First of all, how is it already week 5?! Anyways..
I am amazed that anyone that knows anything about clinical teaching and student requirements could ever say ‘clinical instructor’ and ‘supervisor’ are synonyms. I strongly disagree that clinical teaching is supervision. Yes, supervision of students by clinical instructors is legally required, and students are practicing under the instructors’ licenses. However, clinical teaching is much more.
Clinical teaching provides a new learning opportunity and environment each day. As students see different patients, new challenges and concerns present themselves. Clinical instructors are there to help students develop the best plan of action for each patient, and guide them along the way. From the dissertation report “Students’ Perception of Important Teaching Behaviors in Classroom and Clinical Environments of a Community College Nursing and Dental Hygiene Education Program”, the researcher concluded that students ‘valued instructors that created a safe environment for trial and error’. Students want to be challenged and encouraged to engage in critical thinking, but also want to know they are able to make mistakes. Instructors act as mentors in this sense, and give students an outlet to come to with questions without fear of judgement.
Clinical instructors also bring the ‘real-life’ aspect into the clinic and teaching setting. These instructors have been in private practice, working directly with patients, which is still new to students. Instructors have learned more effective techniques and have tips to help students be more successful. I will never forget when an instructor told me to use the 204S on the lower anteriors. I could not help but think this was wrong, because that is not what the book says. In reality, it was much more effective than any other instrument I was trying to use in the area. That day changed my life as a hygienist, and my love for the 204S began.
The cognitive domain is all about acquisition of knowledge and learning. It relies on the thought process to recall information. In the clinical setting, it is important to draw on what students already know and the facts they have learned. We need to draw in didactic course material, and help students apply it to clinical practice. For example, students look at radiographs in the classroom and learn what decay looks like on an x-ray and such. When they take radiographs on their patients, it is important for instructors to review the x-rays with the students and help interpret them, rather than just grading them and sending the student on in their appointment. Instructors can draw on the fact that students know decay appears as radiolucent triangles, and can ask the student if they see any decay. The same principles go for evaluating bone health, which they learn in their perio courses.
The affective domain deals with feelings and emotions. In a dental hygiene program, students are under a large amount of stress, and we know they are balancing other issues with their school work. As instructors, we can take these kinds of things into consideration to help the students be successful. In a didactic setting, instructors can be flexible with assignment due dates or such. If students already have 2 midterms on one day, instructors are often understanding of the stress level and studying required, and offer to move their due dates. In a clinical sense, instructors can also take this into consideration. As a student, I had a very rough day in clinic and had missed many areas of tarter at my final check. I knew I performed poorly. Instead of just giving me a bad grade and moving on, the instructor took the time to figure out what was going on. She knew that kind of performance was not typical of me, and knew something else was going on. She talked to me and gave me some advice, and told me she knew I was better than that and would be fine in the future. I really appreciated this from her. No, she did not feel bad for me and grade leniently. She did her job as an instructor, but also embraced her role as a mentor.
The psychomotor domain involves the development of motor skills from simplistic to expert and mastery level. In dental hygiene, the skill aspect of the profession is extremely important. Without strong movement skills, a hygienist can not properly perform their tasks. When reading the article about teaching psychomotor skills, I really liked the whole-part-whole teaching. I did not know the name of it or that it was a teaching technique, but I have seen it done before. It makes a lot of sense. Students get an overview first, then an explanation, then a chance to see the different steps combine to an effective movement. For example, students are taught how to assemble a syringe. As instructors, we can show how to assemble with some discussion, then break it down and point out specific actions like aspirating, then show it again. CIE chapter 10 also discusses many effective techniques for clinical instruction, such as demonstration, questioning, and listening. As clinical instructors, it is our job to properly demonstrate how to talk to patients, positive attitudes, and clinical skills. We also want to encourage students to ask questions, but also ask them questions. Listening is also an important aspect of clinical teaching. Students will say things quickly, and we will have multiple students at once. We need to keep track of the different patients and what is going on in each appointment.
