clinical method of teaching in nursing education

nursing education

1. PRACTICE TEACHING ON CLINICAL METHODS OF TEACHING PRESENTED BY, AYANTIKA BHOWMIK M.SC. NURSING,1ST YEAR SESSION: 2024-2026 TATA MEDICAL CENTER

2. INTRODUCTION OBSERVE STUDY DISCUSSION DEMONSTRATE DIRECTED 2

3. DEFINITION The ideal way to teach clinical nursing is center the teaching around specific patients Clinical teaching is a series of deliberate actions on the part of the teacher to guide students in their learning. It involves a sharing and mutual experience on the part of both teacher and student and is carried out in an environment of support and trust. 3

4. 1. Systematic & holistic approach 2. Technical & competent skills 3. Collect & analyse the data 4. C ognitive , conative, affective PURPOSE

5. 5. Standards of nursing practice 6. To become independent enough to practice nursing 7 . To meet the needs of a client 8. D evelop the techniques related to observation PURPOSE contd ..

6. OUTCOMES OF CLINICAL TEACHING METHOD THEORY CLINICAL OUTCOMES ARE RELATED TO –>

7. Attitude produces important outcomes in attitudes and values that represent the humanistic and ethical dimensions of nursing

8. CRITERIA FOR SELECTION OF CLINICAL TEACHING MODEL : • Educational philosophy of the nursing program • Philosophy of faculty about clinical teaching • Goals and desirable learning outcomes of the clinical course and activities • Level of nursing student • Type of clinical setting • Availability of expert nurses and health professionals in the practice settings to provide clinical instruction • Willingness of health care personnel to participate in teaching students CLINICAL TEACHING MODELS

9. TRADITIONAL MODEL The clinical instruction and evaluation executed by Academic faculty members 9

10. Traditional model advantage & disadvantage

11. A faculty member from the nursing program serves as a liaison between the nursing institution and clinical setting ( Oermann 1997, Stokes 1998). PRECEPTOR MODEL

12. Advantages of Preceptor Model Promotes socialization Bridges the gap between theory and practice Allows interns to gain an understanding of how to function as staff nurses Develop self-confidence Improve decision-making skills Learn new skills under the guidance of preceptor Disadvantages of Preceptor Model There is lack of integration of theory, research and practice. Lack of flexibility in reassigning students to other preceptors, if needed

13. 13 Clinical teaching associate model involves a staff nurse who instructs a small group of nursing students in the clinical settings collaboratively with clinical instructor. CLINICAL TEACHING ASSOCIATE MODEL

14. CLINICAL TEACHING PARTNERSHIP MODEL Clinical teaching partnership model varies with institutions but generally a collaborative relationship between the clinical area and nursing program involving advanced practice nurse and faculty member

15. Advantages& disadvantage of clinical partnership model

16. Teaching skills in clinical methods of teaching NEEDS & 4. 3 . 6. 5. 1 . 2 . COMMUNICATE LEARNING OBJECTIVES ACCORDING TO ASSIGNMENTS EXERCISE CLINICAL DECISION CRITICAL THINKING AVAILABILITY WHEN STUDENT NEEDS 7. INTEREST

17. 17 Methods of clinical teaching 1. Client and family centred approach. 2. Conference (a. Group conference, b. Staff conference, c. Nursing care conference, d. Individual conference, e. Team conference.) 3. Bedside clinic 4. Nursing rounds 5. Patient care Assignments 6. Field visit 7. Process recording 8. Ward teaching 9. Case method (a. case study, b. analysis method, c. case incident method, ) 10. Brain storming method 11. Group discussion 12. Demonstration method 13. Laboratory method 14. Ward class 15. Ward clinic

18. 18 Client and family members will be involved in education about illness and health concept , sign and symptoms ,treatment the client and whole family will be aware and involved in meeting the clients need .It is nothing but bringing awareness and to reach the goal i.e. health for all CLIENT AND FAMILY CENTERED APPROACH

19. 19 Group conference Staff conference Clinical conference CONFERENCE Nurse care conference Individual conferences

20. Purposes of conference To implement the nursing process effectively To set objectives and criteria for nursing care To plan methods for improving care To solve problems which interfere with good nursing care To evaluate results of report

21. Phases of conference

22. ADAD Advantage & disadvantage of conference

23. BEDSIDE CLINIC Bedside nursing clinic is a method of clinical teaching, which is also called as bed- side teaching where a small group of students are taught about a disease condition or nursing care practices directly on a real patient at bedside, which provide rich opportunity of visual, auditory, tactile and olfactory experiences

24. Purposes of bedside nursing clinics To apply theory into actual practice by observing, interviewing and studying a patient. To apply knowledge and experience to real-life situation. To highlight the uniqueness of each individual patient, this can give deeper insight into their individualized nursing problems To understand certain types of apparatus used for particular patient care To improve quality nursing care

25. Advantages & disadvantages of bedside clinic

26. 26 NURSING ROUND It is a clinical teaching method in which a group of nursing students are taken for a selected patient's bedside visit by one or more nursing faculties to discuss about the progress of the patient and further plan of care, which provides the students first-hand clinical learning experiences.

