Unit I Chapter 1 Overview of Education in Health Care

UNIT I:
PERSPECTIVES
ON TEACHING
AND LEARNING
CHAPTER 1: Overview of
Education in Health Care
Michael Jhervis C. Dalagan, RN MAN

OBJECTIVES
After completing this chapter, the students will be able to:
 Discuss the evolution of the teaching role of nurses.

 Compare and contrast the education process to the nursing
process.
 Define the terms teaching and learning.
 Identify reasons why patient and staff education is an important
duty for professional nurses.
 Discuss barriers to education and obstacles to learning.
 Formulate questions that nurses in the role of educator should
ask about the teaching–learning process.
01 02
Our Teaching Method Our Academic Areas
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03 04
Our Teachers Enrollment Process
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Introduction
The focus is on outcomes—whether it be

that the patient and his or her family have
learned essential knowledge and skills for
independent care or that staff nurses and
nursing students have acquired the up-to-
date knowledge and skills needed to
competently and confidently render care
to the consumer in a variety of settings.
Introduction
■ offer a perspective on the current
trends in health care making patient
teaching a highly visible and required
function of nursing care delivery.
■ The focus is on the overall role of the nurse in

teaching and learning, no matter who the
audience of learners may be.
■ Nurses must have a basic prerequisite

understanding of the principles, practice,
and process of teaching and learning to
carry out their professional responsibilities
with efficiency and effectiveness.
HISTORICAL FOUNDATIONS FOR THE TEACHING
ROLE OF NURSES
• Florence Nightingale, the

founder of modern nursing,
was the ultimate educator.
• Not only did she develop
the first school of nursing,
but she also devoted a
large portion of her career
to educating those
involved in the delivery of
health care.
ROLE OF NURSES
• For decades, then, patient teaching has

been recognized as an independent
nursing function.
• Nurses have always educated others—

patients, families, and colleagues—and it
is from these roots that nurses have
expanded their practice to include the
broader concepts of health and illness
ROLE OF NURSES
• This organization recognized the
responsibility of nurses for the
promotion of health and the prevention
of illness in such settings as schools,
homes, hospitals, and industries.
• Two decades later, the NLNE declared
that a nurse was fundamentally a
teacher and an agent of health
regardless of the setting in which
practice occurred.
ROLE OF NURSES
• By 1950, the NLNE had

identified course content
dealing with teaching skills,
developmental and
educational psychology, and
principles of the educational
process of teaching and
learning as areas in the
curriculum common to all
nursing schools.
ROLE OF NURSES
• In recognition of the importance of

patient education by nurses, the Joint
Commission on Accreditation of
Healthcare Organizations (JCAHO)
delineated nursing standards for
patient education as early as 1993.
ROLE OF NURSES
Required accreditation
standards have provided the
impetus for nursing service
managers to put greater
emphasis on unit-based clinical
education activities for staff to
improve nursing interventions
relating to patient education for
the achievement of these client
outcomes
ROLE OF NURSES
More recently, JCAHO has

expanded its expectations to
include an interdisciplinary
team approach in the provision
of patient education as well as
evidence that patients
and their significant others
understand what they have
been taught.
In addition, the Patient’s Bill of Rights,
first developed in the 1970s by the
American Hospital Association and
adopted by hospitals nationwide, has
established the rights of patients to
receive complete and current
information concerning diagnosis,
treatment, and prognosis in terms
they can reasonably be expected to
understand.
Accomplishing the goals
and meeting the
expectations of these
organizations calls for a
redirection of education
efforts. Over time, the role
of the nurse as educator
has undergone a
paradigm shift.
this transition toward
wellness has entailed a
progression “from
disease-oriented patient
education (DOPE) to
prevention-oriented
patient education (POPE)
to ultimately become
health-oriented patient
education (HOPE)”
Also, the role of today’s
educator is one of
“training the trainer”—
that is, preparing
nursing staff through
continuing education,
in-service programs, and
staff development to
maintain and improve
their clinical skills and
teaching abilities.
THE
EDUCATION
PROCESS
DEFINED
EDUCATION PROCESS
education process is a These changes foster
systematic, sequential, growth in the learner and, it
planned course of action should be acknowledged,
consisting of two major growth in the teacher as
interdependent operations, well.
teaching and learning.
Thus, the education
process should always be
a participatory, shared
approach to teaching and
learning.
COMPARISON
The education process
has always been
compared to the
nursing process—
rightly so, because the
steps of each process
run parallel to one
another, although they
have different goals
and objectives.
DIFFERENCE
The two are different in that
the nursing process
focuses on the planning
and implementation
of care based on the
assessment and diagnosis
of the physical and
psychosocial needs of the
patient.
DIFFERENCE
the education process
identifies instructional
content and methods
based on an
assessment and
prioritization of the
client’s learning needs,
readiness to learn, and
learning styles.
DIFFERENCE
The outcomes of the
nursing process are
achieved when the
physical and psychosocial
needs of the client are met.
The outcomes of the

