Teaching & Learning Flashcards
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Is a change that occurs in behavior, knowledge, skills, or attitudes
Learning
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Is an interactive process that involves planning and implementing instructional activities to meet the intended learner outcomes or to provide activities to allow the learner to learn
Teaching
Why is Teaching in Nursing Important?
Patients are expected to be active participants in their healthcare decisions; ensure true informed consent
Hospital stays are shorter, and patients are discharged needing medication, treatments, and/or skilled procedures
Healthcare is expensive!
- Cost effective
Why is Teaching Cost-Effective?
Clients can have many different diagnoses
e.g. CHF
Upon discharge, if client is readmitted within 30 days, the hospital is required to cover all costs of readmission and receives no reimbursement from the insurance company
Reason they’re readmitted due to poor or incomplete patient teaching
Ensure they know about their diagnosis, treatment plan, when to follow up and leave them in a place of confidence upon discharge so they won’t return in the 30 days
Teaching can…
___ wellness
Prevent or limit the illness
___ health
___ to changes in body function
Facilitate coping with illness, stress, and/or loss
Promote
Restore
Adapt
Who do nurses teach?
Clients
Their family members and/or their caregivers
Teach clients independently or in a group setting
Teach in private or community setting
Who do nurses teach? cont’d
Teach other healthcare workers (UAP’s, LPN’s, novice nurses, student nurses, and peers)
What are my teaching responsibilities?
Teaching is an ___ nursing function
Defined by state ___
Independent
nurse practice acts (NPAs)
The American Nurses Association (ANA)
“Nurses are responsible for promoting and protecting health, safety, and rights of patients.”
*Teaching is a key component in meeting that responsibility
Nursing teaching activities include:
- Providing health promotion teaching
- Teach in accordance with the patient’s values, beliefs, health practices, developmental level, learning needs, readiness to learn, language preference, spirituality, culture, and socioeconomic status
- Seeking opportunities for feedback and evaluation
- Use of information technology to deliver healthcare information
- Teach about expected and adverse effects of proposed therapies
The Joint Commission (TJC)
Patient teaching is a hospital accreditation standard
Healthcare organizations must consider patient…
- Literacy
- Developmental and/or physical limitations
- Financial limitations
- Language barriers
- Culture
- Religious practices
They must also include any person who will be responsible for the patient’s care
Advisory Commission on Consumer Protection and Quality in the Healthcare Industry
Patient Care Partnership (previously the ___)
Patients have the right to receive accurate and easily understandable information regarding their healthcare
If a patient’s primary language is different from the teacher or if the patient has a physical or mental disability, they are entitled to have the right help to make informed healthcare decisions; right to request an interpreter and right to have accomodations made
Patient Bill of Rights
Five Rights of Teaching
They are…?
Acronym:
Trading Card Games Cost Money
Time
Context (quiet environment or distractions?)
Goal (does client identify objectives?)
Content (new or reinforcement?)
Method
Learning Theories
Social Learning Theory
Behavioral Learning Theory
Cognitive Theory
Humanism
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Sees learning as a complex mental activity while recognizing the importance of the developmental stage as well as the social, emotional, and affective influences
e.g. [Bloom]’s Taxonomy (what is used for nursing exams)
Cognitive Theory
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Is rooted in psychology; belief that environment influences behavior
e.g. Pavlov, Skinner, Bandura
Behavioral Learning Theory
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Emphasizes the learner’s active participation while focusing on their effective, cognitive, and attitudinal qualities
* Learning is self-motivated, self-initiated, and self-evaluated with a purpose of self-development
Humanism
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Explains characteristics of the learner; large focus on self-efficacy (a person’s perceived ability to successfully perform a task)
Social Learning Theory
Learning Domains
Cognitive
Psychomotor
Affective
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Involves changes in feelings, beliefs, attitudes, and values
Done through role-modeling, group work, role-playing
Affective
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Involves mental activities for processing information
Helps to increase client learning about remembering and understanding to even higher levels of applying, evaluating, and creating
Done through lectures, panel discussions
Cognitive
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Involves learning skills that require both mental and physical activity
Learners practice and receive feedback
Done through demonstrations, simulation models
Psychomotor
Teaching Strategies
The method used to present content (methodology)
- Lecture
- Group discussion
- Demonstration and Return Demonstration
- One-to-One Instruction and Monitoring
- Printed Materials
- Role Modeling
- Digital Sources of Information (websites, videos)
Teaching Strategies cont’d
Allow area for feedback to encourage patients to ask questions and avoid misunderstanding
Ensure Patient Understanding
The Joint Commission (TJC) recommends __ and __ to ensure patient understanding
