Personalized Facilitated Learning Plan

Personalized Facilitated Learning Plan

In Australia, healthcare is one of the largest industries as it keeps on growing and changing. People want to live longer and better. However, the challenge for the healthcare industry is planning, responding, and effectively managing change in this complex setting. Importantly noted, at the center for managing and transforming healthcare facilities, a competent workforce is a critically important factor. Health organizations can achieve this by employing medical staff with authentic clinical experiences who can adequately integrate their experience with factual knowledge.  The adequate exposure of healthcare students is directly related to several clinical cases that positively contribute to developing their clinical competence. Traditionally, the curriculum has always been divided into two distinct phases; the preclinical and clinical period, with the latter taking place at a later stage.  As AlHaqwi and Taha (2015) note, providing students with an extensive clinical experience in their training is vital. There are several identified benefits in relation to nurturing an appropriate attitude in medical students towards patients and the whole clinical experience. Supporting students through their clinical training also gives them the necessary motivation and boosts their confidence. Consequently, clinical learning can take place anywhere patients are receiving medical care, such as inpatient units, ambulatory care environment, family practice, and community centers. Consistent with the significance of clinical learning, we identify Karen’s learning needs to provide a conceptual framework to develop a personalized facilitated learning plan to address her current challenges at the clinic. The plan will include a comprehensive overview of the educational strategies that will be used to address her challenges as well as ways to monitor the success of each method. We will also consider ways in which we will mitigate the risk to patients care, and ways in which the facilitator will be able to balance their responsibilities

Clinical Setting

ABC General Health Nursing covers more than a dozen of clinical areas. Each clinical department functions differently, united under one collective goal, which is to promote the health and safety of our patients. The nursing leadership considers teamwork as a critical factor in the success of the facility and provides clear and well-defined directions for the nursing team as a whole. At the same time, the organization recognizes individuality and the uniqueness of every individual working in the various departments and their contribution towards achieving their goals as well as ensuring appropriate use of resources, patient safety, and student-centered learning

Karen Learning Needs

Karen is a final student, originally from Indonesia and English is her second language. Karen has difficulties applying theory to practice and rationalizing evidence behind her clinical practice. As a result, Karen is at a risk of failing, especially because of her poor record-keeping practices and inability to work as a team. As mentioned earlier, Karen has had difficulties applying theory to practice and rationalizing evidence to her clinical practice. Additionally, Karen has poor record practices, and this puts her at a risk of failing the unit of study. Ideally, one of the most enduring problems in clinical settings is the poor clinical observation and integration of theory into practice (Ahtisham & Jacoline, 2015). While theory is taught in the healthcare institutions, integration into clinical practice is not fully tested. Clinical situations are likely to become daunting without theoretical knowledge. In fact, healthcare professionals become passive as opposed to active workers, and this could lead to poor misunderstanding and integration of theory into practice, as well as compromise patient safety and outcomes. Consequently, clinical record keeping is an integral part of the planning and provision of care (Wright, 2013). Healthcare professionals have a responsibility to record care according to the principles of the profession and employer local policy. Usually, health records are critically significant and often used to determine patient care and safety measures when a serious incident occurs or a complaint. The records form a large part of the incident investigations especially when the issue relates to patient care. The process also ensures accountability on the part of the healthcare professional since they are mandated to account for their practice and care delivery. Unregistered practitioners such as student nurses or care assistants are expected to be accountable, and their supervisors should ensure they are competent to deliver care and document.

Learning Objectives

Every scenario must be accompanied by a few specified learning objectives for the participants. Depending on the expected outcome, learning objectives often vary, but should also be relevant and appropriate for the level of the participants involved (Alinier, 2011). It is also advisable to consider the participant’s educational curriculum and more particularly, the challenge they are experiencing in the workplace. Karen has problems keeping clinical records and maintaining teamwork. The purpose of the personalized facilitated learning plan is to help Karen to be able to improve her skills in clinical record keeping and to encourage her to work with others as a team.  

Educational Strategies

Within the clinical settings, students and trainees often report concerns about lack of a clear definition of their roles, knowledge of what is expected of them, and limited opportunities to practice and receive feedback. As Morris (2010) acknowledges, the workplace offers various opportunities for learning while enabling trainees to develop professional knowledge, skills, behaviors, attitude, and engage collaboratively with others. In fact, it is a place of professional socialization, where professional identity is established. That notwithstanding, finding ways to support such development is a challenge for learning facilitators. Research indicates that increasing demands on training hours, limited patient encounters, and a focus on patient safety have led the healthcare sector to shift from the traditional teaching method to technological and innovative ways to provide standardized education curriculum. Medicine has learned a lot from professionals that have established programs in simulation for training, and there has been an exponential and enthusiastic adoption of simulation in healthcare education. Accordingly, there is a wide range of strategies that can be used for teaching or training professional entry practitioners. In the case of Karen, the facilitator will adopt several teaching strategies including developing an individualized learning in a simulated environment, posters and bulletin boards, education fairs, audiovisuals, written materials, and computer-assisted instruction. Virtually, use of multiple strategies has a significant impact on learning outcomes. In particular, they are effective in enabling learners to achieve the learning objectives of education programs within the healthcare settings.

