Rapid Teaching Moments
For the mentor, the patient-care environment provides many opportunities and experiences to facilitate student learning. Using innovation, the mentor can create an environment for learning and enhance the knowledge and skills of their mentee. When with the student, these ‘rapid teaching moments’ can often create a new way of looking at things or can prompt the team to come up with others, linked to the placement speciality. Here are just a few examples which have been organised according to the NMC Essential Skills Clusters:
Care, Compassion and Communication:
Abbreviations - Your student looks at the abbreviations on their handover sheet or in the patient notes and identifies what they mean. They should be encouraged to seek help with the ones they do not know. Alternatively you could give the student a short list of common abbreviations to identify.
Google - Ask your student to Google anything that they have not understood from their handover sheet or from discussion with yourself e.g. diagnosis, procedure etc. Also you could give your student a set of questions to answer and ask them to search the intranet or internet for the answers e.g. symptoms of hypoglycaemia, side-effects of a drug that has just been given.
Handover 1 - one patient or more - Ask your student to handover a patient e.g. at end of shift or on transfer to another area. Give the student time to sit down and decide what they will say – they could write this down if they prefer. This could be shown to you before they do the handover with your support if needed.
Handover 2- an aspect of care - Prior to shift handover, ask the student nurse to handover one aspect of care for the patient-e.g. nutrition, breast feeding. As confidence improves the student can handover more aspects of care or one aspect for more patients.
How has your condition affected your life? - Choosing a patient carefully, and with consent, ask your student to discuss their condition with a patient e.g. COPD, diabetes, depression. Prompt the student to ask about, for example: eating, social life, getting dressed, going to a restaurant, employment etc.
Patient story telling - Choosing a patient carefully and, with their permission, your student sits and talks to them, asking the patient about their journey, from first signs of illness to current admission. Emphasise that they should ask questions about the patient’s perspective of their illness and treatment. Requires careful patient selection, and may not be appropriate for all students at the start of their training.
Patient perspective of a procedure - Following careful selection of the patient and obtaining consent ask your student to discuss with them a procedure which they have been to and to explore that procedure from the perspective of the patient e.g. angiogram, X-ray.
Online patient forums - Your student can look at patient discussions online to gain insight into the daily difficulties, challenges and concerns of patients with, for example, ileostomy or bipolar disorder. Ask the student to reflect on whether the principle concerns differ from what they thought they would be.
Practice writing documentation - Ask your student to do a rough copy of a piece of documentation for a patient e.g. evaluation of care for the shift, theatre checklist, social services referral. To then show this to their mentor and possibly fill in the copy to go with the patient, into the notes etc.
Peer-to-peer teaching
Ask your student to hand over a patient to another student. Then ask the second student to reflect on whether all the information required to give care has been given.
Peer assisted learning
When more than one student is on the ward they can practice skills on each other e.g. manual blood pressure, taking a temperature.
Organisational Aspects of care:
Bedside safety - Ask your student to go into your bay of allocated patients and to look at any bedside safety issues they can identify. E.g. Suction not working, no O2 mask, bags on the floor.
Care planning - Ask your student to write a care plan- as rough copy- for a patient they are caring for- identify the patient needs and the care to be planned to meet those needs. This can be done for all needs or just 2-3 dependent on the experience and confidence of the student.
Environment safety - Ask your student to walk around the ward and identify any safety issues e.g. sitting scales without the brakes on, boxes in front of a fire escape. Discuss risk assessment, patient safety and accountability.
Equipment for a procedure - When doing a procedure ask the student to go ahead of you and assemble all the equipment that you will need e.g. passing an NG tube, wound dressing, catheter washout.
Follow the patient through a procedure
When a patient is going for a procedure e.g. going to theatre, colonoscopy- your student can accompany a patient through the length of the journey from leaving the ward to procedure room to recovery and back to the ward. You may like to have a list of questions or aims already prepared so that the student can focus on learning
Hub & Spoke
Together with your student identify other professionals or clinical areas with close links to the practice placement that will help the student to get a more holistic view of clinical practice -e.g. diabetic CNS, Pain team, Pre-assessment unit. Ask your student to find out the relevant bleep numbers or extension numbers and arrange to spend some time there or with that member of the MDT. You will need to ensure that time is structured- possibly by having a set of suggested questions for them to take with them.
Images - Have a series of photographs or images - relevant to your speciality, which you can discuss with your student. For example, wounds (easily obtained from Google images), routine equipment etc.
Out-of-date equipment - Rather than throw away equipment that is out of date, keep it for students to practice with and to discuss away from the bedside.
Patient assessment using a template - Second and third progression point students – with a patient’s permission ask your student to do a holistic systematic assessment of a patient, writing their findings down for you to check. If your student finds this too difficult then ask them to address just one part of assessment e.g. respiratory function, personal care. Encourage the student to involve the patient in the assessment.
National guidelines - Ask your student to look up a national guideline (SIGN, NICE, RCOG, etc.) relevant to your area. For example, treatment following stroke or MI, or guidelines for the management of group B strep in pregnancy, or routine postnatal care. Together with your student, identify whether your area is following the guideline at all stages along the patient journey, including after discharge.
What if.....? - Give the student a clinical scenario to think about e.g. patient starts to fit, patient falls on the floor orappears drowsy – ask your student to tell you what they think should be done in this situation. This could be done as a group activity with other students and then discuss later when their mentors are more easily available.
