Transcript Return Demonstration

Demonstration &
Return Demonstration
Courtney Crannell, Erin A. Eckhart, Geraldine Keeley, & Tiara Reid
MSN7750 Teaching & Learning
Wilmington University
Overview of Strategy
• Demonstration: done by teacher to show learner
how to perform task/skill
• Return Demonstration: done by learner, attempts to
perform task/skill, with cues from instructor
• Both:
– Require different skill sets from teacher & learner
– Effective in teaching psychomotor domain skills
– May enhance cognitive & affective domains of learning
• Cognitive processes necessary for skill development
• Learner must correctly perceive & interpret stimuli from
environment (cognitive & affective), then choose & control
appropriate motor responses (psychomotor)
Braungart & Braungart, 2008; Fitzgerald, 2008; Gaberson & Oermann,1999
Overview of Strategy
Educational Theory: Behaviorist Learning Theory
• Both theory & teaching strategy:
– Focus on directly observable behaviors
– Observe learner behaviors/responses to stimuli & manipulate environment to create
desired change
• Principles of Operant Conditioning Model directly applicable to return
demonstration
– Increase desired behaviors:
• Positive reinforcement: pleasant stimulus (i.e. compliments)
• Negative reinforcement: removal of unpleasant stimulus
– Escape conditioning: applied unpleasant stimulus creates desired learner behavior
– Avoidance conditioning: learner expects unpleasant stimulus, performs desired behavior to
avoid unpleasant event
– Decrease undesired behaviors:
• Non-reinforcement: no response from teacher
• Punishment: unpleasant teacher response
Braungart & Braungart, 2008; Fitzgerald, 2008
Usages
Application
• Prior to Demonstration:
– Inform learners of purpose, sequential steps, equipment, & expected
actions
– Provide detailed proficiency check-list
– Insure equipment is available & functioning
• Demonstration:
– Passive activity for learners
– Enhance learning:
• Slow timing
• Exaggerate steps
• Break lengthy procedures into smaller parts
– Explain whys & sequencing of each step
– Work with exact equipment learner will use
Braungart & Braungart, 2008; Fitzgerald, 2008; McGovern-Billings & Halstead, 2005
Usages
Application
• Return Demonstration:
– Should occur close to time of demonstration
– Reduce learner anxiety:
• Reinforce teacher’s role: coach not evaluator
• Stress perfection not expected on initial performance
• Explore alternative approaches
– Incorporate games music, posters, etc.
– Create relaxed, flexible atmosphere
– Teacher’s role:
• Should remain silent; offer cues when necessary, briefly answer questions
• Avoid casual conversation & asking questions, these interrupt learner
thought processes; inhibit retention & learning
• Praise learner – reinforces behavior & increases confidence
• Emphasize how to do correctly, rather than mistakes or how not to do
Braungart & Braungart, 2008; Fitzgerald, 2008; McGovern-Billings & Halstead, 2005
Usages
Application
• Return Demonstration:
–
–
–
–
Practice should be supervised until learner masters performance
Practice high-risk skills on model/simulator prior to clinical setting
Learners require varying levels of practice to become proficient
Compensate for individual learner differences
• Left-handed versus right-handed:
– Same handed as learner? Sit on same side of table
– Different handed from learner? Sit on opposite sides of table
• Sensory deficits:
– Ensure learner has resources available to address (i.e. glasses, hearing aids,
additional time for learning disabilities, etc.)
– Provide learner with opportunity for mental rehearsal
• Associated with improved performance & retention
Braungart & Braungart, 2008; Fitzgerald, 2008
Usages
Settings
• May be used in any
setting
• Frequently seen in
clinical & learning
lab
• Requires:
– Small groups
– All necessary
equipment on hand
– Limited interruptions
– Repetition &
Reinforcement
Fitzgerald, 2008
Pros & Cons
Pros of the Strategy
Cons of the Strategy
• Effective for learning in
psychomotor domain
• Requires small teacher-student
ratios
– Skill acquisition: giving IM/IV
injections or dressing changes)
• Creates active learner
– Stimulates all senses
• Increases learner confidence,
competence, & skill retention
through repetition & constant
reinforcement
• Provides over-learning to achieve
goal
Braungart & Braungart, 2008; Fitzgerald, 2008
– Ensures learner able to visualize
demonstration
– Ensures adequate learner practice
– Competency evaluation requires
1:1 teacher-student ratio
• Extra space & equipment needed
depending on task/skill
• Extra costs for purchasing &
replacing equipment
• Requires precise time allotment
for both learner & teacher
Pros & Cons
Strategy Adaption
• General:
– Provide teaching content & examples prior to return demonstration (i.e.
case studies)
• Reinforces cognitive & affective domains
• Ties to Adult Learning Theory: makes it relevant to the learner, if they
know why they’re learning it, they pick it up quicker
• Speeds learning, decreasing necessary class time commitment
• For Nurse Learners:
– Offer course at multiple times to ensure small groups, makes return
demonstration more beneficial & manageable
– Re-use materials when possible to reduce costs
• Patient Education:
– Return demonstration ensures mastery of new task/skill
Fitzgerald, 2008; Hodson-Carlton & Worrell-Carlisle, 2009
Evaluation
Determining Effectiveness
• Demonstration:
– Is effective if learner able to reproduce task/skill accurately
• Return Demonstration:
– Initial return demo may be done with peer/partner supervising task/skill
• Use of peers or videotaping of return demo to obtain feedback
– Video replay allows students to evaluate themselves
– Advantages:
» Self-paced learning
» Student must think about the necessary skills needed in order to critique
» Reinforces learning; gives more opportunities to create mental images &
procedural knowledge
» Self-critique provides more ownership of evaluation & less antagonism
toward faculty; & some research says is less stressful
– Final Evaluation must be performed by an expert: ensures accuracy of
learning
Braungart & Braungart, 2008; Fitzgerald, 2008
Conclusion
• Demonstration & return demonstration are separate, but related
functions
– Demonstration is teaching
– Return demonstration is a measure of learning
• Successful learning is:
– A measure of psychomotor skill acquisition
– Involves repetition of movement & constant reinforcement
• Benner’s Novice to Expert
– Stages of clinical competence depend on skill acquisition & development
• 3 general aspects of skilled performance; the learner:
– Moves from abstract principles to concrete experience
– Changes perception; focus shifts from pieces to the whole
– Changes from detached observer to an involved performer
Benner, 1984; Braungart & Braungart, 2008
References
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA:
Addison-Wesley.
Braungart, M. M., Braungart, R. G. (2008). Applying learning theories to healthcare practice. In S. B. Bastable (Eds.),
Nurse as educator: Principles of teaching and learning for nursing practice, (3rd ed., pp. 93-146). Sudbury, MA:
Jones & Bartlett.
Gaberson, K. B., & Oermann, M. H. (1999). Clinical teaching strategies in nursing. New York: Springer.
Hodson-Carlton, K. E., & Worrell-Carlisle, P. J. (2009). The learning resource center. In D. Billings & J. Halstead
(Eds.), Teaching in nursing, (3rd ed., pp. 349-376). St. Louis, MO: Saunders Elsevier.
Fitzgerald, K. (2008). Instructional methods and settings. In S. B. Bastable (Eds.), Nurse as educator: Principles of
teaching and learning for nursing practice, (3rd ed., pp. 429-471). Sudbury, MA: Jones & Bartlett.
McGovern Billings, D., & Halstead, J. A. (2005). Teaching in nursing: A guide for faculty, (2nd ed.). St. Louis, MO:
Elsevier Health.