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Clinical Teaching Methods

Chapter Overview
This chapter delves into clinical teaching methods, focusing on enhancing nursing
skills and knowledge through hands-on experience. It covers various aspects of
clinical learning, including the environment, influencing factors, teaching models,
characteristics of effective teachers, learning outcomes, and teaching strategies.

Clinical Learning Environment (CLE)

The clinical learning environment (CLE) is where health professions students learn
and practice skills in real-life scenarios. It encompasses:

Physical aspects: Facilities, equipment

Social aspects: Staff, patients, culture
Organizational aspects: Policies

The CLE significantly impacts student learning outcomes, satisfaction,

motivation, and professional development.

A positive CLE fosters theory-practice integration and enhances clinical reasoning,

while a negative CLE can cause stress and hinder learning.

Purpose of Clinical Teaching

Provide individualized care using a systematic approach.
Develop high technical competence.
Practice various procedures.
Collect and analyze data.
Develop communication skills and interpersonal relationships.
Maintain high standards in nursing practice.
Develop cognitive, affective, and psychomotor skills.
Learn diagnostic procedures.
Learn health education techniques.
Develop proficiency and efficiency in procedures.

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Principles of Clinical Teaching

Establish clear objectives aligned with the curriculum.
Prepare in advance with appropriate resources.
Identify and seize teachable moments.
Promote active participation and feedback.
Model professional thinking, behavior, and attitudes.
Respect patient privacy and obtain informed consent.

Factors Influencing Clinical Learning

Clinical learning experiences are influenced by several factors:

Student-Based Factors:
Self-confidence, interest, and satisfaction
Academic performance and communication skills
Ability to integrate theory and practice
Psychological and social well-being
Hospital-Based Factors:
Leadership style and organizational culture
Availability and quality of teaching resources
Pedagogical atmosphere
Patient characteristics and workload
Future intention and career choice
Clinical Teacher Related Factors:
Clinical competency and experience
Teaching and feedback skills
Professional values and attitudes
Appearance and communication skills
Relationship and accessibility to students
Evaluation and reflection methods

Clinical Teaching Models/Practice Models

Clinical teaching models guide clinical education, especially for nursing students,
aiming to enhance learning outcomes and clinical reasoning.

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Model Description Advantages Disadvantages

The faculty member

is responsible for the Difficult to
Teacher can assist in
student's clinical accommodate all
Traditional applying concepts and
experience, student demands;
Model choose suitable learning
supervising and teachers may lack
experiences.
evaluating their clinical experience.
performance.
Promotes socialization,
An expert nurse bridges theory and
works one-on-one practice, enables effective Lack of integration
with the intern, functioning as a staff between theory,
Preceptor
acting as a role nurse, enhances self- research, and practice;
Model
model, with a faculty confidence and decision- limited flexibility in
member serving as a making skills, provides reassigning students.
liaison. opportunities to learn new
skills.
A staff nurse and a
clinical instructor
Clinical Enhances the learning
collaborate to
Teaching experience through N/A
instruct a small
Associate cooperation.
group of nursing
students.
Enhanced knowledge
A collaborative
acquisition through Limited availability of
relationship between
association with advanced advanced practice
Clinical the clinical area and
practice nurses, nurses; potential for
Teaching nursing program,
development of implementation
Partnership involving advanced
competency skills, better issues due to varied
practice nurses and
understanding of curriculum.
faculty members.
professional roles.

Characteristics of Effective Clinical Teachers

Effective clinical teachers facilitate learning and professional development. Key
characteristics include:

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Thorough knowledge and refined skills in their clinical field

Good communication and interpersonal skills
Compassionate, respectful, and supportive attitude
Passion for teaching and lifelong learning
Ability to simplify complex concepts
Ability to identify and seize teachable moments
Providing constructive and timely feedback
Being a role model of professional behavior
Professional appearance and a good sense of humor
Flexibility, creativity, and adaptability
Problem-solving and decision-making skills
Leadership and management skills
Accessibility and approachability
Ability to evaluate and reflect on their teaching

Functions of Effective Clinical Teachers

Provide guidance and supervision.
Facilitate integration of theory and practice.
Assess and evaluate student performance.
Give constructive feedback.
Model professional values and attitudes.

