Teaching

TEACHING IN NURSING - NURS 1108

CHAPTER 9

TEACHING AND LEARNING PROCESS
  • Transfer of Knowledge
    • Defined as a process intentionally designed to produce learning.
    • Objectives include:
    • Helps maintain and promote health.
    • Prevents illness.
    • Facilitates coping.
    • Promotes desired health outcomes.
CONCEPTS TO REMEMBER WHILE TEACHING
  • Listen to your patients and their families.
  • Recognize every interaction as an opportunity to teach.
  • Foster education that is patient (person) centered.
  • Begin teaching at the first encounter with the patient.
  • Engage and motivate patients throughout the learning process.
TEACHABLE MOMENTS
  • Identified opportunities for teaching during patient interactions include:
    • Dressing changes.
    • Medication administration.
    • Admission processes.
    • Pre-operative preparations.
    • Discharge planning and instruction.
FACTORS AFFECTING PATIENT LEARNING
  • Age and developmental level.
  • Family/caregiver support networks.
  • Financial resources available.
  • Cultural influences and language barriers.
  • Individual's health literacy.
  • Levels of motivation.
  • Readiness to learn.
  • Timing of information delivery.
  • The environment in which teaching occurs.
  • Consider additional factors as they arise.
PSYCHOMOTOR ABILITY
  • Greatly influences teaching and learning outcomes:
    • Muscle strength
    • Motor coordination
    • Energy levels
    • Sensory acuity
FOUR ASSUMPTIONS ABOUT ADULT LEARNERS (KNOWLES’ 1990)
  1. As individuals mature, their self-concept tends to shift from dependence to independence.
  2. Prior experiences in adults act as a rich resource for learning.
  3. A readiness to learn is frequently related to a developmental task or a social role.
  4. Most adults prefer learning material that they can apply immediately rather than at a later date.
TEACHING OLDER ADULTS
  • To enhance learning, consider:
    • Identify learning barriers specific to older adults.
    • Allow extra time for comprehension.
    • Plan for shorter teaching sessions to prevent fatigue.
    • Accommodate sensory deficits (e.g., hearing, vision).
    • Minimize environmental distractions to facilitate focus.
    • Relate new information to familiar activities or previously known information.
SPECIAL TEACHING CONSIDERATIONS FOR OLDER ADULTS
  • When developing educational material, consider:
    • Use large print for readability.
    • Utilize buff-colored paper for easier reading.
    • Target a reading level of 6th to 8th grade.
    • Allow for additional time in the learning process.
    • Be organized and systematic in presenting information.
    • Repeat key points to reinforce learning.
    • Use concrete examples to facilitate understanding.
GENERAL CONSIDERATIONS FOR ALL POPULATIONS
  • Challenges in effective patient education include:
    • Not all individuals can read proficiently.
    • Individuals may attempt to feign understanding.
    • Use plain, non-medical language for clarity.
    • Speak clearly and at a moderate pace.
    • Provide small amounts of information incrementally.
    • Reinforce key points through repetition.
    • Utilize visual aids to enhance understanding.
    • Encourage patient questions to promote engagement.
    • Confirm understanding through demonstration or teach-back.
CONSIDERATIONS WHEN DEVELOPING WRITTEN MATERIAL
  • Ensure that written content is effective by:
    • Keeping language simple and straightforward.
    • Using active voice to improve readability (e.g., direct commands).
    • Employing second-person perspective for relatability (use 'you' instead of 'we').
    • Utilizing a large font size to facilitate reading.
    • Keeping sentences concise and manageable.
    • Avoiding the use of all capital letters as it can be harder to read.
    • Prioritizing essential information at the beginning of materials.
    • Emphasizing key information through bold typeface.
    • Leaving adequate white space in the document for clarity and ease of reading.
TEACHING LOW LITERACY PATIENTS
  • Effective strategies for low literacy individuals:
    • Incorporate multiple teaching methods: pictures, videos, role play, demonstrations.
    • Use simple terminology to emphasize key points.
    • Distribute information in small increments over several sessions.
    • Create associations to easily relate new information.
    • Employ repetition to enhance retention.
    • Engage patients actively in the process of learning.
    • Involve the teach-back method and return demonstrations.
    • Avoid lengthy written handouts that may overwhelm.
POTENTIAL LEARNING BARRIERS
  • Possible barriers to learning include:
    • Acute illness.
    • Physical pain.
    • Emotional challenges.
    • Language barriers.
    • Cultural or religious beliefs impacting understanding.
    • Physical or mental disabilities.
    • Varying levels of existing knowledge.
PROVIDING CULTURALLY COMPETENT PATIENT EDUCATION
  • Key actions to ensure effective cross-cultural education:
    • Develop an understanding of the cultural background of the patient.
    • Collaborate with a multicultural healthcare team.
    • Recognize and address personal biases or assumptions.
    • Understand core cultural values associated with the patient or their community.
    • Create written educational materials in the patient's preferred language.
