I think that you should demonstrate your competence in an annual program---maybe frequenting periodicaly the clinical unit?

I think that this depends on the subject. Ways of thinking are always changing. How can someone formulate a feeling of or an opinion of, if the experience of, it is not there. I am a hands on person. I could not teach about things such as team Nursing vs Primary Nursing without actually experiencing it. Without the experience it is like teaching a basketball play. Skills can be taught and demonstrated at any time. Collaboration with a team is another experience that needs to be learned. Your queston depends on your goals. Do you want to teach facts and ways of doing or do you want to share with the students an experience?

Any how what u want, the most important that you can lead your students to the right way, be honest in your practice with them, try to include evidence based in your practice, read more and more, encourage them to start looking and connection between the real case they face and the evidence based...

With such long experience of clinical practice, I think you can still be an excellent mentor:

1/ under the condition that you sometimes attend clinical settings where those skills are implemented.

2/ Make sure you like it.

3/ Make sure your colleagues support you or nobody is available to do so or help you.

4/ I assume that both your pedagogical skills and motivation are excellent. As Darlene said, it also depend on the subject. If I take the exemple of ALSO (Advanced Life support in Obstetrics), episiotomy repair management or shoulder dystocia management don't change much over years.

Joseph

"Clinical skills" is an extensive concept . What do you mean ?

In any case if are you are able to teach, it means that for you updating is necessary.and also you need investigation to observe the results of your teaching and the method validity and efficacy. Moreover you have to be updated on clinical practice methods. This experience could be made also with the cooperation of your students. It is important to involve students in the teaching-learning procedure. Your past experience is necessary and important. We learn also from our students and teaching method is a procedure which quests for a continuous implementation.

If you teach Clinical Method you have to update in Person Centered Medicine as all clinical teacher have to do it , because epistemological principles and consequently medical education of medicine are changed It is valid also for nursing.

I agree to the remarks of Joseph Vyankandondera and Darlene Paliswat

Prof.Giuseppe R.Brera

Requisite for a good teacher is a thorough knowledge base, combined with clinical application skills. I believe that there is no substitute for real-life experience. Admittedly, however, I am a clinician of 34 years who has had no true experience with high tech, clinical simulation models. Still, it would be interesting to see how easily and well you would function in a "real" clinical environment, after 10 years away.

I appreciate your honesty and reflection in asking a question like this. I go through the same question in my head every few years of continuous teaching in a nursing college. I would think like Joseph, that your clinical experience before the last 10 years would be invaluable to your students in developing their skills & attitude. Currently, while teaching in simulation lab there must be a lot you bring in from your vast clinical experience. However, i personally have benefitted in maintaining my clinical skils from changing jobs between clinical experience and academic teaching or by doing short adaptation courses from other countries with a clinical component. Definitely current clinical experience is highly beneficial and adds tremendous value to student learning. However , after long years of being a nurse one develops experiential learning and this helps even if we don't practice regularly. However, I am a great supporter of one day a week clinical practice for nurse educators. The least one could do is "put your hands with your student in patient care literally" . Help your student with patient care competencies at the bedside. You are fine O'Connor. Thank you for stimulating many of us to think.

All practioners should take part in continueous devwelopment practice,it is my belief that regardless of the dicipline if you are only teaching you can become didtant from the realities that face the practioner.We all have the technical and theoretical know how,but proficiency comes with practice.All our teachers should be required to do locum work if their teaching hours prohibit combining in practice.

I would say that if you are required to be registered with a regulatory college, as we are here, there is an expectation of demonstrated continuing competency in whatever area you practice. Regardless of what we do, we are responsible to ensure we are competent to "practice". If that is teaching students then you need to reflect on what is required to continue to do that competently - a locum, reading. Regardless of the requirements of the employer, there is the requirements of the profession.

Great answers! I would only add that with any skill I have learned I have always found there are variations from patient to patient and situation to situation that require more than simulation practice. Even the simplest task of flushing a PICC line changes when dealing with a confused, paranoid, or combative patient. If the teacher is immersed in practice, they will teach their students to at least expect such variation, and will have, in some instances, tips that will help them cope when they are faced with situations that are outside the norm.

Good morning all, I've appreciated the conversation so far and agree with all that has been said.

1) What we teach we are competent and confident with the topic.

2) That the content and methodology used is current and evidenced based.

3) We are prepared to learn from our students and share experiences.