Writing Clinical Learning Outcomes/Practice Competencies

Clinical learning outcomes define what learners should achieve, demonstrating
observable knowledge, skills, values, and attitudes in the clinical setting.

Knowledge
Focus on developing knowledge beyond the classroom, emphasizing cognitive skills.

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Problem Solving:

Ability to effectively solve problems related to a patient's condition.

Critical Thinking:

A process used to determine the most appropriate course of action

based on relevant data.

Decision Making:

Gathering, analyzing, and evaluating information to select the best

course of action.

Skills
Highly significant outcomes, comprising psychomotor, interpersonal, and
organizational skills.

Psychomotor Skills: Activities requiring coordinated physical responses.

Interpersonal Skills: Assessing patient needs and communicating effectively.
Organizational Skills: Setting priorities and managing work efficiently.

Attitudes
Outcomes in attitudes and values that represent the humanistic and ethical
dimensions of nursing, internalized through professional socialization.

Clinical Teaching Strategies

Clinical teaching strategies are methods used to facilitate student learning and
professional development.

Patient Assignment
Assigning students to specific patients to apply theoretical knowledge.

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Benefits:
Enhances motivation and interest
Provides feedback opportunities
Exposes students to various clinical problems
Fosters autonomy and responsibility
Promotes professional values
Challenges:
Requires careful planning
Depends on patient availability
Ethical and legal issues
Potential role conflict
Increased workload
Type of Assignment Description

Student provides comprehensive care independently,

Case Method Nursing
supervised by a teacher.
Functional Nursing Student performs specific tasks for a patient group.
Team Nursing Student collaborates in a team led by a teacher.
Primary Nursing Student autonomously cares for assigned patients.
Case Management Student coordinates care for patients with similar needs.
Progressive Patient
Student cares for patients based on acuity in different units.
Care

Clinical Conference
A meeting to discuss patient observations, diagnosis, treatment, and outcomes.

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Types:
Group Conference: Involves a group of professionals sharing knowledge
and receiving feedback.
Individual Conference: A one-on-one meeting for eliciting or providing
information.
Benefits:
Enhances clinical reasoning
Promotes theory-practice integration
Fosters professional development
Improves communication and collaboration
Provides feedback opportunities
Challenges:
Requires careful planning
Depends on patient suitability
Ethical and legal issues
Potential role conflict
Increased workload

Clinical/Case Presentation
Formal communication regarding a patient's clinical information.

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Guidelines:

Tailor presentation to the audience

Organize information
Avoid unnecessary details
Use clear language
Verify facts
Cite sources
Maintain patient confidentiality
Use neutral language
Acknowledge limitations
Encourage feedback

Structure:

Introduction
History
Examination
Investigations
Diagnosis
Management
Summary

Advantages:

Enhance clinical reasoning

Foster integration of knowledge and skills
Promote critical appraisal of evidence
Facilitate communication
Improve patient care
Provide feedback opportunities
Stimulate learning
Demonstrate competence
Contribute to medical knowledge

Disadvantages:

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Time-consuming preparation
Subject to bias
Variability in cases
Potential for criticism
Risk of misuse

Bedside Clinic
Involves the presence of the patient, either at the bedside or in a conference room.

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Forms:

Doctor-led clinics (emphasizing symptoms and medical therapy)

Nursing clinics (emphasizing nursing care)

Purposes:

Apply theoretical knowledge

Observe and interact with patients
Connect concepts with healthcare scenarios
Develop critical thinking
Learn roles of healthcare professionals
Develop empathy
Practice effective communication
Learn about professional behavior
Increase cultural competence
Gain confidence

Steps:

Planning
Conducting
Phases (Introduction, Patient-centered discussion, Post-clinic evaluation)

Advantages:

Real-life scenarios
Better interaction
Assesses achievement of objectives
Enhances observation
Closer exposure to healthcare
Develops self-confidence

Disadvantages:

Increased costs
Patient discomfort
Lack of standardization
Narrow applicability

Nursing Rounds

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Staff members visit patients at their bedsides to understand conditions and

determine solutions.