Develop an Individualized Learning in a Simulated Environment

Ideally, the word simulation is often defined as the process of designing a real system model and conducting experiments with the model for the purpose of understanding its behavior or assessing the system operations. In a simpler definition, simulation is described as the technique of imitating the behavior of a specific process for the purpose of study or training. According to Abdulmohsen (2010), the second definition is suitable and readily applicable to the use of simulation in healthcare education, amidst different perceptions from people. The benefits of clinical simulation are increasingly reported, adding validity to the use of the learning strategy in healthcare education. However, as Abdulmohsen further notes, the effectiveness of a simulated-learning environment relies on how well it is applied. For instance, it is important first to identify the outcome of simulated-education and utilize it to guide its integration into the learning environment. Secondly, feedback is critically important and should be determined by individual needs. Thirdly, the simulation should be used in a controlled environment where opportunities for deliberate practice and evaluation are available. Importantly noted, when applied effectively, simulation has the ability to improve participant skills and skill retention.

In healthcare education, simulation is increasingly gaining popularity. Despite divergent perceptions, simulation ranges from the basic exercise with no special equipment to placing trainees in a realistic simulated clinical setting with patient-like interactive patient simulators. As part of simulated learning, individualized learning provides a chance to individuals for standardized educational experiences, where the learner is the active participant and not merely passive observers. The strategy provides learners with a unique experience consistent with their specific learning needs. Consequently, it allows trainees to progress along their learning curve in a way that maximizes their progress towards mastery or competence in a given area. With Karen, the interactive clinical teaching strategy will be used to offer her an opportunity to harness her interpersonal skills with other staff for enhanced teamwork. Consequently, the facilitator will use the role to supplement Karen’s record keeping skills. Ideally, role play involves constructing unstructured scenarios, which are developed based on various guiding principles, rules, and structured relationships. Usually, students are assigned roles consistent with their learning needs and goals. For the strategy to be implemented, Karen will be presented with a scenario where she will be expected to improvise behavior according to her assigned role. The facilitator will act as a patient or get another student to take the role of a patient, Karen will be expected to record the ‘patient’s’ clinical assessment. The practice will be repeated twice or thrice a month to arouse the student interest in record keeping, help Karen practice learned skills, and to help her value the importance of teamwork.

Use of Posters and Bulletins

Within clinical settings, posters are a common and effective form of presenting health information in conferences and to the community. Consequently, they have been recognized as an effective form of disseminating information especially concerning evidence-based practice. Healthcare organizations now use posters for staff education and the benefits are more widespread as originally projected. According to Maiocco (2002), in their line of duty, nurses interact and ask questions and posters can be used to improve staff education and teamwork. Additionally, staffing is often tight and proves hard to schedule healthcare professionals for in-services, posters can be used to effectively fill in the gap of training nurses without necessarily adjusting their work schedule. In the case of Karen, posters will be used to provide mentoring and remind her the importance of keeping clinical records. The strategy will also help other healthcare professionals who may be having problems keeping clinical records for patients. Karen will be able to read and refer to it on her own or even when interacting with a colleague. 

Bulletin board postings have been used in multiple learning institutions to supplement in-class time to update students and staff on emerging trends. For instance, as Painter and Fink (2010) point out, the pharmaceutical Outcomes and Policy graduate program at the University of Kentucky College of Pharmacy used a bulletin board in the main classroom area to display articles from different sources addressing issues related to pharmaceutical policy. The intention is to publicize to those who pass near the bulletin board on a wide range of issues as well as providing an insight to the faculty and staff on contemporary issues affecting the pharmaceutical sector. Accordingly, a bulletin board will be initiated with board postings to remind Karen and others of the importance of getting correct clinical records. The message will be clear and concise to make it easy for the student to read and understand what is expected of them and its significance. 

Case-based learning

Ideally, case-based learning is used in medical schools to integrate theory with practical clinical practice. The strategy was first used in the study of anatomy to enhance student interest and enable them to apply knowledge gained in clinical practice. Nowadays, CBL is used in multiple health-care settings around the globe to improve student knowledge and skills within the clinical settings (Singh & Bhatt, 2011). Case-based learning will be structured in a way that Karen will be able to explore clinical record-keeping practices. The strategy will be used to complement the role-play learning strategy. The implementation of the strategy will require real-situation learning, where Karen will observe other healthcare professionals take note and rationalize their clinical records. In return, she will be expected to carry out an assessment of the patient’s medical history and maintain a record. The records will be compared to assess if Karen was successful.

