INDEX OF CONTENTS S.no 1 2 3 4 5 6 7 8 9 A B C D E F G H I J
CONTENTS Introduction of clinical teaching Definition of clinical
teaching Philosophy of clinical teaching Outcome of clinical
teaching Clinical teaching model Clinical teaching skills Factors
influencing clinical teaching Guidelines for selecting clinical
teaching Clinical teaching methods: - Case method - Process
recording - Nursing clinic - Bed side clinic - Individual
conference - Group conference - Nursing care conference - Teaching
rounds - Nursing assignment - Morning and evening reports - Role
play - Field trip PAGE
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CLINICAL TEACHING METHODSINTRODUCTION: The clinical teaching is
a type of group conference in which a patient or patients is or are
observed and studied, discussed, demonstrated And directed towards
the further improvement of nursing care. In nursing clinical
teaching may be given by the doctor in order to discuss the medical
aspects of a patients condition more vividly that can be done in
the class room. Alternatively the clinical can be given by any
faculty member
that is clinical instructor or tutor or ward staff and will
concentrate on a particular patients needs as a person and how the
doctors treatment orders can be met by the right understanding and
nursing care. PHILOSOPHY OF CLINICAL TEACHING : Philosophy
determines the teachers understanding of his or her roles,
approaches to clinical teaching, selection of teaching and learning
activities, use of evaluation processes and relationships with
learners and education and the others in clinical setting.
Philosophy of clinical about the purposes of clinical
responsibilities of the teachers and learners teaching is a set of
beliefs
in clinical setting. To change their practice of clinical
teaching , initially educators should reflect on their fundamental
beliefsCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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about the values of clinical education, roles and relationships
of teachers and learners and hoe desired outcomes are best
achieved. OUTCOMES OF CLINICAL TEACHING: Outcome of clinical
teaching attitude learning. (A)Knowledge : clinical learning
activities should focus on the in development of the knowledge that
can not be acquired include knowledge, skills and
that are accomplished through clinical teaching and
the classroom or in any other learning setting. Knowledge
outcomes include cognitive skills in the (a) problem solving (b)
critical thinking (c) decision making. (a) Problem solving :
ability is significant outcome as the problems related to the
patients requires innovative methods of or in the health care
reasoning and problem environment is unique , complex and ambiguous
and often solving strategies. (b) Critical thinking : it is a
process used to determine a course of action following data
collection that is relevant and appropriate, analyze the validity
and utility of the data , evaluating multiple lines of reasoning
and arriving to valid conclusions.critical thinking is enhanced by
attitudinal dimensions of self confidence, maturity and
inquisitiveness.
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(c) Decision making : it involves gathering, analyzing, weighing
and valuing informations in order to choose the best course of
action from a number of alternatives. (B) Skill :It is the most
significant outcome of clinical teaching. There is three types of
skills included in this. (a) Psychomotor skills : They activities
are that purposeful, involve complex, an overt movement physical
oriented response
requiring neuromuscular co-ordination. They compass the ability
to carry out proficiently, smoothly and consistenly under carrying
conditions and within limits. (b) Inter personal skills : They are
used to assess the patients needs, to plan and implement patient
care , to evaluate the outcome of care and to record and
disseminate that therapeutic use of self. (c) Organizational skills
: Nurse require these skill in order to set priorities, manage
conflicting expectation and sequence their work to perform
efficiently. Clinical learning activities provide opportunity for
learners to develop leadership, followership and management skills.
(C ) attitudes :Page 4
appropriate time
information. These
skills are communication using the teaching process and
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Clinical learning
produces
important
outcomes
in
attitudes and values that represent the humanistic and ethical
dimensions of nursing. Professional nurses are care and to use the
process of koral expected to value inculcate and act on certain
values with regard to patient reasoning, clarification and value
injury. These values are developed and internalized through the
process of professional socialization. CLINICAL TEACHING MODEL :
Criteria for selection of clinical teaching model: there is no one
model that meets the need of nursing
programme. The teacher should select a model considering the
following factors:
Educational philosophy of the nursing program Philosophy of
faculty about clinical teaching Goals and desirable learning
outcome of the clinical course and activities
Level of the nursing student Type of clinical setting
Availability of expert nurses and health professionals in the
practice setting to provide clinical instruction Willingness of
health care personnel to participate in
teaching students.
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TRADITIONAL MODEL : The clinical instruction and evaluation of a
group of students are executed by academic faculty member who were
supervising the students during the clinical experience. Advantages
of the model:
Assist students in using concepts and theories learned in the
classroom. Teacher can select appropriate learning experience
for
students that are congruent with learning objectives
Disadvantages of traditional model:
A teacher may be attached with
a large number of
students for clinical instruction where she may not be able to
meet the demands of all students.
Teachers without clinical experience may find difficulty to
establish relationships with health care professionals or extensive
time to establish the same. may require
PERCEPTOR MODEL : An expert nurse works with the basis, intern
on one to one the learner in the clinical setting. In addition to
one to one
teaching , the preceptor guides and supports
and serve as a role model. A faculty member from the nursing
program serves as a liaison between the nursing institution and
clinical m setting.CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
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Advantages of preceptor model:
Promotes socialization Bridges the gap between the theory and
the practice. Allows the inter to gain an understanding of how to
function as a staff nurse. Develop self confidence. Improve
decision making skills , Learn new skills under the guidance of the
preceptor Disadvantages of the preceptor model: There Lack is of
lack of integration in of theory , research to and other
practice.
flexibility
reassessing
students
preceptors, if needed. CLINICAL TEACHING ASSOCIATE MODEL.: This
model involves a staff nurse who instructs a small group member
coordinate students, serve as a Faculty planning. of nursing with
with the assist may works students clinical clinical in in the
clinical The of setting faculty to the and collaboratively
instructor. teaching clinical
associate
overall students conduct of the
clinical
experience
performance
resource. teaching nursing for staff , provide
consultation in clinical setting and assist with discharge
Majority institutions attachedPage 7
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with
hospitals do follow this model in order to enhance
learning.
CLINICAL TEACHING PARTNERSHIP MODEL : This model varies with
institutions but generally a collaborative relationship between the
clinical area and nursing program involving advanced practice nurse
and faculty member. Advantages of clinical teaching partnership
model:
Students develop
acquire clinical
advanced and
knowledge
for
practice and
,
technological skills
gain
understanding of the role for which student prepare By working
closely with a person in that role. Disadvantages of clinical
partnership model:
Advanced practice nurse is not available in all clinical setting
in Indian situation.
CLINICAL TEACHING SKILLS:
Assess learning needs of the students, recognizing and accepting
the individual differences. Communicates the objectives and
expectations very clearly to students before providing clinical
experiences to the students.
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Considers
students
needs
and
goals in
planning
the
clinical experiences.
