WEEK 1 Flashcards
1
Q
Phases in the Development of Organized
Health Care
A
- First phase
- Second phase
- Third phase
2
Q
Began in 1800 to 20th century
A
- First phase
3
Q
What is National League of Nursing Education
(NLNE) called in the present time?
A
National League for Nursing (NLN)
4
Q
– Observed in 1918 that health teaching is an
important function within the scope of
nursing practice
A
- Florence Nightingale
5
Q
– Responsible for establishing standards and
qualifications for practice, including patient
teaching
A
- American Nurses Association (ANA)
6
Q
– Endorses health education as an essential
component of nursing care delivery
A
- International Council of Nurses (ICN)
7
Q
– Universally include teaching within the scope
of nursing practice
– Nursing career ladders often incorporate
teaching effectiveness as a measure of
excellence in practice.
A
- State Nurse Practice Acts
8
Q
- Professional nurses are responsible for:
A
– Educating colleagues
– Serving as a clinical instructor for students
in the practice setting
9
Q
- Significant forces influencing nursing
practice:
A
– Federal government and Healthy People
2020
– Recommendations from the Institute of
Medicine
– The Affordable Care Act (ACA)
– Growth of managed care
– Emphasis on public education for disease
prevention and health promotion
– Importance of health education to reduce
the high costs of health services
– Concern for continuing education as vehicle
to prevent malpractice and incompetence
– Expanding scope and depth of nurses’
practice responsibilities
– Consumers demanding more knowledge and
skills for self-care
– Increasing number of self-help groups
– Demographic trends influencing type and
amount of health care needed
– Incidents of medical harm
– Increased prevalence of chronic conditions
– Impacts of advanced technology
– Health literacy increasingly required
– Research findings that client education
improves compliance
– Advocacy for self-help groups
– Increased use of online technologies
– Screenings occasioned by advances in
genetics and genomics
10
Q
Major component of The Evolution of the Teaching Role
of Nurses
A
Florence Nightingale
10
Q
Also called as the ultimate educator
A
Florence Nightingale
10
Q
Began during 1st four decades of 20th century
A
- Second phase
10
Q
– Began after WW2
– Committee on Educational Tasks in Chronic
Illness in 1968
– Educational processes
– President Nixon and the concept of patient
education
– U.S. Department of Health, Education, and
Welfare
– American Hospital Association’s Statement
on a Patient’s Bill of Rights
– The Joint Commission’s Accreditation
Manual for Hospitals
– Healthy People 2000, Healthy People 2010,
and Health People 2020
established
– Pew Health Professions Commission
A
- Third phase
11
Q
Benefits of education to staff
A
– Enhances job satisfaction
– Improves therapeutic relationships
– Enhances patient-nurse autonomy
– Increases accountability in practice
– Provides opportunity to create change that
Matter
12
Q
a systematic, sequential,
planned course of action on the part of both
the teacher and learner to achieve the
outcomes of teaching and learning
A
Education Process
13
Q
a deliberate
intervention that involves sharing
information and experiences to meet the
intended learning outcomes
A
Teaching/Instruction
14
Q
a change in behavior
(knowledge, attitudes, and/or skills) that
can be observed or measured, and that can
occur at any time or in any place as a result
A
Learning
15
Q
the process of helping
clients learn health-related behaviors to
achieve the goal of optimal health and
independence in self-care
A
Patient Education
16
Q
the process of helping
nurses acquire knowledge, attitudes, and
skills to improve the delivery of quality
care to the consumer of exposure to
environmental stimuli
A
Staff Education
17
Q
- A useful paradigm to assist nurses to
organize and carry out the education process
A
ASSURE Model
18
Q
Components of ASSURE Model?
A
– Analyze the learner
– State the objectives
– Select instructional methods and materials
– Use instructional methods and materials
– Require learner performance
– Evaluate/revise the teaching plan
19
Q
- Nurses act in the role of educator for a
diverse audience of learners—patients
and their family members, nursing
students, nursing staff, and other agency personnel. - Despite the varied levels of basic nursing
school preparation, legal and
accreditation mandates have made the
educator role integral to all nurses. - The new educational paradigm focuses on
the learner learning.
