Clinical Teaching Methods
Clinical Teaching Methods
Clinical Teaching Methods
INTRODUCTION:
The clinical teaching methods is a type of group conference in which a patient or patient or
patients are observed and studied ,discussed ,demonstrated and directed towards the
improvement and further improvement of nursing care .Clinical teaching may be given by any
faculty member that is clinical instructor or tutor or ward staff and will concentrate on a
particular patient’s needs as a person and how the doctor’s treatment orders can be met by the by
the right understanding and nursing care .
DEFINITION:
The ideal way to teach clinical nursing is center the teaching around specific patients .
PURPOSES:
2. Conference
*Group conference
*Staff conference
*Individual conference
*Team conference
3.Bedside clinic
4.Nursing rounds
5.Assignments
6.Field visit
7.Process recording .
8.Ward teaching
9.Ward class
10.Ward clinics
11.Case method
13.Group discussion
14.Demonstration method
16.Health talks
Individualized care will be provided in holisticmanner .Here not only the client will be assisted
for therapeuticmeasures ,the family members also will be involved in educationabout illness and
health concept ,signs and symptoms ,treatment,prevention of the problem ,thereby the client and
whole family will be aware and involved in meeting the clients need .It isnothing but bringing
awareness and to reach the goal i.e. healthfor all .
2.Conference
*Group conference :
A conference is the act of consulting together of two or moreindividuals in an formal meeting for
the purpose of giving orexchanging ideas .It involves a two-way flow of conversation .
Purposes :
*Staff conference:
These type of conferences will be held in teaching institutions e.g.: faculty meeting, in hospitals.
E.g.; Nursing superintendent will conduct conference to all nurses .The leader of the conference
,opens it by briefly stating purpose even though the staff should already know the problem or
subjects to be discussed She starts the discussion by asking a careful thought out question or
prelude to the conference or making a statement designed to bring out needs suggestions or
problems of various staff members .The leader should accept each person’s suggestions as
worthy of consideration make a note it on a blackboard or small pad .Each member should
encourage to express their thoughts. The leader then summarizes the suggestions .A group
discussion is usually in order. The leader ends the conference by stating thenext steps and
delegating any responsibility that might be entitled.
Purposes:
2. Before presenting ,the student will have collected all data regarding the patient .She will have
worked with that patient and collected information about sings and symptoms since how long the
patient is sick.What are the laboratory finding? What about his family backgrounds
,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
Technique:
1. The nursing care conference is need as a consultation too 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 re-channeling if necessary .
4. Teacher has to draw out the potentials of thestudents to the maximum in discussion .She will
provide ample time for the student to think .
Phases:
The nursing care conference is used as a consultation tool to help in problem solving .It has got
three phases.
1. Opening phase
2. working phase
3. Closing phase
1.Opening phase :
It can be defined as the first two minutes of the conference. 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 .
2. 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 delineating the problem clearly .In some conferences there is a difference of opinion
among nurses often the data are inconsistent or incomplete .In is helpful the group focus their
discussion by asking direct questions,rephrasing what the group has said and summarizing
.Conferencing time can be used to identify just what information is needed .The problems are
identified and the group can often reach its own solutions .Offering concrete solutions to
problem behavior allows thestaff to feel they are getting something from the group and
theconsultant who offers alternatives and support to a frustratedstaff establishes credibility and
does them a great service and sheshould be careful to ask the groups opinion on the validity of
hersuggestions.The nurses can validate their anxiety by expressingtheir feelings .
3. 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. The student 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.
Disadvantages:
2. There are chances of using these conference hours for class room teaching.Conference is an
important method of clinical teaching. It uses problem solving techniques in discussion and the
students will have to identify the problems and solutions. It provides students ample opportunity
to think.
d) Individual conference:
Purposes:
1. To guide in teaching.
3. To discover the interests, needs and the problems of the individual student.
Techniques:
3. Provide privacy.
6. Good listening.
7. Positive effect.
8. Recording of data.
Practical Uses:
2. Supplemental teaching.
3. Discipline.
4. Clinical teaching.
e) Evaluation.