Monitoring Success of each Education Strategy

Evaluating the success of the clinical teaching process is a critically important aspect of effective learning. The process helps to identify areas of strength and weaknesses that need to be reinforced and improved. Virtually, when measuring the effectiveness of clinical setting teaching, several aspects should be considered such as gathering and interpreting information from various sources to act as a guide for valid teaching assessment. According to AlHaqwi and Taha (2015), assessment measures often depend on student scores, although this has its limitations because it cannot be used to evaluate knowledge and skills level. Multiple sources of information are necessary to give a comprehensive overview of the effectiveness of the education strategies. Before collecting data, a purpose for evaluation should be determined and the person who will make decisions regarding the success or failure of the learning process identified. Tools should also be developed to measure the effectiveness of the learning process as well as standards for the evaluation to avoid the measurement tools affecting the process. Consequently, the learning is a complex process that not only relies on the effectiveness of the clinical supervisors or instructors, but several other factors. In light of this, it is crucial to consider these other factors to help develop a comprehensive instrument that aims at measuring all elements related to clinical education. 

Consistently, in healthcare teamwork is one of the core approaches towards increased levels of quality and safety care. Simulation provides a powerful tool for delivering this form of training, especially in dynamic areas within the clinical settings. Consequently, like Rosen, Weaver, and Lazzara (2010) highlight, the effectiveness of teamwork relies on team performance, which refers to the degree in which the actual behavior of the individuals satisfies the team, organization, and other pre-set goals.   Through this lens, team performance depends on teamwork and the effective processes that teams engage in to coordinate their interaction towards organizational goals. In this line, the effectiveness of the education strategies targeting teamwork will be based on the evaluation of team performance. Similarly, in order to measure team performance, it is important to define the determining factors. To comprehensively assess team performance, the facilitator must consider the behavioral, cognitive, and attitude of the members. It also means capturing diagnostic information of individual members, providing specific feedback to help develop teamwork competencies. As earlier noted, capturing the range of team processes to assess team performance demands multiple approaches. For instance, trainees’ reactions can be evaluated to determine if they found the training program useful. Unfortunately, this strategy has demonstrated weak relationships to other important outcomes. In particular, a difficult training process may be rated less enjoyable, but it does not mean it was not effective. As a countermeasure, observational rating and event-based approach will be used to measure the effectiveness of the education strategies. Virtually, observational rating scales involve having qualified observers to record and rate the behavior of the team members. On the other hand, event-based techniques will be used to counter the complexity of performance rating in complex simulation cases. It involves developing critical events that provide opportunity to perform key teamwork competencies that are integrated into contextualized scenarios.

Alongside teamwork, clinical record keeping practice is critically significant to the delivery of quality care, patient safety, and the overall success of the organization. Formal and informal training was used to provide Karen with the induction program. In order to evaluate the effectiveness of the education strategies in enhancing Karen’s skills on clinical record keeping, two measures will be used. The first measure will consider the significant increase in self-rating of the individual in successive tests. The second measure will consider improvements in task performance followed by daily experiences from the onset of the training program. 

Mitigating Risk to patient care during clinical setting education

Healthcare systems are complex and dynamic organizations with uncontrollable and unpredictable variables with the potential to affect care delivery and patient safety. According to Debourgh (2012), the systems require the management of healthcare professionals who have the necessary knowledge and skills to safely and effectively provide care for the complex patient population. Healthcare schools have the challenge to embed patient safety content and quality in the pre-licensure curricula to allow students engage in the clinical application of knowledge and skills required for the specific profession. Consequently, in order to ensure students develop clinical knowledge and skills and gain an accurate insight of their role and responsibilities, they must be integrated into the clinical setting where they can interact with the healthcare team and provide direct care as they learn. Sometimes, healthcare facilities restrict student clinical practice for fear of compromised patient safety and supervision. In a way, the fears emanating from healthcare facilities are true; unfortunately, the restrictions often deny students the opportunity to participate fully in activities of direct patient care, which is necessary for their knowledge and skills. Virtually, as Debourgh elaborates, it is estimated that 80 percent of medical errors come from system factors such as work environment, the task itself, equipment and technology, and administrative variables, which include leadership, a chain of command structures, and knowledge span of individual among others. Human factors are individual characteristics of healthcare professionals and their contribution to performance and transformation that takes place during their interaction with health system processes and outcomes. Additionally, human factors include insufficient and wrong communication, lack of teamwork and collaboration, as well as low individual and collective situational awareness among others. Therefore, in order to mitigate risk to patient safety, effective interpersonal communication and teamwork are some of the primary factors that will be considered. Ideally, good patient outcomes are determined by educated and qualified healthcare providers who understand their responsibilities and collaborate with others working as a team. Effective communication is a part of patient safety advocacy and is established and maintained by healthcare teams during their planning and evaluation of care. Healthcare professionals have the power to influence patient safety by remaining vigilant, maintaining clear communication with others in the team, patients, and family. In light of this, and in order to mitigate risk to patient care, the facilitator will maintain clear and concise communication with Karen and other clinical staff members who may be involved. Consequently, we recognize that Karen has a problem working in a team, which may hinder effective teamwork. Nonetheless, the inability will be considered by encouraging Karen to communicate effectively and efficiently with those who are in-charge as well as members of her team. Along with that, the risk of patient care is mitigated by the presence of healthcare professionals who can predict high-risk patient complications and salvage conditions by purposefully responding and acting to minimize the potential for harm. The facilitator recognizes this and understands that Karen may not be competent enough to mitigate patient harm. The risk will be prevented by always assigning a qualified personnel to work alongside Karen during her training and to ensure accurate patient records to avoid complications in the future. 

