Stephanie Reynolds – pre observation reflection

Initially I was really quite excited by the prospect of having this particular session evaluated and observed by students and staff. Health Promotion simulation is a new session we have introduced within the module and this will be the second run having trialled it last year and initial evaluations proved positive. This particular session will be the 5th lecture delivered in this way.

The style of this lecture which is predominantly simulation was born out of recognition that students find the concept of practising health promotion awkward, they don’t know how to, and rarely do they see it done well.  With Health promotion being such a big part of a nurses’ role in accordance with the NMC and National Guidance, it should not be overlooked, nor side lined as an ‘add on’ to practice.  The addition of health promotion to any nurses’ practice to me is associated with high quality care and confidence, where a nurse is comfortable in role and communication with patients in order to be able to offer choice. Therefore reflecting on previous delivery of this subject, talking to students about the importance of health promotion is really not enough if we are to demonstrate how it is to be done and thus practising it and reflecting on individual practice or performance.

The session is structured by first having a half an hour talk on how to deliver health promotion including reflecting on good or bad experiences, then offering 3 scenarios where students can interact with an actor (another lecturer) and have a go using the principles taught.

The session delivered this way is risky as owing to large class sizes the luxury of making the environment comfortable is limited.  When we ask students to volunteer to practice, we not only expect them to be vulnerable within that learning, but to be observed and critiqued by their peers of which there can be up to 100 in number. My role as facilitator I feel is to make the environment as safe as possible by being encouraging and adopting a reflective style.  I have decided this time around not to pick on students to undertake the task, but to ask for volunteers only, encouraging where necessary some of the interaction to tell me answers but to direct that line of thought to the patient actor.

For the observation, I want feedback from the colleague observer on how I made the environment safe, if there are any ways to improve, and what to do particularly when students weren’t successful in their efforts.  I have in previous sessions been very tempted to steer the outcomes of the scenarios and tell students the answers rather than allowing time for reflection and development of their own thinking. A previous session to this worked well, where students were excellent in drawing out and empowering the patients, thus getting the point of the learning outcome. If students don’t get the learning outcome, I’m not sure where to go with it, e.g do I tell them eventually or do I leave it for them to reflect….does it actually matter if they don’t achieve the learning outcome?  Sometimes it feels like I am hosting a guessing game as one of the scenarios in particular can be drawn out as students list a number of things they can do for the patient and miss the point of empowering the patient to do it for themselves.

It would be good to get both student and staff perspectives on this learning in particular and also gauge whether large groups inhibit the participation, or widen the possibility of observation.

Another aspect of learning or feedback that would be useful to know is what to do when students don’t readily volunteer as the silence can often be uncomfortable. Should I wait? Should I pick on people or should I do it myself?

From a student perspective I would like to know what learning was achieved from participating, and what learning was achieved by observing.  Could they relate back to the aspects of a health promotion model as they observed, and or reflected on their learning? And would they feel more confident in applying this to their practice and their care planning? To further expand this observation further it would be good if students could reflect how this session has influenced their practice?