Clinical Practicum 1

Running head: CLINICAL PRACTICUM

Clinical Practicum

Jennifer G. Fox

Ferris State University

 Clinical Practicum 2

Abstract

The purpose of this paper is to discuss the author’s practicum in the staff

development department at Munson Medical Center in Traverse City, Michigan.

First, the foundation of the practicum will be introduced, including the National

League for Nursing (2005) Core Competencies selected for the practicum. Next,

the issues, challenges, and concerns that arose will be covered, as well as

strategies used to address them. A detailed description of the clinical project will

be included, in addition to analysis of the project. Finally, the author will present

an evaluation of the practicum from the perspective of the preceptors, students,

and self.
 Clinical Practicum 3

Clinical Practicum

A practicum experience allows supervised practice to refine skills needed

for a professional role before actually assuming the role (Gaberson & Oermann,

2007). The ability to practice prior to graduating is necessary to expand basic

skills, develop independence, and improve self-confidence (Gaberson &

Oermann, 2007). Additionally, a practicum involves well-defined learning

objectives based on the student’s past experience (Gaberson & Oermann, 2007).

Having already completed a practicum for my undergraduate education, I knew

the importance of this experience at the graduate level. The purpose and focus

of my graduate practicum was to further develop myself for the advanced

specialty role of academic nurse educator, which was accomplished by working

collaboratively with Munson Medical Center’s (MMC) staff development

department in Traverse City, Michigan.

According to Benner (1982), my entry into staff development (SD) at the

beginning of the semester was that of advanced beginner, or possessing

marginally acceptable performance. Advanced beginners need support and

guidance in aspect recognition; therefore, the preceptorship was inherent to this

practicum (Levi, 2001). Working in staff development with preceptors allowed

me to gain teaching experience that differed from what I possessed and

facilitated my transition to the nurse educator role.

The purpose of this paper is to discuss the foundation of my practicum

experience, the issues, challenges, and concerns that arose, and strategies

employed to address the issues. Moreover, description and analysis of the

 Clinical Practicum 4

clinical project will be provided, concluding with evaluation of the practicum from

the perspective of preceptors, students, and self.

Practicum Foundation

To develop the advanced specialty role of nurse educator during this

practicum experience, I employed the National League for Nursing (NLN) The

Scope of Practice for Academic Nurse Educators (2005). I chose NLN (2005)

Core Competency I: Facilitate Learning and Core Competency IV: Participate in

Curriculum Design and Evaluation of Program Out to guide my practicum

because of their relation to MMC SD mission which is to create, promote, and

maintain an environment conducive to learning (MHC, 2005). The selected

competencies also allowed me to obtain desired experience in these areas.

According to the NLN (2005), nurse educators are responsible for

facilitating learning in classroom and skills lab settings as part of Core

Competency I, which was accomplished by teaching portions of nursing

orientation and various skills labs and assisting with simulation education.

Additionally, weekly journal entries were kept to facilitate self-reflection, which

improves teaching practices that facilitate learning (NLN, 2005). Participation in

course and curricula creation for my practicum project, and evaluating the

outcome of the project facilitated fulfillment of Core Competency IV (NLN, 2005).

The theoretical foundation for the practicum chosen was Benner’s (1982)

Novice to Expert. At the initiation of this practicum, I assumed the role of

advanced beginner; after completion of the practicum, I have a greater

knowledge base that enables me to function at Benner’s (1982) level of

 Clinical Practicum 5

competent in the specialty role of nurse educator by having gained a mastery of

more routine educational situations, such as classroom and skills lab teaching. I

also feel more comfortable in my role as a nurse educator.

Issues, Challenges, and Concerns

When embarking on any project or task, there are bound to be concerns

that arise. While some of the challenges did not directly affect my practicum, for

example, budget issues, there were three that impacted my practicum

considerably. The most noteworthy issues for the purpose of this practicum were

time management, clinical competence for nurse educators, and student incivility.

Time Management

First, time management seemed to be the overwhelming challenge that I

encountered. This is not a new issue to nursing (Weston, 2009). Nurses are

responsible for balancing many tasks for multiple patients throughout a shift

(Lawrence & Sherrod, 2009). This balancing act emerged during the practicum

as well, where performing multiple roles as educator, writer, facilitator, creator,

and simulation programmer became normal routine. I assumed multiple projects

with varying deadlines, which required strict time management skills. Managing

time is not a skill that comes naturally to all educators, can be learned, and will

be discussed in the next section.