Ward rounds/case meetings/clinical incident meeting - Support your student to gain greater understanding of MDT working– either as observer or for more senior students as a participant – by arranging for your student to attend MDT meetings, case conferences or to accompany the ward round visiting patients. The student should be accompanied by their mentor or other qualified staff member for support. Then ask the student to reflect on the role of the nurse in the meeting or on the ward round.
Talking through a skill - While observing you as the mentor doing a skill e.g. wound dressing- the student tells you what should be done next throughout the practice of that skill. You can also ask the student why each step in the procedure is necessary.
Preparation for a procedure - Ask your student to write a list of all the things that need to be checked before the patient goes to surgery or for an invasive procedure. Then ask the student to explain why each item is checked. For a more junior student you may want to go through the theatre checklist and explain why each item is checked and potential problems if not done correctly.
Patient Journey Map
Get your student to look at the patient journey for one patient and to identify all the members of the MDT who have impacted upon their care. Draw as a mind map with the patient at the centre and indicate the role and aims of each member of staff. Emphasise the importance of multidisciplinary care.
Pain - Draw a quick outline of the human body. Get the student to mark where a patient can get pain and discomfort induced by clinical treatment- e.g. pain from insertion of a drain, NG tube, IV cannulaetc.
Nursing at Night.
Identify all the sources of noise at night. Ask the student how this would impact on the patients/clients and how they think that they could reduce night-time noise.
Pressure area care - Draw a picture of the human body and ask the student to identify where the patient can get skin damage from pressure e.g behind the ears from oxygen mask, calves from wrinkles in anti-embolic stockings
Infection Prevention and Control:
Hand hygiene 1 - Get a couple of students to observe each other washing their hands and critique- ask them to score out of 10 against the seven steps of hand washing
Hand hygiene 2 - Ask your student to tell you each time you should gel or wash your hands. Tell them that you want to be prompted!
Vectors of infection - Ask your student to think about the different ways in which infection may be spread between patients e.g. shared equipment, weighing scales, your pen, notes file. Ask the student to identify what appropriate measures can be taken to prevent transmission of infection.
Nutrition and Fluid Management:
Fluid balance - Ask your student to assess the fluid status of a patient - having chosen a patient carefully. Students should get all the information available- obs. chart, fluid chart, blood results, IVI prescription chart, drug chart - to calculate fluid balance, but also look at other factors , for example, drugs that are renal toxic, electrolytes, skin turgor etc. A more senior or more able student could do this for a small number of patients.
Special diets 1 - With their permission get the student to talk to the dietician about any special diets that your patients are on, what restrictions or supplementation they have.
Special diets 2 – Carefully selecting the patient get the student to talk to a patient who is on a long term special diet e.g. renal diet or diabetic diet, to identify how this affects their life style, and to understand restrictive diet from the patient perspective.
Nutritional difficulties – Ask the student to identify any reasons why your patient cohort may have difficulty in eating or drinking and how this should be resolved. Alternatively, ask the student to write a list of the reasons why a patient may have difficulty eating.
Medicines Management:
Allergy to penicillin - Write out a list of common antibiotics and then ask your student nurse to identify if they can be given to someone who has an allergy to penicillin. If the student is not sure then they can look it up in the BNF
Medications and past medical history - The student looks at the medications that a patient is currently on along with their past medical history and current complaint. Using this information and their knowledge of medications your student should identify why each drug is being given. They should also check the dosage, frequency, route of administration etc.
Drug chart - Have a practice drug chart (clearly marked as a teaching aid only) which contains deliberate errors for the student to identify. E.g. No doctor’s signature, co-amoxiclav with a penicillin allergy, wrong doses or frequency. Encourage your student to look up in the BNF any items they do not know. Ask them to explain how the prescriptions can be improved to make them a valid prescription.
Drug chart layout - Ask a junior nurse to look at the layout of an empty drug chart and then to locate where a number of items would be written e.g. Warfarin, anti-embolic stockings, IV fluids, drugs not administered, stat dose. Or ask the student to suggest drugs that would be prescribed in each section
Drugs at home - Choosing a patient carefully, and with consent,ask the student to talk for a few minutes to the patient about the drugs that he or she takes at home, any routines that aid taking the drugs, side-effects, any problems, coping strategies e.g. Diuretics, insulin.
Medication errors - Ask your student to identify where medication errors can take place or to identify patients who are at risk of medication errors. E.g. elderly, patient with allergies renal dysfunction, transfer of care between areas, rewriting drug charts, insulin.
High risk medications - Ask your student to research which medications are identified as "high risk” and then to identify ways in which this risk is reduced e.g. warfarin and daily INR measurement.
BNF 1 - Your student can download the latest edition of the BNF to their smartphone or tablet and encourage them to look up drugs as they are administered
BNF 2 - Give the student a list of common drugs to look up in the BNF. Ask them to feedback to you the route, dose, frequency, side-effects, contra-indications etc.
Nil by Mouth - Looking at the drug chart of a patient ask the student which drugs they would give if the patient was nil by mouth prior to a procedure. How would you resolve giving the drug if the patient cannot take it orally?
Pharmacist - Ask the pharmacist if the student can accompany her -looking at charts, discussing what they check for and advise patients, drug resolution.
Do you have any Rapid Teaching Moments of your own that you'd like to share? Please let us know at
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