Clinical Teaching

INDEX OF CONTENTS
S.no CONTENTS PAGE

1 Introduction of clinical teaching
2 Definition of clinical teaching
3 Philosophy of clinical teaching
4 Outcome of clinical teaching
5 Clinical teaching model
6 Clinical teaching skills
7 Factors influencing clinical teaching
8 Guidelines for selecting clinical teaching
9 Clinical teaching methods:
A - Case method
B - Process recording
C - Nursing clinic
D - Bed side clinic
E - Individual conference
F - Group conference
G - Nursing care conference
H - Teaching rounds
I - Nursing assignment
J - Morning and evening reports
- Role play
- Field trip
CLINICAL TEACHING METHODS
INTRODUCTION:
The clinical teaching is a type of group conference in

which a patient or patients is or are observed and studied,
discussed, demonstrated And directed towards the further
improvement of nursing care.
CLINICAL TEACHING METHOD, REKHA.C.R,1ST YR M.SC(N)[Type text] Page 1

In nursing clinical teaching may be given by the doctor in order
to discuss the medical aspects of a patient’s condition more vividly
that can be done in the class room.
Alternatively the clinical can be given by any faculty member

that is clinical instructor or tutor or ward staff and will concentrate
on a particular patient’s needs as a person and how the doctor’s
treatment orders can be met by the right understanding and
nursing care.
PHILOSOPHY OF CLINICAL TEACHING :
Philosophy determines the teacher’s understanding of his or her

roles, approaches to clinical teaching, selection of teaching and
learning activities, use of evaluation processes and relationships
with learners and others in clinical setting. Philosophy of clinical
teaching is a set of beliefs about the purposes of clinical
education and the responsibilities of the teachers and learners
in clinical setting. To change their practice of clinical teaching ,
initially educators should reflect on their fundamental beliefs
about the values of clinical education, roles and relationships of
teachers and learners and hoe desired outcomes are best achieved.
OUTCOMES OF CLINICAL TEACHING:
Outcome of clinical teaching include knowledge, skills and

attitude that are accomplished through clinical teaching and
learning.
(A)Knowledge :
clinical learning activities should focus on the
development of the knowledge that can not be acquired in
the classroom or in any other learning setting. Knowledge
outcomes include cognitive skills in the (a) problem solving
(b) critical thinking (c) decision making.
(a) Problem solving : ability is significant outcome as the
problems related to the patient’s or in the health care
environment is unique , complex and ambiguous and often
requires innovative methods of reasoning and problem
solving strategies.
(b)Critical thinking : it is a process used to determine a
course of action following data collection that is relevant
and appropriate, analyze the validity and utility of the
data , evaluating multiple lines of reasoning and arriving
to valid conclusions.critical thinking is enhanced by
attitudinal dimensions of self confidence, maturity and
inquisitiveness.
(c) Decision making : it involves gathering, analyzing, weighing
and valuing informations in order to choose the best
course of action from a number of alternatives.
(B) Skill :-
It is the most significant outcome of clinical teaching.
There is three types of skills included in this.
(a) Psychomotor skills :
They are purposeful, complex, movement oriented
activities that involve an overt physical response

requiring neuromuscular co-ordination. They compass the
ability to carry out proficiently, smoothly and consistenly
under carrying conditions and within appropriate time
limits.
(b) Inter personal skills :
They are used to assess the patient’s needs, to plan and
implement patient care , to evaluate the outcome of care
and to record and disseminate that information. These
skills are communication using the teaching process and
therapeutic use of self.
(c) Organizational skills :
Nurse require these skill in order to set priorities,
manage conflicting expectation and sequence their work
to perform efficiently. Clinical learning activities provide
opportunity for learners to develop leadership,
followership and management skills.
(C ) attitudes :
Clinical learning produces important outcomes in

attitudes and values that represent the humanistic and ethical
dimensions of nursing. Professional nurses are expected to
inculcate and act on certain values with regard to patient
care and to use the process of koral reasoning, value
clarification and value injury. These values are developed and
internalized through the process of professional socialization.
CLINICAL TEACHING MODEL :

Criteria for selection of clinical teaching model:
there is no one model that meets the need of nursing

programme. The teacher should select a model considering the
following factors:
 Educational philosophy of the nursing program

 Philosophy of faculty about clinical teaching
 Goals and desirable learning outcome of the clinical
course and activities
 Level of the nursing student
 Type of clinical setting
 Availability of expert nurses and health professionals in
the practice setting to provide clinical instruction
 Willingness of health care personnel to participate in
teaching students.
 TRADITIONAL MODEL :
The clinical instruction and evaluation of a group of
students are executed by academic faculty member who
were supervising the students during the clinical
experience.
Advantages of the model:
 Assist students in using concepts and theories learned in
the classroom.

 Teacher can select appropriate learning experience for
students that are congruent with learning objectives
Disadvantages of traditional model:
 A teacher may be attached with a large number of

students for clinical instruction where she may not be
able to meet the demands of all students.
 Teachers without clinical experience may find difficulty to
establish relationships with health care professionals or
may require extensive time to establish the same.
 PERCEPTOR MODEL :
An expert nurse works with the intern on one to one
basis, in the clinical setting. In addition to one to one
teaching , the preceptor guides and supports the learner
and serve as a role model. A faculty member from the
nursing program serves as a liaison between the nursing
institution and clinical m setting.
Advantages of preceptor model:

 Promotes socialization
 Bridges the gap between the theory and the practice.
 Allows the inter to gain an understanding of how to
function as a staff nurse.
 Develop self confidence.
 Improve decision making skills ,

 Learn new skills under the guidance of the preceptor
Disadvantages of the preceptor model:
 There is lack of integration of theory , research and
practice.
 Lack of flexibility in reassessing students to other
preceptors, if needed.
 CLINICAL TEACHING ASSOCIATE MODEL.:

This model involves a staff nurse who instructs a small
group of nursing students in the clinical setting
collaboratively with clinical instructor. The faculty
member works with clinical teaching associate to
coordinate the overall clinical experience of the
students, assist students in clinical performance and
serve as a resource.
Faculty may conduct teaching for staff , provide
consultation in clinical setting and assist with discharge
planning. Majority of the nursing institutions attached
with hospitals do follow this model in order to enhance
learning.
 CLINICAL TEACHING PARTNERSHIP MODEL :

