Facilitation And Education Skills For Clinical Teaching

Discuss about the Facilitation and Education Skills for Clinical Teaching.

Clinical teaching is basically teaching and learning focused on the involvement of the patients and their problems directly. Clinical teaching is the heart of medical education. In current time, medical schools are trying to give as much clinical exposure as possible to the students. In the course, medical schools are focused on providing effective nursing and clinical experience to the students. Learning in the clinical environment has various strengths. It is basically focused on the accurate problems in the context of professional practices. Learners in this environment are motivated by its significance and by active participation (Polit and Beck, 2013). In the clinical learning, professional behavior, thinking, and attitude are developed by the teachers. Learning in the clinical environment is the setting in which the skills of physical examination, decision making, empathy, clinical reasoning and professionalism are developed in the students. Despite of strengths, there are some challenges with the clinical teaching i.e. lack of clear objectives  and expectations, time pressure, competing demands, increased number of students, often under-resourced and fewer patients. This report focuses on the learning theory of the clinical environment and role of that theory in the clinical learning practices. Further, report focuses on facilitating the learning of nurses within the clinical environment that will assist in the development of culture of learning (Yazdannik, Yekta, and Soltani, 2012).

The educational psychology researchers have done research on learning from different viewpoints and explained the learning process based on various theories.  There are different theories which can be used as the guide of teaching-learning process learning theories basically have great use in  not only education but also psychology counseling. The learning theories can be used single or separated or in combination in the clinical education including nursing.

There is the need of learning theory in the clinical environment for the clear understanding of educational activities, management, interaction with the clients and patients, health promotion programs and continuous education in the current healthcare structure. in many institutes, nurses are responsible for the implementation, design and procedures to promote health training. Learning theories can be used separately, group-wise or at the community level. It can be used not only for understanding and learning new things but also for changing health habits, problem solving control emotions, affecting behavior development and constructive communication. For the discussion, report focuses on the behavioral learning theory in the clinical environment. This learning theory is the most beneficial when the change is the desired outcome of an educational involvement (Haghani & Masoomi 2010).

Behavioral Learning Theory

Behaviorism is the most dominant approach for the psychology researchers. Traditional behaviorists perceived that continuous learning depends upon the observable behavior and it is possible with the communication between two events i.e. a stimulus and a response. In the simple words, researchers believe that behaviorist learning theory has made its unique way in the medical education. According to the Bastable (2008), while dealing with people, behavioral learning theory views the learning process as the simple cycle or chain.  Behavioral learning theory basically focuses on the observable stimulus conditions and the learning process associated with this. For improve the learning process and getting desired results, learners can deeply observe and control the environment by using operant condition techniques in the positive or negative manner. 

Currently, in the clinical education, behavioral learning theory is mostly used in the combination with other learning theories i.e. cognitive theory. In the behavioral learning theory, teachers continue to be considered important in the nursing practices to achieve high level of delivery of health care services. For encouraging and motivating people to learn new information or to change the behavior, responses and attitude, behaviorists recommend to change the conditions in the environment and focus on the positive behavior. Motivation can be described as the desire to achieve something or reduce some drives i.e. desire for food, recognition, safety or money. That is the reason the person who is satisfied or has what he wants, need little motivation to learn new information, behavior or change old behavior (Guey, Cheng, Shibata, 2010).

Behavioral learning assumes that the learning can take place when the changes in the behavior can be seen. The behavioral learning model is the effect of conditioning. Along with this, reinforcement is the key concept of the behavioral learning theory. Continuous reinforcement is crucial in each case of desirable behavior when the behavior is introduced. In this theory, it is stated that desired behavior should be rewarded immediately and undesired behavior should not be rewarded. This is the crucial term for getting success in the learning process. Nursing is focused on providing support in each step of the learning process. For instance, while a patient is learning about injecting the process of insulin, nurse shoes positive behavior and gives immediate support to the patient by his or her words (Daley & Torre, 2010).

