The Role of the Clinical
Skills Laboratory in
Preparing Students for the
Real World of Practice
Catherine E. Houghton
October 2007
Supervisor: Dr. Dympna Casey
Aim of the Presentation
 Exploration of previous research
 Aim of the research in progress
 Interpretivism
 Case study design
 Challenges
Changes in Nurse Education
 emphasis on theory/decreased
emphasis in skills learning
 In clinical setting:



More rapid patient turnover
Increased high dependency patients
Shortage of qualified practitioners
 “physical structure” supporting the
new “academic structure”
How does the CSL facilitate this
statement?
During the course of their education,
students are expected to acquire
knowledge, incorporate critical
thinking and psychomotor skills,
develop self-confidence in their
abilities, and then transfer this
knowledge to the clinical setting
(Childs and Sepples, 2006)
The Function of the CSL
 Simulated Learning



Simulated Models
Standardised Patients
Computer-based Simulation
 Audio Visual Recording
 Skills assessment (i.e. OSCE)
Simulated Models
 Low-fidelity
 Moderate fidelity
 High Fidelity
Standardised Patients
 Coached to present a patient
problem accurately
 Increased levels of judgement,
performance and communication skills
 Same outcome as real patients
 ? Reliability of SP feedback
Computer based Simulation
 Higher Satisfaction and self-efficacy
 ? Improve ability to demonstrate skill
 Penfield Virtual Hospital
 Authentic World
Audio-Visual Recording
 Benefits
 Immediate
Analysis and Feedback
 Recognise own mistakes
 Distracting, anxiety, behaviour
modification
OSCE (Objective Structured
Clinical Examination)
 Positive
 Feedback and reflection
 Motivation to learn
 Dependent on assessors’ subjectivity
 Cause of Anxiety
Benefits of CSL Teaching
 Gain confidence
 Motivation to learn
 Student Satisfaction
 Safe environment to practice skills
 Patient Safety
 Communication Skills
 Interprofessional Learning
 Improvement on traditional methods
Disadvantages of CSL Teaching
 Student Anxiety
 Comparison with reality of clinical
setting
Needs context
 ? Learning opportunities in clinical area
 ? Learn non-evidence based methods

Methodological Issues
Qualitative Quantitative Triangulation Total
Nursing Research
9
18
1
28
Medical Research
1
15
1
17
Medical & Nursing
Research
1
1
1
3
Other Health
Professionals
0
2
0
2
Total
11
25
3
50
Methodological Issues
 Criticism of the primarily positivist
approach
 ? use of OSCE to determine the
effectiveness of CSL teaching
 Level of education
Research Aims




To analyse the teaching strategies used in Irish
Clinical Skills Laboratories
To investigate the factors which influence how
student nurses use their learned skills in the
practice setting.
To examine student nurses’ perceptions of the
methods used to teach clinical skills in the
laboratory.
To explore qualified clinical and CSL staff’s
perceptions of undergraduate clinical skills
teaching.
Research Process
Phase 1
Visit all the 13 Nursing Centres
Criteria for Selection of 4 Sites
Gain Access
Phase 2
Pilot phase
Phase 3
Data Collection
observation, interviews, documentary sources
Phase 4
Cross-case/Within Case Analysis
Interpretivist Paradigm
 Nature of the world as it exists
 Subjectivity
 Multiple realities
 Emic and Etic perspective
Multiple Case Study Research
 Natural context
 Exploratory
 Emic
 Embedded
Perspective
 Instrumental
 Flexibility
 Multiple
Challenges
Gaining Access
Ethical Issues
Semesters/Timetables
Thank You
Catherine Houghton
catherine.houghton@nuigalway.ie
Department of Nursing and Midwifery Studies
Aras Moyola
NUI Galway
Ireland