Demonstration Method In Nursing Education
Whats are Demonstration and Return Demonstration
It is important to begin this discussion by making a clear distinction between demonstration and return demonstration. Demonstration by the educator is done to show the learner how to perform a certain skill. Return demonstration by the learner is carried out as an attempt to establish competence by performing a task with cues from the educator as needed.
These two methods require different abilities of both the educator and the learner. They are especially effective in teaching psychomotor domain skills. However, demonstration and return demonstration also may be used to enhance cognitive and affective learning, such as when helping a staff member develop interactive skills for crisis intervention or assertiveness training.
Method of Demonstration in Nursing Education
Prior to giving a demonstration, the educator should inform learners of the purpose of the procedure, the sequential steps involved, the equipment needed, and the actions expected of them. It is important to stress why the demonstration is important or useful to the participants. Equipment should be tested prior to the demonstration to ensure that it is complete and in good working order.
For the demonstration method to be employed effectively, learners must be able to clearly see and hear the steps being taught. Therefore, the demonstration method is best suited to teaching individuals or small groups. A large screen or multiple screens for video or for streaming presentations of demonstrations can allow larger groups to participate.
Demonstration Method Use In Nursing Education
Demonstrations can be a passive activity for learners, whose role is to observe the educator presenting an exact performance of a required skill. Demonstrations are more effective instructions when are explained verbally either before or during the demonstration.
This method of instruction can be enhanced if the educator slows down the pace of performance, exaggerates some of the steps (Radhakrishna, John, & Edgar, 2011), or breaks lengthy procedures into a series of shorter steps. This incremental member develops interactive skills for crisis intervention or assertiveness training.
Prior to giving a demonstration, the educator should inform learners of the purpose of the procedure, the sequential steps involved, the equipment needed, and the actions expected of them. It is important to stress why the demonstration is important or useful to the participants. Equipment should be tested prior to the demonstration to ensure that it is complete and in good working order.
For the demonstration method to be employed effectively, learners must be able to clearly see and hear the steps being taught. Therefore, the demonstration method is best suited to teaching individuals or small groups. A large screen or multiple screens for video or for streaming presentations of demonstrations can allow larger groups to participate.
Demonstrations can be a passive activity for learners, whose role is to observe the educator presenting an exact performance of a required skill. Demonstrations are more effective instructions when are explained verbally either before or during the demonstration. This method of instruction can be enhanced if the educator slows down the pace of performance, exaggerates some of the steps (Radhakrishna, John, & Edgar, 2011), or breaks lengthy procedures into a series of shorter steps.
This incremental approach to sequencing discrete steps of a procedure is known as scaffolding and provides the learner with a clear and accurate image of each stage of skill development (Brookfield, 2006).
In the process of demonstrating a skill to either nurses or clients, it is important to explain why each step needs to be carried out in a certain manner to prevent bad habits from being acquired prior to the learner performing a new skill set (Brookfield, 2006 ; DeYoung, 2014; Lorig. 2003).
Demonstration as a teaching method provides educators with the opportunity to model their commitment to a learning activity, builds credibility, and inspires learners to achieve a level of excellence (Brookfield, 2006).
The key to performing the demonstration is practice, practice, and practice. If the demonstration is difficult for the educator, how can you expect your learner to perform the skill? Determine whether the skill is appropriate for the experience level of your learner (Radhakrishna et al., 2011).
The educator's performance should be flawless, but it is important that the educator takes advantage of a mistake to show how errors can be handled. If an error does occur, it may serve to increase rapport with the learners and allow them to relax and not feel intimidated, knowing mistakes do happen and can be corrected (Brookfield, 2006). However, too many mistakes disrupt the mental image that the learners are forming.
When demonstrating a psychomotor skill, if possible, the educator should work with the exact equipment that the learner is expected to use. This consideration is particularly important for novice learners.
For instance, the patient or family member who is learning to carry out an activity of daily living at home will be anxious and frustrated if taught in the hospital or community based agency with one type of assistive device, such as a wheelchair or shower seat , when another type is used after discharge. Often the learner is too inexperienced to follow the skill pattern and, instead, may become confused when using a different device.
