(PDF) Learner initiatives and learning opportunities

The Purpose of This Project Is for You
to Recognise Opportunities for
Learning and Teaching

TABLE OF CONTENTS
TOPIC..............................................................................................................................................3
INTRODUCTION...........................................................................................................................3
Case Scenario...................................................................................................................................4
CONCLUSION..............................................................................................................................10
REFERENCES................................................................................................................................1

TOPIC
To recognise opportunities for learning and teaching in the clinical setting to plan
strategies for maximising student engagement by developing framework for clinical teaching and
supervision practice.
INTRODUCTION
In the health and care setting, practitioner and supervisor plays a significant role in
managing effectiveness and quality in care services and treatment. The study will address the
issues and difficulties faced by practitioner, at the time of dealing with patient. Further, in
clinical setting, there are numerous learning opportunities for practitioner, supervisor and learner.
However, clinical teaching is a form of interpersonal communication between two people that is
teacher and learner. The main purpose of this study is to understand and recognise several
opportunities of learning and teaching in the clinical setting. This report will outline various
strategies which can help in overcoming problems that arise during training and clinical teaching
Main Body
Identify a difficult clinical teaching situation and experience
A clinical teaching is a procedure of human interaction which involves educators, learners
and learning groups. It usually involves patients, clinical procedure, necessitates sensitivity,
confidentiality and discretion. (Aal, 2015). It is a process of interpersonal communication among
learner and teacher through which learner is able to gain knowledge and idea about clinical
practices.
In clinical teaching, it is very important for supervisor to conduct training session for
students by which they can learn the criteria of delivering high quality treatment and care related
services to patient within the hospital. In the present situation, as a supervisor in the clinical
setting, I have various kind of roles and responsibilities related to the training of clinical students
for improving the quality of care services. I am responsible to teach and guide medical students
in such a way that can in turn assist them to learn the criteria of effective working in clinical
setting to deliver high quality services of care to the patients.
Recently I am working in the famous health care home where large numbers of medical
students are engaged with me in training program. The training program is going to organise fort
teach medical students about hostile patient. Main objective of training is to teach students about

how to deal with four kind of hostile patients such as violent patient, patient who are a little too
friendly, tempered patients, non compliant patient, somatizing patient and frequent fliers. Hostile
person is that patient who has the characteristics of an enemy and they are having or showing an
ill will with an unfriendly and antagonistic attitude. With help of clinical teaching, student can
learn the way to deliver high quality of treatment and care services to hostile patient. In order to
meet objective, my responsibility is to plan and set strategies to promote student engagement in
clinical teaching. For this context I will focus on several clinical strategies such as case
presentation, collaborative learning, sink or swim approach, manipulated structure approach,
case presentation etc. These all clinical techniques are very important for teach clinical teaching.
For example Case presentation is the most frequently used teaching strategy in case of clinical
learning. It is also a mean by which, the competency level of clinical students is being evaluated
to assess their medical knowledge as well as reasoning skills. Using this approach to guide
students is necessary to maximise the desired interpersonal learning outcomes. On the other
hand, another method I collaborative learning under supervisor teach students in collaborative
manner. It is essential for clinical students to practice critical thinking so that they can develop
crucial skills. Co-operative learning approach is an interactive teaching method that allow
clinical students to think critically,
At the time of providing treatment to patient in the healthcare organisation, there are
numerous issues as well as opportunities of learning. It was quite difficult to deal with hostile
patient but with help of effective arrangements, support, learning attitude, polite behaviour, set
boundaries and by avoid arguing supervisor can easily deal with vulnerable patients. At the time
of dealing with such aggressive patients, the practitioner should keep calm. Mr X is a patient and
is suffering from such similar kind of health issue. He has lost his mental well-being and he was
acting as an enemy in the warfare. The practitioner need to focus on the mental health issues and
emotional stability of patients (Atkinson, 2018). Being a senior supervisor within clinical setting,
I was assigned a team of 10 nursing students for clinical teaching. My team was dealing with
hostile patient, Mr X, who was suffering from various health issues such as obsessive anger,
hyper aggressiveness, narcissistic rage, brain trauma and substance abuse (Wu and et.al., 2015).
The students were new to clinical environment and therefore, the learners were unaware of the
clinical situation which arisen while treating hostile individual. The fresher medical students
have no idea and knowledge of handling aggressive patient’s.