– Instead of the teacher teaching
– The nurse becomes the “guide on the
side.”
A
The Contemporary Role of the Nurse as
Educator
20
Q
Gap between nursing education and practice
A
- Nursing education transformation
21
Q
Nursing Alliance for Quality Care (NAQC)
goals?
A
Consumer-centered health care, performance measurement and public reporting, advocacy, and leadership
22
Robert Wood Johnson Foundation (RWJF)
Quality and Safety Education in Nursing
(QSEN) competencies?
* Patient-centered care
* Teamwork and collaboration
* Evidence-based practice
* Quality improvement
* Informatics
* Safety
23
– Written in response to the Affordable Care Act
– Describes the role of nursing in a transformed healthcare system
* Institute of Medicine report: The future of nursing
24
Give at least 5 Future of Nursing recommendations
* Remove scope of practice barriers.
* Expand opportunities for nurses to lead in
collaborative efforts.
* Implement nurse residency programs.
* Increase proportion of nurses with
baccalaureate degrees to 80% by 2020.
* Double number of nurses with a doctorate
by 2020.
* Ensure that nurses engage in lifelong
learning.
* Prepare and enable nurses to lead change to
advance health.
* Build infrastructure for the collection and
analysis of data.
25
Benefits of education to clients
– Increases consumer satisfaction
– Improves quality of life
– Ensures continuity of care
– Decreases client anxiety
– Reduces complications of illness and
incidences of disease
– Promotes adherence to treatment plans
– Maximizes independence
– Empowers consumers to become involved in
planning their own care
25
Factors impeding the nurse’s ability to deliver
educational services.
Barriers to teaching
25
What is the primary goal of Client and
Staff Education?
to increase the responsibility
and independence of clients for self-care
26
What is the purpose of Client and
Staff Education?
to increase the competence and
confidence of clients for self-management
27
Factors that negatively impact the learner’s ability to pay
attention and process information.
Barriers to learning
28
8 Factors affecting the ability to teach
– Lack of time to teach
– Inadequate preparation of nurses to assume
the role of educator with confidence and
competence
– Personal characteristics
– Low-priority status given to teaching
– Environments not conducive to the teaching–
learning process
– Absence of third-party reimbursement
– Doubt that patient education effectively
changes outcomes
– Inadequate documentation system to allow
for efficiency and ease of recording the
quality and quantity of teaching efforts
29
9 Factors affecting the ability to learn:
– Limited time due to rapid discharge from
care
– Stress of acute and chronic illness, anxiety,
sensory deficits, and low literacy
– Low literacy and functional health illiteracy
– Negative influence of hospital environment
– Variations in readiness to learn, motivation
and compliance, and learning styles
– Extent of behavioral changes (in number and
complexity) required
– Lack of support and positive reinforcement
from providers and/or significant others
– Denial of learning needs, resentment of
authority, and locus of control issues
– Inconvenience, complexity, inaccessibility,
fragmentation, and dehumanization of the
healthcare system
30
a relatively permanent change
in mental processing, emotional
functioning, and behavior as a result of
experience
Learning
31
a coherent framework
of integrated constructs and principles
that describe, explain, or predict how
people learn
Learning Theory
32
* To change behavior, change the stimulus
conditions in the environment and the
reinforcement after a response.
Behaviorist Theory
33
Behaviorist Dynamics
* Motivation: drives to be reduced,
incentives
* Educator: active role; manipulates
environmental stimuli and
reinforcements to direct change
* Transfer: practice and provide similarity
in stimulus conditions and responses
with a new situation
34
Contribution of Learning Theories
* Provide information and techniques to
guide teaching and learning
* Can be employed individually or in
combination
* Can be applied in a variety of settings as
well as for personal growth and
interpersonal relations
34
Also called association learning
Respondent Conditioning
35
Also called classical/Pavlovian conditioning
Respondent Conditioning
36
Learning occurs as the organism
responds to stimulus conditions and
forms associations.
