Week 2 Flashcards
throughout the learning process, nurses should be: (6)
- assessing problems or deficits
- providing imp infor and presenting it in unique and approp way
- identifying progress being made
- giving feedback and follow up
- reinforcing learning in the attainment of new knowledge, skills, and sttitudes
- evaluating learners’ abilities
what is the first step in the process of pt education? whats included in this
learner assessment:
- assess their learning needs
- preferred learning style
- readiness to learn
learner assessment includes (5)
- finding out what pts already know and believe
- what they want and need to learn
- what they are capable of learning
- their attention: factors affecting their ability to concentrate and focus
- memory and recall : challenges
what are some factors that influence a pts capacity and motivation to learn
- situational psychological states:
ex. anxiety, depression, fear, and acceptance or denial of illness
what are learning needs
- defined as gaps in knowledge that exist between a desired lvl of performance and the actual lvl of performance
what should be assessed in one’s evaluation of learning needs (9)
- identify the learner & how many needs they have
- identify the learner’s target
- choose the right setting
- collect imp info about the learner
- involve members of the healthcare team
- assess prior learning: what they know, understand, and believe
- consider personal time management
- determine availability of educational resources
- prioritize needs
- take time management issues into account
what is an appropriate setting to conduct a learner’s assessment
- trusting, private, and confidentiality
what is imp info to collect from the learner (4)
- health issues which are of concern to ur patient
- eval how much they already know
- what social supports are available
- help them define their own problems
why is it important to prioritize needs
- if multiple needs, need to determine which is the most important to address first
- will help avoid the mistake of overeducating or underwhelming the pt
what are the 3 criteria for prioritizing learning needs
- mandatory
- desirable
- possible
what are mandatory learning needs
- needs that must be learned for survival when the learner’s life or safety is threatened
what are desirable learning needs
- needs that are not life-dependent but are related to well-being
what are possible learning needs
- needs for info that are “nice to know”
- not essential or required
- need might not be directly related to daily activities or the particular situation of the learner
what are 5 methods to assess learning needs
- informal convo
- structured interviews
- questionnairs
- observations
- eval of documentation (ex. IPN detailing that a pt did not understand something)
what are the 3 determinants of learning
- learned needs (what they need to learn)
- readiness to learn (when the learner is receptive, willing able to participate in the learning process)
- learning style (how the learner learns best)
what assessment is used t determine a pt’s readiness to learn
PEEK assessment
what does each letter in the PEEK assessment stand for
Physical readiness
Experiential readiness (refers to learners past learning experiences)
Emotional readiness
Knowledge readiness
what does physical readiness include (5)
- measures of ability
- complexitiy of task (more complex the task, harder it is to achieve)
- enviro effects
- health status
- gender
what is measures of ability
ability to perform a task
- do they have adequate strength, flexibility, coordination, and endurance?
- are all sense intact?
what are environmental effects
want an enviro favorable to learning and holding the pts attention
- loud noise?
- distractions?
- is there a stressful time limit to learning? (ex. only 15 min and it is a complex task)
what impact does health status have on physical readiness to learn
- consider if an acute or chronic illness
- does the person have enough energy to learn?
- if the pt is acutely ill, they focus their attention and energy on the physiological and psychological demands of the illness = learning minimal –> learning in this case should only be r/t tests, treatment, pain, etc.
what impact does gender have on readiness to learn
- men are typically less receptive to healthcare intervention than women
what does emotional readiness include? (6)
- anxiety lvl
- support system
- motivation (determine lvl of motivation, not necessarily reasons)
- risk-taking behavior
- frame of mind (involves concern about the here and now vs the future)
- developmental stage
what impact does anxiety lvl have on emotional readiness to learn?