teach-back
show-back
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Is having the patient demonstrate the information or skill you have taught them; used to promote patient confidence
Show-back
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Is having the patient restate the information you taught them in their own words
Lets you assess for areas of weakness and misconceptions they may have
Teach-back
Factors Affecting Client Learning
Motivation
- Little learning can occur without it
- Greatest when client recognizes the need for learning, believes it is possible to improve their health, and are interested in the information
* Convey interest in and respect to the learner
* Create a warm, friendly environment
* Help the client identify the practical need
* Use rewards and incentives
* Help client realize that health and safety really matter
Factors Affecting Client Learning cont’d
Readiness
- Indicate that the learner is motivated and able to learn at a specific time
- Physical condition (e.g. pain interferes with the ability to concentrate)
- Emotions (e.g. anxiety can interfere with the ability to learn)
Factors Affecting Client Learning cont’d
Timing
- Present the information at a time that the learner is open to learning
- People retain information better when they have an opportunity to use it soon after it is presented
- Note that learners may need more time to absorb and apply information
Factors Affecting Client Learning cont’d
Active Involvement
- Learning is most meaningful when the client is actively involved
- Passive listening is not as effective for processing and retaining information
Factors Affecting Client Learning cont’d
Repetition
- Clients are more likely to retain information and incorporate it into their lives when it is repeated
- Especially true with psychomotor skills
Factors Affecting Client Learning cont’d
Learning Environment
- Ideal is private, quiet, physically and psychologically comfortable, and free from distractions
Factors Affecting Client Learning cont’d
Scheduling the Session
- Plan for uninterrupted time
- Shorter teaching sessions can be best for comprehension and retention
Factors Affecting Client Learning cont’d
Amount and Complexity of the Content
- The more complex or detailed the content, the more difficult it is for most people to learn and retain
- The greater the change, the greater the teaching challenge for both the teacher and the learner
Factors Affecting Client Learning cont’d
Communication
- Listen carefully to verbal and nonverbal feedback from your client
Factors Affecting Client Learning cont’d
Special Populations
- Clients with special learning needs
- Plan carefully to ensure appropriate teaching strategies are used to optimize learning
- Including a family member or caregiver may help to reinforce learning
Factors Affecting Client Learning cont’d
Developmental Stage
- Stages of Cognitive Development
* The Preoperational Stage (2-7 years old)
* The Stage of Concrete Operations (7-11 years old)
* The Formal Operational Stage (11 years and older)
Factors Affecting Client Learning cont’d
Teaching Older Adults
- Allow extra time
- Assess for hearing and visual deficits
- Review Table 19-2 (p. 396-397) “Characteristics of Adult and Older Adult Learners”/”Tips for Teaching Adults”
Factors Affecting Client Learning cont’d
Teaching Children
- Use strategies to gain trust, reduce anxiety, promote cooperation, and enhance their emotional readiness
- In the preoperational stage, simplify information and use pictures, videos, and concrete examples
Factors Affecting Client Learning cont’d
Cultural Factors
- Be aware of norms, values, communication, social structure, time orientation, and cultural identification
- Use an interpreter or translator application if the client speaks a different primary language than you
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Is “the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate health decisions”
Health literacy
Health Literacy
How well can a person find information and services; communicate health needs to others; and understand and apply information and services to meet health needs
Patients with low health literacy are not as likely to understand the connection between behavior and health
Health Literacy cont’d
Promote health literacy by:
- Asking questions that involve “how” and “what”
- Assist patients in completing forms
- Organize information so what is most important stands out
- Present information in 3-5 “chunks” at a time
- Use headings
Health Literacy cont’d
Promote health literacy by:
- Write out instructions in plain language
- Provide printed materials with words of three or less syllables
- Speak using simple words and short sentences
- Use as many drawings and photographs as possible
- Provide materials in their primary language
Barriers to Teaching and Learning
For the teacher:
- Competing demands / conflicting schedules
- Ineffective coordination / lack of space and privacy
- Not viewed as a priority / no third-party reimbursement
- Frustration with the amount of documentation
Barriers to Teaching and Learning cont’d
For technology-based learning:
- Lack of social interaction / poor learner motivation
- Diverse learning styles / time issues
- Technical problems / access to the internet
Creating a Teaching Plan
Teaching plans are similar to your nursing process, with two key differences:
Interventions are instead ___
Planning consists of content, sequencing, and forms of instructional materials
teaching strategies
See p. 404-405 of Wilkinson & Treas for a sample Teaching Plan
Creating a Teaching Plan cont’d
- Teaching strategies (lectures, handouts)
- Content (the info/facts/skills/emotions)
- Scheduling and sequencing
- Instructional materials
