The Nurses As Health Educator 2

THE NURSE AS HEALTH EDUCATOR:
CONCEPTS, PRINCIPLES AND

STRATEGIES IN TEACHING
TEXT and WORKBOOK
SECOND EDITION 2017
CRESTITA B. TAN, RN, RM, MAN, PHD

Professor of Nursing Education
College of Nursing
Faculty of Graduate School
University of Santo Tomas
Consultant, Reviewer for Allied Health Sciences
Manila, Philippines
APD EDUCATIONAL PUBLISHING HOUSE 526-528 UNITED NATIONS AVENUE, ERMITA,

MANILA Tel. 525-0464 Telefax 525-0468 Email: jadebookstoreun@gmail.com
TABLE OF CONTENTS
Chapter 1: OVERVIEW OF EDUCATION ON HEALTH CARE AND CHANGE 7

Intended Learning Outcomes 8
Introduction 8
HEALTH EDUCATION DEFINED 9
THE PROCESS OF HEALTH EDUCATION 9
PURPOSE OF HEALTH EDUCATION 11
TYPES OF HEALTH EDUCATION 13
DIMENSIONS OF THE HEALTH EDUCATION PROCESS 13
ASPECTS OF HEALTH EDUCATION 16
IMPORTANCE OF HEALTH EDUCATION 17
THE CHANGE PROCESS 18
MANAGING CHANGE 19
FACTOR AFFECTING CHANGE 20
CHANGE AND ITS EFFECT ON THE FILIPINO HEALTH VALUE SYSTEM 21
MEMORY AID 22
Critical Thinking Exercises 24
PRACTICAL TEST 24
Chapter 2 : CONCEPTS OF TEACHING AND LEARNING 26

Intended Learning Outcomes: 26
DEFINITION OF TERMS 26
THE EDUCATION PROCESS 28
THE NURSING PROCESS 29
PURPOSES OF THE NURSING PROCESS 29
NATURE OF THE NURSING PROCESS 29
CHARACTERISTICS OF THE NURSING PROCESS 30
STEPS IN THE NURSING PROCESS 30
EDUCATION AND THE NURSING PROCESS DIFFERENTIATED 32
IMPLICATIONS OF THE CONCEPTS OF TEACHING AND LEARNING IN NURSING
PRACTICE 32
MEMORY AID 33
CRITICAL THINKING EXERCISES 34
PRACTICE TEST 34
PRACTICE TEST 36
Chapter 3 : ROLES AND RESPONSIBILITIES OF THE NURSE AS HEALTH EDUCATOR IN

TEACHING PATIENTS 38
DEFINITION OF A NURSE EDUCATOR AND HER ROLES 38
FUNCTIONS OF A HEALTH EDUCATOR 39
PATIENT TEACHING DEFINED 40
PURPOSES OF CLIENT TEACHING 40
THE ROLE OF THE NURSE IN CLIENT TEACHING 41
FACTORS THAT INFLUENCE CLIENT'S LEARNING 41
PRINCIPLES OF CLIENT TEACHING AND LEARNING 42
THERAPEUTIC COMMUNICATION 43
GUIDELINES FOR THERAPEUTIC COMMUNICATION 43
THERAPEUTIC COMMUNICATION TECHNIQUES 45
DOCUMENTATION OF CLIENT TEACHING 45
MEMORY AID 47
PRACTICE TEST 49
Chapter 4 : HALLMARKS OF EFFECTIVE TEACHING IN NURSING 51

HALLMARKS OF GOOD TEACHING 52
CHARACTERISTICS OF AN EFFECTIVE TEACHER IN NURSING 52
QUALITIES OF AN EFFECTIVE NURSE EDUCATOR 53
ESSENTIAL TEACHING SKILLS 57
ROLES AND FUNCTIONS OF THE TEACHER OR NURSE EDUCATOR 59
MEMORY AID 61
PRACTICE TEST 61
Chapter 5 : PRINCIPLE OF GOOD TEACHING PRACTICE 63

PRINCIPLES OF GOOD TEACHING PRACTICES 64
TEACHING PRINCIPLES 64
GUIDELINES IN THE CHOICE OF TEACHING AND LEARNING METHODS 65
APPROACHES TO TEACHING SKILLS 67
MEMORY AID 68
PRACTICE TEST 70
Chapter 6 : TEACHING STRATEGIES 72

