Teaching/Learning and Therapeutic Communication Flashcards
Why do nurses need teaching skills?
- teaching clients is part of independent nursing practice
- ANA standard in promoting health demands skill in teaching
- patients participate in healthcare decisions
- hospital stays are brief
- healthcare is expensive
***What are the three domains of learning?
Cognitive- storage and recall of information (facts about a disease)
Psychomotor- hands on skill (ex: insulin)
Affective- challenging feelings, beliefs, attitudes, and values (changing a belief about a diet)
What is the social learning theory?
explains the characteristics of the learner
What is self-efficacy?
a person’s perceived ability to successfully perform a task
What is the behavioral learning theory?
explicit identification of information to be taught and immediate reward for correct responses
What is the cognitive learning theory?
- learning is a complex mental activity
- learning is an intellectual or thinking process in which the learner structures and processes information
What is the humanism learning theory?
- focuses on the learners affective, cognitive, and attitudinal
- self-motivated, self-initiated, and self-evaluated
What are the five rights of teaching?
- right time
- right context
- right goal
- right content
- right method
poop?
poop
What are some barriers for the teacher that affect teaching? (6)
- competing demands
- conflicting schedules
- lack of space and privacy
- teaching not seen as a priority
- no third-party reimbursement for teaching
- frustration with amount of documentation needed
***What are some barriers for the learner? (11)
- illness
- fatigue
- anxiety/stress
- low literacy
- lack of time to learn
- overwhelming amount
- overwhelming complexity
- lack of support
- lack of motivation
- language barrier
- does not perceive need for information taught
What are some barriers to technology-based learning?
- lack of social interaction
- poor learner motivation
- diverse learning styles
- time issues
- technical problems
- access to the internet
***What are some examples of teaching strategies?
lecture, group/individual demo, multimedia, pamphlets, simulations, role playing, internet, mentoring, gaming, concept mapping
How do we evaluate learning? (4)
- Increased knowledge
- Direct observation
- Client reports of performance
- Change in Behavior
What is a nursing diagnosis related to lack of knowledge? When should we use it?
Deficient knowledge
- use when the lack of knowledge is the primary problem
- usually you can write a nursing order to provide informal teaching for routine things that are not extensive
What are some outcomes we try to achieve when deficient knowledge is used as a problem?
- learning contract (informal statement of understanding of what is expected of the teacher and learner)
- teaching goals (broadly set out what the final outcome should be)
- learning objectives (specific behaviors that must be completed to accomplish goal)
What are some teaching strategies?
lecture, group discussion, demo/return, one-on-one instruction, digital info, printed info, role-modeling
How can we evaluate outcomes of teaching?
- oral questions, questionnaires, checklists
- clients reports and records
- tests
What factors affect verbal communication? (9)
- vocab
- denotative vs connotative meaning
- pacing of convo
- intonation
- clarity and brevity
- timing
- relevance of info
- credibility of sender
- humor
What factors affect nonverbal communication?
- facial expression
- posture and gait
- personal appearance
- gestures
- touch
What is passive communication?
- avoids conflict
- lets others take the lead
- submissive, helpless, indecisive, apologetic, whining
What is aggressive communication?
- forces others to lose
- bossy, arrogant, opinionated, sarcastic, manipulative, intolerant, overbearing
How to use assertive communication?
- speak clearly and in a positive manner “can do” attitude
- professional composure
- question care decisions openly and honestly
- “I” statements
- focus on issue, not participants
- do not invite negative responses
- accept criticism
- use negative inquiry
- find workable compromises
What are the goals of therapeutic relationships in healthcare?
- improvement of the health of the client
- providing information about health, treatments, and care
- use of therapeutic communication
What is therapeutic communication?
client-centered communication directed at achieving client goals
What is the preinteraction phase of the therapeutic relationship?
gathering of info prior to meeting
What is the orientation phase of the therapeutic relationship?
establishes rapport and trust
What is the working phase of the therapeutic relationship?
- nurse communicates caring
- client expresses thoughts and feelings and concerns
What is the termination phase of the therapeutic relationship?
conclusion of the relationship at end of shift or at discharge
**What are the key characteristics of therapeutic communication?
- empathy (desire to be sensitive to the client)
- respect (value the client and their needs)
- genuineness (responding honestly)
- concreteness (clear responses)
- confrontation (confronting client to get clarification, being willing to be confronted if unclear)
What are the nursing diagnosis’ we can use to describe problems with communication? When to use?
Readiness for enhanced communication- use when client expresses willingness to improve already good communication
Impaired Verbal Communication- use if pt has aphasia, dyspnea
Impaired Communication- use if client is non-english speaking
What are some “interventions” to enhance communication? (10)
- address pt
- listen actively
- establish trust
- be assertive
- restate, clarify msg
- interpret body language
- explore issues
- use silence
- summarize convo
- use recordings
What are some barriers to therapeutic communication? (10)
- asking too many questions
- fire-hosing info
- asking why
- changing subject
- failing to probe
- expressing approval or disapproval
- offering advice
- false reassurance
- stereotyping
- using patronizing language
How to enhance communication for a client with impaired speech?
- ask pt to use hand gestures
- picture board
- get help from family members to interpret
- speech pathology referral
