HE Finals Reviewer

Compliance and Motivation

Both are used implicitly or explicitly in many **health behavior models.**

Compliance

It implies that the healthcare provider or educator is viewed as the __**authority**__. The consumer or learner is in a **submissive** role, passively following recommendations. Also implies an attempt to control the learner's right to decision-making.

Adherence

The extent to which a person’s behavior **corresponds** with agreed recommendations from a health care provider.

This is considered __**more**__ __**patient centered**__ than compliance because it supports the patient’s right to choose whether to follow treatment recommendations.

A commitment or attachment to a prescribed, predetermined **regimen.** With compliance in the measurement of health outcome.

Noncompliance

Describes __**resistance**__ of the individual to follow a predetermined regimen. As such, this term carries a negative connotation of the learner, but may in fact be resilient because this may be a response or defensive coping mechanism to a stressful situation.

Categories of noncompliance

1\. A patient problem to be solved by nursing interventions.

2\. Rationalization - critical of the term noncompliance but acknowledges its importance in healthcare issues.

3\. Evaluative - expresses concern about the term but offers various perspectives.

Compliance

Can be viewed from various perspectives and are useful in explaining or describing compliance from a multidisciplinary approach, including psychology and education.

\- Eraker, Kirscht, and Becker (1984) and Levanthal and Cameron (1987),

Biomedical theory

which links compliance with __**patient characteristics**__ such as demographics, severity of disease, and complexity of treatment regimen.

Behavioral/Social learning theory

which focuses on external factors that influence the patient's adherence, such as rewards, cues, contracts, and __**social supports.**__

Rational belief theory

which suggests that __**patients make a decision**__ to comply or not comply by weighing the benefits of treatment and the risks of disease through the use of cost-benefit logic.

Self-regulatory systems

in which patients are seen as problem solvers whose regulation of behavior is __**based on perception**__ of illness, cognitive skills, and past experiences that affect their ability to plan and cope with illness.

Locus of control

refers to an individual's __**sense of responsibility**__ for his or her own behavior and the extent to which motivation to act originates from within the self (internal) or is influenced by others (external).

Externals

\
believe that fate is a powerful external force that determines life's course

Internals

believe that they control their own destiny.

Functional illiteracy

The inability to read or write at a level sufficient for everyday living.

Noncompliance

Can be related to patient issues such as knowledge or motivation, treatment factors such as side effects, disease issues such as prognosis, lifestyle issues such as transportation, sociodemographic factors such as social and economic status, and psychosocial variables such as depression and fear (Rosner, 2006).

Motivation

from the Latin word __movere__, means to set into motion.

has been defined as a psychological force that moves a person toward some kind of action (Haggard, 1989).

It has also been described as a willingness of the learner to embrace learning (Redman, 2007).

motivation

According to Kort (1987), ___________ is the result of both internal and external factors and not the result of external manipulation alone.

Lewin

an early field theorist which conceptualized motivation in terms of positive or negative movement toward goals.

·        Once an individual's equilibrium is disturbed, such as in the case of illness, forces of approach and avoidance may come into play.

·        He noted that if avoidance endured in an __**approach-avoidance**__ conflict, there would be negative movement away from a goal.

Maslow

developed a theory of human motivation that is still widely used in the social sciences. The major premises of his motivation theory are __**integrated wholeness of the individual and a hierarchy of goals.**__

Motivational incentives

need to be considered in the context of the individual. What may be a motivational **incentive for one learne**r may be a motivational **obstacle to another.**

Axioms

are __**premises**__ on which an understanding of a phenomenon is based.

Personal attributes

Environmental influences

Learner relationship systems

Facilitating or blocking factors that shape motivation to learn can be classified into three major categories, which are not mutually exclusive:

Personal attributes

which consist of __**physical**__, developmental, and psychological components of the individual learner

Environmental influences

which include the physical and __**attitudinal climate**__

leaner relationship systems

such as those of significant other, family, community, and teacher- learner interaction.

