UNIT 2:Skills lab manual for Teachers and students of senior four►

UNIT 1:GENERAL INTRODUCTION

  • UNIT 1:GENERAL INTRODUCTION

     Skills lab based education practice in healthcare has been defined as any 
    educational activity that utilizes simulative aides to replicate clinical scenarios. 
    In skills lab setting students use variety equipment such as manikins, medical 
    equipment, consumables and checklists of procedures, but also, they can watch 
    videos on healthcare professional education. The acquisition of hands-on clinical 

    skills in a long education way is a key to protect patient safety.

    1.1.Goal of skills laboratory

    The goal for clinical skills laboratory is to create an artificial replication of the real 
    world situation in which students can gain knowledge and psychomotor skills and 
    be able to critically think through complex scenarios in a safe and non-threatening 
    environment. This approach to experiential learning is a ‘learner centric’ educational 
    method, which integrates the cognitive, psychomotor, and affective domains in a 
    non-threatening and safe environment thus ensuring accuracy and competency of 

    skills before the student enters the clinical environment. 

    1.2.Purpose of Skills lab

    Maintain state-of-the-art laboratories that are equipped with human patient 
    simulators, digitalized video, and electronic supply and static mannequins. These 
    laboratories were designed to reproduce realistic practice settings, including the 
    basic hospital unit, critical care, surgical/operating suite, pediatrics neonatal nursery, 
    maternity, home care, health assessment and diagnostic laboratory. All laboratory 
    spaces are also outfitted with tables and chairs for reflective thinking exercises that 
    allow the students time to review their decisions and actions with the instructor and 

    their classmates. 

    The Clinical Skill Laboratories exist primarily to serve the students, faculty and staff  
    of Nursing department
     The clinical skill laboratories provide a clinical learning environment utilizing task 
    trainers and human patient simulation technology, as specified by the curriculum 
    and on recommendation by the faculty, and facilitate optimum and efficient utilization 

    of those resources.

    1.3.Purpose of this teacher’s guide

    To facilitate the teacher in  teaching activities, the content of this teacher`s guide is 

    self-explanatory so that you can easily use it.

     1.3.1.Purpose

    The purpose of the rules and regulations of skills lab is to guide teachers, students 
    and other health care professionals to use the available facilities for the development 
    of clinical competencies required in a skills lab environment before translating them 
    to the real clinical settings for the provision of safe and quality health care services to 

    clients.  

    1.4. Structure of the guide
     The guide has two main parts
     1.4.1.Part I: General guidelines
     This part provides general guidance on: 
    • Rules and regulation for skills lab
     • Methodological principles to be used in skills lab

     • Guidance on assessment

     1.4.2.Part II: Development of Checklist

    This is the most important part of the guide. It includes Checklist of fundamental of 
    Nursing for senior 4, 5 and 6, and Checklist of Maternal and Child health for Senior 

    4, 5 and 6.

     Each checklist is developed in the following structure:- - - 
    Checklist title: this title is taken from course units; it contains the theory that need 
    to be translated into practices.
     Procedure: each checklist is divided into different procedures; technique and all 
    steps composed each checklist.

     Aims of techniques(procedures).

    1.5.Objectives of the Nursing Skills Laboratory 

    1. The objective of the Nursing Skills Laboratory is to provide realistic and quality 
    clinical learning experience to associate nursing students through various 
    clinical learning opportunities in the Nursing Skills Laboratory and serve as a 
    provision for the students to become associate nurses. It specifically aims to: 
    2. Build the students’ basic skills  by providing definite connections between the 
    theoretical and clinical learning of the students through definite and adept 
    clinical learning experiences in the laboratory. 
    3. Develop the students’ associate nurse in providing nursing care in accordance 
    with the norms and values. 
    4. Foster the students’ ability to utilize the nursing process in performing nursing 

    procedures. 

    1.6. Duties and Student Nurse responsibilities in skills laboratory

    Students are expected to come to skills laboratory prepared by having reviewed the 
    skill(s) to be practiced and/or demonstrated as well as having read the assigned 
    topics/chapters (if any) by his/her instructor prior to laboratory demonstration. They 

    are advised to take advantage of every opportunity to enhance their nursing skills. 