- some degree of anxiety is a motivator to learn, but too high or low anxiety can be a barrier
- people w low lvls of health related anxiety are less motivated to learn –> not driven to take steps to maintain their health
- emotional readiness tends to be highest when the pt is experiencing moderate anxiety
what does experiential readiness include (5)
- level of aspiration
- past coping mechanisms
- cultural background
- locus of control
- orientation
what is lvl of aspiration
- the extent to which people want to change or acquire new knowledge or behaviors
- previous successes and failures influences the goals learners set for themselves
what impact does past coping mechanisms have on experiential readiness
- consider how the pt has dealt with stress before and if it was effective, and if it will work well in the present situation
what is locus of control and does it impact their readiness to learn
- people w an internal locus of control feel that their fate is in their hands and feel motivated to learn –> drive to learn comes from the learner
- people w external locus of control are driven by outside forces –> depend on expectations and initiatives of others to get motivated to learn (= nurses responsibility to motivate them)
what does orientation include r/t readiness to learn
- tendency to adhere to a parochial or cosmopoliitan point of view
- are they close minded, conservative, less willing to learn new ideas, place most trust in authorative figures? = parochial
- are they receptive to new ideas, new ways to do things, more worldly perspective on life? = cosmopolitan
what impact might cultural background have on readiness to learn (3)
- influences what the illness means to the person
- try to build on their belief system if possible
- may cause language barriers
what does knowledge readiness include? (4)
- present knowledge base
- cognitive ability
- learning disabilities
- learning styles
how can learning styles be determined? (3)
- thru observation
- interviews
- use of learning style tools and instruments
what are learning styles? why is there some controversy about learning styles
= refers to the way individuals process info
- may be preferences rather than definitive style
what should you consider regarding learning styles
- developmental stage
- contexts of individual’s life
who is Carl Jung and what did he do? (4)
- psychologist who defined the terms extravert and introvert
- created the idea of personality “types” – each with charcteristics patterns and preferences
- thinking vs feeling
- introversion vs extraversion
who is Myers Briggs and what did she do? (2)
- added judgement-perception
- 16 personality types
what is Kolb experiential learning model
- model represented as a cycle of learning
- describe learning as a continuous process
- in this model, the learner is not a blank slate, but rather approaches a topic to be learned based on past experiences, heredity, and the demands of the present enviro
- created learning concepts based on how people percieve and process info
the dimension of perception has 2 opposing viewpoints:
- some learners perceive thru concrete experience
- where others perceive thru abstract conceptualization
the dimension of process has 2 opposing orientation:
- some process thru reflective observation
- some process thru active experimentation
what are the 4 pairs of opposing personality types identified by Myers and Briggs (4)
- extravert/intravert
- sensing/intuitive
- thinking/feeling
- judging/perceiving
kolb describes each learning style as…
- a combo of the four basic learning modes (concrete experience = feeling, abstract conceptualization = thinking, reflective obs = watching, active experiementation = doing)
what are the 4 learning styles based based off Kolb’s experiential learning model
- accommodator
- diverger
- converger
- assimilator
what is the diverger
- combines the learning modes of CE and RO
people w the diverger learning style like to: (8)
- view concrete situation from many points of view
- observe, gather info, and gain insights rather than take action
- working in groups
- high value on understadning for knowledge’s sake
- personalize learning by connecting info with something familiar in their experiences
- active imaginations
- enjoy being involved
- sensitive to feelings
what is the assimilator
- combines the learning modes of RO and AC
describe the learning style of the assimilator
- ability to understand lrg amts of info by putting it into concise, logical form
- less interested in people
- more focused on abstract ideas and concepts
- good at inductive reasoning
- value theory over practical applicaytion
- need time to reflect on what has been learned and how info can be integrated into their past experience
- ## rely on knowledge from experts
how do assimilators learn best (3)
- one-on-one instruction
- lecture
- self- instruction methods with ample reading materials
what is the converger
- combines learning mods of AC and AE
describe the learning style of the converger (6)
- find practical application for ideas and theories
- ability to use deductive reasoning to solve problems
- like structure and factual info
- look for specific solutions to problems
- prefer technical tasks than dealing w social and interpresonal issues
- have skills imp for specialist and technology careers
how do convergers learn best
- thru demo accompanied by handouts and diagrams
what is the accommodator
- combines learning mods of AE and CE
describe the learning style of the accommodator (6)
- learn best by hands-on experience
- enjoy new, challenging situations
- act on intuition and gut feelings rather than logic
- like to explore all possibilities
- learn by experimenting w materials and objects
- learn best via role play, gaming, computer simulations
what type of learning style in most challenging to nurses? why?