This model varies with institutions but generally a
collaborative relationship between the clinical area and

nursing program involving advanced practice nurse and
faculty member.
Advantages of clinical teaching partnership model:
 Students acquire advanced knowledge for practice ,
develop clinical and technological skills and gain
understanding of the role for which student prepare
By working closely with a person in that role.
Disadvantages of clinical partnership model:
 Advanced practice nurse is not available in all clinical
setting in Indian situation.
CLINICAL TEACHING SKILLS:
 Assess learning needs of the students, recognizing and

accepting the individual differences.
 Communicates the objectives and expectations very clearly
to students before providing clinical experiences to the
students.
 Considers students needs and goals in planning the
clinical experiences.
 Plan assignments that help in application of theoretical
knowledge in clinical practice and promote acquisition of
knowledge and development of skills.
 Structures clinical assignments and activities in clinical
practice so that they can accumulate on one another.

 Explain accurately concepts and theories applicable to
patient care.
 Demonstrates sffectively clinical skills procedures and use
of technology.
 Provides opportunity for students to exercise clinical skills
and procedures considering the individual differences
among students.
 Provide adequate exercises for students to solve problems,
arrive at clinical decision and use of critical thinking.
 Guides learning and student’s use of resources for
learning.
 Is available always for students and especially when thay
need assistance.
 Provides specific timely feed back on student’s progress.
 Encourages students to execute self evaluation
 Correct mistakes immediately and supervises till students
perform correctly.
 Display fairness in evaluation
 Uses variety of clinical Tching:
 strategies to create interest among students.
 Serves as role model for students.
FACTORS INFLUENCING CLINICAL TEACHING:
Irby and papadak ids identified 6 factors that are

associated with excellence in clinical teaching.
 Knowledge and analytical ability
 Organization and clarity of presentation
 Enthusiasm and stimulation of interest
 Group interaction skills
 Clinical supervision skills
 Clinical competence and professionalism
GUIDELINES FORSELECTION OF CLINICAL TEACHING

METHODS:
 Selection of method must be appropriate to objectives and

desired behavioral changes.
 Selection of method must be in accord with principles of
learning.
 Selection of method must be in accord with capacity of the
student. Know your student.
 Selection of method must be in accordance with availability
of resources.
 Selection of method must be in accord with teacher’s ability to
use it effectively and creatively.know yourself.
CLINICAL TEACHING METHODS:
I) CASE METHOD:
The case method of teaching and learning is often
used with group discussion. Hippocratus had used it
as a method of teaching medicine . in 1940 Gragg
wrote an article which introduced a new case system of
instruction and described the teachers and the students
roles there in. in nursing case method has been
extensively used as a prime method of teaching than
any other methods. Florance nightingale used a
modification of the case study in the teaching of nursing
students. She adviced students to own a note book to
make a note of exceptionally interesting cases and later
quizzed them to evaluate how much of learning had
taken place.
There are three methods of which are identified as ;
 Case study
 Case analysis method
 Case incident method
A) CASE STUDY:
Case study describes the life history of an

individual or all of the factors which affect a situation. It
gives the breadth and depth of an individual . the
nursing case study centers on the patient, his problems,
his needs and nursing care. Both medical and nursing
care studies almost attain the well rounded picture of
the patient from the onset of the problem that is before

hospitalization as well as entire facts about his illness
and treatments.
B) CASE ANALYSIS METHOD:
Case analysis method of teaching focus on a

central situation which requires some decision or
solution . it presents a concrete case for analysis and
discussion by a group of students under the guidance
of the clinical instructor. Adequate information presented
to the students for them to make judgements on the
problem or situation.
Objectives of the case analysis method :
 Develop a mind that has the power to transfer from

familiar type of problems to new ones and to be able to
explain wisely the basis for a decision.
 Develop the ability to master a tangle of circumstancial
evidence , selecting important factors from a whole set
of facts and weighing their importance in the context of
the base.

 Enlarge the ability to utilize ideas, to test them against
the facts of the problem , to examine ideas and facts
and to discuss ways which make them appropriate for
the solution of the problem.
 Extend the ability to utilize data from experience as a
test of validity of the ideas already obtained with
flexibility to revise goals and procedures when the
need arises.
 Expand the ability and communicate thoughts to others
in a way which stimulates further thought.
 Develop the ability to use ideas in theoretical form to
create a framework of general propositions from a problem
solving experiences.
General guides to use case analysis method:
Establishment of atmosphere:
The teacher must establish a permissive non-authoritarian

injunction to think along certain lines preferred by the
instructor. And she should treat each student with respect,
tolerance and will to understand. All these would facilitate
student to express their ideas and gain familiarity with
difficulties in reaching conclusions and communicating others.
Student Preparation for discussion of the case:

An important prelude to productive group discussion relevant
and meaningful. Each student should be provided with a written
copy of case to be discussed. Bauer has developed an excellent
student guide for interpreting case material. He defines case
interpretations as a process of analysis and synthesis which goes
through following series of phases.
1. Identifying important event or events in the case. It might be

the problem of impersonal relationship, a controversy over an
issue etc.
2. Setting the stage for analysis of the case by choosing an
appropriate frame of reference or conceptual model, for
example , a theory which focuses on person or their attitudes.
3. Identifying and classifying the parts or the elements in the
case . These may be persons , relationships, values, customs
etc.
4. Specifying the relevant attributes or variables in these
elements. These may be qualitative or quantative.
5. Relating these elements to one another to see if any type of
sequence or correlation or pattern changes . This is the
beginning of synthesis phase and purpose is trying to see
trying to see the structure of the case as a whole.
6. Explaining these connections or patterns by going deeper than
merely establishing connections or correlations. This is done
by applying abstract principles or theories to concrete events
in case.

