Response Article Discussion Paper

The article has been well presented in three sections to discuss the different aspects of clinical nursing education. The first section discusses the advantages and disadvantages of clinical laboratory and simulation experiences as two learning approaches. It defines the two approaches, noting the situation in which they are useful as well as how to maximize the gains that can be derived from them as well as the key differences. However, it does not include the disadvantages of the two concepts. The disadvantages should mention how the two learning approaches fail to realistically replicate complex care conditions, high costs that drain limited learning resources, taking up space, requiring significant attention from stakeholders, and unrealistic expectations. Including the disadvantages in the discussion offers a more comprehensive awareness of the two learning approaches, presenting their true value to clinical learning education (Gaberson, Oermann & Shellenbarger, 2015). The second section discusses the expectations of students as they prepare for a clinical learning experience.

However, it fails to present the expected material since it only talks about the need to set realistic expectations but does not present the actual expectations. There is a need to include student expectations such as meeting communication needs, incorporating practice into theory, access to instructors, overcoming practice fears, and demonstrating expertise and competence (Gaberson, Oermann & Shellenbarger, 2015). In addition, this section should mention information on reasons why students can fail to meet their learning expectations. This could include failure to understand the expectations, and personal factors. Discussing both the expectations and reasons for failing to meet them allows readers to understand the position that these expectations play in the learning environment so that faculty members are better prepared to instruct their students throughout the clinical experience (Billings & Halstead, 2016). The final section discusses what clinical educators should consider when planning pre-conference, post-conference and off-unit experiences for students as clinical learning activities. It defines the three activities and uses the definition as the basis for planning, explaining how communication is central to planning for the three activities. Still, there is no clear demarcation of what educators should plan for when preparing for these activities. Response Article Discussion Paper For instance, there is a need to note how educators should plan for exploring the verbalized and non-verbalized responses of students to previous clinical encounters. This would be an acknowledgement that some students will not verbalize their concerns and there is a need for educators to identify these concerns and ensure that they are accounted for as students are prepared for the clinical experience (Billings & Halstead, 2016). Overall, the paper has been well written using descriptive language and examples that engage readers to learn more about clinical nursing education.

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References

Billings, D. & Halstead, J. (2016). Teaching in nursing: a guide for faculty (5^th ed.). St. Louis, MO: Elsevier.

Gaberson, K. B., Oermann, M. H. & Shellenbarger, T. (2015). Cleaning teaching strategies in nursing (4^th ed.). New York, NY: Springer Publishing Company, LLC.

1. Clinical Lab/SIM

Simulation can be an excellent exercise in helping students identifying their strengths and weakness in terms of clinical care. Though simulation can be a source of stress for the students involved, the benefits may bear fruit once they are in clinical. Learners are varied and simulation can provide an environment where different learning style may be accommodated (Gaberson, K. B., Oermann, M. H., & Shellenbarger, T., 2015, p. 182). Simulation before clinical may be used as a measurement of student ability, but a clinical laboratory can help to improve different nursing skills before an actual rotation. Patient care can be replicated, but the physical and mental aspect of caring for a unique individual may not be easily replicated. After having experience is a different conversation altogether. A study of various nursing professionals on performing a perioperative simulation scenario revealed that these individuals stated they were able to apply what was learned to their current practice (Whelan et al., 2018). A survey was sent to the individual’s post-simulation and 86% indicated they were satisfied with the intended results of the exercise. For students, simulation can build upon skills learned during clinical and address areas of potential weakness. Simulation can’t replace live patient experience, but it may be an asset for their development.

2. Expectations

Expectations for clinical learning depend on the level and year of the learner. A clinical cohort for fundamental would have vastly different expectations than a final practicum student. The author’s specific cohort are first-semester nursing students and their level generally reflects basic nursing knowledge. Expectations would be conveyed pre-conference on each clinical site visit. This can assure there is a goal each time students begin their day and progress as the semester continues. If expectations are not met, students can be addressed by individuals or as a group to help voice concerns. Even as an educator, the expectation may need to be adjusted if they are not appropriate for the learner’s level. Simulation can also be an option to help improve areas of concern as well. A study was conducted with nursing students to improve the safe administration of medication pre and post-simulation (Green, 2018) Students were anxious throughout, but the results showed improve skills in the safety of administrating medication (Green, 2018). Setting expectations for students requires a thorough assessment of the students, educators, and even the facilities in use. There are options to address goals not being met to improve both students and educators alike.

3. Conference/Off Floor
   • Pre-conference

Pre-conference can be used as a way to voice expectations, early anxiety, and how to improve upon earlier encounters. Students should enter clinical knowing what to expect, what areas of improvement that need to be addressed, and which staff to be assigned too. Educators may also look at the patients on the unit in which they will be practicing and assign students based on skills and experience they need to encounter.

• Post-conference

Post-conference serves as a reflection of the experience and dialogue to begin. Development of problem-solving, critical thinking, and clinical, debriefing of clinical experiences, development of cooperative learning, group process skills, assessment of own learning, and development of oral communication skills can all take place during post-conference and be developed during each site visit Gaberson, K. B.,Oermann, M. H., & Shellenbarger, T. ,2015, p. 246). The events of the day must be addressed with students and any goals not met to voiced as well. The goal of the post-conference is to confirm the purpose of the site visit was achieved and students can build upon the experience.

• Off-unit experiences

Off-Unit experiences serve to expand the clinical site visit for the student. Off-unit experiences can have a relation to their patients if it involves a procedure, imaging, or other clinically relevant events. They serve to help students see the clinical processes involved in patient care and how truly collaborative nursing is with other disciplines. The importance of communication can be echoed through this exercise as well as what the patient may go through when facing uncertainty with imaging or invasive procedures. It also can serve as a break from everyday clinical for students and as a stress relief that comes with it.

Gaberson, K. B., Oermann, M. H., & Shellenbarger, T. (2015). Clinical teaching strategies in nursing. New York, NY: Springer Publishing Company, LLC.

GREEN, D. (2018). Medication Simulation: Enhancing Nursing Students’ Clinical Environmental Awareness through Self-Care and Promotion of Patient Safety. Whitireia Nursing & Health Journal, 25, 37–51. Retrieved from http://search.ebscohost.com.ezproxy.fiu.edu/login.aspx?direct=true&db=rzh&AN=138594530&site=eds-live

Whelan, T., Xinzhe Shi, Andony, K., Yorke, S., & Poonai, S. (2018). Evaluating Learners’ Satisfaction Following Perioperative Nursing Simulation Training.  Response Article Discussion Paper