Clinical Competence

Second, the issue arose of whether or not nurse educators should be

required to maintain some form of clinical competence. I noticed this when I first

observed other staff development educators at the beginning of my practicum.

 Clinical Practicum 6

They would ask me about the topic so I could provide input on the current

practice on the floor. One educator even commented that it was nice I was in

class, so she could bounce information off me, because it had been so long since

she had worked on the floor.

Clinical credibility may be used interchangeably with terms such as clinical

competence but refers to student perceptions of the lecturer’s ability to apply

theory to practice (Barrett, 2007). During the practicum experience it was evident

that my preceptors lacked relevant recent clinical experience, and thus, were not

clinically credible. My preceptors would make statements such as, “It’s been so

long since I’ve worked on the floor, I don’t think I could go back,” which further

illuminates this point. Additionally, role modeling, as in social learning theory,

should be done with an expert practitioner (Barrett, 2007). The NLN (2005)

suggests that nurse educators remain competent in professional practice so they

can prepare learners for contemporary nursing practice, as well as recommends

an ongoing commitment to develop and maintain competence in the role, which

enhances role modeling and learning in practice (Barrett, 2007).

There are barriers to maintaining clinical competence, which include lack

of time, heavy workload, fear of being incompetent, less value placed on clinical

work, shortage of staff, financial constraints, increased administrative duties, and

lack of organizational commitment (Griscti, Jacono, & Jacono, 2005; Little &

Milliken, 2007; Owen, Ferguson, & Baguley, 2005; Williams & Taylor, 2008). It is

interesting to note that the separation of nursing practice and education occurred

when nursing education moved from hospital-based instruction to institutions of

 Clinical Practicum 7

higher education, which further contributes the this role conflict (Williams &

Taylor, 2008). There will be several suggested strategies to ensure clinical

competence in the next section.

Student Incivility

Third, student incivility occurred during the practicum experience, and is

defined as disregard and insolence for others, causing an atmosphere of

disrespect, conflict and stress in a teaching-learning environment (Clark, 2008a).

Reports of student incivility include inattentiveness, sleeping, being unprepared

absence from class, tardiness, objectionable physical contact, verbal abuse, and

disruptive behaviors, such as using cell phones during class (Clark & Springer,

2007; Frank & Halstead, 2005). The amount of student incivility I encountered

during my practicum was somewhat surprising. This is congruent to the research

in nursing education, which demonstrates these behaviors are increasing across

the nation (Clark, 2008a; Clark, 2009). A national survey of nursing programs

reported by Frank and Halstead (2005) revealed 100% had instances of incivility.

This is unexpected, but obviously a growing trend.

During one of my observation experiences, the lights were dimmed in the

room, and one student, sitting furthest from the instructor, started nodding off,

complete with head bobbing. I do not know if the instructor saw this student, but

I did, and did not say anything about it. Another instance occurred when I was

teaching a nursing assistant class, and one student had her cell phone in her lap,

and was constantly texting. I, again, did not say anything about this behavior.

Both of these examples demonstrate uncivil student behaviors identified by Clark

 Clinical Practicum 8

(2008a), left me feeling uneasy because I knew it was disrespectful behavior,

and yet I felt unprepared to address it at the time.

Issues with incivility can cause physical and psychological symptoms for

student and educator, increased stress levels, decreased self esteem, as well as

result in an educator’s self-doubt in teaching abilities, which can even end in an

educator leaving nursing education (Clark, 2008a; Clark, 2008b; Luparell, 2007).

This is an issue that should be addressed when it occurs, but often proves

difficult because of lack of training to deal with incivility (Clark, 2008a). The

increase in student incivility, coupled with lack of training further compounds this

important concern identified during my practicum. Strategies to address student

incivility will be discussed next.

Strategies to Address Issues, Challenges, and Concerns

Time Management

As previously stated, time management was the most prevalent issue

encountered during the practicum. While I balanced multiple tasks and

obligations, it would have been helpful to have some guidance on best practices

in time utilization. I, unfortunately, did not receive such advice, but did discover

some useful strategies to make the most of one’s time.