7. Examining critically the concepts or the themes used to
determine their adequacy and to suggest their possible
alternatives and revisions.
8. Applying the knowledge and understanding gained through
the case analysis by suggesting how decisions and actions in
the case could have been improved recommending a course of
action or a change in policy.
Cases grow change during discussion :
The background of knowledge , skills and experience of each

student influences the way in which he/ she deals with each
case. One student may identify himself /herself with a character
in the case; other may project his / her own feelings and
attitudes into this situation; a third student may deal with stereo
types rather than with the people the case. All these phenomena
are typical and have to be dealt with if the support of the class is
to be maintained and if a leaning is to result. Gragg identifies
three objectively discernible phases through which students pass
typically when learning by means of case analysis. They are given
below:
1. Discovering the inability to think of everything that his fellow

students can think of. It is discouraging to students after
having prepared a case as well as they can, to listen for an
hour in class to other students, bringing out all sorts of
interpretations and arguments that they had no thought of.

2. Accepting easily and without fear the need for cooperative
help. When this happens students learn to draw more fully on
each other’s ideas in working out problems.
3. Recognizing that teacher does not always necessarily know the
best answers and even when she does seem to know them,
each student is still free to present and to hold his / her own
views. When student reaches this point he/ she is ready to
make the independent progress. He/ She is
Operating as a responsible member of the community taking
help when needed but taking his / her own decisions without
fear of disapproval or search for an authoritative crutch to
lean upon.
C) CASE INCIDENT METHODS :
Case incident method of teaching is a modification

of the case analysis method. Originated by Paul and Faith
Pigors. It focuses on a critical or crucial incident in a case or
situation which requires immediate decision and action. It does
not present any background information ;it just pinpoint the
incidents which requires solution. The case incident may be
used in various ways. It may be used in such a way that part of
the procedure is to gather the background information on the
case or to describe what would be needed to make a logical
decision. The most usual way of using the case incidents is to
state the incident and then to ask the student what they would

do in a similar situation and to give their seasons for their
decisions. The students may be asked to make written
statements which would be discussed later in the class. The
case incident of teaching may be used in class room. In clinical
conferences, in testing and evaluating students. Many of the
objectives identified for the use of the complete case analysis
method of teaching and learning also may be attained through
the use of this technique but not with the same degree of depth
and understanding, for it is a much less complicated and
rigorous technique of learning and teaching.
The Pigors , the originators of the case incident technique,

suggest that it be used in a five phase process.
Phase 1: The Incident: After discussing the various factors
which may influence the behavior of adult hospital, the class
is presented with an incident taken from a life situation .
Phase 2: Getting the facts: The students are now asked what
information they need before they can make an effective and
intelligent decision. The leader has the fact of the case and
gives them as requested by the group. A group member may
be asked to summarize the fact that are brought out before, to
check if any aspect is left out
Without explanation. These may be highlighted on the
blackboard. When the facts have been developed adequately,
the group is ready to enter the next phase.

Phase 3: Determining the source of the problem and the
consequences : In this phase the group tries to determine
what the crux of the problem is that needs immediate decision
and what the possible consequences may be if an immediate
decision is not made and acted upon.
Phase 4: Stating decisions and reasons for decisions by
individuals students :
Each student is asked to write she would have done in that
particular situation.
Phase 5: Identifying the major decision and issues raised

by the individual students through group discussion:
If the class group is small, each student can be given
opportunity to give her decision and reasons for it, which are
then discussed by the group. In contrast , if the class is large,
small group may get together and clarifies issues raised and
summarize the decision reached before joining the full class
for discussion. The objective of this phase is to identify and to
discuss the major decisions and issues raised by the
individual members of the class and to classify them into
categories.
D) NURSING CARE STUDY:
Nursing case study describes the actual nursing care of the

patient. It is a case study in which there is a holistic of the

individual patient to bring about complete understanding of
the required nursing care, to provide a factual basis on which
to plan and to implement nursing care, to get a perspective
and understanding of patients total care, with particular
emphasis on continuity of the patient care. A nursing care
study may be hypothetical one , it may be a real life one, either
previously written or presently being studied and prepared by
a student.
Advantages of Nursing Care Study:
1. Stimulates students to utilize critical thinking, reflective

practical skills.
2. Students learn to see the patient as a person. Students are
directed to consciously plan a program of nursing care
adapted to the need of a patient.
3. It accentuates health and social aspects of nursing .
4. It points out the relationship and the cooperation of the
various disciplines interested in patient’s problems.
5. Acquaints the students with professional literature
pertaining to nursing problems.
6. Enables the students to compare the book and clinical
picture.

7. Helps the student to integrate all his / her knowledge of the
various subjects.
8. Contributes to the building up of a specific body of
knowledge in nursing science.
General Principles in the Use of the Care study:
Students should study the patient’s state of health and self

help abilities , his / her cultural background, his / her
economic level, his / her hobbies , and interests , for an
understanding of all these factors will contribute to the
patients welfare. He / she should study the medical aspects of
the patients condition as this knowledge is essential to render
timely nursing care. Subsequent with the data collection from
the patient pertaining to health and illness. Formulation of
nursing diagnosis and description of the defining
characteristics of a patient, helps the student understand the
patient’s condition better. All these constitute the first part of
the care study and the second part involves with activities
which the nursing student will be concerned in giving holistic
care to the patient. It involves rendering nurse –initiated,
physician-initiated and collaborative management of the
patient . Nursing care study serves as an excellent medium to
help the student develop skills and techniques needed to
function well the nursing team. Emphasis should be on the
individual needs of the patient and how these needs met
throughout nursing. Nursing care study serves as an excellent

means for the student to demonstrate his / her nursing skills ,
his/ her scientific knowledge , his / her sociologic and
physiological insight into problems of the patient and his / her
skill in interpersonal relations with the patient as a nurse.
forms and presentation:
The nursing care may be :
(a)Written and
(b)Oral.
Advantages of written and oral nursing care study
Advantage of written nursing Advantage of oral nursing care

care study study
 It provides for individual  It provides an
differences of the opportunity for the
student. instructor to direct a
 It provides an student’s thinking into
opportunity for self- new channels and to
expression in writing. correct errors of
 It provides experience in information.

