MOCHAKI N.W

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MOCHAKI N.W

• NURSE EDUCATOR
• LIMPOPO COLLEGE OF NURSING

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CLINICAL ACCOMPANIMENT

• Outcomes of the presentation
• Definition of accompaniment
• Clinical accompaniment, learning and experience
  in the clinical setting
• Relationship between clinical accompaniment and
  learning
• The Limpopo College of Nursing
• Improving clinical accompaniment

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Accompaniment is defined as

• To go with as a companion, escort, attend
• Conscious and purposeful guidance and support of
  students in clinical areas, an act of adding
  completeness or symmetry It
• focuses on students needs. creation of learning
  opportunities, leading to growth, becoming active
  participants
• Students become critical thinking practitioners

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Accompaniment, learning experience

• Learning ensures behavioural change
• Experience differentiates change in behaviour of
  students
• Change in behaviour is an indication of
  maturation process
• Accompanist/clinical instructor plays critical
  role in behavioural change towards professional
  maturity
• Choose appropriate experiences
• Involve students in such choice of experience

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• Students involved in choosing information/skills/p
  rocedures to learn
• Involvement means
• Sharing information with students
• Perceptual field for students
• Mutual experience,
• Do not dictate skills/procedure
• Facilitation of learning

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Facilitation leads to

• Curiosity in students
• Excitement and discovery of information eg
  diseases, health profs and their skills, patients
  profile, family needs
• These serve as opportunities for knowledge,
  skill acquisition, use of these for betterment of
  care and treatment
• Students also learn holistic care

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The Limpopo Province

• Limpopo College of Nursing Structure

Limpopo College of Nursing
Giyane
Thohoyandou
Sovenga
Clinical teaching areas
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Accompaniment in Limpopo

• Contractual obligation between college clinical
  settings, contract not followed properly
• Students grouped to these settings
• Accompaniment done by tutors
• Allocation list, learning outcomes and content
  sent to these settings
• Clinical settings have varying profiles
• Some with good facilities, others not
• These imply human physical resources

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Challenges in Limpopo

• Student factor
• Large numbers
• Poor behaviour
• Low motivation
• Students protests
• Questionable SRC role
• Selective on subjects to study e g GNS

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Physical resource factor

• Inadequate clinical facilities
• Hospitals classified in terms of facilities
• No offices/places for tutors for break during
  accompaniment
• Lack or inadequate library

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Relationship factor

• Poor cooperation between college clinical
  settings
• Poor communication between college clinical
  settings
• Students undermining registered nurses
• Lack of professional role models

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Curriculum factor

• Inadequate integration of theory-practice
• Content-based
• Curriculum fragmentation
• Overloaded curriculum e g four discipline in 4
  years
• Some tutors ill-prepared for accompaniment
• Registered nurses not ready/unwillingness

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IMPROVED ACCOMPANIMENT

• Promoting learning in clinical settings
• Consideration of environmental influence
• Participation by students in actual observations
  and treatment of patients
• Emphasise bedside nursing
• Deliberate plan and involvement of students
• Proper facilitation of clinical skill learning

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Caring attitude displayed by tutor/instructor

• Formation of humanistic values
• Instillation of hope
• Sensitivity to self to students
• Develop helping-trusting relationship
• Systematic problem solving caring process
• Intrapersonal learning promotion
• Provide supportive and corrective environment
• Allowance of feelings
• Listen to students

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Problems experienced by students

• Not being regarded as emerging R/N by health team
  members
• Health personnel antagonism towards students
• Used as workforce
• Not allowed to ask questions
• Their knowledge disregarded
• Lack of work ethics in some health personnel
• Negative feedback on performance (Carlson, Kotze
  Van Rooyen 200570).

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Clinical accompaniment

• Research-based or based on models
• Engage students tutors in research
• Proper planning
• Use of relevant assessment system
• Tutor/instructor to question own teaching
  approach
• Relevant and up-to-date curriculum

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College-clinical setting relationship

• Hold effective, outcomes based bilateral meetings
• Open communication
• Engage R/Ns in meetings
• Establish clinical instruction responsibility
• Inform clinical settings about curriculum changes
• Enter into contractual obligation

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Registered nurses roles

• Act as counselors for students in
• recognizing, facing, accepting and resolving
  challenges in clinical settings
• Act as leaders in initiating and maintaining
  learning goals through interaction
• Act as technical experts by displaying clinical
  skills, operating, understanding and manipulating
  equipment
• Act as surrogates supportive, conflicting
  resolution

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Use of experiential learning

• Stage of concrete experiences
• Accompanist observes behaviour and intervene to
  turn problems or unique occurrences into learning
  experiences
• Stage o reflective observation
• help students grasp meanings of
  ideas/situations by impartial description.
  Students reflect on previous occurrences

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Use of Experiential Learning Model (Kolb 1984)

• Stage of abstract conceptualisation
• involves concept formation where previous
  information is organised into meaningful
  conceptual structure, students engaged in more
  logical thinking in solving problems
• Stage of active experimentation
• students apply concepts learned into new
  situations, thus serving as a basis or
  problem-solving and decision making. Students
  help change or influence decisions made by
  accompanist (Kolb 1984)

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CONCLUSION

• The field of clinical accompaniment is broad.
  Nursing college and clinical settings should
  collaborate meaningfully to attain accompaniment
  goals
• Students must be prepared earlier to take active
  participation during accompaniment
• Nurse educators should strive to question and
  improve their methods used during clinical
  accompaniment
• Accompaniment should be consistent with
  contemporary changes in health care system

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• THANK YOU