Behavioral learning theory is applied in the clinical education or nursing. This theory has important role in the clinical learning process for the students. Students in the clinical learning has to deal with number of different points which need various combined forces. So, behavioral learning theory is more than to be scientific theory of learning including the set of techniques and principles which can be used in various fields for managing humans. By supporting the desired behavior, it is possible for the teachers in the clinical learning to achieve the learning goals. The conditioning theory in the behavioral approach can be used for the behavior therapy of the students and nurses in the educational environment of clinic. The behavioral therapy in the clinical learning process can be used to deal with the psychological problems, behavioral modification conflicts, methods for improvements, and disorder and criminal behavior. Along with this, change and modification methods in the behavior techniques are also used to train the students and implement the change in their social and academic behavior in the educational environment (Khadjooi & Rostami, 2010).

Use of Behavioral Theory in Nursing

The behavioral learning theory can be used especially in the teaching clinical skills. In starting, the initial behaviors of every process are motivated for implementing the process completely. After that, students are encouraged to analyze, understand and implement the right process of learning. Motivation and encouragement is crucial and desirable to maintain the behavioral manners. Along with this, teachers in the clinical learning can teach every process by providing information to the students before starting the learning procedures. For instance, teachers can remind them to have expected and appropriate behaviors for achieving desired results in the learning process. Further, computer programs can also be designed for learning appropriate methods of patient care along with other methods.

Although this process is quite time consuming but it is stated that favorable results of students’ behavior can be achieved easily. In the clinical learning process, the results may be desirable by the use of behavioral learning theory as it is helpful in achieving pleasing results such as admiration of classmates and client and satisfaction. In this method or theory, every good or bad behavior depends upon the understanding of student from favorable or unfavorable outcomes of behavior. The application of behavioral learning theory in clinical learning is most crucial part of nursing. In this theory, core principles of the education includes the aim of the education, combination of contents from simple to complex, providing right answers to the questions, preparing the students to learn in the positive environment, developing a disciplined environment for learning and training session, and giving reward to the learners after their success (Webb, Sniehotta & Michie, 2010). This theory is based on Thorndike law and according to this law; there will be a strong relationship between the response and stimulus for desired behavior. Thorndike law is commonly used in the nursing education. In the hospitals, nursing staff are involved in many cases of nursing students. In this theory, the role of manager or teacher is manipulating the learning environment, providing support and giving information to the students. In this theory, the learning environment is improving and stimulating. Role of behavioral learning theory is most important in clinical learning. The behavioral objectives are very crucial in the clinical training in nursing as it can be used as the guide for evaluating and teaching the clinical performance of the students in the learning process (Upham et al, 2009).

Based on above discussion, it is observed that behavioral learning theory is crucial for the clinical learning process. By using various conditions of the theory, learning of the nurses can be facilitated within the clinical environment that will assist in the development of a culture of learning. Behavioral theory focuses on the directly observed and measured behavior of individual. For the behaviorists, learning is the product having stimulus conditions and response. For this theory, learning is acquirement of new behavior by conditioning. By focusing on the conditionings, teachers will be able to improve learning process. There are two types of conditioning i.e. respondent conditioning and operant conditioning (Wood, Hutchinson & Cantillon, 2003).

In this theory, a natural incentive is combined with the unlearned stimulus along with the unconditional response. After such pairings, natural stimulus extracts with the same response. For instance, a person without any kind of experience of hospitals visiting to a sick friend may feel uneasy and disgusted and in future visit, he may feel anxiety. Sometimes, without thinking visitors and patients establish connection with their behavior as the result of hospital experience.

This condition basically focuses on the particular behavior of the person and the support occurs after the response. A support is applied after the response that improves and strengthens the possibility that the positive response will be performed again. By focusing on some factors i.e. hugs, praise, prizes and money as the positive reinforcement, the learning process in the clinical environment can be improved. When the specific responses are supported within proper schedule, positive behavior can be improved. To improve the possibility of positive, it is important to apply positive rewards and supports after the behavior occurs. For instance, if a patient is trying to get up and walk for the first time after an operation, encouragement and praise for that patient’s efforts will improve his or her continuous struggle towards independence (Quinn, 2007).

