·-,'~ Occasional Papers

Clinical nurse teaching:programme for the practising nurse

Anthony 1. Carr, SRN, NDNCert, QN, FHA, FRSH, MBIM,

THE Newcastle area is a medium size rsingle district teaching area. At presentit cont-ains two large general teachinghospitalstotalling some 1 70D'beds wioha third hospital of 800 beds nearingcompletion. There are, in addition, aovariety of smaller hospitals (15) plus alarge mental hospital. Severalregionaland sub-regional specialties are to befound <in the area and over the nextfew years more are expected to be ;established. The Community HealthServices maintain a population of308 000 people.

For over 18 months, planning hasprogressed on a variety of Joint Boardof Clinical Nursing Studies courses. litwas envisaged that within the next fiveyears the area would be able to main-tain about 12 types of course. One-ofthe difficulties was the lack Of facilities.to allow specialist sisters/charge nursesto add properly organised teachingtheory and supervised practice to theirqualifications without takdng a full six-month course in clinical teaching.

About two years ago the principal ofthe ROY<lJlVictoria Infirmary School ofNursing, Miss M. F. Dixon, suggesteda plan which would allow interestedand experienced specialist sisters/:charge nurses to take a special dayrelease City and Guilds Further Educa-tion Teachers Course (No. 730) .andqualify as clinical teachers.

After discussion with clinical nursingstudies officer for the Northeast, MissM. G. Shout, it was decided to pursuethis matter further, as it was felt thatthis new venture would, in fact, pro-duce the appropriate number of quali-fied teachers for the. Joint Boardcourses by the time they were required.Discussions extended further and pro-duced what in our opinion was' anexceptional development within clinicalteaching both at ward and patient levelfor the area and maybe for the pro-fession as a whole. The idea was tobase the City and Guilds course withinthe School of Nursing and orientate thecourse towards the needs of nursingstaff who were already supervising the

NURSING TIMES JANUARY 27, 1977

Summary: In an attempt to build up a teaching team, for the fullimplemeritationof the courses of the Joint Board of Clinical NursingStudies, and in anticipation of legislation of the recommendation ofthe Committee on Nursing, Newcastle AHA have introduced a part-time programme of day release for experienced sisters/ chargenurses to gain the City and Guilds Further Education Teachers Courseand qualify as clinical teachers. Within five years it is hoped that atleast 100 experienced nurses will have obtained this qualification.

care of patients directly.We agreed to' invite charge nurses/

sisters, nursing officers and communitynursing staff to participate in' thecourse, ~n addition to the special staff .who were selected to teach on JointBoard courses.

The scheme was never intended toproduce scores of registered clinicalnurse teachers for the school of nursingbut rather to have on the staff, nurseswho 'were firmly orientated towardsteaching nursing <lJtpatient care levelin the 'community .and in the hospitalas parrof their day-to-day work. ".

The course was to be arranged~ithin the school of nursing by theSouth, Shields Marine and TechnicalCollege. The tutors from the collegewere not .nu-rses but were'. wellqualified and exceptionally well moti-vated towards, bur ideas. The course,covering an academic year on a dayrelease basis," .was planned and thesyllabus of the' 730 course was usedcarefu lIy; giving a nursing emphasiswherever possible.

A selection panel was appointed andnomina:tions invited via the principalnursing officer i-n the first instance.The response was quite unexpected.The panel received over 60 applica-tions. Although it was late in theacademic year: it was decided to goahead with a concentrated two-termcourse instead' of the full academicyear., The 28 nurses chosen' for the firstcourse' were selected as follows:

6 nursing officers (Hospital)2. nursing officers (Community)

18 sisters/charge nurses ' .2 unqualified tutors

SyllabusThe syllabus followed closely the

City and Guilds Further EducationTeacher's Certificate, namely

I.Iittroduction. Brief survey of .theaims and organisation of the differentstages of education, including primary,secondary and further education.

2. Principles of teaching. The aim ofthis section was to introduce studentsto some aspects of learning and theprinciples of teaching. A directapproach was recommended by con-sidering the factors in the teachingsituation: students, teacher, subject.

(a) An introduction to learning:requirements of the learning process,including interest, motivation andactivity.

(b) The nature of learning: trial anderror in learning, conditioning andreinforcement, insight learning.

(c) The characteristics of skilledperformance, acquisition of skills andtransfer of training.

(d) Individual differences in learn-ing and retention; the problems whichthese create.

(e) . Principles of teaching withregard to the formation of habits,training in skills and explanation ofideas.

(f) Ways of developing discrimina-tion and judgement in students.

(g) The value and importance offormal, informal, group and individualteaching methods in these respects.

i

(h) Class management and control,

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in all parts of the examination in thesame year, except that a candidate whoreceived a satisfactory assessment forcourse work and reached the requiredstandard in either the written paper orteaching practice assessment may bepermitted to. enter again at the nextexamination for the section in whichhe/she failed.

Thirty six days were allowed for dayrelease and 12 hours of supervisedpractice under the direction of thecourse tutors. Out of the 28 participantson the first course, 27 obtained theteaching certificate and one was re-ferred in the written paper.