Plan assignments that help in application of theoretical
knowledge in clinical practice and promote acquisition of knowledge
and development of skills.
Structures clinical assignments and activities Explain
accurately concepts and theories
in clinical to
practice so that they can accumulate on one another.
applicable
patient care.
Demonstrates sffectively clinical skills procedures and use of
technology. Provides opportunity for students to exercise clinical
skills and procedures considering the individual differences among
students.
Provide adequate exercises for students to solve problems,
arrive at clinical decision and use of critical thinking. Guides
learning. learning and students use of resources for
Is available always for students and especially when thay need
assistance. Provides specific timely feed back on students
progress. Encourages students to execute self evaluation Correct
mistakes immediately and supervises till perform correctly. Display
fairness in evaluation Uses variety of clinical Tching:Page 9
students
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strategies to create interest among students. Serves as role
model for students.
FACTORS INFLUENCING CLINICAL TEACHING: Irby
and
papadak
ids
identified
6
factors
that
are
associated with excellence in clinical teaching. Knowledge and
analytical ability Organization and clarity of presentation
Enthusiasm and stimulation of interest Group interaction skills
Clinical supervision skills Clinical competence and professionalism
FORSELECTION OF CLINICAL TEACHING
GUIDELINES METHODS:
Selection of method
must be appropriate to objectives and principles of
desired behavioral changes.
Selection of method must be in accord with learning.
Selection of method must be in accord with capacity of the
student. Know your student. Selection of method must be in
accordance with availability of resources.
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Selection of method must be in accord with teachers ability to
use it effectively and creatively.know yourself.
CLINICAL TEACHING METHODS: I) CASE METHOD: The case method of
teaching and learning used as a with group method of discussion.
Hippocratus teaching medicine . in 1940 is often Gragg had used
it
wrote an article which introduced a new case system of
instruction and described the teachers and the students roles any
there other in. in nursing case method nightingale has been than
used a extensively used as a prime method of teaching methods.
Florance
modification of the case study in the teaching of nursing
students. She adviced students to own a note book to make a note
quizzed taken place. There are three methods of which are
identified as ;
of exceptionally interesting cases and later
them to evaluate how much of learning had
Case study Case analysis method Case incident method A) CASE
STUDY:
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Case gives the
study breadth
describes and depth
the of
life an
history
of
an the
individual or all of the factors which affect a situation. It
individual . nursing case study centers on the patient, his
problems, his needs and nursing care. Both medical and nursing care
studies almost attain the well rounded picture of the patient from
the onset of the problem that is before hospitalization as well as
entire facts about his illness and treatments. B) CASE ANALYSIS
METHOD: Case analysis method of teaching focus on a central
situation which requires some decision or solution . it presents a
concrete case for analysis and discussion by a group of students
under the guidance Adequate information presented on the of the
clinical instructor. problem or situation.
to the students for them to make judgements
Objectives of the
case analysis method :
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Develop a mind that has the power familiar type of problems
explain wisely the basis for a decision.
to transfer from
to new ones and to be able to
Develop the ability to master a tangle of circumstancial
evidence , selecting important factors from a of facts and weighing
their importance in the the base. whole set context of
Enlarge the ability to utilize ideas, to test them against the
facts of the solution the problem , to examine ideas of the
problem. of the ideas already obtained with and facts and to
discuss ways which make them appropriate for
Extend the ability to utilize data from experience as a test of
validity flexibility to revise need arises. goals and procedures
when the
Expand the ability and communicate thoughts to others in a way
which stimulates further thought. Develop the ability to use ideas
in theoretical form to create a framework of general propositions
from a problem solving experiences.
General guides to use case analysis method: Establishment of
atmosphere:
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The teacher must establish a permissive non-authoritarian
injunction to think along certain lines preferred by the
instructor. And she should treat each student with respect,
tolerance and will to understand. All these would facilitate
student to express their ideas and gain familiarity with
difficulties in reaching conclusions and communicating others.
Student Preparation for discussion of the case: An important
prelude to productive group discussion relevant and meaningful.
Each student should be provided with a written copy of case to be
discussed. Bauer has developed an excellent student guide for
interpreting case material. He defines case interpretations as a
process of analysis and synthesis which goes through following
series of phases. 1. Identifying important event or events in the
case. It might be the problem of impersonal relationship, a
controversy over an issue etc. 2. Setting the stage for analysis of
the case by choosing an appropriate frame of reference or
conceptual model, for example , a theory which focuses on person or
their attitudes. 3. Identifying and classifying the parts or the
elements in the case . These may be persons , relationships,
values, customs etc. 4. Specifying the relevant attributes or
variables in these elements. These may be qualitative or
quantative.
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5. Relating these elements to one another to see if any type of
sequence or correlation or pattern changes . This is the beginning
of synthesis phase and purpose is trying to see trying to see the
structure of the case as a whole. 6. Explaining these connections
or patterns by going deeper than merely establishing connections or
correlations. This is done by applying abstract principles or
theories to concrete events in case. 7. Examining critically the
concepts or the themes used to determine their adequacy and to
suggest their possible alternatives and revisions. 8. Applying the
knowledge and understanding gained through the case analysis by
suggesting how decisions and actions in the case could have been
improved recommending a course of action or a change in policy.
Cases grow change during discussion : The background of knowledge ,
skills and experience of each student influences the way in which
he/ she deals with each case. One student may identify himself
/herself with a character in the case; other may project his / her
own feelings and attitudes into this situation; a third student may
deal with stereo types rather than with the people the case. All
these phenomena are typical and have to be dealt with if the
support of the class is to be maintained and if a leaning is to
result. Gragg identifies three objectively discernible phases
through which students passCLINICAL TEACHING METHOD, REKHA.C.R,1ST
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typically when learning by means of case analysis. They are
given below: 1. Discovering the inability to think of everything
that his fellow students can think of. It is discouraging to
students after having prepared a case as well as they can, to
listen for an hour in class to other students, bringing out all
sorts of interpretations and arguments that they had no thought of.
2. Accepting easily and without fear the need for cooperative help.
When this happens students learn to draw more fully on each others
ideas in working out problems. 3. Recognizing that teacher does not
always necessarily know the best answers and even when she does
seem to know them, each student is still free to present and to
hold his / her own views. When student reaches this point he/ she
is ready to make the independent progress. He/ She is Operating as
a responsible member of the community taking help when needed but
taking his / her own decisions without fear of disapproval or
search for an authoritative crutch to lean upon.
C) CASE INCIDENT METHODS : Case incident method of teaching is a
modification of the case analysis method. Originated by Paul and
Faith Pigors. It focuses on a critical or crucial incident in a
case or situation which requires immediate decision and action. It
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not present any background information ;it just pinpoint the
incidents which requires solution. The case incident may be used in
various ways. It may be used in such a way that part of the
procedure is to gather the background information on the case or to
describe what would be needed to make a logical decision. The most
usual way of using the case incidents is to state the incident and
then to ask the student what they would do in a similar situation
and to give their seasons for their decisions. The students may be
asked to make written statements which would be discussed later in
the class. The case incident of teaching may be used in class room.
