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Nursing Fundamentals Focus XIII

Health Teaching Module

Objectives

• List 3 major purposes of health teaching and give examples of each.

• Explain the 3 steps of assessment required to define the client’s learning need. Identify the major tasks involved in each step.

• Describe 3 different types of learning. Give examples of tasks with each type of learning.

• Discuss the factors to be considered for planning the effective “teaching–learning situation”

• An integral part of the nursing professional role– Important independent nursing function– Right of all clients

• A Patient’s Bill of Rights – 1992– State nurse practice acts

• A function of nursing• Legal and professional responsibility

– JCAHO• evidence that patients and family have been

taught and understand

Health Teaching

• Three major purposes of health teaching– Promoting health– Prevention of illness– Coping with illness and disability

Health Teaching

• Promoting Health– Increasing level of wellness– Growth and development topics– Fertility control– Hygiene– Nutrition– Exercise– Stress management– Lifestyle modification– Resources within the community

Health Teaching

• Prevention of illness/injury– Health screening– Reducing health risk factors– Specific protective health measures– First aid– Safety

Health Teaching

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• Coping with illness and disability– Adaptations in lifestyle– Problem-solving skills– Adaptation to changing health status– Strategies to deal with current problems

• Medications, home treatments, diet, activity limitations

– Strategies to deal with future problems• Pain, cancer, surgery, treatments

– Referrals to other agencies or services– Facilitation of a strong self image– Grief and bereavement

Health Teaching

Basic right of every patientHow is health education legally mandated in nursing practice?• Evidence that patients and significant others understand

what has been taught• Evaluate literacy, educational background• Language skills, cultural considerations• Reducing health risk facotrs• Increase level of wellness• Specific protective health measures

The acquisition of knowledge, behavior or skill-through experience, practice, study, instruction thus changing behavior

This is ______________.

• Assessment of the Patient’s Learning Needs– Primary Health Problem – Health Beliefs– Cultural Factors– Learning Style– Support System

Basic right of every patient

• General Data Collection– Age

• Developmental considerations• Slower psychomotor skills• Slower recall

– Primary Health Problems• Knowledge deficit? Misinformation?• No longer manage ADL?

– Health Beliefs• How does client see general health?• Preventive measures for maintaining health?• What changes would client be willing to make?

Basic right of every patient

• Cultural Factors– Language– Other health practitioners– Herbs or homeopathic medications– Conflict in care?

• Learning style– Age and developmental level– Level of education– Like to read?– How do you learn best?

• Support system– Who is there to help you

Basic right of every patient

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• Illness• Pain• Prognosis• Biorhythms• Emotion (anxiety, denial, depression, fear)• Language• Age• Culture• Disabilities

Barriers to Learning

The Teaching process vs. the Nursing process

Teaching Process

1. Collect data, analyze learning strengths/deficits

2. Make educationaldiagnoses

3. Prepare teaching plan– Learning outcomes– Prepare content/time– Select teaching strategies

4. Implement teaching plan5. Evaluate client learning

Nursing Process

1. Collect data: analyze strengths and deficits

2. Make nursing diagnosis3. Plan nursing goals /

outcomes – Select Interventions

4. Implement nursing strategies

5. Evaluate outcomes based on goal criteria

• What is the function of the client teaching plan?– Activities intended to produce learning– Dynamic interaction between teacher and learner

• Exchange of information, emotions, perceptions, attitudes

– Take the patient from dependence to independence– Assess previous experiences as resources for learning– Goal to meet a need in the life situation– Present useful, timely material to meet a need

• What are the elements of an objective?

Learning objectives

Types of Learning

• Cognitivism– Learning is a complex cognitive activity– Information is structured and processed– Perceptions are highly personal – Social, emotional and physical context to

learning– Relies on developmental and personal

readiness

Types of Learning

• Bloom’s domains of learning– Cognitive – Thinking– Affective – Feeling– Psychomotor – Skills

Types of Learning

• Cognitive Domain– Thinking domain

• Knowing, comprehending, applying, analysis, synthesis and evaluation

• Affective Domain– Feeling domain

• Specifies degree of person’s depth of emotional response to tasks

• Feelings, emotions, interest, attitudes, appreciations

Types of Learning

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• Psychomotor domain– Skill domain

• Motor skills – injections, dressing changes, medication

• Include all domains in teaching plan– Teaching to give insulin

• Skill• Why Insulin is needed• What to do when not feeling well• Accept chronic nature of disease/health promotion

Types of Learning

Principles for Effective Teaching and Learning

• Conditions for Effective Learning

• Conditions for Effective Teaching

• (Part of group project to explore these areas)

Health teaching• What are the factors that effect client teaching? • How?