Shellenbarger (2009) discusses time and project management tips for

educators. She begins with assessing one’s time use by keeping an activity log

and figuring out what times of day are most and least productive (Shellenbarger,

2009). Her strategy seems somewhat daunting, because she suggests either

writing down each activity every half hour or each time you switch tasks (2009).
 Clinical Practicum 9

This might appear counterproductive at first, but can help determine your most

productive work time. Next, schedule the most challenging tasks during your

most productive time and schedule less important things during off-peak times

(Shellenbarger, 2009). Especially minimize the number of times you switch

between tasks, as Shellenbarger (2009) reports could reduce efficiency by 20-

40%. This was a surprising fact, but mirrors what Halloran (2008) reports about

multitasking. Studies show that people who do 10 things at once do none of

them well (Halloran, 2008). This means that all of the educators in staff

development were completing low quality work because of constantly

multitasking. I would much rather complete one task to the best of my ability,

than 10 things poorly.

Subsequently, prioritize what needs to be done beginning with the least

appealing task, so that the remainder of time can be spent on something more

enjoyable (Shellenbarger, 2009). Delegation can also be a useful strategy, as

long as you are willing to let someone else be in control (Halloran, 2008).

Additional tips include: create a daily to-do list; increase organization, as it is a

key component to efficient use of time; learn to say no to decrease stress

associated with time management; and schedule fun or personal time just as you

would an appointment (Halloran, 2008; Shellenbarger, 2009).

I struggled with time management throughout the practicum, yet I was

solely managing a small component of the educator role. I did not have to

answer student emails, hold office hours, grade papers, revise curricula, or reply

to online postings (Parker & Howland, 2006). During my practicum, I did not
 Clinical Practicum 10

implement Shellenbarger’s (2009) strategies, which most likely would have

helped because of the amount of multitasking I did. I tried to keep a running to-

do list in my head, but writing it down would have allowed me to be more

organized. Reflecting on my practicum, I could have benefitted from the

application of time management strategies.

Implementing time management strategies from the beginning can

facilitate a sense of control in a novice educator (Halstead & Billings, 2005).

Additionally, as a novice educator, having a mentor who could provide support

and guidance in time management strategies would be beneficial (Parker &

Howland, 2006). The helpful tips presented, although a little late for application

to my practicum, can greatly reduce stress associated with time management

and increase improved working time (Shellenbarger, 2009).

Clinical Competence

The second concern during the practicum related to clinical competence of

nurse educators. I became aware of this while observing my preceptors and

other educators in the staff development department. They would ask, “Is this

what you do on the floor?” in front of the class, which I felt immediately

discounted their clinical credibility. I was happy to provide insight, but again, feel

that those who teach clinical skills should remain competent in those skills. Nurse

educators who are able to practice what they preach are regarded as credible

leaders, inspirational mentors, and understanding colleagues (Little & Milliken,

2007). However, Williams and Taylor (2008) present clinical competence as a

theoretical ideal for academic nurse educators. To me, this means an

 Clinical Practicum 11

unattainable paradigm, which is far from reality.

True, it is difficult to acquire dual expertise when looking at Benner’s

definition of expert: An expert has practiced for six or more years in the same or

similar setting and does not rely on maxims, rules, or analytic frameworks (Little

& Milliken, 2007). This would essentially imply that to be an expert nurse

educator, one would need to be an expert in both education and nursing.

Although difficult to acquire, Balachandran (2008) found that a majority of nursing

personnel (98.1%) felt a dual role is necessary. This is not possible for most

nurse educators because of the numerous previously mentioned barriers.

The NLN (2005) Core Competencies support dual obligations. Core

Competency I: Facilitate Learning includes a descriptor recommending nurse

educators to maintain the professional practice knowledge base needed to help

learners prepare for contemporary nursing practice (NLN, 2005). Benner (1984)

distinguishes between theoretical knowledge and practical knowledge, stating

that practical knowledge requires actual clinical experience (as cited in Barrett,

2007). Having practical knowledge is ideal, can enhance lectures by using real-

life examples and anecdotes, but is not essential (Barrett, 2007).

