SEMINAR ON CLINICAL TEACHING METHODS

SUBMITTED TO, MRS,SATHYA M.SC(N), LECTURER

SUBMITTED BY, M.SHOBA M.SC(N) I YEAR

CLINICAL TEACHING METHODS

Introduction: The clinical teaching methods is a type of group conference in which a patient or patient or patients are observed and studied ,discussed ,demonstrated and directed towards the improvement and further improvement of nursing care . Clinical teaching may be given by any faculty member that is clinical instructor or tutor or ward staff and will concentrate on a particular patients needs as a person and how the doctors treatment orders can be met by the by the right understanding and nursing care . Definition: The ideal way to teach clinical nursing is center the teaching around specific patients . Purposes: To provide individualized care in a systematic ,holistic approach. To develop high technical competent skills . To practice various procedures . To collect and analyze the data . To conduct research . To maintain high standard of nursing practice . To become independent enough to practice nursing . To develop cognitive ,conative ,affective and psychomotor skills . The students will develop the techniques e.g.:observation. To meet the needs of a client . To improve the standards of nursing practice . To develop various methods in delivering care. To identify the problems of clients . To learn various diagnostic procedures . To learn various skill in giving health education techniques to the client and significant others.

 To help in integration of theoretical knowledge into practice . To develop communication skills and maintain interpersonal relationship To maintain inter- institutional relationship To develop proficiency and efficiency in carrying out various nursing procedures . To learn managerial skills . To become professionally active member . To encounter reality in the practice of nursing ,synthesis learning ,practice activities described in the course objectives.
METHODS OF CLINICAL TEACHING:

1. Client and family centered approach 2. Conference *Group conference *Staff conference *Nursing care conference *Individual conference *Team conference 3.Bedside clinic 4.Nursing rounds 5.Assignments 6.Field visit 7.Process recording . 8.Ward teaching 9.Ward class 10.Ward clinics 11.Case method

12.Brain storming method 13.Group discussion 14.Demonstration method 15. Laboratory method 16.Health talks 1. Client and family centered approach: Individualized care will be provided in holistic manner .Here not only the client will be assisted for therapeutic measures ,the family members also will be involved in education about illness and health concept ,signs and symptoms ,treatment ,prevention of the problem ,thereby the client and whole family will be aware and involved in meeting the clients need .It is nothing but bringing awareness and to reach the goal i.e. health for all .

2.Conference *Group conference :

A conference is the act of consulting together of two or more individuals in an formal meeting for the purpose of giving or exchanging ideas .It involves a two-way flow of conversation .

Purposes : To To To To set objectives and criteria for nursing care . plan methods for improving care solve problems which interfere with good nursing care evaluate results of report

*Staff conference: These type of conferences will be held in teaching institutions e.g.: faculty meeting ,in hospitals . E.g.; Nursing superintendent will conduct conference to all nurses . The leader of the conference ,opens it by briefly stating purpose even though the staff should already know the problem or subjects to be discussed She starts the discussion by asking a careful thought out question or prelude to the conference or making a statement designed to bring out needs suggestions or problems of various staff members . The leader should accept each persons suggestions as worthy of consideration make a note it on a blackboard or small pad . Each member should encourage to express their thoughts .The leader then summarizes the suggestions .A group discussion is usually in order.The leader ends the conference by stating the next steps and delegating any responsibility that might be entitled . 3.Nursing care conference: It is a method of teaching which provides an opportunity for an informal discussion of a problem and free exchange of knowledge and experience about the common interest and it consists of a group discussion using problem solving techniques or nursing process. A nursing care conference is designed around a consultation visit of a clinical nurse specialists .But more frequently they are

