Practice Experience in Multi-Level and/or Complex Care
Suggested Learning Strategies
The following learning strategies can be applied within a variety of contexts, depending on the parameters of the clinical placement and the preferences of the instructor.
Strategies that Focus on Caring
1. Gathering Information About a Client
Early in the clinical placement, ask students to gather information about a client for whom they are providing care. Potential sources of information include the client, family, friends, staff, the chart, and other client-specific documents. Ask students to describe what they learned about the client and how the information has influenced how they provide care to them (Learning Outcomes #1, #2, #3, #4, #6, and #7).
2. Person-Centred Goals
Have the students write person-centred goals for the care of their client(s). This will help them become more focused on the client(s), ensuring their best care, rather than placing focus on other areas (e.g., their time schedule).
Strategies that Focus on Critical Thinking, Problem-Solving, and Decision-Making
1. Pre- and/or Post-Conference Sessions
Have students gather with the clinical instructor topics and issues to discuss related to their clinical placement.
Topics to support pre- or post-conference discussions or journal writing are outlined below.
- Describe a situation when you provided person-centred care to one of your clients.
- Describe a situation where you applied a holistic approach to client care.
- Reflect on your cultural competence and whether you feel prepared to provide adequate care.
- Describe a communication challenge that you experienced this week and how you responded. Discuss an alternative approach you could have taken to effectively address the situation.
- Has there been a time during this placement that you felt out of your depth or overwhelmed? How did you manage it? What did you learn from it?
- Describe a communication challenge that you experienced with a staff member. How did you handle it?
- Describe how you organize your day and prioritize care.
- Describe a situation where your organization and time management went well.
- Describe how you are using resources (e.g., textbook, nurse, instructor) to inform your practice.
- Describe a situation where you used creativity when you did not have the supplies you required.
- Use Gibbs’ Reflective Cycle to analyze a situation that you encountered during clinical:
- Description: What happened?
- Feelings: What did you think and feel about it?
- Evaluation: What were the positive and negative aspects?
- Analysis: What sense can you make of it?
- Conclusion: What else could you have done?
- Action Plan: What will you do next time?
2. Communication Challenges
Ask students to identify a scenario where they faced a challenge related to communication with a client, family member, or staff member. Have the students use the problem-solving/decision-making process to analyze the problem, identify what they learned through the situation, and describe how it has impacted their approach to future communication in this context (Learning Outcomes #2, #6, and #8).
3. Observation in Person-Centred Care
Invite students to use their clinical practice to learn the importance of observation to person-centred care. Students, working individually or in small groups, will choose a client experiencing cognitive challenges and observe this individual closely for at least two days, being particularly aware of the person’s behaviours and what aspects of the environment and of the client’s needs seem to be related to the behaviours. Students are also encouraged to talk with other members of the health care team who know this client and, if possible, research the client’s background.
Students will review the information and discuss what environmental factors seem to be contributing to the client’s behaviours, both positively and negatively. This should include the social environment as well (e.g., the actions of staff and other residents). Students should also observe for unmet needs of the client which may be causing responsive behaviours.
This information can be brought back to post-conference for wider discussion of possible causes of responsive behaviours and determination of how the information might help to guide caregiving practices.
Strategies that Focus on Professional Approaches to Practice
1. Orientation Activities
Provide orientation activities where students become familiarized with the clinical setting and routines, staff, and the clients. As an orientation activity, invite students to engage in a “search and find activity” for important items and information at the clinical site. Include a list of staff members for students to meet and introduce themselves to.
2. Learning from Other Professionals
Invite members of the team at the clinical site to talk with students about their role or profession. As part of these sessions, have the team member and students identify how the role of the HCA interacts with the specific discipline and how the two parties can work most effectively together (Learning Outcomes #5 and #9).
3. Synthesizing Learning
Provide reflective learning activities where students record observations, challenges, and other information. This will help students to synthesize their learning.
4. Additional Skills Assessment
Assist students to obtain the HCA job description for their practice education site and to assess what, if any, additional skills they would need to acquire to be employable in that setting (Learning Outcome #8).
Suggested Course Assessments
The course learning outcomes may be assessed by the following tasks:
- A skills checklist, completed by instructors when observing skills practised by the student for the first time in the clinical setting, will be useful for verifying the proficiency and safety of students to perform these skills without direct supervision (Learning Outcome #7). Refer to Section 5: Sample Evaluation Tools.
- A mid-term evaluation, completed by the instructor and the student, will be helpful to evaluate a student’s progress towards meeting the program learning outcomes, as well as identifying areas for improvement prior to the final evaluation (Learning Outcomes #1 to #9).
- A final evaluation assessing whether students have met (or not met) the program learning outcomes will assist the instructor to determine whether or not students have the required skills to progress to the next practice education experience (Learning Outcomes #1 to #9). Refer to Section 5: Sample Evaluation Tools.
- A reflective journal will help students to process information from their clinical experience and relate it to the program learning outcomes. Students should complete entries on a regular schedule throughout the placement. Thought-provoking questions can be provided to help students (e.g., asking students to reflect on professionalism – their own and what they have observed in others, their “aha” moments, etc.).
- For a self-evaluation tool, ask students to consider the learning outcomes for the practice education placement and whether they have met (or not met) them or are still progressing to meet them. Have them record situations to illustrate how they met each outcome and put forward ideas on how they could meet any that have not yet been met. The self-evaluation tool can be reviewed and discussed with students at the mid-term and final evaluation as a method of ensuring all learning outcomes have been or will be demonstrated by the end of the practice education placement period (Learning Outcomes #1 to #9).
- A professional behaviour development rubric can be completed by the course instructor to assess the student’s ability to behave in a manner that supports their success in the workplace (Learning Outcomes #1, #2, #5, #6, #8, and #9). Refer to Section 5: Sample Evaluation Tools.
Resources for Practice Experience
B.C. Academic Health Council. (n.d.). B.C. preceptor development initiative: Supporting health preceptors in practice, modules 1–8. http://www.practiceeducation.ca/modules.html
B.C. Care Aide and Community Health Worker Registry. (2014). B.C. health care assistants core competency profile. https://www.cachwr.bc.ca/getattachment/About-the-Registry/Resources/HCA-Core-Competency-Profile_March2014-(2).pdf.aspx
Gibbs, G. (2013). Learning by doing: A guide to teaching and learning methods. Oxford Brooks University. https://thoughtsmostlyaboutlearning.files.wordpress.com/2015/12/learning-by-doing-graham-gibbs.pdf
Hampe, Narelle. (2013). Reflective practice and writing: A guide to getting started. Australian Library and Information Association. https://www.betterevaluation.org/en/resources/guide/reflective_practice_and_writing
Melrose, S. Park, C. & Perry, B. (2015). Creative clinical teaching in the health professions. Athabasca University. http://solr.bccampus.ca:8001/bcc/file/c6d0e9bd-ba6b-4548-82d6-afbd0f166b65/1/CREATIVE-CLINICAL-TEACHING-IN-THE-HEALTH-PROFESSIONS.pdf
Phaneuf, M. (n.d.). Learning and teaching in clinical settings. http://www.prendresoin.org/wp-content/uploads/2014/05/LEARNING-AND-TEACHING-IN-CLINICAL-SETTINGS.pdf
Practice Education Guidelines for B.C. (2021). https://hspcanada.net/pegs/
- Gibbs’ Reflective Cycle. (1988). Retrieved from https://www.brightknowledge.org/knowledge-bank/medicine- and-healthcare/spotlight-on-medicine/what-is-reflective-practice ↵