Teaching clinical skills in pre-registration nurse education: value and methods
This article explores the value of teaching clinical skills in pre-registration nurse education. It touches on stages of competence and the knowledge necessary to enable the learner to meet the standards of proficiency expected of registered nurses. Some contemporary issues around clinical skills teaching are discussed. How clinical skills can be taught and learnt as well as common problems encountered by learners and by educators are highlighted. This article also aims to stimulate discussion around the Nursing and Midwifery Council's new standards of proficiency for registered nurses. It discusses how learners will be prepared to undertake all nursing procedures outlined in these standards within a changing healthcare education landscape and an increasingly complex health and social care environment.
Undertaking clinical skills is a central part of a nurse's professional role and successful clinical outcomes depend on the competent performance of technical procedures as well as an appropriate level of understanding and a professional attitude (McNett, 2012; Harmon et al, 2016). Therefore, clinical skills teaching is a vital part of the curriculum for pre-registration learners.
There is debate around whether skills teaching is the domain of universities or practice placement settings (Borneuf and Haigh, 2010). Francis (2018) suggests that, as curriculum and practice pressures have changed over time, questions have arisen over who is responsible for clinical skills teaching, with nurse educators not viewing it as their role and clinical staff having insufficient resources to deliver the teaching (Borneuf and Haigh, 2010). Tensions exist between the demands placed on nurse educators to demonstrate excellence in teaching, research and maintaining clinical credibility (Råholm et al, 2016). Leonard et al (2016) argue that nurse educators do not need to undertake regular clinical practice to demonstrate professional credibility in the teaching environment of a university. Although it is suggested that clinical skills should be taught by practitioners in the care setting, in practice the capacity for doing this has declined because of busier environments, increased patient complexity and a more risk-averse culture (Staykova et al, 2017).
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