Use of Individual Conference in Nursing Courses:
4. It can be used as u means of assisting the individual who is having difficulties in keeping up
with the classroom situation.The individual conference can be a means of bringing unity to the
entire nursing course, by aiding the student in integrating her previous knowledge and experience
in relation to the present learning experience.
Nursing team conference as a teaching tool offers valuable opportunities for learning. The ability
to observe, report and analyze significant findings is put to its greatest test as students are
confronted with this daily responsibility. Concomitant values gained by this type of
experienceare related to the ability to share knowledge of patient’s needs and to work co-
operatively with other members of the nursing team and total health team. Such experiences
inevitably lead to the improved performance of nursing care activities in the clinical nursing
setting.
“The assignment method should be used which will make possible the best nursing care to the
staff members, giving them interest and challenge and that will keep the unit functioning
smoothly and effectively.
Meaning of Conference:
A conference is the act of consulting together the conference is the nucleolus of the in-service
nursing program me. Observation made during nursing team conference offer unique opportunity
for guidance of nursing service personnel.
Advantages of the Nursing Team Conference:
It is used to plan for the daily continuity of nursing care that best meets the patient’s
need.
As a teaching tool, nursing team conference, offers valuable opportunities for learning.
It gives an ability to observe report and analyze significant findings input to its greatest
test as students are confronted with their daily responsibility.
CONFERENCE PROCEDURE:
A time is planned each day for the members of the nursing team to meet as a group .During this
period, patient’s problem are identified and explored and an approach is developed by team .The
nursing care plans are revised or further developed according to changing needs of patients. Each
member of the nursing team has recorded during the course of the day and the response of the
patient to her care, questions and comments of the patient and individual notes are used as guides
in conference. The team leader, using the kardex as a guide, reads the patient’s name and
objective of nursing care .The members who have the contract with that particular patient discuss
his response to his care and any additional information from the patient or his family problems
are identified by the group, a plan is projected for the solution of the problems .The kardex is
revised and the objective is altered by the leader. The head nurse functions as a resource person
and assist the team leader and the team members in identifying nursing problems and developing
nursing care plans .The nursing team conference is the planning stage for the team and
assignment of nursing personnel for the following day is developed during and immediately after
the conference
Are held at the beginning of a work shift and an hour prior to the ending of the shift .The
purpose is to give and receive pertinent ,accurate information concerning the care of the patients
and to create an environment that encourages collective and cooperative participation .
Are planned meetings to identify problems and evaluate nursing care These conferences
provide a means for all the team who are directly contributing care to a group of patient’s have
benefit from the experience of others .The members as a group aim to formulate nursing
intervention for one or two patients analyze the nursing care given .The clinical nurse
coordinator and the supervisor are important members of the patient centered conferences .
It should be part of the planned scheduled meetings for each unit or section .The supervisor
assisted by the clinical coordinator is the leader here .The topics presented are discussed may
include standards of patient care and policies ,procedures ,safety measures ,infection control
,nursing audit evaluation ,unit staffing measures and clarification of new personnel policies .
3.BEDSIDE CLINIC:
As we all know a planned teaching should not be restricted to the classroom only .It is to
carryout in the clinical area .It is one of the best methods of teaching . The purpose of the
bedside clinic is to portray the nursing problems and to give viva picture of the related nursing
care by associating it with a specific individual .
Purposes:
1. To provide a learning experience for the nursing student to collect information about the
patient with tact and skill.
2. To improve the students ability to solve nursing problems by detailed study and analyzes of
nursing situation .
3. To realize the need for understanding each patient as an individual in order to appreciate his
problems and outlook .
5. To be able to workout a nursing care plans to fit the needs of individual patient on the basis of
his special problems.
*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 co-operation is essential during the 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.
1.Introduction phase:
If serves to acquaint the student with the patient background, presenting nursing care situation,
the purpose of the clinic, significant observation to be made, type of question to be asked, etc.
During this phase a few simple questions are asked to obtain the needed information from
patient. No question which hurts the feelings of the patient should be asked .Ample opportunities
should be allowed for the patient to verbalize the needs and how he perceives his particular
problem .soon after second phase of clinic patients should be sent to the ward by thanking him
for his cooperation .