Additionally, Core Competency VI: Pursue Continuous Quality

Improvement in the nurse educator role requires that nurse educators recognize

the multi-dimensional nature of the role and that an ongoing commitment to

develop and maintain competence is essential (NLN, 2005). Authors who

advocate a clinical role for nurse educators feel those who are out of practice do

not teach as effectively and may actually hinder the learning process (Barrett,
 Clinical Practicum 12

2007). Clinically credible nurse educators can also narrow the theory-practice

gap by basing teaching on a more realistic picture of what occurs in practice

(Barrett, 2008; Sullivan, 2010).

To address the issue of clinical competence in nurse educators, some

schools are promoting joint appointments. Joint appointments allow shared time

between academia and practice settings (Fowler, et al., 2008; Little & Milliken,

2007). Joint appointments are common practice among medical schools, yet are

a minority in most nursing schools (Fowler, et al., 2008; MacPhee, 2009).

Benefits to joint appointments include strengthened relationships between the

university and the hospital, increased clinical credibility of lecturers, increased

confidence in skills teaching, increased networking opportunities, broadened

perspectives, reduction of the theory-practice divide, role modeling, introduction

of a change agent, and helping to prompt research questions and facilitating

easier access to subjects (Fowler, et al., 2008; Owen, Ferguson, & Baguley,

2005). The employing institutions should support and encourage nurse

educators who wish to maintain this clinically active role. This support could

come from a mentor who is matched based on experience and expertise of the

mentee (Fowler et al., 2008). Additionally, equal value should be placed on

clinical work, teaching, and research output, instead of the latter two taking

precedence in the university setting (Owen, Ferguson, & Baguley, 2005). Further

support could be to provide practice development opportunities, clinical skills

update workshops facilitated by current practitioners, and focusing research

interests and activities on clinical issues and practice (Owen, Ferguson, &
 Clinical Practicum 13

Baguley, 2005).

Ultimately, it is up to each individual nurse educator to decide what

competence means and how to achieve it. This can mean a sustained

commitment to the clinical practice arena or scholarly activities such as reading

journals, writing for publication, and carrying out research (Barrett, 2007).

Personally, I did not struggle with maintaining clinical competence during my

practicum because I continued to work as a staff nurse on the weekends. By

currently practicing, I was able to demonstrate the necessary professional

practice base needed to help learners prepare for nursing practice, which also

gave me clinical credibility (Little & Milliken, 2007). This is my ideal role, and I

was able to maintain it during my practicum. I would like to continue to remain

dually competent by remaining active in the clinical setting, while embarking on

my nurse educator role.

Student Incivility

During the practicum, the author encountered student incivility and was

unprepared and, thus, did not address it. Looking back on my experiences with

incivility during the practicum, I feel uneasy about my lack of action. This

correlates with Clark (2008a) and Luparell’s (2007) reports of psychological

symptoms when confronted with student incivility. Had I addressed this issue

with my preceptors, I may have learned strategies to deal with this important

issue.

Techniques to attend to this important issue are to establish open

communication, address any incivility immediately, directly, and fairly, learn

 Clinical Practicum 14

conflict negotiation skills, create classroom norms, and hold students

accountable (Clark & Springer, 2007). Open communication can create a culture

of civility, increase awareness of the problem, and help to dispel this growing

problem (Clark, 2008b). Clark (2009) describes the importance of faculty role

modeling professional behaviors, which is critical for student development and

socialization into nursing. If faculty role model behavior such as belittling or

asserting their superiority, it could have a negative affect on student role

socialization, and perhaps contribute to uncivil behaviors (Clark, 2009).

Conversely, if faculty role model professional behaviors, incidences of student

incivility may decrease (Clark, 2009).

After reviewing the suggested strategies to manage uncivil student

behaviors, I realize I should have addressed each incivility immediately. This

would have established a norm of acceptable behavior that did not include the

uncivil activities I encountered during my practicum. My lack of action while a

student was texting while I was talking, made it acceptable, and devalued me as

an educator. In the future, I hope to role model professional behaviors including

effective communication, respectful language, and listening to students to help

prevent student incivility such as what I experienced in my practicum (Clark,

2009).

Description of Clinical Project

Undertaking a project during the practicum ensured that the author gained
 Clinical Practicum 15

nurse educator experience by taking an active role during the practicum. This

was accomplished by completely recreating an orientation class for nursing

assistants about the gastrointestinal (GI) system and related nursing assistant

(NA) duties. The class needed revision because the original staff development

educator who created the course left the department, and since that time, many

other educators had taught the class, but no one took ownership. The recreation

of the GI class meant I had to forego my nursing knowledge and put myself if the

shoes of the novice nursing assistant. I did this so I could attempt to understand

the GI system from the novice perspective of my intended students as described

by Benner (1982).