designed for the staff of a specific nursing unit and are planned around some aspect of nursing care or focus on a scientific nursing problem presented by a patient in that unit . A nursing care conference is a course of action discussion , the focus is on assessing the nursing problem arriving at possible solutions ,helping staff to examine a patients problem from his point of view.It can provide a good learning experience for all the staff who share a common nursing problem in providing care to a specific patient . Purposes: To portray the nursing problems typically associated with a particular disease with such factors as social , age , or ethical background and to picture the related nursing care with a specific individual . To learn ways to help clients identify their needs and solve their own problems . To suggest approaches to the patient and planning ways to help himself . Planning and preparation: 1. The organizers should prepare well in advance regarding particular conference . 2. Before presenting ,the student will have collected all data regarding the patient .She will have worked with that patient and collected information about sings and symptoms since how long the patient is sick.What are the laboratory finding? What about his family backgrounds ,socioeconomic conditions .,etc. 3. The conference should be planned in relation to the objective of the conference and it should be spontaneous in nature . 4. The student should be given ample opportunity to work in the ward for quite a good amount of time before she is assigned to present in the conference .

Technique:

1. The nursing care conference is need as a consultation too help in problem solving . 2. The teacher must be flexible and she will help the students during discussion . 3. The conference should involve all the students in discussion The teacher involves all the students by putting questions giving guidance and re-channeling if necessary . 4. Teacher has to draw out the potentials of the students to the maximum in discussion .She will provide ample time for the student to think . Phases: The nursing care conference is used as a consultation tool to help in problem solving .It has got three phases. 1. Opening phase 2. working phase 3. Closing phase 1.Opening phase : It can be defined as the first two minutes of the conference. Task here is to make a commitment to work on a problem relating to a particular patient .What happens during these few minutes often sets the tone for the entire session . 2.Working phase: The task of the working phase is to arrive at a consensus on problem identification and solution .Once the patient is selected we have found that a great deal of time during this phase is spent in delineating the problem clearly .In some conferences there is a difference of opinion among nurses often the data are inconsistent or incomplete .In is helpful the group focus their

discussion by asking direct questions ,rephrasing what the group has said and summarizing .Conferencing time can be used to identify just what information is needed .The problems are identified and the group can often reach its own solutions . Offering concrete solutions to problem behavior allows the staff to feel they are getting something from the group and the consultant who offers alternatives and support to a frustrated staff establishes credibility and does them a great service and she should be careful to ask the groups opinion on the validity of her suggestions.The nurses can validate their anxiety by expressing their feelings . 3.Closing phase : Once the group has worked through problem solving and has decided on solutions ,the next phase is closure .The task here is to delegate responsibility to one or more of the staff to act on the problems .

Advantages: 1. It helps the students to collect the information in creative way. Ie the student will be able to validate the data pertaining to the situation and appropriateness. 2. It provides real practical learning environment to the students. 3. It fortifies the thinking of students, thereby the creativity and judgement capacity will be increased. 4. It provides free opportunity to think. 5. Each member will be actively participating in the conference. Disadvantages:

1. It will be of little use if the students do not accustom to such situation. 2. There are chances of using these conference hours for class room teaching. Conference is an important method of clinical teaching. It uses problem solving techniques in discussion and the students will have to identify the problems and solutions. It provides students ample opportunity to think. d) Individual conference: It sometimes described as a conversation with a purpose, or more simply, as an interview. The teacher may introduce the student to new fields of knowledge, impact information to her regarding this field and strive to motivate her in the acquisition. Purposes: 1. To guide in teaching. 2. To acquire more knowledge. 3. To discover the interests, needs and the problems of the individual student. 4. To help the student to help himself/herself. Techniques: 1. Teacher should establish good rapport with the students. 2. Allow him to talk freely. 3. Teacher should not show any prejudice, emotional reactions or bias. Principles of Individual Conference:

1. Establishment of a definite purpose and specific issues to be covered. 2. Knowledge of the student. 3. Provide privacy. 4. Establish good rapport. 5. Provide sufficient time. 6. Good listening. 7. Positive effect. 8. Recording of data. Practical Uses: 1. Diagnostic and remedial teaching in individual conference. 2. Supplemental teaching. 3. Discipline. 4. Clinical teaching. a) The nursing care study. b) Diagnostic and remedial purposes. c) The nursing care plan. d) Preparation and orientation to new clinical areas. e) Evaluation. Use of Individual Conference in Nursing Courses: 1. It can be used to clarify clause material. 2. It helps in supplement instructions.

