Shifting the focus to · PDF file · 2013-08-01staff nurses, and have meaningful learning opportunities? ... Fluid & Electrolytes, Nutrition ... – Attends to sequencing of activity

Shifting the focusto Learning

Clinical Education Redesign:Key Questions

• What are the purposes of clinical education?

• Is total patient care the best approach to achieve these goals?

• How can we protect the safety of patients, reduce burden on staff nurses, and have meaningful learning opportunities?

• How can we help nurses prepare for future practice through clinical experience in today’s health care systems?

The New Science of Learning

• Situated Learning

• Problem Based Learning

• Deliberate Practice

• Cognitive Apprenticeships

• Fill out, extend, deepen theoretical knowledge

• Develop practical knowledge

• Develop skilled know‐how

• Develop habits of thought:– Clinical Judgment– Critical thinking & perspective‐taking– Ethical reasoning

• Develop understanding of self as instrument of care

© Oregon Consortium for Nursing Education OCNE Do not replicate without permission

Purposes of Clinical Education

CERG Partners Together

© Oregon Consortium for Nursing Education OCNE Do not replicate without

permission

CLINICAL LEARNING MODEL

CLINICALLEARNING

Focused Direct

Client Care

Intervention Skill

Based Experiences

Case BasedSimulation

Concept Based

Integrative Experience



CLINICALLEARNING

Focused Direct Client Care

Intervention Skill

Based Experiences

Case BasedSimulationConcept Based



Concept‐Based Learning

• Example: Fluid & Electrolytes, Nutrition and Skin Condition


CLINICALLEARNING


Intervention Skill

Based Experiences


Concept Based


Do not copy without permission.© Oregon Consortium for Nursing

Education OCNE Do not replicate without permission

Case‐Based Learning

• Example: Care of child with acute asthma in the ED


CLINICALLEARNING

Focused Direct

Client Care

Intervention Skill

Based Experiences


Concept Based


.© Oregon Consortium for Nursing Education OCNE Do not replicate without permission

Intervention‐Skill Based Learning

• Example: Flu Vaccinations in a seasonal clinic


CLINICALLEARNING


Intervention Skill

Based Experiences

Case Based

SimulationConcept Based



Focused Direct Care

• Example: Patient Safety


CLINICALLEARNING


Intervention Skill

Based Experiences

Case BasedSimulationConcept Based




• Example: short integrative experiences throughout the curriculum and 240‐480 hours with a Clinical Teaching Associate (CTA)

• “Designed in” strategies and design– Planned learning activities to achieve specific outcomes

– Attends to sequencing of activity that systematically and explicitly builds understanding and leads students to the point of handover where they are becoming responsible for the undertaking

Macro Scaffolding

• Strategies used “in action” which reframe, redirect, or recontextualize the students actions or thinking with intent to support accurate conceptual understanding or appropriate application of knowledge/understanding

• In new and more complex situations the student may require scaffolding support again

Contingent Scaffolding

Oregon Consortium for Nursing Education (OCNE): Elements of Clinical Education

OCNE Clinical Model for EARLY Clinical Learning Experiences

Intervention‐SkillBased

Case BasedConcept Based

Direct‐FocusedCare



Focused DirectPatient Care

Concept Based

Case Based

InterventionSkill Based

OCNE Clinical Model for MID‐Clinical Learning Experiences



II

OCNE Clinical Model for LATE Clinical Learning Experiences

Concept‐Based

Case‐Based

Intervention‐

Skill Based



On you 3 X 5 card:

• 1. When were you most engaged during today’s session? What is most useful to you?

• 2. What are questions, concerns, puzzles that you would like us to address?

Documents

Shifting the focus to · PDF file · 2013-08-01staff nurses, and have meaningful learning opportunities? ... Fluid & Electrolytes, Nutrition ... – Attends to sequencing of activity