Chair side Teaching Valuing the Experience? Students

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Chair side Teaching Valuing the
Experience?Students Nurses Perspectives

• Lesley Pugsley,
• John Sweet Jeff Wilson
• Cardiff University

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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

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Study Design Phase 1

• Participant Groups
• Dental students year 5
• Dental Tutors
• Dental nurses
• Patients

• Research Method
• Focus Groups
• Interviews
• Focus Groups
• Questionnaire Survey

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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

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Researching the Dental Nurses Perceptions

• Volunteers from the Clinic Nurses
• 2 x Focus Groups N 12
• Free Lunch
• Thank you book token

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Emergent Themes
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Learning by Doing

• Its 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)
• Its the opportunity for them to make the
  adjustment from head to hands (Nurse)
• Experiential Learning Kolb

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Peer Interaction

• Its 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 thats really good,
  really helpful, you feel comfortable with them.
• Involving the students in teaching that works
• really well.
• Vygotsky Zones of proximal development

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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
  thats 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

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Structured Learning

• Each case is different, you may be thinking at
  first, well its a filling. But each one is
  different, each patient is different. So its
  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.
• Its really important to see the patient not
  just the tooth.
• Cognitivism - Ausubel

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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

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Teaching Qualities 2

• The GP tutors and academics chose to teach and
  so they should have training. Its 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 dont bother.

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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 whats been done
  before, but that varies by individuals, some
  dont bother with a briefing

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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 dont get done so much now.
• Sometimes the feedback is good, theyll ask
  what youre doing and why, but some tutors they
  jump in and tell you what to do and thats no
  help.
• Its variable as to what they do at the end of
  clinics some tutors just rush off.

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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, hes
  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 shouldnt have
  done, but Im the one wholl be in trouble for
  not signing off. They should stay till the end
  of the session and do the teaching properly.

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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

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Messages

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

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Chair side Teaching to be- Humanistic not
Mechanistic