3. It can also help to explain answers to questions of individuals. 4. It can be used as u means of assisting the individual who is having difficulties in keeping up with the classroom situation. The individual conference can be a means of bringing unity to the entire nursing course, by aiding the student in integrating her previous knowledge and experience in relation to the present learning experience. E)Nursing Team Conference: Nursing team conference as a teaching tool offers valuable opportunities for learning. The ability to observe, report and analyze significant findings is put to its greatest test as students are confronted with this daily responsibility. Concomitant values gained by this type of experience are related to the ability to share knowledge of patients needs and to work co-operatively with other members of the nursing team and total health team. Such experiences inevitably lead to the improved performance of nursing care activities in the clinical nursing setting. Meaning of team nursing: Team nursing as stated by Miss. Dorothy Finkbiner The assignment method should be used which will make possible the best nursing care to the staff members, giving them interest and challenge and that will keep the unit functioning smoothly and effectively. Meaning of Conference: A conference is the act of consulting together the conference is the nucleolus of the in-service nursing program me.

Observation made during nursing team conference offer unique opportunity for guidance of nursing service personnel. Advantages of the Nursing Team Conference: It is used to plan for the daily continuity of nursing care that best meets the patients need. As a teaching tool, nursing team conference, offers valuable opportunities for learning. It gives an ability to observe, report and analyze significant findings input to its greatest test as students are confronted with their daily responsibility. Objectives of the Nursing Team Conference: Identifies the patient nursing problem. Recognizes ability and limitation of various team members. Help to communicate the ideas, information on related nursing care. Utilizes scientific information to influence the cause of nursing care. Makes generalization from specific information that is factual . Helps to report ,interpret ,channelize and carryout hospital or health care problems . Teaches what is required to help team members fulfill their roles . Help to plan nursing care cooperatively with other team members . Brings also maximum creative potential of the team .

CONFERENCE PROCEDURE: A time is planned each day for the members of the nursing team to meet as a group .During this period ,patients problem are identified and explored and an approach is developed by team .The nursing care plans are revised or further developed according to changing needs of patients. Each member of the nursing team has recorded during the course of the day and the response of the patient to her care ,questions and comments of the patient and individual notes are used as guides in conference . The team leader ,using the kardex as a guide ,reads the patients name and objective of nursing care .The members who have the contract with that particular patient discuss his response to his care and any additional information from the patient or his family problems are identified by the group ,a plan is projected for the solution of the problems .The kardex is revised and the objective is altered by the leader . The head nurse functions as a resource person and assist the team leader and the team members in identifying nursing problems and developing nursing care plans .The nursing team conference is the planning stage for the team and assignment of nursing personnel for the following day is developed during and immediately after the conference THE MAJOR TYPES OF CONFERENCE: 1.Team leader direction conference: Are held at the beginning of a work shift and an hour prior to the ending of the shift .The purpose is to give and receive pertinent ,accurate information concerning the care of the patients and to create an environment that encourages collective and cooperative participation .

2.Patient centered approach : Are planned meetings to identify problems and evaluate nursing care These conferences provide a means for all the team who are directly contributing care to a group of patients have benefit from the experience of others .The members as a group aim to formulate nursing intervention for one or two patients analyze the nursing care given .The clinical nurse coordinator and the supervisor are important members of the patient centered conferences . 3.Nursing service management conferences: It should be part of the planned scheduled meetings for each unit or section .The supervisor assisted by the clinical coordinator is the leader here .The topics presented are discussed may include standards of patient care and policies ,procedures ,safety measures ,infection control ,nursing audit evaluation ,unit staffing measures and clarification of new personnel policies . 4.Intershift and Interdepartmental conferences: Are necessary to pass on information from one individual or group to another .

