Appendices
4 Appendix C: In-Situ Remedial Activities
Maggie Convey
Early identification of concerns is of paramount importance. Consider using the early interventions in the first days of the clinical course, and in instances of performance concerns.
| Early | |
| Case Studies |
These activities can be used prior to the first clinical shift (ie. orientation) or in the first days of the clinical term. These activities help to draw out student’s competence in the clinical setting, while anchoring their previous knowledge, skills, and experience. As well, such activities help identify decision-making skills, critical thinking, clinical judgement, and professionalism. |
| Group or Individual Concept Mapping | |
| Group Discussions | |
| Once Performance Concerns are Noticed | |
| Case studies | Case studies with meaningful debriefing help correct student thinking, planning, prioritizing and allows instructors to better identify where thinking may be askew. |
| Individual concept mapping | Concept mapping is an evidence-based activity to support students’ clinical judgement skills, as well as helping students make connections in prior learning. |
| Taking extra time to review pre-clinical preparation, additional debriefing and connecting learning at the end of the day (consider DML framework) | Allows the instructor to offer feedback on preparatory activities and evaluate resources the student may be using to prepare. Supports self-awareness, especially for debriefing. |
| Working alongside students, joining them for clinical care, increasing observation and meeting the student “where they are at” | Builds and fosters a positive, trusting relationship. Allows for role-modeling of desired behaviors. Students may hide their clinical struggles if they perceive the student/instructor relationship to be safe. Allows the instructor to know the student as a person, and identify/understand the etiology of clinical struggle. |
| Bringing in new people (faculty, peers) |
Consult team members (without breaching student confidentiality) for other teaching tips. Consider liaising with the FN for suggestions, and resources. When unsure about what you are seeing/hearing/sensing, contact the BScN Student Chair. Allow the student to work in peer dyads for role-modeling, and self-awareness. Allows peer-peer feedback, which may elicit change. |
| Referral to counseling | For those students with anxiety, mental health concerns, counselors are the preferred professionals to optimize student success. |
| Referral to nursing lab staff | Drop-in lab time may address students’ deficiencies in psychomotor skills, priority setting, and clinical judgment in a safe setting. This will require direction-setting from the clinical instructor and may require that the instructor prepare activities that allow work on deficits. |
| Use of simulation | High-fidelity and low fidelity simulation provides safe experiences for student learning. Additionally, virtual simulation activities are available for supplemental learning. |
| Socratic questioning | Asking students “why” improves critical thinking skills, moves students from rote mimicry to thinking through why they are doing what they are doing. |
| Provide multiple opportunities for mastery | For students who are struggling with a task (ie. medication administration), assigning them to perform only particular tasks/skills enhances their mastery and confidence in the clinical setting. Similarly, giving students a similar patient profile over the course of 2-3 clinical days will solidify their knowledge, facilitate confidence, and allow more accurate identification of etiology of concerns. Supports application over multiple days. |