In the behavioral theory, decreasing a negative response or behavior it is important to use punishment or non-reinforcement in the learning process. To get rid of a negative behavior, then best way is not to provide any kind of support for some unwanted actions. The behaviorist theory is easy and simple to use. There should be the requirement of careful analysis of the actions in the clinical environment that impact the behavior of people during the learning process. Theory focuses on the reward and support and promotes the value of each person. By applying basic principles of the behaviorist theory, the learning process in the clinical environment can be improved:

• Teachers should focus on the drives of the learners along with the external factors in the environment that impact learning capacity of the learners. Teachers should also focus on the reinforcements to improve the positive responses.
• The objective of the teacher should be to analyze the conditions of the environment that lead to specific behaviors. He must analyze the past history and habits of the learners. After that teacher must manipulate the conditions effectively to provide right support, to build new connections and to improve positive behavior or response of the person (Rahmani, et al, 2009).

Conclusion

From the above discussion, it is observed that various learning theories have important role in the learning process of clinical environment. Effective learning is the result of good teaching. It can be improved by the learning environment including active communication and interaction among the students, faculty and student peers. Effective learning in the clinical environment can be achieved by the use creative strategies and learning theories to inform and stimulate to the students. For the effective learning process, faculty and teachers should identify the students as individuals by the personal ways of learning and knowing them. Along with this, by developing learning situations for the students, faculty will be able to recognize diversity and improve their capabilities to think in the new way. 

References

Daley, B. J., & Torre, D. M., (2010), Concept maps in medical education: An analytical literature review, Med Educ., 44, 440–8

Guey C. C., Cheng Y.Y., Shibata S., (2010), A triarchal instruction model: Integration of principles from Behaviorism, Cognitivism, and Humanism. Procedia Soc Behav Sci., 9, 105–18

Haghani F., & Masoomi R., (2010), Overview of learning theories and its applications in medical education, Iran J Med Education, 10, 1188–97

Khadjooi, K., & Rostami, K., (2010), The implications of Behaviorism and Humanism theories in medical education: Research Institute for Gastroenterology and Liver Diseases, 3(2), 65-70

Polit, D. F., and Beck, C. T, (2013), Essentials of Nursing Research: Appraising Evidence for Nursing Practice, USA: Lippincott Williams & Wilkins, Philadelphia, Pa,

Quinn, F. M., (2007), Principles and practice of nurse education, (5^th), London: Nelson Thornes, pp. 15–21

Rahmani A, Mohajjelaghdam A, Fathiazar E, & Roshangar F., (2009), The effect of adapted model of mastery learning on cognitive and practical learning of nursing students, Iran J Med Educ. 7:27–9 

to inform interventions for addictive behaviors: Addiction, 105, 1879-1892

UPHAM, P., WHITMARSH, L., POORTINGA, W., PURDAM, K., DARNTON, A., MCLACHLAN,

Upham, P., Whitmarsh, L., Poortinga, W., Purdam, K., Darnton, A., Mclachlan, C. & Devine-Wright, P. (2009). Public Attitudes to Environmental Change: A selective review of theory and practice: Living With Environmental Change Program

Webb, T.L., Sniehotta, F.F., & Michie, S., (2010), Using theories of behavior change

Wood, D., Hutchinson, L., & Cantillon, P., (2003), ABC OF LEARNING AND TEACHING IN MEDICINE, accessed on 31^st August 2017 from https://edc.tbzmed.ac.ir/uploads/39/CMS/user/file/56/scholarship/ABC-LTM.pdf

Yazdannik, A., Yekta, Z. P., and Soltani, A., (2012), Nursing professional identity: an infant or one with Alzheimer: Iranian Journal of Nursing and Midwifery Research, 17(2), article S178