Post Conference Discussion
Joy N. Adeola
Graduate School, Department of Nursing
The Ohio State University
While teaching a topic of interest excites me, I never thought I could be a teacher when I was growing up. My new position has stirred up my interest in teaching and passing on my nursing skill. Teaching has not only allowed me the opportunity to “give back” but has also helped to sharpen my understanding of nursing practice, and of new technology in nursing. Teaching has certainly become very exciting and rewarding to me. This paper will attempt to discuss the usual post conference feedback I have with my staff and students. The paper will also discuss steps that I have taken to improve my teaching in the wake of my own reflections and the reflections of others.
This will be accomplished through the reflection of my teaching experiences. Some of the experiences that will be mentioned in this paper include both my clinical nurse practice and nurse management. My nursing experiences span the length of over thirty years. Starting from student nurse, I have worked in all levels and in almost all departments of nursing in some capacity. And these experiences are beginning to be expressed and communicated to others that might benefit. For me now, the ultimate, is teaching all those to both new graduate and experience nurses. I am so fortunate to have arrived at the right position at the right time! And am dedicated to do my very best!!
Usually before I teach any class, clinical or class room, I do a shot pre-conference in form of class introduction where I, as a teacher, will introduce myself after which the students will also introduce themselves. The introduction is often followed by the overview and the expectations of the class. In addition to these and especially since I teach simulated classes, the students are always informed of my intention to debrief (post Conference) after each class.
The post conference feedback has helped me in particular to improve on my teaching skills. For example, the post conference reflection carried out after my very first teaching shows that my back was turn on the students throughout the lecture time. While I was surprised to hear this, I am thankful for the opportunity to improve on my postures in classrooms.
I believe that post conference discussion time is one of the most valuable time of teaching for both students and the instructor. I have developed the habit of having using the last ten minutes of the class time to ask questions about the past lecture I just gave. And the students’ thoughts about the class. My students also agree that this question time is very valuable to them as it helps both parties to clear some misconceptions and allows for relaxed participation from everyone. My post conference discussion is often planned to allow for relaxed atmosphere for discussion. So, for every class I teach, I plan for the post discussion time. I realized that it is better done and less stressful if it is planned. I put that time in my calendar and invite students, it is like another class, students have voiced their appreciation of these times.
How do I go about it?
During clinicals/class instructions, I collect data as I teach by observation especially. I watch how the students interact during class/clinicals; I make notes for myself for later discussions, I jot things like expressions on their faces, and some critical questions they ask, if possible, I try to explain the questions. During post conference discussion, I now examine the data I collected during class/clinicals, this is an excellent opportunity to examine students’ understanding of the subject matter. I focus my questioning of the students during this time on their understanding of the material taught in class/clinical to measure students’ progress and their understanding. For example, I taught simulated Barcode Medication Administration(BCMA), using a Voice Activated Mannequin(VAM), the students were sent to practice on the unit with a real patient, I later discovered that one student was not confident in completing the BCMA, when I asked why at the post conference, she confided that she had been reprimanded in the past for administering a wrong narcotic.
What I did to correct?
I reassured her, I knew her problem was fear of failure, not incompetence. I peered her with another experienced staff on the unit and asked the Charge Nurse to keep an eye on her. I also notified her Nurse Manager(NM) of her need to gain confidence. I followed up with her via email and visiting the unit periodically to see how she is doing. And followed up with her NM. Today, three months later, she is an expert, and even, precepts other new staff members!
After that incident, I had always made sure students/staff are comfortable completing the BCMA and other skills on their own before sending them to the unit, if they require extra help, and their orientation time is up, I hand them over to the NM, letting he/she know of students’ needs. And follow up with students after wards to ensure complete weaning off.
I use simulated teaching in almost every class I teach. I especially use it to teach BLS and ACLS classes, and during code blue classes. My NEO class is solely by simulation, we already have a teaching packet for NEO competency check. Every new staff competency is checked using simulated technology. For example, assessing the staff skills on G-Tube feeding in one of the classes, I noticed she did not check for residual before feeding a bolus, I was able to correct immediately because we were it was simulated, safe from embarrassment and patient harm. During debriefing, I emphasized the need to check for residual, and the part it could play against the facility in the presence of regulatory bodies like the Joint commission and Accreditation. Students and staff have voiced their appreciation on using simulated teaching in our facility, they said it prepared them for the clinical experience in an unknown world(unit). That knowing how to perform skills as it is done in the facility gave them an edge over the usual fear and anxiety of being the new nurse.
Since nursing education is both theoretical and practical, students are assessed based on clinical competencies as well as their behaviors to everyone and especially to the patients. For example, during one of the clinical rounds, one of my students unconsciously showed a disgusting face when we were passing by a patient who had defecated on self and is being cleaned up. During our brief discussion on our way out of the unit, I encourage the student that patients are very sensitive to how nurses carry out their duties and that nurses’ countenance makes a big difference in the treatment of the patients and sometime works better than medicine. The students did not buy that. I encouraged the students to be considerate and do not really show how disgusting.
I also list personal things about students on my list during class time, and ask that student if okay to discuss in the presence of other students, or not, if not okay, I will speak with her in private. For one student, she was dressed inappropriately to class. Am a policy fan by the book. I called her aside and told her she need to go and change her dressing and that she will be charged leave without pay for being out. Why? We had just discussed the facility Dress code policy the week before, and I emphasized that hair color and exposed tattooed skin. I also told her the consequence if she does not come back to class in an hour. The situation was corrected in thirty minutes, she went to the canteen shop and bought new clothes, covered her tattoo and cut her nails. She came back to class smiling and apologetic. Am sure she shared with her peers; I did not discuss in class because it was not necessary since others were not affected.
I very much welcome students’ feedback about me. At NEO, we always have a post NEO survey where students/staff tell us how their NEO went for those two weeks. Their feedback orchestrated our change of NEO from four weeks to two weeks in February 2019. The staff at several NEO and the unit NMs had complained about the lengthy NEO time. They had asked to shorten the stay to allow more time for unit orientation. We tried it and found out that it is more beneficial for the facility and more rewarding for staff. Besides, the units had more time to teach unit specific classes during the extra two weeks of orientation. For example, the Community Living Center(CLC) staff had time to be taught Restorative Care Nursing, Minimum Data Set(MDS), and Patient Centered Care which are only utilized on CLC.
I also like to check on students’ disposition from time to time during class and clinical posting and discuss their experiences during the post conference. Sometimes waiting for post conference might not be the best. For example, I attended a code orange event with three of my NEO students on a CLC floor. The Resident was very disruptive and causing injury to self and was threatening to kill staff with a gun. One of the NEO staff I went with was suddenly very afraid and shaky pulled her side, and we left the scene. I explained that the resident has the diagnosis he was displaying, and that the code team are always present to arrest the situation, and that residents do not have guns on unit, that this resident was displaying Post Traumatic Stress disorder(PTSD) symptoms and will be treated. And I emphasized coping strategies at debriefing.
Promoting the development of clinical reasoning is the crux of nursing education. A nurse who is adept at clinical reasoning will be able to make timely and effective patient-centered decisions. Sound clinical reasoning is essential for preserving the standards of the nursing profession and promoting good patient outcomes( Koharchik, Caputi, Robb, Culleiton,2015).
Reference
Koharchik, L., Caputi, L., Robb, M., Culleiton, A. L. (2015). Fostering clinical reasoning in nursing students. American Journal of Nursing, 115(1), 58-61.