TEACHING STRATEGIES 72
TRADITIONAL TEACHING STRATEGIES 73
1. Lecturing 73
2. Discussion 73
3. Question and Answer Techniques 74
4. Uses Audiovisual Aids 75
ACTIVITY-BASED TEACHING STRATEGIES 76
1. Cooperative Learning 76
2. Writing to Learn 77
3. Concept-mapping 77
4. Debate 77
5. Simulations 78
6. Problem-based Learning 78
7. Self-learning Modules 79
COMPUTER TEACHING STRATEGIES 79
b. Internet 80
c. Virtual Reality 80
DISTANCE LEARNING 81
CLINICAL TEACHING 81
1. Related Learning Experience (RLE) or Laboratory 82
2. Models of Clinical Teaching 83
TEACHING PSYCHOMOTOR SKILLS 85
OTHER TEACHING STRATEGIES 85
CLASSROOM MANAGEMENT 86
MEMORY AID 87
PRACTICE TEST 89
Chapter 7 : BARRIERS TO EDUCATION 91

BARRIERS TO EDUCATION 91
GENERATIONAL DIFFERENCES 95
1. Baby Boomers (Current Workforce) 95
2. Emerging Workforce: Generation X 96
Characteristics of Generation X (1961 to 1981) (Adapted from Emerson: 2007) 96
3. Newest Generation: Net-Gen , Generation Y or Millenials 96
MEMORY AID 98
PRACTICE TEST 99
Chapter 8 : CURRICULUM PLANNING AND CONDUCTING CLASSES 101

CURRICULUM PLANNING AND DEVELOPMENT 101
TYPES OF CURRICULUM PREPARATION 102
ELEMENTS OF GOOD DAILY PLANNING 103
GUIDEPOST FOR THE DEVELOPMENT OF THE DAILY CLASS PLAN 103
4. Daily Class Plans 103
SAMPLE CLASS PLAN 104
CRITERIA FOR TEXTBOOK SELECTION 106
IMPLEMENTING TEACHING PROGRAMS 107
EVALUATION OF TEACHING AND LEARNING OBJECTIVES 108
MEMORY AID 109
PRACTICE TEST 112
Chapter 9 : DETERMINANTS OF LEARNING 115

CATEGORIES OF LEARNERS ACCORDING TO GROWTH AND DEVELOPMENT 115
CATEGORIES OF LEARNERS ACCORDING TO STAGES OF DEVELOPMENT 117
GROWTH AND DEVELOPMENT 117
CATEGORIES OF LEARNERS ACCORDING TO INDIVIDUAL DIFFERENCES 121
1. Intelligence 121
2. Multiple Intelligences 123
3. Emotional Intelligence 127
4. Socioeconomic Status (SES) 128
5. Culture 128
6. Gender Differences 129
7. At-Risk Students 130
LEARNING NEEDS BASED ON MASLOW'S HIERARCHY OF NEEDS 132
OTHER LEARNING NEEDS 133
MEMORY AID 135
Chapter 10 : MOTIVATION IN LEARNING 139

MOTIVATION DEFINED 140
PURPOSES OF MOTIVATION 140
TYPES OF MOTIVATION 141
MASLOW'S THEORY OF MOTIVATION AND NEEDS 142
MOTIVATIONAL FACTORS OF LEARNERS 144
IMPORTANCE OF MOTIVATION IN LEARNING 149
ASSESSING MOTIVATION AMONG LEARNERS 150
MEMORY AID 151
PRACTICE TEST 152
Chapter 11 THE LEARNING PROCESS 154

LEARNING AS A PROCESS 155
STAGES OF LEARNING 155
THE LEARNING PROCESS 157
MEMORY AID 160
PRACTICE TEST 161
Chapter 12 THEORIES AND PRINCIPLES OF LEARNING 163

THEORIES OF LEARNING AND THEIR IMPLICATIONS 163
BASIC PRINCIPLES OF LEARNING 164
MAJOR TYPES OF LEARNING 172
ASPECTS OF SKILL DEVELOPMENT 176
CONDITIONS OF LEARNING 179
LEARNING STYLES 181
LAWS OF LEARNING 182
LEARNING THEORIES 184
1. Stimulus Response 185
2. Cognitive Theories on Learning 190
3. Social Theories 193
MEMORY AID 194
III. PRACTICE TEST 196
Chapter 13 EDUCATION COMMUNICATION IN TEACHING AND LEARNING 198

ROLE OF COMMUNICATION IN TEACHING AND LEARNING PROCESS 199
ELEMENTS OF COMMUNICATION 200
TYPES OF COMMUNICATION 203
RELEVANCE OF COMMUNICATION TO TEACHING AND LEARNING 205
MEMORY AID 205
Chapter 14 : EVALUATING THE TEACHING PROGRAM 207

