DETERMINANTS OF LEARNING

1. Learning Needs

2. Readiness to Learn

3. Learning Style

THREE DETERMINANTS

LEARNING NEEDS

gaps in knowledge between what someone knows and what someone needs to know due to lack of knowledge, attitudes or skills

Mandatory

meet immediately; life-threatening

Mandatory

• a patient who has experienced a recent heart attack needs to know the signs and symptoms and when to get immediate help.

• The nurse who works in a hospital must learn how to do cardiopulmonary resuscitation or be able to carry out correct isolation techniques for self-protection.

Desirable

promote well-being

Desirable

not life dependent but that are related to wellbeing or the overall ability to provide high quality care in situations involving changes in institutional procedure

Desirable

it is important for patients who have cardiovascular disease to understand the effects of a high-fat diet on their condition.

Possible

nice to know information; not related to ADL’s

Possible

The patient who is newly diagnosed as having diabetes mellitus most likely does not need to know about self-care issues that arise in relationship to traveling across time zones or staying in a foreign country because this information does not relate to the patient’s everyday activities

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

• often learning needs are discovered during impromptu conversations

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

STRUCTURED INTERVIEWS

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

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

• the nurse should strive to establish a trusting environment, use open-ended questions, choose a setting that is free of distractions, and allow the learner to state what are believed to be the learning needs.

WRITTEN PRETESTS

• help identify the knowledge levels of potential learners

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

• prevents the educator from repeating already known material in the teaching plan.

• useful to the educator after the completion of teaching when pretest scores are compared with posttest scores to determine to what extent learning has taken place.

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

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

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

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

teachable moment

peak time for readiness to learn

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

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 ( rapid estimate of adult literacy in medicine)

• requires patients to pronounce common medical and anatomical words

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

WRAT (Wide Range Achievement Test)

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

• 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.