Caracterización de las políticas educativas hasta la década de 1940

Skills practice may begin in the classroom with an introduction to the skill and a demonstration. Depending on the type of skill, it continues with opportunities for practice either in the classroom or in a simulated practice environment before students perform the skill with patients. What steps do you take before a clinical practice session? What preparations do you feel are most important for giving students a valuable clinical practice experience? Once an appropriate site has been selected, consider all the different aspects of clinical practice as you prepare for the activity—the physical environment, logistics, patient caseload, and the clinic staff. (See the module Manage Clinical Practice.)

Prepare for the clinical practice session by making sure the physical

environment will support your objectives. Consider the following

questions when preparing for clinical practice:

zHas a room been reserved for gathering the students for discussion or small group activities? You will need some space

for meeting with students before and after each clinical experience. If there are times when there are no patients, the meeting room can be used for the students to participate in case studies, role plays, or other small group activities. Arrange for a room or space before the clinical practice session.

zAre the essential drugs, supplies, and equipment available?

Each clinical session has its own required supplies. For example, for IMCI, the essential IMCI drugs and supplies must be available for learning to treat the sick child. For many topics related to reproductive and maternal health, certain equipment and supplies must be available for clinical practice sessions. Coordinate with the chosen clinical practice site to ensure that the necessary supplies are available. Clinical facilities must have enough instruments and supplies to provide services to patients on an ongoing basis. It may be necessary to supplement the clinic’s basic supplies of consumable items (e.g., gloves) or to provide additional instruments needed for the procedure to be taught. If all of the supplies you need are not available, you may have to ask students to bring some of them. Plan for and obtain necessary supplies before the clinical practice session.

Another important aspect of preparing the clinical practice environment is managing logistics. Consider the following as you prepare:

zIs practice scheduled at a time when patients are available and that is convenient for clinical staff? You should schedule

practice at times when students will have enough exposure to patients but not interfere with regular service provision. Also, consider what time of day will provide students with the most appropriate patients for the related clinical experience.

zWith whom do you need to coordinate clinical practice? Who in

administration, the clinic, or floor management needs to assist you in making arrangements for and conducting clinical practice? Arrange times with site administration and the head of the related floor or area for the clinical visit. If there are assigned clinical preceptors, coordinate with them to be sure that they will be available to work with students on the chosen day.

Consider what preparations are needed for adequate and appropriate

patient flow for clinical practice sessions. The patient caseload has

already been considered during selection of the clinical site, so preparations involve ensuring appropriate patient caseload and flow for each clinical practice session. Consider the following as you prepare:

zIs there adequate patient caseload? Will the number of patients

be sufficient to provide all students enough learning opportunities on the clinic day? Will students need to be sent to several sites or rotated through the existing site?

zWill you need to schedule patients? Certain skills (Norplant

implants and IUD insertion, antenatal and postpartum exams, feeding assessment, breastfeeding counseling) may require scheduling patients to ensure a sufficient caseload. Coordinate with the staff to arrange for a sufficient number of appropriate patients for the clinical practice visit.

zAre there appropriate types of patients? The type of patients is

just as important as the number of patients. If patients who request certain procedures or who have specified health problems are needed, arrange with clinic staff to schedule appointments or help select appropriate patients from the wards.

There may be times of either low patient flow or inactivity during clinical practice sessions. Prepare other activities or exercises for the students to work on in case they have time with nothing else to do. Completing related case studies, observing procedures, and doing other small group exercises may provide learning experiences when the clinic is not busy.

Perhaps the most important aspect of preparation is selecting and preparing the clinical staff who will assist with clinical practice sessions. Their assistance ranges from supervising clinical practice as clinical instructors on-site, to working alongside students demonstrating procedures and assisting, supervising, and providing feedback to students as they work with patients. Selecting and preparing clinical instructors and staff are essential to creating an effective clinical practice environment. This subject is discussed in detail in Manage Clinical Practice.

SUMMARY

You should prepare for both classroom and clinical teaching by remembering that classroom and clinical experiences build on each

other, from the introduction of theory, explanation and demonstration of skills, practice of skills in a safe environment, and finally to practice with patients. Prepare the classroom environment by ensuring that students are able to see demonstrations and any presentations involving visual aids and complete any assigned group learning activities. Prepare any homework or classroom learning activities for your class. Create a simulated environment for demonstration and opportunities for small group activities and practice with feedback. Select and prepare the clinical environment by ensuring adequate supplies for the related skills, adequate and appropriate patient caseload and flow, and informed clinical instructors. Refer to the diagram below illustrating the process of learning from the classroom to the clinic.

Figure 4-2. The Process of Learning

Introduce theory and provide opportunities to develop understanding through activities such as work in small groups and demonstrations

Provide opportunities to apply new knowledge and develop skills through practice in a simulated environment with feedback

Apply new knowledge and skills under supervision with patients