How to deal with situations in lab

[lefrench123]

I work in an ASN program as a lab and clinical instructor. I am looking for tips on how to deal with students who may have LPN or paramedic experience. Although I want to include them in the discussion, I don't want them to "take over" or give the wrong information. I had 4 groups to teach skills to today. In one group, I had been warned that one of the students was an LPN and often acted like she had more knowledge than she did, and would sometimes tell the students the wrong things. When I had each group break into smaller groups, I immediately noticed that she was teaching her group and could already tell she wasn't giving the best tips "doesn't have to be sterile" "we never do it like that" etc. I went to her group first and taught the skill and had her assist. This way, she could give pointers to the next group correctly, and it seemed to work.

In another group, I had another LPN who performed the skill all the time, and I could tell she had a lot of experience with the skill in the setting she worked in. She was really helpful and I valued her input, but a lot of times, she would not let me answer a question fully before jumping in. Maybe I'm paranoid, but I am a new instructor and I felt like this was making me look a little incompetent. It also made some students a little confused because they read things about the way the skill is done in the acute care setting, and she was bringing up information about the way things are done in her setting. I tried to have others answer questions, but she always seemed to jump in and add more info than what was needed.

I also noticed that some students seemed reluctant to perform the skills at all. I tried to assure the that I was there to help and this was just practice. Even though they would say they understood, they were asking questions and having to be corrected the whole way through. I'm not sure why they would say they understood how to do something if they didn't?

Does anybody have any tips about what to do in situations like these?

[NICU Guy, BSN, RN]

I had the same situation in reverse. I was an advanced EMT for five years about 15 years ago. The way I was taught originally was not the most aseptic technique (reusing tourniquets and taping down the IV instead of Tegaderm film cover). I allowed the instructor to teach the clinical group how to start an IV. We then started to test out of the skill and while a student was being tested, the rest of us practiced. Other people in my clinical are aware of my experience. I "tutored" them the same as the instructor. I told them that this is how I was going to test out but don't rely on my instruction as being perfect technique. I had to forget my old ways (teaching old dog new tricks). My instructor is quiet and not assertive. I could have stepped all over her, but I knew that she is the instructor and it's her job to teach, not mine.

You need to pull them aside and state while you appreciate their help. you are the instructor and need to teach the way the school and the clinical facility wants it taught. They are essentially sabotaging your instruction by giving bad technique advice or techniques that are not taught at your school which causes the other students to question the proper way. You have to take control and be the alpha dog otherwise they will sense your weakness and take over.

[nurse2033, MSN, RN]

I agree with Don. You need to take any student like this aside and lay down the law. You should tell them that class participation is part of their grade. And, class participation includes not engaging in behavior that is distracting or interferes in class (I have this defined in a participation rubric). You should tell them that this is not a round-table discussion, it is a class and you are the point-of-contact for disseminating information. And if you hear anyone say "that's not how its really done" you have to intervene immediately.

[lefrench123]

Thanks for the advice. I agree that it is the best thing to do.