A 'Toolkit' for Clinical Educators to Foster Learners' Clinical Reasoning and Skills Acquisition

Abstract
Teaching clinical skills continues to be a mainstay in assisting novice practitioners towards competence and expertise, whether at a patient's bedside or in simulated settings.  Despite his vital role, those tasked with these responsibilities such as nurse educators, preceptors or clinical teaching associates, draw primarily from their own tacit knowledge of how to pass on their practice wisdom about skills mastery.  There is often scant educational preparation for nurses involved in clinical teaching.  Therefore learners' skills acquisition may be ad hoc, rather than an efficient process designed to develop novice nurses.  The 'intuitive' teaching of clinical skills risks learners gaining technical competence but not being able to articulate a critical analysis of whether and why a technique is best practice, nor how they ensured holistic care throughout a procedure.  Clinical reasoning may lag far behind technical know-how.  Although Patricia Benner identified that novices learn best by following rules and frameworks, little subsequent research about the novice to expert continuum has been applied to the development of novice educators.  This article is a syntheses of three teaching and learning models:  the Model of Practical Skill Performance; the 4A Model; and Five Minute Preceptor; and three specific skills: 'think aloud'; questioning; and feedback.  These models and skills bring together a readily accessible 'toolkit' of micro-skills teaching to assist educators in planning learners' skills acquisition, maximising efficiency and satisfaction for educators and learners.  The toolkit also provides educators with 'scaffolding' frameworks to support their own progress towards becoming expert educators.

Keywords
Novice to expert; clinical teaching; teaching models; clinical reasoning