    1. Log in on arrival to the attendance sheet provided by the laboratory instructor 
    and log out before leaving. 
    2. Inform the laboratory instructor of any particular learning needs. 
    3. Gather and return the equipment used for skill performance. 
    4. Approach situations and scenarios as if they are actual client interactions. 
    5. Follow safety measures at all time. 
    6. Maintain cleanliness of the laboratory area. 
    7. Dispose of sharps appropriately. 
    8. Demonstrate respect and consideration for self and others. All students 
    should display professional, courteous conduct. 
    9. Alert the laboratory instructor of allergies and injuries including latex allergy. 
    10. Any damage or malfunction of mannequins or equipment should be reported 
    to the laboratory instructor immediately. 
    11. Students should at all times observe the safety precautions and appropriate 
    techniques while learning and practicing skills in the lab. If not sure where to 
    locate equipment, supplies or resources, ask. 
    12. Students should be knowledgeable of the care, handling, and proper use of 
    equipment prior to using it in the laboratory. 
    13. The Identification card or ID should be always surrender when borrowing 

    equipment 

     1.7.Skills lab Technician responsibilities 
    1. Conduct monthly inventory of the existing laboratory equipment and supplies and 
    submit semestral report to the program coordinator. It should include utilization, 
    losses, and breakages/damages on all laboratory rooms, laboratory equipment 
    and supplies. 
    2. Catalog and maintain security for audio visual and other media resources. 
    3. Check that the number of borrowed materials is complete and in good condition 
    when returned. 
    4. Prepare laboratory equipment and supplies for each skills laboratory class based 
    from the laboratory instructor or demonstrator’s requests. 
    5. Oversee maintenance of laboratory equipment and supplies, and computer 
    technology equipment for simulation; responsible in monitoring all equipment for 
    optimum performance and also for the certification. 
    6. Initiate processes on ensuring repairs of damaged laboratory equipment. 
    7. Coordinate with the laboratory coordinator in the procurement/requisition of 
    equipment and supplies. 
    8. Directly responsible on the documentation of usage of laboratory, laboratory 
    equipment and supplies. 
    9. Ensure that the laboratory rooms are clean, safe, and organized. 
    10. Accomplishes the Daily Nursing Skills Lab Follow-Up Sheet. 
    11. Promote safe laboratory practices. 
    12. Ensure the completeness of the first aid kit everyday. He/she will replace supplies 
          as needed. 
    13. Responsible for the Nursing skills laboratory lock/key. 

    1.8. Physical safety guidelines 
    1. Students should perform proper body mechanics during practice and return 
    demonstration especially in moving, lifting, and transferring skills. 
    2. Equipment used for body mechanics practice (bed, wheelchairs, stretcher, 
    etc.) should be used only if in good working condition. Any malfunction in 
    the equipment should be reported immediately to the laboratory technician 
    using the incident/injury form. 
    3. The wheels of all equipment (wheelchairs, stretchers, and beds) should be 
    locked during practice and return demonstration. 

    1.8. Managing hazardous waste: 
    1. Batteries which are not functioning should be disposed properly.
     2. Contaminated supplies used during laboratory activities are collected, 
    singed as hazardous waste material and stored in designated area of the 
    skills laboratory. 

    3. All biohazard wastes will be taken by a designated transporter.

     2. RULES AND REGULATION FOR SKILLS LAB
     2.1.Users of skills lab
     Skills lab can be used by:
    – Individual student,
    – Individual instructor for his/her preparation before practice session,
    – Group of students accompanied by a teacher,
    – Group of students for peer tutoring,
    – Group of instructors for continuous professional development,

    – People from outside the institution upon request

     2.2.Main consideration during a skills lab
     1. In accordance with humanistic education, all manikins and models are to be 
    treated with respect as though they are real clients. Models and manikins 
    are to be handled gently and carefully, draped appropriately when used, and 
    covered when not in use.
     2. All skills lab users shall dress for skills lab as if attending the real clinical 
    setting among others name badges and uniform (or clinical coat), tied up 
    hair, close-toe shoes wear.
     3. Tutors are responsible for supervising all students brought to the lab for 
    tutor-led sessions. He/she must prepare and rehearsal the practical sessions 
    before they start.
     4. The tutor should not exceed a group of 8 students for session demonstration 
    and the student should not have more than 3 practical sessions for one day. 
    5. English as a medium language of instruction is recommended in all teaching 
    sessions including demonstration of procedures in skills lab.
     6. Anybody who wants to practice in skills lab must make a booking for practical 
    rooms and equipment. 
    7. If the program permits students/tutors/other users to check out equipment 
    from the simulation lab, all procedures for signing out and returning equipment 
    are to be followed. Failure to responsibly adhere to the policy may mean loss 
    of check-out privileges.   
    8. Attendance and logbook for students should be signed after each simulation 
    teaching/learning session. 
    9. If the material(s)/equipment(s) are lost or damaged the person responsible, 
    signs the form of accepting the act and submit to the skills lab Technician 
    within 24 hours of the incidence in working days, then the procedure of 
    replacing it/them starts. 
    10. Clean-Up of the Area after Sessions: Upon completion of practice session, 
    it is the responsibility of the users to ensure that they tidy up the room 
    (furniture, trolleys,…) and leave the lab as they found it.
     11. Coats, backpacks, and other personal belongings are not allowed in skills 
    lab rooms.
     12. Food and drinks are prohibited in the skills lab rooms.
     13. Universal precautions are to be followed at all times as are all safety 
    guidelines used in the clinical setting. Sharps and syringes are to be disposed 
    in appropriate containers. 
    14. Incident report: In case of any incidence during session, the responsible 
    person should report it in writing to the skills lab Technician within 24 hours 

    of the incidence in working days.

