Establishing Effective Working Relationships, Assessment and Accountability - Essay Example

Establishing Effective Working Relationships, Assessment and Accountability. Establishment of effective working relationships, as well as leadership is of particular importance as far as mentorship role is concerned. Establishment of effective working relationships is beneficial because it provides room for families to work together, and also provides care for the family as one of the patient in order to give a satisfactory standard of care. Additionally, establishing an effective working relationship helps in reducing poor student experiences, as well as improving their abilities to assure competence to practices. Leadership in the clinical setting entails role modelling, influencing others, improving care and considering situational leadership particularly when in communication with different parties in all situations1. Practice based learning, on the other hand, helps in providing experience and serves a pivotal role in development of skills among students in interacting with their families and patients2. The students assist in interpersonal, technical, psychomotor and communication skills. Practice based learning gives students an opportunity to link practice and theory while promoting professional identity development. By ensuring that specific standards are dully met alongside the assessment in practice, practice based learning, effectively ensures students are well informed for practice before registration. Because of the vocation nature of the nurses’ jobs, practice based learning serves a crucial role in the professionalism of nursing and it helps in safeguarding the public, as well as in assessment of the clinical competency of the nurses. This study analyses the factors that impact on how students integrate into the practice setting, as well as the assessment and accountability processes in the learning practice. Q-1 level 6 Standard 1. There are five factors that impact on how students integrate into the practice settings. These are orienting the learner to the practice setting, encouraging the patient acceptance of the learner and the role of the practice as a teaching facility, adapting the patient schedule while working with the learner, keeping the flow going, and finding some time to teach the students3. Orientation. The efficient and effective orientation includes the establishment of a system that can orient learners to help assure the teacher that he or she will be able to cover all the relevant points with each learner. Some preceptors tend to use checklist in reminding the learners of the topics that are to be covered while clarifying his or her expectation4. If learners are made to be available throughout, it can help save time in writing out procedures, policies, expectations and responding to questions after the learner reviews the handout. Letting learners note their past experiences reviewed in previous meetings can also be an efficient step in assessing the levels and skills of the students. As an orientation process, the development of 5-8 rotation objectives that can be achieved with the learners can help in focusing the process of teaching during the rotation process. Preceptors that adopt the process do write the rotation objectives down and make sure they are hang in the clinical area to create awareness to other staff of the interest of the learner. Encouraging other staff to take part in the orientation process lightens the workload and helps the staff to feel that they have invested in the education of the learner. Finding some time to dedicate to the learner can at the time be extremely challenging. The detailed orientation of the preceptor should not occur as the first thing in the morning. After the orientation by the staff and some brief introduction, the learner ought to be allowed for leisure orientation at other time of the day. A thorough learner’s orientation set the rotation off to a good start5. This helps familiarise the learners with office systems and the expectation of the person orienting them in an efficient manner and helps in preventing the learner from mistakes. Though, orientation might need some extra time during the start of the rotation the responsibility is shared with the staff. There should be room for flexibility as how and when the orientation process is to be scheduled. Patient Acceptance. Many preceptors are of the view that learners should become part of their practice6. They are much concerned about the way their patients might respond to the presence of the learners. It is said that the majority of patients now seem to enjoy and benefit from the learners’ presence. The patients tend to enjoy the increased “face time” with the provider. Several measures should be put in place to assure the positive reaction, as well as help, prevent the potential problems with the patients. The manner in which patients respond to the teaching advanced to them depends a lot on how the teaching is presented to them. They are likely to appreciate the teacher’s precepting activities if perceived as the indication of accomplishing clinician that is recognized by the medical school for knowledge to be shared with the learners7. The patients are likely to open up to the learner once they are informed in advance that they would be seen by the learner and also if they are able to view their role as being able to help the learner to teach the learner. The patients are, as well likely to be receptive should they get extra time to be observed by the learner. With such precautions taken, many practices find patients interested and