organizing and writing a  It serves as a basis for a
paper in a scientific better personal
manner. understanding and a
 It provides a source of relationship between a
material for future instructor and the
reference. student.
 It is time saving. It does
not require lengthy
recopying of notes into
acceptable form.
 It offers an opportunity
for public speaking
experience.
 Discussion is invited
after presentation, the
case becomes
cooperation and all
benefits from the study.
This is a source of
motivation to the student
because he / she shares
the benefits of his /her
study with other student
ts.
 The student feels the
thrill of achievement in

presenting his / her
study to others.
Disadvantage of written and oral nursing care study
Disadvantages of written Disadvantages of nursing care

nursing care study study
 It leaves no opportunity  It does offer an
once the study is opportunity for writing
complete, to branch out and other creative
and intertwine novel expression because only
ideas. notes are used for
 It needs a great deal of presentation.
time to rewrite into an  It leaves no record for
acceptable form. future references.
II) PROCESS RECORDING:
A learning tool which aids a student to develop observation

and communication skills .
DEFINITION OF PROCESS RECORDING:
1. The process record as "a verbatum account of a visit for purpose

of bringing out the interplay between and the nurse and the patient
in relation to the objectives of the visit". —Walker

2. Process recording as "an exact written report of the conversation
between the nurse and patient during the time that they were
together. It is also record of the nurse's feelings about what was
going on at that time and of the observations of the patient's
behavior during the conversation. -Hudson
3. Process recording is a written reports or verbatum recording of

all that transpired immediately before, during and immediately
following the nurse-patient interaction. It may be written during the
interaction or immediately after the one-to-one interaction.
PURPOSE OF PROCESS RECORD:
 Guide the student in the development of self-awareness

of own behaviours-verbal and nonverbal on patient.
 Encourage students to use variety of strategies to
accomplish the stated communication goal.
 Enable student to become more objective in the
processing of patient messages.
 Create opportunity for students to propose alternative
response to patient messages for faculty feedback.
 Provide the student with the comparative record of own
progress in the development of communication skill.
 Help the teacher to gain understanding of student’s
progress in the ability towards therapeutic
communication.

The process record may be used as a data-collecting
instrument for the following three purpose communication.
1. As a teaching tool
2. As a self-evaluating tool
3. As a therapeutic tool.
PROCESS RECORDING TECHNIQUE:
There are three important phases in process recording that are give
below :
1. Prepare the student for process recording

2. Prepare nurse – patient interactions.
3. Evaluating the interactions by the instructor and the students.
1. Prepare the student : The teacher must assist the student to

define clearly the appropriate objectives to be accomplishing
regarding nurse-patient interactions. Then, the process record as
a teaching and learning tool should be discussed with the light of
these objectives and also to determine how it can be used best to
accomplish the desired goals. Subsequent with this, teacher
should guide the students to write process records.
2. Recording nurse- patient interactions: When used as a

learning tool there are four significant parts in process recording.
They are (a) the exact verbatim report of the patient- nurse
conversation (b) The students conscious feelings and his / her
interpretation of the patients feelings (c) Analysis for meanings
and clues to patients need and (d) The Instructors and students
evolutions of the total process recording experience.
There are number of conditions which have to be met if process

recording is to be an effective teaching and learning instrument.
They are :
 A minimum of two people

 Reassurance of the patient regarding the confidentiality of
the interview. The student also must be impressed with the
importance of keeping the interview material confidential.
 Recording of all verbal interaction.
 Notations of thoughts, feelings and actions that the student
experiences during the interaction.
 Notations on the nonverbal communication of the patient.
 Notation of the interaction done as soon as possible after
interaction occurs. Noting the time lapse between
interaction and actual recording.
3.Evaluating the nurse-patient interactions :
Following the interaction data have been collected by the

student, the teacher and student have the subject matter or
material of the learning experience. Analysis of the data should
be recognized as the crux of the learning experience. Failure to
follow up the recording of an interaction with analysis of
guidance in the analysis of the interaction process renders the

data fruitless and frustrates the student’s effort. This element of
analysis of data is time consuming and should be considered by
the teacher before he / she selects the process recording as a
teaching tool. During the process of analyzing the recordings, the
objectives of the learning experience should be kept in focus. The
teacher needs to guard against dealing with process recording as
written work to be handed in by the student , corrected and
returned . If the teacher to aid the student to further to stage of
self- evolution, he / she must discuss the process record with the
student. Rather than evaluating a student behavioral response ,
the teacher should help the student to explore the reason for
such a response and the possible effects it might have on nurse-
patient interaction. This would result in deeper understanding of
students behavior and effect that his or her behavior may have
on others . As the students still increases he / she may assume
greater responsibility for independent analysis of the patient
communication and his / her own. Thus , self- evaluation is an
integral part of process recording analysis.
Advantages of Process Recording.
 Helps students to have an objective look of his or her own

communication skills.

 Provides teacher with an accurate account of the students
clinical learning experience.
 Assists the teacher to explore the areas where students require
improvement a refine in communication skills.
Disadvantages of Process Recording :
 Lengthy involvement of time in teaching and implementing this

tool.
 It cannot record all subtle nuances such as tones of voice,
mannerisms, timing etc. as well as other non verbal cues which
a nursing student could miss.
III) NURSING CLINIC:
The nursing clinic or patient presentation utilizes the

presence of a selected patient as its focus for group discussion. It
affords a direct experience in the discussion of principles and
practices of nursing care relative to a given patient. The purpose is
the improvement of nursing care. Students have the opportunity to
sharpen their observation and interviewing skills while
simultaneously developing increased ability to see relationships
between the patient's concept of his health and nursing problems
and his resources for coping with the total problem and the nurse's
concept of the patient's problem and how it might be solved.
The most effective nursing clinics are those that are

planned, which involves (i) determining the purpose, (ii) selecting a

patient for whom students have given nursing care, (iii) securing the
patient's consent and proper legal clearance, (iv) selecting the
setting to be used—the patient's bedside or a conference room
visited by the patient; and (v) providing advance preparation of the
student in terms of the name of the patient, the purpose, place,
date and time, and any specific instructions regarding preparation
for the discussion.
The group discussion generally consists of three phases:

