Chair side Teaching Valuing the Experience? Students & Nurses Perspectives

1. Chair side Teaching Valuing the Experience?Students & Nurses Perspectives LesleyPugsley, John Sweet & Jeff Wilson Cardiff University

2. Background to the study • Setting Undergraduate Dental Education • Focus – Dental Chair side Teaching • Epistemological framework - interpretative • Research Questions • How are students taught at the Chair-side? • What do students learn? • How do students learn? • Can the learning experience be improved? LTSN Funded project

3. Participant Groups Dental students year 5 Dental Tutors Dental nurses Patients Research Method Focus Groups Interviews Focus Groups Questionnaire Survey Study Design ~Phase 1

4. Researching the Student Experience • Volunteers from Year 5 • 3 x Focus Groups N= 24 • Gender and ethnic mix for each group • ‘Free’ Lunch • Thank you – book token

5. Researching the Dental Nurses Perceptions • Volunteers from the Clinic Nurses • 2 x Focus Groups N= 12 • ‘Free’ Lunch • Thank you – book token

6. Emergent Themes

7. ‘Learning by Doing’ “It’s really a way for allowing us to learn by doing. You know, all the stuff that we are told about in lectures and we read about and the phantom head practices, they all come together in these sessions” (Student) “It’s the opportunity for them to make the adjustment from head to hands” (Nurse) • Experiential Learning – Kolb

8. ‘Peer Interaction’ “It’s really good when we have the House Officers in clinic. They are just above us and so know what we need to know. They are more of an equal” “I like learning from other students, you can listen and learn in pairs and that’s really good, really helpful, you feel comfortable with them.” “Involving the students in teaching that works really well.” Vygotsky – Zones of proximal development

9. Interprofessonal Education “The senior dental nurses can give very useful little tips, these are really helpful, we can learn a lot from them and hopefully they learn too in these sessions.” “I wish the nurses did more of the teaching, the experienced ones are brilliant and a lot of them do supervise us in the one clinic at Bayside and that’s invaluable.” “Most of us have a teaching qualification, so we could be used a lot more formally.” “We could ask questions, get them to think about what they are doing and why.” “We often feel undervalued, invisible even.” • Barr – Learning and working together

10. ‘Structured Learning’ “Each case is different, you may be thinking at first, well it’s a filling. But each one is different, each patient is different. So it’s really important to have a chance to think about what we have been taught and draw on it, learn from it.” “You need to think about want you know and how you are going to use that knowledge.” “It’s really important to see the patient – not just the tooth.” • Cognitivism - Ausubel

11. Teacher Qualities ~1 “The problem is it depends who is supervising the clinic. There is so much variation in the teaching.” “The treatment plans vary week by week depending on who is in charge. Often there is a mismatch of specialty with the teaching and the teacher” “It varies so much – often there is no consistency in the approach”

12. Teaching Qualities ~2 “ The GP tutors and academics chose to teach and so they should have training. It’s very obvious that many of them are not trained to teach and then the sessions are often a waste of time.” “Some of them are not prepared for the sessions and certainly not very enthusiastic, if they volunteer to do the clinic, they should want to be there, not just see it as a half day away from work.” “They are not trained to teach and some GDPs want to teach, others don’t bother.”

13. Briefing Sessions “These can be really useful, when they happen. Which is not that often. You have the opportunity to get a breakdown on the clinic and information on the cases. You can consolidate your knowledge if you can prepare for stuff coming up.” “We have no learning resources on the clinic. If disaster strikes we have no access to a website , or pictures or models and so briefings are really important, but only a few teachers bother.” “The sessions should start with them finding out the learning needs – checking what’s been done before, but that varies by individuals, some don’t bother with a briefing

14. Debriefing and Feedback “Having an opportunity to debrief after a clinic is really useful, you can talk through what you have learned, what went well or what was rubbish.” “I loved the debriefs, but the tutors are often in a rush to leave at the end of clinic and so they don’t get done so much now.” “Sometimes the feedback is good, they’ll ask what you’re doing and why, but some tutors they jump in and tell you what to do and that’s no help.” “It’s variable as to what they do at the end of clinics – some tutors just rush off.”

15. Experiencing Education…..The Good, the Bad & the Ugly “You can tell Mrs Best has been on a teaching course, she is brill. She explains things, asks what you think and lets you ask questions.” “Mr Hyde spends all his time avoiding us, he’s in the office drinking coffee.” “Some tutors disappear before they sign off our lists and we need the signatures for the records. When this happens I either hide the list and pretend its been misfiled or keep it in my locker and try and catch them the next week, once I did forge the handwriting, I know I shouldn’t have done, but I’m the one who’ll be in trouble for not signing off. They should stay ‘till the end of the session and do the teaching properly.”

16. Thoughts on the themes so far….. • Illustrates students & nurses awareness of educational theory in practice • Highlights variations in the quality of the chair side teaching • Stresses the need for teaching programmes for tutors • Suggests a greater role for nurses

17. Messages • The value of formalised educational training for tutors • The need for an awareness of the value of interprofessional working • The students want …………….

18. Chair side Teaching to be- Humanistic not Mechanistic