CENTRAL LUZON DOCTORS’ HOSPITAL

EDUCATIONAL INSTITUTION, INC.

Romulo Highway, San Pablo, Tarlac City
Department of Graduate Studies

Course Title: Advance Clinical Teaching

Prepared by: Charmaine Damasco, RN
Topic: Promoting Integration of Theory and Justice
a. Case Studies
b. Seminars
c. Nursing Rounds
d. Written Assignments
Developing Critical Thinking and Reflective Thinking

Introduction:

Higher education curriculum is not predetermined, but subjected to changes, since it is created in
a specific historical moment and culture. Therefore, what should be taught was not established in
a privileged moment in the past but is in constant change. Professors in a nursing undergraduate
course should be committed in giving students more than a true knowledge. Furthermore, one of
the greatest challenges faced today by nursing professors is to offer teaching methods that
increase interest and develop student learning.

Promoting Integration of Theory and Justice

A. CASE STUDIES

The objective of case studies was to present health care situations to stimulate theoretical
knowledge research on pathology, signs and symptoms, semiology, and physical examination
techniques related to nursing. 

The use of case studies is essential to stimulate students to seek knowledge simulating a future
situation in their professional lives. This method focusses on students; therefore, it is necessary
their active participation in the search for knowledge and it is not purely informative as in most
traditional pedagogical practices. To solve the problem situation, students are encouraged to
identify doubts and to formulate questions.

Case studies are thus presented and discussed in the big group to define learning process
questions; a moment called "case opening". Based on these questions, which ranged from 7 to 10
questions, each group of approximately six students organizes the strategy to answer the
questions critically using any resources they have and identifying academic research sources
with help of two professors. Small group discussions improve communicational skills, ideas
exposure, and ability to position oneself and to argue. In this perspective, the development of
critical thinking and analytical skills are sought as well as the assessment of available
information. The answers should be given based on reflection, organization, and synthesis of
knowledge, in such a way that the "case closure" becomes an opportunity to share and build
knowledge with all groups and professors.

B. SEMINARS

Nursing seminars and continued education are imperative to maintaining the right skills to be
effective. Here are some of the reasons continued learning is important.

The Importance of Nursing Seminars and Continued Education

Nursing seminars and continued education are imperative to maintaining the right skills to be
effective. Here are some of the reasons continued learning is important.
1. Medical Breakthroughs
2. Changing Procedures
3. Computers and Technology
4. Maintaining Excellence
5. Networking in the Industry

C. NURSING ROUNDS

“A nursing rounds is one which presents an overview of certain aspects of the nursing or
medical care of all patients on the ward of selected patients” -GABERSON

A small group of the staff members, not more than five and a leader & teachers visit the bed
sides of the clients nursing superintendents ward sisters taking rounds of hospital wards. it helps
the nursing members to know about all the patients in the wards their problems & ways of
solving. Nursing rounds is an excursion into patients’ area involving the student learning
experiences.

Purpose:

 Instructional purpose for student nurses.

 To illustrate successful improvisation & to give opportunity for the use of
different application
 To acquaint nurses with all patients on the more purposeful care may be achieved
for each patient
 To help nurses to get acquainted with new patients
 To carry out demonstration of therapeutic procedures on / for the patients
 To illustrate skillful nursing care
 To learn about disease, pattern of care and treatment
  To demonstrate the effect of drugs used in the treatment

Steps involved in the Nursing Rounds

 The entire clinical group of students is assembled at the bedside of a pre selected patient
who has agreed to participate and who has been briefed before hand as to his role in the
learning experience
 The instructor of the student who is caring for the patient briefs the nursing care.
 The staff nurses of the ward are also allowed to contribute certain genuine points
regarding patient care
 Background information of the patient can be provided away from the bedside
 The main focus is made on nursing care and only important aspects of the care are
discussed.
 At the end the instructor concludes the discussion by giving her opinion, guidance and
relevant instructions. The patient is finally briefed up on the conclusions reached
following discussion
 The staff nurse on duty records all the instructions and suggestions given by the instructor
and a register (providing the information) is maintained in the ward

Advantages

 It ensures high degree of autonomy among students.

 The presence of the patients as a means to illustrate assessment parameters or
intervention techniques
 Nursing rounds provides input and feedback from the perspective of patient care and
therefore gives an opportunity to clarify issues related to patient care.
 It facilitates a detailed discussion on the nursing care of a single patient
 Nursing Rounds helps the students to develop psychomotor skills and inculcate proper
attitude among the nurses
 Interaction with the senior members promote team spirit and professionalism among
students
 Nursing Rounds motivate students to develop an ability to discriminate or classify the
patients into high risk, risk, and no risk categories depending on the severity of illness.
 Helps students to learn in depth regarding a case management

Disadvantages

 The patient may overhear the discussion and he may not like the thought that he is being
talked about. Other patients in the same ward may over hear the discussion which the
patient may not like
  Insufficient information may lead to inappropriate result. There may be distractions in
the ward and there could be problems for the nurses to stand in the ward
 It cannot be organized for large group and hence teaching cannot be done for more
number of nurses. If the nurses are familiar with all the patients the discussion may be
held in the conference room

D. WRITTEN ASSIGNMENTS

In most nursing courses, students complete some type of written assignment. With these
assignments, students can develop their critical thinking skills, gain experience with different
types of writing, and achieve other outcomes specific to a course. Written assignments with
feedback from the teacher help students develop their writing ability, which is an important
outcome in any nursing program from the beginning level through graduate study.