It offers an excellent opportunities for students to evaluate the patient behavior ,ability to solve
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 ability to use problem
solving technique .
Advantages:
Disadvantages :
3. Poor standardization .
4.NURSING ROUNDS:
It is an excursion into patient’s area involving the students learning experiences .Nursing rounds
revealed that students responded to this method of teaching with enthusiasm .Their interest in
learning increased and they showed ability to share ideas and knowledge with others for the
benefit of patients Nursing rounds are given separate names according to the purpose they serve .
It is used to acquaint the staff with all patients on the ward or division .
b)Instructional rounds :
Here the nurse is expected to read the charts and come to rounds with basic information in mind .
This is to help the nursing staff learn to conduct initial interviews make assessment of patient’s
needs and identify nursing care problems .
6. To compare method of meeting nursing needs and to have better understanding and to give
more purposeful care to patients.
7. To illustrate successful improvisation and to give opportunity for the use of different
applications .
1. To consult student’s previous clinical experience to avoid repetition and to add to earlier
experience .
3. If some demonstration is done ,it should not have a deleterious effect on the patient .
8. Record the nursing rounds in the ward teaching records with a summary of nursing points
stressed .
1. Demonstration of symptoms
2. To clarify terminology
· Herpes simplex
· Anemic pallor
3. Effects of drugs
· Allergic reactions
· Side effect
5. Successful improvisation
· Neutral position
· Fowlers position
In nursing rounds ,a small group of staff or students preferably not more than 4 or 5 and a leader
or a teacher visit the bedside of patient.
The head nurse selects the patients before hand according to the time available .Rounds not lost
longer than an hour .The head nurse needs to read the patient’s histories ,know the plan for their
treatment and its results the patient’s progress and prognosis ,their nursing care and its
effectiveness .She should post the time for rounds at least a week in advance and indicate the
type of preparation the nurse is to make ,that in whether she is to know thoroughly the history
care and progress of her own patients or briefly that of all patients in the ward . The central
figure in nursing round is the patient .If the purpose of the sound is instructional or problem
solving the patient will be included in the discussion.
A brief conference at the side of the patient’s room/word has to beheld. Necessary data are given.
The purpose of the visit to the patient is by the head nurse, special observation to be made or
pointed out at this time. 4 to 5 patients are selected for instruction. 4-5 minutes are apent. The
head nurse herself may present the uses or she may ask the students who are assigned to these
patients to answer the questions of the group or her questions. The students are asked to present
the cases regarding other particulars. The participants may also be involved such as counting
pulse, respiration, examining the conjunctive, pitting, edema etc. The patient’s case sheet can
also be utilized with presentation. Thank the patient before leaving and tidy up the bed.
Post Conference:
The presentation is summarized and further explanation if any, may be given, questions are
invited from the students.
5.NURSING ASSIGNMENT:
Definition:
It is the past of learning experience where the students are assigned with patients or other
activities concerning to patients in clinical laboratory.
Objectives:
2. To plan assignments which are interesting to nurses and stimulating to their professional
growth.
1. Patient method:
In this method of assignment a nurse is expected to give complete nursing care to one or more
patients including general nursing measures, treatment, medications, taking temperature, pulse,
respiration, serving nourishments and giving health instructions. If she goes on “off duty” her
group of patients in taken over by another nurse for the period of her absence in order that the
patient may still receive individualized care.
In the nurses are assigned to specific functions in the ward such as giving medications or
treatment to all patients, taking the temperature of all or giving general nursing care to a group of
individuals. Most hospitals which use the patient method modify it to some period of the day
such as evenings and nights when a few nurses are on duly.
Nursing care is given to the patients with team conference by all the members of the team.
Nursing leader supervises and guides the team in giving quality nursing care. The principles
relative to making assignments within the team will include….
1 .In planning the patient care a well qualified team members are involved in which amount and
type of responsibility, a student can assume depends upon a stage of her education.
2. All the physical needs and treatment are given by the same nurse but the specific treatment is
given by professional nurse.