EVALUATION DEFINED 208
FUNCTIONS OF EDUCATIONAL EVALUATION 209
EVALUATION PROGRAM FOR TEACHERS OF NURSING COURSES 210
CRITERIA FOR SELECTION OF EVALUATIVE DEVICES 210
STEPS IN EVALUATION 211
EVALUATIVE DEVICES 211
EVALUATING PATIENT LEARNING 213
EVALUATING STUDENT LEARNING 214
EVALUATING THE TEACHER 216
CRITERIA FOR SELF-EVALUATION OF TEACHING WITH SPECIAL REFERENCE TO 217
CHOICE OF LEARNING EXPERIENCES 217
MEMORY AID 218
PRACTICE TEST 221
CONCLUSION 223
GLOSSARY 224
Appendix A : STUDENT BILL OF RIGHTS 229
Appendix B : FILIPINO PATIENT BILL OF RIGHTS 230

EXPLANATORY NOTE 231
AN ACT DECLARING THE RIGHTS AND OBLIGATIONS OF PATIENTS AND
ESTABLISHING A GRIEVANCE MECHANISM FOR VIOLATIONS THEREOF AND FOR
OTHER PURPOSES. 231
Title I 231
Title and Declaration of Policies 231
Title II Definition of Terms 231
Title III 234
Declaration of Rights 234
Title IV Declaration of Obligations 239
Title V 240
Title VI Miscellaneous Provisions 241
Appendix C : PRINCIPLES OF CRITICAL THINKING 242
Appendix D : NURSES CODE OF ETHICS 243

PROMULGATION OF THE CODE OF ETHICS FOR REGISTERED NURSES 243
ARTICLE I PREAMBLE 244
ARTICLE II 244
REGISTERED NURSES AND PEOPLE 244
ARTICLE III 246
REGISTERED NURSES AND PRACTICE 246
ARTICLE IV 247
REGISTERED NURSES AND CO-WORKERS 247
ARTICLE V 248
REGISTERED NURSES, SOCIETY, AND ENVIRONMENT 248
ARTICLE VI 249
REGISTERED NURSES AND THE PROFESSION 249
ARTICLE VII 249
ADMINISTRATIVE PENALITIES, REPEALING CLAUSE, AND EFFECTIVITY 249
Chapter 1: OVERVIEW OF EDUCATION ON HEALTH CARE AND CHANGE
"Without continual growth and progress, such words as improvement, achievement, and
success have no meaning."
-Benjamin Franklin
Intended Learning Outcomes
● Differentiate education, health, and health education

● Explain the objectives and processes of health education
● Discuss the change process and the various factors that affect change
● Differentiate the three types of health education
● Explain the importance and the various dimensions of health education
● Discuss the various strategies in the management of change
● Explain the impact of change on the Filipino health value system
Introduction
For a long time, health care and teaching were pursued by religious orders. As is the
health care and welfare norm, the sisters and priests delivered the health bulletins to the
citizenry. However, prior to the coming of the religious orders to the Philippines, albularyos' or
local doctors already had been tending to the health needs of the community. They relied on
indigenous ways and materials of treating the sick. These individuals were also repositories of
knowledge of how to take care of one's health. They also subscribed to superstitious beliefs and
practices to explain the ailments of the sick. The patient for example could have been the
subject of witchcraft or sorcery and needed a special ritual to drive the evil spirits away which
the 'albularyo' should perform.
With the coming of the religious orders, the more informed way of treating the sick had
been institutionalized with the awarding of degrees in nursing and medicine. The religious
sisters continued to be nurses until lay individuals were able to secure nursing degrees in the
1800s.In the longest time, teaching in health education adapted the norm of transmitting
knowledge for the sake of teaching the students. There was neither an effort to understand the
learning process nor the learner. However, teaching was more than it is known today.
Good teaching is more than mere intellectual challenge. It is a very thorough discipline,
which demands, among others, adaptability, inventiveness and creativity. The teacher should be
able to adapt to both different situations and types of students. Due to the ever changing
demands of learning, the teacher must constantly be creative of new approaches to teaching in
anticipation of the various mental and psychological make-up of the prospective learners.
Teachers of nursing therefore must keep both body of knowledge and skills continually updated
and evolving. They must keep striving to improve and supplement their existing knowledge and
attain deeper understanding of the nursing profession. This helps prepare the students for
challenges they will face, with the advancing technology in nursing practice and patient care and
their increasingly complex responsibilities.
Although flexibility is important, today's teacher of nursing must have an established