(i) the introduction, (ii) the patient-centered discussion, and (iii) the
evaluation discussion; the patient is present only during phase two.
The introductory phase serves to acquaint the students with the
patient's background, presenting nursing care situation, the
purpose of the discussion, significant observations, types of
questions to be asked, and needed information. During the patient-
centered discussion, a few simply asked questions directed to the
patient are usually sufficient for obtaining the needed information.
Ample opportunities should be allowed for patients to verbalize their
needs and how they see their particular problem. Sometimes
demonstrating a particular nursing care measure or allowing the
patient to do so is sufficient for meeting the purpose. When the
patient appears unresponsive or tired, it is wise to close the
discussion, even though the purpose may not have been
accomplished. The evaluation discussion offers an excellent
opportunity for students to evaluate the patient's behavior, ability
to solve his own problems, and various other aspects. The students
can be evaluated in terms of their observations and ability to use

problem-solving techniques. The discussion should be summarized
in terms of application of background knowledge to the given
nursing care problem and goals accomplished, with provisions
made for follow-up on comparisons between the student's views of
the patient's problems and the patient's views of his problems. Such
an approach opens the door to many other ways of developing the
student's views of the patient's problems and the patient's.
This same basic pattern can be adapted easily for use

in planning and implementing interdisciplinary patient-centered
clinics. The modification would be in terms of identifying kinds of
input needed from each team member and seeking appropriate
contributions from each.
The nursing clinic is a group discussion which utilizes

the presence of a selected patient, whereby the nursing aspects are
presented and discussed.
In a nursing clinic the patient's medical history and

therapy are discussed only briefly, but the emphasis is on the
nursing problems, including the physical, mental and social
aspects.
Purpose:
1. To apply theory into actual practice by observing interviewing

and studying a patient.

2. To apply knowledge and experience to the real life situation.
3. To understand certain types of apparatus.
4. To improve the nursing care.
Size: Small size, approximately 15 students.
Preplanning the Clinic
1. Determining the purpose of the clinic.
2. Selecting a patient for home students have given the nursing

care.
3. Securing the patient's consent.
4. Selecting the setting to be used, i.e. bedside or conference room.

5. Provicing advance preparation of the students.
Levels of Discussion:
1. Introduction.
2. Patient centered discussion.
3. Post-clinic evaluation discussion.
IV) BEDSIDE CLINIC
Bedside clinic always entails the presence of the patient. Either the
group visits bedside or the patient is brought to the conference
room.
FORMS OF BEDSIDE CLINICS

 Clinics may be given by the doctor in which case symptoms and
medical therapy are emphasized.
 Nursing clinics are conducted by head nurse by clinical instructor
PURPOSE
1. To provide a learning experience for nursing student to collect

information about the patient with tact and skill.
2. To improve the student's ability to solve nursing problems by

detailed study and analysis 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 student to do nursing observation in an organised

systematic way.
5. To be able to work out a nursing care plan 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 patient's consent as his cooperation 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 comfort is provided to patients.
▪ patient is kept at ease.
• The clinic usually lasts for 30 minutes.
• The number of students should not exceed 10-15 in number.
'The discussion relative to the nursing clinic consists of three

phases.
• introduction phase
 Patient centered discussion

• post clinic evaluation .

I) Introduction phase:
This phase serves to acquaint the student with the patient
back grouping, presenting nursing care situation, the
purpose of the clinic, significant observation to be made, type
of question to be asked, etc.
II) 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 patient to
'verbalize his needs and how he perceives his particular
problem. Soon after second phase of clinic patient should be
sent to the ward by thanking him for his cooperation.
III) Post-clinic evaluation:
It offers an excellent opportunities for students to
evaluate the patient behaviour, ability to sole 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 and ability to meet the
stated purposes of clinic through their observations and
ability to use problem solving technique.
The nursing clinic provides an excellent opportunity

to show symptoms and to show how to use different
appliances in any particular condition and how nursing
situations and problems have been met.

Advantages of Bedside Clink/Bedside Teaching:
1. Bedside teaching puts the student 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 taking.
5. Ensures closer contact with reality (Professional-patient health

situation of community, colloaguos and teachers).
6. Permits comparison between reality and theory.
7. Enables students to develop self-confidence.
8. Increases variability.
Disadvantages of Bedside Clinic Bedside Teaching :
1. High personnel costs.
2. Sometimes puts the patient in a difficult situation.
3. Poor standardization.
4. Narrow limits of utilization.
V) INDIVIDUAL CONFERENCE
Individual conference is described as conversation with purpose.

This specific purpose in the interview is to obtain facts or to

provide information. The skills essential in successful use of
individual conference are skills in observation; in the use of setting;
in the establishment of rapport; in meeting resistance ; in
recognizing ambivalent feelings; in the establishment of authority;
in the use of questions and silence as a skillful procedure.
The individual conference can be used by the clinical instructor to

clarify class material, to supplement instructions, to explain
answers to questions of individual students which do not concern
the entire class. It can also be used as a means of assisting the
individual who is having difficulties in keeping up with the class or
the student with the potentiality of advancing ahead of the group
as a whole. Individual conferences facilitates nursing students to
understand the relationship between class content of courses and
the application of problems of nursing practice and patient care. It
can be a means or bringing unity to the entire nursing course, by
helping the student in integrating his / her previous knowledge
and experience in relation to the present learning experience.
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 herself/himself.

Teachnique of the individual Conference:
1. Teacher should establish good rapport with the students.

2. Allow him to talk freely
3. Teacher should not show any prejudices, emotional reaction 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. provide sufficient time.
5. establish good rapport
6. good listening
7. positive effect
8. recording of data
VI) GROUP CONFERNCE
Conference is the act of consulting together. It always involves a two

way flow of conversation. Group should be small enough so that
member will be permitted to participate.

