Clinical Skills Lab Suggestions

KRVRN, BSN, RN · Jan 31, 2005

I liked that my skills lab instructors taught us the correct, textbook ways of doing things, but would also acknowledge that there are often other ways of doing things and would describe some of them to us.

Practicing skills on each other is appropriate only as far as taking each others' vitals, and bed positioning and turning and such. Practicing foleys, NG's, bed baths, etc. on each other is absolutely inappropriate and should not be allowed. The set up and process of doing these skills can be practiced on the mannequins and the real thing can be done in the clinical setting. Inserting one NG doesn't make you an expert at it, so why should students do it on each other?

My skills lab could have been an everyday part of my school experience, but it was only open a few days a week!

mitchsmom · Jan 31, 2005

The only thing I can think of is relatively minor... be sure the temperature is comfortable in the room (if are able to control it). Ours is always freezing. Like I said, minor... but it's hard to concentrate and do things when you are shaking. :)

Ours lab was good (I don't use it this semester) but I would call it more serious than "fun" per se... although once I think we did have a contest to see who could match up a bunch of photos to their proper skin conditions the fastest.

PS... I am sort of assuming that you won't be having students do invasive procedures on each other as the above poster mentioned... I was appalled to see a student once post that they did NG tubes on each other... there is just no way I'd do something like that. We had to do breast exams on each other, you can imagine how well that went over (although as a breastfeeding counselor it didn't bother me as much as the others). We didn't have anything else that was controversial, we just went through system by system (for assessment class), last day we picked a system from a hat for the lab final.

abundantjoy07, RN · Jan 31, 2005

The thing that I like the most about our skills lab is that we have so many dummies! We have several full dummies that are different ages, colors, and have different body types. We also have smaller dummies. For a gyno. exam we have a small representation of a womans reproductive organs. We have a dummy cut in half for NG tubes so we can see where it's going. We even have baby dummies...and they are so heavy. Just like real babies. There's so many dummies for so many situations. One that I really liked is an arm with tons of vessels. And a slab of skin with different sizes of veins in a row. You can see through them so you can see if you are puncturing the other side of the vessel when doing IVs.

The thing that I don't like....hum....nothing at all! Our teachers always divide us up so the labs aren't crowded. We have real equipment to use. We were able to take kits home to practice with before our checkoffs. Our instructors are great and involved. I think our labs are great.

Catys_With_Me · Feb 1, 2005

Frustrations about lab: not enough instructors for the amount of students -- next week we're going to have 2 instructors for 14 students in a 3 hour time period and the instructors often take up to 45 minutes to check off one student on one thing -- it can be a nightmare trying to get all your checkoffs done. Nothing's assigned it's sign up first come, first served. You come in prepared and ready to go... but can't get an instructor.

Too many different instructors from one week to the next and none of them are on the same page about how you should officially perform your checkoff.

Demos and actual teaching are sometimes rare (although they're doing much better this term) so you can be left with a book and your child at home (wanna be mommy's patient??) and you stumble through trying to figure it all out before you go to check off.

No open lab time where you can go in and practice skills in your off time. The only lab access time is during check-offs 3 hours a week. The rest of the time you do the above at home with the book and the child (or the black lab if the child is crying foul).

Oh, and we're not actually allowed to have fun in lab. If they see that happening they'll politely request that we immediately cease and decist... Lol... just kidding (kind of) we're required to wear our uniforms to lab and keep things professional.

Things I appreciate: We are not forced to do anything embarrassing or invasive on one another (except for IV starts). We have a lot of mannequins as well and even Sims that can be programmed to replicate different disease states and corresponding s/s (projectile vomiting anyone??).

And thank you for asking...

aegirl · Feb 1, 2005

We don't have enough instructors. Right now we aren't in clinical so we are in the lab MWF from 8-4 and have about 5 instructors with 40 students. We don't have enough beds. Sometimes you can't even get a bed to practice. The lab is too small, lol. The lab should have evening hours. All the instructors have a different idea of what this and that should be which is frustrating. One thing I hate is not giving demos...and when they do give demos...i've already tested off or am about too. They give the demos too late.

Now...for what I like. The instructors are great about helping out and answering any questions. We don't have a limit on how many times we can fail testing off on a certain skill (not that I have ever done that!). We don't have to wear our uniforms in lab, just our lab coat which is nice. I like that our instructors aren't drill sergeants in the lab. It's a relaxed environment and it's easier to work in. Can't think of anything else right now...but i'll let you know if I do!

Aneroo, LPN · Feb 1, 2005

One of our biggest complaints was confusion between instructors. We'd have the book, and the instructor in the front telling us something different than what our new book said.

I'm a senior this year, an they've changed a few things around for the new students. They have a lab overview Wed, where the instructor gets up and teachs about it. For lab days, they're required to have already studied the material, and come in prepared to ask questions and practice. If you're not prepared, then you go home, missing clinical time.

