Teaching in a clinical setting

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teaching in a clinical setting

Junior employees have a lot to learn but how do you teach and mentor newbies to the industry without it becoming a mental burden to yourself? Tracy Porter reports

When it came to fulfilling her life’s ambitions, emergency and critical care veterinary nurse Kym Salter opted for the road less travelled.

She began by enrolling in Cert II in Animal Studies while working in a piggery in rural Queensland before becoming pregnant with her first child and switching to study graphic design.

A move to Brisbane coincided with an opportunity to complete her Cert III while working part-time in a small vet clinic in Clontarf. More children, more study and more jobs came and went, until Salter found herself a clinical skills tutor at the Australian College of Veterinary Nursing.

The job involved teaching student nurses clinical skills and speaking about various nurse-related topics. Yet while enjoyable, she felt she was capable of more. 

Three years ago, Salter applied for a job in emergency in Queensland’s Moreton Bay and with it, found her rightful home. In a role that has since taken her full circle, part of her responsibilities now include the supervision of students on work placement.

“Mentors as a junior nurse were everything to me. I thought they were so great at what they did and that they knew everything. They were crucial to my learning and they taught me almost all of my practical skills. [In my current role], I have made some guidelines for the students to follow when in the clinic and I try to teach them as much as I can while they are here.”

Research has shown the clinical setting is a powerful environment for learning but both students and their supervisors say there are numerous challenges faced by both parties, including balancing the supervisor relationship and student or practitioner fatigue.

While Salter says her own knowledge base has “skyrocketed” since making the shift into emergency veterinary care, she agrees inconsistencies in the type of skills expected and what she sees as a lack of support for students on placement has her questioning whether more needs to be done to ensure the clinical environment remains a great place for students to learn. 

Mentors as a junior nurse were everything to me … They were crucial to my learning and they taught me almost all of my practical skills.

Kym Salter, emergency & critical care veterinary nurse

“Nurses need both practical and theoretical knowledge equally but placement doesn’t always give the student what they need as clinics are usually always understaffed so they find it difficult to give their time to students. This is also a problem if the fundamental skills are taught incorrectly as this sets up the student nurse for failure.”

Having experienced both sides of the fence, Salter admits it can also prove “quite mentally draining” to have to teach someone each shift she is on. 

“The way I relieve this is by only having one student on with me at a time and only one shift a week. I do love teaching and it does make you realise just how much you know but it is difficult to juggle your own tasks as well as help the student learn.”

Vet nurses like Salter are not the only ones struggling to strike the correct balance. 

Practising veterinarian, author and consultant Dr Diederik Gelderman, the owner of Highlands Veterinarian Hospital, also admits he feels torn about the value of teaching and learning in a clinical environment.

Dr Gelderman says while he loves having students around because “they are at the cutting edge with respect to theoretical knowledge”, it can also have its disadvantages.

From a practitioner perspective, he says a lack of structure around what needs to be covered off during the student’s placement means there are discrepancies between what the tertiary provider expects the student to achieve during their residency, and the type of cases coming through the clinic’s door.

“For the students, university is great but a lot of the stuff we commonly see in practice isn’t specifically university-focused. In a university setting or a traditional teaching setting you just follow the syllabus but in a lot of cases in the clinic you fly by the seat of your pants.”

I think there are many more good points than bad points in acting as mentor to those eager to learn outside of the traditional education environments.

Dr Diederik Gelderman, veterinarian, author & consultant

Dr Gelderman, who over a career spanning several decades has mentored both domestic and international students as well as a host of junior staff, says another challenge for those teaching in the clinical environment is how to deal with unmotivated students. 

Some students or junior staff members are happy to just sit there and not contribute in any way, he says.

“No matter what you do or how you manage them they just won’t get stuck in. I’ve been there and I know plenty of practices I’ve talked to that have been there. But what leverage do you have as a mentor to say ‘get off your arse and get in there and do something?’ As mentors, we probably don’t feel we have that authority. For the students that want to get in and do stuff I think it can be a really good learning curve but for the students that may be a little reluctant because they’re embarrassed or scared… I think there’s a good opportunity for them to sit back and do nothing.”

He argues the length of the placement can also have a big impact on the success or failure of a placement.

While a week is enough to “frustrate” everyone because the student doesn’t know enough about practice processes to assist, once a student has been there three weeks or more they can become a real help, he says, because they have “some idea” about how the place runs and can be of some assistance.

While conceding that some practice owners and senior staff struggle with teaching and mentoring younger employees, Dr Gelderman says experience has taught him not to compromise his own mental wellbeing when assisting the student or junior staff member in his care. 

“I can certainly have them in an exam room or mentor them in a consult or whatever it happens to be. I don’t get frustrated if they stuff up or anything like that but I didn’t used to be like that. When I was younger, probably in my first 20 or 25 years, I was not a good mentor because I got frustrated. But being a bit older I think I can manage it a lot better and I’m a lot more open to being questioned.

“In summary I think there are many more good points than bad points in acting as mentor to those eager to learn outside of the traditional education environments but both parties have to come to the table. You need to have a student that wants to be mentored but if he or she doesn’t want to I don’t think there’s anybody that can help them.”

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