In clinical conferences, in testing and evaluating students. Many
of the objectives identified for the use of the complete case
analysis method of teaching and learning also may be attained
through the use of this technique but not with the same degree of
depth and understanding, for it is a much less complicated and
rigorous technique of learning and teaching. The Pigors , the
originators of the case incident technique, suggest that it be used
in a five phase process. Phase 1: The Incident: After discussing
the various factors which may influence the behavior of adult
hospital, the class is presented with an incident taken from a life
situation . Phase 2: Getting the facts: The students are now asked
what information they need before they can make an effective and
intelligent decision. The leader has the fact of the case and gives
them as requested by the group. A group member mayCLINICAL TEACHING
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be asked to summarize the fact that are brought out before, to
check if any aspect is left out Without explanation. These may be
highlighted on the blackboard. When the facts have been developed
adequately, the group is ready to enter the next phase. Phase 3:
Determining the source of the problem and the consequences : In
this phase the group tries to determine what the crux of the
problem is that needs immediate decision and what the possible
consequences may be if an immediate decision is not made and acted
upon. Phase 4: Stating decisions and reasons for decisions by
individuals students : Each student is asked to write she would
have done in that particular situation. Phase 5: Identifying the
major decision and issues raised by the individual students through
group discussion: If the class group is small, each student can be
given opportunity to give her decision and reasons for it, which
are then discussed by the group. In contrast , if the class is
large, small group may get together and clarifies issues raised and
summarize the decision reached before joining the full class for
discussion. The objective of this phase is to identify and to
discuss the major decisions and issues raised by the
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individual members of the class and to classify them into
categories. D) NURSING CARE STUDY: Nursing case study describes the
actual nursing care of the patient. It is a case study in which
there is a holistic of the individual patient to bring about
complete understanding of the required nursing care, to provide a
factual basis on which to plan and to implement nursing care, to
get a perspective and understanding of patients total care, with
particular emphasis on continuity of the patient care. A nursing
care study may be hypothetical one , it may be a real life one,
either previously written or presently being studied and prepared
by a student.
Advantages of Nursing Care Study:1. Stimulates students to
utilize critical thinking, reflective
practical skills.2. Students learn to see the patient as a
person. Students are
directed to consciously plan a program of nursing care adapted
to the need of a patient.3. It accentuates health and social
aspects of nursing .CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
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4. It points out the relationship and the cooperation of the
various disciplines interested in patients problems.5.
Acquaints
the
students
with
professional
literature
pertaining to nursing problems.6. Enables the students to
compare the book and clinical
picture.7. Helps the student to integrate all his / her
knowledge of the
various subjects.8. Contributes to the building up of a specific
body of
knowledge in nursing science. General Principles in the Use of
the Care study: Students should study the patients state of health
and self help abilities , his / her cultural background, his / her
economic level, his / her hobbies , and interests , for an
understanding of all these factors will contribute to the patients
welfare. He / she should study the medical aspects of the patients
condition as this knowledge is essential to render timely nursing
care. Subsequent with the data collection from the patient
pertaining to health and illness. Formulation of nursing diagnosis
and description of the defining characteristics of a patient, helps
the student understand the patients condition better. All these
constitute the first part of the care study and the second part
involves with activities which the nursing student will be
concerned in giving holistic care to the patient. It involves
rendering nurse initiated,CLINICAL TEACHING METHOD, REKHA.C.R,1ST
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physician-initiated and collaborative management of the patient
. Nursing care study serves as an excellent medium to help the
student develop skills and techniques needed to function well the
nursing team. Emphasis should be on the individual needs of the
patient and how these needs met throughout nursing. Nursing care
study serves as an excellent means for the student to demonstrate
his / her nursing skills , his/ her scientific knowledge , his /
her sociologic and physiological insight into problems of the
patient and his / her skill in interpersonal relations with the
patient as a nurse. forms and presentation: The nursing care may be
: (a)Written and (b)Oral.
Advantages of written and oral nursing care study Advantage of
written nursing Advantage of oral nursing care care study It
provides for individual study It provides anPage 21
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differences student. It
of
the an self-
opportunity instructor students new correct information. to
for direct and
the a to of into
provides for
thinking errors
opportunity
channels
expression in writing. It provides experience in organizing and
writing a paper in a scientific manner. It provides a source of
material reference. for future
It serves as a basis for a better understanding relationship
instructor student. It is time saving. It does not require lengthy
recopying of notes into acceptable form. It offers an opportunity
for public is speaking invited the all of becomes and source
experience. Discussion after case cooperation This is a
presentation, personal and a a the between and
benefits from the study. motivation to the studentCLINICAL
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because he / she shares the benefits of his /her study with
other student ts. The student feels / the her thrill of achievement
in presenting his study to others.
Disadvantage of written and oral nursing care study
Disadvantages of written Disadvantages of nursing care study It and
notes does other are offer for an study is opportunity writing
creative used for
nursing care study It leaves no opportunity once and ideas. It
needs a great deal of time to rewrite into an acceptable form. the
complete, to branch out intertwine novel
expression because only presentation. It leaves no record for
future references.
II)
PROCESS RECORDING:
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A learning tool which aids a student to develop observation and
communication skills . DEFINITION OF PROCESS RECORDING: 1. The
process record as "a verbatum account of a visit for purpose of
bringing out the interplay between and the nurse and the patient in
relation to the objectives of the visit". Walker 2. Process
recording as "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 during
the conversation. -Hudson 3. Process recording is a written reports
or verbatum recording of all that transpired immediately before,
during and immediately following the nurse-patient interaction. It
may be written during the interaction or immediately after the
one-to-one interaction.
PURPOSE OF PROCESS RECORD: Guide the student in the development
of self-awareness of own behaviours-verbal and nonverbal on
patient. Encourage students to use variety of strategies to
accomplish the stated communication goal. Enable student to become
more objective in the processing of patient messages.CLINICAL
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Create opportunity for students to propose alternative response
to patient messages for faculty feedback. Provide the student with
the comparative record of own progress in the development of
communication skill. Help the teacher to gain understanding of
students progress in the ability towards therapeutic communication.
The process record may be used as a data-collecting instrument for
the following three purpose communication. 1. As a teaching tool 2.
As a self-evaluating tool 3. As a therapeutic tool. PROCESS
RECORDING TECHNIQUE: There are three important phases in process
recording that are give below : 1. Prepare the student for process
recording 2. Prepare nurse patient interactions. 3. Evaluating the
interactions by the instructor and the students.
