The view from within: perspectives of clinical teaching

Supervision of Resident Physicians

Supervision of resident physicians is a high-risk area of emergency medicine, and what constitutes appropriate supervision is a complex question. In this article, policies and procedures for appropriate supervision of resident physicians and the implications for billing are reviewed. Recommendations on supervision of resident physicians in the emergency department are detailed, with attention paid to addressing challenges in balancing patient safety with resident autonomy and education during the course of patient care and graduate medical education.

Professional Development Needs of Novice Nursing Clinical Teachers: A Rapid Evidence Assessment

The current nursing profession is challenged with a decreasing supply of competent clinical teachers due to several factors consequently impacting the quality of nursing education. To meet this demand, academic nursing programs are resorting to hiring expert nurses who may have little or no teaching experience. They need support during their transition from practice to teaching. Using the systematic approach of a Rapid Evidence Assessment (REA), scholarly literature was reviewed to identify existing professional development needs for novice clinical teachers as well as supportive strategies to aid the transition of experienced nurses into teaching practice. The REA included 29 relevant studies. Findings revealed three main professional development needs for novice clinical teachers and key supportive strategies. Based on these findings recommendations for best practices to support and prepare novice clinical teachers are presented.

An analysis of clinical teacher behaviour in a nursing practicum in Taiwan

AIM AND OBJECTIVES

The aim of this study was to identify and assess the teaching behaviours (knowledge, attitudes and skills) observed in nurse educators as they taught in the clinical setting.

BACKGROUND

Many quantitative studies have defined and evaluated teaching effectiveness in the clinical area. Some of these studies established instruments to evaluate faculty effectiveness in the clinical setting; however, they tended to be so broad that they were of limited use in understanding clinical teaching behaviours in nursing education.

DESIGN

This study explored clinical teaching behaviours in a nursing practicum. Ten nurse educators taught 10 students in the medical-surgical unit at a hospital in Taiwan for about four weeks. Each teacher was observed by the researcher and one other observer for two days during regularly scheduled clinical teaching time.

METHODS

Data collection and analysis were done by a qualitative approach. Content analysis is a process of identifying, coding and categorizing the themes in the data.

CONCLUSION

The themes of clinical teaching that emerged from data analysis included teaching aims (task-oriented and learner-centred), teacher competence (teacher knowledge, instructional strategies, planning learning experience, teaching priorities, feedback and caring) and teaching commitment (professional identity and giving of self). These findings offer a holistic blueprint of clinical teaching for nursing faculty members, which will enhance the quality of nursing education.

RELEVANCE TO CLINICAL PRACTICE

Complexity in nursing education has increased as it is challenged to meet the needs of diverse populations in rapidly evolving and highly technical health-care settings. Clinical teachers must be enabled and empowered to provide students with appropriate knowledge and skills to meet the needs of patients. To develop students' professional nursing identity now and in the future, nurse educators have to commit themselves to both nursing and teaching in clinical settings. More nurses need to be prepared for careers in education at the master's and doctoral levels.

Effective supervision in clinical practice settings: a literature review

CONTEXT

Clinical supervision has a vital role in postgraduate and, to some extent, undergraduate medical education. However it is probably the least investigated, discussed and developed aspect of clinical education. This large-scale, interdisciplinary review of literature addressing supervision is the first from a medical education perspective.

PURPOSE

To review the literature on effective supervision in practice settings in order to identify what is known about effective supervision.

CONTENT

The empirical basis of the literature is discussed and the literature reviewed to identify understandings and definitions of supervision and its purpose; theoretical models of supervision; availability, structure and content of supervision; effective supervision; skills and qualities of effective supervisors; and supervisor training and its effectiveness.

CONCLUSIONS

The evidence only partially answers our original questions and suggests others. The supervision relationship is probably the single most important factor for the effectiveness of supervision, more important than the supervisory methods used. Feedback is essential and must be clear. It is important that the trainee has some control over and input into the supervisory process. Finding sufficient time for supervision can be a problem. Trainee behaviours and attitudes towards supervision require more investigation; some behaviours are detrimental both to patient care and learning. Current supervisory practice in medicine has very little empirical or theoretical basis. This review demonstrates the need for more structured and methodologically sound programmes of research into supervision in practice settings so that detailed models of effective supervision can be developed and thereby inform practice.

Concept mapping. Navigating the learning process

Critical thinking, meaningful learning, and concept synthesis are key phrases pervading nursing literature as educators strive to promote optimal learning and improve clinical instruction and problem solving across levels of nursing education. Concept mapping offers a state-of-the-art metacognitive approach to achievement of these important goals. The author explores concept mapping from the perspective of cognitive theory, analyzes its strengths and drawbacks, presents examples of various concept maps and graphic organizers, and suggests pragmatic applications to nursing clinical, classroom, curriculum, and research situations.

The use of questioning strategies by clinical teachers

By using questioning and other appropriate teaching strategies, clinical teachers can facilitate the development of critical thinking, decision making and problem solving in students. This study examined clinical teachers' use of questioning and the variations in their use of questioning as a teaching strategy. Although there was a variation in the number of questions asked, predominantly low level questions were asked by 26 clinical teachers at two post-clinical conferences. Based on the findings of this study, it is recommended that clinical teachers are taught how to ask questions, particularly high level questions.

Learning the practice of nursing: views about preceptorship

The provision of clinically based education for nursing students is an essential part of their learning needs. In this article, the opportunity to enhance clinically based learning by means of preceptors is discussed and investigated. A case study was conducted of one college of nursing after the introduction of the Preregistration Diploma of Higher Education in Nursing (Project 2000) course. The study involved preceptors (62), nursing students (15), ward managers (4), senior nurse managers (2) and nurse teachers (8). The investigation involved quantitative and qualitative approaches, data being gathered through questionnaires and interviews. The results indicate that preceptors included functions such as being a role model and supervision of learners' skills but not assessment as part of their role. These views were supported by students, teachers and managers. Knowledge of the clinical area and experience were reported to be preceptors' greatest assets for the role but lack of time to work with students was cited as the greatest barrier. Extra resources required were reported to be protected time for the student and preceptor to work together and further in-service education. The implications of these results for clinically based learning opportunities in the future are discussed.