Observation in the Clinical Setting

Definition• Observation of an

actual experience in the field or of a demonstration provides for learning through modeling. (Oermann)

Observation in the Clinical SettingValued Purposes

• Prepares learners for future experiences with clients, giving them a perspective of what the care or specific intervention is like

• Enables them to view others in practice, which serves as guide for the development of their own behaviors

• Makes it possible for students to observe a clinical situation with which they may not have an opportunity to be involved themselves

• Provides a means for improving their own observation skills

Observation in the Clinical Setting

• Learners may be assigned to observe nurses or other professionals performing various aspects of healthcare that learners usually cannot perform.

• Learners might be placed, for instance in an endoscopy room or cardiac catheterization lab for few hours of observation.

Observation in the Clinical Setting

• Give some guidelines to channel their observations, they usually find this as a valuable experience.

Observation in the Clinical Setting

Action Student 1 Student 2 Student 3Contributes ideas

Encourages participation

Checks for understanding

Describes feelings

Summarises

Gives group direction

Makes connections to new and old learning Is on task

Other

Observation in the Clinical Setting

If they can be paired off with nurses whom they can both observe and ask question, the learning experience may be even better.

• Field trip is one of the most concrete and most realistic educational procedures

• It is one of the oldest method used even by the Early Greek teachers.

Definition

∞ An educational procedure by which

the students obtain first hand information by OBSERVING places, objects, phenomena or activities and process in their natural setting, to further learning’. ((Basavantappa))

Definition

∞ It provides an opportunity for observations outside of the clinical setting in which students are presently involved in practice. Students gain experiences that are generally not available in their own setting to augment current knowledge and acquire a broader perspective of health care problem or issue under discussion. (Oermann)

Purposes• To provide real life

situations for first hand information.

• To supplement classroom instruction, to secure definite information for a specific lesson.

• To serve as a preview of a lesson for gathering instructional materials.

Purposes• To verify previous information,

class discussion and conclusion of individual experiments.

• To serve as a means of arousing specific interest in materials objects, places or processes.

• To create teaching situations for cultivating observation, keenness and discovery.

• To serve as a means to develop positive attitudes values, and special skills.

Organization and Procedure of Field Trip

• Preplanning

• Actual conduct of the Trip

• Evaluation

•Preplanning–By teacher

–By students

•  

PreplanningBy the teacher

• Decide on the trip.

• Know the resources.

• Obtain administrative sanction of school/college.

• Dealings with the organization-obtain permission, data and time, visit and know the resources. Inform the objectives.

• Arrange transport, time and date.

• Prepare the students with theoretical base.

PreplanningTeacher plans with the students

• Formulate objectives.• List down specific information to

be obtained.• Formulate questions to be asked

to the guide and prepare guide sheet.

• If a large group, divide and allot specific jobs.

• Brief them-equipments or accessories needed, data and time of transport, actual location, set-up, conduct and behavior during the trip, safety precautions to be observed. 

Actual Conduct of the trip• Follow the schedule.

• Strictly follow safety precautions.

• Observe and collect information needed.

• Collect source/study materials if provided.

• Teacher supervisors, and call attention to the pertinent points.

• Observe formalities and extend courtesies.

Evaluation Phase• Should be done as early as

possible.• Students write a report with the

observations, effectiveness of the trip, and difficulties faced.

• Teacher evaluates the report of the student.

• Teacher prepares an evaluation and along with specific observations from the students maintains a record which can be referred later.

• Conducts discussion with the students.

• Experiences of the student and information obtained during the trip should be carefully correlated and integrated with the class subjects and activities. 

Organization and Procedure of Field TripThe essential prerequisite to any successful field trip is a well

thought out plan.

• Knowledge: Teacher has to know whether the field trips planned will contribute to the attainment of desired objectives.

• Rapport: The teacher should establish and maintain cordial relations with those in charge of the situations to be visited.

• Objectives: Objectives should be stated carefully and completely. The learning activities have to be selected and it should contribute for the attainment of objectives. Time and Transportation: Necessary arrangements have to be made with the administrative personnel of the place to be visited regarding the time, place of meeting and length of visit.

Organization and Procedure of Field TripThe essential prerequisite to any successful field trip is

a well thought out plan.

• Preparation of the Students: 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 an observation and special points to note.

• Supervision: Trips should be supervised carefully. The teacher can assist the student by calling attention to pertinent point.

Values of the Field Trip

• It breaks monotony of the classroom and provides real life experiences.

• It furnishes first hand information to supplement and to enrich the classroom instruction.

• It provides opportunity in learning attitudes and positive values, i.e. cooperation, discipline.

Values of the Field Trip

• They correlate and blend school life with the outside world, providing direct touch with persons and with community situations.

• It provides opportunities in learning and acquiring skills, i.e. observation, communication, critical thinking and social skills.

• Students develop better understanding of the etiologic factors of a disease.

Values of the Field Trip

• Field trips arouse interest and vitalize instruction thereby providing motivation, i.e. it provides opportunity to have above participations and gears motivation.