Identification of the reasons behind the difficult situations
Following are several difficulties that I have faced at the time of clinical teaching and
supervising students at the time of treating the hostile patient Mr X - Unaware about symptoms of Hostile patient- As a health care practitioner in the
hospital, I have to teach and train medical students. I have identified that the fresher
students of nursing had no idea deal and treat hostile patient. They have not knowledge
about symptoms and characteristics of hospital patient and its types. Due to lack of
practical experience in nursing, the students are not experts to diagnose the kind of
hostile patient (Carlson, 2015). Mr X was tempered patient so that during treating Mr X, I
have found that students are not experienced in dealing with different type of hostile
patient. Medical students have no idea about treatment that is required for Hostile patient.
Furthermore, I noticed that Mr X was aggressive towards students at the time of care
service and instead of understanding his situation the learners also started arguing with
him, due to which, Mr X became more aggressive and violent. Lack of knowledge regarding treatment of hostile patient- I have also analysed that
medical students have little knowledge about care services and treatment required for
hostile patient. I was handling fresher medical students in hospital who are just pass out
from medical college so it is quite difficult for me to teach them for handle hostile
patient. Inconsistency between theoretical and practical training- As medical students have not
knowledge to implement their theoretical knowledge into practical work. The students are
qualified in theoretical practices of nursing with no experience of practically treating the
patient’s and delivering care services to them (Farrell and et.al., 2017). I have analysed
that learner have theoretical knowledge to handle difficult patients such as non complaint,
tempered, violent etc but they have not experienced to deal with them. Conflict between educational and training objective- Sometime students do not
understand the actual objective of training and learning at hospital (Clinical Teaching
Phases, 2018). They come into the hospital for getting training and development. I have
analysed that many of the students in my team were focused on attaining their
educational objective rather than delivering proper care related services and treatments to
the patients (Huth and et.al., 2016).

 Student's responsibilities in the hospital is not clear- This is another difficulty which I
have faced during clinical teaching of medical students within hospital. Management
authority do not allot proper responsibility and role to handle and treat hostile patient
within hospital.
Clinical teaching strategies and techniques to overcome this difficulties
As per the above discussion, it has been analysed that there are numerous difficulties that
arises during clinical teaching and supervising. Medical students do not have proper idea
regarding treating the patients. (Huth and et.al., 2016). In order to deliver effective training and
teaching to the medical students, supervisor can thereby use various clinical teaching techniques
and strategies that are as discussed below- Case presentation: - Case presentation is the most frequently used teaching strategy in
case of clinical learning. While preparing it, presenter has to organise all the information
gathered from patients. The facilitator must know how to improve it to diagnose the
presenter. This learning of case presentation helps students to test battery, generate
assumptions about an issue and create a plan of action. It allows the students to learn
effective practices, criteria and methods to handle hostile patient.(Van Der Leeuw and
et.al., 2016). It is also a means by which clinical students are evaluated for their
competence in medical knowledge & reasoning skills for treat hostile patient. Case
presentation is the key form in clinical communication among medical professionals. The
expectations of the presenter of presentation increases at the students gains more & more
knowledge and vice versa. Using this approach to guide students is necessary to
maximise the desired interpersonal learning outcomes regarding deliver care services to
hostile patient. With help of case presentation, I can effectively provide idea, knowledge
and experience to deal with Mr X who is hostile patient. Collaborative learning: - It is essential for clinical students to practice critical thinking
so that they can develop crucial skills and knowledge to deliver care services and support
to Mr X who is hostile patient. Co-operative learning approach is an interactive teaching
method that allow clinical students to think critically, interact effectively with other
students and accept their responsibilities (Huth and et.al., 2016).By this approach, learner
can collectively learn criteria and practices dealing with hostile patients and deliver them
high quality of care services. Here the presenter develops a case and medical students