One newer thing this year, is senior nursing students are coming into the labs to help teach. It's part of our leadership clinicals. We go to their labs that week, and are expected to know what's going on. We go around and help the students with their skills, and ask them questions about it. "Why would you use this size needle instead of this?" type of stuff. They're very responsive to it, I guess because we remember being right where they are (heck, it was only a year ago), and because our classes have an awesome bond.

We don't practice invasive stuff on each other, including FSBS (you can do that yourself, but no one does it to you), but we did practice baths and bed linen changes. For the baths, we were in a tank top and shorts (there are some schools that make you get in a bathing suit or sports bra).

Hope this helped. -Andrea

Nurse Bethie · Feb 1, 2005

Wow! I am impressed by the amount of feedback! Thank you so much!

I appreciate that time, space and individual attention are the greatest difficulties in the lab setting. I am shocked at the teacher to student ratio that some of you described. I cannot imagine those numbers and there being any effectiveness in teaching/learning.

Do you find that the more sophisticated computer driven simulators are helpful in learning or do you prefer the simpler mannequins that basically allow you to preform the task with no computerized feedback? Would the use of these simulators help with the teacher to student ratio problem - could the simulator give you enough feedback to help you?

I am learning so much - I hope you don't mind continuing the discussion!

Beth :redpinkhe

Imafloat, BSN, RN · Feb 2, 2005

I love our skills lab!

What I like:

The instructors are fabulous, they always have snacks for us. We take the instruction seriously, but we also laugh about stuff.

I like the simple mannequins without feedback.

There is a calendar book that you sign up on for check-offs, we don't check off the same day we learn a skill.

If you make a mistake during checkoff it isn't the end of the world, they ask us to back up and rethink what we just said or did.

Anytime our lab is open we are allowed in there, even if there is another lab group going on. At first I thought it would be distracting if other people were in there during my scheduled class, but you hardly notice them.

Our lab instructors really work at learning all of our names.

There is really nothing that I don't like about our lab. I think that your students are lucky to have you since you care so much.

jennany01 · Feb 2, 2005

What I like about our lab:

:) there are morning and evening hours; it is also open saturdays ;and during school breaks, the lab remains open for skills practice and for watching videos --> esp helpful to incoming freshmen who are not used to seeing 'bloody' or 'invasive' procedures; it could help them prepare themselves esp those who easily get nauseous

:) the laboratory is kept clean (I don't like one comment made in this thread where food is allowed in their lab)

:) lab hours are posted a week in advance so that we can schedule our day of practice

:) most lab technicians are helpful (however, there is always an exception!!!)

:) there is another lab that was set-up which is really awesome - complete with adult and pediatric simulators and EKG machines (but please see comment # 1 below)

:) professors teach a particular skill in the lecture; but when we practice said skill in the lab, the technicians tell us we're doing it wrong!!! Students get confused! (old school VS new school!!??)

What I do not like about our lab:

we do have simulators (which cost millions according to our prof) but so far, we were able to use it only twice (I've been in my school for 4 semesters now) - I just hope the next students will have access to the new facilities on a regular basis

mom2michael, MSN, RN, NP · Feb 2, 2005

I'm a 1st year student in a 2 year ADN program. Our 1st year labs are taught by 2nd year students, which is GREAT!!! The 2nd year students totally remember what it is like for the 1st year students (being a bit overwhelmed). We have a ratio of 1:5, so check offs are easy. We keep the same lab instructor throughout the whole semester. They teach us the "book" way and then the "real" way. Everyone is patient and kind. If you mess up, it's not the end of the world, they just have you try again.

The biggest thing I've noticed is that some of the instructors forget the "basics" and rush through labs assuming that everyone knows what is going on. Most of the people in my lab group are vocal enough to tell the instructor to slow down....but it's nice to always keep in the back of your mind that everyone may not know what's going on or may not have seen "X" done before.

I think it's so nice of you to post this to try and find ideas for your labs!!!

Nurse Bethie · Feb 2, 2005

Thank you again for all your great suggestions!

I think that the comments about food in the lab are right...we do not allow food in our lab - just water in bottles - for those students who just practice for hours and hours!

I am hearing that there are lab hours in evenings and weekends...are there lab instructors/techs there at those times?

We are open M-T 0800-1700 and F 0800-1600 with one instructor always here - evening and weekends are available bu there is no instructor or tech - it has to be two or more health sci students.

Also, I am hearing a lot about upper year studenst assisting 1st year students. Are these paid students "tutors" or is it part of the curriculum?

My students are loving the feedback from you as well...they think it is awesome to hear the expereinces of other students from all over and that they are not the only one's feeling some frustration in certain areas.

Thank you again! :redpinkhe