BENEFICIARIES OF THE GROUP CONFERENCE :
The subjects discussed in short group conferences are often of

importance the entire nursing staff. Conferences may be conducted
by a student nurse , staff nurse , the assistance head nurse or head
nurse.
SUBJECTS SUITABLE FOR GROUP CONFERENCES :
The best subject matter for the conference is patient care. The
following subjects lend themselves well to the group conferences :
# Individualized nursing care . The need for health teaching ,

symptoms to observe , methods to determine progress, suggestion
to approach the patient , way to help a discouraged patient.
# Importance of accurate recording on a patient whose diagnosis is

not established or one who is manifesting unusual symptoms.
# An unusual drug or treatment which is being used in the ward for

one or more patients.
# Routine investigations and specific diagnostic tests in relation to

specific patients having such tests that day.
# New hospitals or ward routines.
# Changes in nursing procedures.
# Review of procedures which are unfamiliar or which are not being

performed well.

# Display of equipment which has been damaged by improper care,
misuse, methods of prevention and so on.
TIME FOR CONFERENCE :
Group conference may be held at any period of the day when the
staff is free to attend , that is, during a period of relatively light
ward activity. But when it is planned on same hour weekly, the
staff’s can make themselves free during that hour.
PLACE FOR CONFERENCE :
There are four requisites for the place where conference are held.
 The patients must not be able to hear any part of the discussion.
 Seating arrangements are essential.
 Patient’s signals must register in the conference room unless
some members of the staff remains away from the meeting to
care for patients.
 The place for conference should be one where interruptions will
be minimal.
VII) NURSING CARE CONFERENCES:
Nursing care conference 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.

Nursing care conferences are so "old hat" and so
identified with basic nursing education that their potential value in
staff development and continuing education is often unrecognised.
Within the institution, particularly at the unit level, a nursing care
conference can provide a good learning experience for all the staff
who share a common nursing problem in providing care to a
specific patient.
A nursing care conference is designed around a

consultation visit of a clinical nurse specialist. 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 patient's problems
from his point of view".
Planning and Preparation :
1. The organisers should prepare well in advance regarding

particular conference.
2. Before presenting, the student will have collected all the data
regarding the patient. She will have worked with that patient and
collected information about the signs and symptoms since how long
the patient is sick, the laboratory finding, his family back grounds,
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 used as a consultation tool to

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 rechanelling, 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
students to think.
Phases
The nursing care conference is used as a consultation tool to

help in problem solving. It has got three phases. They are:
(1) Opening phase,
(2) Working phase

(3) Closing phase.
Opening phase:
The opening phase can be defined as the first two

minutes of the conference. The 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.
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 delieneating the problem clearly. In some
conferences there is a difference of opinion among the nurses, often
the data are inconsistent or incomplete. It is helpful the group focus
their discussion by asking direct questions, rephrasing what the
group has said and summarising. Sometimes, when data on the
patient are incomplete the group will try to fill in. If the consultant
and group view the absent data as critical to the solution, time is
better spent in getting the facts than in speculation. Conference
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 group's opinion on the validity of her
suggestions.
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,

i.e. the students 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 classroom

teaching.

VIII) TEACHING ROUNDS :
The aim of teaching round is to acquaint nurses/ student nurses

with all patients on the ward in order that better understanding
and more purposeful care may be achieved for each patient.
Usually all patients are visited on rounds and the visit is
accompanied by a discussion pertaining to each patient’s care.
Ways of conducting rounds : The teacher with a group of

student nurses goes to patient’s room. The discussion should
take place outside the door out of patient’s hearing and then the
group moves towards the patient and converse few minutes and
further to next patient. The discussion must of necessity be brief
including only outstanding points if the purpose is to visit all the
patients on the ward.
TYPES OF WARD ROUNDS :
 Rounds with doctors.

 Rounds to discuss psychological problems.
 Nursing rounds.
 Medical round for nurses.
 Rounds with physical therapists.
 Social service rounds.
ROUNDS WITH DOCTORS :

Sometimes the emphasis in teaching rounds is on medical aspects
of patient’s condition and care. A professor may take medical
interns to discuss the patients on the service. Often the patient is
examined in the presence of a nurse. It is highly valuable
experience for staff and student nurses to accompany group of
doctors. The student should accompany with head nurse or clinical
instructor in order to clarify concepts not understood by the
student.
Social service rounds :
This is conducted by the medical social worker and attended by

doctors and nurses, keep the nurses in touch with social problems
of the patients and plans which are being made for their care
following hospitalization . Student nurses should be given
opportunity to attend theses rounds and value of discussion is
increased if the nursing implications are also highlighted.
Rounds to discuss psychological problems of patients: In hospitals

with psychiatry makes rounds with medical and nursing students
to discuss the psychological problems of all the patients.
IX) NURSING ASSIGNMENT:
DEFINITION OF ASSIGNMENT :
The assignment applies to that part of instructional

activity devoted to the clear recognition and acceptance by the
pupil of the next unit of learning to take place and of the
processes by which this learning may be achieved most
effectively.
DEFINITION OF CLINICAL ASSIGNMENT
It is that part 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
Generally there are three methods of assignment :
1. Patient method.
2. Functional method.
3. Team method.
1. Patient method :
This method of assignment involves a nurse n rendering complete

nursing care to one or more patients including complete nursing
cares to one or more patients including complete nursing care,
treatments , medications , taking vital signs, serving food and
patient education. When she completes her duty or during break
hours, her group of patient is handed over to another nurse for the
period of her absence in order that the patient may still receive
individualized care.
ADVANTAGES OF PATIENT METHOD:
Individualized nursing care is possible:
When one nurse is responsible for the total care of the patient she
comes to him as a person. She also extends her knowledge about
the patient’s symptoms and treatment. Patient develops a sense of
belongingness and develops trust on the nurse and will express
about his problems and progress to the nurse without reluctant.
Better Nursing Education :
When nursing care is patient centered, the student knows the

patient as an individual . She gains better knowledge of disorders
and the way in which they affect the patient physically,
psychologically and socially. When the nurse / student nurse is
assigned to provide total patient care she has an opportunity to
make her plans for their patient’s care and to observe the results of
her efforts.
Satisfaction of the nurse :