3. When two persons are needed to give a patient certain care it is often well for the team leader
to be one of the two. When assisting a team member, the leader has an opportunity to observe the
condition of the patient, work of student and aid and relationship with the patient and at the same
time he can teach them.
iii. Students are to be given the learning experiences which are outlined in the objectives for
particular clinical experiences.
iv. Students are to given facilities to practice nursing according to principles taught.
v. Only recognized wards of the hospital or community are to be selected for students to achieve
required learning experience.
vi. Assignments have to be assigned according to the consistent level of learning that students
have reached or attained.
vii. Proper guidance and supervisor has to be provided to the student during their clinical
experience.
viii. Sufficient time to be provided to carryout the assignment allotted to the students.
ix. Student’s performance should be evaluated and discussed with the students for this
improvement, correction etc.
xii. Students are to be watched, that high standard of patient care are being practiced by all
concerned.
2. Adjusting plans to meet existing and an anticipated conditions in the clinical setting and
merging patient needs, revising in effective plans or pursuing additional experiences to meet the
learning needs best.
Advantages:
Patient method:
Functional method :
method”.
b)Most work is turned out in less given period of time .
If there is no cooperation within the team members ,the work will not be done properly and
patient will suffer . It is one of the best methods of teaching, by which, students get more
learning experiences and patient gets good care and good ward management.
6. PROCESS RECORDING:
Definition:
-“Walker”
2. “ An exact written report of conversation between the nurse and the patient during the time
they were together”.
-“Hudson”
-“Conen”
Guidelines to student:
1.Your goals for working with assigned patients should be written down before starting the
process recording .
3.Mention about the therapies which patient is getting both past and present .
6.A brief description should be written about the setting and situation before your conversation .
8.Identify mental mechanisms that you think the patient is using and give examples .
9.After completion of process record ,give your comment on how well you were able to meet the
goals which you set before starting your work .
10.Evaluate the process record as a learning experience for you at the end of the assignment.
7.FIELD VISIT:
It is a visit especially planned for its possible contribution to the objectives of the curriculum
,course ,lesson or other unit of instructions.
Definition:
It is defined as an educational procedure by which the students obtain first hand information by
observing laces ,objects ,phenomena or activities and process in their natural setting ,to further
learning.
Purposes:
2. To supplement classroom instruction ,to secure definite information for specific lesson .
a. Preplanning
c. Evaluation
a. Preplanning :
By teacher
By students
By teacher :
5. Brief them ,equipments or accessories needed ,data and time of transport ,actual locations ,set
up ,conduct and behavior during the trip ,safety to be observed .
Points to remember :
C. Evaluation phase :
1. Should be done as early ads possible
2. Students write a report with the observations effectiveness of the trip and difficulties faced.
4. Teacher prepares an evaluation and along with specific observation from the students
maintains a record which can be referred later .
1.Knowledge :
The teacher has to survey the area to know whether the field trips planned will contribute to the
attainment of desired
objectives.
2.Rapport :
The teacher should establish and maintain cordial relations with those in charge of the situations
to be visited .
3.Objectives :
It should be stated carefully and completely .The learning activities have to be selected and it
should contribute for the attainment of objectives .
Necessary arrangements have to be made with the administrative personnel of the place to be
visited regarding the time ,place of meeting and the length of visit .
Students should be given an opportunity to list cooperatively the objectives for which the trip is
planned
Directions to be given, on the procedure to be followed in the observation and the special points
to note.
6.Supervision :
Trip should be supervised carefully. The teacher can assist the student by calling attention to
pertinent point .
An hour should be allotted for an open discussion .It can be done by means of student’s reports.
2. It furnishes first hand information to supplement and to enrich the classroom instruction .
3. It provides opportunity in learning attitudes and positive 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 .
7. It 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. They serve as an effective means of correlating the subjects of the curriculum.
11. They provide opportunity to consider and to solve problems arising from individual and
group participation in a natural social situation .
Disadvantages of field trip :
5. Since the students are going out of school /college premises it is risky ,safety precautions
essential.