Respondent Conditioning
37
Other respondent-conditioning concepts
used in psychology and healthcare
– Systematic desensitization
– Stimulus generalization
– Discrimination learning
– Spontaneous recovery
38
* A reinforcer is applied after a response,
strengthening the probability that the
response will be performed again under
similar conditions.
Operant Conditioning
39
A neutral stimulus is paired with an
unconditioned stimulus–unconditioned
response connection until the neutral
stimulus becomes a conditioned stimulus
that elicits the conditioned response
Respondent Conditioning
39
* Learning occurs as the organism
responds to stimuli in the environment
and is reinforced for making a particular
response
Operant Conditioning
40
Changing Behavior Using Operant Conditioning : To increase behavior
– Positive reinforcement
– Negative reinforcement (escape or
avoidance conditioning)
40
Changing Behavior Using Operant Conditioning : To decrease behavior
– Positive reinforcement
– Negative reinforcement (escape or
avoidance conditioning)
41
* To change behavior, work with the
developmental stage and change cognitions,
goals, expectations equilibrium, and ways of
processing information.
Cognitive Learning Theory
42
Concept of this theory are cognition, gestalt, perception,
developmental stage, information-processing,
memory, social constructivism, social
cognition,
Cognitive Learning Theory
43
Cognitive Dynamics
* Motivation: goals, expectations,
disequilibrium, cultural and group values
* Educator: organize experiences and make
them meaningful; encourage insight and
reorganization within learner
* Transfer: focus on internal processes and
provide common patterns with a new
Situation
44
* The way individuals perceive, process,
store, and retrieve information from
experiences determines how learning
occurs and what is learned.
Information-Processing Perspective
45
Efforts to incorporate emotional
considerations within a cognitive
framework
– Empathy and moral emotions in moral
development and prosocial behavior
– Memory storage and retrieval and
decision making involves cognitive and
emotional brain processing.
– Emotional intelligence
– Self-regulation
46
* To change behavior, utilize effective role
models who are perceived to be rewarded,
and work with the social situation and the
learner’s internal self-regulating mechanisms.
Social Learning Theory
47
To change behavior, work to make
unconscious motivations conscious,
build ego-strength, and resolve
emotional conflicts.
Psychodynamic Learning Theory
48
* Physiological and neurological bases of
thinking, learning, and behavior
* Neurological conditions, mental health
issues, and learning disabilities
* Relationship between stress and learning
* Integration of learning theories
Neuropsychology and Learning
49
* Learning is a function of physiological and
neurological developmental changes.
* Brain processing is different for each
learner.
* Learning is active, multifaceted, and
complex.
* Meaningful practice strengthens learning
connections.
* Stress can interfere with or stimulate
learning.
Generalizations about Learning
50
- is useful in addition to theories of psychological learning.
* Examples of skills taught
– Walking with crutches
– Putting on a colostomy bag
Motor Learning
51
Stages of Motor Learning
Cognitive stage
Associative stage
Autonomous stage
52
Motor Learning Variables
* Prepractice
* Practice
* Feedback
53
Perception and the patterning of stimuli
(gestalt) are the keys to learning, with
each learner perceiving, interpreting, and
reorganizing experiences in her/his own
way.
Gestalt Perspective
53
* Learning occurs through the reorganization
of elements to form new insights and
understanding.
* Perception is selective.
Gestalt Perspective
54
Recognize the developmental stage and
provide appropriate experiences to
encourage discovery.
Cognitive Development Perspective
54
* Organizing information and making it
meaningful aids the attention and storage
process; learning occurs through
guidance, feedback, and assessing and
correcting errors.
Information-Processing Perspective
54
* Learning is heavily influenced by the
culture and occurs as a social process in
interaction with others
Social Constructivist Perspective
55
* Learning depends on the stage of cognitive functioning with qualitative, sequential changes in perception, language, and thought occurring as children and adults interact with the environment.
