Teaching Strategy: Return Demonstration

Broad overview of strategy

Return demonstration is effective strategy when learning a psychomotor domainThis strategy is
effective when combined with a demonstration, the learner should return demonstration as close to
demonstration as possibleGives the learner an opportunity to show what they have learned in a
comfortable non-intimidating environment

Educational theoriesSelf Efficacy theory: theory based on performance accomplishments. The

learner is taught a skill and then given the opportunity to demonstrate the skill learned.According to
Albert Bandura, self-efficacy is “the belief in one’s capabilities to organize and execute the courses
of action required to manage prospective situations” (Bandura, 1994).

Educational Theory: Self Efficacy Defined

People with strong self efficacyView challenging problems as tasks to be masteredDevelop deeper
interest in the activities in which they participateForm a stronger sense of commitment to their
interests and activitiesRecover quickly from setbacks and disappointments (Bandura, 1994)People
with weak self efficacyAvoid challenging tasksBelieve that difficult tasks and situations are beyond
their capabilitiesFocus on personal failings and negative outcomesQuickly lose confidence in
personal abilities (Bandura, 1994)

Usages of the strategyDemonstration of blood glucose testing, explained and the learner is given the
opportunity to demonstrate this to the instructor. Best used with individualized instruction.Other
examples:Dressing ChangeInjectionsBlood Pressure MeasurementMedication AdministrationHand
washingDonning Sterile Gloves

Pros of strategy Effective for learning in the psychomotor domain

Engages the learner using visual, auditory and tactile sensesRepetition of movement and constant
reinforcement increases confidence, competence, and skill retentionProvides opportunity for over
learning to achieve goal

Cons of strategy Best completed with 1:1 instruction Can be costly

Need to limit the size of instructionRequires plenty of time to be set aside for teaching and for
learningExtra space and equipment may be necessary for certain skills

EvaluationReturn demonstration is beneficial in making patients comfortable with new skills.This

strategy permits the nurse to document patient’s progress and any areas they need
improvement.Evaluator/Coach can use a checklist to make sure the learner is mastering each step,
and which steps require more practice

ReferencesBastable, S. B. (2008). Nurse as educator (3 ed.). Sudbury, MA: Jones and

Bartlett.Cirone, N. (2010). Documenting return demonstration. Nursing Retrieved May 24, 2010
fromFinkelstein, E., Wittenborn, J. & Farris, R. (2004). Evaluation of public health demonstration
programs: The effectiveness and cost effectiveness of wise woman. Journal of Women’s Health.
Retrieved May 24, 2010 from ebscohost.London, F. (1997, February). Return Demonstration: How to
validate patient education. Nursing 97, 32.
Bandura, A. (1994). Self-Efficacy. New York, New York: Academic Press.Bastable, S. (2008). Nurse
as educator: principles of teaching and learning for nursing practice. Sudbury: Jones and
Bartlett.Mantik Lewis, S., & Heitkemper, M. (2004). Medical-surgical nursing: assessment and
management of clinical problems. Mosby.

DEMONSTRATION
shows the learner how to perform a skill by the teacher (Bastable, 2008)

Return-DemonstrationCarried out by the learner to perform a task with cues from the teacher
(Bastable, 2008)

Why demonstration?“A demonstration provides a concrete, realistic learning experience. It has the
advantage of using visual as well as oral perceptions. Other senses may be used such as smell or
touch. The emphasis is on what to do, rather than on what not to do.” (Cooper, S., 1982)“Ensures
that learning and comprehension have occurred. This method can increase the opportunity for the
learner to understand and apply the skill that is taught. Verbalizing what they are doing, in their own
words, will also increase the likelihood of patients’ retention.” (Burkhart, J.A., 2008)

DESCRIPTION Models- Replicas: constructed to scale:

models of the heart, kidney, DNA helix, resuscitation dolls, breast modelsAnalogues: has the same
properties and performs like the real object:Dialysis machines, computer model of the brainSymbols:
used in teaching situations:Traffic signals, words, mathematical signs, stick figures, international
signs. (Bastable, 2008)

Domains of Learning Primarily effective in teaching psychomotor skills

Examples: teaching self-injections, breast self-exams, testicular exams using anatomical modelsMay
enhance cognitive and affective learningExamples: assisting developing interactive skills for crisis
intervention, grief counseling, interviewing, history taking (Bastable, 2008).

Cognitive Learning Theory by Robert Gagne

Reception-gain learner’s attentionExpectancy-inform learner of objectivesRetrieval-stimulate
learner’s recall of prior learningSelective- perceptionSemantic encoding-facilitate learner’s
understandingResponding-learner demonstrates the new skill or informationReinforcement-give
feedback to the learnerRetrieval-assess the learner’s performanceGeneralization-enhance retention
and transfer through application and varied practice.(Bastable, 2008, p )

Uses of Demonstration and Return Demonstration

CPRInsulin self-injectionsDressing changesSelf-catheterizationGlucose monitoringTesticular/Breast
exams on modelsPreparing medicationsHow to use an asthma inhalerTube FeedingsColostomy
irrigationEpi-pen self-injectionsMonitoring blood pressuresTaking patient historiesCrisis intervention
skills

Advantages Especially effective for learning in the psychomotor domain

Actively engages the learner through stimulation of visual, auditory, and tactile sensesRepetition of
movement and constant reinforcement increases confidence, competence, and skill
retentionProvides opportunity for over-learning to achieve the goal (Bastable, 2008).Increased ability
to control the environment and simulate clinical practice (Billings, D.M.& Halstead, J.A., p. 309,
2009)Effective teaching method for low literacy, can increasing health literacy

Evaluation Evaluation of learning and retention is a complex task.

Learning is defined as a change in cognitive, psychomotor and/or affective behavior.”Activities used
for teaching are only effective to the extent that they result in a change in one or more of the 3
learning domains (Dougal, J., Gonterman, R., 199

Methods of Evaluation Formative:

Can my teaching be improved to enhance learning?Am I giving the learner enough time to
practice?Is the demonstration material appropriate for the learning objectivesDo I need more
opportunities for return demonstration?

14 Methods of Evaluation Summative: Was the overall goal accomplished?

Were the behavioral objectives met?Was the level of competency increased?Was the skill learned-is
the patient able to perform return-demonstration with 100% accuracy?Likert scales, questionnaires,
pre-test and post-test comparisons, Return demonstration checklists (performs independently,
performs with minimum verbal clues, unable to perform)

ReferencesBastable, S.B. (2008). Nurse as educator: Principles of teaching and learning. 3rd Ed.
Boston: Jones & Bartlett.Burkhart, J.A. (2008). Training nurses to be teachers. TheJournal of
Continuing Education in Nursing. 39,Billings, D., & Halstead, J. (2009), Teaching in nursing; A guide
forfaculty. St. Louis: Saunders Elsevier.Cooper, S. (1982) Methods of teaching-revisited the
demonstration. The Journal of Continuing Education in Nursing, 3, pDougal, J., Gonterman, R.
(1999) A comparison of three teaching methods on learning and retention. Journal for Nurses in
Staff Development, vol. 15, 5,