1. Prepare the student : The teacher must assist the student to
define clearly the appropriate objectives to be accomplishing
regarding nurse-patient interactions. Then, the process record as a
teaching and learning tool should be discussed with the light of
these objectives and also to determine how it can be used best
toCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type text]
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accomplish the desired goals. Subsequent with this, teacher
should guide the students to write process records. 2. Recording
nurse- patient interactions: When used as a learning tool there are
four significant parts in process recording. They are (a) the exact
verbatim report of the patient- nurse conversation (b) The students
conscious feelings and his / her interpretation of the patients
feelings (c) Analysis for meanings and clues to patients need and
(d) The Instructors and students evolutions of the total process
recording experience. There are number of conditions which have to
be met if process recording is to be an effective teaching and
learning instrument. They are : A minimum of two people Reassurance
of the patient regarding the confidentiality of the interview. The
student also must be impressed with the importance of keeping the
interview material confidential. Recording of all verbal
interaction. Notations of thoughts, feelings and actions that the
student experiences during the interaction. Notations on the non-
verbal communication of the patient. Notation of the interaction
done as soon as possible after interaction occurs. Noting the time
lapse between interaction and actual recording.
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3.Evaluating the nurse-patient interactions : Following the
interaction data have been collected by the student, the teacher
and student have the subject matter or material of the learning
experience. Analysis of the data should be recognized as the crux
of the learning experience. Failure to follow up the recording of
an interaction with analysis of guidance in the analysis of the
interaction process renders the data fruitless and frustrates the
students effort. This element of analysis of data is time consuming
and should be considered by the teacher before he / she selects the
process recording as a teaching tool. During the process of
analyzing the recordings, the objectives of the learning experience
should be kept in focus. The teacher needs to guard against dealing
with process recording as written work to be handed in by the
student , corrected and returned . If the teacher to aid the
student to further to stage of self- evolution, he / she must
discuss the process record with the student. Rather than evaluating
a student behavioral response , the teacher should help the student
to explore the reason for such a response and the possible effects
it might have on nursepatient interaction. This would result in
deeper understanding of students behavior and effect that his or
her behavior may have on others . As the students still increases
he / she may assume greater responsibility for independent analysis
of the patient communication and his / her own. Thus , self-
evaluation is an integral part of process recording analysis.
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Advantages of Process Recording. Helps students to have an
objective look of his or her own communication skills. Provides
teacher with an accurate account of the students clinical learning
experience. Assists the teacher to explore the areas where students
require improvement a refine in communication skills.
Disadvantages of Process Recording : Lengthy involvement of time
in teaching and implementing this tool. It cannot record all subtle
nuances such as tones of voice, mannerisms, timing etc. as well as
other non verbal cues which a nursing student could miss. III)
NURSING CLINIC: The nursing clinic or patient presentation utilizes
the presence of a selected patient as its focus for group
discussion. It affords a direct experience in the discussion of
principles and practices of nursing care relative to a given
patient. The purpose is the improvement of nursing care. Students
have the opportunity to sharpen their observation and interviewing
skills whilePage 28
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simultaneously developing increased ability to see relationships
between the patient's concept of his health and nursing problems
and his resources for coping with the total problem and the nurse's
concept of the patient's problem and how it might be solved. The
most effective nursing clinics are those that are planned, which
involves (i) determining the purpose, (ii) selecting a patient for
whom students have given nursing care, (iii) securing the patient's
consent and proper legal clearance, (iv) selecting the setting to
be usedthe patient's bedside or a conference room visited by the
patient; and (v) providing advance preparation of the student in
terms of the name of the patient, the purpose, place, date and
time, and any specific instructions regarding preparation for the
discussion. The group discussion generally consists of three
phases: (i) the introduction, (ii) the patient-centered discussion,
and (iii) the evaluation discussion; the patient is present only
during phase two. The introductory phase serves to acquaint the
students with the patient's background, presenting nursing care
situation, the purpose of the discussion, significant observations,
types of questions to be asked, and needed information. During the
patientcentered discussion, a few simply asked questions directed
to the patient are usually sufficient for obtaining the needed
information. Ample opportunities should be allowed for patients to
verbalize their needs and how they see their particular problem.
Sometimes demonstrating a particular nursing care measure or
allowing theCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text] Page 29
patient to do so is sufficient for meeting the purpose. When the
patient appears unresponsive or tired, it is wise to close the
discussion, even The though the purpose may not have an been
accomplished. evaluation discussion offers excellent
opportunity for students to evaluate the patient's behavior,
ability to solve his own problems, and various other aspects. The
students can be evaluated in terms of their observations and
ability to use problem-solving techniques. The discussion should be
summarized in terms of application of background knowledge to the
given nursing care problem and goals accomplished, with provisions
made for follow-up on comparisons between the student's views of
the patient's problems and the patient's views of his problems.
Such an approach opens the door to many other ways of developing
the student's views of the patient's problems and the
patient's.
This same basic pattern can be adapted easily for use in
planning and implementing interdisciplinary patient-centered
clinics. The modification would be in terms of identifying kinds of
input needed from each team member and seeking appropriate
contributions from each. The nursing clinic is a group discussion
which utilizes the presence of a selected patient, whereby the
nursing aspects are presented and discussed.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text]
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In a nursing clinic the patient's medical history and therapy
are discussed only briefly, but the emphasis is on the nursing
problems, including the physical, mental and social aspects.
Purpose: 1. To apply theory into actual practice by observing
interviewing and studying a patient. 2. To apply knowledge and
experience to the real life situation. 3. To understand certain
types of apparatus. 4. To improve the nursing care. Size: Small
size, approximately 15 students. Preplanning the Clinic 1.
Determining the purpose of the clinic. 2. Selecting a patient for
home students have given the nursing care. 3. Securing the
patient's consent. 4. Selecting the setting to be used, i.e.
bedside or conference room. 5. Provicing advance preparation of the
students. Levels of Discussion: 1. Introduction.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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2. Patient centered discussion. 3. Post-clinic evaluation
discussion. IV) BEDSIDE CLINIC Bedside clinic always entails the
presence of the patient. Either the group visits bedside or the
patient is brought to the conference room. FORMS OF BEDSIDE CLINICS
Clinics may be given by the doctor in which case symptoms and
medical therapy are emphasized. Nursing clinics are conducted by
head nurse by clinical instructor PURPOSE 1. To provide a learning
experience for nursing student to collect information about the
patient with tact and skill. 2. To improve the student's ability to
solve nursing problems by detailed study and analysis of nursing
situation. 3. To realize the need for understanding each patient as
an individual in order to appreciate his problems and outlook. 4.