system of eclectic principles and beliefs to guide her. It is important to maintain one's own
character and value system for her to serve as an effective role model in stimulating the growth
of his or her students' character, by improving their clinical skills and helping them recognize the
value of the role of nurses in society. The teacher's adaptability comes into play when
understanding differences in the behavior of her students. The teacher must have the ability to
adjust her teaching to individual differences in order to convey effectively her knowledge and
skills to the most number of students, demonstrate what is expected of them and what they are
to expect in terms of student and patient behavior, help them integrate their classroom teaching
into practical, clinical setting and finally, evaluate their performance effectively through their
student and patient behavior.s nomanbe d
Principles and practices of teaching enable teachers to adapt various methods and
techniques of teaching and adjust to students' level of understanding, background knowledge
and experience, and the objectives and content of learning.
HEALTH EDUCATION DEFINED
Health education refers to the act of providing information and learning experiences for
purposes of behavior change and improved for health of the client. The acquisition of knowledge
through exchange of information from the teacher and the learner facilitates better
understanding of the need for change. Health education is the totality of experiences which
favorably influence habits, attitudes and knowledge relating to individual, community and racial
health (Health Education: 2006).
According to the Joint Committee for Health Education (2005), health education is "a
process with intellectual, psychological, and social dimensions relating to activities that increase
the abilities of people to make informed decisions affecting their personal, family and community
wellbeing. The process, based on scientific principles, facilitates learning and behavioral change
in both health personnel and consumers, including children and youth." The nurse, as health
educator, provide clients with basic information geared to the promotion and maintenance of
health, the prevention of illness and the development of self-reliant behaviors
THE PROCESS OF HEALTH EDUCATION
Health education consists of learning experiences that promote behavior conducive to good
health. It provides the tools for developing physical, emotional, spiritual and sound mental
health.
● Physical health - learning experiences that help promote the ability of the body to
function accordingly.
● Emotional health - the ability of an individual to cope with stress and strain as one faces
the realities and challenges of life.
● Mental health - the ability of an individual to make correct judgments or sound decisions
to cope with situations or conditions affecting her daily activities.
● Social health - the ability of an individual to relate well with others regardless of status or
position.
● Spiritual health - recognizes the supernatural aspect of divine healing and the
individuals' communion with his/her creator.
Green and Ottoson (2012) posited that health education is based on the assumption that
"beneficial health in both children and adults results from the combination of planned,
consistent, integrated learning opportunities." This assumption rests on direct evidence from the
evaluation of health education programs in schools, worksites, medical setting, and the mass
media.
"The challenge for the educator is to find the most productive ways of influencing
voluntary individual and community behavior without violating individual freedom.
-Green and Ottoson
The process of health education has certain key aspects:
1. It is a planned opportunity of learning through information about health guided by specific

goals, objectives, activities and evaluation criteria.
2. It occurs in a specific setting.
3. It is a program of series or events that introduces concepts at appropriate learning levels.
4. It is based on what was previously learned in order to determine what is to be learned in the
future.
5. It comprehensively emphasizes how the various aspects of health interrelate and how health
affects the quality of life.
6. It includes interaction between the qualified educator and learner.
Effective health instruction interrelated issues: "what to teach and how to teach it."
hinges on two
-Heidgerken
Health educators plan and conduct health teachings for the following purposes, which is for
clients to:
1. Be aware of the values of health;

2. Develop the skills in the promotion and maintenance of health;
3. Acquire and apply concepts and information received;
4. Develop and discuss opinions regarding health; and
5. Formulate accurate and effective decision-making.
PURPOSE OF HEALTH EDUCATION
Health education aims at more than merely the dissemination of information regarding
good health practices and disease treatment. It serves several vital purposes in society, such as
the following (Creasia and Parker: 2007):
1. A Means of Propagating Health Promotion and Disease Prevention
Health education describes the interrelationship of the learner's mental, emotional,

social, and physical health. It serves to analyze how environment and personal health interrelate
in ways that enhances health, thereby reducing client risks.
Health education is also concerned with how lifestyle, family history and other risk
factors relate to the cause or prevention of diseases and other health problems. This seeks
support of family and peers to influence the personal health of an individual. Furthermore, the
nurse explains the relationship between positive health behavior and the prevention of injury,
illness, disease, and premature death (Breckon: 1994).
Health education analyzes how prevention and control of health problems are influenced
by education, research, and advances in technology in all health-care areas. It explains the
impact of personal health behaviors on the functioning of body systems. It is also concerned
with the analysis of how public health and social policies, along with government regulations,
influence the health promotion and disease prevention of the individual, family and community.
2. Used to Modify or Continue Health Behaviors as Necessary
Health education determines the role of an individual to be self-reliant and assume self-
responsibility improvement of health and personal health assessment. for
It also determines strategies for health maintenance and risk reduction, identifies short
and long-term consequences of various behaviors, and demonstrates strategies for improving
and maintaining personal, family and community health.
Health education provides information on injury prevention and management strategies