Nurse attains satisfaction when she has professional contact
with the patient and the opportunity to observe her plans of his
care materialize.
2.Functional Method :
In this method of assignment , nurses are assigned to

specific functions in the ward such as administrating medications
or providing hair wash to all patients. The functional method may
be used at some periods when there is shortage for nurses. Very
young students may not be capable of providing total patient care
when they can be assigned this method.
Advantages of Functional Methods:
More can be accomplished in a given period of time because there

are fewer interpretations, there is less confusion and because skill
develops when a purposeful activity is repeated often in a short
period of time.
3.Team Method :
This method is in limited use in modified form it is

followed in some hospitals. The appearance of large numbers of
practical nurses and nurses aides in hospitals make it imperative
that some way be found to give these groups sufficient supervision.
This result has been the development of the team method of
assignment in which two or more members of nursing staff, one

being designated as leader, are assigned to work together in giving
care to a group of patients. The team leader is always a professional
nurse. The members may be graduate or student professional or
practice nurses, nurses aids or any combination of these.
Advantage Of Team Method :
This method has resulted largely because of

shortage of lack of professional nurses to provide
total care of the patient.
Disadvantage Of Team Method:
It can be performed by individuals with less knowledge, skill and

judgment resulting in lack of execution of independent nursing
interventions.
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.
ii. Students are to be oriented to new clinical area.
iii. Students are to be given the learning experiences which are
outlined in the objectives for particular clinical experiences.
iv. Students are to given facilities to practice nursing
according to principles taught.

v. Only recognized wards of the hospital or community are to
be selected for students to achieve required learning
experience.
vi. Assignments have to be assigned according to the
consistent level of learning that students have reached, or
attained.
vii. Proper guidance and supervision has to be provided to the
students during their clinical experience.
viii. Sufficient time to be provided to carry out the assignment
allotted to the students.
ix. Student's performance should be evaluated and discussed
with the students for their improvement, correction, etc.
x. Students should be given opportunities for working in a
team.
xi. Students are to be encouraged to develop a pride in the
nursing profession.
xii. Students are to be watched, that high standard of patient
care are being practised by all concerned.
PRINCIPLES OF STUDENT'S ASSIGNMENTS:
• The rotation of students through departments and wards should

be according to the curriculum plan of their course.
• Sometimes, reassignments can be arranged according to the

students who require the same kind of experience.

• First year students should be posted where they will receive the
maximum supervision and guidance from qualified nursing staff.
• The departmental and ward sisters or nursing superintendent

should be informed in advance regarding the student's assignments
in their speciality.
• The individual student's differences should also be informed to the

staffs.
• The record should be maintained of the number of hours spent

on day, evening, night duty in each block of experience.
• A record of sick leave and other types of leave utilized by the

students also be maintained. If needed, reposting or reassignments
may be done.
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 patient's

records.
3. Proximity of patients should be considered.
4. Assignments should be varied frequently enough to maintain the

interest of students.

5. Sociological and the psychological aspects of the patient should
be considered.
X) MORNING AND EVENING REPORTS:
DEFINITION:
A report summarizes the services of the nurse and or

the agency. Reports may be in the form of an analysis of
some aspect of a service.
TYPE OF REPORTS
1. Oral report
2. Written report
Oral report:
Oral reports are given when the information is for

immediate use and not for permanency. They may be based on
material included in a written report. An oral Report is made by the
nurse who is assigned to patient care to another nurse who is
planning to relieve her. The head nurse makes oral reports to the
supervisor, the nursing office and the doctor.
Written reports:
Reports are written when the information is used by several

people or is more or less or permanent value. Day and night report

census, interdepartmental reports to admitting and business office,
are all included in written report.
CRITERIA FOR A GOOD REPORT
Report should be made promptly, if they are to serve their

purpose well.
A good report is clear, concise, complete. If it is written all

pertinent, identifying data are included, the data and time, the
people concerned, the situation, the signature of the person making
the report.
It is clearly stated and well-organized for easy

understanding.
No extraneous material is included.
Good oral reports are expressed and presented in an

interesting manner and important points are emphasized.
A good report is unhurried.
reports between the head nurse and her assistant :
The assistant head nurse should know everything

pertinent to the management of the ward even though she may
never be concerned with parts of the information. The well-informed
assistant head nurse knows the condition of all patients, the
treatment they are receiving, observations which are to be made,
changes in the ward and hospital routine, etc. In other words, she

has all the information she needs to keep the ward running
smoothly without interruption of waste of time. When the head
nurse returns to the wards after hours or days of absence, the
assistant head nurse tells her all changes in the situation including
the condition, the patients and happening during her absence. It is
advisable for the head nurse and her assistant to keep, in a note
book or in a note pad memoranda of information which they plan to
report.
Reports Between Nurses Who Are Assigned to Bedside Care
Contents reports of students and staff nurses to those

who are to relieve them include the condition of all patients
assigned to her care treatments, and medications which have been
given and those which are due, adaptations in method required by
each patient, information about the patient as a person and his
diagnosis if these are not already known to the relieving nurse.
Reports to the Clinical Instructor:
Reports to the clinical instructor include everything in the

ward situation which affects the educational process. Hence they
receives the same report relating to patients as that given to the
administrative supervisor. Since she is responsible for teaching the
instructor especially needs information about concerning new drugs
as well as therapeutic and diagnostic measures which are being
used.
Report of the Charge Nurse to the Physician:

The specific information which every doctor expects to
receive from the nurse incharge of the ward relates to his patients
under her care. He wishes to be told of the symptoms which they
show, the results of treatment, inability to carry out his orders and
difficulties or mistakes in doing so.
Day, Evening and Night Reports :
The change of shift report is the oldest report in the

nursing service. Since, its longevity attests to its importance in
carrying forward the goals of the enterprise. Though, it has
undergone so many changes over the years, it remains essentially a
transmission instrument for the care of patients from one set of
works to another, using a written report, the nursing care plan as
contained in a card file, and patients charts. Some institution
include only the sickest patients in the written report. Others
include them all. It may help the day nurses to start the day more
easily if the night nurse includes in her report a list of the patients
on whom new orders have been written.
The daily census, or the number of patients in the hospital

at midnight, furnishes important source material for hospital
statistics. It can be readily understood that census figures must be
correct.
XI) ROLE PLAY:
DEFINITION :

Role playing is a relatively new educational technique in which
people spontaneously act out problems of human relations and
analyze the enactment with the help of other role players and
observers.
Role playing, sociodrama and psychodrama are closely

related and the terms role-playing and sociodrama are frequently
interchangeable.
PURPOSES OF ROLE-PLAY IN NURSING
1. To convey information.
2. To develop specific skills.
3. To develop a situation for analysis.
4. To prevent alternative courses of action.
5. To prepare for meeting future situations.
6. To develop understanding of points of view of others.
7. Increasing their insight into typical ways of dealing with them.
PRINCIPLES OF ROLE-PLAY
11. To convey information.
2. To develop specific skills.
3. To develop a situation for analysis.
4. To prevent alternative courses of action.