Purposes of Written Assignments

Written assignments are a major instructional and assessment method in nursing courses. With
written assignments students can:
(a) critique and synthesize the literature and report on their findings;
(b) search for, critique, and integrate evidence for nursing practice;
(c) analyze concepts and theories and apply them to clinical situations;
(d) improve their problem-solving and higher level thinking skills;
(e) gain experience in formulating their ideas and communicating them in a clear and coherent
way to others; and
(f) develop writing skills.

Types of Written Assignments in Nursing Course

 Analysis of a clinical experience, the care given by the student, and alternative
approaches that could have been used.
 Teaching plan
 Nursing care plan
 Evidence-based practice paper in which students critique and synthesize the evidence and
report on its use in clinical practice
 Paper analyzing concepts and their application to clinical practice
 Paper on how the content they learned in class and read about in their textbook and
articles compares with their experiences in the clinical setting and how it applies to
patient care
 Critical analysis papers in which students analyze issues, compare different options, and
develop arguments for a position

DEVELOPING CRITICAL THINKING SKILLS AND REFLECTIVE PRACTICE

Critical thinking is used to describe:

"... the use of those cognitive skills or strategies that increase the probability of a desirable
outcome...thinking that is purposeful, reasoned and goal directed - the kind of thinking involved
in solving problems, formulating inferences, calculating likelihoods, and making decisions when
the thinker is using skills that are thoughtful and effective for the particular context and type of
thinking task. Critical thinking is sometimes called directed thinking because it focuses on a
desired outcome." Halpern (1996).

Someone with critical thinking skills can:

 Understand the links between ideas.

 Determine the importance and relevance of arguments and ideas.

 Recognize, build and appraise arguments.

 Identify inconsistencies and errors in reasoning.

 Approach problems in a consistent and systematic way.

 Reflect on the justification of their own assumptions, beliefs and values.

The Skills We Need for Critical Thinking

The skills that we need in order to be able to think critically are varied and include observation,
analysis, interpretation, reflection, evaluation, inference, explanation, problem solving, and
decision making.

Specifically, we need to be able to:

 Think about a topic or issue in an objective and critical way.

 Identify the different arguments there are in relation to a particular issue.

 Evaluate a point of view to determine how strong or valid it is.

 Recognize any weaknesses or negative points that there are in the evidence or argument.

 Notice what implications there might be behind a statement or argument.

 Provide structured reasoning and support for an argument that we wish to make.

REFLECTIVE THINKING
Reflective thinking, on the other hand, is a part of the critical thinking process referring
specifically to the processes of analyzing and making judgments about what has happened.
Dewey (1933) suggests that reflective thinking is an active, persistent, and careful consideration
of a belief or supposed form of knowledge, of the grounds that support that knowledge, and the
further conclusions to which that knowledge leads. Learners are aware of and control their
learning by actively participating in reflective thinking – assessing what they know, what they
need to know, and how they bridge that gap – during learning situations.

Developing and Using Reflective Practice

What can be done to help develop the critical, constructive and creative thinking that is necessary
for reflective practice?

Neil Thompson, in his book People Skills, suggests that there are six steps:

1. Read - around the topics you are learning about or want to learn about and develop

2. Ask - others about the way they do things and why

3. Watch - what is going on around you

4. Feel - pay attention to your emotions, what prompts them, and how you deal with
negative ones

5. Talk - share your views and experiences with others in your organization

6. Think - learn to value time spent thinking about your work

The Reflective Learning Process

 Identify a situation you encountered in your work or personal life that you believe could
have been dealt with

 Describe the experience.

 What happened?  When and where did the situation occur?  Any other thoughts you have
 Reflection
 How did you behave?  What thoughts did you have?  How did it make you feel?  Were
there other factors that influenced the situation?  What have you learned from the
experience?
 Theorizing
  How did the experience match with your preconceived ideas, i.e. was the outcome
expected or unexpected?  How does it relate to any formal theories that you know?  What
behaviours do you think might have changed the outcome?
 Experimentation
 Is there anything you could do or say now to change the outcome?  What action(s) can
you take to change similar reactions in the future?  What behaviours might you try out?

https://www.skillsyouneed.com/ps/reflective-practice.html

https://www.skillsyouneed.com/learn/critical-thinking.html

https://nursekey.com/assessment-of-written-assignments/

https://www.slideshare.net/mahesh0926/nursing-round

https://www.scielo.br/scielo.php?pid=S0034-71672016000601231&script=sci_arttext&tlng=en