This is a subject that does not get raised often yet there are some very good /exemplary educators teaching clinical practice and skills that are no longer practicing. When I had raised it with my coleagues, their reactions were varied to say the least- some felt that as experienced practitioners we should be able to teach clincial practice forever, however others like me see our roles as teaching others to teach and develop the non technical skills that are required for effective practice - such as teaching clinicians to teach, preceptor and mentor, guide the process of program development, implementation and evaluation, and build stronger healthcare teams in clinical practice. I get great satisfaction as an educator to work with health care teams to develop their non technical skills in the event of a crisis by facililating onsite simulation events, especially in remote clinics.

Having over 25 years nursing experience in rural and remote Australia has provided me with an understanding of the issues surrounding education (and lots of stories)- especially ongoing education for post graduate health professionals. So whilst I feel my clinical/technical skills teaching days are close to expiring I am still able to contribute to the development of a robust health care workforce.

Just to note, I am able to meet my professional obligations as a licenced practitioner by maintaining ongoing health professional education development and practice.

regards

Gill

As a nurse who is working as an educator in a hospice agency and someone who can no longer practice for medical reasons, I do think that teaching is possible without current experience. I can also add the experience of having taken 15 years off to raise my children so I know what I missed during those years. When I returned to nursing I took a refresher course offered by one of the universities here and that was eye opening because I had not kept up on what was happening. I learned a lot in a very short period of time and read everything I could get my hands on to bring me up to speed. I was surprised to see how much remained in the cobwebs and was up to speed very quickly while I was working on a very busy med/surge floor. I have now been working in hospice for 16 years and have been out of the field for the last six years. I do believe that I could go in and care for any of our patients and provide excellent hospice care. I would be much slower to work with med/surg patients because it has been so long but with some work and with some help I believe it is possible because we see patients with a variety of illnesses and I am always reading, updating and learning.

The short answer is yes it is possible but takes some extra time to keep up with the latest information and skills. I bring many years of experience to the education table and an ability to teach the subject the employees can and do learn from what I know.

Which clinical skills are more important for the Registered Nurse? The tasks of initiating a bowel management system or enema, or the global thinking of holistic care in the framework of the nursing process? I think your answer lies there, Gill.

I am not familiar with the research on the subject, but I know for myself, I wanted to not only keep my clinical skills sharp, but I wanted to retain the 'nursing experience'. To accomplish this, I acquired a prn job on a medical unit. I think that one tends to forget all the pressures of nursing if not in practice. Also, ways of doing have changed over the years, as well as the equipment, ways of documentation, etc. So, in short, I find that staying in clinical practice is beneficial for my students and myself.

As same nurse same patient assignment has influence on bonding with patient , introduction of a new face every week for a day may interfere the bonding process. Staying focused on patient care and experience ,I think as surgeons operate on many patients a day, Nurse educators too should selectively perform planned procedures each day to hone nursing skills.It could also include participation in clinical discussions,grand rounds,documentaion etc.etc.students will enjoy learning walk the talk .Besides clinical experience and expertise,it is of utmost importance to keep ourselves most updated and develop our ability to stimulate learner's interest.Simulation is no replacement of living experience.

Often times we second guess ourselves as we watch the profession evolve. Leadership, change agents, evidenced based practice all seem to drift our attention away from the basics. /The answer to your question lies in your gut feeling about your own relevency. Staying current through your educational role is being a practioner. there are many great teachers but poor clinicians. Just because one excells at clinical practice doesn't necessairly make him a good teacher. Good luck.

being a part of the process of putting theory into practice by remaining clinically active is an invaluable adjunct to my teaching role that I do not think could be achieved by simulation alone. Sharing the challenges, frustrations and rewards of this process makes me a more credible teacher and enhances my ability to relate theory to everyday practice - I do not think there is any substitute for this if teaching acute care

The answers are helpful and interesting. Re the aforementioned literature "Within health professional education literature, there is strong support for the notion that to be a good clinical educator' .. can you recommend any recent and/or seminal articles?

Are you still the right person to teach clinical skills to present day practitioners? ABSOLUTELY YES. You have foundation of knowledge in your specialty area. But I will suggest 2 weeks practicum in actual clinical setting of your area of specialization before you start teaching clinical skills. Using simulation to practice nursing skills is not sufficient. In my practice I require clinical instructor for 2 weeks practicum or fieldwork before teaching clinical skills. Please allow me to say it this way. Your skills become dormant and practicum will reactivate your skills. Honesty will make you an effective and successful clinical instructor. I admire your courage of self knowing. Wish you all the best.

