Leadership and Clinical Education ( LaCE )

1. Leadership and Clinical Education (LaCE) Workshop 1 ‘Clinical education through a leadership lens’ Robyn Nash and Pauline Calleja, QUT Leading clinical learning

2. Session Objectives Provide a forum which explores: • Connections between leadership and clinical education • A clinical education leadership framework • Opportunities for personal/professional development as a leader of clinical learning Leading clinical learning

3. What is leadership? • Buzz session 1 What is your concept of ‘leadership’? Leading clinical learning

4. What is leadership? …. any behaviour that influence the actions and attitudes of others to achieve certain results Australian Leadership Development Centre, 2007 Leading clinical learning

5. Characteristics of effective leadership? • Inspire aspiration • Strive for excellence, know own strengths • Set direction • Communicate on both information and interpersonal levels • Bring out the best in people, help them develop capabilities and skills • Guide people to the right destination in a smooth and efficient way • Persist in the face of unexpected setbacks • Be the change, role model by example • Reward success ............. (Burns 1978; Bass 1985; Bennis & Nanus 1985; Kouzes & Posner 2003) Leading clinical learning

6. What is clinical education? • Buzz session 2 What is your concept of ‘clinical education’? Leading clinical learning

7. What is clinical education? • ... commonly described as the component of health practitioner education that allows students to put theoretical knowledge into practice within the patient/client care environment (Clare et al. 2003) ‘… the translation of theory into clinical knowledge and professional skills ....’ McAllister et al. (1997, p.3) ‘… the co-creation of new knowledge through critical reflection and dialogue between learner and facilitator ‘ Harvey et al. (2002, p. 578) .. a process of contextualand experiential learning which involves clinical educators and students working in partnership to achieve professional development outcomes ... Leading clinical learning

8. Experiential learning “.. learning is the process whereby knowledge is created through the transformation of experience. Knowledge results from the combination of grasping experience and transforming it“ (Kolb 1984, p. 41) Leading clinical learning

9. Experiential learning Feeling Watching Doing Thinking Kolb’s Cycle of Experiential Learning (1984) Leading clinical learning

10. Kolb’s ‘principles’: • learning is a process which combines experience, reflection, thinking and doing • different people prefer different style/s of learning, and learn more effectively if they can utilize their preferred learning style • learning results from constructive interactions between the person and his/her environment • learning is a holistic process of adaptation.It is not just the result of thinking, but involves the integration of thinking, feeling, perceiving and behaving • time is needed for learners to process their experiences in order to derive new meanings that can be applied to future situations. Leading clinical learning

11. Learning styles • Active learners • like to be constantly challenged, can think on their feet and enjoy the challenge of being thrown in the deep end, learning best 'on the job' through practical exposure, trial and error and direct experience. • Reflective learners • need time to plan, prepare and have time to reflect on their learning before being confronted with a new challenge. • Theoretical learners • stimulated by abstract ideas and concepts. They like to consider viewpoints and theories and to analyse situations before selecting options and approaches to a task. They learn through observation, discussion, analysis, and enjoy logical and sophisticated reasoning. • Pragmatic learners • enjoy learning from qualified demonstration, and need to see the practical advantage of all that they are doing. They need to know that what they are doing works and is realistic Honey & Mumford (2000) Leading clinical learning

12. Four stages of professional development: a ‘competency’ model McKimm & Swanwick (2009) All styles are important. The key = choosing the style that is appropriate to the situation (UMDNJ 2006) Leading clinical learning

13. Leadership and clinical education: A good fit Clinical education .. a process of contextual and experiential learning which involves clinical educators and students working in partnership to achieve professional development outcomes ... • Inspiring quality learning • Knowing the stakeholders • Interacting supportively • Developing competence • Sustaining commitment Ramsden 1998; Kouzes & Posner 1997-2007; Bennis & Nanus 1987 Lee et al. 2002; Tang et al. 2005; Lambert 2007; Robinson 2009 Leadership ...’any behaviour that influence the actions and attitudes of others to achieve certain results’ (ALDC 2007) Leading clinical learning

14. Leadership and Clinical Education Framework – E4 REFLECTION ON PRACTICE Establishing direction Enhancing commitment Executing the role Enacting self development ACTION LEARNING Leading clinical learning

