WEEK 1 Flashcards
Phases in the Development of Organized
Health Care
- First phase
- Second phase
- Third phase
Began in 1800 to 20th century
- First phase
What is National League of Nursing Education
(NLNE) called in the present time?
National League for Nursing (NLN)
– Observed in 1918 that health teaching is an
important function within the scope of
nursing practice
- Florence Nightingale
– Responsible for establishing standards and
qualifications for practice, including patient
teaching
- American Nurses Association (ANA)
– Endorses health education as an essential
component of nursing care delivery
- International Council of Nurses (ICN)
– Universally include teaching within the scope
of nursing practice
– Nursing career ladders often incorporate
teaching effectiveness as a measure of
excellence in practice.
- State Nurse Practice Acts
- Professional nurses are responsible for:
– Educating colleagues
– Serving as a clinical instructor for students
in the practice setting
- Significant forces influencing nursing
practice:
– 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
Major component of The Evolution of the Teaching Role
of Nurses
Florence Nightingale
Also called as the ultimate educator
Florence Nightingale
Began during 1st four decades of 20th century
- Second phase
– 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
- Third phase
Benefits of education to staff
– Enhances job satisfaction
– Improves therapeutic relationships
– Enhances patient-nurse autonomy
– Increases accountability in practice
– Provides opportunity to create change that
Matter
a systematic, sequential,
planned course of action on the part of both
the teacher and learner to achieve the
outcomes of teaching and learning
Education Process
a deliberate
intervention that involves sharing
information and experiences to meet the
intended learning outcomes
Teaching/Instruction
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
Learning
the process of helping
clients learn health-related behaviors to
achieve the goal of optimal health and
independence in self-care
Patient Education
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
Staff Education
- A useful paradigm to assist nurses to
organize and carry out the education process
ASSURE Model
Components of ASSURE Model?
– Analyze the learner
– State the objectives
– Select instructional methods and materials
– Use instructional methods and materials
– Require learner performance
– Evaluate/revise the teaching plan
- 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.”
The Contemporary Role of the Nurse as
Educator
Gap between nursing education and practice
- Nursing education transformation
Nursing Alliance for Quality Care (NAQC)
goals?
Consumer-centered health care, performance measurement and public reporting, advocacy, and leadership
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
– 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
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.
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
Factors impeding the nurse’s ability to deliver
educational services.
Barriers to teaching
What is the primary goal of Client and
Staff Education?
to increase the responsibility
and independence of clients for self-care
What is the purpose of Client and
Staff Education?
to increase the competence and
confidence of clients for self-management
Factors that negatively impact the learner’s ability to pay
attention and process information.
Barriers to learning
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
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
a relatively permanent change
in mental processing, emotional
functioning, and behavior as a result of
experience
Learning
a coherent framework
of integrated constructs and principles
that describe, explain, or predict how
people learn
Learning Theory
- To change behavior, change the stimulus
conditions in the environment and the
reinforcement after a response.
Behaviorist Theory
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
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
Also called association learning
Respondent Conditioning
Also called classical/Pavlovian conditioning
Respondent Conditioning
Learning occurs as the organism
responds to stimulus conditions and
forms associations.
Respondent Conditioning
Other respondent-conditioning concepts
used in psychology and healthcare
– Systematic desensitization
– Stimulus generalization
– Discrimination learning
– Spontaneous recovery
- A reinforcer is applied after a response,
strengthening the probability that the
response will be performed again under
similar conditions.
Operant Conditioning
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
- Learning occurs as the organism
responds to stimuli in the environment
and is reinforced for making a particular
response
Operant Conditioning
Changing Behavior Using Operant Conditioning : To increase behavior
– Positive reinforcement
– Negative reinforcement (escape or
avoidance conditioning)
Changing Behavior Using Operant Conditioning : To decrease behavior
– Positive reinforcement
– Negative reinforcement (escape or
avoidance conditioning)
- To change behavior, work with the
developmental stage and change cognitions,
goals, expectations equilibrium, and ways of
processing information.
Cognitive Learning Theory
Concept of this theory are cognition, gestalt, perception,
developmental stage, information-processing,
memory, social constructivism, social
cognition,
Cognitive Learning Theory
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
- The way individuals perceive, process,
store, and retrieve information from
experiences determines how learning
occurs and what is learned.
Information-Processing Perspective
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
- 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
To change behavior, work to make
unconscious motivations conscious,
build ego-strength, and resolve
emotional conflicts.
Psychodynamic Learning Theory
- 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
- 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
- is useful in addition to theories of psychological learning.
- Examples of skills taught
– Walking with crutches
– Putting on a colostomy bag
Motor Learning
Stages of Motor Learning
Cognitive stage
Associative stage
Autonomous stage
Motor Learning Variables
- Prepractice
- Practice
- Feedback
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
- Learning occurs through the reorganization
of elements to form new insights and
understanding. - Perception is selective.
Gestalt Perspective
Recognize the developmental stage and
provide appropriate experiences to
encourage discovery.
Cognitive Development Perspective
- 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
