Our thesis aims to evaluate work based learning approaches in developing acute skills for nurses in critical care wards. In this section of the literature review, we will discuss policies in the nursing profession, case studies and various approaches to work based acute skills learning programmes. For our purposes we conducted a literature search using popular medical databases and terms such as ‘acute skills’ ‘learning programmes’ and ‘critical care learning’. Our review highlights on the several important approaches to work based learning ranging from reflective practice to experiential learning and work based formal practical training to enhance professional skills.
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less experienced learner for a practice session on experiential learning using the elements of complete support and highlighting the high challenge. The purpose of critical companionship is to enable others to practise in person-centered, evidence based manner. Critical companionship is thus a work based experiential learning approach in which a senior experienced nurse helps a colleague and this practice is especially effective in either one-to one or group learning projects as also in practice development projects, organizational change management, practitioner research, work based learning approaches, clinical supervision areas as well as action learning (Titchen, 2003). Titchen describes the critical companionship framework as a learning approach and examines and analyses the approach through action research giving examples on the efficacy of the critical companionship framework in an acute medical ward. The same framework has also been used in practice development programs, in NHS trusts to help nurses to become critical care companions of older people who take the NHS services.
However a work based learning program for acute ward nurses can also be based on reflective practice and reflection on nursing experiences is an important tool that enhances professionalism. Johns (1995) discusses a single shared experience within guided reflection and highlights the process of guiding learning through reflection showing the importance of reflective practice in work based learning within nursing. The shared experience discussed in the paper relates to an every day nursing experience in which a ward nurse of an acute ward for the elderly responds to a request for medical attention. The reflective practice is discussed here and it becomes a significant source of knowledge informing other nurses of the nursing practice. Reflective accounts are subjective accounts and based within specific contexts. The contextual nature of these accounts actually helps to extrapolate the reflective accounts to similar situations and aid in interpretations. Reflective
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practitioners use their experiences to interpret similar situations and also use existing knowledge on practice to interpret and analyze their situation as related to practice and their profession in general.
A structured ward programme should be implemented in critical care units and Hodges et al (1986) assert that a structured ward programme is essential for a regular staff-patient interaction. Staff –patient interaction differs according to programme structure, staff-patient ratios, and chronicity of the illness in the patient. Structured ward programmes and increased staff-patient interaction is necessary in chronically disturbed and ill patients and the lowest staff patient interaction occurs in acute or emergency wards. Acute ward patients have been found to receive the least attention...