The Art & Science of Bedside Teaching

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WELCOME Optimizing Teaching Learning in Nursing: A Focus on Bedside Teaching :

WELCOME Optimizing Teaching Learning in Nursing: A Focus on Bedside Teaching

The Art and Science of Bedside Teaching-A Reorientation :

The Art and Science of Bedside Teaching-A Reorientation Dr.(Mrs.)Mary Mathews N. Principal MGM College of Nursing Kamothe

Definition of Nursing(ICN) :

Definition of Nursing(ICN) Nursing encompasses autonomous and collaborative care of individuals of all ages, families, groups and communities, sick or well and in all settings. Nursing includes the promotion of health, prevention of illness, and the care of ill, disabled and dying people. Advocacy, promotion of a safe environment, research, participation in shaping health policy and in patient and health systems management, and education are also key nursing roles. Updated 12 April 2010

Florence Nightingale 1820-1913:

Florence Nightingale 1820-1913

Florence Nightingale:

Florence Nightingale “Nursing is an art; and if it is to be made an art, it requires as exclusive a devotion, as hard a preparation, as any painter's or sculptor's work; for what is the having to do with dead canvas or cold marble, compared with having to do with the living body - the temple of God's spirit? It is one of the Fine Arts; I had almost said the finest of the Fine Arts” Florence Nightingale

Patient Centered Learning:

Patient Centered Learning

Patient Centered Learning:

Patient Centered Learning “To study the phenomena of disease without books is to sail an uncharted sea. Whilst to study books without patients is not to go to sea at all.” Sir William Osler (1849-1919) Founder of modern clinical medical education system,

Patient Centered Learning:

Patient Centered Learning "The student begins with the patient, continues with the patient and ends his studies with the patient, using books and lectures as tools as means to an end” There should be “no teaching without a patient for a text, and the best teaching is that taught by the patient himself.” Sir Osler 1905

Objectives Of This Session :

Objectives Of This Session Discuss the meaning of bedside teaching Outline the goals of bedside teaching Discuss the diverse contexts of bedside teaching Review the history and present status of nursing education Recognize the importance of bedside teaching

What is bedside?:

What is bedside? Any where there is a patient Out Patient Operating theatre Home Wards

What is bedside teaching? :

What is bedside teaching? Teaching / active learning with the patient present Bringing together the “learning triad” of patient, learner, and clinical teacher “A rich visual, auditory, tactile & olfactory experience”

Objectives of Bedside Teaching :

Objectives of Bedside Teaching Teaching on data generated by or about the patient Learn to respect for the patient's comfort and dignity Learning of psychomotor skills Provision of feedback to learners Transmit values of the profession and the teacher’s enthusiasm for patient care

What can be learned at the bedside?:

What can be learned at the bedside?

What can be learned at the bedside?:

What can be learned at the bedside? Communication Skills Obtaining Histories Conducting Physical Examinations

What can be learned at the bedside?:

What can be learned at the bedside? Applying Basic Science Knowledge Evidence-based Nursing Self-Directed Learning

What can be learned at the bedside?:

What can be learned at the bedside? Professionalism & ethics Humanism –caring attitude, Humility,

What can be learned at the bedside?:

What can be learned at the bedside? Time management Documentation

What can be learned at the bedside?:

What can be learned at the bedside? Bedside manners The patient as An individual

What can be learned at the bedside?:

What can be learned at the bedside? Cognitive Domain

What can be learned at the bedside?:

What can be learned at the bedside? Psychomotor Domain Affective Domain Hidden Curriculum

Importance of Bedside Teaching :

Importance of Bedside Teaching “Learn to see, learn to hear, learn to feel, learn to smell, and know by practice alone that you can become an expert.” Osler

The Art and Science of Bedside Teaching:

The Art and Science of Bedside Teaching The Art of Bedside teaching is intuitively obvious (automatically known) The Skill of Bedside teaching is deceptively difficult A Learner go through 4 phases Unconsciously Incompetent Consciously Incompetent Consciously Competent Unconsciously Competent

History of Nursing Education:

History of Nursing Education

History of Nursing Education :

History of Nursing Education Nursing schools under control of hospitals Students largely staffed the wards and learned the art Apprentice type of training Service needs precede student’s learning

Present Scenario:

Present Scenario Decreased teaching at the bedside 1930s - 75% 1964 - 20% 1978- 16% . Present-?

Present Scenario:

Present Scenario Separate institutions for nursing education

Present Scenario:

Present Scenario Effective educational environment

Present Scenario:

Present Scenario Nurse educators: No longer the practicing nurses Appear with students for a teaching encounter

Present Scenario:

Present Scenario Students-Competing demands of classroom and clinical

Present Scenario:

Present Scenario Frustration of nursing student to be both technically and academically expert.

Present Scenario:

Present Scenario Nurse educators: No longer directly involved in the delivery of nursing services Not responsible for quality of care patients assigned

Present Scenario:

Present Scenario Wide gap between education and practice, preparing students to function in ideal environments

Present Scenario -Can "theorize but not catheterize”:

Present Scenario -Can "theorize but not catheterize” Significant knowledge of nursing process and theory Graduate nurses lack practical skills

Present Scenario-Bridging the Gap:

Present Scenario-Bridging the Gap State-of-the-art simulation laboratories Supervised experiences in the hospital, Internships .

Research-Theory Practice Gap:

Research-Theory Practice Gap A study of to increase understanding about how student nurses’ experiences contribute to the theory-practice gap in nursing (n= 205 ) (Koh 2002). Teaching of theory, 40% thought equipped them for practice 39% thought insufficient to inform nursing care 29% of unsure

Research-Theory Practice Gap:

Research-Theory Practice Gap Course content and curriculum 39% of students felt course did not equip them for clinical practice. Clinical practice 64% agreed that the repetition of practice increases the process of learning 55% of the students indicated that their instructors did not take part in practice actively 50% indicated that instructors did not contribute to any improvement in their clinical ability.

Research-Theory Practice Gap:

Research-Theory Practice Gap Conclusion Clinical role modeling is important to validate students’ experiences in practice. Lecturer’s educational expertise-Micro Skills- should be brought to the “Bed side” to create a good learning environment, thus bridging the theory-practice gap.

Take Home Message:

Take Home Message Bedside teaching : One of the most enriching, intimate teaching that a teacher can do Opportunity for directly demonstrating procedures Direct observation of learner skills Immediate feedback to learners

Greatest Lesson Learned...:

Greatest Lesson Learned... “The greatest lesson I learned during my time spent in the--- Practical Nursing program was learning to trust myself.  I have always been the quiet, shy, and insecure type.  I never wanted to speak up because I was afraid of what people would think of me, so when I was put into a hospital setting and patients' lives were in my hands I had no choice but to step out of my comfort zone and rely on myself, and myself only.  Through the semesters, I've grown to believe in myself and to be proud of what I know and can do. Without this program I know I would still be that shy, quiet, timid girl I use to be.  Now, I've grown into an outgoing, secure, mature young adult ready to take on whatever God places in front of me.”

Some Fun….:

Some Fun….

Thank you:

Thank you