Download 5.2 Nursing and complex clinical activity

MODULE DESCRIPTION
Module 11
Nursing and complex clinical activity
This module description has been drawn up in accordance with the Ministerial Order on
Professional Bachelor Programmes in Nursing (Order No. 29 of 24. 01. 2008). It was revised 7 July 2010.
Contents
1 Introduction..........................................................................................4
2 Learning outcomes and core subject areas............................................5
3 Frameworks for clinical training........................................................... 5
3.1 Co-operation between education institutions and training sites.......6
3.2 Student interviews..............................................................................6
Preliminary interviews..........................................................................6
Follow-up interviews.............................................................................7
Final interviews.....................................................................................7
3.3 Portfolio..............................................................................................8
4 Literature..............................................................................................9
5 Organisation of training.......................................................................10
5.1 Introductory training in the clinic............................................................9
5.2 Nursing and complex clinical activity................................................10
Providing nursing care.........................................................................11
Communication and nursing...............................................................11
Managing nursing................................................................................11
Developing nursing .............................................................................12
6 Fixed study activity..............................................................................12
7 Internal clinical test.............................................................................13
7.1. Written paper...................................................................................13
7.2 Examination.......................................................................................14
7.3 Assessment........................................................................................14
7.4 Cancellation of internal clinical tests.................................................14
1 Introduction
Welcome to Module 11.
The objectives of the nursing programmes run in the Capital Region are to train nurses
to work in an integrated fashion on the basis of their knowledge, skills and
competences, and to work in a methodically rigorous manner, think critically and be
internationally oriented.
The module is prescribed to 15 ECTS credits, equivalent to 10 weeks of clinical training.
The module is aimed at nursing and complex clinical activity.
Clinical training is provided at approved sites throughout the Capital Region within the
fields of psychiatry, primary and/or secondary care for children, young people, adults or
senior citizens.
During the period of complex clinical activity, students learn to provide, under
supervision, an increasing level of nursing care in complex clinical situations, based on
the module's learning objectives.
Students taking Module 11 are expected to:
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actively plan their own learning processes
actively learn and reflect
be proactive in relation to the acquisition of knowledge, skills and competences
use and update their portfolios.
The module includes fixed study activities and culminates in an internal clinical test
based on the module's learning outcomes and total ECTS credits.
2 Learning objectives and core subject areas
Nursing and complex clinical activity
The module is aimed at clinical nursing related to patients/citizens with complex, acute and
chronic conditions, as well as the individual patient and his/her network, e.g. the family,
with a view towards planning, organising, providing and documenting coherent patient care.
The module can be organised in psychiatry, primary care or secondary care, in relation to
children, young people, adults or senior citizens.
On successful completion of the module, students will have achieved the following
learning objectives[1]:
A. The ability to identify nursing needs, set objectives, and provide, evaluate, adjust
and document nursing care in collaboration with selected patients and groups of
patients
B. The ability to argue in favour of evaluations and interventions in relation to core
nursing problems in the light of practice-, development- and research-based
knowledge
C. The ability to communicate orally and in writing in clear academic language
D. The ability to master key instrumental nursing activities, methods and standards in
complex patient situations
E. The ability to administer medicine to selected patient groups
F. The ability to identify and reflect on professional/ethical dilemmas and power
relationships in the provision of nursing care
G. The ability to act in an ethical and responsible manner that takes into account the
individual patient/citizen
H. The ability to plan, organise and participate in diagnostic tests, treatments and
observations.
Core subject areas:
Subject – ECTS credits
Nursing
Philosophy, religion and ethics
Pathology
Pharmacology
Theoretical
0
0
0
0
Clinical
7
2
3
3
3 Frameworks for clinical training
These frameworks are designed to help to provide structure, content and coherence in
the organisation of the students' clinical and theoretical training.
3.1 Co-operation between educational institutions and training sites
The educational institution ensures that the co-operation is established and maintained
(cf. the Ministerial Order on Professional Bachelor Programmes in Nursing, Part 4, 10).
