Psychomotor skills nursing care mgt.pptx

Nursing care management 102

1. NCM 102 Psychomotor Skills

2. TEACHING PSYCHOMOTOR SKILLS   What skills professional nurses need to learn vs. what skills should be learned & performed by technical & ancillary personnel (ex. janitor, helping or supporting people, like maintenance). The primary focus of nursing was on “practical skills” or the “art of nursing” that emphasized hands-on “doing” for patients ( Bjork, 1997 et al) Reilly (1991) said that – psychomotor skill competency is evidenced thru performance which includes efficient and effective neuromuscular coordination, knowledge of underlying theory and principles which guides its rationale for use and processes involved in its execution, with a sensitivity in carrying it out with clients so as to reflect their inherent worth and dignity

3. Phases of Skill Learning Stage one : Getting the idea of the movement eg . The need to catheterize the patient’s bladder Stage two : Fixation/diversification  

4. Approach to Teaching Skills Independent Learning vs. Teacher Instruction - Haukenes & Halloran (1984) describes a college laboratory in which self- instruction is the primary teaching method. - Research finding on this, documented that, self-learning of skills vs. faculty-taught skills is more cost effective because less faculty time is involved, that both produce adequate skill learning but still many students prefer skills taught by the faculty. Demonstrations - The basic premise of Bandura’s (1997) theory is that people learn as they observe other people’s behavior Simulations - the idea is to make the practice setting & condition like the real world in which skill will eventually be performed to increase the likelihood of positive transfer of learning.

5. Assessment of Psychomotor Skill Learning Utilizing the skill performance checklist as a common means of organizing skill learning & assessment Checklists describe the step-by-step progression of skill activity needed to achieve the goal. A checklist contains a number of items that are checked off when completed, there may be some elements on the checklist considered to be absolutely essential & if the learner doesn’t complete those critical elements, they may fail the test even if all other elements are satisfactory.  

6.   CLINICAL TEACHING- teaching in the clinical setting.  Purpose of Clinical Laboratory Learners have the opportunity to apply the theoretical concepts, rules & propositions they have learned in the classroom. Many skills are perfected in the clinical laboratory The skill of observation is greatly enhanced in the clinical laboratory (Infante, 1985) Problem-solving & decision-making skills are refined in the clinical laboratory ( Fothergill -Bourbonnais & Higuchi, 1995)

7.  CLINICAL TEACHING -teaching in the clinical setting Purpose of Clinical Laboratory Learners gain organization and time-management skills in clinical setting ( Gaberson & Oermann, 1999) Cultural competence is a skill that can be learned well in the clinical laboratory. Learners become socialized in the clinical laboratory . (Chan, 2002) - Nurses learn which behaviors & values are professionally acceptable or unacceptable. - Place where consequences for one’s actions are readily apparent & accountability is demanded.

8. Models of Clinical Teaching 1. Infante’s (1985) Model - a model that relies heavily on keeping nursing students in a skills lab until they are proficient with their skills. 2. Packer’s (1994) Model - contends that more information about clinical practice should be taught in the classroom before going to the clinical area. - hypothesizes that after taking the course, students would be more self-confident and better able to handle clinical situations in the real world. 3. Preceptorship models - a student is taught and supervised by a practicing nurse employed by a healthcare agency while an educator oversees the process and indirectly supervise the student. example: Clinical Teaching Associates (CTA) – a triad between a staff preceptor, educator and student wherein the 1 st day the CTA takes the lead to the educator and students and on the 2 nd day, the educator takes over the teaching and supervisory role.

9. Preparation for Clinical Instruction - To ensure a positive learning experience for learners, educator must: Plan before clinical instruction begins Clinical agency site must be chosen and learning experiences available there. Obtaining clinical experiences that correlate with theoretical content Are there enough rooms around the nurses’ station or office for learners to use patient’s charts The educational credentials & experience level of the staff Are there staff receptive to having learners on their unit?

10. Preparation for Clinical Instruction Written Contracts must be drawn up between the school & the clinical agency Availability of the clinical unit for certain days & weeks Availability of conference space, parking and locker space Maximum student-faculty ratio Meeting with the Agency Staff who will be involved in the education process. Expectations of both parties can be discussed Sharing clinical learning objectives with the manager/head nurse Making specific assignments for learners on a weekly or daily basis If staffs are aware of the learning objectives, they can direct the instructor to suitable assignments.

11. Preparation for Clinical Instruction Goldenberg & Iwasiw (1988) conducted an investigation of the criteria used by the educators in selecting students’ clinical assignments – The 3 most important criteria are: Students’ individual criteria needs Patients’ nursing care needs Matching of students learning needs with patient’s needs