27. Purposes of nursing rounds To demonstrate the specific clinical features of particular disease condition, To clarify the terminology studied. To compare a patient's reaction to disease and study the disease condition. To demonstrate effects of the drugs. To plan and illustrate skilful nursing care. To promote team spirit and professionalism among nurses

28. 28 Types of nursing rounds Rounds with doctors Rounds to discuss psychological problems Round with staff nurses Medical round for nurses Rounds with physical therapists Social service rounds

29. Method of conducting nursing rounds 29 Planning Phase Inform students about the ward and time of nursing rounds Select patients for discussion, know them thoroughly, inform them and seek their consent Plan nursing rounds for 40-45 minutes The group may consist of 4-5 students

30. 30 CONDUCTION PHASE Take the students to the ward and start nursing rounds Stop at the bedside of each patient for a short discussion Discuss the nursing problems of the patients in the group Keep in mind the comfort and privacy of the patients, maintain their respect and confidentiality as required Call the student who is giving care to the patient and ask him/her to present the history Investigations and results, mode of treatment and nursing care planned for the patient to their group members

31. 31 Discuss any important manifestations of the disease with the group after taking permission from the patient Take suggestions from the group after the case presentation on nursing care of the patient Keep the discussion focused on the nursing care of the patient Address the questions of the patient during nursing rounds Ask the students to record the discussions Take the group to the conference room and summarize the discussion Leave the patient comfortable

32. 32 Advantages and Disadvantages of nursing rounds

33. 33 PATIENT CARE ASSIGNMENTS Patient care assignment refers to the process of delegating and assigning specific patient care responsibilities to nursing staff, ensuring that each patient receives comprehensive and individualized care .

34. Methods of assignment THE PATIENT METHOD This involves a nurse in rendering complete nursing care to one or more patients. THE FUNCTIONAL METHOD Nurses are assigned to specific functions in the ward. THE TEAM METHOD Two or more members of nursing staff one being designated as leader, are assigned to work together in giving care to a group of patients.

35. 35 Criteria for effective assignment Students are informant about the objectives of their assignment to a particular ward or unit of the hospital Students are to be oriented to the new clinical area Proper guidance and supervision has to be provided to students during their clinical experience Students should be given opportunities for working in a team

36. 36 Advantages and Disadvantages of Patient Care Assignments

37. 37 FIELD VISIT Field visit is defined as a planned activity to take the students out of classroom for an observation of particular place, persons, organization or situation to obtain first- hand experience .

38. Purposes of field visit To make learning more meaningful and memorable . To supplement the regular classroom instructions and establish a connection between reality and literature . To give students experiential learning environment . Field visit is also useful in developing the concrete skills, such as note taking and public speaking . To help the students to appreciate the relevance and importance of what they have learnt in the classroom.

39. 39 Advantages of Field Visit first-hand source of knowledge and information,supplements & enriches classroom instructions. Integrates theory with real-life situations ,help to develop a sympathetic understanding of problems , recognize the contribution of other organizations in patient care. Develop a better understanding of the natural history of the disease and aetiological factors. It helps students to develop keen observation skills to study problems/situation. It provides realistic resource material for study

40. 40 PROCESS RECORDING "An exact written report of conversation between the nurse and the patient during the time they were together". -Hudson

41. 41 Features of process recording Written during and immediately after the therapeutic nurse-patient interaction. Also can be used as an excellent clinical teaching method. Also has therapeutic purposes Uses of process recording As a teaching-learning tool As an evaluation tool.

