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Practicum Experience

Running head: Practicum Experience

Practicum Experience Synthesis Paper


Lycia L. Harris
Jacksonville State University

Practicum Experience
Abstract

Practicum Experience

An important part of becoming a nurse educator is the practicum experience. This is a time where
all acquired knowledge and skill obtained for this role through prior course work is utilized and
applied to practice. For this practicum experience, a career nurse educator at the Supora Thomas
Pediatric Nursing Education and Resource Center at Childrens of Alabama was contacted to be
the preceptor. 100.5 clinical hours were used to learn the various roles, responsibilities, project
development requirements and challenges facing a nurse educator in a hospital based setting. The
teaching strategies, practice knowledge, curriculum development and research applied to this
project are indicative of theory learned in courses related to the Master of Science in nursing
program at Jacksonville State University and this paper describes and analyzes the clinical
teaching project created to facilitate transition to the academic nurse educator role. Practicum
Experience Synthesis Paper

Teachingpracticumsareeducationalexperiencesdesignedtoassistfuturenurse

educatorstogainimportantteachingexperienceandhelpsthemdefine,implement,and
strengthentechniqueslearnedinpriorcoursework.Conceptslearnedinnursingpracticums,if
doneproperly,willlastthenurseeducatorwellbeyondtheircareer(ncbi.nlm.nih.gov).The
valuesofnursepracticumsarebestexpressedbythosewhohaveexperiencedthem
(ncbi.nlm.nih.gov).The purpose of this practicum experience was to learn how to properly
incorporate and develop the skills and competencies required to be a successful and effective
facilitator of nursing education. Forthispracticumexperience,acareernurseeducatoratthe
SuporaThomasPediatricNursingEducationandResourceCenteratChildrensofAlabamawas
contactedtobethepreceptor.100.5clinicalhourswereusedtolearnthevariousroles,
responsibilities,projectdevelopmentrequirementsandchallengesfacinganurseeducatorina
hospitalbasedsetting.

Practicum Experience

Setting
TheSettingofthepracticumexperiencewastheSuporaThomasPediatricNursing
EducationandResourceCenteratChildrensofAlabama.COAisapediatricspecialtyhospital
andistheonlyallpediatricfacilityinthestateofAlabama.Theoriginalhospitalwasfoundedin
1911.In2012,anewexpansion,theRussellBuilding,wasaddedtoChildrens,whichhelpsit
holditstitleasthethirdlargestpediatrichealthcarefacilityinthecountry.Thehospitalboasts
332inpatientbedswith48neonatalintensivecarebassinettes,andhasnumerousoffsite
facilitiesaroundthestate.Thehospitalsystememployeeover2000peopleandisoneofthe
largestemployersinthecityofBirmingham.ThenursingeducationdepartmentofChildrensof
Alabamaisresponsiblefortheeducationofnursingpersonnelatthemainhospitalcampus,as
wellasthoseatoffsitefacilities.
Childrens,isateachinghospital,therefore,manystudentnurses,doctors,respiratory
therapist,socialworkersetc.,canbeseenallaroundthebuilding,eachday.Thisnurses
preceptorhasbeenworkinginthenursingeducationdepartmentofChildrensofAlabamaonly
oneyear,however,shehasheldteachingfacultypositionsatbothSamfordUniversityIdaV.
MoffettSchoolofNursingandatJeffersonStateCommunityCollege.Sheisoneofseveral
educatorsinthenursingeducationdepartment,andistaskedwithoverseeingtheeducationof
newhires,nursesandclinicalassistants,continuingstaffeducation,intensivecaretrainingfairs
andcardiopulmonaryresuscitationmarathons.Teachingprojectswereaccomplishedthrough
classroomteaching,labinstruction,andgrouplectureactivities.
MeetingthePreceptor
Itisthisnursesopinion,oneofthefirststepstoensuringapositiveclinicalpracticum
experienceistohaveagoodpreceptor.Preceptorshavespecificrolesinmodelingand

