Clinical Pedagogy Research Articles

Health science staff and student experiences of teaching and assessing clinical skills using digital tools: a qualitative study

Introduction Once considered a supplement to traditional teaching approaches, digital tools now play a pivotal role in building core clinical competencies. This study aims to explore staff and student experiences of navigating the challenges of teaching and assessing clinical skills using digital technology. It also aims to provide insight into what skills, or aspects of skills, may be best suited to digitally enhanced teaching, thereby advancing the future of health science education. Methods This qualitative study comprises the second phase of data generation for a mixed-methods research project entitled DEPTH (Digitally Enhanced Practical Teaching in Health Science). Health science staff and students expressed interest in taking part in the current study during the first stage of data collection. Qualitative data was collected in January 2022 through semi-structured group interviews and individual semi-structured interviews. An interpretivist qualitative research design underpinned by a critical realist epistemological position was used. Themes were generated following Braun and Clarke’s 6-step process for reflexive thematic analysis. Results Overall, 10 staff and 8 students across 11 health science disciplines participated in this research. Fourteen hours of transcripts were analysed and 4 themes generated. Our findings highlight the suitability of digitally enhanced teaching for low-stake skills requiring visual and auditory training, while skills requiring tactile training require in-person practice to build student competency. Importantly, our findings indicate a desire for increased remote teaching. While our work was not specifically aimed at documenting experiences related to the Covid-19 pandemic, all participants had lived experience teaching or learning during the pandemic and many spoke specifically about this. Conclusions The timing of this paper captures a novel moment in the history of clinical pedagogy. Staff and students advocate for the continued integration of technology into health science education generally, and clinical skills teaching specifically. For this to be successful, judicious selection of methods, skills, skill components and technology, that can be appropriately mapped onto specific learning outcomes, is required.

Lessons learned from clinical course design in the pandemic: Pedagogical implications from a qualitative analysis.

The purpose of this study was to examine clinical pedagogy based on experiences of changes and adaptations to clinical courses that occurred in nursing education during the pandemic. Beyond learning how to manage nursing education during a pandemic or other crisis, we uncover the lessons to be learned for overall improvement of nursing education. Qualitative descriptive analysis using semi-structured interview data with baccalaureate nursing students. Data were collected in the spring of 2021 using semi-structured interview with 15 participants. Transcribed text was analysed using thematic content analysis. The COREQ checklist was used to guide our reporting. Three themes were identified related to course design in clinical courses for nursing students: the role and limitations of simulation, competency evaluations and career implications. Students expressed some concern over not 'finishing hours', loss of in-person clinical experiences and their reduced exposure to different clinical settings. To prepare work-ready nurses, educators need to keep in mind the trends, issues and demands of future healthcare systems. Simulation may have been a temporary measure to achieve clinical competence during the pandemic but needs to be of high-quality and cannot meet all the expected learning outcomes of clinical courses. Exposure to different patients, families and communities will ensure that the future nursing workforce has experience, socialization, competence, and desire to work in various clinical settings. Competency evaluation similarly needs to be robust and objective and consider the role and perception of hours completed. No patient or public contribution. Participants were nursing students.

On the education of the whole person

Against the prevailing outcomes-based education and the instrumentalization of education, a movement has arisen towards holistic education. This aims to go beyond objective measurement of the outcomes of education in order to treat the student as a whole person. In this paper, we shall examine some strands of education in Japan which in some way or another feature the idea of the whole person. This includes the tradition of clinical pedagogy, which originated in Kyoto University, Yukichi Shitahodo’s educational anthropology (Kyoiku-Ningengaku), Kuniyoshi Obara’s Zenjin Education (the education of the whole person) and holistic education. Notwithstanding the fact that such education is benevolent in intention, it can be miseducative in some respects. In the light of this, and with some reference to criticism of the idea of the whole person, we shall point to an alternative vision of education of the whole person following Cavell’s Emersonian moral perfectionism – a perfectionism that is thoroughly anti-foundationalist and that transcends self-entrapment in circulatory discourse on the whole. In critical dialogue between the rich traditions of Japanese thought and the critical voice of liberalism raised from within the West, we hope to find a more nuanced answer to the question of how being a whole might make sense.