42. 42 Purposes of process recording Gain competency in interpreting and synthesizing raw data under supervision Helps to consciously apply theory to practice Helps the students develop an increased awareness of their habitual, verbal and nonverbal communication pattern Helps the nurse to learn to identify thoughts and feelings in relation to self and others Helps to increase observation skill

43. 43 Process recording technique

44. 44

45. 45 Advantages and Disadvantages of Process Recording

46. 46 WARD TEACHINGS The clinical instructor will assign the topic well in advance and give the date forward to teaching classes for all the students in group posted in the clinical area. The topics are related to the clinical conditions and basic associated clinical conditions and basic associated clinical field knowledge. The scheduled student will present the topic in presence of teacher along with appropriate audio-visual aids to other group members

47. 47 Purposes of Ward teaching To supplement, to integrate the classroom instruction To aid the students to make correct applications of scientific principles basic to the specific nursing activity To enable the student to gain a real understanding of individual differences and substitute variations of case and circumstances to tactfully respond and adjust to them by adopting nursing procedure and treatment without violating basic principles To inspire the student for self-development

48. 48 CASE METHOD Used in three forms

49. 49 CASE STUDY/CASE PRESENTATION The student will be given the opportunity to provide nursing care for specific client, after 4 or 5 days of careful study, the student nurse will prepare case study by comparing with the text, the student presents the case before the batch of companions, general discussion about the client will be dealt.

50. 50 CASE STUDY Nursing case study is the blueprint of nursing care rendered by a nursing student to a selected patent for a particular period by following nursing process approach, with an intention to develop comprehensive nursing care abilities

51. Purposes of case study 51 It provides an opportunity to the student to learn nursing skills using the problem solving approach Students learn to identify and define a patient's problem It trains the students to problem. locate, gather and process the information required to solve the patient problem It develops a sense of accomplishment from providing individualized comprehensive care It helps the student solve the patient's problems by critical and reflective thinking It emphasizes the facts that the patient is an individual personality with unique problems It accentuates the health and social aspects of nursing It points out the relationship and cooperation of the various agencies interested in the patient's problems and welfare such as social service and public health nursing

52. 52 Principles of case study The students should be able to make their nursing care study on a patient for whose nursing care they are responsible for. The selection of patients can be done by coordination between the clinical instructor and students With the help of a case study, the student should be able to study the patient's state of health self-help abilities, his cultural background, his economic level, hobbies and interests, as an understanding of all these factors will contribute to the patient's welfare. The first part of the study should be concerned with information and facts about the patient, la disease condition and his social and personal history, and how this knowledge is applied providing nursing care to the patient.

53. 53 the nursing study will be concerned with in giving complete comprehensive nursing care to the patient. It should emphasize on the individual needs of a patient and how they are met. Special emphasis should be made on patient learning. If outpatient experience and home nursing is included in the study, it helps in better evaluation of the patient's recovery and his ability to maintain healthy health habits

54. 54 54 Forms and presentation of case study

55. 55 Advantages of Written case study It provides for individual differences of the student It provides an opportunity for self-expression in writing It provides experience in organizing and writing a paper in a scientific manner It provides a source of material for future reference Disadvantages of Written Case Study It gives no opportunity to branch out and incorporate new ideas It requires a great deal of time to rewrite to an acceptable form

56. 56 56 Advantages of Oral Case Study Provides an opportunity for the instructor to direct student dunking into new channels and to correct errors of information Serves as a basis for better personal understanding and relationship between the instructor and the student Time-saving, and does not require lengthy recopying of the notes to acceptable forms Offers an opportunity for a public-speaking experience If discussion is invited after presentation, the case becomes cooperative and everyone involved benefits from the study. This is a source of motivation to the student because the shares the benefits of her study with other students. The student feels the thrill of achievement in presenting her study in others

57. 57 57 Disadvantages of Oral Case Study • It does not offer an opportunity for writing and other creative expressions, only some are used for the presentation. • It leaves to records that may be kept for future reference its generally

58. 58 CASE ANALYSIS A concrete case for analysis and discussion by a group of students under the leadership of the instructor. Sufficient information is presented to the students to make judgment of problem or situation in case

59. 59 CASE INCIDENT TECHNIQUE A critical incident technique which requires immediate decision and action is taken from a case and presented to the students for their analysis and decision.

60. 60 BRAINSTORMING METHOD Here the intellectual capacities of trainees will be utilized in solving or suggesting solutions to problems and make the group to become active and answer the problems among them only. The instructor will acts as a referee and give answers for the unsolved problems

61. 61 61 GROUP DISCUSSION A cooperative problem-solving activity which seeks a consensus regarding the solution of a problem

62. Values of Group Discussion It encourages the student to think for her, to develop critical habits of study. To interpret problems of the past, that she can throw light into ways for shaping the future. Helps her to advance in creative thought. Enables the student to enrich her own conceptions by reacting to those of others. The teacher can observe the student as she participates in the class and can plan for individual differences It gives the student an opportunity to learn how to adjust to social situations. Gives an opportunity to cooperate with others in the reflective solving of a problem. Self-activity is increased Cooperation in its highest sense is developed.