It helps the student to do nursing observation in an organised
systematic way. 5. To be able to work out a nursing care plan to
fit the needs of individual patient on the basis of his special
problems.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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6. To be able to recognize opportunities for health teaching in
the hospital. 7. To understand certain types of apparatus being
used on patients. 8. To improve the quality of nursing care. STEPS
INVOLVED IN CONDUCTING THE BEDSIDE CLINIC
Planning technique: Determine the clinic to whom it is to be
conducted, place, date and time of clinic to be held and on what
topic the students have to come prepared. Select a patient for whom
students have given the care. Secure the patient's consent as his
cooperation is essential during the clinic. Conducting bedside
clinic: After preplan, the next step is conducting actual clinic.
The clinic should be conducted in the ward or in a class-room,
which is adjacent to the ward. If such conveniences are not there,
the clinic should be held apart from other patients providing him
sufficient privacy in a corner of the ward. Physical and mental
comfort is provided to patients. patient is kept at ease. The
clinic usually lasts for 30 minutes. The number of students should
not exceed 10-15 in number.CLINICAL TEACHING METHOD, REKHA.C.R,1ST
YR M.SC(N)[Type text] Page 33
'The discussion relative to the nursing clinic consists of three
phases. introduction phase Patient centered discussion post clinic
evaluation . I) Introduction phase: This phase serves to acquaint
the student with the patient back grouping, presenting of question
to be asked, etc. II) patient centered discussion: During this
phase a few obtain the needed Ample simple questions are asked to
information from patient. No question nursing care situation, the
purpose of the clinic, significant observation to be made, type
which hurts the feelings of the patient should be asked.
opportunities should be allowed for patient to 'verbalize his needs
and how he perceives his particular problem. Soon after second
phase of clinic patient should be sent to the ward by thanking him
for his cooperation. III) Post-clinic evaluation: It offers an
excellent opportunities for students to evaluate the patient
behaviour, ability to sole his own problems and various other
aspects. The student can be evaluated in terms of their ability to
meet the stated purposes of clinic through their observations and
ability to meet theCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
M.SC(N)[Type text] Page 34
stated purposes of clinic through their observations and ability
to use problem solving technique. The nursing clinic provides an
excellent opportunity to show symptoms and to show how to use
different appliances in any particular condition and how nursing
situations and problems have been met. Advantages of Bedside
Clink/Bedside Teaching: 1. Bedside teaching puts the student in an
active actual situation. 2. Covers a limited group of students. 3.
Permits evaluation of degree to which educational objectives have
been attained. 4. Develops qualities of observation and decision
taking. 5. Ensures closer contact with reality
(Professional-patient health situation of community, colloaguos and
teachers). 6. Permits comparison between reality and theory. 7.
Enables students to develop self-confidence. 8. Increases
variability. Disadvantages of Bedside Clinic Bedside Teaching : 1.
High personnel costs. 2. Sometimes puts the patient in a difficult
situation.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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3. Poor standardization. 4. Narrow limits of utilization.
V)
INDIVIDUAL CONFERENCE
Individual conference is described as conversation with purpose.
This specific purpose in the interview is to obtain facts or to
provide information. The skills essential in successful use of
individual conference are skills in observation; in the use of
setting; in the establishment of rapport; in meeting resistance ;
in recognizing ambivalent feelings; in the establishment of
authority; in the use of questions and silence as a skillful
procedure. The individual conference can be used by the clinical
instructor to clarify class material, to supplement instructions,
to explain answers to questions of individual students which do not
concern the entire class. It can also be used as a means of
assisting the individual who is having difficulties in keeping up
with the class or the student with the potentiality of advancing
ahead of the group as a whole. Individual conferences facilitates
nursing students to understand the relationship between class
content of courses and the application of problems of nursing
practice and patient care. It can be a means or bringing unity to
the entire nursing course, by helping the student in integrating
his / her previous knowledge and experience in relation to the
present learning experience. Purposes:CLINICAL TEACHING METHOD,
REKHA.C.R,1ST YR M.SC(N)[Type text] Page 36
1. To guide in teaching. 2. To acquire more knowledge. 3. To
discover the interests, needs and the problems of the individual
student. 4. To help the student to help herself/himself. Teachnique
of the individual Conference: 1. Teacher should establish good
rapport with the students. 2. Allow him to talk freely 3. Teacher
should not show any prejudices, emotional reaction or bias
Principles of individual conference: 1.establishment of a definite
purpose and specific issues to be covered. 2. knowledge of the
student 3. provide privacy 4. provide sufficient time. 5. establish
good rapport 6. good listening 7. positive effect 8. recording of
dataCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type text]
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VI)
GROUP CONFERNCE
Conference is the act of consulting together. It always involves
a two way flow of conversation. Group should be small enough so
that member will be permitted to participate.
BENEFICIARIES OF THE GROUP CONFERENCE : The subjects discussed
in short group conferences are often of importance the entire
nursing staff. Conferences may be conducted by a student nurse ,
staff nurse , the assistance head nurse or head nurse. SUBJECTS
SUITABLE FOR GROUP CONFERENCES : The best subject matter for the
conference is patient care. The following subjects lend themselves
well to the group conferences : # Individualized nursing care . The
need for health teaching ,
symptoms to observe , methods to determine progress, suggestion
to approach the patient , way to help a discouraged patient. #
Importance of accurate recording on a patient whose diagnosis is
not established or one who is manifesting unusual symptoms. # An
unusual drug or treatment which is being used in the ward for one
or more patients. # Routine investigations and specific diagnostic
tests in relation to specific patients having such tests that
day.CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type text]
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# New hospitals or ward routines. # Changes in nursing
procedures. # Review of procedures which are unfamiliar or which
are not being performed well. # Display of equipment which has been
damaged by improper care, misuse, methods of prevention and so on.
TIME FOR CONFERENCE : Group conference may be held at any period of
the day when the staff is free to attend , that is, during a period
of relatively light ward activity. But when it is planned on same
hour weekly, the staffs can make themselves free during that hour.
PLACE FOR CONFERENCE : There are four requisites for the place
where conference are held. The patients must not be able to hear
any part of the discussion. Seating arrangements are essential.
Patients signals must register in the conference room unless some
members of the staff remains away from the meeting to care for
patients. The place for conference should be one where
interruptions will be minimal. VII) NURSING CARE CONFERENCES:
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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Nursing care conference is a method of teaching, which provides
an opportunity for an informal discussion of a problem and free
exchange of knowledge and experience about the common interest and
it consists of a group discussion using problem solving techniques
or nursing process. Nursing care conferences are so "old hat" and
so identified with basic nursing education that their potential
value in staff development and continuing education is often
unrecognised. Within the institution, particularly at the unit
level, a nursing care conference can provide a good learning
experience for all the staff who share a common nursing problem in
providing care to a specific patient. A nursing care conference is
designed around a consultation visit of a clinical nurse
specialist. But more frequently they are designed for the staff of
a specific nursing unit, and are planned around some aspect of
nursing care or focus on a scientific nursing problem presented by
a patient in that unit. A nursing care conference is a "course of
action discussion, the focus is on assessing the nursing problem
arriving at possible solutions, helping staff to examine a
patient's problems from his point of view". Planning and
Preparation : 1. The organisers should prepare well in advance
regarding particular conference.CLINICAL TEACHING METHOD,
REKHA.C.R,1ST YR M.SC(N)[Type text] Page 40
2. Before presenting, the student will have collected all the
data regarding the patient. She will have worked with that patient
and collected information about the signs and symptoms since how
long the patient is sick, the laboratory finding, his family back
grounds, socioeconomic conditions, etc. 3. The conference should be
planned in relation to the objective of the conference and it
should be spontaneous in nature. 4. The student should be given
ample opportunity to work in the ward for quite a good amount of
time before she is assigned to present in the conference.