The co-operation is formalised on three levels:
1. Management
2. Teachers and supervisors
3. Teachers, supervisors and students.
See also Part 6 of the curriculum in the Ministerial Order on Professional Bachelor
Programmes in Nursing.
The clinical supervisors and the teachers from the educational institution collaborate on
the students' clinical training. The objective is to ensure that both the theoretical and
the clinical training relate to the module's learning objectives in a coherent manner.
Teachers from the educational institution and clinical supervisors work together to
incorporate the latest practice-, development- and research-based knowledge related to
the module's learning outcomes.
If the students or clinical supervisors identify any problems related to the students'
learning or to the learning environment at the training site, they are referred to the
"Guidelines for Solving Problems between a Clinical Training Site and a Nursing Student"
(drafted by the Clinical Committee of the Capital Region, April 2009).
Links:
www.phmetropol.dk
www.sygeplejeskolen.diakonissen.dk
www.sygeplejerske.ucc.dk
3.2 Student interviews
Min. four student interviews are held during the clinical training period, either
individually or in small groups.
Preliminary interviews
A preliminary interview is held within the first two weeks of the clinical training period.
Interviews involve the student, a clinical supervisor and if appropriate a teacher from
the educational institution.
The interview is based on the module description for Module 11, the general study plan
for the training site and the student's portfolio, and culminates in the drawing up of an
individual study plan.
The study plan contains agreements on:
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individual study needs
clinical training and supervision, e.g. content, form and dates
compulsory participation in clinical training
literature (both recommended and self-selected)
dates and documentation for student interviews
the use of and co-operation on the portfolio
date for the internal clinical test.
An individual study plan is drawn up during the interview. The student then types this
up and must e-mail it within two days of the interview to the clinical supervisor and to
the teacher from the educational institution, pursuant to Ministerial Order No. 29 of 24
January 2008 on Professional Bachelor Programmes in Nursing, Part 3, 9.
The clinical supervisor and the teacher from the educational institution each
acknowledge receipt of the individual study plan. The clinical supervisor then certifies
on the documentation form for Module 11 whether the student's individual study plan
is approved/not approved.
The individual study plan is kept in the documentation part of the student's portfolio.
Follow-up interviews
A minimum of two follow-up interviews are held, at which the individual study plan is
evaluated and adjusted. These interviews involve the student, a clinical supervisor and,
if appropriate, a teacher from the educational institution.
In the event of adjustments to the individual study plan, students must submit them by
e-mail to the clinical supervisor and the associated teacher from the educational
institution within two days of the interview.
The clinical supervisor and teacher from the educational institution each acknowledge
receipt of the individual study plan. The clinical supervisor then certifies on the
documentation form for Module 11 whether the student's individual study plan is
approved/not approved.
Final interviews
After the internal test, a final interview is held, involving the student, clinical supervisor
and, where appropriate, a teacher from the educational institution. At the final
interview, the clinical training is documented and evaluated in its entirety.
The students' portfolios form the basis of a discussion of their overall learning
experience, including how students can continue their studies.
The evaluation includes:
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educational frameworks and opportunities for students
co-operation on clinical training between students, clinical supervisors and other
health professionals
co-operation on clinical training with the educational institution.
Students prepare their own written evaluation of the clinical training. This is kept in the
portfolio, and a copy is handed in to the clinical training site.
The clinical supervisor completes and signs the module's documentation form, which
includes a bibliography, compulsory participation record, evaluation, and, where
appropriate, attainment of other EU requirements beyond those that students are
expected to achieve in the area of clinical specialisation/department concerned.
Students receive a copy of the documentation form for their portfolios.
The clinical supervisor must submit the original documentation form to the educational
institution at the latest eight days after the last day of the student's training.
3.3 Portfolio
The portfolio provides the basis for reflection and learning, both in theory and in clinical
practice, throughout the whole programme. It consists of three sections: presentation,
learning and documentation.
