Facilitating Learning and Assessment in Practice essay

Within this portfolio I will show that I have facilitated learning and assessment in my practice area. I am a registered nurse (URN. ) with the Malaysian Nursing Board since I obtained my Diploma in Nursing in 2009 from a private nursing college. My post-registration posting was in a private specialist hospital in southern Malaysia. I was designated to work in the coronary care unit (ICC) with 18 beds, where mostly critically ill patients’ are nursed. For the past 5 years Of experience of working in CALL, I have completed coronary care nursing in post-basic course, certified in both BasicLife Support (BLESS) and Advanced Cardiac Life Support (CALLS) (Appendix). Currently, I am one of the senior staff nurse assigned for training new nurses in my unit.

Recently, a newly registered nurse joined my unit, URN. J (Appendix 2). We flirts met and sat together in our unit pantry. We had simple “ice breaking” session prior establishing professional relationship.

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It is essential to build up relationship prior commencing mentoring (Merit, 2004). During the conversation, she expressed her anxiety to nurse critically ill patients’ as she never had the experience before.Mullioned and McKee (2011 ) highlighted, ruses enrolling for intensive care for the first time will experience anxiety about their insufficient knowledge and skills.

I managed to alleviate her anxiety by giving her encouragement and motivation. Communication skills are deemed to be listening, empathy, giving support and information in the context of the therapeutic relationship (Bach & Grant, p. 13, 2009). Eventually, she expressed her willingness to learn with my guidance in order to be a competent and knowledgeable nurse.

Identifying Learning Needs, Planning and Managing the Student Experience According to Mimic and Swanking 2009), learners’ from different background have different learning needs and it is important for the educator to pay attention to it. Initially, I had a professional conversation with URN. J to assess her learning needs. Learning needs can be assessed through professional ‘conversation’ which aligns with reflective practice (Mimic and Swanking, 2009). Indeed, reflective practice is part of requirement for nurses to enhance professional skills (Somerville and Keeling, 2004).She told me, that she wants to sharpen her skill in endothelial tube (ET) suctioning under aseptic technique for patients’ on a ventilator.

She was worried after seeing most of our patients’ are ill and ventilated. She admits that she has less exposure during her student time performing ET suctioning due to limited clinical posting at intensive care units. Further, she reflects to me, her experience on ET suctioning during her student time, which caused her embarrassment after scolded by her tutor in front her colleagues for not maintaining sterile procedure.Reflection-on- action is the most common form of reflection practice interlinking mind events that have occurred in the past which challenge the thoughts to improve (Somerville and Keeling, 2004). In fact, ET suctioning is an essential skill to learn by URN for arrival management, as she is going to nurse patients’ on mechanical ventilation in our unit later.

Lack of skill and knowledge in ET suctioning may lead to complications for patients (Proto et al. , 2013).Eventually from there, agreed with URN to teach and guide her to develop her skills to be competent in performing (ET) suctioning so we signed the learning contract.

In the learning contract, I asked her to fill up her own learning goals (Appendix 3). URN. J had the strong desire to learn and want to be a competent nurse. She emphasized to me that she will take all the initiative to learn and to gain the skill competency. Timing (2002) describes learning contract encourages self-directed learning among learners to focus along their learning for improvement.

Besides, Chain and Chine (2000) highlights, by using learning contract, effectiveness of learning increased among learners’. An individual effectively learns best through their preferred learning style (Franken, 2009). Franken (2009) also suggests consideration on individual learning styles is important in planning effective training programs for learners’.

So, prior drafting lesson plan and teaching strategies for URN. J, I told her that I wanted to assess her learning style. Unloaded the Honey and Uniform Learning Style Questionnaires (LSI) online and asked her to answer it (Appendix 4). According to Honey and Uniform (1992), their LSI can be a selection tool for both learner and trainer to identify and decide the best learning experience opportunities for them on the job. Further, Honey and Uniform LSI outcome categorize individual according to their learning style as an activist, reflector, theorist and pragmatist (Appendix 5). The (LSI) revealed URN. J learning style was a pragmatist.An individual with pragmatist earning style benefits from what is learned in practice and like to try out new techniques that is relevant to their work with practical advantages (Burton, 201 1).

URN. J was happy as the result was similar to her personal manner of learning style initially. The following day, I came up with a lesson plan (Appendix 6) which will suit URN. G’s learning style, which emphasize “hands on” practice at the clinical practice area. The lesson plan was set with similar learning objectives that URN.

J filled up earlier in the learning contract.It is to allow appropriate learning activities to take place in order to meet the earning outcomes in this learning partnership. A well planned lesson plan, aids to brief the daily teaching plan for the educator (Neural, 2003). I gave URN. J a copy of the lesson plan for her reference and mental preparation. Neural (2003) describes, a lesson plan gives a better picture for the learner about what activities the educator intends to carry out for the learning. We also discussed about her role as an adult learner, she has to be responsible for her own learning to gain knowledge besides I will guide her alongside.I asked her to keep a learning diary to reflect and write about her learning activities.