- accommodators
- demand new & exciting experiences, and are willing take risks that may endanger their safety
what are gardeners 8 types of intelligence in children
- linguistic
- logical-mathematical
- spatial
- musical
- bodily-kinesthetic
- interpersonal
- intrapersonal
- naturalistic
describe linguistic intelligence (5)
- highly developed auditory skills and think in words
- like writing, telling stories, spelling, reading
- can recall names, places, dates
- learn best by verbalizaing, hearing, or seeing words
- word games and crosswords
describe logical-mathematical intelligence (7)
- explore patterns, categories, relationships
- question may things
- ask where, when, what
- do arithmetic problems quickly in their heads
- like to learn w computers
- do experiments to test concepts
- enjoy strategy board games
what is spatial intelligence (5)
- learn by images and pictures
- enjoy building blocks, pizzles, daydreaming
- like to draw & do art
- read charts and diagrams
- learn w visual methods like pictures and videos
describe musical intelligence (3)
- found singing, indicating when a note is off key, play instruments, dance, keep time rhythmically
- sensitive to sounds in the enviro
- learn best w music in the background
describe bodily-kinesthetic intelligence (6)
- learn by processing info thru bodily sensations ex. moving around, acting things out
- difficult to sit still for periods of time
- good at sports
- highly developed fine-motor coordination
- use body language to communicate
- copying people’s behaviors or movements comes easily for them
describe interpersonal intelligence (6)
- understand people
- notice other’s feelings
- tend to have many friends
- gifted in social skills
- learn best in groups
- gravitate toward activities that involve others in problem solving
describe intrapersonal intelligence (7)
- have strong personalities
- prefer the inner world of feelings & ideas
- like being alone
- private individuals
- desire quiet area to learn and prefer to be by themselves
- self-directed and confident
- learn well w independent, self-paced instruction
describe naturalistic intelligence (3)
- can distinguish and categorize objects or phenomena in nature
- enjoy subjects, shows, and stories dealing w animals or naturally occurring phenoma
- keenly aware of their surrounding & subtle changes in enviro
what is a good teaching approach for a child w linguistic intelligence
- practice quizzes
what is a teaching approach for a child w spatial intelligence
- diagrams and charts
- storytelling
what is a teaching approach for a pt with kinesthetic intelligence
- model that can be left out, taken apart, manipulated
- act-out appropriate behavior
what is a teaching approach for logical-mathematic intelloigence
- group concepts into categories
- start w simple generalizations or health behaviors
- reasoning works well to show a child the consequences of action
what is a teaching approach for a pt with musical intelligence
- teach self-care or material by putting it into song
- soft music can help relax
what is a teaching approach for a pt with interpersonal intelligence
- have group of children play a card game that matches health info with medical pictures or picturs of healthcare activities & procedures
what is a teach approach for a pt with intrapersonal intelligence
- suggest they write to friends, family, or local & state government officials to advocate for disease research
what is a teaching approach for a child w naturalist intelligence
- provide pet therapy
- allow child to engage in outside activites like gardening or nature walks
- offer videos that feature nature, science, or animals
see learner assessment ppt for example questions to ask during learner assessment
….
what is health literacy (4)
a person’s ability to:
- access info
- understand meaning of health info
- eval health info
- communicate to make informed decisions
what is a common reason for pts misunderstanding health instructions
- low health literacy skills
what subgroups have the lowest lvls of health literacy (4)
- seniors
- new canadians
- unemployed persons
- those w ongoing and historic challenges to access determinants of health
what consequences does limited health literacy have
- places pts health at risk
- reflected in high usage of health care resources
- can be the root cause for behaviors that might lead to the perception of non-compliance or non-adherence
what are some red flags for low literacy (8)
- frequently missed appts
- incomplete registration forms
- problems w adherence to meds
- unable to name meds, explain purpose, or dosing
- identify pills by looking at them, not reading the label
- unable to give coherent, sequential history
- asking few questions
- lack of follow thru on tests or referrals
what is a strategy to improve health literacy
- use a health literacy universal precautions approach
= structure the delivery of care as if everyone may have limited literacy
why is it important to use a health literacy universal precautions approach (5)
- cannot determine literacy lvl by looking
- high literacy lvls does not = understanding
- anxiety can reduce ability to manage health info
- everyone benefits from clear communication
- virtually all people prefer plain language regardless of their literacy lvl
what is plain language communication? what is the benefit?