Benner (1982) discusses novices as learners with no experience with

situations in which they are expected to perform tasks. Novices follow rules

because they are not able to discern or use judgment to guide decisions during a

task (Benner, 1982). Appropriate tasks for novices are obtaining vital signs,

measuring intake and output, and other objective measurements (Benner, 1982).

New nursing assistants fall into this novice category.

In order to become a novice, I first, observed the nursing assistant GI

class in January 2010. This allowed me to understand the basic format of the

class and provided me with a starting point. Then, I read the two chapters

assigned to the NA (Nutritional Needs and Diet Modifications & GI System) to

understand the level of knowledge covered. I decided on the most important

content from the chapters for a new NA at Munson Medical Center and created

learning objectives based on the content. Objectives are descriptions of a

 Clinical Practicum 16

performance you want learners to be able to demonstrate before you consider

them competent (Rowles & Brigham, 2005). For the purpose of the GI class,

these are basic skills that the NA must learn in class before allowed to work on

the floor. This proved challenging because I only had two hours to convey two

chapters’ worth of information.

After reviewing my list of objectives to ensure they were measureable

using Duan’s (2006) discussion of Bloom’s taxonomy, I collaborated with my

preceptor to refine the objectives. Objectives are specific, observable, and

measureable learning outcomes, and consist of an action verb, conditions,

standard, and the student (Waller, n.d.). Bloom’s taxonomy is a method of

classifying learning outcomes (Duan, 2006). The labeling of learning outcomes

then assists in selecting congruent instructional strategies (Duan, 2006). An

example of one of the learning objectives for the GI class was, “By the end of the

GI class, the student will be able to list six essential nutrients and provide one

example of each.” The instructional strategies utilized to facilitate learning of the

nutrient groups were a PowerPoint review, as well as a nutrient game.

Next, I created a teaching outline (See Appendix A). Harton (2007) offered

a sample lesson plan with content outline, time, methods, materials, and

evaluation that facilitated the development of the teaching outline. Ultimately,

Munson required the use of a pre-existing format for the teaching outline, which I

had to follow. While creating my teaching outline, I needed to consider the

cognitive, affective, and psychomotor learning domains. I wanted to incorporate

all domains of learning to facilitate the students’ achievement of desired

 Clinical Practicum 17

competencies (Jeffries & Norton, 2005). For example, the cognitive domain was

addressed while I was leading the educational activity using PowerPoint in a

lecture format. This domain includes knowledge and comprehension, which was

assessed when asking the students which nutrient group was represented by the

descriptors on the PowerPoint slides (Jeffries & Norton, 2005). The affective

domain encompasses attitudes, beliefs, values, feelings and emotions and was

accomplished by having the students feed each other (Jeffries & Norton, 2005).

This opportunity allowed them to attempt to empathize with a patient who

required feeding. This also allowed the practice of psychomotor skills, which are

“doing” skills and the most commonly used in clinical practice (Jeffries & Norton,

2005; Waller, n.d.).

Additionally, I incorporated components of Knowles’ theory of adult

learning. All of my students were adults, who are self-directed and use previous

experiences to build new knowledge (Vandeveer & Norton, 2005). This is

important to consider when developing learning activities because adult learners

are usually self-motivated and self-directed (Vandeveer & Norton, 2005). Using

principles of adult learning, I assumed the students would be prepared for class

by reading the two assigned chapters and able to participate in the PowerPoint

activities.

Using PowerPoint can be detrimental to the teaching/learning experience

if not used correctly (Jones, 2009). One way to use PowerPoint effectively is to

decrease the amount of content on a PowerPoint slide. This allows the speaker

to be more engaged with the material, but also requires more preparation
 Clinical Practicum 18

(Woodring & Woodring, 2007). The PowerPoint I created (See Appendix B) used

many pictures and few words to decrease the participants need to read all the

information on the slide, and allowed my presentation to be more conversational.