Cognitive Development Perspective
55
An individual’s perceptions, beliefs, and
social judgments are affected strongly by
social interaction, communication,
groups, and the social situation.
Social Cognition Perspective
55
A person’s knowledge may not
necessarily reflect reality, but through
collaboration and negotiation, new
understanding is acquired
Social Constructivist Perspective
56
Individuals formulate causal explanations
to account for behavior that has
significant consequences for their
attitudes and actions (attribution theory).
Social Cognition Perspective
56
* Learning occurs on the basis of a
person’s motivation, derived from needs,
the desire to grow in positive ways, self-concept, and subjective feelings.
Humanistic Learning Theory
57
* Learning is facilitated by caring
facilitators and a nurturing environment
that encourage spontaneity, creativity,
emotional expression, and positive
choices
Humanistic Learning Theory
58
* Chronological age vs. stage of
development
* Growth and development interact with
experiences, health (physical and
emotional), motivation, and
environmental factors to affect a person’s
ability and readiness to learn
Developmental Characteristics
59
Maturity continuum
(childhood to adulthood)
60
3 Phases of Developmental Characteristics
– Dependence (infant and young child)
– Independence (child)
– Interdependence (advanced individual)
61
the art and science of helping
children learn.
* Pedagogy
62
Stages of childhood divided by behavior
patterns
– Infancy and Toddlerhood
– Early Childhood
– Middle and Late Childhood
– Adolescence
63
A variable of motor learning- Motivation, attention, goal setting,
understanding of task goals, modeling/
demonstration
* Prepractice
63
A variable of motor learning - – Massed vs. distributed, variability, whole vs. part, random vs. blocked, guidance vs. discovery learning, mental
Practice
64
A variable of motor learning- Intrinsic and extrinsic
* Feedback
64
A type of feedback where Sensory and perceptual information arises when a movement is produced
– Intrinsic (inherent) feedback
64
A type of feedback where Provided to learner from outside source
(nurse, biofeedback)
– Extrinsic (augmented or enhanced)
feedback
65
– Learning is through sensory experiences and
through movement and manipulation of
objects; eventual object permanence and
causality
sensorimotor stage
66
What stage is sensorimotor stage
Infancy (0-12 Months of Life)
Toddlerhood (1–2 Years of Age)
66
WHo theorized the sensorimotor stage?
Piaget
67
Who theorized trust vs. mistrust (birth to 11/2
months), autonomy vs. shame and doubt
(1-3 years)
Erikson
68
Building trust and establishing balance
between feelings of love and hate; learning to
control willful desires
• Erikson: trust vs. mistrust (birth to 11/2
months), autonomy vs. shame and doubt
(1-3 years)
68
WHo theorized the sensorimotor stage?
Piaget
69
Stage where trust vs. mistrust (birth to 11/2
months), autonomy vs. shame and doubt
(1-3 years) belong?
Infancy (0-12 Months of Life)
Toddlerhood (1–2 Years of Age)
70
Cognitive of infant and toddlerhood stage?
– responds to step-by-step commands
- language skills develop rapidly during this
stage
71
WHo theorized the sensorimotor stage?
Piaget
72
Teaching strategies for infancy and toddlerhood?
– Orient teaching to caregiver
❖Focus on normal development, safety,
health promotion, and disease prevention.
– Use repetition and imitation of info
– Stimulate all senses.
– Provide physical safety & emotional security
– Allow play and manipulation of objects.
73
Stage where they are egocentric?
promotion, and disease prevention.
– Use repetition and imitation of info
– Stimulate all senses.
– Provide physical safety & emotional security
– Allow play and manipulation of objects.
74
Stage where they are egocentric?
Early Childhood (3-5 Years of Age)
75
– Egocentric; thinking is literal and concrete;
precausal thinking
Piaget: preoperational period
76
preoperational period
Piaget
77
Stage of childhood preoperational period belong?
