Importance of Teaching Role
Teaching is a system of activities intended to produce learning
- Important independent nursing function
- American Hospital Associations Patient’s Bill of Rights, mandates client education as a right of all clients
- State Nurses Practices Act
- client teaching as function of nursing, thereby making teaching a legal and professional responsibility.
- Joint Commission expanded its standards of client education by nurses to include “evidence that patients and their significant others participate in care and decision making and understand what they have been taught”.
- This requirement means that providers must consider the literacy level, educational background, language skills, and culture of every client during the education process
Bloom’s Learning Domains
Cognitive Domain - “thinking” (brain)
* 6 intellectual abilities and thinking processes such as knowing, comprehending, applying to analysis, synthesis, and evaluation
Affective Domain - “feeling” (heart)
* divided into categories that specify the degree of a “person’s depth of emotional responses to tasks”. It includes emotional and social goals such as feelings, interests, attitudes, and appreciations
Psychomotor Domains - “skill” (hands)
* fine and gross motor abilities such as giving and injection
Learning Theories - Behaviorism
- Behaviorism (Thorndike)
- learning should be based on the learner’s behavior and what is directly observable
- Positive Enforcement - praise and encouragement for a response that is repetitious
- Imitation - pt copies what they observe
- modeling - person learns by observing the behavior of others
Nurses that use the behaviorist theory identify what to be taught and reward the correct response. In order to get the correct response the nurse must allow for practice time (immediate and repeat testing), and opportunity to solve problems by trial and error
Learning Theories - Cognitivism
- Cognitivism (Bloom)
- complex cognitive activity
- learner structures and processes info
- Personal characteristics impact perception
Nurses that use the cognitive theory encourage a positive learning relationship, select multisensory teaching strategies since perception is perceived by the senses, adapt teaching to cognitive level, asses developmental and individual readiness to learn, and develop appropriate approaches to target different learning styles
Learning Theories - Humanism
- Humanism (Maslow, Rogers)
- learning is self-motivated, self-initiative, and self-evaluated
- learning focuses on self-development and achieving full potential are important
- Autonomy and self-determination
- learning is an active participant and takes responsibility for meeting learning needs
Nurses that use the humanistic approach convey empathy, encourages the learner to establish goals, promotes self-learning, using active learning, and encourages learner to seek their own answers
Factors that Affect Learning
Age and Development - physical, cognitive, and psychosocial maturation
Motivation - desire to learn ex…smoker needs to know the effects of smoking before they want to stop
Readiness - cues or behaviors that reflect the learners motivation ex…pt in pain wont be ready to learn about a dressing change
Active Involvement - learner becomes meaningful when the pt is involved
Relevance - knowledge or skill must be personally relevant to learner ex…overweight, fatigued client understands he needs to lose weight if he remember he had more energy when he weighed less
Feedback - client’s performance in reaching a desired goal
Nonjudgemental Support - no good or bad client, people learn best when they believe they are accepted and will not be judged
Simple to Complex Learning -material is organized and logical
Repetition - facilitates retention of newly learned material, improves performance
Factors that Affect Learning (2)
Timing - short interval ex…giving injections in the hospital enhances the clients learning
Environment - privacy, lighting, ventilation, reduce distractions,
Emotions - fear, anger and depression impede learning.
Psychological Events - critical illness and pain inhibit learning ex…provide analgesics before teaching
Culture Aspects - language and values. Understanding the nurses language may learn little
Psychomotor ability - pt w/ severe osteoarthritis may not be able to self-administer insulin
Health Literacy
health literacy is the capacity to obtain, process, and understand the basic health information and services needed to make appropriate health decisions
Low Health Literacy - result in poor health outcomes and higher health cost. ex…not being able to read a prescription to take or take the wrong number of pills.
Fails to seek preventive care b/c they have less info about health promotion and/or management of disease process.
Silent epidemic - NVS was created to find out the health literacy of a patient
Suspecting a Literacy Problem
- pattern of noncompliance (frequent errors in medications of self-care instructions)
- insisting that the already know the info
- forms filled out wrong
- having a friend or family member read the document for them
- pattern of excuses for not reading the instruction (broken glasses or forgot them, stating they will read later or when they get home)
- withdrawn during explanation
- frequent missed appts and consults
Teaching Hints
- Use plain language , not medical terminology or health care language
- use “teach back” and “show back” methods, patient repeats back and performs a demonstration
- 2 or 3 important points
- don’t teach too fast or slow
- use drawing models
- involve senses
- repetition reinforces learning
Teaching Content and Strategies
Content should be :
- Accurate
- Current
- Based on learning outcomes
- Adjusted for the learners age, culture, and ability
- Consistent w/ what the nurse is teaching
- Carefully selected with time and resources available
- Role playing
- Modeling
- computer learning resources
Documentation
- Diagnosed learning needs
- Learning outcomes
- Topics taught
- Client outcomes
- Need for additional teaching
- Resources Provided