Presentation
This consists of a presentation by the student on the nursing programme. The student
decides what he/she wants to convey, and in how much detail. The presentation is used,
for example, for the preliminary interviews in the clinical modules.
Learning
This section contains a range of different study methods, e.g. student interviews,
reflection exercises, learning contracts, a study diary, descriptions of practice,
citizen/patient care, nursing narratives, and the students' own creative contributions.
The student, in collaboration with the clinical supervisor and the teacher from the
educational institution, uses the study methods that are the most appropriate to the
module's learning outcomes.
Selected parts of this section can, by agreement with the clinical supervisor, form the
basis for subsequent examination and internal tests.
Documentation
This contains documentation related to the student's studies, e.g. individual study plans,
bibliography, fixed study activities, attendance, internal tests and final evaluations.
3.4 Compulsory participation
Final documentation for the module's clinical training (corresponding to 15 ECTS credits)
is contingent upon min. 80% participation for the entire period, cf. Ministerial Order no.
29 of 24 January 2008, Part 6, 12 (2).
Shift work
Students may work shifts provided the work fulfils a learning purpose, and on the
precondition that supervision is possible. The objective is:
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to improve the student's ability to develop the knowledge, skills and competences
described for the module
to improve the student's ability to follow individual patient cases.
For further description, see "Guidelines for Compulsory Participation in Clinical
Practice", adopted by the Clinical Committee of the Capital Region, April 2009.
Links
www.phmetropol.dk
www.sygeplejeskolen.diakonissen.dk
www.sygeplejerske.ucc.dk
4 Literature
The syllabus must cover 17–33 pages of literature per 1 ECTS credit, corresponding to
255–495 pages.
The literature selected must support the module's learning outcomes. The literature
must represent the module's three core subject areas, with a weighting corresponding
to the ECTS-credit allocation.
The choice of literature must emphasise texts that are clinically relevant to the training
site concerned, and which are based on practice-, development- and research-based
knowledge. Students can, for example, select literature from the training site's
recommended literature, as shown in the general study plan. Literature used for fixed
study activities and internal tests may be included in the selected literature for the
module.
The bibliography is approved and certified by the clinical supervisor at the final student
interview.
The bibliography is included in the student's portfolio.
5 Organisation of training
The clinical supervisor is responsible for selecting and presenting planned and targeted
training and supervision based on the described learning outcomes.
The clinical training is organised so that students are involved in nursing situations and
patient/citizen care, in conjunction with clinical supervisors, other nursing professionals
and interdisciplinary partners.
The student trains and performs nursing interventions for patients/citizens with
complex, acute and chronic conditions. The student follows the process of
patient/citizen care both at the individual clinical training site and, where possible, in
situations that transcend sectors and institutions.
As part of the planning and provision of clinical training, students are supervised before,
during and after the provision of nursing care.
The clinical training includes:
1.
2.
Introductory training in the clinic
Nursing and complex clinical activity.
5.1 Introductory training in the clinic
At the clinical training site, students are introduced to nursing and complex clinical
activity. They are also introduced to nursing's knowledge base and methodology.
During this period, the student follows a clinical supervisor or nurse while they perform
nursing interventions for patients/citizens with complex, acute and chronic conditions.
Students are introduced to:
the clinical training site
the training site's patient/citizen categories and patient/citizen care
the organisation of the nursing
forms of documentation and communication
study methods and learning and study environments in clinical teaching
the general study plan for the clinical training site
the student interview, including drafting an individual study plan.
5.2 Nursing and complex clinical activity
The module is aimed at clinical nursing related to patients/citizens with complex, acute
and chronic conditions, as well as the individual patient and his/her network, e.g.
the family, in order to plan, organise, provide and document coherent
patient/citizen care.
The knowledge base for patient- and citizen-directed nursing activity consists of
practice-, development- and research-based knowledge.
To achieve the module's learning objectives, students must learn how the content of the
clinical training relates to nursing work, i.e. the provision, communication, management
and development of nursing.