3.Bedside clinic:
As we all know a planned teaching should not be restricted to the classroom only .It is to carryout in the clinical area .It is one of the best methods of teaching . The purpose of the bedside clinic is to portray the nursing problems and to give viva picture of the related nursing care by associating it with a specific individual . Purposes:

1. To provide a learning experience for the nursing student to collect information about the patient with tact and skill. 2. To improve the students ability to solve nursing problems by detailed study and analyzes of nursing situation . 3. To realize the need for understanding each patient as an individual in order to appreciate his problems and outlook . 4. It helps the students to do observation in an organized systematic way . 5. To be able to workout a nursing care plans to fit the needs of individual patient on the basis of his special problems. 6. To be able to recognize opportunities for health teaching in the hospital . 7. To understand certain types of apparatus being used on patients . 8. To improve the quality of nursing care . Steps involved in conducting the bedside clinic : *Planning technique : Determine the clinic to whom it is to be conducted, place, date and time of clinic to be held and on what topic the students have to come prepared. Select a patient for whom students have given the care. Secure the patients consent as his co-operation is essential during the clinic. Conducting bedside clinic: After preplan the next step is conducting actual clinic.

The clinic should be conducted in the ward or in a class room, which is adjacent to the ward. If such conveniences are not there, the clinic should be held apart from other patients providing him sufficient privacy in a corner of the ward. Physical and mental is provided to patients. Patient is kept at ease. The clinic usually lasts for 30 minutes. The number of student should not exceed 10-15 in number. The discussion relative to the nursing clinic consists of three phrases. 1.Introduction phase: If serves to acquaint the student with the patient background, presenting nursing care situation, the purpose of the clinic, significant observation to be made, type of question to be asked, etc. 2.Patient centered discussion: During this phase a few simple questions are asked to obtain the needed information from patient. No question which hurts the feelings of the patient should be asked .Ample opportunities should be allowed for the patient to verbalize the needs and how he perceives his particular problem .soon after second phase of clinic patients should be sent to the ward by thanking him for his cooperation . 3.Post clinic evaluation : It offers an excellent opportunities for students to evaluate the patient behavior ,ability to solve his own problems and

various other aspects .The student can be evaluated in-terms of their ability to meet the stated purposes of clinic through their observations ability to use problem solving technique . Advantages: 1. It puts the students in an active actual situation . 2. Covers a limited group of students . 3. Permits evaluation of degree to which educational objectives have been attained . 4. Develops qualities of observation and decision making . 5. Ensures closer contact with reality . 6. Permits comparison between reality and theory . 7. Enables students to develop a self confidence . 8. Increases variability . Disadvantages : 1. High personnel costs . 2. Sometimes puts the patient in a difficult situation . 3. Poor standardization . 4. Narrow limits of utilization . 4.NURSING ROUNDS: It is an excursion into patients area involving the students learning experiences .Nursing rounds revealed that students responded to this method of teaching with enthusiasm .Their interest in learning increased and they showed ability to share ideas and knowledge with others for the benefit of patients .

Nursing rounds are given separate names according to the purpose they serve . a)Information giving rounds : It is used to acquaint the staff with all patients on the ward or division . b)Instructional rounds : Here the nurse is expected to read the charts and come to rounds with basic information in mind . c)Problem solving rounds: This is to help the nursing staff learn to conduct initial interviews make assessment of patients needs and identify nursing care problems . Purposes of nursing rounds : 1. To demonstrate symptoms important in nursing care . 2. Clarify terminology studied . 3. To compare patients reaction to disease and study the disease conditions. 4. To demonstrate effects of drugs i.e. indication ,actions and reactions of drugs . 5. To illustrate skillful nursing care . 6. To compare method of meeting nursing needs and to have better understanding and to give more purposeful care to patients. 7. To illustrate successful improvisation and to give opportunity for the use of different applications . Factors to be kept in mind when planning nursing rounds :

1. To consult students previous clinical experience to avoid repetition and to add to earlier experience . 2. Keep in mind the probable value and availability of clinical material . 3. If some demonstration is done ,it should not have a deleterious effect on the patient . 4. Explain the plan to the patient . 5. Introduce the patient to the group . 6. Make the patient feel important . 7. Have post conference for summary and further explanation . 8. Record the nursing rounds in the ward teaching records with a summary of nursing points stressed . Advantages of nursing rounds : 1. Demonstration of symptoms 2. To clarify terminology Herpes simplex Anemic pallor 3. Effects of drugs Allergic reactions Side effect 4. Skillful nursing care Progressing improvement of bedsore Maintenance of adequate fluid intake (oral) 5. Successful improvisation