education process are
achieved when changes in
knowledge, attitudes, and
skills occur.
THE PROCESSES
If mutually
agreed-on outcomes in
either process are not
achieved, as determined
by evaluation, then
the nursing process or the
education process
can and should begin
again through
reassessment, replanning,
and reimplementation
READINESS
LEARNING STYLES
LEARNING NEEDS
TEACHING PLAN
• TEACHING METHOD
• TEACHING
STRATEGIES
• MATERIALS
RETURN DEMO
• Teaching is a deliberate
intervention that involves the
planning and implementation
of instructional activities and
TEACHING experiences to meet
AND intended learner outcomes
according to a teaching plan.
LEARNING
• Instruction, a term often
used interchangeably with
teaching, is one aspect of
teaching.
• Teaching and instruction are
often formal, structured,
organized activities prepared
days in advance, but they
TEACHING can be performed informally
AND on the spur of the moment
LEARNING during conversations or
incidental encounters
with the learner.
The cues that
someone has a need
to learn can be
communicated in
the form of a verbal
request, a question, a
puzzled or confused
look, or a gesture of
defeat or frustration.
• Learning is defined as
a change in behavior
(knowledge, skills, and
TEACHING attitudes) that can
AND occur at any time or in
LEARNING any place as a result of
exposure to
environmental stimuli.
• The success of the
nurse educator’s
endeavors at teaching
TEACHING is measured not by
AND how much content has
LEARNING been imparted, but
rather by how much the
person has learned.
Specifically, patient education is
a process of assisting people to
learn health-related behaviors
(knowledge, skills, attitudes, and
values) so that they can
incorporate those behaviors into
everyday life.
Staff education, by contrast,
is the process of influencing
the behavior of nurses
by producing changes in their
knowledge, attitudes, values,
and skills.
Both patient and staff
education involve forging a
relationship between learner
and educator so that the
learner’s information
needs (cognitive, psychomotor,
and affective) can be met
through the process of
education.
BARRIERS TO
EDUCATION AND
OBSTACLES TO
LEARNING
• The educator should not limit learning to the
information that is intended but should clearly
make possible the potential for informal,
unintended learning that can occur each and
every day with each and every teacher–learner
encounter.
• Barriers to education are those factors
impeding the nurse’s ability to deliver
educational services.
• Obstacles to learning are those factors that

negatively affect the ability of the learner to
attend to and process information.
BARRIERS TO EDUCATION
• The following are the key

organizational, environmental, educational,
and clientele factors that serve as
impediments to educating others:
Lack of time to teach is
cited by nurses as
the greatest barrier to
being able to carry
out their educator role
effectively.
In
addition, nurses’
schedules and
responsibilities are
very demanding.
Many nurses and other

healthcare personnel are
traditionally ill prepared to
teach.
Many nurses admit that they

do not feel competent or
confident with
regard to their teaching skills.
Personal characteristics of
the nurse educator play an
important role in determining
the outcome of a teaching–
learning interaction.
Motivation to teach is a
prime factor in
determining the success of
any educational
endeavor
The lack of space and

privacy in the various
environmental settings
where nurses are
expected to teach and
learners are expected
to learn is not always
conducive to carrying
out the teaching–learning
process.
Some nurses and physicians question

whether patient education is effective
as a means to improve health
outcomes.
They view patients as impediments to

teaching when patients do not display
an interest in changing behavior,
when they demonstrate an
unwillingness to learn, or when their
ability to learn is in question.
There are a multitude of

healthcare
providers covering much of the
same content, but not
necessarily with consistency.
Content needs to be
standardized,
teaching responsibilities need
to be made clear, and lines of
communication must be
strengthened among a wide
variety of healthcare providers.
The type of documentation

system used by healthcare
agencies has an effect on
the quality and quantity of
patient teaching recorded.
In addition, most nurses do

not recognize the scope
and depth of teaching that
they perform on a daily
basis.
OBSTACLES IN
LEARNING
The stress of acute and chronic
illness, anxiety, sensory deficits, and
The following are some low literacy in patients are just a
of the major obstacles few problems that can diminish
interfering with a learner motivation and interfere
learner’s ability to with the process of learning.
attend to and process
information
OBSTACLES IN
LEARNING
The negative influence of the hospital

environment itself, resulting in loss of
control, lack of privacy, and social
isolation, can interfere with a client’s
active role in health decision making
and involvement in the teaching–
learning process.
OBSTACLES IN
LEARNING
Lack of time to learn due to rapid

patient discharge from care can
discourage and frustrate the learner,
impeding the ability and willingness
to learn.
OBSTACLES IN
LEARNING
The extent of behavioral changes

needed, both in number and in
complexity, can
overwhelm learners and dissuade
them from attending to and
accomplishing learning objectives
and goals.
OBSTACLES IN
LEARNING
Lack of support and ongoing positive

reinforcement from the nurse and
significant others serves to block the
potential for learning.
OBSTACLES IN
LEARNING
Denial of learning needs,

resentment of authority, and lack
of willingness to take
responsibility (locus of control)
are some psychological obstacles
to accomplishing behavioral
change.
OBSTACLES IN
LEARNING
The inconvenience, complexity,

inaccessibility, fragmentation,
and dehumanization
of the healthcare system often
result in frustration and
abandonment of efforts by
the learner to participate in and
comply with the goals and
objectives for learning.
ACTIVITY TIME!
GOOD LUCK FUTURE RNs! 

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UNIT I:

Michael Jhervis C. Dalagan, RN MAN

 Discuss the evolution of the teaching role of nurses.

The focus is on outcomes—whether it be

■ The focus is on the overall role of the nurse in

■ Nurses must have a basic prerequisite

• Florence Nightingale, the

• For decades, then, patient teaching has

• Nurses have always educated others—

• By 1950, the NLNE had

• In recognition of the importance of

More recently, JCAHO has

The outcomes of the

• Obstacles to learning are those factors that

• The following are the key

Many nurses and other

Many nurses admit that they

The lack of space and

Some nurses and physicians question

They view patients as impediments to

There are a multitude of

The type of documentation

In addition, most nurses do

The negative influence of the hospital

Lack of time to learn due to rapid

The extent of behavioral changes

Lack of support and ongoing positive

Denial of learning needs,

The inconvenience, complexity,

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