readily accepting to help train the learners. Scheduling. Research shows that the presence of learners in any practice tends to increase the workload by about 40 minutes daily8. However, preceptors address the same issue in different ways with some preceptors seeing the same number of patients and having a longer work day other preceptors see fewer numbers of patients and schedule different appointments on working with a learner. This should be dealt with through scheduling of patients, as well as scheduling the learner time. In scheduling patients, preceptors tend to block out various appointment sports on the schedule when working with the learner and this can serve as a teaching time9. More so preceptors at times include sports for walk-in sharp problem visit on their schedule whenever they have a learner. This is more appropriate for the learner and can be handled faster. In scheduling the learner time, the learner needs not to spend every half-day of her rotation seeing patients. Preceptors often share the teaching with other staff in their work place. Learner’s projects contribute immensely to the office. They can help in the provision of follow-up phone calls for the patient, assess the concerns of community health, conduct the activities of the Quality Assurance, and in developing the patient education materials to be used by the preceptors. The trick is always to make sure the learners ‘activities help to accomplish high-priority work and should be of interest to the learner. Key steps of each project should be outlined and the contact people identified. There are various activities the learners take part in. First, he or she is involved in making of the follow-up phone call to the patients that the learner has seen10. Such an activity would help the learner to develop a better rapport with the patient making the patients much willing to be seen by the learners in future. Secondly, the learner takes part in developing patient education materials that should be handed out in the waiting room. The learner should take part in patient education needs. Precepting learners lengthen the workday of clinicians and Preceptors tend to react to such a fact differently with some having longer workdays for months that preceptors are precepting11. Keeping Things Moving. The practice of keeping things moving alongside teaching in a busy practice is a crucial yet an ongoing challenge. Several measures help in preventing one from getting far behind the schedule. The learner needs not to see each patient. One should schedule in advance and also indicate the patient the learner need to see12. This will provide a chance for the selection of the most appropriate patients, as well as fit in time for the learner to take notes and get time and look things up for the learner to see the rest of the patients. At times, preceptors might slow down things through trying to get much teaching. Through the use, of focused teaching techniques like the One Minute Preceptor helps make effective use of the time. The major challenge in precepting is always to set a sustainable pace for seeing the teaching and the patients13. This helps to tell the learner who is in the initial orientation how long he or she is expected to spend with the patient and evaluate the strategies for being efficient in case the need arises. The backup activity for the learner whenever things get behind, and making the learner to understand that the situation rise periodically can help catch up efficiently. Teaching Time. Precepting should be about teaching, though sometimes it becomes difficult to get energy or time to access the formal teaching. In recognizing that there is always a tremendous amount of experiential learning occurring in ones office, it is difficult to optimize the formal teaching that one does. Alongside seeing patients, it can be helpful using the technique designed especially for the outpatient setting in responding to a case that is presented while briefly highlighting one or two things and getting back to the other aspects of the case as time could permit14. Some time when one has a moment for teaching, it becomes difficult recalling pertinent topics. Likewise, the learner should be encouraged to always keep records of questions and issues to be discussed at later times. Finding time for reviewing of the topics discussed is one critical challenge, however, spending some minutes during the day to review the list of patients that are seen gives one an opportunity to review the teaching points that are made during the day. Travelling time to and from the hospital rounds can be a routine time for the feedback and for teaching. While one might get “bogged down” in trying to integrate much of the teaching every day, failure to set aside any time for teaching could lead to adverse outcomes. To a larger extend it can be helpful in proactively setting aside time for teaching each day. Focussing on the brief teaching points alongside observing learner-patient can help in responding to case presentation during the day. The learners should be Encouraged always to seek knowledge from other relevant sources. This will promote the learner’s active learning, as well as relieving the teacher some teaching time15. Q-2 Level 6 Standard 3 Assessment. Assessment is a valuable tool that is used to monitor and record the progress of students over a long or short duration of time16. To start with the long term progress, assessment involves the act of looking back on a student’s performance. This is one feature of summative assessment. Summative assessment is an assessment technique that recognizes an individual’s attainment