Teaching-Learning Process in Nursing

1. Teaching-Learning Process in Nursing E. Heim, FA09

2. RANC Objectives • Identify the components of the teaching-learning (T-L) process. • Describe potential barriers to the learning process. • Compare and contrast barriers and facilitators of the teaching-learning process. • List strategies to motivate learners. • Describe methods to evaluate learning.

3. Teaching Plan • Improve quality of care • Reduce HC costs • Keep pts better informed about their Tx plan

4. T-L: Standard of Care • Nurse Practice Act • American Nurses Association (ANA) • Joint Commission • Assess learning needs • Provide education: Speak Up “Know Your Rights” initiative (2007): http://www.jointcommission.org/PatientSafety/SpeakUp/ • http://www.jointcommission.org/NR/rdonlyres/58A5230D-3E58-48D8-8114-C95AF53ECA27/0/Speakup_Rights.pdf • Pain • Plan of care • Meds • Nutrition • Med equipment • Success = Collaboration

5. What is the T-L Process? • Teaching • An interactive process that promotes learning • Learning • The purposeful acquisition of knowledge, skills, behaviors, & attitudes

6. Who do we Teach? • Educational Needs vary: • Disabled • Children • Older Adults • Cultures • Clients • Families • Other nurses even!

7. Why do we educate clients? • To help individuals, families, or communities achieve optimal levels of health • Client education includes: • Maintenance & promotion of health and illness prevention • Coping with impaired functioning • Restoration of health

8. Role of the Nurse in Teaching and Learning • Teach information the client & family needs to know in order to make informed decisions regarding their care. • Determine what clients need to know. • Identify when clients are ready to learn.

9. Components of T-L process • Communication • (Table 25-1) • Verbal, non-verbal • Domains of Learning • (Box 25-3) • Cognitive, Affective, & Psychomotor • Basic Learning Principles • (p368-Table & Box) • Motivation, Ability, Environment

10. Communication in T-L Process • T-L closely parallels communication process. • Depends in part on effective interpersonal communication. • The learning objective describes what the learner will be able to accomplish after instruction is given.

11. Domains of Learning • Cognitive • Includes all intellectual behaviors & requires thinking • Acquiring knowledge through a series of steps • Affective • Includes feelings, opinions, values, appreciation, enthusiasms, motivations, & attitudes • The “receiver” that responds and values in a characteristic & organized manner • Psychomotor • Involves acquiring skills that require integration of mental and muscular activity • Perceiving, practicing, doing, and imroving

12. Basic Learning Principles • Motivation to Learn • Addresses pt’s desire or willingness to learn • Ability to Learn • Physical & cognitive abilities, developmental level, physical wellness, thought processes • Learning Environment • Facilitates attention to instruction

13. Motivating Learners • Motivation: the force that causes a pt to behave in a particular way • Social— Need for connection, approval or self-esteem • Task mastery— Need for achievement & competence • Physical— Need to return to former level of normalcy (“survival mode”) • Compliance: adherence to prescribed Tx • Self-efficacy: person’s belief in their ability to successfully do the task • Verbal persuasion, vicarious experience, enactive mastery experience, physiological & affective states.

14. Assess motivation: • Ask questions to ID and define motivation. • What are their motivational factors? • Behavior (attention span, memory, ability to concentrate) • Health beliefs & sociocultural background • Perception of severity of Dx & benefits/barriers to Tx • Perceived ability to perform health behaviors • Desire to learn attitudes about HC providers • Learning style preference • What event led to the “now” part and what do they want to do about it?

15. Ability to Learn • Physical strength, movement, dexterity & coordination • Fatigue, electrolyte levels, oxygenation status, blood glucose level • Sensory deficits • Reading level • Developmental level • Cognitive function • Pain, fatigue, anxiety

16. Resources for Learning • Social network: family, friends, & pt • HIPAA • Financial or material resources • Computer, car, insurance • Learning Skills • ADHD, “learner-type”, math skills. literacy • Printed material that matches reading level • Functional illiteracy: • Inability to read above a 5th grade level • Culturally sensitive: language, pictures, etc

17. Facilitators & Barriers developmental culture spirituality coping ability environment physical conditions The Patient social motivation emotions learning styles

18. Integrating: Nursing Process & Teaching Process • A relationship exists. • The nursing & teaching process are not the same. • The nursing process requires assessment of all data. • The teaching process focuses on the client’s learning needs & ability to learn.

19. Assessment • Assess factors that influence content, ability to learn, & resources available: • Expectation of learning • Learning needs • Motivation • Teaching environment • Health literacy and learning disability

20. Nursing Diagnosis • Select the Nursing Dx that best reflects the assessed learning • Clarifying the Dx by domain to help focus on the subject matter & teaching methods. • Cognitive: Knowledge deficit: Signs of hypoglycemia • Affective: Noncompliance R/T fear of pain • Psychomotor: Ineffective therapeutic regimen R/T dexterity difficulties secondary to Carpal Tunnel Syndrome

21. Planning: Goals/Outcomes • Determine specific goals & expected outcomes that guide the choice of teaching strategies & approaches with a client: • Be realistic • Set priorities. • Select timing to teach. • Avoid “overload” • Define measurable goals • Organize the teaching material. • Goal Ex: “demonstrates” or “verbalizes”

22. Implementation • Maintain learning attention and participation. • Build on existing knowledge. • Select teaching approach. • Incorporate teaching with nursing care. • Select appropriate instructional methods. • Illiteracy & other disabilities. • Cultural diversity. • Using different teaching tools. • Special needs of children and older adults (p379) collaboration!

23. Patient Teaching • Approaches • Telling • Participating • Entrusting • Reinforcement • Methods • One-on-one • Group • Preparatory instruction • Demonstrations • Analogies • Role play simulation

24. Teaching while “Doing” • More effective if tied to the “problem” • Application of theory to practice

25. Evaluation of Learning

26. Methods to Evaluate Learners • Determines whether the client has learned the material • Helps to reinforce correct behavior & change an incorrect behavior • Success depends on the client’s performance of expected outcomes • “demonstrates” • “verbalizes”

27. Success! • Document • Supports TJC standards of care, QI efforts, & allows for reimbursement • Written care plans • Teaching flow sheets • Ask questions to verify understanding of teaching • Realistic goals? Value the info? Barriers? Any problems or questions?

28. The End • eheim productions 