In the article “Students’ Perceptions of Effective Classroom and Clinical Teaching in Dental and Dental Hygiene Education”, the authors found that students want instructors to have individual rapport. They want instructors to make them feel welcome and be accessible outside of the classroom. They also want instructors to be organized and prepared. It also states that, “Given these context-specific dynamics, rapport as defined by creating an open and trusting learning environment, highlighting tone-setting, facilitating, and role modeling were viewed as critical responsibilities for effective clinical teaching.” I strongly agree with these findings. I want an instructor that is approachable, but also knowledgeable. It is important to have a strong skill set and mental sharpness, but not be too intimidating. I thought many of the dental instructors had the intimidating factor when I was in school. I want instructors to foster a learning environment where I feel I can be open with questions, have a good vibe, and a role model instructor.
As you said, clinic is probably the most stressful time of a dental hygiene student’s day; however, it can also be one of the most rewarding periods of the day! There are countless situations that I can think of where I was stressed out and was barely able to handle it when an instructor motivated me to push through it. As clinical instructors, we need to build relationships with our students, understand where they are coming from, and establish trust, so students are comfortable coming to us for questions and for motivation. Having a friendly face that is both knowledgeable and caring that students can go to at any time is invaluable in their clinical rotation experiences. As you said, clinical instructors are so much more than supervisors! Moreover, students did not once mention fantastic supervision skills as something they valued in an effective clinical instructor. Rather, they placed the most importance upon the relationships they formed with their instructors. Clearly, as future instructors, we need to keep this in mind. We will be very busy working with multiple students at a time, but we must make time to build meaningful relationships with each student we work with.
Lauren,
Having an approachable and thoughtful yet firm instructor is a balance that I feel all clinical instructors need to find. I too remember some of my clinical instructors being so unapproachable and by the book that clinic days were difficult, exhausting and stressful. I love that you mention how an instructor showed an additional use of the s204s. While textbook it is a posterior instrument, it often times is the perfect anterior instrument in adjusting to a patient mouth to remove calculus. Its great to be able to rely on our clinical instructors for guidance, support and mentorship. Furthermore, it is important for an instructor to notice when a student may be struggling. For example, a couple weeks ago a student signed up for a scale check for quadrant one. The patient she was seeing was classified as a “D” patient which in our clinic is considered the most difficult calculus classification. I sat down to check the areas with the 11/12 explorer and was “clicking” just about everywhere. I had the student sit back down and feel what I was feeling with the explorer to make sure we were both on the same page. She agreed that she wasn’t going subgingival enough. This was her first difficult patient she had ever scaled and instead of failing her, I had her take radiographs and then go back to the areas. I let her know that we would basically wipe the slate clean this time. She was very appreciative. At the end of clinic she had completed the quadrant only missing two areas. She stated that she was not prepared for that and really had no idea what to expect or the effort it took to scale calculus some days. I reassured her that it wasn’t her fault but that each patient will present with different levels of difficulty. Being able to recognize when a student may need a second chance when it’s the first time something is seen, is important to me and it’s how I learned best as a student. With that being said, instructors cannot let students abuse the “second chances”.
Lauren,
I love how you mention the 204s and using it for the lower anteriors. This is one of the best pieces of advice I received from a clinical instructor. I recently asked my boss if we could order the 204s because we didn’t have any in the office. Its definitely a life saver when trying to remove calculus from the lower anterior teeth, even on kids. I’ve learned in the profession of dental hygiene, you have to find the things that work best for you, even if it does go against what the book says. I also agree, as clinical instructors we must be approachable and be able to build those lasting relationships with our students and we shouldn’t have an intimidating demeanor. I remember one instructor when I was in hygiene school, she was very intimidating and I tried my best to avoid her in clinic. I can’t remember her name, which is perfect for this example lol. There is an instructor I will never forget though, her name was Mrs. McClure. She was very approachable and always had a warm, welcoming spirit. She was also very encouraging during those stressful times I know we’ve all experienced in dental hygiene school. When thinking about a future career as a dental hygiene instructor, she always comes to mind as the perfect example of a good instructor.