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  • Subject Name : Nursing

Clinical Facilitation

Table of Contents

Introducing the role of the facilitator

Underlying principles that would guide the facilitator's approach to working with these students

Practical examples of activities to support their learning.


Reference List

1. Introducing the Role of The Facilitator

In this scenario, the facilitator is required to establish a relationship with the students or allow the students to develop relationship with the nurse get assimilated within the process with the registered nurse working as a clinical facilitator. The facilitator needs to understand that the students are also required to assimilate with the other member of the team of clinicians. The facilitator will be working as a role model for the students so that they can be guided towards implementing their skills. The facilitator will not only supervise the students in performing their tasks but provide assistance adequately to help them make sense of their knowledge. Additionally, the nurse is also required to adequately work in the line of the organisational impediments also. The current study will identify and discuss the guiding principles for the approach of the facilitator in teaching the students being placed along with practical examples of activities in the discipline of expertise, aged care.

2. Underlying Principles that Would Guide the Facilitator's Approach to Working with These Students

There are several theoretical frameworks that provide understanding regarding the approach a facilitator is required to take while working with the students. One of the major theoretical frameworks is the Legitimate Peripheral Participation. This elaborates upon the process through which the new students are turned into experienced members of a community (Dubé, Schinke & Strasser, 2019). The underlying principles that may guide the performance of the facilitator include understanding and allowing the students to observe primarily how to perform the skills before they actually implement those. This is the principle of encouraging students so that they can place themselves in the actual situation and understand the underlying rules of performing nursing tasks. For instance, assisting an aged person in regular self care

Students are also required to be allowed for social interactions so that they can engage with the clinician team. This will help bringing knowledge sharing and team learning through the practice of group discussion. This indicates towards maintaining an environment for the students which will be open for discussion so that their learning can be facilitated through exchange of knowledge. Even without the active participation in the situation, passive observation will help the students to understand the norms and expectations and will help to understand if the students are ready to perform as an active member (Wiggins et al., 2017). However, the facilitator will not only allow the students to learn or observe without active participation, as it is highly required for gathering practical knowledge. Therefore, in the aged care setting, students will be guided to perform tasks actively as per the level of engagement required with the process.

Another theoretical framework that provides some guiding principles to the facilitator in working with the students is the Zone of Proximal Development and Scaffolding. As defined by Vygotsky, the zone of proximal development is “the distance the distance between the actual developmental level as determined by independent problem solving and the level of potential development as determined through problem-solving under adult guidance, or in collaboration with more capable peers" (Yusuk, 2018). Therefore, when the students are in the zone of proximal development, the facilitator is required to focus on fundamentally three principles. The facilitator is required to perform as a more knowledgeable other for the students. Students are required to be assisted throughout their placement through support and additional practical knowledge which they could not gather before. Additionally, students are required to be treated as members and social interactions will be required to be facilitated. The facilitator also requires providing supportive activities while assisting the students at the time of proceeding.

For instance, in an aged care setting, the clinical facilitator may provide assistance through offering supporting activities such as developing an intervention plan for bed sore and so on. This will provide the students a place for applying their knowledge and skills along with increasing their confidence in actually performing the tasks during placement.

Apart from that, the facilitator is also required to depend upon the adult learning principles that would direct the learning of the students currently aspiring for placements. Adult learning principles include self direction. As mentioned by Arghode et al. (2017), adult learners are required to have some control over their learning. Therefore, they are required to be provided with the charge of their learning. They are also required to be encouraged to contribute in the learning of the peers. However, the adult learners are also experienced, have self-respect and are proud about them. Therefore, they are required to ask about their previous knowledge and understanding and showing respect to their knowledge is highly crucial. The adult learners are required to build their learning based on the knowledge they have gathered. Therefore, it can be stated that students are necessarily required to be allowed to use their own knowledge and understanding into the clinical practice implementation. Therefore, they can be asked for opinion to be considered while caring for an aged person.

Additionally, it can be stated that adult learners are goal-oriented due to which it is essential to convey the utility of every tasks they are asked to perform in the clinical setting so that those do not seem unnecessary and not required (Barrett, 2016). These students are required to be allowed for solving the problems by themselves, it is also required to be recognised by the students that the learning outcomes will be adequate for their placement and will increase their opportunity in this area. Apart from that, the tasks should also contribute to the professional growth of the students. For instance, the group of students must be allowed to share their thinking with the other group members regarding how specific tasks they are performing and learning in the aged care setting may be useful in future.