standards at the end of a teaching period17. It employs a number of methods and tools used to obtain information on whatever a student learnt at the end of a certain period of teaching. In this regard, summative assessment gives information at school, classroom and student levels. Summative assessment involves a clear alignment of curriculum, instruction, and assessment. The assessment used, in this case needs to be reliable and valid. After the clear specification of the objectives and their clear connection to the instruction, this assessment gives out information concerning the achievement of a student on the particular objectives of learning. Summative assessment is provided on a periodic basis so as to determine whatever the learners either knows or do not know. Summative assessment is a large scale and accurate, standardized mode of assessment. However, within care practice, this assessment technique has been criticized because of a number of reasons. First, it gives out information about the performance of a student when it is too late. Secondly, this assessment is disconnected from the real classroom practice. Thirdly, it has an effect of construct underrepresentation implying that a unit assessment cannot have a full representation of the whole content area. This means that, the results of a test in summative assessment are normally used in the way that is inappropriate. Lastly summative assessment lacks the element of accountability18. This is because higher stakes like teacher performance or student retention pay, is linked to performance of the systems of the state, even though this assessment is normally not designed for the purpose, which it serves. Despite this, summative assessment can give out information that is critical concerning the student’s overall performance in learning. This information would act as a proof of the quality of instruction in the classroom thus informing the practice. Summative assessment may involve processes like the end of unit projects19. If the assessment is meant to reflect the objectives of learning, a well-organized end of unit project gives teachers the information about the students in practice learning. This assessment will identify students who did not meet the learning objectives. In addition, it will give out a general indication of instructions of the classroom. The next process is the course grades. When the course grades at the end of a teaching unit rely on specific criteria, it gives out information to the teacher about the student meeting the specific expectations of a particular course. Standardized assessments are the next processes of assessment20. Tests, which reflect accurately, on the performance of the state and standardization on content gives out a proof of the number of students who would be achieving the established expectations of the specific level of grade. In addition, portfolios form part of the processes of summative assessment21. If they are used as a mode of evaluation of the learning of the student, portfolios give out the evidence supporting the learning objectives that are stated in the specific learning practice. However, information from summative assessment can only be useful in evaluation of certain aspects within the process of learning. In relation to the students contribution to care within the multidisciplinary team, summative assessment helped to inform the planning that was done on the learning practice. As part of the practice progress and policy of assessment, each student is expected to the required progress. Using the level descriptors of attainment, this assessment informed the planning about what the students required in order to make further progress. Formative assessment, on the other hand, is a short term assessment that promotes effective learning by the students22. This may be done by producing helpful feedback to students and giving the respective teacher information that enables the teacher to meet the future learning needs of the learners in an effective manner. Formative assessment involves a number of processes like feedback, journaling, and observation. The major requirement for formative assessment that is successful involves using tools of quality assessment. It also involves the use of delivered information from the assessment subsequently to better the instruction. This assessment is characterized by an interactive nature. At the level of a learning practice, for example, instructors gather information concerning the learning of a student, the adjustments in the instruction, and progress in the collection of information. Formative assessment would lead to immense gains in learning if the results of assessment are used in informing the learning and instruction process. Feedback as one of the process of formative assessment involves a teacher providing written or oral response to the student’s work or discussion23. For instance, an instructor may respond orally to questions that are asked by the students in class. A teacher may also provide a comment that is written in a reflective or response journal, and provide feedback concerning the work of students. Another formative process is the (CBM) curriculum based measurement24. This is a set of measures that are standardized and used in the determination of the progress of students and performance. For instance in multidisciplinary team, an occupational therapy, for example, can use activities that are purposeful as a tool of therapy with a patient who has a problem with his mental health. For a social worker, for example, can take a primary perspective in individuals view concerning their