Technique: 1. The nursing care conference is used as a consultation
tool to help in problem solving. 2. The teacher must be flexible
and she will help the students during discussion. 3. The conference
should involve all the students in discussion. The teacher involves
all the students by putting questions, giving guidance and
rechanelling, if necessary. 4. Teacher has to draw out the
potentials of the students to the maximum in discussion. She will
provide ample time for the students to think. Phases
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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The nursing care conference is used as a consultation tool to
help in problem solving. It has got three phases. They are: (1)
Opening phase, (2) Working phase (3) Closing phase. Opening phase:
The opening phase can be defined as the first two minutes of the
conference. The task here is to make a commitment to work on a
problem relating to a particular patient. What happens during these
few minutes often sets the tone for the entire session. Working
phase: The task of the working phase is to arrive at a consensus on
problem identification and solution. Once the patient is selected
we have found that a great deal of time during this phase is spent
in delieneating the problem clearly. In some conferences there is a
difference of opinion among the nurses, often the data are
inconsistent or incomplete. It is helpful the group focus their
discussion by asking direct questions, rephrasing what the group
has said and summarising. Sometimes, when data on the patient are
incomplete the group will try to fill in. If the consultant and
group view the absent data as critical to the solution, time is
better spent in getting the facts than in speculation. Conference
time can be used to identify just what information is needed.
TheCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type text]
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problems are identified and the group can often reach its own
solutions. Offering concrete solutions to problem behavior allows
the staff to feel they are getting something from the group and the
consultant who offers alternatives and support to a frustrated
staff establishes credibility and does them a great service and she
should be careful to ask the group's opinion on the validity of her
suggestions. Closing phase: Once the group has worked through
problem-solving and has decided on solutions, the next phase is
closure. The task here is to delegate responsibility to one or more
of the staff to act on the problems. Advantages 1. It helps the
students to collect the information in creative way, i.e. the
students will be able to validate the data pertaining to the
situation and appropriateness. 2. It provides real practical
learning environment to the students. 3. It fortifies the thinking
of students, thereby the creativity and judgement capacity will be
increased. 4. It provides free opportunity to think. 5. Each member
will be actively participating in the conference.
DisadvantagesCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
M.SC(N)[Type text] Page 43
1. It will be of little use if the students do not accustom to
such situation. 2. There are chances of using these conference
hours for classroom teaching.
VIII) TEACHING ROUNDS : The aim of teaching round is to acquaint
nurses/ student nurses with all patients on the ward in order that
better understanding and more purposeful care may be achieved for
each patient. Usually all patients are visited on rounds and the
visit is accompanied by a discussion pertaining to each patients
care. Ways of conducting rounds : The teacher with a group of
student nurses goes to patients room. The discussion should take
place outside the door out of patients hearing and then the group
moves towards the patient and converse few minutes and further to
next patient. The discussion must of necessity be brief including
only outstanding points if the purpose is to visit all the patients
on the ward. TYPES OF WARD ROUNDS : Rounds with doctors. Rounds to
discuss psychological problems. Nursing rounds. Medical round for
nurses.CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text] Page 44
Rounds with physical therapists. Social service rounds. ROUNDS
WITH DOCTORS : Sometimes the emphasis in teaching rounds is on
medical aspects of patients condition and care. A professor may
take medical interns to discuss the patients on the service. Often
the patient is examined in the presence of a nurse. It is highly
valuable experience for staff and student nurses to accompany group
of doctors. The student should accompany with head nurse or
clinical instructor in order to student. Social service rounds :
This is conducted by the medical social worker and attended by
doctors and nurses, keep the nurses in touch with social problems
of the patients and plans which are being made for their care
following hospitalization . Student nurses should be given
opportunity to attend theses rounds and value of discussion is
increased if the nursing implications are also highlighted. Rounds
to discuss psychological problems of patients: In hospitals with
psychiatry makes rounds with medical and nursing students to
discuss the psychological problems of all the patients. IX) NURSING
ASSIGNMENT: DEFINITION OF ASSIGNMENT :CLINICAL TEACHING METHOD,
REKHA.C.R,1ST YR M.SC(N)[Type text] Page 45
clarify concepts not understood by the
The assignment applies to that part of instructional activity
devoted to the clear recognition and acceptance by the pupil of the
next unit of learning to take place and of the processes by which
this learning may be achieved most effectively. DEFINITION OF
CLINICAL ASSIGNMENT It is that part of learning experience where
the students are assigned with patients or other activities
concerning to patients in clinical laboratory. OBJECTIVES 1. To
provide the patient with the best possible nursing care. 2. To plan
assignments which are interesting to nurses and stimulating to
their professional growth. 3. To provide a well-rounded educational
experience for student nurses. 4. Achieving good ward management.
METHODS OF ASSIGNMENT Generally there are three methods of
assignment : 1. Patient method. 2. Functional method. 3. Team
method.CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text] Page 46
1. Patient method : This method of assignment involves a nurse n
rendering complete nursing care to one or more patients including
complete nursing cares to one or more patients including complete
nursing care, treatments , medications , taking vital signs,
serving food and patient education. When she completes her duty or
during break hours, her group of patient is handed over to another
nurse for the period of her absence in order that the patient may
still receive individualized care. ADVANTAGES OF PATIENT METHOD:
Individualized nursing care is possible: When one nurse is
responsible for the total care of the patient she comes to him as a
person. She also extends her knowledge about the patients symptoms
and treatment. Patient develops a sense of belongingness and
develops trust on the nurse and will express about his problems and
progress to the nurse without reluctant. Better Nursing Education :
When nursing care is patient centered, the student and the way in
which they affect the patient knows the physically,
patient as an individual . She gains better knowledge of
disorders psychologically and socially. When the nurse / student
nurse is assigned to provide total patient care she has an
opportunity to make her plans for their patients care and to
observe the results of her efforts.CLINICAL TEACHING METHOD,
REKHA.C.R,1ST YR M.SC(N)[Type text] Page 47
Satisfaction of the nurse : Nurse attains satisfaction when she
has professional contact with the patient and the opportunity to
observe her plans of his care materialize. 2.Functional Method : In
this method of assignment , nurses are assigned to specific
functions in the ward such as administrating medications or
providing hair wash to all patients. The functional method may be
used at some periods when there is shortage for nurses. Very young
students may not be capable of providing total patient care when
they can be assigned this method. Advantages of Functional Methods:
More can be accomplished in a given period of time because there
are fewer interpretations, there is less confusion and because
skill develops when a purposeful activity is repeated often in a
short period of time.