Learning diary is a useful tool for learner to evaluate their learning progress and think of action plans for their improvement (Tang, 2002). Facilitating Learning and Assessment The clinical practice area plays a vital role in providing quality clinical learning environment and patient care (Japanning & uses, 2013). A person who teaches and guides an adult learner functions as facilitator in creating a learning environment (Lee, 2014, p.

5).According to Elevate-Jones and Lateran (2008), learning at clinical practice area open opportunities for learning nurses to develop their skills, knowledge, attitudes and values of a URN. On the first day as per lesson plan, URN and met up in our clinical practice area and had a simple briefing about the learning objectives, learning outcomes and the learning activities that were planned for 1 week of the time period. Then, I started my orientation tour with the physical layout of the unit. I lead her to our unit discussion room where a mini library is set up with various relevant reading materials for learning purpose.

Besides, a computer with internet access is placed in that room. I encouraged URN. J to use the facility available for learning. For new nurses transitioning into a new practice area, good orientation is important (Jewell, 2013). Additionally, I introduced her to my team members’ who are available during that shift with names and titles’. New nurses need to feel accepted prior integrating into the inter-professional team. My intention was to help URN.

J build interpersonal relationship and communication skills with our team members’.An analysis by Japanning and Lessee (2013) reveals good relationships are needed to accommodate an environment conducive for clinical learning while poor relationships may cause denomination and stress to learn in becoming a competent practitioner. Next, we were at the patient cubicle, there was an empty bed. I showed her our unit patient bedside setting. I taught her how to function the professor pump, cardiac monitor, wall unit 02 and vacuum port with suction pressure regulator. Then, showed her items and equipments needed for ET suctioning. Showed her where to obtain the consumable items for the procedure. Et her ‘hands On’ On those equipments so that she gets used to them.

Lee (2014, p. 9), highlights learner would be in ‘comfort zone’ if they are allowed to handle the equipment prior practicing a procedure. URN. J expressed the orientation tour was informational for her. Further, we discussed for next day lesson plan, I asked her to revise on the human respiratory system and the importance of ET suctioning skill in airway management.

Second day, URN. J and met up at our unit discussion room. We briefly discuss on the human respiratory system and the importance of ET suctioning.I praised her for the good knowledge in theory. According to Cooley (2003), it is necessary for a professional nurse to balance in both academic and clinical skills to relate theory-practice independently. Then, I gave URN.

J printed hand out on ET suctioning procedure steps (Appendix 7). Passable (2008), identifies Bloom Taxonomy (1956) supports teaching in cognitive domain can be one-to-one instructed by using written tools to stimulate learning. The cognitive domain of learning needs to gain knowledge and promote critical thinking to implement on psychosomatic skill development.Finally, we were in the practice area, URN. J had a chance to observe a nurse performing TIE suction. Consequently, on the third day I started with a short intro to the skill by referring the note that have given her earlier. Lee (2014, p. 9) stated an individual with pragmatist or kinesthesia learning style is not interested with Eng lecture.

Then, we assessed the patient’s need for suctioning. I prepared the items and equipments needed, and then demonstrated the full procedure to her by explaining every step with rationales. She observed carefully and took notes.According to Book (1997), observation of a skill with relevant knowledge input through list Of direction and explanations with demonstration enhances skill-learning process. For that day, I demonstrated on two patients’. During URN. G’s turn for redecoration with another patient, she was nervous, I told her many nurses have done it before and to be infinite.

Finally, she was able to carry out the procedure under my guidance. Later, privately I gave feedback about her communication skills with patients’ that she needs to inform the patient before performing the procedure although they are mildly sedated.Besides, she should not confuse about the use of dominant and non-dominant hand. She took the feedback openly and didn’t have questions to ask me. Subsequently, on the fourth day, URN. J and went around the clinical area and performed ET suctioning for ventilated patients. She was not shy or feared to offer the nurses to do the reoccurred with my guide for their patients. I guided her in some steps of the procedure for about six patients.

Clinical coaching sessions, aid in building self- confidence and motivate the nurse to improve their skills towards competency with a better understanding (Skeleton, 2014).According to Passable (2008), a learner with psychosomatic learning behavior, develop their skills by observing, imitating, practicing and adapting. Towards the end of the day, I asked URN. J about how the learning process is taking place in the practice area.

She told with more practices, she is improving her skills and quenches in performing ET suctioning under aseptic technique. Furthermore, Beck et al. (2002), supports ‘practice by doing’ is part of an active learning in obtaining and retaining info. I encourage her to keep the good work and to be prepared for the formative skill assessment next day to evaluate her learning.I briefed her about how she will be assessed. According to Quinn (2000), formative assessment provides information on the learners progress towards meeting the competency in progress while, summarize assessment is done at the end of learning to determine whether the competency been achieved. Formative assessment is done in the mid of the learning process, to provide feedback about learners progress and look for areas of development.

