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Upon completion of this module, the student

will be able to:
1. Identify the role of the nurse in client
education.
2. Identify learning styles, and factors that
determine readiness and ability to learn.
3. Compare and contrast barriers and
facilitator's of the teaching-learning process.
4. List strategies to motivate learners.
5. Describe methods to evaluate learning

Teaching and Learning

Teaching

Learning

Change in human disposition or capability that persists

Represented by change in behavior

Dynamic interaction between teacher and learner

One of many roles of professional nurse

System of activities designed to produce learning

Teach clients, families; may teach colleagues

Teaching is affected by:

Federal and state regulations
Developmental level, cultural, and socioeconomic background
Primary language, previous knowledge, experience
Information and resources

Occurs inside the learner

Discovery of personal meaning/relevance of ideas
Consequence of experience
Collaborative and cooperative process
Evolutionary process that builds on past learning and
experiences
Intellectual and emotional process

Nurse education prepares practitioner with beginning skills

Continue learning to keep current

American Nurses Association (ANA) standards
State board of nursing (BON) continuing education requirements

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Teaching

Activities intentionally designed to produce specific learning

Goal-directed
Create conducive learning environment
Requires knowledge of the subject matter, understanding of the learning
process, judgment, and intuition
Learning theories successful teaching

Holds the learner's interest

Involves learner in process
Creates partnership
Fosters positive self-concept
Sets realistic goals
Directed at helping learner meet objectives
Supports learner with feedback
Accurate and current

Trust and respect

Teacher has knowledge and skill
Learner has ability to attain goals
Teaching process continues until:
Achievement of mutually agreed-on goals
Mutual changing of goals
Mutual decision that goals cannot be met

Development
Communication
Health, Wellness, and Illness

Appropriate for learner's age, condition, abilities

Optimistic, positive
Nonthreatening
Uses variety of methods
Provides multisensory opportunities
Evaluates learning
Gathers information from reliable sources
Is cost effective

Learning need

Individual desire to learn/act on learning

Desire or requirement to know something that is presently unknown to

learner
Compliance and adherence

Pedagogy
Andragogy
Geragogy

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Adult learning theory

Four basic differences from child learning

Adult learning theory

Andragogy

Self-concept

Move from dependence to independence

Experience

Previous experience can be used as resource

Readiness to learn

Readiness to learn related to task, role

Time perspectives

Adult learning theory

Characteristics

Behaviorist theory

Need to know

Learning occurs:
Individual's reaction to stimulus (response) is either positively or negatively

reinforced

Learner's self-concept

Alter stimulus to change response

Use positive reinforcement (pleasant experience or praise) to increase
probability of a response

Role of learners' experience

Readiness to learn
Orientation to learning
Motivation

Behaviorist theory

Applying
Provide sufficient practice time
Redemonstrate, retest

Provide opportunities for learners to solve problems by trial and error

Behaviorist theory

Applying
Select teaching strategies
Avoid distracting information

Praise correct behavior, provide positive feedback

Provide role models

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Cognitive theory

Recognizes developmental level of learners

Cognitive theory

Acknowledges learner's motivation, environs

Readiness
Developmental and individual

Cognitive theory

Bloom's three domains

Applying
Use each domain in teaching plan
Provide environment conducive to learning
Encourage positive teacherlearner relationship
Use multisensory teaching strategies

Bloom's three domains

Affective domain feeling domain

Six abilities or thinking processes

Knowing
Analyzing
Comprehending
Synthesizing
Applying
Evaluating

Cognitive theory

Sensorimotor
Preconceptual
Intuitive
Concrete operations
Formal operations

Cognitive theory

Cognitive domain thinking domain

Jean Piaget
Five phases of cognitive development

Contexts in which learning occurs

Feelings, emotions, interests, attitudes

Psychomotor domain skill domain

Motor skills

Cognitive theory

Applying
Use each domain in teaching plan
Develop approaches for different learning styles
Assess readiness and adapt strategies
Remember personal characteristics impact perceptions

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Social learning theory

Developed by Albert Bandura

Learning process has three factors

Social learning theory

Provide information

Characteristics of the person

Model how to perform new skill

Person's behavior

For example, teach a client to

Environment

Most learning is observational learning

Social cognitive theory

Humanistic learning theory

Abraham Maslow and Carl Rogers

Cognitive, affective qualities of learner
Self-development, achieving full potential
Focus on feelings, attitudes of learners

Convey empathy in relationship

Perception
Conceptualizing
Learning
Decision making

Encourage learner to establish goals

Promote self-directed learning
Facilitate, mentor, be a resource

Use active learning strategies

Physiological needs are met first

Safety and security needs
Love and belonging needs
Esteem and self-esteem needs
Ultimately, growth needs

Categorization (Jerome Bruner)

Applying

Encourage active learning

Maslow's Hierarchy of Needs

Prioritize interventions

Self-motivation

Humanistic learning theory

Administer an injection
Change a wound dressing
Change a suprapubic catheter
Use assistive technology device