Early Childhood (3-5 Years of Age)
78
Taking on tasks for the sake of being
involved and on the move; learning to express
feelings through play
Erikson: initiative vs. guilt
79
initiative vs. guilt
Erikson:
80
WHo theorized the sensorimotor stage?
Piaget
81
WHo theorized the sensorimotor stage?
Piaget
82
Stage of childhood initiative vs. guilt belong?
Early Childhood (3-5 Years of Age)
83
WHo theorized the sensorimotor stage?
Piaget
84
WHo theorized the sensorimotor stage?
Piaget
85
Stage of childhood has limited sense of time and are egocentric/egocentric causation thinking;
transductive reasoning
Early Childhood (3-5 Years of Age)
86
Teaching strategies for Early Childhood (3-5 Years of Age)?
– Use warm, calm approach
– Build trust.
– Use repetition & imitation of info
– Allow for manipulation of objects &
equipment
– Give care with explanation
– Reassure not to blame self
– Explain procedures simply & briefly
– Provide safe & secure environment
– Use positive reinforcement.
– Encourage questions to reveal
perceptions/feelings
– Use simple drawings and stories.
– Use play therapy with dolls and puppets
– Stimulate the senses, visuals, auditory,
tactile, motor
87
– Developing logical thought processes and
syllogistic reasoning; understands cause and
effect and conservation
Piaget: concrete operations stage
88
concrete operations stage
Piaget
89
Which stage of childhood does Piaget: concrete operations stage belongs?
Middle and Late Childhood (6–11 Years of
Age)
90
– Gaining a sense of responsibility and
reliability; increased susceptibility to social
forces outside the family unit; gaining
awareness of uniqueness of special talents
and qualities
* Erikson: industry vs. inferiority
91
WHo theorized the sensorimotor stage?
Piaget
92
Stage of childhood where - play is his/her work and fears loss of body integrity; active
imagination; interacts with playmates
Early Childhood (3-5 Years of Age)
93
WHo theorized the sensorimotor stage?
Piaget
94
Which stage of childhood where the client is able to draw conclusions and intellectually can understand cause and effect
Middle and Late Childhood (6–11 Years of
Age)
94
Which stage of childhood does Erikson: industry vs. inferiority stage belongs?
Middle and Late Childhood (6–11 Years of
Age)
95
industry vs. inferiority
Erikson
96
Which stage of childhood where the client : fears failure and being left out of groups; fears illness and disability?
Middle and Late Childhood (6–11 Years of
Age)
97
– Capable of Abstract thought; propositional
reasoning; adolescent egocentrism
(imaginary audience)
Piaget: formal operations stage
97
* Teaching Strategies for Middle and Late Childhood (6–11 Years of
Age)
– Encourage independence and active
participation
– Be honest, allay fears
– Use logical explanation
– Allow time to ask questions
– Use analogies to make invisible processes
real
– Establish role models
– Relate care to other children’s experiences;
compare procedures
– Use subject-centered focus
– Use play therapy
– Provide group activities
– Use diagrams, models, pictures, digital
media, printed materials, and computer,
tablet, or smartphone applications as adjuncts
to various teaching method
98
WHo theorized the sensorimotor stage?
Piaget
99
WHo theorized the sensorimotor stage?
Piaget
100
– Struggling to establish own identity; seeking
independence and autonomy
* Erikson: identity vs. role confusion
101
WHo theorized the sensorimotor stage?
Piaget
102
WHo theorized the sensorimotor stage?
Piaget
103
WHo theorized the sensorimotor stage?
Piaget
104
identity vs. role confusion
Erikson
104
Which stage of childhood does Erikson: identity vs. role confusion belong?
Adolescence (12–19 Years of Age)
105
Teaching strategies for Adolescence (12–19 Years of Age)?