The format for the slides appealed to the visual learner, while my discussion of

the information appealed to the auditory learner, although Frankel (2009) found a

majority of staff preferred visual or kinesthetic learning, with auditory being the

least preferred method of learning. I incorporated kinesthetic learning in the

practice of feeding, as well as the GI games.

I also was able to incorporate games into the GI class (See Appendix C).

One game was called “GI Geography” and required students to get up out of their

seats to participate by putting organ names and definitions on the correct part of

the picture using pre-affixed Velcro dots. The second game was used as review

of the major nutrients and involved printed, laminated food pieces, which the

students then had to place on the corresponding nutrient group on the board

(carbohydrate, protein, fats). There were a few extra Velcro dots, as well as

some foods that had more than one major nutrient group (pizza and peanut

butter and jelly sandwich). Games are a valuable addition to education because

they make the learning experience creative and can enhance learning by

increasing awareness of one’s experience with the world (Picard, Landis, &

Minnick, 2007). Jaffe (2007) discusses the transition to a society with decreased

attention span, and that games in learning are experiential and help sustain

interest in leaning activities. Learners possess different learning styles, which is

why it is important to plan and implement a variety of learning activities and

 Clinical Practicum 19

teaching methods to facilitate learning for all types of learners (Harton, 2007).

Analysis of Clinical Project

Analysis of my project was somewhat limited related to the fact that there

were only two students. Nancy observed the class session, and gave favorable

feedback (See Appendix D), with the exception of using “um” as a filler. Filler

words, or disfluency, cause disruption in the flow of speech and can discount a

speaker’s credibility (Peterson, 2010). Corley, MacGregor, and Donaldson

(2006) actually studied the effect of disfluency on listeners. They found that

hesitation in speech affects the way in which learners process language, and can

impact the intent of the message (Corley, MacGregor, & Donaldson, 2006;

MacGregor, Corley, & Donaldson, 2009). I am more cognizant of my use of filler

words after the practicum, and realize this is an area in which to improve to

enhance learning. Student evaluation of my teaching was also positive (See

Appendix E).

Overall, the practicum project was a valuable learning experience. During

my practicum project, I was able to create a class from start to finish. I utilized a

variety of teaching methods including lecture, PowerPoint, games,

demonstration, and role-playing, all of which contributed to the acquisition of

student knowledge. Using differing learning modalities attempts to address

learners’ unique learning styles, which allows greater knowledge attainment

(Frankel, 2009). I also learned how to write measureable learning objectives,

which is an important quality for a nurse educator to possess (Waller, n.d.). This

allows evaluation of the effectiveness of teaching and acquisition of knowledge

 Clinical Practicum 20

(Harton, 2007). The practicum project, along with these activities, issues,

challenges, and concerns were valuable learning experiences and will forever

benefit me in my future as a nurse educator.

Practicum Evaluation

Evaluation is an important and essential concept in nursing. It measures

quality and productivity against a standard, and also provides a means to

appraise strengths and weaknesses (Bourke & Ihrke, 2005). Evaluation of the

practicum experience occurred through preceptor, student, and self-evaluations.

The first component of evaluation of the practicum included preceptor

evaluations. My preceptors completed formative evaluations (See Appendix F),

which focused on identifying progress toward objectives, which I then used to

improve my performance for the remaining weeks of the practicum (Bourke &

Ihrke, 2005). Suggestions at that time suggested I learn more about various

learning modalities and using the simulation lab. Positive feedback from the

formative evaluations revealed they saw me as a positive role model,

knowledgeable, energetic, calm, and that I prioritized well.

Also, each staff development educator who observed my teaching

provided an evaluation of that class (See Appendix G). When I taught restraints, I

was unusually nervous, and the evaluation revealed that I spoke rapidly,

especially for the new NA with no previous experience with restraints. Rapid

speech can be interpreted as insecurity, which I do not want to convey in the

future (Wyeth, 2008). Additionally, my preceptors provided summative

evaluations (See Appendix H) at the end of the practicum experience, and

 Clinical Practicum 21

included the extent to which objectives were met (Bourke & Ihrke, 2005).

Positive feedback from my preceptors included my easy-going nature, calm, non-

threatening manner, approachable nature, enthusiastic, ability to function

independently, self-motivation, ability to connect with students, well-prepared

with content, knowledgeable, flexible with teaching methods, and good time

management. Suggestions for improvement included increase ease with public

speaking and continue to teach to strengthen and maintain skills in this area.