     2.3.Attendance & evaluation skills lab
    1. The signed attendance sheet is used in skill lab sessions as proof. 
    2. The module leader communicates the date of evaluation (OSCE) to be done 
    in skills lab to the students and any change is communicated at least two 
    weeks before.
     3. OSCE should be prepared and rehearsed one day before by teachers.   
    4. Student must practice individually at least three times each procedure 
    taught, before the OSCE.
     5. The student who hasn’t regularly attended the skills lab as indicated is not 
    allowed to sit for OSCE. 
    6. The average pass mark of OSCE is 60% and the results should be 
    communicated to the students within 48 hours of working days.
     7. Debriefing is mandatory for all students within 2 working days after OSCE 
    and HoD should be informed of the process.
     8. The evaluator should turn off his/her phone during OSCE, and follow each 
    step of the procedure done by student.
    9. The student who missed the OSCE without sound justification is awarded a 
    zero mark. The justification has to be notified to the head of department at 
    the latest within 48 hours after the OSCE.
    10. No teacher shall accept a justification which is not countersigned by the 

    head of the department.

     2.4.Methodological principles to be used in skills lab
     2.4.1.Techniques to be used in skills lab
     Skills lab is an opportunity for a student to apply practically what he/she 
    learned theoretical. Even if there are different techniques to be used, one of the 
    recommendable techniques is Scaffolding. 
    Scaffolding is supporting new learning by building new concepts on previously 
    learnt concepts. There are various ways teachers can do this. One way is by 
    reminding the learners about concepts they have previously learned. Another is to 
    display previously learned concepts so that learners can focus on the new learning. 
    This gradual release of responsibility is sometimes called “I do, We do, You do”. 
    This model proposes a plan of instruction that includes demonstration, prompt, and 

    practice. 

    At the beginning of a procedure or when new material is being introduced, the 
    teacher has a prominent role in the delivery of the content. This is the “I do” phase. 
    But as the student acquires the new information and skills, the responsibility of 
    learning shifts from teacher-directed instruction to student processing activities. In 
    the “We do” phase of learning, the teacher continues to model, question, prompt 
    and cue students, but as student move into the “You do” phases, they rely more on 

    themselves and less on the teacher to complete the learning task. 

    2.4.1.1.The roles and responsibilities of teacher and student at every phase.
     The table below shows the roles and responsibilities of teacher and student at 

    every phase.

     2.4.2. Attention to special educational needs specific to skills lab practice
     Teachers need to:
     • Pair a student who has a disability with a friend. Let them do things together and 
    learn from each other. Make sure the friend is not over protective and does not do 
    everything for the student. Both students will benefit from this strategy.
     Below are strategies related to each main category of disabilities and how to deal 
    with every situation that may arise. However, the list is not exhaustive because 

    each student is unique with different needs that should be handled differently. 

    2.4.3.Strategies to help student with physical disabilities:
     • Do activities together with the student.
     • Be patient! If you find that the student takes longer than others to learn or to 
    do an activity, allow more time.
     • Gradually give the student less help. 
    • Let the student do the activity with other students and encourage them to help 
    each other.
     • Divide the activity into small achievable steps.
     • Remember to praise and say ‘Well done’ when the student learns something 

    new or makes a strong effort.

     2.5.Guidance on assessment
     The various assessment will be undertaken to assess students in skills laboratory :
     OSCE: 
    The objective structured clinical examination (OSCE), is designed to assess the 
    student ability to competently apply the professional nursing or midwifery skills and 
    knowledge into real practice. It is set at the level expected of nurses and midwives 
    as they enter the profession. This means that you must show that you are capable 
    of applying knowledge to the care of patients.

    The examination is testing the student ability to apply knowledge to the care of 
    patients rather than how well you can remember and recite facts. All of the scenarios 
    and any questions relate to current best practice and you should answer them in 
    relation to published evidence and not according to local arrangements. 

    Time for OSCE:     The  OSCE will be scheduled at the end of each unit theory, 
    organized to assethe students competencies using different stations according to 
    the course units. 

    Equipment :     All equipment needed to complete the station successfully,according 

    to the station requirements. 

    UNIT 2:Skills lab manual for Teachers and students of senior four►