for potential health problems to maintain personal, family, and community health. Health
education continues to demonstrate ways of avoiding and reducing health threatening situations
(Quinn: 2014).
3. Provides Health Information and Services
Health education provides health information, products and services in the maintenance
of good health. It also demonstrates the ability to evaluate resources from home, the school and
the community that provide health information. Health education, also, demonstrates the roles
and responsibilities of school and community health services to self and others. It is also used to
assess the cost and availability of health care services and analyze situations requiring
professional health care.
"Patients look for something more in every nurse... Beyond technical skill,
conscientious performance and pleasing appearance is that intangible something that
makes the truly successful nurse."
-Dorothy Densing
4. Emphasizes Good Health Habits and Practices as an Integral Aspect of Culture, Media
and Technology
Health education evaluates the influence of culture on the health behaviors and care
services which people get from healthcare providers. It evaluates the effect of media,
technology and other factors on personal, family, and community health. Health Education
analyzes information necessary in reaching out to people in the community to facilitate
understanding and compliance with what is being taught geared towards self-reliant behavior.
5. A Means to Communicate Vital Information to the Public
Health education helps the family, peers, and others to communicate their needs, wants
and feelings effectively to enable them to resolve health conflicts and problems. This is done to
communicate care, consideration and respect for themselves and others. It also helps analyze
possible causes of conflict and in the formulation of strategies for solving interpersonal conflicts
without harming oneself or others.
6. It is also a form of Advocacy
Health education evaluates the effectiveness of various methods of teaching to express

health information and ideas correctly. It conveys valid information and cites opinions about
health-related issues (Bastable: 2004).
Health education is a means to work cooperatively with people in advocating health to
individuals, families, schools, and communities. It is the ability of the nurse to convey health
messages and use effective communication techniques to a particular group of people,
influences these clients in making positive health choices, and make use of strategies to
overcome barriers when discussing about information, ideas, feelings, and opinions on health
issues.
TYPES OF HEALTH EDUCATION
a. Biological. Information about human biology and hygiene. The nurse provides health
information about the human body and how to take care of it.
b. Health Resources. Health services which direct the individual regarding the "sensible" use of
health care resources.
c. Society and Environment. An environment in which health choices dotare made. This is
concerned with lubnational, regional, and local within education policies, which are often
pursued and implemented without considering health consequences.
DIMENSIONS OF THE HEALTH EDUCATION PROCESS
Health education is a complex process that requires eclectic knowledge, skills, and
values on the part of the educator. This needs a conceptual framework which envisions the
totality of the learning process and all its dimensions. It begins with the formulation of
objectives and the anticipated outcome for each particular subject area which prepares the
teacher and the learner to assume their roles and responsibilities during the process.
Heidgerken (1971) described the four (4) dimensions of the educative process, namely:
● substantive or curricular dimension

● procedural or methodological dimension
● environmental or social dimension
● human relations or interactional dimension
1. Substantive or Curricular Dimension
Substantive or curricular dimension refers to the subject matter specific to nursing education
and is best embodied by the phrase with "what is taught and what is learned".
Subject matter is usually listed in the course curriculum which includes all basic elements and
learning activities for a particular planned purpose and directed by a faculty member for a
specific group of students.
Substantive or curricular dimension also refers to providing opportunities for nursing

students to acquire essential knowledge, skills and attitudes that will prepare them for
professional duties and responsibilities in actual nursing practice.
2. Procedural or Methodological Dimension
Procedural or methodological dimension consists of strategies or methods of teaching

which motivate students to learn. These are learner activities in teaching concepts ranging from
those planned by the teacher to those self-initiated by the students in their quest for knowledge.
Some of the more common challenges encountered by teachers in dealing with students
in the course of the learning process are as follows:
a. Choice of the most appropriate methods in helping the students learn;

b. Identification of the method most likely to lead and direct learners in their own learning; and
c. Initiation of ways that continue the lifelong process of learning.
NOTE:
When the learner shows resistance or difficulty in adapting to the learning process, it is
important to understand her goals and motivation toward achieving these goals, her ability to
effect change, and her previous knowledge and experiences. This helps determine the kind of
learning activities an individual needs that will be most effective in overcoming the difficulty of
imparting the knowledge needed or desired by the learner.
3. Environmental or Social Dimension
Environmental or social dimension refers to physical and social factors in the teaching-learning
situation. It also refers to extrinsic factors that capture the interest of the learner. In turn, it
makes students adapt to varying changes in order to see the difference between what is ideal
from what is real.
Physical factors refer to the actual setting where learning takes place, including the following:
a. The classroom, equipped with audio-visual materials;

