Determinants of Learning

1. Learning Needs

2. Readiness to Learn

3. Learning Style

Three determinants

Good assessments

Ensure that optimal learning can occur with the least amount of stress and anxiety for the learner.

Learning needs

Gaps in knowledge between what someone knows and what someone needs to know due to lack of knowledge, attitudes or skills. It may arise because of a lack of knowledge, attitude, or skill.

Identify the learner

Who is the learner? What are the learning needs?

Choose the right setting

Establish a trusting environment by ensuring privacy and confidentiality especially if confidential information will be shared.

Collect data on the learner

By determining the characteristics learning needs of the target population or any recipient of the learning material.

Include learner as the source of information

Allow the learner to actively participate in identifying his needs and problems.

Include members of the healthcare team

Collaborate with those who may have knowledge of the patient.

Determine availability of educational resources

The materials and equipment used to demonstrate procedures should be appropriate, available, affordable, easy and simple to manipulate by the learner.

Assess demands of the organization

Examine the organizational climate (philosophy, vision, mission, goals) to know its educational focus.

Consider time management issues

(1) allow learners to identify their learning needs (2) identify potential opportunities to assess the patient anytime, anywhere (3) minimize distractions/interruptions during planned assessment interviews.

Prioritize Needs

Take note of Maslow’s hierarchy of needs.

Mandatory

Meet immediately; life-threatening

Desirable

Promote well-being

Possible

Nice to know information; not related to ADL’s.

Gauge of Success

To be able to transfer one’s skills, knowledge, values and attitudes to the learner

Readiness to learn

The time when the learner demonstrates an interest in learning the information necessary to maintain optimal health or to become more skillful in a job.

Timing

The point at which teaching should take place.

Teachable moment

Best time to teach

Informal Conversations

o often learning needs are discovered during impromptu conversations

o rely on active listening to pick up cues and information regarding learning needs.

Structured Interviews

o form of needs assessment most commonly used to solicit the learner’s point of view.

o The nurse educator asks the learner direct and often predetermined questions to gather information about learning needs.

Written Pretests

o Giving written pretests before planned teaching can help identify the knowledge levels of potential learners

o assist in identifying their specific learning needs before instruction begins.

Health Behavior Observation

Observing health behaviors in several different time periods can help the educator draw conclusions about established patterns of behavior that cannot and should not be drawn from a single observation.

Measures of Ability

Ability to perform a task

Complexity of the task

Affect the extent to which the learner can master the behavioral changes in the cognitive, affective, and psychomotor domains.

Environment

Helps to hold the learner’s attention and stimulate interest in learning.

Health Status

Amounts of energy available and the individual’s present comfort level are factors that significantly influence that individual’s readiness to learn.

Gender

Women are generally more receptive to medical care and take fewer risks with their health than do men.

Anxiety

Affects patients’ ability to concentrate and retain information.

Fear

It is a major contributor to anxiety.

Support system

Availability and strength of a support system also influence emotional readiness and are closely tied to how anxious an individual might feel.

Reachable moment

Unique opportunity that nurses have in providing emotional support to patients and family members.

Motivation

Knowing the motivational level of the learner assists the educator in determining when that person is ready to learn.

Risk taking behavior

Develop awareness in the patient as to how this can shorten his lifespan, develop strategies to minimize the risk, recognize signs and symptoms of probable disease state and what to do should this worst-case scenario develop.

Frame of Mind

It involves concern about the here and now versus the future.

Developmental Stage

Each task associated with human development produces a peak time for readiness to learn, known as a teachable moment

Levels of Aspiration

Extent to which someone is driven to achieve is related to the type of short- and long-term goals established.

Past coping mechanisms

Explore the coping mechanisms that learners have been using to understand how they have dealt with previous problems

Cultural background

Avoid teaching in opposition to cultural beliefs

Health Status

Amounts of energy available and the individual’s present comfort level are factors that significantly influence that individual’s readiness to learn.

Locus of Control

Motivation to learn

Orientation

Person’s point of view

Parochial

Close-minded thinking, conservative, less willing to learn new materials and have great trust in the physician.

Cosmopolitan

Worldly perspective and more receptive to new innovative ideas.

Present knowledge base

How much someone already knows about a specific subject or how proficient that person is at performing a task.

Cognitive ability

Extent to which information can be processed is indicative of the learner’s capabilities.

Learning disabilities

Require educators to use special or innovative approaches to instruction to sustain or bolster readiness to learn.

Learning styles

The way learners learn that takes into account the cognitive, affective, and physiological factors affecting how learners perceive, interact with, and respond to the learning environment.

Motivation

Drives the learner to learn; significantly related to measure of compliance with medical regimen.

Health behavior frameworks

Facilitate motivation and compliance to health regimen.

Literacy and Readability

Concerned when assessing learning styles.

Literacy

Ability to read, write, understand and interpret information.

Health literacy

Ability to read and understand instructions for medications, procedures, appointments for follow- up care and patient health education programs.

Reading

Process of transforming letters into words and being able to pronounce them correctly.

Readability

Ease with which written or printed information can be read.

Comprehension

Degree to which individuals understand what they have read; the ability to grasp the meaning of the message (get the gist of it).

REALM

o rapid estimate of adult literacy in medicine

o requires patients to pronounce common medical and anatomical words

o contains 66 words arranged in three columns in ascending order of number of syllables and increasing difficulty

WRAT

o wide range achievement test

o patient is asked to read aloud from a list of 42 words of increasing difficulty.

o Examiner asks the patient to pronounce each word and checks off each word that is pronounced incorrectly. When 10 consecutive words is mispronounced the test is stopped.

Establish a trusting relationship

o Focus on patient’s strengths

o Specify what needs to be learned

Teach what needs to be learned

o Prioritize behavioral objectives

o Present context first before giving any new information

o Teach for 20-30 minutes

Vivid and explicit explanation

o Simple terms

o Visual aids

o Underlining, highlighting, color coding

Teach one step at a time

o Teach in increments (simple to difficult)

o Chunk information

o Evaluate progress and give positive reinforcements

Use multiple teaching methods and tools requiring fewer literacy skills

o Repetition of information

o Supplement oral instructions with other forms of media

o Interactive computer