work upon it with the help of him and evaluate strategies, possible diagnoses and
recommendations. Collaborative learning fosters the development of thinking effective
resolution of problems, and it also prepares students for patient care.
 Sink or Swim approach: - This is another one of significant approach of clinical teaching
that can support supervisor to teach students for handle hostile patient. In this strategy
presenter is entirely responsible for the actions performed by students and he is always
available to them to solve their problems. This method is used to teach medical
interviewing students skills (Farrell and et.al., 2017). It is determined that this approach is
not much effective in starting but works well with transformational students who requires
some pushing to improve their skills. Clinical students who are involved in this strategy,
often does not appreciate this sink and swim approach because it forces them to depend
on their own knowledge.
As per the discussion, it has been analysed that there are various kinds of clinical teaching
strategies to overcome difficulties that faced by supervisor at the time of training and teaching
clinical students. In the above case scenario, Mr X is 50-year-old men who was hostile patient
and he needed effective treatment and care services so as he can improve their health issues. In
order to handling team of clinical students. In order to provide high quality of care services to Mr
X, I have to teach and supervise clinical students so as they can deliver impressive treatment to
hostile patient and understand their health issue. In order to implement these clinical teaching
strategies, management should also focus on various criteria of working within hospital. With
help of these criteria, clinical teaching can more improve- Establish a comfortable environment for learning- In order to improve clinical teaching
for handling Mx X, I can consider working on building an effective learning
environment, where medical students can easily understand the objective, procedure,
policies and working criteria (Farrell and et.al., 2017). With help of comfortable working
environment, students can be motivated and encouraged for effective learning and can
deliver effective care related services to the hostile patient. Provide effective feedback- In order to decrease the difficulties in clinical teaching,
supervisor should take feedback from students related to their work within the hospital.
With the help of feedback method, supervisor will be able to understand the actual area of
improvement and could identify their issues related to clinical learning. Supervisor can

also diagnose student’s capacity of learning and their needs with assistance of effective
feedback method (Van Der Leeuw and et.al., 2016).By these criteria, students can
improve their performance and learn criteria to deal with hostile patient.
 Assuring an appropriate supervision of students- Supervisor should regularly check and
monitor activities of clinical students (Pai, 2015). They should monitor the performance and
working criteria of learners. With the help of regular monitoring procedures, the supervisor can
improve clinical learning of medical students. In the above case, I should effectively supervise
and guide the medical learners with a special consideration of directing them to learn the criteria
of dealing a hostile patient.
Document a plan and framework that could be used in similar circumstances
In order to provide high quality of care services and treatment, I have planned to use
innovative and evidence based teaching and training strategies. With the help of this learning
techniques, below are some steps defining a systematic plan and framework to effectively teach
and train the clinical students-

Illustration 1: Plan for clinical teaching
(Source: Effective Clinical Teaching Methods, 2018)
 Formulation of objective- This is one of the most important stage in the clinical teaching
under which superior aim at identifying the necessity and importance of this process.
(Schmidt and Mamede, 2015). In this phase, supervisor will focus on the requirement for
improving clinical teaching process and will focus on engaging students in order to make
them to understand a method in better manner. The main aim of this study is to link pupil
with this procedure to improve their knowledge of understanding hostile patient and to
also enhance their quality of service. Determining knowledge- After defining the objectives, the main aim of the study will be
to determine knowledge. It can be defined by preparing questionnaires and making them
filled by students in order to test their learning. On the basis of these forms teaching will
be provided to students regarding handle hostile patient.