15. Clinical teachers: what do students value? • Medical residents 3 most important characteristics • Nonjudgemental • Clinical competency • Enthusiasm • Buchel & Edwards (2005) • Nursing students’ perceptions of effective Vs ineffective clinical teachers • Teaching ability • eg. encourages thinking and learning • Personality characteristics • eg. enthusiastic approach • Professional competence • eg. good professional knowledge • Interpersonal relationships • eg. good relationships with nursing team Tang et al. (2005) 3 48% 47% 2 32% 4 1 Leading clinical learning

16. Clinical instruction: what do students value? • Open, collegial relationship • Adapting the experience to the student • Facilitating clinical reasoning • Making time for the student • Supportive environment Kelly (2007) Leading clinical learning

17. Importance of clinical supervision • Clinical experience is a core element of health professional education, but... • Experience in the real world does not automatically translate to positive student learning experiences, or mean that the development of professional knowledge and skills will occur effectively • Factors that are key to the promotion of optimal learning in the clinical environment include: • supportive practice environments • effective supervisory relationships • a positive learning culture • collegial relationships between students and staff • The importance of clinical supervisors in playing a central role within this context cannot be underestimated Leading clinical learning

18. Some closing thoughts… Leaders are responsible for getting results through others. Leaders should be judged not by what they do, but rather by what those around them are doing and achieving. In this light it is very clear that leadership is people work, with a focus on achieving results. Australian Leadership Development Centre Leading clinical learning

19. References Allied Health Professions Australia (2006). Clinical Education Discussion Paper, October. Available at: www.ahpa.com.au Buchel, T. & Edwards, F. (2005). Characteristics of effective clinical teachers. Family Medicine, 37(1), 30-35. Clare, J. et al (2003). Evaluating clinical learning environments: Creating education-practice partnerships and benchmarks for nursing. AUTC final report. Adelaide: Flinders University. Clark, D. (1997). In Zilembo, M. & L. Monterosso. (2008)., Nursing students’ perceptions of desirable leadership qualities in nurse preceptors: a descriptive study, Contemporary Nurse, 27(2), 194-207. Gibson, E. et al (2002). Towards the Development of a Work Integrated Learning Unit. Division of Environmental and Life Sciences and Centre for Professional Development, Macquarie University, Australia. Available at: www.cfl.mq.edu.au/celebrate/refereed.htm Harvey, G., Loftus-Hills A., Rycroft-Malone J., et al. (2002). Getting evidence into practice: the role and function of facilitation. Journal of Advanced Nursing, 37, 577–588. Kelly, C. (2007). Students’ perceptions of effective clinical teaching revisited. Nurse Education Today, 27, 885-892. Kouzes, J. & Posner, B. (2003). The five practices of exemplary leadership. In Kouzes, J. Business Leadership. San Francisco: Jossey-Bass. Lambert, V. & Glacken, M. (2006). Clinical education facilitators’ and post-registration paediatric student nurses’ perceptions of the role of the clinical education facilitator, Nurse Education Today, 26(5), 358-366. Lee, C., Cholowski, K. & Williams, A. (2002). Nursing students’ and clinical educators’ perceptions of characteristics of effective clinical educators in an Australian university school of nursing, Journal of Advanced Nursing, 39(5), 412-420. McAllister, L., Lincoln, M., McLeod, S. & Maloney, D. (1997). Facilitating learning in clinical settings. Cheltenham, UK : Stanley Thornes. McKimm, J. & Swanwick, T. (2009). Assessing learner needs. British Journal of Hospital Medicine, 70(6), 348-351. Pratt, D., Arseneau, R., & Collins, J. (2001). Reconsidering “good teaching” across the continuum of medical education, The Journal of Continuing Education in the Health Professions, 21, 70–81. Robinson, C. (2009). Teaching and clinical education competency: Bringing two worlds together, International Journal of Nursing Education Scholarship, 6(1), 1-14. Tang, F., Chou, S., Chiang, H. (2007). Students’ perceptions of effective and ineffective clinical instructors, Journal of Nursing Education, 44(4), 187-192. Leading clinical learning