b. Laboratory settings, such as skills laboratory, RLE laboratory commensurate with the number
of students and consistent with the standards of nursing education;
c. Home-based and modern or traditional hospital set-ups; and
d. Community health agencies.
NOTE:
The crucial aspect of the environmental dimension of learning is the human or social factor,
because relationship between teacher and learner(s) determines the quality of the learning
climate that prevails.
Figure 1: Heidgerken's Conceptual Model of the Total EducationalProcess for Nursing.
4. Human Relations Dimension
The human relations dimension takes into account the relationship of the nurse educator with
individuals involved in nursing care practice, which influences the effectiveness of the teaching
and learning process. It includes the following:
a. The learners who are the recipients of knowledge.

b. The teacher as the source of knowledge.
c. Administrator, who are the resource allocator.
d. Group of learners, who use the holistic knowledge in a discipline.
e. Patient, as end-users of nurses' teaching and learning experiences.
f. Nursing Service Personnel knowledge of and training support for students.
g. Allied health personnel and their group interaction.
ASPECTS OF HEALTH EDUCATION
1. Behavioral Sciences
The behavioral sciences which incorporate psychology, sociology and cultural

anthropology, are concerned with how people behave and why they behave in a particular way
(Feldman: 2006). They define the primary determinants of behavior as follows:
a. Psychological predispositions: such as attitudes, knowledge, beliefs, skills, and experiences;

b. Environmental reinforcement: family, friends, authority figures, and associates; and
c. Socio-cultural context: sustained societal norms such as attitudes and behavior.
Behavior change is a desired outcome of health education; hence primary behavioral

determinants are crucial to the practice of a nurse as health educator and clients as recipients of
health care.
2. Public Health
Health promotion is a common function in public health agencies. Health education

relies on public health and health statistics for epidemiologic information. Determinants of health
problems include the environment, medical care, personal lifestyle which are often discovered in
the public health realm.
Other issues, such as population dynamics, epidemiology, and biomedical science are
deeply rooted in public health.
3. Education
Education refers to the study and practice of teaching and learning which plays a vital
role in the development of health education. Learning theory, development, pedagogy,
educational psychology, human andragogy, curriculum development, measurement, and testing
are all rooted in the education literature.
IMPORTANCE OF HEALTH EDUCATION
Health education is a system of teaching and learning process. It facilitates common

understanding among people in a social structure to modify behaviors, make decisions and
change social conditions in ways that are health enriching. Among its many aims are the
following (Breckon: 1994):
1. Enhance knowledge awareness
Provides guidance and instruction to all that will help individuals or group of individuals
maintain a high level of wellness.
2. Promotes health, safety, and security of the people.
Promotes personal hygiene, environmental sanitation, and maintenance of a hazard-free

environment for one to avoid illnesses, accidents and reduce mortality rate.
3. Develop and improve community resources.
Help individuals gain knowledge, and understanding of the different community health
agencies who can provide health care services. Likewise develop habits, attitudes, and ideals
that will help them live as healthy individuals and members of the community and share the task
of community building and health care.
4. Increase productivity and strength of character.
Help develop productive individuals who can adjust successfully and live happily with
social groups to which they belong. Health education further enhances coping patterns that
minimize the effects of stress on individuals and family.
5. Disease prevention.
Promotes individual and public health awareness on prevention of disease using various
health care strategies and for the state to be the home of healthy and productive citizens,
6. Minimize cost.
Health education enables the government to attain health objectives at least cost.
Knowledge and awareness of the people regarding health promotion and disease prevention
minimize health care cost.
7. Self-reliant behavior.
Health education provides information and services necessary in fostering independent

behaviors or self-care attitude conducive to health.
THE CHANGE PROCESS
"Nothing is permanent but change."
-Heraclitus (500 BC)
Change is inevitable in all aspects of human life, hence there is continuing need to
reevaluate and improve the educational process in order to meet the evolving needs of learners.
School administrators and educators need to familiarize with current trends, issues, and
practices related to both nursing and teaching practice. This way, teachers may be able to
provide effective ways that will equip learners with vital knowledge and skills in facing the
challenges of life.
The following guidelines may help affect change in learners:
1. Perceive the need for change
Teachers and students must be able to assess their own need for change. Progress
requires modification, improvement or replacement of obsolete knowledge through re-education
and training. Change is a necessary ingredient to modify or improve teaching and learning to
attain progress. This can be done through identification and discussions with a specific group of
people and areas that need change.
2. Initiate group interaction
The teacher must initiate and motivate students to think critically of nursing situations
which will help them build a framework for problem-solving processes, which calls for the
following responses:
a. Identify external and internal forces for change;