1\. state of optimal anxiety

2\. learner readiness

3\. realistic goal setting

4\. learner satisfaction/success

5\. uncertainty-reducing or uncertainty-maintaining dialogue.

5 Motivational axioms (SLRLU)

motivational assessment

Edman (2001) views ___________________ as a part of general health assessment and states that it includes such areas as level of knowledge, client skills, decision-making capacity of the individual, and screening of target populations for educational programs.

Cognitive variables

Affective variables

Physiological variables

Experiential variables

Environmental variables

Parameters for a comprehensive motivational assessment of the learner (CAPEE)

Cognitive variables

·        Capacity to learn.

·        Readiness to learn.

·        Expressed self-determination.

Constructive attitude

·        Expressed desire and curiosity.

·        Willingness to contract for behavioral outcomes

·        Facilitating beliefs

·        Motivational assessment of the learner needs to be comprehensive, systematic, and conceptually based.

·        Cognitive, affective, physiological, experiential, environmental, and learning relationship variables need to be considered.

Affective variables

·        Expressions of constructive emotional state

·        Moderate level of anxiety

Physiological variables

·        Capacity to perform required behavior.

Experiential variables

·        Previous successful experiences

Environmental variables

·        Appropriateness of physical environment

·        Social support systems

·        Family

·        Group

·         Work

·        Community resources

teaching-learning

Assessment of learner motivation involves the judgment of the educator because _____________ is a two-way process.

dialogue

A subjective means of assessing level of motivation is through _______.

Incentives and motivation

are both stimuli to action

Cognitive evaluation theory

posits that knowing how to foster motivation is essential because educators cannot rely on intrinsic motivation to promote learning. They note, however, that __**autonomy and competence are intrinsic motivators that can be enhanced by selected teaching strategies**__ (Ryan & Deci, 2000) .

Concept mapping

·        One contemporary nursing educational strategy suggested to promote motivation is _____________, which enables the learner to integrate previous learning with newly acquired knowledge through diagrammatic "mapping."

·        As a motivational technique, this facilitates the acquisition of complex new knowledge through visual links that acknowledge previous learning.

·        Learner interest is sustained by perceived competence and autonomy. As a less instructor-regulated learning activity, this promotes interest and value on behalf of the learner.

Attention

Relevance

Confidence

Satisfaction

ARCS model

Motivational models

Health Belief Model

Health Promotion Model (revised)

Self-Efficacy Theory

Protection Motivation Theory

Stages of Change Model

Theory of Reasoned Action

Therapeutic Alliance Model

Create

Evaluate

Analyze

Apply

Understand

Remember

Bloom’s Taxonomy

Planning and conducting classes

Before entering a classroom, the teacher need to formulate objectives, select and organize content, choose teaching methods, and design assignment, and finally evaluation the learning.

course outline

______ or syllabus is considering a contract between teacher and learners. This includes:

·        The name of the course

·        The name of Instruction

·        A one-paragraph course description

·        A list of course description

·        Teaching methods to be used.

·        The textbook or other readings

Cognitive (knowing)

Psychomotor (Doing)

Affective (feeling, valuing)

Educational objectives suggested by bloom (1984) is divided into 3 domains:

Characteristics of the learner

Characteristics of the medium

Characteristics of the task

Making appropriate choices of instructional materials depends on a broad understanding of three major variables:

Delivery system

Content

Common form of presentation

The three major components of instructional materials

Delivery system

Includes both the software and hardware used in presentation of information. Influence by the size of the intended audience, pacing or flexibility needed for delivery, and sensory aspects most suitable to the audience.

Content

·        Intended message. Independent of the delivery system and is the actual information being communicated to the learner.

·        When selecting instructional material(s), the nurse educator must consider several factors: Accuracy of the information being

·        conveyed. Is it up to date and accurate? Appropriateness of the medium to convey the chosen information.

·        Appropriateness of the readability level of materials for the learner(s)

Realia

·        A condition of being real

·        Most concrete form of stimuli that can be used to deliver information.

