LIVE WEBINAR RECORDING

If you would like to listen to the live webinar recording for Teaching the Senior Student, please email your request to:

Julie Cabanatan, Program AssistantRyerson Midwifery Education Programjcabanat@ryerson.ca

GOOD AFTERNOON

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We will start at 2:00 pm

- Elizabeth Allemang

TEACHING THE SENIOR STUDENTElizabeth Allemang

May 25, 2017

WELCOME

Introductions

• Name

• Practice

• Preceptor experience - are you currently a C&C preceptor?

• One issue you would like to discuss today

Adobe Connect basics

Permissions for recording

WEBINAR OUTLINE

• Senior year overview

• Placement structure and workload

• Feedback and evaluation

• Teaching and learning strategies

• What to do when challenges arise

• Ryerson MEP and university resources

• Wrap up

SENIOR YEAR OVERVIEW

C&C MNP Clerkship

Academic learning

• atypical conditions

• weekly PBL tutorials

• 2 papers/2 exams

• abnormal conditions

• weekly PBL tutors

• 2 papers/2 exams

• professional issues

• bi-weekly tutorials

• 2 comprehensive exams

Clinical learning

• learning to lead care

• consolidate normal

• integrate aytpical

• assist with emergencies

• confident to lead care

• consolidate atypical

• Integrate abnormal

• initiate emergency care

• entry level care under

supervision

• final consolidation and

refinement

Placement length • 11 weeks + 4 days • 12 weeks + 3 days • 12 weeks + 4 days

Birth numbers• ≥ 12 primary

• ≥ 6 seconds

• ≥ 12 primary

• ≥ 6 seconds

• ≥ 12 primary

• ≥ 8 seconds

Expanded role• one routine postnatal visit

> Day 3 < 6 weeks

• 2 routine postnatal visits

> Day 3 < 6 weeks

• hospital birth: 1 of 2

midwives

• 3 routine postnatal visits

> Day 1 < 6 weeks

• hospital/OOH birth: 1 of

2 midwives

C&C ACADEMIC CURRICULUM

CourseWeeks in

placement

Planned

continuity*

Planned

observed

Planned

primaries

Planned

seconds

Minimum

planned

Maximum

planned/

attended

Minimum

attended

MWF 150 ≥ 2

NC 17 12 2 ≥ 14 ≥ 6 22 30 18

Third Year 18 0 Unlimited 5 0 Unlimited Unlimited 5

C&C 12 ≥ 7 0 ≥ 12 ≥ 6 18 22 14

MNP 12≥ 18

0 ≥ 12 ≥ 6 18 22 14

Clerkship 12 0 ≥ 12 ≥ 8 20 24 15

TOTAL ≥ 37 4 ≥ 55 26 78 98 66

BIRTH #S

* Continuity = 6 visits per client (ideally including 2 prenatal/2 postnatal)

WORKLOAD STANDARD

15 visits per week - OR - slightly less than the workload of 1.0 FTE midwife

Continuity requirements: 6 visits per client (ideally with 2 prenatal and 2 postnatal visits)

STRUCTURING WORKLOAD

How can you adapt these policies to your preceptor model and your on call model?

student: preceptor ratios call models

- primary call

- shared/rotating call

-

-

STUDENT PLACEMENT CHALLENGES

Balancing clinical & academic responsibilities

On call models and multiple preceptors

Excessive student workload - often clinic workload and seconds

Insufficient clinical experience - often scope of practice issues

Learning-teaching style ‘fit’ with preceptor(s)

Managing stress and anxiety

STRUCTURING AN EFFECTIVE PLACEMENT

Placement orientation

Student learning plan/needs

Preceptor/call model with coordinating preceptor

Appropriate clinical workload and scope of practice considerations

Planning off call time and study time

Active teaching/learning opportunities

Ongoing and structured feedback mechanisms

Formal evaluation processes according to course standards

Do you have other tips for structuring an effective placement?

STUDENT FEEDBACK CHALLENGES

Feeling ‘watched’ and being evaluated

Power dynamic

Working with multiple preceptors and styles

Critique vs constructive feedback for learning

Lack of positive feedback

Lack of structured opportunities for feedback and evaluation

Timing and place, e.g. being critiqued in front of clients, other care providers

EFFECTIVE FEEDBACK

Role model reflective practice

Role model professionalism

Debrief regularly

Provide written feedback

Facilitate student led feedback

Be timely and specific

Be positive and constructive

Focus on learning rather than performance

Be open and straightforward about challenges and how to work together to address them

FEEDBACK STRATEGIES

After a birth, student emails preceptor 3 things did well, 3 areas to improve and 3 things to look up

Structured feedback forms (student or preceptor-led)

Do you have other tips or strategies to share for effective feedback?

COMMON LEARNING/TEACHING CHALLENGES

Skill/knowledge/experience gaps entering placement

Adapting to new practice environment

Managing/balancing primary care responsibilities

Learning to lead care without prompting

Finding time for structured feedback and teaching

Developing an effective/trusting student-teacher relationship

Do you have other learning/teaching challenges you would like to discuss?

