Check-In Check-Out Process

Journal Club Article: Henderson, A., Harrison, P., Rowe, J., Edwards, S., Barnes, M., & Henderson, S. (2018). Students take the lead for learning in practice: A process for building self-efficacy into undergraduate nursing education. Nurse Education in Practice, 31, 14-19 [abstract].

Aim: To prepare graduate nurses for practice, the curriculum and pedagogy need to facilitate student engagement, active learning and the development of self-efficacy. Prepare nurses for the range of diverse health settings they will need to deliver care in the future.

Check-in and Check-out process: “aims to engage students as active partners in their learning and teaching in their clinical preparation for practice.”

Three interdependent elements make up the process:

1. A check-in (briefing) part.
   • What will I be doing today?
   • What are my questions before starting?
   • What are my learning goals?
   • What am I learning about today?
2. A clinical practice part, which supports students as they engage in their learning and practise clinical skills.
3. A check-out (debriefing) part.

The Check-In, Check-Out approach to the clinical practical learning experience has been scaffolded for learning development and incorporates classrooms, practice laboratories, simulation clinical placements. Following the Check-In, Check-Out process here are then 4 self-efficacy statements:

1. I can safely perform the clinical practice (What did I do?)
2. I can identify positive examples of clinical practice role-modelling (What did I see?)
3. I can identify feedback received that helped me achieve my learning objective/s (What was I told?)
4. I have the confidence to initiate and independently perform the clinical practice (How do I feel?)

Then 2 take home self-reflective questions:

1. Have I learnt what I need to know?
2. If not, what do I still need to do?

Summary: “The foundation of the CICO process rests on a collaborative partnership between teachers and students. Its benefits are realised by enabling students as active participants and contributors to the fabric of the clinical learning space. Positive learning relationships develop when teaching staff support students in all aspects of their learning experience and students actively engage in the management of their learning.”

Terminology: The authors use the acronym CICO for their Check-In, Check-Out theory. For those of us in critical care settings this may relate more to terminology for the worrying ‘cant intubate, cant oxygenate’ situation.

Thanks to the amazing oracle of nursing education, Associate Professor Deb Massey for discussing this topic. Definitely a nurse academic and influencer to follow.