A web-based clinical pedagogy program to promote professional development for nurse preceptors: A quasi-experimental study

ObjectiveTo examine the effectiveness of a web-based clinical pedagogy program on nurse preceptors’ clinical teaching competency, self-efficacy, and attitudes toward web-based learning in comparison to face-to-face course. BackgroundPreceptorship is a dynamic educational process that requires designing, and implementing various teaching strategies, evaluation, assessment and feedback. Web-based learning has been recognized as an effective learning approach for nursing professional development. DesignA prospective quasi-experimental approach with two-group pre-test and post-test repeated measures was adopted. MethodsThe web-based clinical pedagogy program was provided to the preceptors in the experimental group, while control group received the face-to-face preceptorship course. Clinical Teaching Competence Inventory (CTCI), Preceptor Self-efficacy Assessment Instrument (PSEQ), and Attitudes toward Web-based Continuing Learning Survey (AWCLS) were used to evaluate preceptors’ learning outcomes. Data were collected at three time points – before, immediately after the learning program, and after 6 months of the clinical teaching experience. ResultsA total of 150 nurses (75 participants/group) were recruited from a tertiary hospital in Singapore from July 2018 to June 2020. The results from the repeated measures analysis of covariance showed that there was a significant interaction effect (group x time) on the overall CTCI score after adjusting for covariate (F = 5.390, p = 0.005). However, there were no significant interaction effect (group x time) on PSEQ (F = 2.693, p = 0.070) and overall AWCLS score (F = 1.341, p = 0.264) between the two groups across the three time points. ConclusionThe web-based clinical pedagogy program produced outcomes comparable to the face-to-face program in terms of preceptors’ clinical teaching competence and self-efficacy. The innovative and cost-effective web-based clinical pedagogy program provided professional development and the flexibility to accommodate preceptors’ busy work schedules. Online learning has become increasingly popular during the COVID-19 pandemic and the web-based clinical pedagogy program was implemented when face-to-face workshop was not feasible.

Perspectives of nurse preceptors on a web-based clinical pedagogy program and clinical teaching: A descriptive qualitative study.

Nurse preceptors are key stakeholders in providing quality clinical education. This study aimed to explore the perspectives of nurse preceptors on a web-based clinical pedagogy program and clinical teaching. A descriptive qualitative design was adopted. The program was made accessible to the nurse preceptors who were assigned nursing students from July 2019 to June 2020. Upon completion of clinical teaching, a total of 19 nurse preceptors participated in four focus group discussions. The discussions were audio recorded and transcribed verbatim, and thematic analysis was conducted. Five themes, with 11 subthemes, emerged: (i) Undergoing the process of self-awareness and development; (ii) Mastering newly acquired skills to refine own teaching approach; (iii) Implementing consistent evaluation and constructive feedback; (iv) Dual roles and responsibilities of preceptor; and (v) Benefits and barriers of the program. This study highlighted the knowledge and skills preceptors gained through the program which gave them newfound confidence and facilitated their clinical teaching and evaluation. As the shift towards online learning progresses, web-based learning can be a useful platform for professional development of nurse preceptors.

Bug-in-Ear Technology as a Clinical Teaching Tool for Au.D. Education: A Pilot Study

Traditional forms of clinical pedagogy include post-observation feedback and side-by-side coaching. The purpose of this pilot study was to evaluate a newer strategy, bug-in-ear technology (BIET), in which clinical supervisors provide live feedback through a discrete earpiece. BIET has the potential to overcome limitations associated with traditional clinical pedagogy. This pilot study compared side-by-side coaching to BIET coaching, using standardized patients in an on-campus audiology clinic. In this study, first-year Au.D. students conducted a case history assessment for two standardized patients. Likert-response ratings and qualitative data from open-set questions indicated BIET coaching was well received by supervisors because it provided a discrete way to deliver quick, live feedback to students. Although supervisor ratings of BIET were slightly more positive than student ratings, comments from both students and supervisors indicated they could see BIET coaching working well in the future, with modifications. Likert-response items indicated student preference for BIET was associated with feelings of confidence and desire to use BIET. More research is needed to examine ways in which BIET coaching can be operationalized to support audiology clinical education.