3.Team Method : This method is in limited use in modified form
it is followed in some hospitals. The appearance of large numbers
of practical nurses and nurses aides in hospitals make it
imperative that some way be found to give these groups sufficient
supervision. This result has been the development of the team
method ofCLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text] Page 48
assignment in which 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. The team leader is always a
professional nurse. The members may be graduate or student
professional or practice nurses, nurses aids or any combination of
these. Advantage Of Team Method : This method has resulted largely
because of shortage of lack of professional nurses to provide total
care of the patient. Disadvantage Of Team Method: It can be
performed by individuals with less knowledge, skill and judgment
resulting in lack of execution of independent nursing
interventions.
CRITERIA FOR EFFECTIVE ASSIGNMENT i. Students are to be informed
of the objectives of their assignment to a particular ward/unit of
the area/ hospital for clinical experience. ii. iii. iv. Students
are to be oriented to new clinical area. Students are to be given
the learning experiences which are outlined in the objectives for
particular clinical experiences. Students are to given facilities
to practice nursing according to principles taught.CLINICAL
TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type text] Page 49
v.
Only recognized wards of the hospital or community are to be
selected for students to achieve required learning experience.
vi.
Assignments attained.
have
to
be
assigned
according
to
the
consistent level of learning that students have reached, or vii.
viii. ix. x. xi. xii. Proper guidance and supervision has to be
provided to the students during their clinical experience.
Sufficient time to be provided to carry out the assignment allotted
to the students. Student's performance should be evaluated and
discussed with the students for their improvement, correction, etc.
Students should be given opportunities for working in a team.
Students are to be encouraged to develop a pride in the nursing
profession. Students are to be watched, that high standard of
patient care are being practised by all concerned.
PRINCIPLES OF STUDENT'S ASSIGNMENTS: The rotation of students
through departments and wards should be according to the curriculum
plan of their course. Sometimes, reassignments can be arranged
according to the students who require the same kind of
experience.CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text] Page 50
First year students should be posted where they will receive the
maximum supervision and guidance from qualified nursing staff. The
departmental and ward sisters or nursing superintendent should be
informed in advance regarding the student's assignments in their
speciality. The individual student's differences should also be
informed to the staffs. The record should be maintained of the
number of hours spent on day, evening, night duty in each block of
experience. A record of sick leave and other types of leave
utilized by the students also be maintained. If needed, reposting
or reassignments may be done.
FACTORS TO CONSIDER WHILE PLANNING ASSIGNMENTS 1. The previous
clinical experience of the students should be considered. 2.
Students must be given sufficient time to study the patient's
records. 3. Proximity of patients should be considered. 4.
Assignments should be varied frequently enough to maintain the
interest of students.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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5. Sociological and the psychological aspects of the patient
should be considered.
X)
MORNING AND EVENING REPORTS:
DEFINITION:
A report summarizes the services of the nurse and or the agency.
Reports may be in the form of an analysis of some aspect of a
service.TYPE OF REPORTS 1. Oral report 2. Written report Oral
report: Oral reports are given when the information is for
immediate use and not for permanency. They may be based on
material included in a written report. An oral Report is made by
the nurse who is assigned to patient care to another nurse who is
planning to relieve her. The head nurse makes oral reports to the
supervisor, the nursing office and the doctor. Written reports:
Reports are written when the information is used by several people
or is more or less or permanent value. Day and night report
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
text]
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census, interdepartmental reports to admitting and business
office, are all included in written report. CRITERIA FOR A GOOD
REPORT Report should be made promptly, if they are to serve their
purpose well. A good report is clear, concise, complete. If it is
written all pertinent, identifying data are included, the data and
time, the people concerned, the situation, the signature of the
person making the report. It is clearly stated and well-organized
for easy
understanding. No extraneous material is included. Good oral
reports are expressed and presented in an interesting manner and
important points are emphasized. A good report is unhurried.
reports between the head nurse and her assistant : The assistant
head nurse should know everything pertinent to the management of
the ward even though she may never be concerned with parts of the
information. The well-informed assistant head nurse knows the
condition of all patients, the treatment they are receiving,
observations which are to be made, changes in the ward and hospital
routine, etc. In other words, sheCLINICAL TEACHING METHOD,
REKHA.C.R,1ST YR M.SC(N)[Type text] Page 53
has all the information she needs to keep the ward running
smoothly without interruption of waste of time. When the head nurse
returns to the wards after hours or days of absence, the assistant
head nurse tells her all changes in the situation including the
condition, the patients and happening during her absence. It is
advisable for the head nurse and her assistant to keep, in a note
book or in a note pad memoranda of information which they plan to
report. Reports Between Nurses Who Are Assigned to Bedside Care
Contents reports of students and staff nurses to those who are to
relieve them include the condition of all patients assigned to her
care treatments, and medications which have been given and those
which are due, adaptations in method required by each patient,
information about the patient as a person and his diagnosis if
these are not already known to the relieving nurse. Reports to the
Clinical Instructor: Reports to the clinical instructor include
everything in the ward situation which affects the educational
process. Hence they receives the same report relating to patients
as that given to the administrative supervisor. Since she is
responsible for teaching the instructor especially needs
information about concerning new drugs as well as therapeutic and
diagnostic measures which are being used. Report of the Charge
Nurse to the Physician:CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
M.SC(N)[Type text] Page 54
The specific information which every doctor expects to receive
from the nurse incharge of the ward relates to his patients under
her care. He wishes to be told of the symptoms which they show, the
results of treatment, inability to carry out his orders and
difficulties or mistakes in doing so. Day, Evening and Night
Reports : The change of shift report is the oldest report in the
nursing service. Since, its longevity attests to its importance in
carrying forward the goals of the enterprise. Though, it has
undergone so many changes over the years, it remains essentially a
transmission instrument for the care of patients from one set of
works to another, using a written report, the nursing care plan as
contained in a card file, and patients charts. Some institution
include only the sickest patients in the written report. Others
include them all. It may help the day nurses to start the day more
easily if the night nurse includes in her report a list of the
patients on whom new orders have been written. The daily census, or
the number of patients in the hospital at midnight, furnishes
important source material for hospital statistics. It can be
readily understood that census figures must be correct. XI) ROLE
PLAY:
DEFINITION :CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
M.SC(N)[Type text] Page 55
Role playing is a relatively new educational technique in which
people spontaneously act out problems of human relations and
analyze the enactment with the help of other role players and
observers. Role playing, sociodrama and psychodrama are closely
related and the terms role-playing and sociodrama are frequently
interchangeable. PURPOSES OF ROLE-PLAY IN NURSING 1. To convey
information. 2. To develop specific skills. 3. To develop a
situation for analysis. 4. To prevent alternative courses of
action. 5. To prepare for meeting future situations. 6. To develop
understanding of points of view of others. 7. Increasing their
insight into typical ways of dealing with them. PRINCIPLES OF
ROLE-PLAY 11. To convey information. 2. To develop specific skills.