family, personal, social-economic, and cultural circumstance, thus propose and pursue interventions in the specific area. In addition to this, observation is another process of formative assessment. In this process, a teacher has a close observation of a student and records the engagement level of a student’s effective behaviour or academic progress25. After this, an implementation plan is made, and a continuous student observation record will be made to facilitate the effectiveness of this process. Self assessment is also a process of formative assessment. In this process, students have a reflection on their progress and monitor their individual progress. In most cases, self assessment could be done together with CBM. This needs to be done in relation to the set behavioural goals, academic objectives and learning contracts. Portfolio is one of the processes of formative assessment. A portfolio that has grown can create a record of the growth of the student’s performance in different areas. For instance, an instructor may use the portfolios of writing to gather the evidences of the progress of students in development of the skills of writing. Putting together the students contribution to care within the multidisciplinary team, the holistic treatment, care and assessment for patients in the learning practice would be realized. This is because formative assessment in a multidisciplinary team leads to benefits of individuals working together. In this case, all the disciplines understand one another and their perspectives, therefore, learning how they could grow within the learning practice. In many cases, not all the team professionals have experiences and skills of a certain level. The interpersonal traits, which each student brings to the team, are crucial. The level of assessment skills and the different interventions, therefore, can go through a development for the certain period of time. However, when an individual in the team fails to believe in team working, remarkably little learning therapies would make the student in this practice be an effective multi-disciplinary member of the team. Despite the fact that the purposes of summative and formative assessment differ, all these two processes need to be ultimately used in a system of assessment, instruction, and curriculum that is integrated26. For effective assessment in a formative and summative, the assessment needs to be integrated with content theories, learning process and instruction. All these processes must be reliable and valid for their use purpose. Establishing Effective Working Relationships is fundamental to achieving the goals of any organization. Orienting the learner to the practice setting, encouraging the patient acceptance of the learner and the role of the practice as a teaching facility, adapting the patient schedule while working with the learner, keeping the flow going, and finding some time to teach the students are the key factors that impact on how students tend to integrate into the practice setting and they constitute an effective working relationship. References. Ainsworth, L, & D Viegut, Common formative assessments, Corwin Press, Thousand Oaks, 2006. Black, P & D Wiliam, Assessment and classroom learning, Jack and sons publishers, New York, 2002. Bloom, S & G Madaus, Formative and summative evaluation of student learning, McGraw-Hill, New York, 2007. Brokebone, B, Assessment of learning, University of California press, Los Angeles, 2007. Chapple, M, ‘Practice learning teams: a partnership approach to supporting students clinical learning’, Nurse Education in Practice, vol. 40, no. 4, 2004, pp. 143–149. Crooks, T, The Validity of Formative Assessments, British Educational Research Association Annual Conference, University of Leeds,2001, retrieved 11th June 2012, Copenhaver, JA, & DJ Sotak, ‘Health profession students as research partners in community-oriented primary care. Journal of Community Health’, 23, 337-346, 2003. Cowie, B, ‘A model of formative assessment in nursing education’. Assessment in Education, vol. 77, no. 6, 2005, pp. 101–116. DaRosa, R, & D Simpson, ‘Ambulatory teaching: Less clinic time, more educationally fulfilling. Academic Medicine’, 72, 358-361, 2000. Ferenchick, GB, & M Dunnington, ‘Strategies for efficient and effective teaching in the ambulatory care setting. Academic Medicine GK’, 72, 277-280, 2006 Goertzen, J, & W Weston, ‘Effective teaching behaviours of rural family medicine preceptors’. Canadian Medical Association Journal, 153, 161-168., 2001. Huhta, A, Diagnostic and Formative Assessment, Blackwell press, Oxford, 2010. Lesh, R, Procedures for formative and Summative assessment, Lawrence Erlbaum publishers, Mahaway, 2000. Irigoyen, M, & HJ Schmidt, ‘A model to structure student learning in ambulatory care settings. Academic Medicine’, 72, 601-606, 2005. Marzano, R, What works in multidisciplinary team care: Translating research into action, ASCD press, Alexandria, VA: 2003. Paden, CM, & A Devera-Sales, ‘Impact of medical student teaching on family physicians use of time, The Journal of Family Practice’, 42, 243-249, 2006. Shepard, L, The Future of Assessment: Shaping Teaching and Learning, Jack and Jill publishers, New York, 2005. Shreve, R, & V S Kaprielian, ‘Independent activities for student learning during community-based rotations’, Family Medicine, 30, 408-409, 2003 Stiggins, A, Classroom assessment for student learning: Doing it right-using it well. Educational Testing Service, Portland, 2006. Waterman, MA, & M Kim, ‘The teaching matrix: A tool for organizing teaching and promoting professional growth. Academic Medicine,’ 71, 1200-1203, 2007. Read More