orientation as learning objective
assessment instruments and teaching methods support each other for desired learning
outcomes.

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 A learning objective is a statement of what the learner should be able to do
after completing the educational activity. A well-written learning objective outlines the
knowledge skills and/or attitude the learners will gain from the educational activity and
does so in a measurable way.

Well defined learning objectives describe what the learner must be able to
achieve upon completion of the educational activity. Bloom’s Taxonomy and SMART are
two tools that educators may leverage towards writing learning objectives that
effectively relate the intended outcomes to the learners simultaneously setting up the
educators to successfully attain the learning outcomes within the time and resources
provided. The successful academic anaesthesiologist can align the instructional
method assessment and intended learning outcome by using SMART learning
objectives rather than learning goals

CONCLUSION

Clinical teaching in nursing is a kind of group meeting that observes,

examines, points out and guides one or more patients towards the improvement and
further development of nursing by nursing students. Nursing’s learning process is very
unique. Nursing students, like general education, must be able to perform professional
activities in real-life situations where it is all about understanding principles in the
laboratory and on nonhuman objects. Nursing learning experiences should provide
opportunities to apply theoretical principles to real-time bedside/community situations
on a daily basis. This unit explores a variety of clinical teaching methods.

BIBLIOGRAPHY

1.Name of the book-Textbook of Educational Technology/Nursing Education

Name of the author – I Clement
Publisher-Jaypee brothers medical publishers
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 Page number- 181- 187

2.Name of the book-communication and education technology 1 st edition.

Name of the author- Suresh K Sharma, Reena Sharma
Publisher-Jaypee brothers medical publishers
Page number- 274 - 275

NET SOURCE:
http://www.slideshare.net
http://www.wikipedia.com

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