Practicum Experience

facilitatingclinicaleducationforstudents,especiallyforadvancednursingstudentsandtypically
serveamoreformalroleinthestudentsevaluations(Billings&Halstead,2012).Thisnurses
preceptorworemanyhats,sothroughoutthepracticumexperience,thisnursewasableto
participateinandlearnfromthemanymeetingsandcouncilsherpreceptorservedon.COAhas
alargenursingeducationdepartmentwithcountlessresources.Thisnursesfirstweekwithher
preceptorwasfilledwithactivities.
Afterinitialacclimationtothenursingeducationdepartment,thisnurseobservedher
preceptorinherdailyactivities.COAhasanewgraduatenurseorientationprogramthatteaches
newnursesskillsandmethodstodeliversafe,effectivepatientcare.Thisprogramtakesplace
severaldaysinthemonthoveraoneyeartimespan,whichhelpsthenewgradlearntothink
criticallywhengivingcare.Brigham(1993)believedthatnursingeducatorsneedstoassist
studentstorecognizehowsystemsrespondtospecifichealthcareproblemsandtheyalsoneedto
knowwhatnursingmeasureswillbeneededwhentheyreadlaboratoryreportswithabnormal
results(Billings&Halstead).Theabilitytoanalyzeandreacttoabnormalitiesinpatient
conditionsdealswithcognitivelearning.
ThisprogramatCOAseemedtogoagoodjobataccomplishingthattask.Taxonomyis
asystemthatdescribes,identifiesandclassifiesgroups(Nilson,2010).Ineducation,taxonomies
classifythreedomainsoflearning:cognitive,affective,andpsychomotor(Nilson,2011).
Taxonomiesrelatetoeducationalgoalsandareusefulforestablishingtestitems(Nilson,2011).
In1956,theTaxonomyofEducationalObjectives,editedbyBenjaminBloomwaspublished.
Bloomscognitivedomainincludesimportanteducationalgoalsrelatedtoknowledge,
comprehension,application,analysis,synthesis,andevaluation(Nilson,2011).Bloomslevelof
knowledgedealswiththeabilitytorecallpreviouslylearnedmaterial,suchassimplefacts,

Practicum Experience

concepts,theoryorpractice(Nilson,2011).Bloomslevelofcomprehensiondealswiththe
abilitytograspthemeaningofmaterialandthisisthelowestlevelofunderstanding(Nilson,
2011).Bloomslevelofapplicationdealswiththeabilitytouselearnedmaterialinnewand
concretesituations(Nilson,2011).Bloomslevelofanalysisistheabilitytobreakdown
materialintoitscomponentpartssoitsorganizationalstructurecanbeunderstood(Nilson,
2011).
Bloomslevelofsynthesisdealswiththeabilitytocombineelementstoformaunique
newidea,procedure,orobjectandrequirescreativebehavioronthepartofthestudent(Nilson,
2011).Finally,Bloomslevelofevaluationistheabilitytousecriteriaandstandardstomake
qualitiveorquantitivejudgementsaboutthevalueofideas,solutions,methods,etc.(Nilson,
2011).Thisnursespreceptorcreatedthisnewgraduateprogrambasedonevidencedbased
guidelinesandtheorythatusescontinuingeducationtostrengthenstudentlearningbasedon
individuallearningstylesandaccuratelyreflectlevelsoflearning.
Classroom/SimulationLab
Thisnursealsowasabletoseelearningintheclassroomandsimulationlab.Thiswasa
periodofhandsonlearninginvolvingsimulatorsandmannequins.Manyskillsweretaughtsuch
assteriletechnique(gowningandgloving),CVLcareandmaintenance,tracheostomycareand
reinsertion,IVtherapyandinsertingurinarycatheters.Thisnursereallylovedthehandson
learningactivities.Thestudentsseemedtobemoreintothisactivitythanthelectures.Itwas
interestingtalkingthestudentsthroughthemotionsofcare.Simulatorsoffernurseeducatorsa
significanteducationalmethodthatmeetstheneedsoftodayslearnersbyprovidinginteractive,
practicedbasedinstructionalstrategies(Billings&Halstead).Beforeusingsimulation,thenurse
educatormusthave:

Practicum Experience

1. Afirmfoundationinexperimentallearning
2. Clearlearningobjectivesforthesimulationexperience
3. Adetaileddesign
4. Sufficienttimeforthelearnerstoexperiencethesimulation,toreflectonthe
experienceandtomakemeaningoftheexperience
5. Facultydevelopmentintheareaofsimulationpedagogy;theteachingstrategy
isstudentcentered,whichformanyisaparadigmshiftinteaching(Billings&
Halstead).
Thebenefitsofusingclinicalsimulation:
1. Activeinvolvementofstudentsintheirlearningprocess
2. Moreeffectiveuseoffacultyintheteachingofclinicalskillsand
interventions
3. Increasedstudentflexibilitytopracticebasedontheirschedules
4. Improvedstudentinstruction
5. Effectivecompetencychecksfortheorientationprocess
6. Correctionoferrorsdiscussedimmediately
7. Standardized,consistentandcomparableexperiencesforallstudents(Billings
&Halstead)
Thisnursespreceptorwasveryknowledgeableaboutsimulationandwouldspendmanydaysof
theweekteachinginsimulationlab.AsimulationlabdealswiththeapplicationlevelofBlooms
taxonomy.
EducationCouncilMeetingsandPlanningSessions

Practicum Experience

EveryfirstWednesdayofthemonth,thisnursespreceptorparticipatesinanursing
educationalcouncilmeeting.Inthismeeting,nursesfromseveraldisciplineswithinthehospital
includingoutsidepracticeclinicsmeettoreviewnursingstandards,policiesandnewevidenced
basedinformation.Thisisalsoatimeofplanningandbrainstormingneweducationalideas.
Therewasalsoaconferencecallwithvendorswhoprovidecomputerbasededucationalmaterial
andtrainingtothehospitalsystemtodiscusswhatworksandwhatdoesnotwork.Therewas
frankdiscussionandproblemssolvinggoingonamongtheparticipants.
OnsomeWednesdaysandmostFridays,thisnursereviewedteachingevaluationsfrom
learningactivitiesandformulatedplanstoimproveplansandincorporateadditionalteaching
methods.Throughplanning,assessmentdataisusedasthefoundationforinstructionalplanning,
whichisessentialforgoodteaching(Billings&Halstead).Teachingplanstendtoserveasthe
maptohelpnurseeducatorsmeettheirgoalsanddeadlines.Instructionalplanningincludes
selectingandorganizingtheappropriateandessentialconceptswithcontentinalogicaland
meaningfulsequence,withattentiongiventotheappropriatedelineationoftheimportant
relationshipsbetweenfacts,concepts,andprinciples(Billings&Halstead).Planningalso
includesselectingtheinstructionalstrategiesanddesigninglearningactivities(Billings&
Halstead).Planningdealswithsynthesis.

Student Population
This nurse worked with her preceptor to develop and teach a hospital wide orientation for
clinical assistants, unit support specialist and behavioral assistants. The participants had various
backgrounds and levels of experience. This orientation sought to promote synthesis of skills and
patient safety by creating a teaching program that defined clinical assistant duties, responsibilities

Practicum Experience

and solutions for patient safety while decreasing hospital acquired infections and near miss events.
Clinical assistants, for this paper, are the traditional nurses aides. Unit support specialists are
clinical assistants, but also have training in secretarial skills. Unit support specialist can serve in
either role, dependent on unit needs.
Behavioral assistants are nursing assistants that work on the adolescent psychiatric ward.
Behavioral assistants have specialized training in the care of the patient with behavioral problems.
There was one clinical assistant in nursing school; however, the others were career clinical
assistants. There was one unit support specialist and no behavioral assistants in the class. The idea
for the teaching project came from clinical assistants and bedside nurses voicing their frustrations
related to the exact role CAs played in patient care to administration.
Theoretical Basis
Whenthisnursewasanalyzingwhyshewantedtobeanurseeducator,sheremembered
themanyoldernursesandinstructorsthathelpedtoinstillinherloveforthenursingprofession.
Thisnursewastaughttobeknowledgeable,competent,andconfidentandtotakeprideindoing
hernursingcare.Nursingcare,andinthiscase,allcareprovidedtoapatient,shouldalwaysbe
theverybestcarethattheprovidercanoffer.Inadditiontocaringforthepatient,thenurses,and
othersinvolvedinpatientcare,areoftentheonlyadvocatesapatientmayhave.Proper
knowledgeoftechniqueisessentialtomakeinformed,safe,ethicaldecisions.
KatherineKolcabawasoneofmanynursingtheoristswhodevelopedherComfortTheoryback
inthe1990s.Kolcababasedthistheoryonresearchandthingsshelearnedasagerontological
nurse.Kolcabastheoryisconsideredamidrangenursingtheory,meaning,itisanapproachto
sociologicaltheorizingaimedatintegratingtheoryandempiricalresearch(currentnursing.com).
Kolcabastheorydescribedcomfortas:

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existing in 3 forms: relief, ease and transcendence (currentnursing.com)


if specific comfort needs of a patient are not met, for example, the relief of
postoperative pain by administering prescribed analgesia, the individual will not

experience comfort in the relief sense (current nursing.com)


if the patient is in a comfortable state of contentment, the person experiences comfort
in the ease sense, for example, how one might feel after having issues that are causing

anxiety addresses (currentnursing.com)


transcendence is described as the state of comfort in which patients are able to rise
above their challenges (currentnursing.com).
Thestateofbeingateaselooksatcomfortasexistingbecausethepatientisinastate

ofcontentment(currentnursing.com).Contentmenthappensbecausetheanxietythat
usuallyaccompaniespainiscalmed(currentnursing.com).PerKolcabastheory,comfort
istheimmediatedesireofallnursingcare(currentnursing.com).Patientcomfortcan
occurinfourways:physical,psychospiritual,environmentallyandsocioculturally
(currentnursing.com).Kolcabastheorylooksatpatientsasindividuals,families,
institutionsorcommunitiesthatneedhealthcare(currentnursing.com).
Theenvironmentisanypartofthepatient,family,institutionorcommunitythatcan
bechangedbyanurseorfamilymembertoaddtopatientcomfort(currentnursing.com).
Kolcabadefineshealthcareneedasthoseidentifiedbythepatientorfamilyinanursing
practicesituation(currentnursing.com).Kolcabadefinedinterveningvariables,suchas
finances,prognosis,socialsupport,etc.,asaspectsofcarewherehealthcareproviders
haveverylittlecontrol(currentnursing.com).Whenapatientlooksforwaystoimprove
hisorherhealth,thisiscalledhealthseekingbehavior(currentnursing.com).
Institutionalintegrityoccursatalocal,regional,state,andnationallevelandhastodo

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withthevalueandintegrityoftheinstitutionwherethepatientseekshealthcare
(currentnursing.com).
Kolcabadefinesbestpoliciesaspolicyorprocedureenactedbyaninstitutionforuse
afterevaluationofevidence(currentnursing.com).Thisnursefeelsthateverypatient
deservesaqualified,welltrained,confident,competentcareprovider.Iftheseattributes
areconveyedtothepatientandfamilies,comfortisfeltbythepatientandfamily,which
aidsinthehealingprocess.Helpingtheclinicalassistants,unitsupportspecialist,and
behavioralassistantsunderstandaspectsofKolcabascomforttheorybyemphasizing
teamworktohelpthepatentbeatease,willhelpthemunderstandhowtheycontributeto
greatpatientoutcomes.

PracticumProject
The need for development of a system wide consensus of care and responsibility for
clinical assistants, unit support specialist and behavioral assistants was identified. The first goal of
this practicum experience is to learn how to properly incorporate and develop the skills and
competencies required to be a successful and effective facilitator of nursing education. The
second goal is for this nurse to work with her preceptor, with little to no assistance, to develop
and teach a hospital wide orientation for clinical assistants. This nurse based her course work on
the National League for Nursing Core Competencies of Nurse Educators with Task Statements
(2005) Competency 1: Facilitate Learning and Competency 2: Facilitate Learner Development
and Socialization. The topic this nurse chose for teaching was: How Do You Contribute to Great
Patient Outcomes

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This nurse felt this topic will help teaching emphasize the importance of teamwork when
planning and doing patient care. Teamwork will help the patient achieve the desired level of
comfort and facilitate healing. The clinical project involved the creation of a power point
presentation, incorporating that power point into lecture, question and answer period and
evaluation of teaching that was delivered during the first CA orientation program day and other
subsequent orientation days. This nurse passed out hand-outs with PowerPoint notes to
participants. The teaching took place over about 1 hour. This nurse started with lecture, which has
become an unpopular method of educational delivery for some educators.
Lecture is just as effective as any other teaching method for conveying factual knowledge,
but, numerous studies say it falls short in promoting deeper-level student learning and
development (Nilson, 2010). This nurse, however, believes in lectures that are not just long
recitation of written words, but lectures that are interactive with periods of skill building. Lecture
can still be utilized if it is used for the right purposes, is carefully prepared and eloquently
delivered, and is supplemental with thought-provoking student activities (Nilson, 2010). This
nurse feels that lecture is still a good way for students to acquire knowledge and re-enforce ideas.
Also, because this nurse is teaching a group with varied experiences, some learners still benefit
from lecture.
This nurse also used audio visual aids, particularly, a power point presentation.
PowerPoint can enhance the visual quality and impact of lectures and professional presentations
(Nilson, 2016). PowerPoint allows the educator to create and project test integrated with images,
animations, Web resources and video clips in full color and with sound (Nilson,2010).
Competency 2 of the NLNs Core Competencies for Nurse Educators states that educators must
identify individual learning style preferences and the unique learning needs of students who are
different in many ways (Billings & Halsted, 2011). Acknowledging diverse student learning styles

