Enhancing the effectiveness of the teaching and learning of core clinical skills

Over the last decade there has been great deal of debate about pre-registration nursing students' lack of confidence and ability, in performing core clinical skills in the UK [P. Elliott, Locality based teaching, Senior Nurse 13 (2) (1993) 35-39; S. Jowett, I. Walton, S. Payne, Challenges and Change in Nurse Education - A Study of the Implementation of Project 2000 Slough: NFER, 1994; P. Hilton, Clinical Skills Laboratories: teaching practical skills, Nursing Standard 10 (37) (1996) 44-47; , Integrating theory and practice: Professional Letter from the Chief Nursing Officer for England London; , Making a difference. Strengthening the nursing, midwifery and health visiting contribution to health and health care, London.]. A variety of solutions have been suggested in attempting to address these perceived deficits. One such initiative within the University of Sheffield was the introduction of the Clinical Demonstrator role, whereby clinicians were seconded to the School of Nursing for a fixed period of time to provide additional support to neophyte students in the classroom, laboratory and clinical settings. An action research approach was adopted where ongoing evaluation influenced further developments [W. Carr, S. Kemmis, Becoming Critical: Education Knowledge and Action Research, Falmer Press, London, 1986]. Formal and informal evaluation was therefore undertaken throughout and this influenced the evolution of the role. The methods used included; questionnaires; reflective diaries; focus group interviews; and ongoing dialogue with lecturers, students, demonstrators, clinicians and trust representatives. Since the start of this 5 year project there have been 25 Demonstrators in post who have in total supported 10 pre-registration nursing student cohorts undertaking the Common Foundation Programme (N=1496). As the study progressed they also provided support to more senior Adult Branch students undertaking the final year of the course (N=76). The outcomes have been exceptionally positive, though a number of lessons have been learnt along the way. This paper outlines this innovative project and shares a number of broad conclusions that can be drawn from the study.