Clinical Coach Standardisation MeetingAugust 2011

Aims

•Define Practical Skills•How can practical skills be learnt?•How can practical skills be taught•Why is assessment important?•How can this be done in a robust way?

What are practical skills?

•Doing!•BUT•Require underpinning knowledge &

understanding•Require ability to perform a dextrous task•Can be simple or complex•May require fine or gross motor skills•Acquisition is a life long process: •child

adult

Practical Skills in Veterinary Nursing

• Technical

• Animal care and welfare

• First Aid• Preparation &

administration of medication

• Diagnostic procedures• Clinical Care

Procedures• Equipment prep &

maintenance

ProfessionalCommunicationTeam WorkingTeachingConduct

BusinessStaff ManagementStock ControlReception DutiesPaymentsEstimatesHealth & Safety

How do we learn?

Kolb’s Experiential Learning Cycle

Concrete Experience

(Doing)

Reflective Observation

Abstract Conceptualisation

(Learning from experience)

Active Experimentation

(Putting into practice what has

been learned)

Blooms Taxonomy

•Imitation

•Manipulation

•Precision

•Articulation

•Naturalisation

Psychomotor

(Practical Skills)

Skill Aquisition

•Dreyfus (1980) proposed a model of how to acquire skills

•Applied to nursing by Benner (1984)•Progressive level of skill based on

experience

Novice Advanced Beginner

Competent Proficient Expert

Conscious Competence Model and its Professional Application

Reflective Competence

Unconsciously

Incompetent

Consciously Incompetent

Consciously Competent

Unconsciously Competent

Expert

Confidently

Incompetent

What Concepts can be used to guide our teaching?

• Activity aids learning• Repetition and practice aids learning• Small steps aid learning• Reinforcement aids learning

Behavioural Therapy

• Learning comes from understanding• Organisation and structure of teaching aid learning

• Perceptual features need attention• Cognitive feedback aids learning• Individual differences need to be taken into account

Cognitive Theory

• Learning is a natural process• Motivation, purposes and goals are important• Choice, relevance and responsibility aid learning• Anxiety and emotion affect learning

Humanisation and Adult Learning Theory

Teaching a skill• Stage 1

Demonstration of skill at normal speed with little/no explanation.

Stage 2Repetition with full explanation and encouraging learner

to ask questions.Stage 3

Demonstration again with learner explaining each step and teacher questioning and correcting. May need to be

repeated multiple times.Stage 4

Learner performs skill under close supervision describing each step before performing it.

Acquisition of skills in Veterinary Nursing

College

Work-based

Why is work based learning important?

Workplace teaching & learning - Limitations•Time and clinical constraints•Effect on smooth running of a business•Ability and willingness of staff whose

main role is not teaching•Availability of teaching opportunities•Variability in technique•Non compliant patients

Simulations

•Allows learning to be in a safe & controlled environment

•Lots of opportunities to practice•Standard techniques can be taught•Less time constrained

•BUT•Experience NOT real•Not possible for all tasks•May result in poor application in practice

Assessment – Why?

•Have learning outcomes been met?•Are learners - Competent, Reliable, Safe.•Can knowledge and practical skills be

used together in a problem solving context?

•Important for public confidence and professional registration

Assessment formats

DoesNPL

Shows How (College & Practice)

Practical examsKnows How (College)Written assessment -

assignments

Knows (College)Written assessment – MCQ’s

Assessment of practical skills must be…….• Feasible

• Credible

• Have educational impact

• Defensible

• Supported by body of evidence in the literature

• Acceptable to all stakeholders

Any Questions?