Before we begin a tour of some resources that can help all of us in clinical education – including faculty and students — let’s consider a scenario:
It is the second day of this clinical rotation and you are on a surgical unit that you have never been on before. You don’t know any of the staff and in spite of doing a couple of shadow shifts before starting, you are still feeling pretty unsure of where things are and how things work.
It’s only 0930 in the morning and 3 out of your 8 students have already cried. One has been tucked into a private space on the unit by a compassionate buddy nurse after a patient with Borderline Personality Disorder was verbally abusive. A second is crying silently while trying to get ready to do a dressing change with you on her patient who is septic. You have no idea what this is all about. You have just finished doing an assessment with another student who burst into tears after leaving the patient’s room because she ‘forgot so many things, am I going to fail?’. You approach a 4th student to give a IV medication with before the dressing change and you find her at the computer reading the drug monograph and yes, wiping the tears from her eyes.
What is happening here!? You are finding the strain of all of this is definitely interfering in your own ability to adapt to the new clinical area. How can these students possibly be learning anything! What can you do?
We are so fortunate to be able to be educators in a clinical practice area. Much developmental research has shown that learning takes place when personal experience allows an individual to work with the concepts that they have been exposed to. According to this Dynamic Skill Theory of learning, skills can only develop when real life tasks are performed (Schwartz & Fischer, 2006). This ‘activity based learning’ process is not linear, predictable or easy and requires constant support while learners build and rebuild their cognitive skills. The physical and emotional environment in which this learning takes place can either help or hinder the process (Schwartz & Fischer, 2006).
The Clinical Learning Experience (CLE) is where this real learning can take place.