Development of a Clinical Competency Pedagogy With Senior Nursing Students as Preparation for Transition to Practice

Development of a Clinical Competency Pedagogy With Senior Nursing Students as Preparation for Transition to Practice

Self-Study: Challenges and Tensions in Supervising and Teaching Graduate Teaching Assistants

ABSTRACT This self-study researched my professional development as a teacher educator who was supervising and teaching Graduate Teaching Assistants (GTAs). I chose self-study as my research method primarily because it allowed me to document and study my own pedagogical thoughts and actions in relation to my supervisees, construct my personal practical knowledge out of my experiences and introspection, and have my subsequent actions progressively reflect the newly generated knowledge. The research questions are: (1) In what ways are my assumptions and actions as a supervisor challenged? and (2) How do tensions that arise during my work with GTAs in instructional practices, professionalism, and idea-elicitation contribute to the refinement of my clinical pedagogy? To answer these questions, I reflected on my dual-role experience working with GTAs based on Burns and Badiali’s conceptual framework for clinical pedagogical skills, foregrounded the process and the tensions as I tried to grow as a supervisor, and listened to my own varied voices as interpretative lenses to study my action. I want to share my findings with others who are in similar situations as teacher educators seeking to prepare novice instructors and simultaneously manage frustrations. I also aspire to reach novice teachers who are interested in understanding the clinical faculty’s side of the process. The challenges, tensions, and development in clinical pedagogy examined in this article offer insights on teacher preparation and contribute to the creation of a more productive and collegial experience of teacher education for both supervisors and supervisees.

Clinicalism: an emerging theory in legal pedagogy

ABSTRACT With growing global scholarship on clinical education, a theory in the field of legal pedagogy is emerging. Such a theory identifies clinical concepts, defines clinical education’s roots, goals, nature, values, content, significance, methods, design, planning, procedures, management, assessment, locus in curricula, critiques, challenges and relevance to various legal systems and theories. A theory for clinical education shapes up the entire notion of clinical pedagogy, makes it more plausible and accessible to diverse local situations. This article claims that there is an emerging theory in the field of legal pedagogy, springing from multiple theories, and placing them under one umbrella that can be called ‘clinicalism’. Clinicalism stems from one’s own clinical practice, comparative models, socio-legal studies, anthropology, philosophy, logic, political and legal theories. Clinicalism may also refer to the process of comprehending clinical practices attributable to existing theories; or to the methodology of theorisation by using tools of social sciences.

A Clinical Teaching Blended Learning Program to Enhance Registered Nurse Preceptors' Teaching Competencies: Pretest and Posttest Study.

BackgroundClinical nursing education provides opportunities for students to learn in multiple patient care settings, receive appropriate guidance, and foster the development of clinical competence and professionalism. Nurse preceptors guide students to integrate theory into practice, teach clinical skills, assess clinical competencies, and enhance problem-solving and critical thinking skills. Previous research has indicated that the teaching competencies of nurse preceptors can be transferred to students’ clinical learning to enhance their clinical competencies.ObjectiveThis study aimed to develop a clinical teaching blended learning (CTBL) program with the aid of web-based clinical pedagogy (WCP) and case-based learning for nurse preceptors and to examine the effectiveness of the CTBL program on nurse preceptors’ clinical teaching competencies, self-efficacies, attitudes toward web-based learning, and blended learning outcomes.MethodsA quasi-experimental single-group pretest and posttest design was adopted. A total of 150 nurse preceptors participated in the CTBL program, which was conducted from September 2019 to December 2019. A set of questionnaires, including the clinical teaching competence inventory, preceptor self-efficacy questionnaire, attitudes toward web-based continuing learning survey, and e-learning experience questionnaire, was used to assess the outcomes before and after the CTBL program.ResultsCompared with the baseline, the participants had significantly higher total mean scores and subdomain scores for clinical teaching competence (mean 129.95, SD 16.38; P<.001), self-efficacy (mean 70.40, SD 9.35; P<.001), attitudes toward web-based continuing learning (mean 84.68, SD 14.76; P<.001), and blended learning outcomes (mean 122.13, SD 14.86; P<.001) after the CTBL program.ConclusionsThe CTBL program provides a comprehensive coverage of clinical teaching pedagogy and assessment strategies. The combination of the WCP and case-based approach provides a variety of learning modes to fit into the diverse learning needs of the preceptors. The CTBL program allows the preceptors to receive direct feedback from the facilitators during face-to-face sessions. Preceptors also gave feedback that the web-based workload is manageable. This study provides evidence that the CTBL program increases the clinical teaching competencies and self-efficacies of the preceptors and promotes positive attitudes toward web-based learning and better blended learning outcomes. The health care organization can consider the integration of flexible learning and intellect platforms for preceptorship education.