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Types:

Information giving rounds

Instructional rounds
Problem-solving rounds

Purposes:

Demonstrate symptoms
Clarify terminology
Compare patient reactions
Demonstrate drug effects
Explain treatment plans
Illustrate skilful nursing care
Compare methods
Provide instruction
Enhance understanding
Showcase improvisation

Factors to Consider:

Students’ prior experiences

Value of materials
Explain plan to the patient
Introduce the patient
Ensure the patient feels important
Conduct a post-conference
Document rounds

Advantages:

Natural patient response

Patient selection
Efficient medication
Early detection
Enhanced communication

Disadvantages:

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Time constraints
Communication barriers
Privacy concerns
Patient stress

Concept Mapping
A graphical representation of knowledge.

"A concept map is a graphical representation of a person's (student's)

knowledge of a domain." - Alpert & Grueneberg

Uses:
Identify patient problems
Organize assessment data
Assess outcomes
Create care plans
Facilitate communication
Enhance academic writing
Improve comprehension
Foster satisfaction
Stimulate creativity
Prepare students

Questioning
A teaching strategy to stimulate critical thinking and assess understanding.

Process:
Instructors ask questions to stimulate critical thinking, promote active
engagement, and assess understanding of clinical concepts and skills.

Questioning
Involves the use of questions like open-ended, closed-ended, or probing
questions to encourage student participation.
Students respond with answers, explanations, or analyses.
Instructors provide feedback and facilitate discussions to deepen
understanding.

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Advantages:

Encourages active learning and student participation.

Enhances critical thinking, problem-solving, and reasoning skills.
Allows for immediate feedback and assessment of student comprehension.

Disadvantages:

Some students may feel anxious about answering questions in front of the
class.
Limited time may restrict the number of questions asked.
Instructors must ensure a balance of questions to challenge students while
maintaining a supportive learning environment.

Written Assignments
Written assignments are a major instructional and assessment method in nursing
courses. They can be used to achieve many learning outcomes, such as developing
critical thinking, writing, research, and clinical reasoning skills.

Written assignments are any tasks that require students to produce a

written product, such as essays, research papers, case studies, critiques,
reviews, reflections, journals, care plans, evidence-based papers, etc.

The elements of a written assignment are:

1. Introduction: Provides background, context, and aim.

2. Body: Develops main ideas, arguments, or findings, supported by evidence and
analysis.
3. Conclusion: Summarizes main points, implications, and recommendations.
4. Reference List

Advantages:

Critique and synthesize the literature and report on their findings

Search for, critique, and integrate evidence for nursing practice
Analyze concepts and theories and apply them to clinical situations
Improve their problem-solving and higher level thinking skills
Gain experience in formulating their ideas and communicating them in a clear
and coherent way to others
Develop writing skills that are essential for academic and professional success
Reflect on their own learning and practice.

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Disadvantages:

Be time-consuming for students to prepare and teachers to read and respond to

Cause frustration and anxiety for students who struggle with writing or have
limited resources or support
Lead to plagiarism or academic dishonesty if students do not understand the
rules and expectations of academic writing
Be repetitive or irrelevant if they do not align with the course objectives or the
students’ needs and interests.

Process Recording
Process recording is a clinical teaching strategy in nursing education that involves
recording and analyzing the interactions between a student nurse and a patient.

Process recording is "an exact written report of the conversation between

the nurse and patient during the time that they were together. It is also
record of the nurse's feelings about what was going on at that time and of
the observations of the patient's behavior-Hudson during the
conversation."

Purposes:

Enhance the student's communication and interpersonal skills.

Develop the student's critical thinking and problem-solving abilities.
Provide feedback and guidance from the instructor or supervisor.
Identify the student's strengths and areas for improvement.
Facilitate the application of nursing theory and process to practice

Formats:

Verbatim: The student writes down the exact words spoken by both parties.
Narrative: The student summarizes the main points of the conversation.
Structured: The student uses a predefined template or form to record the data.
Audio or video: The student records the interaction using a device or software.

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