Developing student evaluation instruments to measure instructor effectiveness

Teaching-learning in clinical education based on epistemological orientations: A multi-method study

INTRODUCTION

Teaching-learning is the heart of medical education in the clinical setting. The objective of this research was to develop a conceptual model of effective clinical teaching in undergraduate medical education and conceptualize its operational framework based on the best fit approach.

MATERIALS AND METHODS

This research consisted of three sub-studies conducted using a multi-method approach. The first sub-study was conducted using a qualitative meta-synthesis approach. The second sub-study used Clarke's situational analysis approach as a postmodern version of grounded theory. Finally, the third sub-study was designed in two stages. First, it was conducted using the expert panel, in the second step, framework of synthesis based on best fit, and the framework of Ottenhoff- de Jonge et al., which formed the basis of this study.

RESULTS

In the first sub-study, qualitative evidence on the factors of effective teaching-learning in clinical education was synthesized into five dimensions. Based on the second sub-study, the clinical teaching-learning situation in undergraduate medical education in Iran was represented in three maps, including situational, social worlds/arenas, and positional. Finally, in the third sub-study, based on model modification and development in the expert panel, the effective teaching-learning dimensions were developed into behavioral, social, pedagogical, technology, contextual, educational leadership, and financial dimensions. In the second step, based on the framework of Ottenhoff- de Jonge et al., a three-dimensional matrix was developed concerning epistemological orientations about teaching and learning.

DISCUSSION

Moving from a single teaching-centered and learning-centered orientation to a teaching-learning-centered orientation is required for effective teaching-learning in clinical medical education.

Professional approach: the key feature of effective clinical educator in Iran

Clinical educators have an important role in the successful completion of a student's clinical education. Clinical educating is a dynamic process that occurs in a variety of socio-cultural contexts. This study was conducted to determine Iranian nursing students and faculty members' perceptions of effective clinical educator characteristics. This study was based on Grounded Theory method. A total of 10 nursing students and clinical educators voluntarily participated in this study. Data was obtained through semi-structured interviews. The analysis was carried out by the Straus and Corbin method. Findings of the study yielded five significant categories. These include (1) personal traits; (2) meta-cognition; (3) making clinical learning enjoyable; (4) being a source of support; (5) being a role model. The core variable "professional approach" in clinical education integrates these categories. The results of the study illustrated that, in an Iranian context, effective clinical educators are those who are in harmony with the spirit of nursing, adopt a reflective approach, make clinical learning enjoyable and provide a patient-centred care. They act as a role model enabling their students to manage their vocational challenges, which are a direct result of the specific socio-cultural conditions of nursing profession in Iran.

Understanding the persona of clinical instructors: the use of students' doodles in nursing research

BACKGROUND

While it is true that understanding the attributes and unique distinction of the nursing faculty has been the subject of most of the studies, little is known about how the use of doodles can help surface the persona of the clinical instructors.

OBJECTIVE

This study aims to capture the essence or the lebenswelt of the concept of "clinical instructor" from the lens of students' doodles which have been considered as a powerful qualitative tool in articulating individual experiences.

METHOD

A total of 195 senior nursing students recruited from a comprehensive university in the Philippines were the subjects in this qualitative study. Data were gathered from self-generated illustrations and written explanations made by the subjects to identify their concept of effective and ineffective clinical instructors. Phenomenological reduction was observed through a repertory grid, where doodles drawn were listed, categorized and thematised to reveal the qualities of the clinical instructor.

CONCLUSIONS

The subjective nature of the findings, though not generalizable, has surfaced how doodling can be a potent tool in identifying collective interpretation of the essence of health professions construct such as the one under study. The doodles revealed that an effective clinical instructor (enlightening, engaging and embracing) is one who is able to facilitate the learning of the students as well as being able to establish a harmonious learning atmosphere for and with the students. On the other hand, an ineffective clinical instructor (detrimental, dangling, and disturbing) impedes students' development in the clinical practice by causing conflict through their personal attitudes and their teaching strategies. This can have benefits for clinical instructors, to improve themselves and realize the impact of their attributes to the clinical learning of students.

Student's perceptions of effective clinical teaching revisited

Despite a wealth of research on clinical teaching, the criteria for determining what constitutes effective clinical teaching remain poorly defined [Cholowski, K., 2002. Nursing students' and clinical educators' perceptions of characteristics of effective clinical educators in an Australian university school of nursing. Journal of Advanced Nursing 39 (5), 412-420]. This paper reports on two studies exploring second and third year nursing student's perceptions of effective clinical teaching over 14 years (1989-2003). The aim of the inquiry was to compare student's perceptions in diploma and baccalaureate programs within existing clinical contexts. This research used a generative approach to elicit learner's views of what teacher characteristics and contextual influences impact them in clinical settings. A convenience sample of 30 students at the end of second and third years volunteered to be interviewed in-depth for each study. The first study was conducted in a diploma program, whereas in the second study all but a few students were elected to complete a four year baccalaureate nursing degree. Findings from both studies are remarkably consistent. Students in both studies rated teacher knowledge as most important followed by feedback and communication skills. Teacher knowledge appeared critical in four areas: as it pertains to the clinical setting, the curriculum, the learner and teaching/learning theory. How well students perceived that they were accepted by staff, student-teacher ratios and peer support also appeared to impact student's views of effective clinical teaching. This research has implications for employment and evaluation practices for teachers in applied fields such as nursing. The study raises questions about the recent trend toward temporary employment of clinical teachers and in the separation of academic and clinical roles of nurse educators.

Central processing technician internship--a unique learning opportunity

A critical shortage of qualified central processing technicians and the opening of a new central processing department (CPD) were driving forces behind the development of a CPD technician internship program at one facility. Classes focused on the principles and practices of central processing, and an OR observation gave interns the opportunity to see the impact that the work of the CPD has on OR function and patient care and safety. Program evaluations have been positive, and staff vacancies have been filled with the graduates of the internship program.

Operating room registered nurses internship program. A recruitment and retention strategy

The acute nursing shortage, particularly in perioperative nursing, was a driving force for the creation of a registered nurse (RN) internship program. The program was developed according to the Association of periOperative Nurses (AORN) Standards and Recommended Practices and national practice. Program evaluations led to positive changes in the program. This article describes the process that was followed and the unique features of the program.