Global Agendas, Cultural Capital and Self-Assessment of Clinical Legal Education Programs

Modern clinical legal education programs are rich in their diversity and ambition, so much so that it is often difficult to decide if a self-described clinical program meets the description of 'clinic' or is in reality something less than that, seeking to achieve academic acceptance without investing in faculty understanding of clinical pedagogy or the money needed to provide reasonable personnel and physical infrastructure. In most countries, there has been little effort to establish standards for clinical legal education through accreditation bodies. Given the dearth of national direction, most law school deans simply decide to let the description and definition issue remain obscure. They do so for many reasons: because national legal education system bureaucrats imperfectly understand or recognise clinical methods; because students' consistent requests for more experiential legal education are muted and respectful; because traditionally-educated legal academics are wary of bringing practice-related content into their doctrinal classes; because doctrinal content is relatively cheap to teach compared to clinical methods; and finally, because finding a definition for 'clinic' and then acting on it is not required in any international accreditation context and rarely in a national context.

A web-based clinical pedagogy program to enhance registered nurse preceptors' teaching competencies – An innovative process of development and pilot program evaluation

BackgroundRegistered Nurse Preceptors guide students to integrate theory into practice, assess clinical competencies, and enhance problem-solving skills. Researches have indicated that the teaching competencies of nurse preceptors can be transferred to students' clinical learning. ObjectivesThe aims of the study are to develop a web-based clinical pedagogy (WCP) program for Registered Nurse Preceptors and conduct pilot program evaluation. DesignA three-step process was applied to integrate the theoretical framework, evidence from the systematic review, and content validity by the experts and pilot test with the Registered Nurse Preceptors in the content and technical development of the program. The WCP program has unique features including use of dashboard, interactive videos, consultation with experts, discussion forum and backend data analysis. ResultsA committee of six content experts evaluated the comprehensiveness, appropriateness, and relevancy of the program. The item-Content Validity Index (CVI) score ranged from 0.83 to 1.00 and the scale-CVI score was 0.87, which indicated that the WCP program had a strong content validity. Ten nurse preceptors were invited to use the WCP program. Preceptors shared that the website was easy to use and navigate. They commented that the videos in each module are beneficial for nurses to understand the real situation in the clinical setting. This feature also makes the website more interactive. Feedback from preceptors was subsequently used to further refine the program. Discussion and conclusionThe WCP program is an evidence-based program that provides a comprehensive coverage on clinical teaching pedagogy and assessment strategies. The unique web-based technology and interactive features provide a platform for nurse preceptors to discuss clinical encounters with peers and consult experts. The flexible and resource-rich nature of web-based learning encourages nurses to use it for continuing education.

Adrian Evans - Contribution to Clinical Pedagogy and Global Justice

Adrian Evans - Contribution to Clinical Pedagogy and Global Justice

Towards Clinical Sustainability from Evolution to Revolution: A Study of Sustainable Factors for Law Clinics

Clinical legal education (CLE) has grown from country-specific concept to a widely feted global practice with a high degree of momentum and acceptability. There is an increasing profound interest from universities, law schools, law academics and researchers, non-governmental organizations and students alike towards mainstreaming this concept. A growing body of literature designed around different creativities, ideas and methodologies aimed at expanding its scope of operability, values and rationales has sufficed. Nonetheless, there is a little strand of academic literature on the sustainability of CLE in all respects. While the question of whether CLE has come to stay may seem axiomatic, it however depends on certain critical sustainable factors. Thus, it makes sense to consider in what ways law clinics can bring a sustained clinical legal practice. This article takes a forward-looking approach by exploring critical sustainable factors considered as crucial accelerators for wheeling clinical pedagogy in growth motion and driving the effectiveness of law clinics and clinical activities. The study provides a framework for ensuring not only that the rationalistic status quo of CLE is maintained but also offers a futuristic context in fostering clinical movement and activities and ensuring inclusiveness.

