Linical Teaching/Learning Experience posts

Respond to at least three of your colleaguesa postings in any of the ways suggested below.


Suggest why you might see things differently.


Offer and support an opinion.


Validate an idea with your own experience.


Expand on your colleagueas posting.

1st response 80 words and one quote Christina



Week 5 Discussion: Clinical Teaching/Learning Experience



Something about community health has always interested me. When I was a BSN student, I was excited when my clinical rotation in community health started.



Describe one clinical experience of yoursa either as an educator or as a learnera that you consider to have been particularly challenging and/or unsatisfactory. What was the specific learning goal? In what kind of clinical setting did it occur?



On one day, I was paired with another student and we were sent off to do a home safety assessment in a patientas home. We had no direct supervision a neither instructor nor nurse accompanied us. My colleague and I completed our visit, however, neither one of us knew what to do a but at least the patient was happy for a little companionship. As the weeks progressed, our clinical days were more of the same. Finally one day I asked one of the nurses what a typical day involved for them; I have a passion for home health care and wanted to learn more about it because itas where I wanted to work. The nurse laughed at me (in front of my instructor) and replied that only experienced nurses can work in home health and so there was no point in training students. The instructor said nothing to these comments, she just shrugged.



Explain what was challenging and/or unsatisfying about this experience for the various partiesa the clinical educator, the students, and/or others involved in the learning experience. (To preserve privacy, do not use actual names.) Analyze the learning experience in terms of its design and implementation. Were the problems due to personal, environmental, and/or organizational challenges? Evaluate the instructoras behavior as a role model in this situation.



What I found so frustrating was that I had no role model nor any inside information into this field that really interested me. Bradshaw and Lowenstein (2011) note that professional identity mentoring is a key component of clinical instruction. The instructor had no experience in community health nursing, the nurse had no interest in students, and most other students had no interest in community health nursing as well. Goals and outcomes were not clearly defined, after our patient visits we simply reported what we did to our teacher then left for the day. Documentation was minimal in poorly kept charts that only students used (the nurses did not want us charting in their charts).



Propose how you would approach this learning situation differently if you were the educator now. Describe at least two strategies or actions you would implement in order to maximize the benefits of this experience for the learner, while also safeguarding any patients involved. Provide a rationale for your choices.



A year after graduation, I landed my dream job in community health and have been there ever since. From bedside, to specialty, to administrative roles, I have worked in a variety of community settings (and loved them all!). As healthcare reform continues, more care is being administered in the community and many agencies are beginning to hire new grads (Billings & Halstead, 2009). When I assign nursing students in the community, I always pair them with a nurse who has been trained as a preceptor. The use of preceptors allows the student to become socialized to the role of the community nurse (Billings & Halstead, 2009). Having direct supervision increases patient safety while allowing the student to gain experiences. The other main strategy I use with students is feedback. While I observe each student in practice, I rely on the preceptors to inform me on how well the student is performing. I also discuss with the student how they feel they are doing. Community nursing requires a lot of autonomy and at times can be lonely. Nurses and students alike need to be reminded that they are never truly alone and that help is a phone call away. In this situation, feedback that is individualized and that fosters independence is very useful (Tanner, 2005). Students often fear calling for support, however, this practice is key in community health to safeguard both nurse and patient safety.



Consider the ways in which reflective thinking might be incorporated as a strategy in this learning experience. Would it be useful in this particular clinical teaching/learning situation? If so, explain how you might implement it. If not, briefly describe a clinical situation in which you would make use of reflective thinking as a teaching/learning strategy.



Community health is such a unique and individualized practice that reflective practice is crucial for professional success. Since no two students will ever have the same experience, a classroom blog where students share what their day was like would be very useful. Bradshaw and Lowenstein (2011) note that this practice would also be useful for nurses as a staff development tool. Students and new nurses could benefit from reading reflective blogs kept by more experienced nurses. As the need for nurses working in the community increases, students need more exposure to this area of practice.





Resources

Billings, D. M., & Halstead, J. A. (2009). Teaching in nursing: A guide for faculty (3rd ed.). St. Louis, MO: Elsevier Saunders.

Bradshaw, M. J., & Lowenstein, A. J. (2011) Innovative teaching strategies in nursing and related health professions (5th ed.). Sudbury, MA: Jones and Bartlett.

Tanner, C. (2005). The art and science of clinical teaching. Journal of Nursing Education, 44(4), 151-152.