The second year is now underwaywith 37 students in <three groups on twodifferent days. The grades of staff in-volved asstudents include:

4 nursing officers (Hospital)2 health visitors

25 sisters/charge nurses2 district nurses2 clinical teachers1 administrative sister1 dental rtutor (unqualified)1 staff nurse

The idea -is spreading throughout theNorthern Region and the scheme is be-ing accepted with great enthusiasm bythe staff concerned. All staff qualifyingfor the certificate and wishing to be-come full-time clinical teachers aregiven the 'oppartunity to study parttime far the Diploma in Nursing,although several participants alreadypossess this qualification. Selection forthe Diploma is by the same selectionpanel.

Students' comments aftercourseTheatre Nursing Officer

'I feel it would be difficult to. em-.phasise enough. the eff'ects v.of thiscourse. If has been like an upsurge ofadrenalin, stimulating' an extremelynew outlook an theory' and practice.The new sense of purpose and objec-tives defined and achieved is mostmarked. '

(g) Library facilities, including the It took me at least .a month to.use of reference boks and periodicals, organise each supervised teaching prac-

(h) The organisation and use of tice. It needed, considerable arganis-'visits to. organisations outside the ation to. book seminar roams or the

II h· . I Our thanks are due to Mr T. A. Morley,ca ege; t e importance of follow-up clinica area to coincide with freeing principal lecturer in charge, Mr T. M.work. student nurses from the service needs; Walsh, lecturer, and Mr B. M, Trotter, all

The examinations consisted af one not to. mention the assessor being able of the Educational Technology unit ofthree-hour written paper; an assess- to. fit in also, the South Shields Marine and Technical

, , College, without whose hard work andment of course work; and an assess- .It stimulated much interest on the. dedication this course would not havement of teaching practice. part of the trained staff and I received commenced.

The written paper which was con- considerable help from them. In fact REFERENCEcerned with the principles of teaching they often joined in the teaching prac- BENDALL, E. (1975). So you passed, nurse.and methods of teaching, was prepared tice. The supervised teaching practice Royal College of Nursing Research series,by the City and Guilds of London was of real value, particularly the as- London.Institute. ' sessor's discussion after the lesson, and Anthony Carr is Area Nursing

All staff were informed that they we were encouraged to use formal and Officer with the Newcastle Areawere required to. satisfy the examiners informal teaching methods. These ran- Health Authority (Teaching)

Requests for offprints of this article should be made 'to Mr A. J. Carr,Newcastle Area -Health Authority (Teaching), 2-10 Archbold Terrace,,Newcastle updn Tyn~NE2.1EF, enclosing stamped addressed envelope

'with special reference to. youngpersons and adult groups; incentives;human relationships; problems ofcommunication.

3. Methods of teaching. This sectionwas concerned with the methods ofteaching appropriate to subjects orgroups of subjects related to thequalifications and experience of themembers of the course.

(a) Preparation, including,(i) syllabus construction• (ii) schemes of work

(iii) lesson planning(iv) organisation and program-

ming of work in workshops,laboratories and specialistrooms. r

(b) Consideration of appropriatemethods of presentation of subjectmatter, including '.

(i) demonstration techniques(ii) the use of questions'(iii) discussion(iv) tutorials(v) projects and assignments.

(c) The problem of catering for thevarying degrees of ability and attain-ment in a group and the special needsof individuals,

(d) Classroom and workshopmanagement; layout and use ofequipment; conditions of safe workingand methods of accident prevention.

(e) The nature and use or audio-visual aids and other equipment,including the effective use of chalkboard; the construction and use ofaids and self-teaching. equipment;significance of programmed learning;the application of colour and display,

(f) The appraisal' of a student'swork; assessment, marking and test-ing, both internal and external: theplace of written work and notes bystudents; the importance' of studentrecords. ,.

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ged from formal teaching in seminarrooms to role play, simulated situationsin the clinical area. These were some-times video-taped and played back, f'ol-lowed by same very lively discussions.Feedback from the teaching practicecame in many ways, from the learnersthemselves and often from the sister ofthe Unit. As you know, I have pro-duceda guideline to teaching learnersthe basic skills in· theatre, This wasbroken down into. skills, knowledge andattitudes' .

Charge nurse (future IBCNS clinicalteacher)

'At my hospital we are very fortu-nate in having good classroom facilities,and with the use of the overhead pro-jector gave a series of lessons onthoracic diseases to four enrollednurses, The nurses seemed keen tolearn and the prior preparation anduse of a lesson plan gave good results.1 feel that nurses working in specialtiesoften do most of their work without aclear: understanding of what they aredealing with. Theoretical teaching ofthese nurses is often neglected due tothe pressure of work by senior staff.'

Community ~~rsing officer'I think the course was useful to me

because 1 now feel I know a little moreabout the psychology of learning, andalso. the use of. audio-visual aids. It hashelped me to look at what I was doingpreviously, and 1 hope 1 have improvedupon my method of presentation.

'J did enjoy the course in spite of theextra work involved and 1 think it hasbeen of benefit to me in my manage-ment as well as my teaching role'.

Tt is hoped that within five years,even taking into' account natural turn-over, well over 100 nurses will havereceived a teaching course and will stillbe close enough to the patient to beable to make a major teaching contri-bution as part of their everyday re-spansibilities. This may go some 'way inmarrying the theoretical approach ofthe School of Nursing and its practicalapplication by the immediate super-visor of the clinical area (Bendall,1975). IliIl

NU'RSING TIMES JANUARY 27, 1977