 Use of a chair as backrest Device for support of ice bag 6. Posture and position as indicated for individual patients Neutral position Position for surgical soak Fowlers position Position for CCF. In nursing rounds ,a small group of staff or students preferably not more than 4 or 5 and a leader or a teacher visit the bedside of patient. Preparation by the head nurse: The head nurse selects the patients before hand according to the time available .Rounds not lost longer than an hour .The head nurse needs to read the patients histories ,know the plan for their treatment and its results the patients progress and prognosis ,their nursing care and its effectiveness .She should post the time for rounds at least a week in advance and indicate the type of preparation the nurse is to make ,that in whether she is to know thoroughly the history care and progress of her own patients or briefly that of all patients in the ward . The central figure in nursing round is the patient .If the purpose of the sound is instructional or problem solving the patient will be included in the discussion.

Method of Conducting Nursing Rounds: A brief conference at the side of the patients room/word has to

beheld. Necessary data are given. The purpose of the visit to the patient is by the head nurse, special observation to be made or pointed out at this time. 4 to 5 patients are selected for instruction. 4-5 minutes are apent. The head nurse 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. The students are asked to present the cases regarding other particulars. The participants may also be involved such as counting pulse, respiration, examining the conjunctive, pitting, edema etc. The patients case sheet can also be utilized with presentation. Thank the patient before leaving and tidy up the bed. Post Conference: The presentation is summarized and further explanation if any, may be given, questions are invited from the students. 5.NURSING ASSIGNMENT: Assignment in the clinical field is the nursing education cum service. Definition: It is the past of learning experience where the students are assigned with patients or other activities concerning to patients in clinical laboratory. Objectives: 1. To provide the patient with the best possible nursing care. 2. To plan assignments which are interesting to nurses and stimulating to their professional growth.

3. To provide a well rounded educational experience for student nurses. 4. Achieving good ward management. Methods of Assignment: 1. The patient method 2. The functional method 3. The team method

1. Patient method: In this method of assignment a nurse is expected to give complete nursing care to one or more patients including general nursing measures, treatment, medications, taking temperature, pulse, respiration, serving nourishments and giving health instructions. If she goes on off duty her group of patients in taken over by another nurse for the period of her absence in order that the patient may still receive individualized care. 2.The Functional method: In the nurses are assigned to specific functions in the ward such as giving medications or treatment to all patients, taking the temperature of all or giving general nursing care to a group of individuals. Most hospitals which use the patient method modify it to some period of the day such as evenings and nights when a few nurses are on duly. 4. Team method of assignment:

Nursing care is given to the patients with team conference by all the members of the team. Nursing leader supervises and guides the team in giving quality nursing care. The principles relative to making assignments within the team will include. 1 .In planning the patient care a well qualified team members are involved in which amount and type of responsibility, a student can assume depends upon a stage of her education. 2. All the physical needs and treatment are given by the same nurse but the specific treatment is given by professional nurse. 3. When two persons are needed to give a patient certain care it is often well for the team leader to be one of the two. When assisting a team member, the leader has an opportunity to observe the condition of the patient, work of student and aid and relationship with the patient and at the same time he can teach them. Criteria for effective Assignment: i. Students are to be informed of the objectives of their assignment to a particular ward/unit of the area/hospital for clinical experience. Students are to be oriented to new clinical area. Students are to be given the learning experiences which are outlined in the objectives for particular clinical experiences. Students are to given facilities to practice nursing according to principles taught. Only recognized wards of the hospital or community are to be selected for students to achieve required learning experience. Assignments have to be assigned according to the consistent level of learning that students have reached or attained.

ii. iii. iv. v.

vi.

vii. viii. ix. x. xi. xii.

Proper guidance and supervisor has to be provided to the student during their clinical experience. Sufficient time to be provided to carryout the assignment allotted to the students. Students performance should be evaluated and discussed with the students for this improvement, correction etc. Students should be given opportunities for working in a team. Students are to be encouraged to develop a pride in the nursing profession. Students are to be watched, that high standard of patient care are being practiced by all concerned.