– Establish trust, authenticity
– Know their agenda
– Address fears/concerns about outcomes of
illness
– Identify control focus Include in plan of
care
– Use peers for support and influence
– Negotiate changes
– Focus on details
– Make information meaningful to life
– Ensure confidentiality and privacy
– Arrange peer group sessions in person or
virtually (e.g., blogs, social
networking, podcasts, online videos)
– Use audiovisuals, role play, contracts,
reading materials
– Provide for experimentation & flexibility
106
Developmental Stages of Adulthood
* Young Adulthood
* Middle-Aged Adulthood
* Older Adulthood
107
the art and science of teaching adult
Andragogy
108
relates learning to immediate needs; self-directed;
teacher is facilitator; learner desires active role
Adult Learning Principles
109
– Abstract thought; reasoning is both
inductive and deductive
* Piaget: formal operations stage (begins in
adolescence and carries through
adulthood)
110
– Focusing on relationships and commitment
to others in their personal, occupational, and
social lives
Erikson: intimacy vs. isolation
111
Which stage of childhood does the client obtain propositional thinking; complex logical reasoning; can build on past experiences; and conceptualizes the invisible belong?
Adolescence (12–19 Years of Age)
112
Which stage of childhood does the need for belonging to a group and a Need for personal space belong?
Adolescence (12–19 Years of Age)
112
WHo theorized the sensorimotor stage?
Piaget
113
Which stage does Erikson: intimacy vs. isolation belong?
Young Adulthood (20–40 Years of Age)
114
WHo theorized the sensorimotor stage?
Piaget
115
intimacy vs. isolation
Erikson
116
Which stage does autonomous; independent; stress
related to the many decisions being made
regarding career, marriage, parenthood, and
higher education belong?
Young Adulthood (20–40 Years of Age)
116
Which stage does cognitive capacity is fully
developed but continuing to accumulate new
knowledge and skills?
Young Adulthood (20–40 Years of Age)
117
Reflecting on accomplishments and
determining if life changes are needed
Erikson: generativity vs. self-absorption and stagnation
118
generativity vs. self-absorption and stagnation
Erikson
119
WHo theorized the sensorimotor stage?
Piaget
120
Teaching Strategies for Young Adulthood (20–40 Years of Age)
– Use problem-centered focus
– Draw on meaningful experiences
– Focus on immediacy of application
– Encourage active participation
– Allow to set own pace, be self-directed
– Organize material
– Recognize social role
– Apply new knowledge through role playing
and hands-on practice
121
WHo theorized the sensorimotor stage?
Piaget
122
WHo theorized the sensorimotor stage?
Piaget
123
Which stage does ability to learn remains steady
all throughout belong?
Middle-Aged Adulthood (41–64 Years of
Age)
124
Teaching strategies for Middle-Aged Adulthood (41–64 Years of Age)
– Focus on maintaining independence and
reestablishing normal life patterns
– Assess positive and negative past
experiences with learning
– Assess potential sources of stress caused
by midlife crisis issues
– Provide information to coincide with life
concerns and problem
125
– Coping with reality of aging, mortality, and
reconciliation with past failures
Erikson: ego integrity vs. despair
125
WHo theorized the sensorimotor stage?
Piaget
126
Which stage does facing issues with grown children,
changes in own health, and increased
responsibility for own parents belong?
Middle-Aged Adulthood (41–64 Years of
Age)
127
WHo theorized the sensorimotor stage?
Piaget
128
WHo theorized the sensorimotor stage?
Piaget
129
WHo theorized the sensorimotor stage?
Piaget
130
ego integrity vs. despair
Erikson
131
the teaching of older persons,
accommodating the normal physical,
cognitive, and psychosocial changes
Geragogy
132
capacity to perceive
relationships, to reason, and to perform
abstract thinking, which declines with aging
Fluid intelligence
133
the intelligence
absorbed over a lifetime, which increases
with experience
Crystallized intelligence
134
WHo theorized the sensorimotor stage?
Piaget
135
Which stage does Erikson: ego integrity vs. despair belong?
Older Adulthood (65 Years of Age and Older)
136
Role of Family in Patient Education
* Family is one of the most important
variables influencing patient outcomes.
* The nurse educator and family should be
allies.
* It is important to choose the most
appropriate caregiver to receive
information