5. To prepare for meeting future situations.
6. To develop understanding of points of view of others.
7. Increasing their insight into typical ways of dealing with them.
SETTING UP OF ROLE-PLAYING
1. Define the problem to be considered and the nursing situation in

a meaningful manner to all students in the class.
2. Identify the characters in the situations and ask for volunteers

to play these roles.
3. Ask the participants to try to place themselves in the position of

the characters.
4. Caution the participants against the desire to express their own

ideas and opinions.
5. Each class member selects one role and identifies herself with it,
listens and tries to anticipate what the persons in the situation
might say or do.
6. Never rehearse for role playing.
7. At any point during a dramatization participants may hold a

short conference to clarify the problem under study.
8. The length of the role play will depend upon how long it takes to
make the nursing situation clear and the students become aware of
feelings and thoughts of these in the actual situation.

9. At the end of the activity time should be given for a discussion.
ROLE OF A TEACHER IN ROLE-PLAY OF TEACHING
1. This provides the teacher with the opportunity to note individual

student needs by observing and analyzing her needs in a real life
situation.
2. Assist the student in meeting her own needs by either giving her
or encouraging group members to give her on the spot suggestions.
3. Encourage independent thinking and action by stepping aside

on giving indirect guidance to emphasize them to themselves.
4. The teacher can correct the errors and use the role-play for
specific teaching on the subject.
VALUES OF ROLE-PLAYING
1. Develop skill in leadership, interviewing and social interaction.
2. Develop sensitivity to others feelings.
3. Develop skill in group problem solving.
4. Develop ability to observe and analyze situations.
5. Practice selected behaviors in a real-life situation without the

stress of making a mistake.
LIMITATIONS OF ROLE-PLAY:
1. Role-play places undue emphasis on the dramatic aspects.

2. It cannot be used successfully till the group understands and
accepts it as a method of learning.
XII) FIELD-TRIP:
A field-trip is a visit especially planned for its possible

contribution to the objectives of the curriculum, course, project,
lesson or other unit of instructions. 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 trip is defined as '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'.
PURPOSES
1. To provide real life situations for first hand information.
2. To supplement classroom instruction, to secure definite

information for a specific lesson.
3. To serve as a preview of a lesson and for gathering instructional

materials.
4. To verify previous information, class discussions 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.
ORGANISATION AND PROCEDURE OF FIELD-TRIP
A. Preplanning.
B. Actual conduct of the trip.
C. Evaluation.
A) Preplanning :
• By teacher
• By students
By the teacher :
1. Decide on the trip.
2. Know the resources.
3. Obtain administrative sanction of school/college.
4. Dealings with the organisation - 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 students:
1. Formulate 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 location, set up, conduct and behavior during the
trip, safety precautions 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 organisation.

C)Evaluation phase :
1. Should be done as early as 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

observations from the students maintains a record which can be
referred later.
5. Conducts discussion with the students.
VALUES OF 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 and social skills.
6) Students develop better understanding of the aetiologic factors
of disease.

7) Field trips 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 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.
5. Since the students are going out of school/college premises it is

risky, safety precaution 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.
SUMMARY:
The objectives of clinical experience are obtained through

various methods of clinical teaching. Each method of clinical
teaching has its own merits and demerits. It is the responsibility of
the clinical instructor to select the apt method of clinical teaching
based on the objectives, type of experience and the level of the
students involved in the scenario.

Clinical Teaching

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INDEX OF CONTENTS

S.no CONTENTS PAGE

CLINICAL TEACHING METHODS

The clinical teaching is a type of group conference in

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Alternatively the clinical can be given by any faculty member

PHILOSOPHY OF CLINICAL TEACHING :

Philosophy determines the teacher’s understanding of his or her

OUTCOMES OF CLINICAL TEACHING:

Outcome of clinical teaching include knowledge, skills and

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Clinical learning produces important outcomes in

CLINICAL TEACHING MODEL :

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there is no one model that meets the need of nursing

 Educational philosophy of the nursing program

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Disadvantages of traditional model:

 A teacher may be attached with a large number of

Advantages of preceptor model:

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 CLINICAL TEACHING ASSOCIATE MODEL.:

 CLINICAL TEACHING PARTNERSHIP MODEL :

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CLINICAL TEACHING SKILLS:

 Assess learning needs of the students, recognizing and

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FACTORS INFLUENCING CLINICAL TEACHING:

Irby and papadak ids identified 6 factors that are

GUIDELINES FORSELECTION OF CLINICAL TEACHING

 Selection of method must be appropriate to objectives and

CLINICAL TEACHING METHODS:

Case study describes the life history of an

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B) CASE ANALYSIS METHOD:

Case analysis method of teaching focus on a

Objectives of the case analysis method :

 Develop a mind that has the power to transfer from

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General guides to use case analysis method:

The teacher must establish a permissive non-authoritarian

Student Preparation for discussion of the case:

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1. Identifying important event or events in the case. It might be

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Cases grow change during discussion :

The background of knowledge , skills and experience of each

1. Discovering the inability to think of everything that his fellow

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C) CASE INCIDENT METHODS :

Case incident method of teaching is a modification

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The Pigors , the originators of the case incident technique,

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Phase 5: Identifying the major decision and issues raised

D) NURSING CARE STUDY:

Nursing case study describes the actual nursing care of the

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Advantages of Nursing Care Study:

1. Stimulates students to utilize critical thinking, reflective

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General Principles in the Use of the Care study:

Students should study the patient’s state of health and self

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