Teachers Responsibility in Assisting Students in their Assignment: There are 2 responsibilities in assisting and helping students in planning and organizing daily assignments are as follows: 1. Establishing a pattern of sequence for accomplishing assigned tasks in-terms of immediately of patient needs discriminating between essential and non-essential in establishing task priorities and preserving economical use of time, energy and equipment. 2. Adjusting plans to meet existing and an anticipated conditions in the clinical setting and merging patient needs, revising in effective plans or pursuing additional experiences to meet the learning needs best.

Factors to Consider While Planning Assignments:

1.

The previous clinical experience of the students should be considered.

2. Students must be given sufficient time to study the patients record . 3. Proximity of patients should be considered 4. Assignment should be varied frequently enough to maintain the interest of students 5. Sociological and psychological aspects of the patient should be considered . Advantages: Patient method: a).Patient have security and belongingness. b).The nurse gets job satisfaction . c).Interpersonal relationship is good . d).The maximum learning takes place. Functional method : a)It is having efficiency in the work ,hence the term efficiency method. b)Most work is turned out in less given period of time . c)There is less confusion . d)The maximum learning takes place . e)Skill is developed when the work is done repeatedly . Team method of assignment: If there is no cooperation within the team members ,the work will not be done properly and patient will suffer .

It is one of the best methods of teaching, by which, students get more learning experiences and patient gets good care and good ward management.

6. PROCESS RECORDING: Definition: 1. A verbatim between nurse and the patient -Walker 2. An exact written report of conversation between the nurse and the patient during the time they were together. -Hudson 3. A teaching- learning tool. -Conen Uses of the process record : There are mainly 3 uses . A)As a teaching-learning tool . B)As an evaluation tool . C)As an therapeutic tool. Different phases in process recording: 1. Preparing the student for process recording. 2. Recording nurse-patient interaction. 3. Evaluating the interactions by nurse teacher and the student. Guidelines to student:

1.Your goals for working with assigned patients should be written down before starting the process recording . 2.Note important factors in patients personality development . 3.Mention about the therapies which patient is getting both past and present . 4.Date of process recording should be mentioned . 5.Amount of time you spent with patient should be recorded . 6.A brief description should be written about the setting and situation before your conversation . 7.Identify the patients needs (as represented by patient behavior). 8.Identify mental mechanisms that you think the patient is using and give examples . 9.After completion of process record ,give your comment on how well you were able to meet the goals which you set before starting your work . 10.Evaluate the process record as a learning experience for you at the end of the assignment. 7.FIELD VISIT: It is a visit especially planned for its possible contribution to the objectives of the curriculum ,course ,lesson or other unit of instructions. Definition: It is defined as an educational procedure by which the students obtain first hand information by observing laces ,objects ,phenomena or activities and process in their natural setting ,to further learning .

Purposes: 1. To provide real life situations for the first hand information. 2. To supplement classroom instruction ,to secure definite information for specific lesson . 3. To serve as a preview of a lesson and for gathering instructional materials . 4. To verify previous information ,class discussion and conclusion of individual experiments . 5. To serve as a means of arousing specific interest in materials ,objects ,places or processes. 6. To create teaching situations for cultivating observation ,keenness and discovery. 7. To serve as a means to develop positive attitudes values and special skills. Organization and procedure of field trip : a. Preplanning b. Actual conduct of the trip c. Evaluation a. Preplanning : By teacher By students By teacher : 1. Decide on the drip 2. Know the resources

3. Obtain administrative sanction of school /college 4. Dealings with the organization ,obtain permission ,data and time ,visit and know the resources ,inform the objectives . 5. Arrange transport ,time, date . 6. Prepare the students with theoretical base Teacher plans with the student : 1. Formulate the objectives 2. List down specific information to be obtained 3. Formulate questions to be asked to the guide and prepare guide sheet 4. If a large group ,divide and allot specific jobs . 5. Brief them ,equipments or accessories needed ,data and time of transport ,actual locations ,set up ,conduct and behavior during the trip ,safety to be observed . b. Actual conduct of the trip: 1. Follow the schedule 2. Strictly follow safety precautions 3. Observe and collect information needed 4. Collect source /study materials if provided 5. Teacher supervisors and call attention to the pertinent points 6. Observe formalities and extend courtesies . Points to remember : Trip should follow in an orderly manner