- the delivery of info in a simple, succinct, and accurate manner
- can help address challenges
what is important to improve pt safety and a key components in the redesign of health care processes
- pt participation in communication
what are PEMs
- patient education material
what are benefits of PEMs (7)
- promote learning and increase knowledge
- promote pt engagement and self-management
- enhance pt experience
- provide consistent information
- save HCP time
- reduce health care utilization and costs
- help pts remember imp. messages
how do PEMS promote learning and increase knowledge (4)
- help pts remember imp info
- allows pts to have more control over learning
- pts may find it difficult to learn at the hospital
- provides accurate info to family member who were not present during teaching
why is it important that PEMs help pts remember imp messages (2)
- 40-80 % of info provided by HCP is forgotten immediately
- and half of the info pts remember is remembered incorrectly
how do PEMs help pts have more control over thei learning (3)
- they can read materials at their own pace
- refer to them as often as needed
- can promote long-term retention
why do some pts find it difficult to learn at a hospital (3)
- noisy and distracting enviro
- pts may feel anxious, tired, or in pain
= interferes w memory and concentration
how do PEMS promote pt engagement and self-management (2)
- providing quality health info allows pts to better manage their health and wellbeing
- allows them to make informed decisions abt their treatment and care
how do PEMs enhance pt experience
- verbal & written info at discharge improve pt satisfaction
- can help pts know what to expect before, during, and after a procedure, treatment or surgery = reduced anxiety, increased satisfaction , decreased uncertainty
- promotes pt engagement and enhances pt’s experiences of care
how do PEMs help promote consistent info (2)
- the content of PEM reflects what the health care team decides are the main messages
- this promotes consistency in patient and family education
how do PEMS help save HCP times (2)
- reinforce info, so HCP may not need to repeat teaching as often as they might otherwise be required
- PEMs help pts understand info and follow instruction = fewer questions, less need for follow-up teaching, visits, etc.
how do PEMS help reduce health care utilization and costs
- providing pts with quality health info is the key to pt engagement and self-management of long-term conditions
= positive impact on service use and cost
PEMs are effective only when..
- used as a part of an overal pt education strategy
PEMs selected for pts should be… (3)
- accurate
- accessible
- actionable
what is meant by PEMs being accurate (3)
- should reflect current practice
- reinforce what you teach
- match the organization’s philosophy and policies
what is meant by PEMs should be accessible
- should be easy to read & understand = enables more people to use the info
what is meant by PEMs should be actionable (3)
- encourage pts and families to take an active part in their health care
- focus on what patients need to know and do
- provide action steps with concrete examples
what should you do when providing PEMS to patients (5)
- dont rely on handouts to educate
- PEMs should be used to support and reinforce messages, not replace discussion
- review the material w the pt & emphasize imp info
- endorse/contextualize info –> explain why important
- invite questions and encourage the pts to tell you if something is unclear
how can HCP individualize info for pts (2)
- personalize materials by adding the pt’s name, notes, and specific instructions
- involve the pt and family as appropriate
how can we check/evaluate a pt’s understanding during health education (7)
- check in throughout the process
- confirm that they have learned a skill by asking them to demonstrate
- give feedback and allow for extra practice
- confirm that they understand verbal and written instruction by using teach-back
- use open ended questions
- make it clear you are checking the effectiveness of your teaching, not testing the pt
- clarify or re-teach as needed
why should we not rely on the internet for pts to access health info
- not everyone has access
- internet use requires additional skills
what additional skills does the internet require (2)
- has overwhelming amt of info = must be read and analyzed to determine what is accurate and relevant
- info may be written at a lvl the average adult would find difficult to read and understand
the internet is helpful for health education when.. (4)
- pts have access
- pt has skills to search for health info
- online info is presented in a way that is easy to read and navigate
- online info is relevant to the persons needs and location
what are some tips for using online info during teaching
- ask pts to discuss the health info they found on the internet
- use interactive websites
- use printed pages from websites you recommend as handouts –> helps pts learn how to find good quality health info
what does PEMAT stand for
- patient education material assessment tool
what is PEMAT
- a standardized and systematic tool developed based on evidence to assist HCP to evaluate / appraise resources
- focuses on short resources and their actionability and understandability
what are 2 versions of the PEMAT`
- PEMAT-P = for printable materials
2. PEMAT-A/V = for audiovisual materials
the PEMAT-P consists of..
- 17 items measuring understandability
- 7 items for actionability
the PEMAT-A/V consists of
- 13 items for understandability
- 4 items for actionability
what should be done once the PEM is selected, reviewed, and scored
- consider how the PEM might be adapted to meet the needs of specific learners
what are some limitations of the PEMAT
- not for evaluating podcasts or websites
- does not assess accuracy, comprehensiveness, or readability tests
- recommended that a readability assessment for print materials is completed in conjuction with using the PEMAT (but using only a readability format is not a subsitute for the PEMAT)
what is the definition of tailoring
- the making or adapting of something to auit a particular purpose/person
- notion that “one size does not fit all”
when can we use tailoring
- tailoring PEMs
