EDUCATION & RESEARCH

Dissertation Abstract

Title : "Students Experiences with Team Teaching, Practical Return Demonstration, and Hospital Exposure as Strategies Towards Excellent Clinical Nursing Practice"

Researcher : James M. Alo

Adviser : Dr. Caridad M. Galban

Date Completed : March 21, 2007

Degree : Doctor of Philosophy in Education

School : Adamson University

The ethnographic study is an in-depth look at learning experiences of baccalaureate nursing students in the school classrooms, laboratory, and hospital clinical practicum as a learning environment. Generic senior nursing students were observed for two years in their clinical area.

The study explored the students’ experiences during their exposure with team teaching, practical return demonstration and hospital exposure. The effort to identify their experiential learning, their description to teaching strategies used by their clinical instructors, the values learned as students experienced providing nursing care to the clients, their experiences in the school and in the hospital, intention to nurse the patient, the outcomes, and relationship of experiential learning as students were exposed to the strategies used by their clinical instructors geared towards excellent clinical nursing practice.

Based on the findings of this study, the researcher arrived at the following conclusions:

1) As a result, there are positive experiences of the student nurses with team teaching that constitute experiential learning. In Team Teaching (TT), teamwork was developed between and among student nurses. This is perceived to be effective, because it bonded them as a group and consequently, boosted their confidence. However, understanding of the student nurse in the delivery of care was developed; knowledge of the students in nursing care management was enhanced, hence, the relationship between and among students involve in group activity was improved and the interaction skills of the student to their client was developed, so also with the critical thinking skills as a result to the academic discourse done by teachers; camaraderie fostered among group members. Students already know how to support the ideas of their co-presenter upon presenting the case of their patient during “case presentation.”

On the other hand, in Practical Return Demonstration (PRD), as a result, the application of knowledge learned from the classroom discussion were executed at the students utmost performance; their understanding of the nursing care were strengthened because of the demonstrations students experienced; consequently, students confidence in delivering care to their patient improves; psychomotor skills was developed as manifested by coordination when administering a particular procedure; it serves as advance training before they will be expose in the hospital area, and because of this the attributes of the student nurse was develop such as; organization, orderliness, prioritizing the needs of the patient through making a “Nursing Care Plan” for the client.

The experiences of the student nurses in the hospital that constitutes experiential learning were the following: students came to learn so much the essence of care-giving to those who are sick; individualized nursing care were delivered through direct contact and set things first by doing nursing assessment to their assigned patients; students expressed the appreciation of the importance of health and well-being by self-care. There is an improvement in their performance in the hospital once students were exposed to practical demonstration, after the clinical instructor demonstrated the particular procedure in nursing laboratory and followed up with return demonstration of the nursing students, then a greater understanding in the delivery of health care to their patients.

2) Teamwork in teaching is considered as a good preparation for the students’ in their hospital exposure, students were able to observe how their clinical instructors coordinated, collaborated and cooperated when presenting a lesson discourse, thus, a preparation for them in teaching their clients in the area of exposure. Moreover, student nurses’ like challenges if students believe they can meet the challenge, especially when the clinical instructor gave immediate reward by praising them appropriately for meeting the challenge. Giving them new responsibilities and delegating authority in making decisions to successfully accomplish their work.

As a result, students were inspired to study the course. Some student nurses like the teaching strategies when students are involved and participated in doing something related for their own interest and cooperate with the activity and discussion presented to them. However, dependency among teachers in presenting their topic discussions was observed by the students, others may be dependent on her colleague’s expertise if one member in team teaching is not prepared on their topic discussion. Resulting to a lack of student interest in listening further, the lesson presented by their teacher.

3) The values learned by the student nurses as they experienced in providing nursing care to their clients are the following: a) Reverence; student nurses have shown respect to their patient as they do nurse-patient interaction, especially to the beliefs of their patient. Students taught about health, respectfully and reverently corrected the wrong beliefs of their client towards better health; b) Integrity; student nurses applied integrally the concept of nursing process as students plan and implement care to their respective patient in their nursing practice. Students gave health education not just to the patient but also to family members that give them the opportunity to prevent sickness; c) Compassion, student nurses were given more time to personally and directly care for patient. They develop the intrinsic value of giving compassionate service to their patient, as they communicate and done interaction with the patient students came to understand the nature of why individual got sick because of varied factors to consider in maintaining good health. d) Excellence, student nurses were able to recognize the importance of nursing education, they remember their classroom lessons when they did their nursing practice and personally gave care and put into implementations all the nursing intervention possible for their patient’s care.