Do not cause disturbance to the organization. C. Evaluation phase : 1. Should be done as early ads possible 2. Students write a report with the observations effectiveness of the trip and difficulties faced. 3. Teacher evaluates the reports by the student . 4. Teacher prepares an evaluation and along with specific observation from the students maintains a record which can be referred later .
5. Conduct discussion with the students

ORGANIZATION AND PROCEDURE FOR FIELD TRIPS : 1.Knowledge : The teacher has to survey the area to know whether the field trips planned will contribute to the attainment of desired objectives. 2.Rapport : The teacher should establish and maintain cordial relations with those in charge of the situations to be visited . 3.Objectives : It should be stated carefully and completely .The learning activities have to be selected and it should contribute for the attainment of objectives . 4.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 the length of visit .

5.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 the observation and the special points to note . 6.Supervision : Trip should be supervised carefully. The teacher can assist the student by calling attention to pertinent point . Follow up and evaluation : An hour should be allotted for an open discussion .It can be done by means of students reports.

VALUES OF THE FIELD TRIP : 1. It breaks monotony of the classroom and provides real life experiences , 2. It furnishes first hand information to supplement and to enrich the classroom instruction . 3. It provides opportunity in learning attitudes and positive values i.e. cooperation ,discipline . 4. They correlate and blend school life with the outside world ,providing direct touch with persons and with community situations . 5. It provides opportunities in learning and acquiring skills i.e. observation communication ,critical thinking and social skills .

6. Students develop better understanding of the etiologic factors of disease. 7. It arouse interest and vitalize instruction ,thereby providing motivation i.e. it provides opportunity to have above participations and gears motivation . 8. It helps to create situations which in turn help to develop observation and keenness 9. Offers an opportunity to apply that which has been taught to verify what has been learned . 10. They serve as an effective means of correlating the subjects of the curriculum. 11. They provide opportunity to consider and to solve problems arising from individual and group participation in a natural social situation . Disadvantages of field trip : 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 . 5. Since the students are going out of school /college premises it is risky ,safety precautions 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 involvements is more .

These kind of field visit provides opportunities ,encourage thoughtful attitudes and personal growth .One student may be chosen to express the thanks of the group at the time and another may write the letter of appreciation . 8.WARD TEACHING PROGRAM : PURPOSES: To supplement ,to integrate and to utilize classroom instruction . To aid the student to make correct applications of scientific principles basic to a particular nursing activity . To enable the student to gain a real understanding of individual differences and substitute variations of case and circumstances to factfully respond and adjust to them by adopting nursing procedure and treatment without violating basic principles. 9.WARD CLASS: A class will be conducted based upon current clinical experience of the student for whom the class is planned. Small group should be planned that is, all the students at one level of experience, who are having similar, experience, who are having similar experience in particular department. 10.WARD CLINIC: In this type, a client is presented to the group, who illustrates all signs and symptoms and require all nursing case procedures. Permission should be taken from the physician.

 Instructor should explain before hand, to the client about the purpose of the clinic. The students will be able to practice procedure in real situation. Suitable place should be selected. Student should understand the purpose on improving the standards of nursing care and their contributions should be directed towards at its end. 11.CASE METHOD: Used in three forms: 1. Case study 2. Case analysis 3. Case incident technique 1. Case study/ Case presentation: The student will be given the opportunity to provide nursing care for specific client, after 4 or 5 days of careful study, the student nurse will prepare case study by comparing with the text, the student presents the case before the batch of companions, general discussion about the client will be dealt. 2. Case Analysis: A concrete case for analysis and discussion by a group of students under the leadership of the instructor. Sufficient information is presented to the students to make judgment of problem or situation in case. 3.Case Incident technique:

A critical incident technique which requires immediate decision and action is taken from a case and presented to the students for their analysis and decision .No background information is given to them regarding details of the incident at the time ,it is presented .The instructor will have facts about the care can be given as requested by the students . 12.BRAIN STORMING METHOD : Here the intellectual capacities of trainees will be utilized in solving or suggesting solutions to problems and make the group to become active and answer the problems among them only . The instructor will acts as a referee and give answers for the unsolved problems . For example the cancelling of AIDS in this topic the expert in the field will make certain opinion regarding AIDS and make the group into 2 or more sections ,according to the number of trainees will be given one paper to write opinions and will give 3 minutes time and request whether it falls into high ,low ,do not know like ,she has to give explanation. Then the referee will ask other groups ,are they satisfied with that particular explanation .if no ,trainee is answering correctly for any problems ,then the trainees will be expert would clarify it. Here the brain of the trainees will be sharpened and the entire class will participate in discussion ,group will become active and enthusiastic . 13.GROUP DISCUSSION: A cooperative problem solving activity which seeks a consensus regarding the solution of a problem . Values : 1.It encourages the student to think for her ,to develop critical habits of study .

2.To interpret problems of the past ,that she can throw light into ways for shaping the future . 3.Helps her to advance in creative thought . 4.Enables the student to enrich her own conceptions by reacting to those of others . 5.The teacher can observe the student as she participates in the class and can plan for individual differences . 6.It gives the student an opportunity to learn how to adjust to social situations . 7.Gives an opportunity to cooperate with others in the reflective solving of a problem . 8.Self activity is increased . 9.Cooperation in its highest sense is developed . 10. It provides proper social environment by the development of favorable attitudes towards cooperation and responsibility. 11.Leadership skills will be developed . Discussion techniques for small group : The individual conference The informal class group discussion The seminar The clinical conference Role playing Case analysis Discussion techniques for larger groups :

 Multiple discussion groups Symposium Panel 14. DEMONSTRATION METHOD : Uses : To demonstrate procedures in the classroom and the ward To demonstrate experiments and its use . To teach the patient ,a procedure or treatment which he must carryout in home . To demonstrate different approaches in establishing rapport with patients ,so that the most effective nurse patient relationship may be established . 15.LABORATORY METHOD : Planned learning activity dealing with original or raw data in the solution of the problems .Laboratory method is a procedure involving first hand experience with primary source materials ,through which the student can acquire psychomotor as well as mental skill . Values : For student . To use the problem solving approach to the solution of real problems . To translate theory into practice . To develop ,to test and to apply principles . To learn methods of procedures.

 Initiates group works .

For teacher . Provides the teacher an opportunity . To observe the student in action . To assess her worth To correct her mistakes To guide her in promising directions . A little encouragement or special help at the right movement may intensify interest and provide the hopes for independent accomplishment in future.

1.Introductory phase : It involves establishment of objectives and a plan of work . Teacher preparation :Discuss objectives or plan of work with the students by means of class discussion . Student preparation :For orientation and motivation achieved through proper instructions and guidance .

2.The work period ;

Supervised study activity ,in which the student is involved in a first hand experience designed to achieve particular objectives by solving the problems. 3.Culminating activities : After the lab work ,the class should meet together for discussion of common problems ,for the organization of findings ,for the presentation of the results of individual or group problem solving activities . 16.HEALTH TALKS : This method will be used when teaching for clients and their relation or a mass .It can be used in hospital and in community .For example ,educating the mass about health and its aspect. Health talks can be conducted incidentally and in a planned manner . CONCLUSION clinical area really pose a great challenge to nursing teachers. professional competency of a nurse is recognized mainly by the demonstration of clinical skills. so the above clinical teaching methods will be helpful for the student to develop appreciable level of nursing skills.
BIBLIOGRAPHY :

said

B.T Basavanthappa (2003), Nursing Education Ist edition, published by Jaypee brothers, New Delhi. Pp No: 359- 384.
Jean Barrette (2004), Ward Management and Education, 14th

edition, komark publishers Pp:357- 368

K.P. Neeraja , ( 2003 ) Text book of Nsg education Ist

edition , by Jaypee brothers , New Delhi , Pp No : 231-235 .