Born to teach
Becoming a clinical instructor
Introduction
Healthcare settings frequently serve as training sites for students who are learning to become practitioners in the discipline. Students are scheduled for clinical training experiences within a particular department and assigned to a healthcare professional who will serve as their mentor. This healthcare professional is often referred to as a clinical instructor or preceptor. In this book, the term clinical instructor is used to describe individuals who are responsible for managing student training in addition to their usual healthcare practitioner duties. Whether you have recently been given the title of clinical instructor or have served in this role for a number of years, this resource will provide tips and strategies to make your time spent educating health professions students both productive and rewarding.
What is a clinical instructor?
The clinical instructor role involves many functions, including teaching, supervising, evaluating, and role modeling professional behavior (Sachdeva, 1996). Teaching students how to apply theoretical knowledge to clinical situations, operate equipment safely, and perform patient care procedures will constitute approximately 60% of your time as a clinical instructor. Supervising and coaching students as they practice these skills will account for another 20% of your time. Finally, evaluating students’ decision-making skills and technical competence, as well as providing feedback regarding their performance will generally round out the remaining 20% of your work as a clinical instructor. Throughout the entire clinical experience you will be expected to role model professional behavior. Role modeling is necessary to ensure that your students will be able to perform as healthcare practitioners once you are no longer closely monitoring them.
The clinical instructor position can be quite intense; practitioners are expected to facilitate student learning while simultaneously providing quality patient care. You may feel some anxiety as you leam to navigate your new position as a clinical instructor. Do not worry. With time and experience these responsibilities will become second nature, and you will look forward to the days when you have a student training at your side.
Clinical practitioners who enjoy having the opportunity to train students or see themselves as educators are made for the clinical instructor role. Often they have a natural sense of what it takes to engage students in learning. Not every healthcare practitioner, however, is meant to have teaching responsibilities, and that is why it is so important to have the right people serving as educators in the clinical setting.
As a clinical instructor one of your main responsibilities will be to help students make sense of what they are learning on campus. In other words, to take the theory they have learned in the classroom (also known as the didactic component of the curriculum) and apply it to patient situations in the clinical setting. Oftentimes students cannot make the connection between what they have heard in class and what is actually happening in the healthcare environment; an environment that in many cases is complicated and unpredictable. Identifying teachable moments in the clinical setting that reinforce didactic lessons can be one of the most challenging parts of a clinical instructor’s job. Patients do not always align with well-defined scenarios found in textbooks and often display signs and symptoms that are characteristic of a number of conditions. As a clinical instructor you will help students sift through patient information to determine what is relevant to their diagnosis or treatment. You will help students determine what information needs to be acted on right away or shared with other healthcare professionals. On occasion, the concepts learned in the classroom will not support the practices used in the clinical setting, and students will need to be taught why. Many students struggle with theoretical concepts. They need to see the technology' or technical procedures firsthand in the clinical setting before they can fully understand the didactic content.
As a clinical instructor you will also spend a great deal of time helping your students develop technical skills. This instruction includes demonstrating how to operate equipment, coaching students as they practice procedures, and evaluating students’ performance to determine their level of proficiency. Technical instruction can be very different for each student depending on their motor skills and the speed at which they process new information. In addition to helping students achieve technical competency, an effective clinical instructor must also demonstrate how to think critically. For example, students must leant how to react appropriately when performing procedures under stressful conditions, what to do when equipment malfunctions, or when to question results because intuition is telling them that something is not right. Critical thinking skills are essential in healthcare, as the time available to make clinical decisions is often only a matter of seconds and the results can have life or death implications.
Besides teaching technical aspects, clinical instructors also play a pivotal role in transforming inexperienced students into self-assured healthcare professionals. This process includes socializing students to the practices of the profession and helping them cultivate their own distinct professional identity (Taylor & Harding, 2007). Students do not instinctively know how to behave as healthcare professionals. They must be mentored into this role, and sometimes that involves blunt conversations about behaviors that need to significantly change. As the clinical instructor it is your responsibility to help students establish themselves as healthcare professionals, and with any luck they will pattern themselves after you!
In addition, you must have a clear understanding of the training policies that have been established by the education program that is entrusting you with their students. In order for students to be adequately prepared for their certification and licensing exams, they must complete a prescribed curriculum that includes defined experiences in the clinical setting. Your job is to make sure students get these authentic experiences. The best advice for clinical instructors is to keep lines of communication open with the education program staff to ensure that all decisions regarding students are made in their best interests.
Most importantly, as a clinical instructor you must maintain a level of mastery in your own discipline. You will need to keep current with new technology and evidence-based practice. You will need to attend continuing education workshops and read professional journals. Your professional development should also include becoming proficient in instructional and assessment techniques. In your role as a clinical instructor you must be a content expert as well as an educator, and you will need to advance your skills in both areas. Serving as a clinical educator is a responsibility that requires a great deal of time and effort to master; the fact that you are reading this book is a sure sign that you are ready for this challenge.
In departments where the clinical instructor is also designated as the clinical coordinator for the institution, there may be additional responsibilities beyond those just described. These additional responsibilities often include: establishing training schedules within the institution, serving as a liaison between students and the clinical staff, monitoring students’ progress throughout the clinical rotation (in this book the term “clinical rotation” will be used interchangeably with clinical experience), and evaluating the effectiveness of clinical instruction. The role of the clinical coordinator will vary depending on the discipline as each healthcare training program is structured differently.
