MOCHAKI N.W

1. MOCHAKI N.W NURSE EDUCATOR LIMPOPO COLLEGE OF NURSING

2. CLINICAL ACCOMPANIMENT Outcomes of the presentation • Definition of accompaniment • Clinical accompaniment, learning and experience in the clinical setting • Relationship between clinical accompaniment and learning • The Limpopo College of Nursing • Improving clinical accompaniment

3. Accompaniment is defined as • To go with as a companion, escort, attend’ • Conscious and purposeful guidance and support of students in clinical areas, an act of adding completeness or symmetry : It • focuses on students’ needs. creation of learning opportunities, leading to growth, becoming active participants • Students become critical thinking practitioners

4. Accompaniment, learning & experience • Learning ensures behavioural change • Experience differentiates change in behaviour of students • Change in behaviour is an indication of maturation process • Accompanist/clinical instructor plays critical role in behavioural change towards professional maturity • Choose appropriate experiences • Involve students in such choice of experience

5. Students involved in choosing information/skills/procedures to learn • Involvement means: • Sharing information with students • Perceptual field for students • Mutual experience, • Do not dictate skills/procedure • Facilitation of learning

6. Facilitation leads to: • Curiosity in students • Excitement and discovery of information eg diseases, health profs and their skills, patients profile, family needs • These serve as opportunities for: knowledge, skill acquisition, use of these for betterment of care and treatment • Students also learn holistic care

7. The Limpopo Province • Limpopo College of Nursing Structure Limpopo College of Nursing Giyane Thohoyandou Sovenga Clinical teaching areas

8. Accompaniment in Limpopo • Contractual obligation between college & clinical settings, contract not followed properly • Students grouped to these settings • Accompaniment done by tutors • Allocation list, learning outcomes and content sent to these settings • Clinical settings have varying profiles • Some with good facilities, others not • These imply human & physical resources

9. Challenges in Limpopo • Student factor: • Large numbers • Poor behaviour • Low motivation • Students protests • Questionable SRC role • Selective on subjects to study e g GNS

10. Physical resource factor • Inadequate clinical facilities • Hospitals classified in terms of facilities • No offices/places for tutors for break during accompaniment • Lack or inadequate library

11. Relationship factor • Poor cooperation between college & clinical settings • Poor communication between college & clinical settings • Students undermining registered nurses • Lack of professional role models

12. Curriculum factor • Inadequate integration of theory-practice • Content-based • Curriculum fragmentation • Overloaded curriculum e g four discipline in 4 years • Some tutors ill-prepared for accompaniment • Registered nurses not ready/unwillingness

13. IMPROVED ACCOMPANIMENT • Promoting learning in clinical settings: • Consideration of environmental influence • Participation by students in actual observations and treatment of patients • Emphasise bedside nursing • Deliberate plan and involvement of students • Proper facilitation of clinical skill learning

14. Caring attitude displayed by tutor/instructor • Formation of humanistic values • Instillation of hope • Sensitivity to self & to students • Develop helping-trusting relationship • Systematic problem solving caring process • Intrapersonal learning promotion • Provide supportive and corrective environment • Allowance of feelings • Listen to students

15. Problems experienced by students • Not being regarded as emerging R/N by health team members • Health personnel antagonism towards students • Used as workforce • Not allowed to ask questions • Their knowledge disregarded • Lack of work ethics in some health personnel • Negative feedback on performance (Carlson, Kotze & Van Rooyen 2005:70).

16. Clinical accompaniment: • Research-based or based on models • Engage students & tutors in research • Proper planning • Use of relevant assessment system • Tutor/instructor to question own teaching approach • Relevant and up-to-date curriculum

17. College-clinical setting relationship: • Hold effective, outcomes based bilateral meetings • Open communication • Engage R/Ns in meetings • Establish clinical instruction responsibility • Inform clinical settings about curriculum changes • Enter into contractual obligation

18. Registered nurses roles • Act as counselors for students in: recognizing, facing, accepting and resolving challenges in clinical settings • Act as leaders in: initiating and maintaining learning goals through interaction • Act as technical experts by: displaying clinical skills, operating, understanding and manipulating equipment • Act as surrogates : supportive, conflicting resolution

19. Use of experiential learning: • Stage of concrete experiences: • Accompanist observes behaviour and intervene to turn problems or unique occurrences into learning experiences • Stage o reflective observation: help students grasp meanings of ideas/situations by impartial description. Students reflect on previous occurrences

20. Use of Experiential Learning Model (Kolb 1984) • Stage of abstract conceptualisation: involves concept formation where previous information is organised into meaningful conceptual structure, students engaged in more logical thinking in solving problems • Stage of active experimentation: students apply concepts learned into new situations, thus serving as a basis or problem-solving and decision making. Students help change or influence decisions made by accompanist (Kolb 1984)

21. CONCLUSION The field of clinical accompaniment is broad. Nursing college and clinical settings should collaborate meaningfully to attain accompaniment goals Students must be prepared earlier to take active participation during accompaniment Nurse educators should strive to question and improve their methods used during clinical accompaniment Accompaniment should be consistent with contemporary changes in health care system

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