Creating the Optimal Clinical Environment
Nurse educators are responsible for both didactic and clinical education. Much thought and planning goes into determining clinical content and clinical placements. Before you can negotiate clinical partnerships, you must decide on the type of clinical experiences students need and where they can get them. After completing this week’s reading, and reflecting on your experiences as a student, consider how an educator should go about making these kinds of decisions.
Initial Post: Use these prompts to think about the topic and share your ideas.
- How would things like active learning, action and reflection, and higher level thinking influence your decisions about student placement (i.e. where would you place new students vs. senior students and why)?
- Scheduling students on the same floor for longer periods of time allows students to adjust and feel comfortable in the learning environment. On the other hand, more frequent changes may provide a greater variety of clinical experiences. As an educator, how do you choose? Which do you prefer? Which do you think students prefer? Support your answers with information about best practices.
- What balance of clinical observation vs. hands on care is optimal and why?
- Who should have the greater role in guiding and supervising students on a clinical floor, the instructor or staff nurses/preceptors? How might this be negotiated/configured.
Influence of Active Learning, Action, and Reflection:
When deciding on student placements, the principles of active learning, action and reflection, and higher-level thinking should play a significant role. These principles can guide decisions regarding where to place new students versus senior students.
- New Students vs. Senior Students: New students would benefit from placements in more structured and familiar environments where they can observe and gradually participate in patient care. Placing them in settings with routine cases can help them build foundational skills and gain confidence. On the other hand, senior students, who have a stronger grasp of fundamental concepts, could be placed in more complex and challenging situations. This could encourage them to think critically, make decisions, and manage unexpected scenarios effectively.
Scheduling and Variety of Experiences:
Balancing longer placements on the same floor with frequent rotations involves considering the trade-offs between comfort and variety.
- Longer Placements: Longer placements on the same floor allow students to become familiar with the unit’s workflow, build rapport with staff and patients, and gradually assume more responsibilities. This can enhance their learning by enabling them to engage in continuity of care and experience the progression of patients’ conditions.
- Frequent Changes: More frequent rotations expose students to a wider range of cases and care settings. This variety can foster adaptability, expose students to diverse patient populations, and help them develop versatile skills. However, frequent changes might limit their ability to develop deep relationships with patients and colleagues.
Optimal Balance of Observation and Hands-On Care:
The optimal balance between observation and hands-on care depends on the students’ level of expertise and the learning objectives.
- Early Stages: In the early stages of education, students should emphasize observation and gradual participation. This ensures they develop a solid foundation of theoretical knowledge and a clear understanding of procedures before taking on direct patient care responsibilities.
- Advanced Stages: As students progress, the balance should shift toward more hands-on care. They should be given opportunities to apply their knowledge, make clinical decisions, and manage patient cases under appropriate supervision.
Guidance and Supervision: Instructor vs. Staff Nurses/Preceptors:
The roles of instructors and staff nurses/preceptors are both important in guiding and supervising students.
- Instructor’s Role: Instructors bring comprehensive theoretical knowledge and pedagogical expertise. They can facilitate discussions, provide context, and help students connect theory to practice. Their role is crucial in helping students critically analyze their experiences.
- Staff Nurses/Preceptors: Staff nurses and preceptors offer practical insights, real-world experience, and role modeling. They can provide immediate feedback on technical skills and share practical tips for effective patient care.
Negotiating/Configuring the Roles: The roles can be negotiated through collaboration and clear communication. Instructors can work with preceptors to establish learning objectives, expectations, and evaluation criteria. Regular meetings can ensure alignment and allow for addressing any challenges.
Ultimately, the ideal clinical environment involves a balanced approach that adapts to students’ needs, learning objectives, and the progression of their education. This balance should incorporate active learning, reflection, and exposure to a variety of experiences, while being underpinned by effective guidance and supervision from both instructors and experienced clinical staff.