Reflections of a Clinical Nurse Educator

Currently, I work for as a Clinical Nurse in a Coronary Care Unit. I have always had a strong emphasis on teaching within my role as I love to see fellow staff develop and become more analytical in their approach to Cardiac Nursing.

Within the Cardiac Services there is a strong emphasis on behaviourism and cognitivism approach to teaching and assessing. Every year all employees have set mandatory training to complete which is competency base assessment. Within our unit we have additional, competencies - in fact I would say it is death by competencies and we seem to only get assessments without notice and no teaching or refreshments on skills.

My Nurse Unit Manager and unit facilitator is very much of the opinion that as nurses we are adults, we are responsible for our own training and development and therefore we should be educating ourselves. However, I have never been in a situation where I actually disliked this approach and I feel it has a negative impact on all of the staff.

Majority of nurses within the unit live and revise our skills out of fear. It is parrot fashion learning as we know that unless we repeat certain words within our assessments we will fail. If you are new to the unit and you are not aware of the key words and explain principles in your own way - you will fail, in fact within 2 minutes without explanation (got the t-shirt). Needless to say, there has been alot of complaints over the years due to this type of assessment.

The above situation goes against every principle of teaching and assessing according to what I have learnt over the years and according to my belief system.

As a Clinical Nurse and usually when I am on duty I am the shift co-ordinator of a busy Coronary Care Unit, it is hard to plan education sessions. However, I love stretching staff knowledge when assisting an employee to make a bed by conducting a 5 minute training session. I use a collaborative style approach to learning; as I find out what they know on a certain topic and then together we explore and expand on the content of learning. This type of learning style falls within the constructivism leaning theory as the learner acquires the knowledge through an active learning style. As a senior nurse, I pose leading questions to facilitate learning.

In the past, I have used the traditional teaching styles for educating particularly when I undertook charity work in Sierra Leonne after the war. The availability of electricity was only once a month and the local hospital only used the generator when we performed operations. So it was back to the old blackboard style teaching.

In England, when I was undertaking renal teaching (also Renal qualified), I substituited traditional teaching methods for powerpoint presentations with an emphasis on augmentation to highlight particular key points within the lesssons. These days, I am reflecting upon how digital learning can enhance the clinical environment in the assessment of clinical competencies and how to develop teaching packages to aid facilitation of knowledge by using interactive programms.