b. State the problem;
c. Identify constraints;
d. List change strategies or possible approaches to problem solving;
e. Select the best change strategy;
f. Formulate the plan for implementation; and Develop or select tools for evaluating change.
3. Implement the change one step at a time.
Change must be done gradually, one at a time in order to have an orderly and
systematic process of change and to safeguard undesirable adverse effects of change. Abrupt
change can create further resistance or fear of change.
4. Evaluate the overall results of the change process and make further adjustments
Change helps students identify strengths and weaknesses so as to provide remedial

measures and allow the gradual process of change to occur with less problems or difficulty on
the part of the teacher and the learners.
MANAGING CHANGE
Considering how far-reaching the effects of change can be, it is important to identify a
particular management strategy for change (Jones: 2007).
1. Thinking-Practice Strategy
This is a strategy which assumes that learners are rational beings with mental faculties and
behave according to their personal beliefs, interests and motivation.
2. Interest and Commitment Strategy
This strategy assumes that learners always act consistently with their desire to change
and commitment to Socio-cultural norms of behavior. They are therefore willing to change for
purposes of acceptance and recognition. It is a self-made process and the extent of learning
depends on the learners' prospective goals of behavior change.
"Learners are eager to change if it is explained to them how they can benefit from the
change process."
-DeYoung
Example:
In a re-educative milieu the teacher strives to foster development of students through
counseling, training, small groups and experiential learning, and encourage individuals to
participate in his or her own re-education process.
3. Power and Self Discipline Strategy
This is a strategy which makes learners comply with instructions given by the teacher as
an authoritative figure in order to bring about change. It is more traditional in style as it often
demotivates students and could make teaching and learning processes offensive (Bradshaw
and Lowenstein: 2007).
FACTOR AFFECTING CHANGE
Change is part of learning desired by both the teacher and the learner. However,
constraints and difficulties are often encountered as the learner undergoes the process of
change.
Following are barriers to change:
1. Culture
Culture determines the beliefs and values important to the learner that may delineate her
potential development for change. Some cultures compete with change, other welcome change
while some resist change. Thus, the socio-cultural background and the learners' personal
characteristics influence the process of change.
2. Demographics
This pertains to the learner's age, gender, heredity, and environment which may
determine innate qualities and potentials as well as tendencies and level of response of the
learners to a learning stimulus.
3. Socio-economic Conditions and Environmental Circumstances
This may involve the learners' adaptability, flexibility, and capabilities in creating change
that may influence the quality and quantity of response to the change process. The learners'
position in the community, social interactions and economic status greatly affects much of the
learners' response to change.
4. State of wellness and development
The learners' state of well-being and development relates to his physical, emotional,
intellectual and spiritual health. This affects the instinctive qualities of the learners' response to a
stimuli and capability of coping with stress related situations.
CHANGE AND ITS EFFECT ON THE FILIPINO HEALTH VALUE SYSTEM

Based on a list of change barriers, the Philippines is a classic example of how large
scale change can influence the state of the health care system. Following are some medical
health remedies used by Filipinos: dog
1. Home Remedies
One remedy is the use of oils or ointments, often Chinese in origin, which serve as
"cure-alls" for relaxing, heating, and comforting the muscles or providing relief for dizziness,
colds, headaches, and sore throats, among others. These include simple touch, adequate rest,
light massage or effleurage, salt gargle, increased water intake, and ventilated rooms, among
others.
2. Traditional Healing Techniques
The use of herbal medicinal leaves such as "lagundi", "banaba', "pito-pito" and other
sources like the bark of trees and stem of plants which provide relief. These can be used in the
treatment of various diseases and disorders in the absence of western medical intervention or
medical equipment.
3. Supernatural Healing or the Use of Faith Healers
Supernatural healing is a holistic and uniform approach to healing, which incorporates

belief in the concurrent physical, emotional, and spiritual state of the patient.
"Healing which is the foremost function of therapeutic touch, could be called a

humanization of energy in the interest of helping or healing others or oneself."
-Dolores Krieger
Faith healing uses techniques which include blessing of the body with holy water,
prayers and devotions, laying hands on the patient's body, and anointing with oil, flagellation, or
isolation.
In the laying of hands, it appears as if the healer is transferring the healing energy from
his or her hands to the patient's afflicted body part. Typically the patient attests to the energy
that seems to enter the body and provides instant well-being.
4. Regulated Drugs or Medicines
These are research-based drugs commonly referred to as regulated "prescription drugs".