The seasoned staff nurse, in contrast, might find it easier to transfer what is already known about a type of assistive device if called on to learn to use a newly purchased piece of equipment from a different manufacturer.
Return demonstration should be planned to occur as close as possible to when the demonstration was given. Learners may need reassurance to reduce their anxiety prior to beginning the performance because they may view the opportunity for return demonstration as a test. Such a perception may lead them to believe they are expected to carry out a perfect performance the first time.
Once a learner recognizes that the educator is a coach and not an evaluator, the climate will be less tense and the learner will be more comfortable in attempting to practice a new skill. Educators can stress the fact that the initial performance is not expected to be perfect.
In addition, allowing the learner to manipulate the equipment before being expected to use it may help to reduce anxiety levels. Some clients, however, may experience an increased sense of unease when faced with learning a new skill because they identify the need to learn a skill with their illness. For example, a young woman learning to care for a venous access device may be very anxious because her diagnosis of cancer has necessitated the need for this device.
It is important to note that when the learner is giving a return demonstration, the educator should remain silent except for offering cues when necessary or briefly answering questions. Learners may be prompted by a series of pictures or coached by a partner with a checklist. The first time that learners perform a return demonstration, they may need a significant amount of coaching.
Educators should limit their help to coaching- they should not do the task for the learner who is struggling. The next time the learner practices the skill the educator should observe and coach only if needed (Lorig, 2003).
Also, the educator should avoid casual conversations or asking questions because they merely serve to interrupt the learner's thought processes and interfere with efforts to focus on mentally imprinting the procedure while performing the task. Breaking the steps of the procedure into small increments will give the learner the opportunity to master one sequence before attempting the next one.
Praising the learner along the way for each step correctly performed reinforces behavior and gives the learner confidence in being able to successfully accomplish the task in its entirety. Emphasis should be on what to do, rather than on what not to do. Practice should be supervised until the learner is competent enough to perform steps accurately.
It is important that the initial skill pattern be correct before allowing for independent practice. To ensure safety, high-risk skills should be performed first on a model prior to actual clinical application.
Different learners will need different amounts of practice to become competent, but once they have acquired the skill, they can then practice on their own to increase speed and proficiency. The value of practice should not be underestimated. For a new skill to become automatic and long lasting, repeated practice beyond the point of mastery is essential (Willingham, 2004).
However, if a new task to be performed is similar to a task previously acquired, less time will be needed to master the new skill. For example, a mother who has already learned to use sterile techniques at home to change the dressing on her son's abdominal wound will likely learn more quickly and with much more ease how to properly use aseptic measures if she also must learn how to manage home intravenous therapy.
Return demonstration sessions should be planned to occur close enough together that the learner does not lose the benefit of the most recent practice session. As with demonstration, the equipment for return demonstration needs to exactly match that used by the educator and expected to be used by the learner. Learners also will require help in compensating for individual differences.
For instance, if you are right-handed and the learner is left-handed, sitting across from each other during instruction would be more helpful than sitting next to one another. The person with difficulty seeing the increments on a syringe may need a magnifying device to accurately perform the skill.
Perhaps the biggest drawbacks to demonstration and return demonstration are the expenses associated with these methods. Group size must be kept small to ensure that each learner is able to visualize the procedures being performed and to have the opportunity for practice. Individual supervision is required during follow-up practices. Furthermore, the cost of obtaining, maintaining, and replacing equipment can be significant and must be factored into the process.
Nevertheless, there are some ways to reduce the cost of these methods. If, for example, the audience is composed of a homogeneous group of health professionals who need annual cardiopulmonary resuscitation (CPR) review, demonstration can be done via videotape or web cameras. Also, return demonstration can initially be performed with a partner supervising the competency of the skill.
Nevertheless, the final evaluation of staff competency must be carried out by an expert to ensure the accuracy of learning. In addition, expenses can be reduced by reusing equipment if doing so will not interfere with the accuracy, safety, or completeness of the demonstration/return demonstration.
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