• It helps to create situations which in turn help to develop observation and keenness.

• Offers an opportunity to apply that which has been taught to verify what has been learned.

Values of the Field Trip

• They serve as an effective means of correlating the subjects of the curriculum.

• They provide opportunity to consider and solve problems arising from individual and group participation in a natural situation.

Disadvantages of Field Trips

1. Field Trip is time-consuming.

2. Careful planning is required.

3. Many parties to be involved, cooperation, coordination of various agencies required.

4. Transportation may be a problem.

Disadvantages of Field Trips

5. Since the students are going out of school/college premises it is risky, safety precaution is essential.

6. If the group is too large, effective observation becomes difficult.

7. Inability to schedule the trip in time when the unit is taught.

8. It involves cost, i.e., sometimes cost involvement is more.

NURSING ROUNDS• Nursing Rounds is an

excursion into patient’s area involving the students learning experiences. ((Basavantappa))

NURSING ROUNDS• Involves a group of learners and

their instructor visiting patients to whom the learners are assigned. (De Young)

NURSING ROUNDS• A small group of staff members, not

more than five and a leader or a teacher, visit, the bedside of clients. (Neeraja)

NURSING ROUNDS• Involve the observation and often

interview of a client or several clients in the setting, generally followed by group discussion. (Oermann)

NURSING ROUNDSNursing rounds

are given separate names

according to the purpose they serve.

1. Information giving rounds • It is used to

acquaint the staff with all patients in the ward or division.

NURSING ROUNDSNursing rounds are

given separate names according to the purpose

they serve.

2. Instructional rounds • The nurse is

expected to read the charts and come to rounds with the basic information in mind.

NURSING ROUNDSNursing rounds are

given separate names according to the purpose

they serve.

3.Problem solving rounds • This is to help the

nursing staff learn to conduct initial interviews make assessment of patient’s needs and identify nursing care problems.

NURSING ROUNDSPurposes of Nursing

Rounds • To demonstrate

symptoms important in nursing care.

• Clarify terminology studied.

• To compare patient’s reaction to disease and study the disease conditions.

• To demonstrate effects of drugs, i.e., indication, actions, and reaction to drugs.

NURSING ROUNDSPurposes of

Nursing Rounds • To demonstrate skillful

nursing care.

• To compare method of meeting nursing needs and to have a better understanding and to give more purposeful care to patients.

• To illustrate successful improvisation and to give opportunity for the use of different applications.

NURSING ROUNDSFactors to be

considered when Planning Nursing Rounds 

• To consult student’s previous clinical experience to avoid repetition and to add to earlier experience.

• Keep in mind the probable value and availability of clinical material.

• If some demonstration is done, it should not have a deleterious effect on the patient.

• Explain the plan to the patient.

NURSING ROUNDS

Factors to be considered when Planning Nursing Rounds 

• Introduce the patient to the group.• Make the patient feel important.• Have post-conference for summary and further

explanation.• Record the nursing rounds in the ward teaching records

with a summary of nursing points stressed.

NURSING ROUNDSAdvantages of

Nursing Rounds • Make classroom

discussion more vivid and real and thus improve learning experiences.

• Response of the patient is more natural.

• Students can select patients with specific problems and plan proper nursing care.

NURSING ROUNDS

Disadvantages of Nursing Rounds

• Requires very careful planning

• A small group of students can be taken out at time

NURSING ROUNDSThe ways of conducting

nursing rounds are as follows:

1. Patients are selected with nursing problems to reinforce their theoretical knowledge.

2. The group observes the behavior of the patient at the bedside and make proper comments The group observes the

equipments and articles under use.

The students return to the classroom to discuss the nursing diagnosis and needed nursing care for patients.

NURSING ROUNDSSome examples

and types of nursing rounds:

1. Demonstration of symptoms.

2. To clarify terminology• Herples Simplex• Anemic Pallor

3. Effects of drug• Allergic reaction• Sedative effect

NURSING ROUNDSSome examples and

types of nursing rounds:

4. Skillful nursing care

• Progressing improvement of bed sore.

• Maintenance of adequate fluid intake (oral)

5. Successful improvisation

• Use of chair as backrest

• Device for support of ice bag

6. Posture and position as indicated for patients

• Neutral position

• Position for surgical shock

• Fowler’s position

• Position for CCF

NURSING ROUNDS

Method of Conducting nursing Rounds

1. A brief conference at the side of the patient’s room/ward has to be held.

2. Necessary data are given.

3. The purpose of the visit to the patient is outlined by the head nurse, special observation to be made or pointed out at this time.

4. 4-5 patients are selected for instruction.

5. 4-5 minutes is spent

NURSING ROUNDSMethod of Conducting

nursing Rounds 6. The head nurse/Clinical instructor 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.

7. The students are asked to present the cases regarding the particulars.

8. The participants may also be involved such as counting pulse, respiration, examining the conjunctive, pitting, edema, etc.

9. The patient’s case sheet can also be utilized with presentation.

10.Thank the patient before leaving and tidy up the bed.

thank you for listening….