Primary care role/responsibilities

• Understand big picture role and responsibilities (R/R)

• Staged entry to R/R within or across components by level or competency

• Staged entry to big picture management (multi-tasking)

• Visual cue for identifying and juggling priorities

• Framework to organize feedback and evaluation

Making care plans

• Understand building blocks to formulate plans

• Recognize plan is outcome

• Consistent and systematic use of standardized model (e.g. ASOAPER, SBAR, CHAT)

• Preceptor mentoring in steps to build plan

• Staged entry into steps

• Encourage anticipation as key step to be prepared and proactive vs. reactive

Decision making and communication

• Provides an ‘easy’ starting point, i.e. observation

• Provides a simple framework for assessment in 3 categories

• Management plan flows directly from assessment

• Staged entry with increasing knowledge and skill

• Provides script that facilitates preceptor ‘correction’

What I see is…

My assessment is…

What I think I should do is…

‘Stop light’ model

Clinical Situation

NormalProceed with routine care

AtypicalIncrease

surveillance until N or AbN

Abnormal Take an action

What I see is…

My assessment is…

What I think I should do is…

e-learning modules

MODULE ONE:

Becoming a Pr imary Care Provider

Understanding primary care 1

EFFECTIVE LEARNING/TEACHING STRATEGIES

Do you tips or strategies to share for addressing common learning/ teaching challenges for senior students?

WHEN LEARNING CHALLENGES ARISE

Identify issues early and make a remediation plan

Set goals and depersonalize - use the Guide to Teaching, Learning and Assessment

Notify tutor and seek assistance ASAP

Give appropriate length of time to improve

Clinical opportunities needed to improve

No surprises at the final evaluation

Provisional satisfactory for discrete gaps which can be addressed in a month

Extensions for insufficient clinical opportunities to develop competence (below minimum numbers)

EFFECTIVE COMMUNICATION

Student

TutorPreceptor

MEANINGFUL FEEDBACK &

PROBLEM RESOLUTION

TOOLS FOR PLACEMENT PROBLEM SOLVING AND CONFLICT RESOLUTION

Under development at Ryerson:

• Literature review of student-preceptor conflict in health professions

• Algorithms for problem solving and conflict resolution - student, preceptor, tutor

• Learning tools

• Policy review

MEP POLICIES & RESOURCES

Policies/Resource Where to find

Ryerson Policy & Information

Handbook

http://www.ryerson.ca/content/dam/midwifery/documents/ha

ndbooks/RU%20P%26I%20Handbook_Nov%2024_2016.pdf

MEP Policy and Information Handbook Student can share access

Guide to Teaching, Learning &

Assessment for Midwifery Preceptors

and Student Midwives

http://www.ryerson.ca/content/dam/midwifery/students/Revis

ed-and-Finalized-Guide-to-T-and-L-July-2013.pdf

Preceptor Handbookhttp://www.ryerson.ca/midwifery/preceptors/becoming-a-

preceptor/

Senior course clinical evaluation form Student to share [online] form at onset of course

Student Guide to Professionalismhttp://www.ryerson.ca/content/dam/midwifery/documents/St

udent-Guide-to-Professionalism-in-Midwifery.pdf

Primary care and clinical decision

making learning modules

http://www.ryerson.ca/openlearning/projects/midwifery/mod

ules/

CLINICAL PLACEMENT POLICIES

RU and MEP Policy & Information Handbooks, e.g.

• placement allocation process

• guide to birth numbers

• off call time

• protected study time

• complaint resolution mechanism

• clinical equipment

• computer access

• car travel and insurance

• incident reporting

• immunization & police check requirements

• grading

• CMO student participation in clinical care

CLINICAL LEARNING RESOURCES

MEP Guide to Teaching, Learning & Assessment for Midwifery Preceptors and Student Midwives:

• Suggestions for learning and teaching in specific skills and areas of practice

• Key resource to understand competency standards and to provide feedback and evaluation

• All skills described in three levels:

Introductory

Intermediate

Entry to practice

CLINICAL LEARNING RESOURCES

Learning primary midwifery care e-learning modules:

• Package of 3 open access online learning modules:

Module 1: Becoming a primary care provider

Module 2: Making clinical decisions and care plans with confidence

Module 3: Finding your voice in professional collaboration and consultation

3 simple tools for teaching and learning midwifery, Allemang [slide presentation] CAM 2016

UNIVERSITY/MEP STUDENT SERVICES

RU Student Services

• Academic Accommodation Support

• Ryerson Aboriginal Student Services

• MEP Aboriginal Student Coordinator

Faculty of Community Services

• Personal Counsellor

• Learning Strategist

• English Language Specialist

School and University Student Awards

THANK YOU

We appreciate your feedback - we will email you a link to a brief webinar feedback survey

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Ryerson MEP Faculty Clinical Education Coordinators:

Elizabeth Allemang

ealleman@ryerson.ca

Vicki Van Wagner

vvanwagn@ryerson.ca