An Analysis of Critical Incidents to Determine Effective and Ineffective Clinical Instructions

It was the purpose of this survey to determine what constitutes effective and ineffective clinical instruction from the student\u27s viewpoint, and to make the findings available. The descriptive survey method using the critical incident technique was used as the method of research. A critical incident report form was constructed as a tool for gathering the data. There were 117 students of nursing who submitted 166 incidents; 52 per cent were of effective instruction and 48 per cent of ineffective instruction. A review of pertinent literature revealed that the reactions of students to teachers were important criteria to use as one means of evaluating teacher effectiveness. It also revealed that the instructor-student relationship was important in clinical instruction. Analysis of the data consisted of sorting, summarizing and classifying the incidents. Four main categories resulted: (1) builds or destroys student\u27s self-confidence, (2) does or does not show understanding of student\u27s needs and feelings, (3) does or does not make tactful correction of mistakes, and (4) does or does not reveal competence as a nurse. Sub-categories were formed under the first three. Examples of incidents demonstrating both effective and ineffective instruction in each of these main categories and their sub-categories were cited. In the first two main categories, comprising 80 per cent of the incidents, the large number illustrated effective instruction. In contrast, the remaining two categories with 20 per cent of the incidents, had the larger number illustrated ineffective instruction. Findings indicated that nearly half of the incidents were concerned with the student\u27s self-confidence. Factors contributing to this were a careful explanation before doing a procedure, trust in the student\u27s ability, calm and unobtrusive observations, trust in the student\u27s judgment and praise. The importance of understanding the student\u27s needs and feelings was shown by 36 per cent of the incidents. The main factor here was that the instructor offer support and help when needed. Approximately one-fifth of the incidents dealt with the correction of mistakes. The fact that 12 per cent were incidents of ineffective instruction in contrast to 5 per cent of effective, would suggest this to be an especially weak area of effective instruction. Based on the analysis of the student responses, a list of critical requirements for clinical instructors was made and recommended for use