Complementary Clinical Experiences In Clinical Learning Environment In Nursing Education

Nursing Education and Complementary Clinical Experiences In Clinical Learning Environment

Nursing Grand Rounds In Clinical Learning Environment, Concept Based Learning Activities In Clinical Learning, Written Assignments In Clinical Learning, Point-of-Care Technology and Mobile Health, Models for Clinical Education In Clinical Learning.

Nursing Grand Rounds In Clinical Learning Environment 

    The practice of nursing grand rounds is a teaching strategy that uses the patients’ bedside for direct, purposeful experiences. These experiences may involve demonstration, interview, or discussion of patient problems and nursing care. Rounds also afford an excellent opportunity for the exchange of ideas about patient care situations, which may involve clinical faculty, students, and staff.

    The use of rounds as a teaching strategy requires planning. Planning includes obtaining permission from the patient and providing information about the nature of the rounds and the role the patient will play. After the session, patient participation should be acknowledged and some form of debriefing should occur, including planning for subsequent rounds.

Concept Based Learning Activities In Clinical Learning 

   Concept-based learning activities are a type of experience used recently in clinical education (Gubrud-Howe & Schoessler, 2009; Nielsen, 2009; Nielsen, Noone, Voss, & Matthews, 2013). This learning activity is designed to develop deep learning and pattern recognition of a particular health problem or medical diagnosis. 

  Concepts are identified for students to study in the context of the patient care environment. Fluid and electrolytes is an example of a concept students may explore. Each student completes an in-depth assessment of a patient with a fluid and electrolyte problem. The pathophysiology, treatment, pharmacology, and patient response to care is explored. 

    The faculty facilitates comprehensive discussion of each case and directs discussion so students begin to see the similarities and differences between each patient in an effort to begin to identify salient findings related to each case. The faculty help students identify unexpected findings in the patients’ situation related to the concept being studied and help students recognize current or potential complications that need to be addressed. 

    Students are not responsible for care but need to address any safety issues that emerge as they are assessing their assigned patient. This activity allows the student to focus on critical thinking about the concept being studied without the distraction of attending to tasks associated with general patient care (Nielsen et al., 2013). 

    Communicating the focus of this assignment and learning activity with staff is essential to avoid misunderstanding of the student’s role on the unit (Gubrud Howe & Schoessler, 2009).

Written Assignments In Clinical Learning 

    Written assignments generally complement clinical experiences and are considered to be useful in that they facilitate development of critical thinking and clinical reasoning and they promote an understanding of content. Such assignments may include short papers, clinical reasoning papers, nursing care plans, clinical logs, journals, and concept maps. 

    Findings from research on the use of clinical logs indicate that their use provides opportunities for students to reflect on clinical experiences, communicate with the teacher, identify mistakes and negative experiences, and learn from these experiences.

Point-of-Care Technology and Mobile Health

    Nurses are increasingly using handheld devices, electronic health records, and other point-of-care technologies in the clinical setting, and faculty must provide opportunities for students to become familiar with their use. 

   Simulated electronic health records can be embedded in clinical simulations as preparation for their use in the clinical agency or as a substitute for learning when agency policy precludes students’ use of them in the agency. 

    Smart phones equipped with reference software enable access to clinical information; care plans; and nursing, procedure, and evidence-based practice guidelines; and can provide access to skills videos and patient teaching materials (Zurmehly, 2010). 

   Increasingly, nurses are using software applications (“apps”) on a smartphone to diagnose, monitor, and teach patients in community-based settings; students must have experience using these point-of-care and mobile health technologies as well. 

Models for Clinical Education In Clinical Learning

    Several models for clinical education are used to educate nursing students. These models, alternatives to the traditional model, include preceptorship, associate model, paired model, academia service partnerships, and adjunct faculty joint appointments. 

    These models have evolved to increase capacity for clinical placements, facilitate development of competency for today’s practice, manage faculty shortages, prepare graduates to be competent for practice, and foster closer ties with clinical agencies (Delunas & Rooda, 2009; Murray, Crain, Meyer, McDonough, & Schweiss, 2010; Neiderhauser, Macintyre, Garner, Teel, & Murray, 2010; Niederhauser, Schoessler, Gubrud-Howe, Magnussen, & Codier, 2012; Nielsen et al., 2013). 

    Given the diversity of health care settings, faculty shortage, and the need for reduced faculty-to-student ratios, new models serve to enhance effective student learning, facilitate development of clinical skills, and promote role development.