·        Example: A woman demonstrating breast self-examination is the most concrete example of reality.

Illusionary representation

Applies to a less concrete, more abstract form of stimuli through which to deliver a message, such as moving or still photographs, audiotapes projecting true sounds and real-life drawings.

Symbolic representations

·        Most abstract types of messages, though they are the most common form of instructional materials to communicate information.

·        This includes numbers and letters of the alphabet, symbols that are written and spoken as words that convey ideas or represent objects.

·        Audiotapes of someone speaking graphs, written texts, handouts, posters, flip charts, and whiteboards on which to display words and images are vehicles to deliver messages in symbolic forms.

Commercially prepared naterials

Written materials

Demonstration materials

Self-composed materials

Types of instructional materials

Written materials

·        Handouts, such as leaflets, books, pamphlets, brochures, and instruction sheets (all symbolic representation)

·        Most widely used and most accessible type of tools for teaching.

·        Printed materials have been described as "frozen language"

·        Most common form of teaching aid because of the distinct advantages they provide to enhance teaching and learning.

Self-composed materials

·        Nurse educators may choose to write their own instructional materials to save costs or to tailor content to specific audiences.

·        Composing materials offers many advantages.

·        Doak et.al (1998) outline specific suggestions for tailoring information to help clients want to read and remember the message and to act on it.

·        These authors define TAILORED INSTRUCTION as personalizing the message so that the content, structure, and image fit an individual's learning needs.

Demonstration materials

·        Include many types of visual, hands-on media. Models and real equipment are one type, and a combination of printed words and visual

·        illustration (diagrams, graphs, charts, photographs, and drawings.

·        Useful for cognitive, affective, and psychomotor skill development.

·        It stimulates the visual senses but can combine the sense of sight with touch and sometimes even smell and taste.

Replica

·        An exact copy constructed to scale that ensemble the features or substance of the original object.

·        Excellent for teaching psychomotor skills because they give the learner an opportunity for active participation through hands-on experience.

·        Example: Replica of the DNA helix, models of the heart, kidney, ear, eye, joints & pelvic organ.

Posters

·        Legitimate & reasonable alternative to more direct, formal presentations for conveying information.

·        leave a mental image long after they are seen.

Planning and designs

key for poster's effectiveness

Lecture

one-way channel of communication to give a formal talk to a group of people and simply convey the knowledge to the students.

Discussion

retains some of the features of lecturing when the teacher still imparts the lesson to the students through interaction. This time she/he gives them the opportunity to share their insights or understanding of the topic. It may be formal or informal. It allows greater student teacher interaction and or student to student interaction.

factual questions

questions that demand simple recall of information.

probing questions

questions used when teacher wants a learner to further explain an answer.

multiple choice questions

questions that can be oral or written, they usually test recall and can be used to begin a discussion.

open-ended questions

questions that are often used to encourage critical thinking and discussion.

discussion-stimulating questions

questions designed to prompt conversation and encourage individuals to share their thoughts, opinions, and experiences on a particular topic.

Questions that guide problem-solving

teachers need to phrase and sequence questions carefully in order to guide learners in problem-solving thinking process.

Audiovisual aids

·        A traditional method that can reinforce teaching and learning.

·        It is used as supplement to a lecture, as a prelude to discussion, or a part of questioning strategy

·        Can greatly enhance teaching and add to students’ interest.

cooperative learning

students work together in small groups on a structured activity. They are individually accountable for their work, and the work of the group is also assessed.

simulation

is a trial-and-error method of teaching whereby an artificial experience is created that engages the learner in an activity that reflects real-life conditions but without the risk-taking consequences of an actual situation.

problem-based learning

is a student-centered approach in which students learn about a subject by working in groups to solve an open-ended problem. This problem is what drives the motivation and the learning.

self-learning method

is an individualized method of learning. The face-to-face teaching is disappearing, and distance mode of education is becoming popular. Self-learning modules are designed where the learner is free to choose what to learn, how to learn, when to learn and where to learn.

computer-assisted instructions

This refers to virtually any kind of computer used in educational settings.  

