Clinical Coach Standardisation
Meeting
August 2011
Aims
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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
Professional
Business
• Animal care and welfare
• First Aid
• Preparation &
administration of
medication
• Diagnostic procedures
• Clinical Care
Procedures
• Equipment prep &
maintenance
Communication
Team Working
Teaching
Conduct
Staff Management
Stock Control
Reception Duties
Payments
Estimates
Health & Safety
How do we learn?
Kolb’s Experiential Learning Cycle
Concrete Experience
(Doing)
Active
Experimentation
(Putting into practice
what has been
learned)
Reflective
Observation
Abstract
Conceptualisation
(Learning from
experience)
Blooms Taxonomy
• Imitation
• Manipulation
Psychomotor
• Precision
(Practical
Skills)
• Articulation
• Naturalisation
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
What Concepts can be used to guide
our teaching?
Behavioural
Therapy
• Activity aids learning
• Repetition and practice aids learning
• Small steps aid learning
• Reinforcement aids learning
Cognitive Theory
• 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
Humanisation
and Adult
Learning Theory
• Learning is a natural process
• Motivation, purposes and goals are important
• Choice, relevance and responsibility aid learning
• Anxiety and emotion affect learning
Teaching a skill
• Stage 1
Demonstration of skill at normal speed with little/no
explanation.
Stage 2
Repetition 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
Workbased
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
Does
NPL
Shows How
(College & Practice)
Practical exams
Knows 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?