During my public speaking experiences during the practicum and previously in

my graduate classes, I have struggled with this skill. I know it is something I will

need to continually work on to become an effective educator.

Student evaluations were the second element of the evaluation of the

practicum. I collected student evaluations for most educational activities I led

(See Appendix I). Student evaluation is best completed at the end of the

educational activity, should be succinct, and allow for anonymous feedback

(Woodring & Woodring, 2007). I was able to obtain student evaluations based

on these guidelines for two ECG Skills Labs, the GI class, and tube feeding on

Nursing Skills Day. The evaluation form included areas on professional

competence, relationships with students, personal characteristics, evaluation

practices, and teaching skills (Iwasiw, Goldenberg, & Andrusyszyn, 2005). This

was reflected in statements such as, “Treated learners with respect”, “

Demonstrated enthusiasm about the subject and for teaching”, and “Completed

the objectives outlined in the class description”. Sample student comments

included, “”Well organized”, “Excellent instruction, well explained, good

 Clinical Practicum 22

examples”, and “Calm experience”. This evaluative information was utilized as a

component of self-reflection and evaluation of the author’s teaching practices.

Self-evaluation was the final piece of evaluating the practicum and

analyzed my performance on the basis of previously developed objectives and

determined ways to improve. Palmer (1998) states, “Good teaching requires self

knowledge” (p.3), which I attained through the use of reflective journaling and

self-evaluation. The reflective journals were turned in at predetermined times

during the semester, which allowed me to continuously know myself as a nurse

educator. I also completed both formative and summative self-evaluations (See

Appendix J). These were then compared with my preceptors’ evaluations. This

comparison revealed that we had similar views on my performance, and that I

could improve on incorporating various learning modalities, which includes ways

to make learning more interactive.

During my practicum, I was able to utilize lecture, skills lab, role-playing,

games, PowerPoint, simulation, and demonstration learning modalities. I think

these methods were effective as teaching methods because of the favorable

evaluations I received from my students. I realize I am just scratching at the

surface of interactive and innovative teaching strategies, with what I completed

during my practicum. I am excited to learn more about educational adjuncts such

as debate, case studies, student-centered learning, online teaching, video, and

creative movement to make learning more interactive (Bradshaw & Lowenstein,

2007).

My preceptor evaluations also encouraged me to continue teaching to

 Clinical Practicum 23

increase my confidence in public speaking. I continue to be nervous in front of a

group, complete with massive diaphoresis despite many opportunities to practice

during my practicum. Confidence and comfort in public speaking is something

that should come with time and experience, and I look forward to improving this

skill (Bradshaw & Lowenstein, 2007). The information gained from all forms of

evaluation will facilitate my development as a future nurse educator.

Conclusion

Using the National League for Nursing The scope of practice for academic

nurse educators (2005) Core Competency I: Facilitate Learning and Core

Competency IV: Participate in Curriculum Design and Evaluation of Program

Outcomes and Benner’s (1982) Novice to Expert to guide my practicum, I feel I

have accumulated valuable experience that prepares me for my future as a nurse

educator. I have developed close relationships with my preceptors, as well as

other members of SD. I had the chance to teach in varying environments

including classroom, online course module creation, psychomotor skills labs, and

simulation lab. I was able to critically self-reflect on my experiences to gain

insight into the role of nurse educator. I developed strategies to address the

most significant challenges that arose during my practicum, which included time

management, clinical competence for nurse educators, and student incivility. All

of these experiences led to increased competence and confidence as a nurse

educator and a rewarding and enlightening clinical practicum experience that I

will definitely draw from in the future.

 Clinical Practicum 24

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Appendix A

Teaching Outline

I. Goal and Objectives

A. Goal: The participant will be able to care for a patient with altered
nutritional needs.
B. Objectives: By the end of the GI class, the student will be able to:
i. List six essential nutrients and provide one example of each.
ii. Select one key element of the following therapeutic diets:
diabetic, heart healthy, clear liquid, full liquid, and sodium
restricted.
 Clinical Practicum 31

iii.Define NA responsibilities for a patient on a dysphagia diet.

iv. Empathize with the patient during mealtime.
v. Demonstrate feeding of the patient.
vi. Identify NA responsibilities with two alternative forms of
nutrition.
vii. List two signs and symptoms of GI elimination problems and
NA role.