Adult learners have also been observed to learn through different methodologies. Therefore, the facilitator is required to investigate and identify the actual learning need of each of the students as all of them are different from each other regrading their experience, individual learning capacity, preferences and others (Master et al., 2016). Based on these elements the facilitator is required to use a range of methodologies such as allowing active participation, hands-on experience, using logical background for every task or anchoring new skills. Along with this, multiple ways of presenting the learning materials will also be facilitatory for the students.

3. Practical Examples of Activities to Support Their Learning

The facilitator is first required to develop a learning culture through communicating the importance of ongoing education and training regarding aged care. Therefore, the facilitator fist needs to develop the group of students in a way so that can work as responsible people for contributing into their learning procedure. Apart from that, the learning facilitators and inhibitors are also required to be identified before starting any session. An ice breaking session would be suitable for bringing the students on the same page where it will be easier to know about the student’s choices and preferences.

  • In integrating a palliative approach, the clinical facilitator would focus on the management related issues and responsibilities along with the tasks to be performed (Sawatzky et al., 2017). Here, the facilitator would introduce the students with the key strategies and policies so that a palliative approach can be taken in aged care facility. The resources would be developed based on the self-directed learning activities principle.
  • In order to start the facilitation process, the clinical facilitator will require identifying the background information of the students such as about their personal experience in the similar field, expertise, preferences, their motivation, goals and others (Moore et al., 2017). These are the factors that highly influence the facilitation process and the success of the process is dependent on this in large portion. For instance, students that are not comfortable in hands on practices may be provided some time of actually implement their skills into a practical setting, instead, they may be provided with some time for assimilating with the setting after which they can be allowed to practice.
  • The facilitator is next required to focus upon enhancing learning regarding assessment and management of five domains of clinical care. For instance, in order to care for the aged people and assist them in assessment and management of pain, dyspnoea, hydration and nutrition, delirium and oral care. Here, the “See, Say, Do, Write and Review” theory will be used through which the students can be kept engaged constantly in the process of learning (Winstone et al., 2017). Students will be encouraged to use this model in identifying issues regarding the five domains mentioned above. Students will be allowed to identify suitable tools that can be used to assist the aged people such as pulse oximeter and others. They would be also allowed to use those tools to manage and assess particular clinical problem such as assessing the heart rate of the patients.
  • The facilitator might arrange a setting where delivering culturally safe and adequate care implementation can be demonstrated. In this approach, the facilitator will demonstrate how the cultural differences can be effectively handled through respectful and dignified clinical care practices (Dickson et al., 2018). Apart from that, the facilitator will also conduct sessions to provide understanding regarding self-care of the aged people.
  • The students will also be provided assistance in learning through identifying their individual needs. Therefore, after each of the session, the students will be asked for questioning about what they have learned throughout the process.
  • The role and scope of practice is also required for the students to acquire for developing skills through being focused upon similar goals. Therefore, the facilitator may conduct a session where the students will be provided differential overview of their roles, responsibilities and tasks to be performed with the others (Zaidi et al., 2017). It is important for the nurses to be aware of their scope of practice so that unnecessary interference does not take place. In performing this task, the facilitator will allow the students to understand how to collaborate with other medical staff members being within the practice scope and how the skills and knowledge can be applied into a practical setting based on the guidelines and their own understanding.
  • In the end of life care setting, a nurse is required to provide support to both the patient and his or her family members so that the ongoing stress level can be managed effectively. This can be performed by the students under the supervision of the facilitator. Apart from that, the facilitator will help the students to effectively implement their communication skills through which they can work better in this area (Karimi‐Shahanjarini et al., 2019).
  • The students are required to be allowed for gathering knowledge through broad range of learning strategies including analysis of case scenario. Different clinical case scenario will be provided to the students and they will be allowed to discuss the same among themselves at the end of the teaching. This is required to make the knowledge span broader and making the applicability high for the students.