 Planning content- In this stage, superior should lay emphasis on planning aspects. They
should try to engage more students in clinical learning and teaching. In this step
supervisor must be involved in planning strategies and ways by which he can provide
teaching to students. Use of advanced technology should be done by him in order to
enhance the understanding of pupils. In this phase, supervisor can create plan to teach the
student regarding treating hostile patient an deliver them high quality of care services. Organising- In this stage, superior will organise the strategies which are required to
improve the learning of students. Effective organisation of practices can help in
enhancing the productivity and efficiency of pupils (Van Der Leeuw and et.al., 2016). Implementing- Once the program for clinical teaching regarding treatment of hostile
patient is been organised then in the next stage supervisor will evaluate and monitor the
program effectiveness (Wu and et.al., 2015). In this phase, they are responsible to
determine the efficiency and productivity of students. Supervisor implements clinical
teaching strategies to teach students regarding handle and treat hostile patient.
 Evaluation-In this stage, supervisor will evaluate the performance of clinical students
and analyse their ability regarding clinical treatment and operation (Zeng and et.al.,
2016).In this phase practitioner analyse that whether students are learning practices and
criteria to deal with Mr X or not.
Following is systematic document plan and framework that could be used by supervisor for
teaching medical students regarding effective treatment and care of hostile patient-
Teaching
Objective
Types of
learner
Clinical teaching
strategies
Outcomes Time frame
Overcome
Inconsistency
between
theoretical
and practical
training
Beginners and
Transitional
learner
Supervisor will use
case presentation
approach for teach and
train students. It is the
most frequently used
teaching strategy in
case of clinical
learning.
With help of this
strategy, students can
easily understand the
way to deal with
hostile patient and
deliver them high
quality of care services
and treatment.
3 Month

Improve
understanding
regarding
nursing
profession
Beginners and
Transitional
learner
Collaborative
teaching is another
clinical strategy that
will use by supervisor
It gives a vivid picture
of the related nursing
care that associated
with patient. It
portrays the nursing
issues associated with
a particular disease or
disorder
6 Month
Overcome the
Mistakes in
determining
the types of
patients
Beginners and
Transitional
learner
Sink or Swim
approach will use by
teacher for clinical
teaching
With help of this
technique, supervisor
can focus on the
nursing problem and
help staff to examine a
patient problem
6 Month
CONCLUSION
From this entire report it has been concluded that in the clinical teaching and learning
program effective participation of supervisor and learner is very important. Management should
create learning environment for provide effective learning opportunities to students. By use of
various clinical teaching strategies such as reflection, manipulated structure approach, sink and
swin approach, collaborative learning, practitioner can effectively provide training to clinical
students.

REFERENCES
Books and Journals
AAl, M., 2015. Clinical Nursing Teaching in Saudi Arabia Challenges and Suggested Solutions.
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Atkinson, P., 2018. The reproduction of medical knowledge. In Health care and health
knowledge. Routledge.
Carlson, J. S., 2015. Factors influencing retention among part-time clinical nursing faculty.
Nursing Education Perspectives. 36(1). pp.42-45.
Farrell, L. and et.al., 2017. An autoethnographic exploration of the use of goal oriented feedback
to enhance brief clinical teaching encounters. Advances in health sciences education.
22(1). pp.91-104.
Huth, K. and et.al., 2016. Real-world implementation of a standardized handover program (I-
PASS) on a pediatric clinical teaching unit. Academic paediatrics. 16(6). pp.532-539.
Pai, H. C., 2015. The effect of a self-reflection and insight program on the nursing competence
of nursing students: a longitudinal study. Journal of Professional Nursing. 31(5). pp.424-
431.
Rudall, N., Kalemeera, F. and Rennie, T., 2015. Implementing clinical pharmacy within
undergraduate teaching in Namibia. International journal of clinical pharmacy. 37(3).
pp.427-429.
Savery, J. R., 2015. Overview of problem-based learning: Definitions and distinctions. Essential
readings in problem-based learning: Exploring and extending the legacy of Howard S.
Barrows. 9.pp.5-15.
Schmidt, H. G. and Mamede, S., 2015. How to improve the teaching of clinical reasoning: a
narrative review and a proposal? Medical education. 49(10). pp.961-973.
Silverman, J., Kurtz, S. and Draper, J., 2016. Teaching and learning communication skills in
medicine. CRC press.
Van Der Leeuw, R. M. and et. al., 2016. Clinical teaching performance improvement of faculty
in residency training: A prospective cohort study. Medical teacher. 38(5). pp.464-470.
Wu, X. V. and et.al., 2015. A systematic review of clinical assessment for undergraduate nursing
students. Nurse Education Today. 35(2). pp.347-359.

Zeng, F. and et.al., 2016. WeChat: a new clinical teaching tool for problem-based learning.
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Online
Clinical Teaching Phases. 2018. [Online]. Available Through: <http://www.online-distance-
learning-education.com/field-experience/clinical-teaching/clinical-teaching-phases.html>