Humanistic learning theory

Individual identifying learning needs

Taking responsibility for learning

Applying

Constructivism

Individuals actively construct knowledge to solve realistic problems

Expose learner to relevant information, encourage answer seeking

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Multiple intelligence

Gardner: intelligence has seven dimensions

Body/kinesthetic/movement

Musical/rhythmic

Personal

Logical/mathematical

Symbols as intellectual strengths, ways of knowing

Spatial

Added eighth: naturalist

Motivation
Readiness to learn
Active involvement
Relevance
Feedback

Factors inhibiting learning

Multiple intelligence

Linguistic

Factors facilitating learning

Gardner: intelligence has seven dimensions

Factors facilitating learning

Nonjudgmental support
Simple to complex
Repetition
Timing
Environment

E-health

Emotions

Fear, anger, depression, anxiety

Physiologic events

Illness, pain, sensory deficits

Cultural aspects

Psychomotor ability

Language, beliefs, values differ

Muscle strength and coordination, energy

Online health information

Application of Internet, related technologies

Improve access, efficiency, effectiveness
Faster growing than any other usage
Affects decision making

Older adults

Use Internet much less

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Client education health literacy

Mandated by American Hospital Association (AHA), A Patient's
Bill of Rights
Areas of education
Promotion of Health
Prevention of illness/injury
Restoration of health
Adapting to altered health/function

Growth, development
Health screening, immunizations
Self-care skills, lifestyle adaptations

Voluntary involvement or part of nurse's role

American Red Cross, Planned Parenthood
Large groups interested in some aspect of health
Nutrition classes, CPR, bicycle safety programs

Small groups or individuals

Childbirth, family planning

Increase level of wellness

Ensure safe transitions between care levels

Discharge plans

Assess learning needs from history, physical, client's support

system

Include learning needs, teaching

Common needs for common health problems

Consider client characteristics

Readiness to learn
Motivation to learn
Reading and comprehension level

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Age and developmental level

Can provide developmental status information
Can indicate teaching content and approaches

Clients' understanding of health problem

Can indicate deficient knowledge

Health beliefs and practices

Cultural factors
Economic factors

Learning styles

Support systems

Provides useful clues

Mental status
Energy level
Nutritional status
Physical capacity to learn, perform self-care activities

Relates to whether client wants to learn

Indicated by nonverbal behavior

Ability to obtain medication and supplies

Varies with individual

Ready asks questions, shows interest

Not ready avoid subject, situation
Physical readiness
Emotional readiness
Cognitive readiness

Able to read/understand/act on information

Limited literacy more common in certain groups
Low health literacy poor outcomes
Challenge to teach client

Low or no reading, writing skills

Behaviors may indicate literacy problem

Readability of written material

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Language at/below fifth-grade level

Active, not passive voice
Easy common words, short sentences
Use second person
Large type size, avoid all capital letters
Priority information first and repeated
Bold for emphasis
Simple pictures, lots of white space

Reinforce through repetition

Involve client in teaching
Obtain feedback
Avoid handouts with many pages, lectures

Risk for (Specify) related to deficient knowledge

Most approved by NANDA International imply teaching
learning need

Use multiple teaching methods

Emphasize key points in simple terms
Limit amount of information per session
Associate new information with known information

NANDA International terminology

Deficient knowledge
Readiness for enhanced knowledge
Noncompliance

Develop teaching plan in series of steps

Determining teaching priorities
Setting learning outcomes

Client behavior or performance

Observable, measureable

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Setting learning outcomes

Compares, describes, explains, identifies, lists

Suited to individual
Suited to material to be learned
May include:

Accepts, attends, initiates, chooses, joins

Assembles, changes, demonstrates, moves

Discovery, practice, group discussion, role play

Modeling, printed, computer or AV material

Determined by learning outcomes

Organizing learning experiences

Explanation, one-to-one discussion, demonstration

Choosing content

Selecting teaching strategies

Verbs for writing learning outcomes

Teaching guides
Start with something learner concerned about
Discover what learner knows
Address early any area causing anxiety
Teach simple to complex
Schedule time for review

Knowledge alone not enough

Willingness and perceived need to change
Barriers to change

Showing flexibility

Plan may need to be revised

Use teaching techniques that enhance learning, reduce barriers to
learning

Guidelines for teaching

Rapport essential
Use client's previous learning
Optimal time depends on learner
Clear, concise communication
Pace
Environment
Teaching aids

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Guidelines for teaching

Multisensory
Stimulate motivation, self-direction

Realistic, specific achievable outcomes

Feedback

Repetition reinforces learning

Organizers connect material, generate logical relationships

Changes within context of client's lifestyle, resources

Anticipatory guidance
Client contracting
Group teaching
Technology-assisted instruction
Discovery/problem solving
Behavior modification
Transcultural teaching

Evaluating learning

Ongoing and final process

Evaluation tools

Additional barriers

Evaluating learning
Psychomotor skills
Modify/repeat teaching plan
Behavior change not always immediate

Direct observation of behavior

Written measurements
Oral questioning
Self-reports, self-monitoring

Evaluating the learning experience

Timing
Strategies
Amount of information

Helpful or overwhelming
Boring or motivating

Feedback questionnaires
Retention

Documenting
Essential legal record teaching occurred
Document responses to teaching activities
Multiple-copy client teaching forms
Parts of teaching to document

Diagnosed learning needs

Learning outcomes
Topics taught
Need for additional learning opportunities
Resources provided

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Documenting

Parts of teaching to document for future reference

Information, skills included
Teaching strategies used
Time framework, content of each class
Teaching outcomes, methods of evaluation

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