4. Conclusion on Principles and Theories of Adult Learning

It can be concluded from the current study that assisting students in a clinical setting for the placement of newcomers, facilitators play a highly crucial role in promoting their skill levels through applying different principles. The study indicates toward different specific principles that will be actually helpful for the facilitators to follow including Legitimate Peripheral Participation, Zone of Proximal Development and Scaffolding and different Adult Learning Principles. Practical examples of the facilitation activities have also been outlined including using nursing tools for assessing and managing health related issues. Checking the rate of oxygen saturation through the use of pulse oximeter is one of them. Case study analysis has been taken under consideration to facilitate the learning of the students.

5. Reference List for Principles and Theories of Adult Learning

Arghode, V., Brieger, E. W., & McLean, G. N. (2017). Adult learning theories: implications for online instruction. European Journal of Training and Development. https://dl1.cuni.cz/pluginfile.php/850493/mod_resource/content/1/Arghode%20et%20al.%20-%202017%20-%20Adult%20learning%20theories%20-Constructivism.pdf

Barrett, T. J. (2016). Principles and theories of adult learning. Alliance Learning Center. http://almanac.acehp.org/p/bl/et/blogaid=86

Dickson, C., Smith, T., Ford, H., Ludwig, S., Moyes, R., Lee, L., ... & McCormack, B. (2018). ‘It’sa nice place, a nice place to be’. The story of a practice development programme to further develop person-centred cultures in palliative and end-of-life care. International Practice Development Journal. https://eresearch.qmu.ac.uk/bitstream/handle/20.500.12289/5429/5429aam.pdf?sequence=1

Dubé, T., Schinke, R., & Strasser, R. (2019). It takes a community to train a future physician: social support experienced by medical students during a community-engaged longitudinal integrated clerkship. Canadian medical education journal10(3), e5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6681930/

Karimi‐Shahanjarini, A., Shakibazadeh, E., Rashidian, A., Hajimiri, K., Glenton, C., Noyes, J., ... & Colvin, C. J. (2019). Barriers and facilitators to the implementation of doctor‐nurse substitution strategies in primary care: a qualitative evidence synthesis. Cochrane Database of Systematic Reviews, (4). https://www.ncbi.nlm.nih.gov/pmc/articles/pmc6462850/

Master, B., Loeb, S., Whitney, C., & Wyckoff, J. (2016). Different skills? Identifying differentially effective teachers of English language learners. The Elementary School Journal117(2), 261-284. https://files.eric.ed.gov/fulltext/ED529176.pdf

Moore, L., Britten, N., Lydahl, D., Naldemirci, Ö., Elam, M., & Wolf, A. (2017). Barriers and facilitators to the implementation of person‐centred care in different healthcare contexts. Scandinavian journal of caring sciences31(4), 662-673. https://onlinelibrary.wiley.com/doi/pdf/10.1111/scs.12376

Sawatzky, R., Porterfield, P., Roberts, D., Lee, J., Liang, L., Reimer-Kirkham, S., ... & Baumbusch, J. (2017). Embedding a palliative approach in nursing care delivery: an integrated knowledge synthesis. ANS. Advances in nursing science40(3), 263. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5555976/

Wiggins, B. L., Eddy, S. L., Grunspan, D. Z., & Crowe, A. J. (2017). The ICAP active learning framework predicts the learning gains observed in intensely active classroom experiences. AERA Open3(2), 2332858417708567. https://journals.sagepub.com/doi/pdf/10.1177/2332858417708567

Winstone, N. E., Nash, R. A., Parker, M., & Rowntree, J. (2017). Supporting learners' agentic engagement with feedback: A systematic review and a taxonomy of recipience processes. Educational Psychologist52(1), 17-37. https://www.tandfonline.com/doi/pdf/10.1080/00461520.2016.1207538

Yusuk, S. (2018). Effects of zone of proximal development based scaffolding techniques on reading comprehension of Thai university students. Interdisciplinary Research Review13(4), 1-6. https://ph02.tci-thaijo.org/index.php/jtir/article/download/117758/111329/

Zaidi, Z., Vyas, R., Verstegen, D., Morahan, P., & Dornan, T. (2017). Medical education to enhance critical consciousness: Facilitators’ experiences. Academic Medicine92(11S), S93-S99. https://journals.lww.com/academicmedicine/FullText/2017/11001/Medical_Education_to_Enhance_Critical.15.aspx

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