I have adapted and modified Bond (1983) criterion reference performance with checklist assessment tool to assess URN.J competency in TIE suctioning. A checklist can be used to evaluate psychosomatic skill competency (Hunt, 2012). On the formative assessment day, URN. J appeared nervous. I reassured her it just a formal assessment to assess her learning progress throughout our learning partnership. She performed the procedure well, but required occasional supportive cues. She expressed her anxiety being assessed makes her to be forgetful and unable to concentrate.

According to Passable (2008), nervousness and anxiety may effect on psychosomatic skill performance. Raised her skill on ET suctioning is not bad. I advised her to be confident and concentrate on patient care. I showed her the assessment sheet (Appendix 8) and pointed out the areas for improvement with verbal feedback. On the sixth day, URN. J was self- directed and independent to find learning opportunities to practice the ET suctioning under my supervision at practice area. I helped her to reflect on her experience with open ended questions.

Through indirect supervision, my colleagues told my minute is doing well. End of the day URN.J is confident to perform the procedure and ready for the summarize assessment on the next day. Subsequently, on the summarize assessment day URN performed the procedure safely and independently without any supporting cues. She was able to answer all the questions I asked pertaining to the skill knowledge. Competency can be also evidenced through knowledge of theory applied in psychosomatic skill.

I praised her for the good work and given her written feedback in her assessment form (Appendix 9). Provide Ongoing Support and Guidance for Learners During the learning partnership with URN.J we both have a positive relationship.

The relationship between the learner and mentor influence the quality of the learning experience for the learner (Andrews & Roberts, 2003). I motivated her to be self-directed to look for her learning opportunity at practice area. A bonding between us, created openness and helped URN. J to ask me any doubts that arise in her learning. I always demonstrate as a good listener and counselor, by giving emotional support to keep away her fear and anxiety to perform better at practice area. Moreover, I always supported her by offering help to guide URN.

J in problem solving during her learning activity at clinical area. I encouraged her to read books or browse health and nursing related journals through online to obtain knowledge and keep abreast with current standard nursing practice for her professional development. I have been always approachable for URN. J by being open and safe to question. Further, I facilitated an environment conducive for her learning at clinical area. During the orientation tour, I introduced URN. J as newly qualified nurse in the unit.

I requested them to give her full support urine the learning activity in the practice area.I motivated URN. J not to be shy or fear to approach the staff and offer to help perform the TIE suction for their patient. Moreover, the team members’ were co-operative enough to give opportunities to URN.

J as she is in learning phase of her skill development. A learner feels motivated to learn if feel accepted and valued when nursing staff in the learning environment were supportive and caring for their learning and professional development (Elevate-Jones & Lateran,2008). Moreover, URN was also able to communicate and build a good interpersonal relationship with the team members’.This aids me to assign a second mentor, URN. K (Appendix 10), a colleague with the same level of experience as mine for URN. According to Andrews and Roberts (2003), both educators and practitioners have an important function supporting learners’ to learn in the clinical practice area.

Second mentor is to supervise and support URN. J, whenever I am not available in the practice area. This is to avoid URN.

J being neglected during my absence. URN. J was introduced to her second mentor. Furthermore, I gave positive clinical experience for URN. J. I was not judgmental about her skills handling but I always guide her along.I promoted her reflective practice to improve her learning (Appendix 1 1) and skill improvement. Reflection gives better understanding for improvement in different clinical situation (Wong & Lee, 2000).

I also kept a diary on URN. G’s learning progress (Appendix 12). I have been a good role model and provide ongoing support for URN. J to meet our learning partnership purpose. I demonstrated my skills on effective and safe ET suctioning to URN. J during the learning activity.

According to Morton-Cooper and Palmer (2000), a mentor functions as a role model to demonstrate skills for the minute to adapt and reform.Summary of Personal and Professional Development in Internship During my mentoring phase with URN. J, I had the opportunity to share my practice skills and knowledge. I was glad that I facilitated learning and assessment for URN.

J to sharpen her skills in ET suctioning safely and independently. I gave URN. J to fill up an evaluation form to give feedback on my mentoring approach (Appendix 13).

Hence, I found that was able to teach her confidently. Moreover, I had job satisfaction and sense of valued at my practice area, as my nurse manager allows me to guide and train the new nurses. Perceived a sense of increased responsibility in the positive way, to provide the best guidance to minute for her skill development. Besides, mentoring improved my performance in the practice area as my skills and knowledge were kept up to dated. Thus, can facilitate my own professional development in the practice area and be an asset to my organization. Furthermore, by providing guidance, support and other insights to minute, I had the opportunity to develop my leadership skills.

Undoubtedly, in the nearest time, am planning to attend a certified internship course to further enhance my mentoring skills.

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