Page 503-504-Berman

Factors facilitate learning

Name 2 factors that facilitate the learning process

1.2.

Assessment of need

What are the steps needed to define learning needs?

Blooms taxonomy: Classified cognitive behaviors in an ordered hierarchy

Knowledge: Recall data or information. Example: tell normal lab value from memory to a patient.

Comprehension: Understand the meaning, translation, interpolation, and interpretation of instructions and problems. State a problem in one's own words.

Application: Use a concept in a new situation or unprompted use of an abstraction. Applies what was learned in the classroom into novel situations in the work place.

Analysis: Separates material or concepts into component parts so that its organizational structure may be understood. Distinguishes between facts and inferences.

Synthesis: Builds a structure or pattern from diverse elements. Put parts together to form a whole, with emphasis on creating a new meaning or structure.

Evaluation: Make judgments about the value of ideas or materials. Formulate examples of each learning behavior! Page 277-278

Cognitive: Mental Skills (Knowledge)

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ReceivingAwareness, willingness to hear, selected attention. Example: Listen for and remember the name of newly introduced people.

Responding: Active participation on the part of the learners. Attends and reacts to a particular phenomenon. Learning outcomes may emphasize compliance in responding, willingness to respond, or satisfaction in responding

Valuing: The worth or value a person attaches to a particular object, phenomenon, or behavior. This ranges from simple acceptance to the more complex state of commitment. Valuing is based on the internalization of a set of specified values, while clues to these values are expressed in the learner overt behavior and are often identifiable.

Organizing: Organizes values into priorities by contrasting different values, resolving conflicts between them, and creating an unique value system. The emphasis is on comparing, relating, and synthesizing values.Characterizing: Has a value system that controls their behavior. The behavior is pervasive, consistent, predictable, and most importantly, characteristic of the learner. Instructional objectives are concerned with the student's general patterns of adjustment (personal, social, emotional). .

Affective (Attitude)

Perception: Has a value system that controls their behavior. The behavior is pervasive, consistent, predictable, and most importantly, characteristic of the learner. Instructional objectives are concerned with the student's general patterns of adjustment (personal, social, emotional). Example: detects non communication cues

Set: Readiness to act. It includes mental, physical, and emotional sets

Guided response: The early stages in learning a complex skill that includes imitation

and trial and error. Adequacy of performance is achieved by practicing.

Mechanism: This is the intermediate stage in learning a complex skill.

Complex overt response: The skillful performance of motor acts that involve complex movement patterns.

Adaptation: Skills are well developed and the individual can modify movement

patterns to fit special requirements

Origination: Creating new movement patterns to fit a particular situation or specific problem.

Formulate examples of each learning behavior! Page 278

Psychomotor

Across a life span

Compare and contrast learning needs of age groups and suggested teaching Strategies

• What are the purposes of learning objectives?

• Which of the learning domain(s) would be necessary to teach a client to learn to give themselves a heparin injection?

• What methods can be utilized to evaluate clients learning? What is the primary focus of evaluation?

• What are the Nsg Dx(s) related to client education?

• What does complex overt psychomotor learning mean? How can it be achieved?

Module questions

• Name 3 education related nursing diagnosis?

• Complimenting a client immediately after demonstrating something learned is inappropriate! True or False

• Role playing is a demeaning learning activity for the patient and should not be used in the teaching plan. True or False

Module questions

Harkreader H.& Hogan.M. (2007) The Fundamentals of Nursing Caring and Clinical Judgment (3rd ed.) St. Louis MO:Saunders

Andrews M. & Boyle J. (2003) Transcultural Concepts In Nursing Care (4th ed.) Philadelphia PN: Lippincott Williams& Wilkins

Satterly, F. (2004) Where Have The Nurses Gone? Impact of The Nursing Shortage on American Healthcare. Amherst NY: Prometheus Books

Bloom B. S. (1956). Taxonomy of Educational Objectives, Handbook I: The Cognitive Domain. New York: David McKay Co Inc.

Krathwohl, D. R., Bloom, B. S., & Bertram, B. M. (1973). Taxonomy of Educational Objectives, the Classification of Educational Goals. Handbook II: Affective Domain. New York: David McKay Co., Inc.

Bibliography

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Blessings and respect