63. It provides proper social environment by the development of favourable attitudes towards cooperation and responsibility Leadership skills will be developed

64. Discussion Techniques of Small Group The individual conference The informal class group discussion The seminar The clinical conference Role playing Case analysis Discussion techniques for larger groups Multiple discussion groups Symposium Panel

65. 65 65 DEMONSTRATION METHOD Uses Of Demonstration Method To demonstrate procedures in the classroom and the ward To demonstrate experiments and its use. To teach the patient, a procedure or treatment which he must carryout in home. To demonstrate different approaches in establishing rapport with patients, so that the most effective nurse patient relationship m3ay be established

66. 66 LABORATORY METHOD Planned learning activity dealing with original or raw data in the solution of the problems. Laboratory method is a procedure involving first hand experience with primary source materials, through which the student can acquire psychomotor as well as mental skill

67. Values of Laboratory Method To use the problem solving approach to the solution of real problems. To translate theory into practice. To develop, to test and to apply principles. To learn methods of procedures. Initiates group works for Students Provides the teacher an opportunity for Teacher

68. 68 HEALTH TALK This method will be used when teaching for clients and their relation or a mass. It can be used in hospital and in community. For example, educating the mass about health and its aspect. Health talks Education can be conducted incidentally and in a planned

69. 69 Definition of Health Talk Lawrence Green (1968) defined Health Education as 'a combination of learning experiences designed to facilitate voluntary actions conducive to health.’ 'Health talk is a process that informs, motivates and helps people to adopt and maintain healthy practices and lifestyles, advocates environmental changes as needed to facilitate his goal and conducts professional training and research to the same’ -National Conference on Preventive Medicine in USA

70. 70 70 Purposes of Health Talk To promote awareness of health. To promote healthy lifestyle and improve quality of life. To promote the utilization of available health services. To promote active community participation. To promote self-confidence and self-reliance. To promote interest in new knowledge, improved skills, and changed attitudes in making right choices and rational decisions to solve own health problems

71. 71 Principles of Health Talk Interest Participation Principles of learning Comprehension Credibility . Reinforcement Motivation Good human relations Learning by doing

72. 72 Phases Involved in Health Education A• Pre-introductory phase: Involve people B• Preparatory phase: Set goals C• Introductory phase: Define problems D• Working phase: Approach E• Working phase 2: Conduct activities F• Post working phase: Evaluate results

73. 73 Advantages of health education It provides a good opportunity to exchange ideas, share feelings and influence others. The health personnel can discuss and persuade the individual to change his/her behaviour. It is an opportunity to provide scientific knowledge to people about health problems and how to maintain and promote health. Health talk will expose the individual to correct information and will eliminate social and psychological barriers of ignorance, prejudice, misconceptions, and increase health awareness. Health talk helps to increase knowledge and modify health behaviour by own actions and efforts. Allows an opportunity for the individual to change their value and belief by desired behaviour. It develops interest and motivates people to learn healthy attitude and provide support to the individual at the time of crisis.

74. 74 WARD CLASS A class will be conducted by current clinical experiences of the students for whom the class planned. the class will be conducted for the student at one level of experience, who are having similar experience in particular department.

75. 75 WARD CLINIC In this type, a client is presented to the group, who illustrates all signs and symptoms and requires all nursing case procedures. Permission should be taken from the physician. Instructor should explain before hand, to the client about the purpose of the clinic. Student should understand the purpose on improving the standards of nursing care and their contributions should be directed towards.

76. 76 SUMMARIZATION 1) Introduction 2) Objective 3) Definition 4) Purposes 5) outcomes of Clinical teaching method 6) Clinical teaching models 7) Teaching skills in methods of teaching 8) Different Methods – Client and family centred approach. Conference ( a.Group conference , b.Staff conference, c. Nursing care conference, d.Individual conference,e.Team conference.) Bedside clinic Nursing rounds Patient care Assignments Field visit Process recording. Ward teaching Case method (a. case study, b. analysis method, c.case incident method, ) Brain storming method Group discussion Demonstration method Laboratory method Ward class Ward clinic

77. 77 Conclusion- The scope of health teaching extends beyond the conventional health model sector. It cover every aspects of family and individual and group or community health reinforce or community health reinforce or clarify prior knowledge and behaviour .

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