Balancing the Responsibilities of ensuring appropriate use of available resources, patient safety, and student-centered learning

Clinical practice is an essential part of healthcare students’ education. The clinical settings are expected to support student achievement of the learning outcome and professional development. Thus, supervision in clinical practice is necessary and the role of supervisors organized. Unfortunately, as Silén, Manninen, and Henriksson (2015) highlight, achieving this is sometimes challenging, especially when it comes to balancing the supervisor’s responsibilities with managing student learning. Supervisors have a moral and legal obligation to ensure high-quality patient care and safety, as well as management of resources and delivering a student-centered education. Beyond healthcare, a prevailing philosophy demands competency in clinical service delivery and effective clinical supervision. In order to balance between clinical practice and effective management of resources, patient safety, and achieving a student-centered learning, the facilitator will consider several aspects of the supervisory process not restricted to regulatory elements. Firstly, to achieve a student-centered learning and ensure patient safety, the facilitator will be physically present to guide the student, but also allow the student to take charge. Sometimes the student will be left alone with the patients, while the supervisor monitors the student work and be available to offer support in case the student needs it. Importantly noted, the facilitator’s approach to student learning is based on a balance between caring for patients and supervising students simultaneously. Finding this balance is a pedagogical challenge, however making a learning plan for students and care plan for patients is also another way to achieve this balance. Working as a team at the clinical education with other clinical staff further plays an important role in student learning and independence. Similarly, the aspect of teamwork is also beneficial to supervisors’ in the development of their confidence levels and proper understanding of the support to give to the students. Along with balancing patient safety and student-centered learning, it is important for facilitators to manage organizational resources. As Silén et al., note, in the learning environment, the facilitator is given organizational resources to help them focus on patient care and student learning. In order to manage organizational resources effectively, the facilitator considered cost-effective learning strategies to avoid wastage.

References

Abdulmohsen H Al-Elq. (2010). Simulation-based medical teaching and learning. Journal of Family and Community Medicine, 17(1), 35-40.

Ahtisham, Y., & Jacoline, S. (2015). Integrating nursing theory and process into practice; virginia’s henderson need theory. International Journal of Caring Sciences, 8(2), 443-450.

AlHaqwi, A. I., & Taha, W. S. (January 03, 2015). Promoting excellence in teaching and learning in clinical education. Journal of Taibah University Medical Sciences, 10(1), 97-101.

Alinier, G. (2011). Developing High-Fidelity Health Care Simulation Scenarios: A Guide for Educators and Professionals. Simulation & Gaming, 42(1), 9-26.

Debourgh, G. A. (2012). Synergy for patient safety and quality: academic and service partnerships to promote effective nurse education and clinical practice. Journal of Professional Nursing, 28(1), 48-61.

Maiocco, G. (2002). Posters Give Nursing Staff Consistent Information. Critical Care Nurse, 22(2), 152-153.

Painter, J. T., & Fink, J. L. (2010). Educational innovations: Categories of bulletin board postings designed to increase awareness of contemporary pharmaceutical policy issues. Pharmacy Practice, 8(4), 255-259.

Rosen, M. A., Weaver, S. J., Lazzara, E. H., Salas, E., Wu, T., Silvestri, S., Schiebel, N., … King, H. B. (2010). Tools for evaluating team performance in simulation-based training. Journal of Emergencies, Trauma and Shock, 3(4), 353-359. 

Silén, C., Manninen, K., Henriksson, E., & Scheja, M. (2015). Supervisors’ pedagogical role at a clinical education ward – an ethnographic study. Bmc Nursing, 14(1), 1-8.

Singh, P. R., & Bhatt, R. (2011). Introduction of case based learning for teaching anatomy in a conventional medical school. Journal of Anatomy & Social, 60(2), 232-235.

Wright, K. (2013). Ensuring best practice in clinical record-keeping. Nursing Times : Nt, 109(35), 20-21.

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