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enhances the learning environment while supporting academic achievement (Billings & Halstead,
2011).
During the process of teaching delivery, this nurse tried to convey that everyone working
to care for a single patient is a part of the same team. The clinical assistants were not just helpers,
but valuable members of the healthcare delivery team and communication between team members
was very valuable for positive patient outcomes. This nurse started the presentation with stating
the objectives of the learning event which were reachable and easy to be assessed.The
PowerPoint was intergraded into the lecture portion of teaching. The synergy model was also
presented related to teamwork. Synergy results when the needs and characteristics of a patient,
clinical unit or system are matched with a nurse's competencies (aacn.org). All patients have
similar needs and experience these needs across wide ranges or continuums from health to illness.
Logically, the more compromised patients are, the more severe or complex are their needs. The
dimensions of a nurse's practice are driven by the needs of a patient and family (aacn.org).
Incorporating a variety of teaching techniques acknowledges the full spectrum of learning styles
and narrows the performance differences that are brought about by reliance on one teaching
method (Billings and Halstead, 2011).
Evaluation
Evaluation was the final step in this teaching project and was done by a brief, formal, posttest at the end of the lecture and PowerPoint. Evaluations can be done in different ways.
Evaluations may be written or oral, formal or informal. Informal evaluations happen when the
educator asks the student informally about what was learned. These types of evaluations are
discouraged because it leaves the student and instructor without objective criteria and a sense of
fairness (Billings & Halstead, 2011).

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In a formal evaluation, statistical analysis of the data will be accessible along with the
findings with specific methods of reporting the findings to students, educators, administrators, and
external audiences that can be discussed and used for change (Billings & Halstead, 2011).
Evaluations are a mutual effort between the evaluator and the individual, group, or program being
evaluated and the purpose of the evaluation must be identified by the educator and administration.
Types of evaluation used in nursing programs are: accreditation, criterion-reference evaluation,
formative evaluation, internal evaluation, outcome evaluation, process evaluation and summative
evaluation (Billings & Halstead). The overall the data from the post-test evaluation showed that
the learners payed attention to the lecture, however, this nurse realized when reviewing the
evaluations that questions or statements related to how the learners contributed to great patient
outcomes were omitted. This nurse would recommend that the development of the CA
orientation program continue to iron out any kinks and improve knowledge obtained through
clinical assistant participation in this program.
Conclusion
This nurse must admit that after this practicum, her view on the role of the nurse educator
in a hospital setting changed greatly. This nurse had no idea the type of planning and knowledge
needed to make the role successful and generate positive learning outcomes. Over all, the
practicum went well and there were only a few challenges which were the results of lecture
speakers cancelling or challenges related to keeping the interest of the learners during some
teaching activities. This nurse had a very multi-faceted experience during this program and
fortunately, her preceptor gave her awesome guidance and opportunities to learn the nurse
educator role, develop skills, and learn about valuable teaching resources.

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References
Billings,D.M.(2012).TeachinginNursing:AGuideforFaculty(4thEd.).St.Louis,Missouri:
Elsevier.
Nilson,L.B.(2010).TeachingAtItsBest:AResearchBasedResourceforCollegeInstructors.
SanFrancisco,California:JosseyBass.
Synergy Model for Patient Care. Obtained: March 2016 from: http://www.aacn.org
unknown.(1992,SeptemberRetrieved:January15,2016).NursingPracticum:Empowering
Strategies.RetrievedfromPubMed:http://ncbi.nlm.nih.gov
unknown.(2005,RetrievedJanuary201614).CoreCompanciesofNursingEducatorswithTask
Statements.RetrievedfromNationalLeagueforNursing:http://www.nln.org
unknown.(2013,September9).NursingTheories.RetrievedfromCurrentNursing:
http://www.currentnursing.com

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