3. To develop a situation for analysis. 4. To prevent alternative
courses of action.CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR
M.SC(N)[Type text] Page 56
5. To prepare for meeting future situations. 6. To develop
understanding of points of view of others. 7. Increasing their
insight into typical ways of dealing with them. SETTING UP OF
ROLE-PLAYING 1. Define the problem to be considered and the nursing
situation in a meaningful manner to all students in the class. 2.
Identify the characters in the situations and ask for volunteers to
play these roles. 3. Ask the participants to try to place
themselves in the position of the characters. 4. Caution the
participants against the desire to express their own ideas and
opinions. 5. Each class member selects one role and identifies
herself with it, listens and tries to anticipate what the persons
in the situation might say or do. 6. Never rehearse for role
playing. 7. At any point during a dramatization participants may
hold a short conference to clarify the problem under study. 8. The
length of the role play will depend upon how long it takes to make
the nursing situation clear and the students become aware of
feelings and thoughts of these in the actual situation.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type
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9. At the end of the activity time should be given for a
discussion. ROLE OF A TEACHER IN ROLE-PLAY OF TEACHING 1. This
provides the teacher with the opportunity to note individual
student needs by observing and analyzing her needs in a real life
situation. 2. Assist the student in meeting her own needs by either
giving her or encouraging group members to give her on the spot
suggestions. 3. Encourage independent thinking and action by
stepping aside on giving indirect guidance to emphasize them to
themselves. 4. The teacher can correct the errors and use the
role-play for specific teaching on the subject. VALUES OF
ROLE-PLAYING 1. Develop skill in leadership, interviewing and
social interaction. 2. Develop sensitivity to others feelings. 3.
Develop skill in group problem solving. 4. Develop ability to
observe and analyze situations. 5. Practice selected behaviors in a
real-life situation without the stress of making a mistake.
LIMITATIONS OF ROLE-PLAY: 1. Role-play places undue emphasis on the
dramatic aspects.
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2. It cannot be used successfully till the group understands and
accepts it as a method of learning. XII) FIELD-TRIP: A field-trip
is a visit especially planned for its possible contribution to the
objectives of the curriculum, course, project, lesson or other unit
of instructions. Field trip is one of the most concrete and most
realistic educational procedures. It is one of the oldest method
used even by the early Greek teachers. DEFINITION: An educational
trip is defined as 'an educational procedure by which the students
obtain first hand information by observing places, objects,
phenomena or activities and process in their natural setting, to
further learning'. PURPOSES 1. To provide real life situations for
first hand information. 2. To supplement classroom instruction, to
secure definite information for a specific lesson. 3. To serve as a
preview of a lesson and for gathering instructional materials. 4.
To verify previous information, class discussions and conclusion of
individual experiments.
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5. To serve as a means of arousing specific interest in
materials objects, places or processes. 6. To create teaching
situations for cultivating observation, keenness, and discovery. 7.
To serve as a means to develop positive attitudes values, and
special skills. ORGANISATION AND PROCEDURE OF FIELD-TRIP A.
Preplanning. B. Actual conduct of the trip. C. Evaluation. A)
Preplanning : By teacher By students By the teacher : 1. Decide on
the trip. 2. Know the resources. 3. Obtain administrative sanction
of school/college. 4. Dealings with the organisation - obtain
permission, data and time, visit and know the resources. Inform the
objectives. 5. Arrange transport, time, date.CLINICAL TEACHING
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6. Prepare the students with theoretical base. Teacher plans
with the students: 1. Formulate objectives. 2. List down specific
information to be obtained. 3. Formulate questions to be asked to
the guide and prepare guide sheet. 4. If a large group, divide and
allot specific jobs. 5. Brief them-equipments or accessories
needed, data and time of transport, actual location, set up,
conduct and behavior during the trip, safety precautions to be
observed. B)Actual conduct of the trip: 1. Follow the schedule. 2.
Strictly follow safety precautions. 3. Observe and collect
information needed. 4. Collect source/study materials if provided.
5. Teacher supervisors, and call attention to the pertinent points.
6. Observe formalities and extend courtesies. Points to Remember
Trip should follow in an orderly manner. Do not cause disturbance
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C)Evaluation phase : 1. Should be done as early as possible. 2.
Students write a report with the observations, effectiveness of the
trip, and difficulties faced. 3. Teacher evaluates the reports by
the student. 4. Teacher prepares an evaluation and along with
specific observations from the students maintains a record which
can be referred later. 5. Conducts discussion with the students.
VALUES OF FIELD TRIP 1) It breaks monotony of the classroom and
provides real experiences. 2) It 3) It furnishes first hand
information to supplement and to provides opportunity in learning
attitudes and positive enrich the classroom instruction. values,
i.e. cooperation, discipline. 4) They correlate and blend school
life with the outside world, providing direct touch with persons
and with community situations. 5) It provides opportunities in
learning and acquiring skills, i.e. observation, communication,
critical and social skills. 6) Students develop better
understanding of the aetiologic factors of disease.CLINICAL
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life
7) Field
trips arouse interest and vitalize instruction thereby
providing motivation, i.e. it provides opportunity to have above
participations and gears motivation. 8) It helps to create
situations which in turn help to develop observation and keenness.
9) Offers an opportunity to apply that which has been taught to
verify what has been learned. 10) 11) They serve as an effective
means of correlating the They provide opportunity to consider and
to solve subjects of the curriculum. problems arising from
individual and group participation in a natural social situation.
DISADVANTAGES OF FIELD TRIPS 1. Field trip is time-consuming. 2.
Careful planning is required. 3. Many parties to be involved,
cooperation, coordination of various agencies required. 4.
Transportation may be a problem. 5. Since the students are going
out of school/college premises it is risky, safety precaution
essential. 6. If the group is too large, effective observation
becomes difficult. 7. Inability to schedule the trip in time when
the unit is taught.
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8. It involves cost, i.e., sometimes cost involvement is more.
SUMMARY: The objectives of clinical experience are obtained
through
various methods of clinical teaching. Each method of clinical
teaching has its own merits and demerits. It is the responsibility
of the clinical instructor to select the apt method of clinical
teaching based on the objectives, type of experience and the level
of the students involved in the scenario.
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