Internet

·        Interconnected computer networks around the globe that can be accessed by the public through standard IP.

·        Consists of all networks including domestic, academic, business, and government networks.

·        Almost all information imaginable is available in the internet.

·        Can also be used to share information and communication.

Virtual reality

·        An advance technology to display perceived environment or situation like reality while on remote.

·        The user wears a head gadget used to cover the eyes and show virtual reality.

·        They can interact with the environment displayed through sensory gears such as in the hands and feet.

·        Can simulate real life situations.

·        Useful for skills-based learning such as nursing.

Distance education

Online courses, correspondence courses, independent study, and video conferencing are just a few of the techniques that can be used to deliver educational programs to students studying at a distance.

Interactive Television (ITV) classes

replicate a traditional classroom experience with one unique exception: the "classroom" can consist of individuals or groups in several separate locations. The instructor and students can both see and talk to each other as if they were in the same room.

Psychomotor skills

refer to the ability to coordinate physical movements with cognitive processes to perform tasks efficiently and effectively.

Fine motor skills

These involve the coordination of small muscles, particularly in the hands and fingers. Examples include writing, drawing, typing, using tools, playing musical instruments.

Gross motor skills

These involve the coordination of large muscle groups and the whole body. Examples include walking, running, jumping, climbing, throwing, kicking, swimming, and engaging in sports activities.

Clinical teaching

is a kind of instruction used in healthcare education that focuses on giving students opportunity for experiential, hands- on learning in actual clinical settings.

Clinical laboratories

are healthcare facilities providing a wide range of laboratory procedures which aid the physicians in carrying out the diagnosis, treatment, and management of patients.

Bedside Clinic

it is a method of clinical teaching which is carried out by either group visits the patient or the patient is brought to the conference room.

Nursing Rounds

a tour of patient's bedside area made by a small group of staff and students, for the purpose of clinical learning and instructional purpose.

Nursing shift report

are written or oral summary of the nursing actions taken in relation to patient's care.

Demonstration

teaches by "exhibition & explanation it trains the students in the art of careful observation

Process Recording

it is a written account or verbatim recording of all that transpired during and immediately following the nurse-patient interaction.

Case study/ Case presentation

laboratory method it is a part of clinical teaching that offers students the opportunities to apply their theoretical knowledge or previous learning into practice in a controlled situation under guidance and supervision where there is no client.

health talks

are a means to share information with the community, and this approach can support and complement more participatory approaches. There is much evidence that health talks are effective in passing on health information.

Nursing care study

Method, which Focuses on information and facts about patient, the disease condition, social and personal history and the application of this knowledge in rendering nursing care

Discussion method

involves interpersonal communication among a teacher, a learner, and a learning group. This technique helps in identifying issues and provides knowledge for comprehending and resolving the issues by imparting relevant skills.

field trips

is a well-organized trip from a usual place for teaching purpose.

Traditional model

the educator delivers instruction and evaluates small groups of nursing students both in the classroom and during their clinical experience.

preceptor model

an experienced nurse in the clinical setting mentors and guides students individually on a one-to-one basis.

Associated/partnership model

focuses on creating a collaborative partnership between the educator and the learner in the clinical setting, emphasizing shared responsibility and active participation.

Evaluation

defined as a systematic process that judges the worth or value of something—in this case, teaching and learning. Evaluation can provide evidence that what nurses do as educators make a value-added difference in the care they provide.

Assessment

The process of __________ focuses on initially gathering, summarizing, interpreting, and using data to decide a direction for action.

evaluation

In contrast, the process of _______ involves gathering, summarizing, interpreting, and using data after an activity has been completed to determine the extent to which an action was successful.

Audience

Purpose

Questions

Scope

Resources

5 basic components of evaluation

Primary audience

individuals or groups who requested the evaluation or who will use the evaluation results.