4. The findings revealed that student nurses’ believed from their experiences that experiential learning in school is more on theory and the application of nursing knowledge is in the hospital, students perceived it is more difficult in hospital settings because students are dealing with real people and situations. The student nurses believed that from all their experiences in the hospital it was anchored from their experience at school. However, others believed that not all problems, principle of nursing care management can be tackle in neither school nor laboratory but the totality of the learning process is found at the hospital. As a result students learning experience at school and in the hospital were the following: in school it is more of theoretical and the actual application of nursing knowledge is in the hospital, it is more difficult in hospital settings because students are dealing with real people and situations, not all problems, principle of nursing care management can be tackle in neither school nor laboratory but the totality of the learning process is found at the hospital and they feel like a real nurse performing their responsibilities for the patient when performed in the hospital. Students believed that the opportunity to be exposed in actual clinical setting and apply what students learn at school enhanced the totality of their learning process in the management of nursing care.

5) Some student nurses expressed their dedication in providing effective and compassionate nursing care by providing comfort and the administration of basic nursing procedure. However, other student nurses experience in providing health education to their respective patient assignment in the hospital. Students make health teaching plans which are designed to basically educate the patient and families on how to do self care and prevent from acquiring disease. Thus, the student nurses intention in doing nursing care is to provide health teachings, effective efficient nursing care to their respective patient assignment when they were exposing in the hospital.

6) The students viewed very significantly the relationship of experiential learning towards clinical nursing practice. Students have shared that their experiences in the classroom, skills laboratory and hospital exposure helped them to become effective and efficient nurse in implementing nursing interventions to their respective patient assignment.

7) The result showed, the student nurses were able to demonstrate therapeutic communication skills as they do nurse – patient interaction. Students were easily understood by their patient while providing nursing care. Students were able to grasp confidence, in interacting with patients during health teaching interventions to their clients. Most of the students have acquired a good level of nursing skills in performing procedures, because of hospital exposure. Students’ nursing knowledge increased as students possess such attribute because hospital experience and it follows the other attributes: good communication, gratitude, motivation and decision-making. However, it is further observed by the students that once students experience every actual nursing procedure, they have learned additional knowledge aside from what students learn in school. It is implicated by the fact that while academic discussions perk up intellectuality, the personal interactions articulate emotionality, actual and personalize delivery of care fortify nursing skills. Some of the students have acquired a good level of nursing skills in performing procedures, because of hospital exposure. Students’ nursing knowledge increased as students possess such attribute because of their hospital experience. Therefore, it is further observed by the students that once they experience every actual nursing procedure, students have learned additional knowledge aside from what students learn in school. It is implicated by the fact that while academic discussions perk up intellectuality, the personal interactions articulate emotionality, actual and personalize delivery of care fortify nursing skills. As a result, the interrelatedness of the strategies such as; team teaching in the classrooms, practical return demonstration of basic nursing procedures through the used of simulations in the laboratory, and actual hospital exposures where student nurses can really apply to their clients all the knowledge learned in school.

Based on the findings and conclusions stated, to further improve the effectiveness of health education, effectiveness and efficiency of the student nurses in the delivery of health care for their clients; the researcher recommends the following: 1) Further researches in this area may be warranted, specifically, into the skills which are needed to be a team teaching member; 2) The researches also suggest that there may be an optimum team-teaching size or number; 3) The health care practitioners would have to accept that nurses are learners themselves and so must be equal with people in the clinical area; 4) The health care practitioners would need to integrate with the people to gain their trust and confidence; 5) More student experiences in the clinical area would be necessary to enable students to acquire essential knowledge and skills; 6) The researcher recommends utilization of “Practical Experiential Learning (PEL),”to nursing students. This is a theory that involves student from practice or action, engaging student nurses in actual activities, being such in practice or effect. Letting student nurses encounter knowledge and skills in a particular field through experienced. Student nurses will be learning from experience students have experienced in the school and in the hospital which cannot be taught by teachers except themselves. Thus, the more experiences student nurses have in the clinical setting, laboratory and classroom the more they will acquire necessary knowledge and skills, hence, effective and efficient nursing care to their clients will be delivered.

This study would also be significant to educators in terms of understanding the experiences of student nurses and could be used as a frame of reference to assist them in formulating actual activities, organize, facilitate, and direct experiences that lead to a meaningful and lasting learning that will lead to a better understanding and appreciation of nursing practice.