II. Equipment and Instructional Aides

A. Dietary Tray order (small container raisins, dysphagia food items)
B. Gloves, extra cups, plates, straws, napkins, silverware,
C. One towel per student
D. Laundry bag/hamper
E. Laptop and LCD
F. Handouts (menus, carb counting practice, dysphagia)
G. Activity posters

Appendix B

GI PowerPoint
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Appendix C

GI Games
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Appendix D

Preceptor Evaluation of GI Class

Instructor Evaluation

Class Name: Nurse Assistant Training: GI Class Date: 3/15/2010

This form is designed to provide an overall assessment of the instructor.

Please read each item carefully and use the following scale to indicate your
reaction:
1=poor 2=fair 3=satisfactory 4=very good 5=excellent

The Instructor usually:

Treated learners with respect. 1 2 3 4 X
Made students feel free to ask questions. 1 2 3 4 X
Was capable of answering questions. 1 2 3 4 X
Demonstrated enthusiasm about the subject and for 1 2 3 X 5
Completed the objectives outlined in the class 1 2 3 X 5
Communicated clearly and logically. 1 2 3 4 X
Used teaching strategies that promoted learner 1 2 3 4 X
Provided fair evaluation of learner performance based 1 2 3 4 X
on grading
criteria provided.
Instructor’s overall effectiveness as a teacher. 1 2 3 X 5

Please provide what you feel is a strength of this instructor:

Jennifer has the ability to make each student feel respected and
to meet each student’s educational learning needs. This class
involved a variety of ages and work experience in the learners.
Jennifer did extremely well adapting the education to their varied
needs.

Please provide an area for improvement of this instructor:

Watch “ums.” Jennifer did not feel well this day and was able to
provide a great class. I could tell she wasn’t quite as energetic
as she usually is, but I don’t think the students noticed at all.
She used a good speed for delivery of the material, and a variety
of creative teaching methods to reinforce learning.
 Clinical Practicum 39

Appendix E

Student Evaluation of GI Class

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Appendix F

Preceptor Formative Evaluations

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Appendix G
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Observation Evaluations by Staff Development Educator

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Appendix H

Preceptor Summative Evaluations

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Summative Evaluation for Preceptor

Ferris State University

NURS 740 Scholarly Practicum
Student Name: Jennifer Fox
Evaluator: Nancy Irish
KEY: 1 = Never 2 = Seldom 3 = Usually 4 = Consistently
Please rate:

Student Skills 1 2 3 4 Comments

Collaborated with and sought
guidance from preceptor in meeting 4 Jen touched based with me as
scholarly project objectives. needed.

Student demonstrated the ability to Excellent work ethic, responsibility

work independently, accepting 4 and self-directed.
responsibility, and accountability for
one’s own learning experiences.

Implemented a variety of teaching Developed a variety of creative

strategies appropriate to learner needs,
desired outcomes, context, and
content.
Utilized extant literature to develop
evidence-based assessment and
evaluation practices.
4 learning activities for GI class with
nurse assistants, and Basic ECG
class. She also developed a
simulation scenario for SimMan.
She also worked on a Healthstream
course for critical care nurses on AV
blocks and did an excellent job.
4 Worked with simulation technology
and helped with running scenarios
and staff assessment and evaluation
during universal skills day.
4

Remained on track with proposed

scholarly project timeline.

4
Yes – very self-directed, and
communicates progress well with
preceptors.

Demonstrated qualities expected of an

academic nurse educator.

4
Dependable, creates enthusiasm for
 Clinical Practicum 49

learning.
Positive attitude.
Collegial
Refers to research
Utilizes a variety of learning methods.

* (Could not write in table cells on last two topics.)

Observed strengths:
Ability to connect with students and generate enthusiasm.
Well- prepared with content – knowledgeable.
Flexibility with teaching methods to best meet the needs of students.
Good time management – organized, teaching plan well thought out and based on
research.

Goals for growth:

Provide more presentations, to strengthen and maintain skills in this area.

Jen, I have enjoyed working with you. And appreciate all the creative work you have
completed.
 Clinical Practicum 50

Appendix I

Student Evaluations
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Appendix J

Self Evaluations
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