Journal of Nursing Education

EDITORIAL 

Second Opinions: When Needed?

Rheba de Tornyay, RN, EdD, FAAN

Abstract

Most faculty teaching clinical nursing courses would agree that clinical teaching is the most vital part of nursing instruction. Students develop understanding of the relevant theory and recognize the problems and rewards of nursing practice when they work with patients. But faculty members responsible for student learning in the clinical area would also agree that it is difficult and demanding of their time, energy, and patience.

Not only must the faculty member relate to patients and staff members in the clinical agency, but a very special teacher-student relationship develops. It is the teacher who listens to the student who becomes upset over a clinical incident. It is the teacher who assists the student with aspects of learning that are difficult or emotionally laden. It is the teacher who becomes involved with the student's personal problems if they interfere with clinical learning. And perhaps, of most importance, it is the teacher who is responsible for evaluating the student to determine if she or he will be able to continue in the nursing program. Given their special relationship, it is little wonder that faculty members sometimes have difficulty evaluating students in the clinical area as objectively as they would like.

Beginning nursing students are frequently awkward and clumsy in their psychomotor and interpersonal skills. They feel embarrassed about mistakes, and often worry that they will repeat an unsuccessful performance, particularly when they realize their teacher was concerned about patient safety. If the student feels threatened by the faculty member, anxiety may interfere with learning and clinical performance. Sometimes students become angry with the teacher for making suggestions, but most often they are upset and impatient about perceived shortcomings and feel humiliated for not meeting their own expectations.

The personalities of the student and teacher influence their interactions. Teachers are fallible human beings and most realize that they work more effectively with some types of students than others. What is commonly termed a "personality conflict" is usually a misunderstanding between two persons who view a situation differently.

When misunderstandings between student and faculty member occur, how can the clinical instructor be assured that the student has the potential for continued growth while meeting the serious societal responsibility for determining patient safety? Professionals in all fields seek the counsel of their peers in difficult situations. Just as the practicing clinician seeks assistance from consultants for difficult clinical situations, the clinical instructor should seek peer advice when there is reason to question a student's capability. Some schools of nursing have adopted the policy that every student be evaluated by a second instructor before failing a clinical course. This is a sound and commendable practice that should be considered by all schools of nursing.

As schools of nursing accept a diverse student body, it becomes even more important that faculty pool their expertise in understanding and evaluating the individual student. It is to everyone's benefit when a second opinion is sought.…

Most faculty teaching clinical nursing courses would agree that clinical teaching is the most vital part of nursing instruction. Students develop understanding of the relevant theory and recognize the problems and rewards of nursing practice when they work with patients. But faculty members responsible for student learning in the clinical area would also agree that it is difficult and demanding of their time, energy, and patience.

Not only must the faculty member relate to patients and staff members in the clinical agency, but a very special teacher-student relationship develops. It is the teacher who listens to the student who becomes upset over a clinical incident. It is the teacher who assists the student with aspects of learning that are difficult or emotionally laden. It is the teacher who becomes involved with the student's personal problems if they interfere with clinical learning. And perhaps, of most importance, it is the teacher who is responsible for evaluating the student to determine if she or he will be able to continue in the nursing program. Given their special relationship, it is little wonder that faculty members sometimes have difficulty evaluating students in the clinical area as objectively as they would like.

Beginning nursing students are frequently awkward and clumsy in their psychomotor and interpersonal skills. They feel embarrassed about mistakes, and often worry that they will repeat an unsuccessful performance, particularly when they realize their teacher was concerned about patient safety. If the student feels threatened by the faculty member, anxiety may interfere with learning and clinical performance. Sometimes students become angry with the teacher for making suggestions, but most often they are upset and impatient about perceived shortcomings and feel humiliated for not meeting their own expectations.

The personalities of the student and teacher influence their interactions. Teachers are fallible human beings and most realize that they work more effectively with some types of students than others. What is commonly termed a "personality conflict" is usually a misunderstanding between two persons who view a situation differently.

When misunderstandings between student and faculty member occur, how can the clinical instructor be assured that the student has the potential for continued growth while meeting the serious societal responsibility for determining patient safety? Professionals in all fields seek the counsel of their peers in difficult situations. Just as the practicing clinician seeks assistance from consultants for difficult clinical situations, the clinical instructor should seek peer advice when there is reason to question a student's capability. Some schools of nursing have adopted the policy that every student be evaluated by a second instructor before failing a clinical course. This is a sound and commendable practice that should be considered by all schools of nursing.

As schools of nursing accept a diverse student body, it becomes even more important that faculty pool their expertise in understanding and evaluating the individual student. It is to everyone's benefit when a second opinion is sought.

10.3928/0148-4834-19851001-03

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