8.It involves cost ,i.e. sometimes cost involvements is more . These kind of field visit provides
opportunities ,encourage thoughtful attitudes and personal growth .One student may be chosen to
express the thanks of the group at the time and another may write the letter of appreciation .
PURPOSES:
· To aid the student to make correct applications of scientific principles basic to a particular
nursing activity .
· To enable the student to gain a real understanding of individual differences and substitute
variations of case and circumstances to factfully respond and adjust to them by adopting nursing
procedure and treatment without violating basic principles.
9.WARD CLASS:
A class will be conducted based upon current clinical experience of the student for whom the
class is planned. Small group should be planned that is, all the students at one level of
experience, who are having similar, experience, who are having similar experience in particular
department.
10.WARD CLINIC:
· In this type, a client is presented to the group, who illustrates all signs and symptoms and
require all nursing case procedures.
· Instructor should explain before hand, to the client about the purpose of the clinic.
· Student should understand the purpose on improving the standards of nursing care and their
contributions should be directed towards at its end.
11.CASE METHOD:
1. Case study
2. Case analysis
The student will be given the opportunity to provide nursing care for specific client, after 4 or 5
days of
careful study, the student nurse will prepare case study by comparing with the text, the student
presents the case before the batch of companions, general discussion about the client will be
dealt.
2. Case Analysis:
A concrete case for analysis and discussion by a group of students under the leadership of the
instructor.
A critical incident technique which requires immediate decision and action is taken from a case
and presented to the students for their analysis and decision .No background information is given
to them regarding details of the incident at the time ,it is presented .The instructor will have facts
about the care can be given as requested by the students .
Here the intellectual capacities of trainees will be utilized in solving or suggesting solutions to
problems and make the group to become active and answer the problems among them only . The
instructor will acts as a referee and give answers for the unsolved problems . For example the
cancelling of AIDS –in this topic the expert in the field will make certain opinion regarding
AIDS and make the group into 2 or more sections ,according to the number of trainees will be
given one paper to write opinions and will give 3 minutes time and request whether it falls into
high ,low ,do not know like ,she has to give explanation. Then the referee will ask other groups
,are they satisfied with that particular explanation .if no ,trainee is answering correctly for any
problems ,then the trainees will be expert would clarify it. Here the brain of the trainees will be
sharpened and the entire class will participate in discussion ,group will become active and
enthusiastic .
13.GROUP DISCUSSION:
A cooperative problem solving activity which seeks a consensus regarding the solution of a
problem .
Values :
1.It encourages the student to think for her ,to develop critical habits of study .
2.To interpret problems of the past ,that she can throw light into ways for shaping the future .
4.Enables the student to enrich her own conceptions by reacting to those of others .
5.The teacher can observe the student as she participates in the class and can plan for individual
differences .
6.It gives the student an opportunity to learn how to adjust to social situations .
10. It provides proper social environment by the development of favorable attitudes towards
cooperation and responsibility.
· The seminar
· Role playing
· Case analysis
· Symposium
· Panel
Uses :
To demonstrate different approaches in establishing rapport with patients ,so that the most
effective nurse patient relationship may be established .
15.LABORATORY METHOD :
Planned learning activity dealing with original or raw data in the solution of the problems
.Laboratory method is a procedure involving first hand experience with primary source materials
,through which the student can acquire psychomotor as well as mental skill .
Values :
For student ….
For teacher ….
A little encouragement or special help at the right movement may intensify interest and provide
the hopes for independent accomplishment in future.
1.Introductory phase :
Student preparation :For orientation and motivation achieved through proper instructions and
guidance.
Supervised study activity ,in which the student is involved in a first hand experience designed to
achieve particular objectives by solving the problems.
3.Culminating activities :
After the lab work ,the class should meet together for discussion of common problems ,for the
organization of findings ,for the presentation of the results of individual or group problem
solving activities .
16.HEALTH TALKS :
This method will be used when teaching for clients and their relation or a mass .It can be used in
hospital and in community.For example ,educating the mass about health and its aspect.Health
talks can be conducted incidentally and in a planned manner .
CONCLUSION
BIBLIOGRAPHY :