Clinical Pedagogy and Pathways of Clinical Pedagogical Practice: A Conceptual Framework for Teaching About Teaching in Clinical Experiences

ABSTRACTAs the field of teacher education evolves to more clinically based educator preparation, understanding how to develop preservice teachers’ professional vision and pedagogy through reflection in and on practice in the clinical context is essential. The purpose of this article is to outline a conceptual framework for clinical pedagogy, or the art and science of teaching about teaching in clinical contexts. This article draws upon prior research of six clinical pedagogical skills (noticing, ignoring, intervening, pointing, unpacking, and processing) among clinical educators and sequences them into seven pathways of clinical pedagogical practice that clinical educators can use to foster preservice teacher learning. The clinical pedagogical skills and pathways of clinical pedagogical practice compose a conceptual framework for clinical pedagogy that has implications for how clinical experiences are resourced, how traditional roles for university supervisors and methods course instructors are reconceptualized, how future scholars of teacher education are prepared, and how future research can use this framework to deepen the knowledge base of clinical pedagogy.

Clinical Pedagogy in Mantaro Kido’s Theory : In Consideration of the Barren of Educational Psychology.

Clinical Pedagogy in Mantaro Kido’s Theory : In Consideration of the Barren of Educational Psychology.

Reforming Legal Education through Clinical Pedagogy: Legal Education in Palestine

This article introduces the modern legal education scene in Palestine, by sharing the experience in setting up and running the clinical programmes of Hebron University. The article pursues a comparative approach by reviewing models of successful clinical programmes in various countries and by shedding light on the existing clinics at Hebron University. It warns, however, that despite achievements, the future of clinical pedagogy in the country remains uncertain. It may take years for clinics to build a solid base within the legal education system. Law schools have yet to develop a clear place for clinics within the curricula. The writer argues that the capacity of clinics to advance legal education, complement the apprenticeship stage, strengthen the legal profession and become a legal aid provider is unbounded. Building a coherent clinical system that is parallel to the systems of professional training, law practice and legal aid will require other reforms.

1980年代の生活指導実践と「臨床教育学」 : 対象関係論の応用と個人指導概念の確立

1980年代の生活指導実践と「臨床教育学」 : 対象関係論の応用と個人指導概念の確立

Clinical nurse leaders' and academics' perspectives in clinical assessment of final-year nursing students: A qualitative study.

The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic-clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences.

Unpacking Clinical Scholarship: Why Clinics Start and How They Last

This article details a qualitative approach in which textual data from a selected batch of 91 papers on clinical legal education were analyzed to identify factors that have been influential in the establishment and sustainability of clinical programmes in different jurisdictions. A systematic approach to literature review was conducted between January 2014 and April 2014 to aid an understanding of clinical legal education in Zimbabwe. Textual data analysis from each article was given a thorough fracturing through the use of grounded theory’s coding system which identified 20 influential factors to consider in the creation and sustainability of clinical programmes. For the purposes of a critical discussion of the reviewed literature, 20 themes were arranged into three main thematic topics: ‘resource’; ‘relational’ and ‘contextual’, where ‘resource’ was selected as a core category around which a storyline was built. The review indicated that there were various positive and negative factors influencing the creation and sustainability of clinical programmes. Enabling factors were most frequently related to positive intervening conditions such as the availability of a healthy financial base upon which a clinical programme was built. Impeding factors were most frequently associated with negative intervening conditions such as resistance to clinical pedagogy. Literature review revealed a wealth of knowledge on key aspects to consider while founding a clinical programme. However, there are still critical knowledge gaps requiring our attention. To fill in the knowledge gaps, this article proposes that empirical research on clinical legal education should be underpinned by a systematic review of literature and grounded theory nexus. In this way, we should be able to systematically generate substantive theories grounded in both textual and empirical data. Such an approach should encourage us to be objective in narrating the benefits of clinical legal education and help us foster more and effective strategies on the creation and sustainability of clinical programmes.