Providing nursing care
During the module, the student must independently focus on [2]:

identifying nursing needs, setting objectives, and providing, evaluating and
adjusting nursing care for selected patients/citizens with complex, acute and
chronic conditions. The nursing is directed towards the individual patient/citizen
and his/her network (A, B, C, D, I)
– providing professional care in collaboration with patients/citizens and
their relatives, in ways that respect their different values, perceptions
and reactions to health and illness
– adopting a patient perspective in the analysis of professional problems
– independently providing nursing care to patients/citizens with different
viewpoints and different cultural, social and family backgrounds
–
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mastering interventions in relation to core clinical patient situations, e.g.
patients suffering pain, patients/citizens with altered perception, patients
with nutrition and fluid balance problems, or patients who are suffering
and dying
– applying and reflecting on methods and standards in the provision of
clinical nursing
– mastering key instrumental nursing interventions
– mastering the administration of medicine to selected citizen/patient
groups
– assisting in connection with various forms of dispensing medication, e.g.
parenteral fluid therapy, intravenous fluid therapy, blood transfusion,
etc.
– assisting in diagnostic tests, treatments and associated observations
– supporting patients/citizens in mastering their life situation and carrying
out health-pedagogical tasks
identifying potential dilemmas and power relationships in care and treatment
situations, as well as structural factors in the health sector, and acting on the
basis of current ethical guidelines, rules for patient safety and environmental risk
factors (G, H)
– accounting for the legal basis for professional practice
– observing ethical guidelines related to the nurse's activities.
Communication and nursing
During the module, the student must focus on:
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communicating with patients/citizens in way that respects their different values,
cultures, intellectual abilities and emotional states (A, B, C, F)
applying data-collation methods relevant to the nursing profession
mastering documentation practices and administrative procedures (A, C, I)
communicating orally and in writing, and arguing on the basis of nursing
observations, knowledge, analyses, evaluations and proposed interventions,
using clear and professional language
justifying proposals for interventions in therapeutic, rehabilitative and palliative
health-promotion, -protection and -prevention work (B, D).
Managing nursing
During the module, the student must focus on:
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ensuring continuity of care and treatment, and focusing on the individual patient
and his/her network, including co-operation with other professions (A, C, E, I).
Developing nursing
During the module, the student must focus on:
 analysing tangible nursing problems and discussing possible interrelationships,
causes and consequences associated with them (B)
 accounting for and reflecting on the methods, standards and procedures used in
professional practice (E).
6 Fixed study activities
Participation in and documentation of fixed study activities are study requirements for
the module and prerequisites for the student sitting the internal test for Module 11, cf.
Ministerial Order No. 29 of 24 January 2008 on Professional Bachelor Programmes in
Nursing, Appendix 2, Section 4.2.
The fixed study activities are aimed at a selected clinical method related to
pharmacology/the administration of medication, including the nurse's responsibilities
and competences.
The student, in collaboration with the clinical supervisor, selects a situation in which the
student is able to demonstrate that she/he has mastered the administration of
medication, including health-pedagogical initiatives for a patient/citizen or a group of
selected patients/citizens.
The student administers the medication in collaboration with the patient/citizen and
clinical supervisor.
The administration of medication is conducted in compliance with existing guidelines
and manuals, including legislation on medicine, documentation, dispensing and
administration, identification of the patient and the labelling of medicine containers.
The fixed study activities conclude with a discussion between the clinical supervisor and
the student, in which the student reflects on his/her administration of medicine,
including the nurse's responsibilities and competences, and also identifies ethical
dilemmas.
The clinical supervisor then certifies on the documentation form for Module 11 that the
student has successfully completed the fixed study activities.
7 Internal clinical test
The module is assessed by an individual internal clinical test. The test takes place during
the last three weeks of Module 11's clinical training period.
The internal test is designed to document whether or not students have achieved the
module's learning outcomes.
A prerequisite for the internal clinical test is that the clinical supervisor is able to certify
that the student has:
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completed the study activities outlined in the individual study plan
completed and had certified the fixed study activities
had the opportunity to meet the compulsory participation requirement (min.