LEARNING DOMAINS
  1. Cognitive: Storing and recalling new knowledge in the brain.
  2. Psychomotor: Learning a physical skill, integrating mental and muscular activity.
  3. Affective: Changing attitudes, values, and feelings.
LEARNING STYLES
  • Various learning preferences include:
    • Visual.
    • Auditory.
    • Read/Write.
    • Kinaesthetic.
REVIEW OF COMMUNICATION TECHNIQUES
  • Effective communication methods entail:
    • Being sincere and honest; showing genuine interest in patient care.
    • Avoiding overloading with detail; sticking to essential points.
    • Asking patients if they have questions to encourage interaction.
    • Acting as a supportive cheerleader, steering clear of lecturing.
    • Utilizing simple language to ensure understanding.
    • Varying tone of voice while maintaining clarity.
    • Ensuring the environment is conducive to learning; free of interruptions.
    • Being sensitive to the timing and length of teaching sessions.
PROMOTING ADHERENCE
  • Adherence is preferred over compliance; refers to the harmony between a patient's behavior and the healthcare provider’s recommendations.
    • Utilizes a team approach towards treatment plans.
    • Respects patient rights to choose their own health trajectory.
    • Encourages active and inclusive participation from patients and caregivers in the process.
    • Enhances adherence through clear instructions aligned with patient goals, interactive teaching strategies, and developing strong interpersonal relationships.
OUTCOME IDENTIFICATION AND PLANNING
  • Important steps involve:
    • Developing a teaching plan that outlines objectives.
    • Determining patient learning outcomes and corresponding teaching content.
    • Selecting appropriate teaching methods and materials.
TEACHING STRATEGIES
  • Various methods include:
    • Lecture.
    • Discussion.
    • Panel discussions.
    • Demonstration.
    • Discovery learning.
    • Role-playing.
    • Utilization of materials:
    • Audiovisual materials.
    • Printed materials.
    • Programmed instruction.
    • Web-based instruction and technology.
WEB BASED INSTRUCTION
  • Considerations in utilizing web-based sources include:
    • Source credibility: .gov, .edu, .org.
    • Assessing quality:
    • Who authored the content? Are they an expert? Have materials been reviewed?
    • Currency:
    • When was the content posted and updated?
    • Security of the website: ensure safety of the information access.
    • Identifying populations that may be disadvantaged in accessing web-based education.
CONSIDERATIONS FOR SUCCESSFUL PATIENT TEACHING
  • Important aspects for successful teaching:
    • Establishing contractual agreements regarding learning expectations.
    • Recognizing and accommodating time constraints for both parties.
    • Scheduling teaching sessions: group vs. individual settings.
    • Differentiating between formal and informal teaching situations.
    • Manipulating the physical environment to support learning.
ROLE OF THE NURSE AS A COACH
  • Responsibilities include:
    • Establishing relationships with patients and recognizing their readiness for change.
    • Identifying patient opportunities, issues, and concerns.
    • Creating patient-centered goals tailored to individual needs.
    • Structuring coaching interactions to be effective.
    • Empowering and motivating patients towards goal achievement.
    • Assisting patients in assessing their progress towards established goals (Hess et al., 2013).
EVALUATE LEARNING
  • Methods for evaluation include:
    • Timing of evaluation: When to assess learning progress.
    • Reinforcing learning through positive feedback and celebration of progress.
    • Evaluating the teaching effectiveness and making necessary revisions to instructional plans.
DOCUMENTATION OF THE TEACHING AND LEARNING PROCESS
  • Documentation should encompass:
    • Summary of identified learning needs.
    • Detailed implementation plan of the teaching session.
    • Results of evaluations conducted post-teaching.
    • Comprehensive documentation of all patient education activities conducted.
QUESTION & ANSWER SECTION

  • Question #1:

    • Is the following statement true or false? Most adults’ orientation to learning is that material should be useful immediately, rather than at some time in the future.
    • Answer: A. True.
    • Rationale: Adult learners often prefer material that has immediate relevance.

  • Question #2:

    • Which action exemplifies cognitive learning?
    • A. A patient demonstrates how to change his wound dressing.
    • B. A new mother follows instructions for caring for the umbilical cord.
    • C. A patient describes how to portion food to maintain within a prescribed calorie range.
    • D. A patient expresses renewed confidence following a teaching session on caring for her mother at home.
    • Answer: C. A patient describes how to portion food to maintain a prescribed calorie range.
    • Rationale: Cognitive learning pertains to knowledge storage and recall.

  • Question #3:

    • What would be the best teaching strategy to instruct a patient on caring for an indwelling catheter?
    • A. Lecture.
    • B. Role modeling.
    • C. Discovery.
    • D. Demonstration.
    • Answer: D. Demonstration.
    • Rationale: Demonstration is key for psychomotor learning, as it combines visual and practical instruction effectively.