Skills Training in nursing education_18 July 2023.pptx

skill training is very important in nursing education.

1. Skills teaching & skills practice P.Princy Fernando

2. Skills teaching and practice

3. Learning outcomes Skill vs Team training – the issue of complexity Feedback vs Debriefing

4. Demonstrate Deconstruction Comprehension Execution T rainee observes Talk the trainee through Trainee talks the trainer through Trainee does Peyton’s four step model

5. Steps of Peyton’s model Description Demonstrate - Insructor demonstrates silently - T rainee observes Deconstruction - Insructor demonstrates and talks through -T rainee observes and hears Comprehension - Insructor demonstrates - T rainee tall through the steps (e.g I wash my hands) & observes Execution - Trainee does - Instructor observes

6. Deliberate practice

7. Types of checklists

8. Using checklists… # Action/ step Rationale Done/ Not done Remarks 1 Close doors and/or use a screen. Maintains client’s privacy     2 Make the client's position comfortable, preferably sitting or lying with the head of the elevated 45 to 60 degrees.   To ensure clear view of chest wall and abdominal movements. If necessary, move the bed linen.     3 Prepare count respirations by keeping your fingertips on the client’s pulse. A client who knows are counting respirations may not breathe naturally.     4 Counting respiration: 1) Observe the rise and fall of the client’s (one inspiration and one expiration). 2) Count respirations for one full minute. 3) Examine the depth, rhythm, facial expression, cyanosis, cough and movement accessory.   One full cycle consists of an inspiration and an expiration. Allow sufficient time to assess respirations, especially when the rate is with an irregular Children normally have an irregular, more rapid rate. Adults with an irregular rate require more careful assessment including depth and rhythm of respirations.     5 Replace bed linens if necessary. Record the rate on the client’s chart. Sign the chart.   Documentation provides ongoing data collection. Giving signature maintains professional accountability     6 Perform hand hygiene To prevent the spread of infection     7 Report any irregular findings to the senior staff. To provide continuity of care    

9. Example of a check-list

10. Checked out to maintain the skill on a simulator? When is someone checked out to do the skill on you or your relatives?  When is someone good enough? 

11. MPS done on a simulator, before you are allowed to do the skill on a patient. Objective  Measurable Fair Minimum passing standard

12. S.No Observations   Marks Participants 1 2 3 4   1 Gather the necessary supplies 1           2 Pull up sleeves 1           3 Remove jewelry on hands, watch etc. and keep at safe place 1           4 Turn on tap water and adjust force and temperature of water 1           5 Do not touch clothes or hands inside of sink 1           6 Wets hands and wrists under running water, keeping hands lower than wrists and forearms. 1           7 Applies liberal amount of soap. 1           8 Rubs hands palm to palm. 1           9 Rubs right palm over left dorsum with interlaced fingers and vice versa 1           10 Rubs palm to palm with fingers interlaced. 1           11 Rubs back of fingers to opposing palms with fingers interlocked. 1           12 Rotationally rubs left thumb by clasping in right palm and vice versa. 1           13 Rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa. 1           14 Continue washing hands for at least 20 seconds 1           15 Rinses hands with water 1           16 Dries hand thoroughly with single use towel 1           17 Turns off tap with paper towel 1           18 Dispose off the paper towel as per institute waste management policy 1           Total 18         OSCE (Objective Structured Clinical Examination)

13. Checklists OSCEs Learning and Practicing Tool Elaborate Can be used by Faculty to teach and by Student for Peer-to-Peer Learning Brings in Standardization of procedures Evaluation Tool Concise Used by Faculty to evaluate Brings in Uniformity of examining the procedures ( No Bias )

14. Novice to expert ADVANCED BEGINNER : Middle stage – the ability more expected, the movements are performed with some confidence and skill NOVICE : Early stages of learning – mimicry, trial and error, rough movements COMPETENT : Fast, accurate, Agile, correct, well-coordinated execution GOOD : Well developed skills, The athlete can modify movement patterns to difficult situations EXSPERT : The individual creates new methods to deal with unique challenges Time Minimum-passing-standard ? Minimum-passing-standard ?

15. Sawyer, T., White, M., Zaveri, P., Chang, T., Ades, A., French, H., ... & Kessler, D. (2015). Learn, see, practice, prove, do, maintain: an evidence-based pedagogical framework for procedural skill training in medicine.  Academic Medicine ,  90 (8), 1025-1033. Peyton JWR.,  Teaching and Learning in Medical Practice . Rickmansworth: Manticore Europe, 1998. Ericsson, K. A., Krampe, R. T., & Tesch-Römer, C. (1993). The role of deliberate practice in the acquisition of expert performance.  Psychological review ,  100 (3), 363. References

16. Exercise: Run session with peyton’s skills training approach, as facilitator… Reflect: What you did? Why? What was the outcome? We want you to practice and reflect

17. Qs