80%).
The clinical supervisor introduces the internal clinical test and offers one guidance
session.
The student, in collaboration with the clinical supervisor, selects one case of
patient/citizen care within complex clinical activity.
In collaboration with the patient/citizen, the student provides the nursing interventions
related to complex clinical nursing. The duration of the nursing interventions depends
on the patient/citizen case chosen (max. 6 hours). The clinical supervisor attends the
nursing interventions as the student's observer and supervisor.
7.1 Written paper
Students write individual papers on the nursing interventions.
The paper should contain a brief introduction to the patient and the nursing
interventions, as well as a presentation of selected theoretically justified nursing
problems related to the care provided.
The description must include theoretical justifications for the nursing interventions.
The written paper must correspond to 9,600 keystrokes (incl. spaces) and comply with
the institution's technical, legal and ethical guidelines for written assignments. A
bibliography must be attached (not included in the number of keystrokes specified).
If possible, relevant excerpts from the nursing documentation pertaining to the
patient/citizen care provided should be attached.
In collaboration with the clinical supervisor, two working days are identified and
earmarked for drafting the written paper. Students are offered one guidance session
with a clinical supervisor.
The student must, at the latest at 12.00 two days after the nursing interventions, send
the written paper by e-mail to the two examiners. The two examiners must
acknowledge receipt by, at the latest, the next day at 12.00. The paper must also be in
the hands of the examiners no later than three working days before the examination is
to take place.
7.2 Examination
The examination is based on the student's written paper from the nursing interventions
and, if possible, relevant excerpts from the nursing documentation pertaining to the
patient/citizen care case.
The examination lasts 30 minutes. The oral examination begins with a student
presentation of max. 10 minutes, during which the student evaluates the nursing
interventions and proposes potential changes to practice.
Students are then examined for 20 minutes, based on the learning objectives for
Module 11. The examination concludes with deliberation and feedback to the students
(10 minutes).
The two examiners conduct the examination together. The clinical supervisor has
primary responsibility for posing questions during the examination. The teacher from
the educational institution may pose supplementary questions.
In connection with the examination, the student signs the written paper to confirm that
the assignment has been done without undue help. See 19 (1) and (2) in the Ministerial
Order on Tests and Examinations on Vocational Programmes (No. 782 of 17 August
2009).
7.3 Assessment
On the basis of the examination, an assessment is made of the extent to which the
student's performance corresponds to the module's learning objectives. The test is
assessed Pass/Fail, cf. Ministerial Order No. 262 of 03.20.2007 on Grading and Other
Assessments.
In terms of grading the exam, the two examiners are on an equal footing. In the event of
disagreement, they must reach a joint position by discussion.
As stipulated in the current Exam Order, only the examiners may be present during the
deliberations.
7.4 Cancellation of internal clinical tests
Cancellation of internal clinical tests is as per the educational institution's current
guidelines. See the Exam Order (No.782 of 17/08/2009, Part 3, 5 (2) and (3)) on
admission to tests.
7.5 Resits for failed internal clinical tests and for absence due to illness
Students who fail the internal clinical test may register for resits, as per the exam order.
Students are offered one guidance session with the clinical supervisor to discuss the
practical examination process. Upcoming tests are planned and agreed in collaboration
with the educational institution.
Students may register for the same internal clinical test up to three times.
In the event of illness, agreement is reached with the educational institution and the
clinical training site about the test process.
Resits or make-up exams are subject to the same frameworks and conditions as the
ordinary tests. See "Guidelines for Resits in the Clinical Programme."
Links:
www.phmetropol.dk
www.sygeplejeskolen.diakonissen.dk
www.sygeplejerske.ucc.dk
[1] The letters A–I used to describe the organisation of training (point 5) are a reference to the specific
learning objectives promoted by the proposed method of organisation.
[2] The letters beside the described content indicate the learning outcomes that they support. See page 3.