Faculty Learning Module 16

Preparing Students to Think Through the Complexities of Practice in Post-clinical Conferences

Introduction

Nursing faculty are challenged to prepare students to practice in complex and rapidly changing clinical environments. When teaching groups of students in clinical settings, however, helping students think through the care they’ve provided and how it can be improved is difficult. This module provides an overview of Cognitive Task Analysis and how this approach can be used as a strategy to help students think through the complexities of practice in post-clinical conferences.

Objectives

Upon completion of this section, you will be able to:

• Explore learning opportunities in post clinical conferences

• Examine a teaching strategy that helps students make sense of their clinical experience and the impact that they can have on quality and safe patient care

• Describe techniques that enable students to reflect on and examine their own clinical learning

Contributors

• Tracey L. Fonacier, MSN, RN

• Angela M. McNelis, PhD, RN, ANEF

• Patricia Ebright, PhD, RN, FAAN

Content

Nursing faculty are challenged to prepare students to practice in complex and rapidly changing clinical environments. When teaching groups of students in clinical settings, however, helping students think through the care they’ve provided and how it can be improved is difficult. A Post-clinical conference is an opportunity for clinical faculty to help students make sense of their experiences and explore quality and safety in the context of care. This module describes the use of Cognitive Task Analysis as a strategy to foster students’ thinking and facilitate student learning through the use of probing questions, active listening, and directed reflection.

Preparing Students to Think Through the Complexities of Practice in Post-clinical Conferences

Resources

Bibliography

Crandall, B., Klein, G., & Hoffman, R.R.. (2006). Working minds: A practitioner’s guide to cognitive task analysis. Cambridge, MA: MIT Press.

Cronenwett, L, Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., Sullivan, D.T., & Warren, J. (2007). Quality and safety education for nurses. Nursing Outlook, 55, 122-131.

Ebright, P.R., Urden, L., Patterson, E., & Chalko, B. (2004). Themes surrounding novice nurse near-miss and adverse-event situations. JONA, 34, 531-538.

Gillespie, M., & Peterson, B. L. (2009). Helping novice nurses make effective clinical decisions: The situated clinical decision-making framework. Nursing Education Perspectives; 30(3),164-170.

Ironside, P.M., & McNelis, A.M. (2010). Clinical Education in Prelicensure Nursing Programs: Results from a National Survey. New York: National League for Nursing.

Lindberg, C., Nash, S., & Lindberg, C. (2008). On the edge: Nursing in the age of complexity. Bordentown, NJ: PlexusPress.

Militello, L.G., & Hutton, R.J.B. (1998). Applied cognitive task analysis (ACTA): A practitioner’s toolkit for understanding cognitive task demands. Ergonomics, 41(11), 1618-1641.

Tanner, C. A. (2006). Thinking like a nurse: A research-based model of clinical judgment in nursing. Journal of Nursing Education, 45(6), 204-211.

Schraagen, J.M., Chipman, S.F., & Shalin, V.L. (2000). Cognitive task analysis. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.

Shachak, A., Hadas-Dayagi, M., Ziv, A., & Reis, S. (2009). Primary care physicians’ use of an electronic medical record system: A cognitive task analysis. Journal of General Internal Medicine, 24(3), 341-348.

Weir, C.R., Nebeker, J.J.R., Hicken, B.L., Campo, R., Drews, F., & LeBar, B. (2007). A cognitive task analysis of information management strategies in a computerized provider order entry environment. Journal of the American Medical Informatics Association, 14(10, 65-75.

Discussion

After you have reviewed the module presentations and resources, consider how this material is relevant to your own work and experience. The following is a list of questions for self-reflection or for use in discussions with colleagues.

1. How might we purpose the questions we ask students during post-clinical conference to help them think more deeply about and make sense of what they are seeing and hearing (mindfulness) during clinical encounters?

2. How do we help students process the information that is continuously presented to them in clinical settings and consider how that information impacts the quality and safety of their emerging practice?

3. How can we be intentional in every communication we have with students to increase the meaningfulness and situational relevance of these interactions?