I think that there is merit with both approaches. I do think from the research that I have done on this subject (I am working on my second Master's - this time a MSN in nursing education), a clear message that comes from students is they value antedoctal scenario-based teaching from an instructor's clinical experiences. The research has shown students prefer this and feel they learn more from true scenarios rather than case studies. From my own student experience, I valued the instructor that spent time actually on the unit where they are taking the clinical students. That university required instructors to have part time jobs during the summer months on the actual units they did clinicals. That way they knew the unit polciies and procedures which decreased the student's and instructor's confusion once in actual clinical time. As a hospital -based nursing unit educator, I can tell you the quality of the student experience is directly related to the instructor's clinical competence in the domain they bring students. Far too often the instructors are hands-on, or will not let the students do something as basic as give medications because the instructor doesn't have the experience in the area. All the students do is observe all day long the staff nurse doing something. The students are never allowed to perform any nursing care. This is a very sad commentary on the quality of education the student is receiving in "clinical" real world time.

You didn't mention if you have responsibilities other than working in the simulation lab. If you do, then I think that clinical time is imperative. If not I still believe that at least once a year you need to spend time in the clinical environment to be able to make the simulation more real world.

I did see that you posted that you had been out of the "clinical world" for a while but I purpose that simulation does not mean you are out of clinical practice. Simulation is clinical practice. I think the issue lies within in your personal vision of being a nurse, and I would propose that it may meet your own internal needs as well as those of your students to spend a few days a year partnering with your local hospital education department to shadow nurses at the bedside. This will give you a sense of how

"the latest and greatest" is assimilated into the nurse's work load, as well as make you feel that you are not removed from clinical practice. The students will value the insights more and you I think will feel better.

Simulation, as gppd as it can be, is absolutely not clinical practice: the two things cannot be compsred - there is no human factor evident in simulation

to Sharon Browne - I will find the articles and post the links for you

simulation and current research will not be as helpful to those you are teaching unless there is the human component. a simulation has no feelings or involuntary reactions when a foley cath or a nasogastric tube is introduced into their being not to mention a 14G iv cath into their veins. if you want to truely be helpful and offer real time and current practice suggestions than i would expect to follow you to the bedside and observe the practice being demonstrated on a real human being. but then again i guess that is what a clinical is for.

This is an interesting question. I have not been in clinical practice for decades because I taught community health nursing and nursing leadership. There have been times when I was assigned to teach clinical skills to supplemental faculty. I was a total loss and didn't provide good information.

So much has changed in nursing and healthcare that I believe it requires an instructor with current knowledge and experience to teach clinical skills.

As both a clinical instructor AND a simulation instructor, I do think we need to be careful about categorizing Simulation as clinical practice when it comes to INSTRUCTORS. Yes, Sim is clinic as far as students are concerned (that's how we use it; we count it as clinical hours). However, the clinical world changes very quickly and there are some issues taught in classrooms that require up to date clinical knowledge.

I see that as being an issue for advanced issues such as simulations covering highly specialized topics. I think the OP is fine teaching most Sim scenarios to entry level students, despite how long she's been out of clinical practice.

However, as a general rule I think ANY nursing instructor should either work part time in clinical practice (as I do), or take a sabbatical to do what we call at my school Return to Industry. At my school, when funds are available, instructors will work part of their normal teaching load by working with staff members at one of our agencies refreshing basic skills and getting up to date on current best practices.

There is not a "use by date" for teaching clinical skills when not practicing those skills anymore other than in simulation as far as I know. However, as both a clinical instructor and a Simulation instructor we need to be careful about using simulation totally as clinical practice as the clinical world does change all the time and the issues we teach in the classroom require up to date clinical knowledge. I rely on evidence base practice and keeping in touch with the educator at the hospital in my area to stay abreast these changes in clinical practice.

The issue I'm having in my area is lack of clinical space. We have numerous community college and university programs in my area (2 BSN programs, plus at least 5 CC programs), and now have to compete for limited clinical space with two for profit RN programs that recently moved into my area. So far we've managed by being creative in use of the clinical spaces, but we're considering expanding the use of Simulation to get the full clinic hours for some courses (pediatrics is a particular problem for us).

 Do you know authors who "define" guidelines to maintaining clinical skills for professors and course teaching.