They require prescription from doctors due to expected adverse effects. These are mostly
produced and manufactured by pharmaceutical companies.
5. Over-the-Counter Drugs
These are non-prescription drugs or medicine mostly produced and manufactured by

multinational pharmaceutical companies. They can be bought by a patient from the counter
without prescription from the physician. Examples of these are analgesics or antipyretics,
paracetamol, ibuprofen, antacids, and laxatives, among others.
MEMORY AID
1. Health Education Defined
It is the sum of all experiences which favorably influence habits, attitudes and knowledge
relating to individual, community and racial health.
2. Purposes of Health Education
a. It is a means to propagate health promotion and disease prevention.

b. It may be used to modify or continue health behaviors.
c. It provides health information and services to clients.
d. It is meant to emphasize on good health practices as an integral part of culture, media and
technology.
e. It disseminates information of vital public importance. f. It is a form of advocacy.
3. Type of Health Education
a. Health education focuses on the body and how to take care of it;
b. Health education and services make "sensible" use of healthcare resources; and
c. Health education relates to the wider environment.
4. Dimensions of the Health Education Process
a. Substantive dimension - "what is taught and what is learned".
b. Procedural dimension - teaching method and learner activities used.
c. Environmental dimension - physical and social factors in the teaching-learning situation.
d. Human relations dimension - includes persons involved in the nursing care practice that
influence the effectiveness of the teaching and learning process.
5. Aspects of Health Education
a. Behavioral sciences
b. Public health
c. Education
6. Aims of the Health Care Education
a. Provides guidance and instruction to all and helps individuals attain physical fitness.
b. Promotes personal hygiene, environmental sanitation and a hazard free environment.
c. Helps individuals live healthful lives.
d. Develop productive individuals.
7. The Change Process
a. Perceived need for change.

b. Initiate group interaction.
c. Implement the change one step at a time.
d. Evaluate the overall results of change and make further adjustments.
8. Strategies in Managing Change assumes that learners are
a. Thinking-Practice Strategy rational beings.

b. and Commitment Strategy - assumes that learners act consistently with their socio-cultural
norms.
c. Power-and Self Discipline Strategy - learners are coerced to comply with instructions.
9. Factors Affecting Change
a. Culture
b. Demographics
c. Socioeconomic Conditions and Environmental Circumstances
d. State of Wellness and Development
10. Health Remedies Used by Filipinos
a. Home remedies
b. Traditional healing techniques
c. Supernatural healing or faith healers
d. Regulated drugs or medicines
e. Over-the-counter drugs
Critical Thinking Exercises
1. What is your personal view of health education? Relate this to the process of change.
2. How do the four dimensions of the health education process create change on the learners?
3. As nurse educator, you are now going to handle a group of learners in the community who
are used to the traditional and supernatural healing techniques. What change strategies will you
use and why?
PRACTICAL TEST
Directions: Read each question very well and encircle the letter of the BEST answer.
1. Which of the following explains the meaning of Health Education?
a. The sum of all experiences which favorably influence habits, attitudes, and knowledge
relating to individuals, community, and racial health;
b. A state of complete physical, mental and social well-being that permits the optimal
functioning of an individual;
c. The process of providing learning materials, activities, situations, and experiences that
enable the clients or learners to acquire knowledge, attitudes, values and skills and to
facilitate the development of self-reliant behavior;
d. Dynamic interaction between the nurse as teacher and the patient as learner.
2. What are the four dimensions of the educative process ?
a. Substantive, procedural, personal, societal

b. Substantive, procedural, environmental, human relations
c. Substantive, systematic, individual, environmental
d. Substantive, systematic, personal, community
3. Dimension refers to the subject matter specific to nursing education and is embedded by the
phrase "what is taught and what is learned". Which one refers to this phrase?
a. Procedural
b. Individual
c. Substantive
d. Environmental
4. Which one refers to the teaching method and learning activities used in teaching concepts for
students to learn?
a. Procedural
b. Individual
c. Substantive
d.Environmental
5. What strategy is used to manage change which assumes that learners are rational beings
and behave according to their personal beliefs and interest?
a. Thinking-Practice Strategy
b. Power-and Self Discipline Strategy
c. Interest and Commitment Strategy
d. None of the above
6. What strategy is used to manage change which assumes that learners act consistently with
their commitment to socio-cultural norms of behavior and are willing to change?
a. Interest and Commitment Strategy

c. Thinking-Practice Strategy
7. What strategy is used to manage change in which learners are coerced to comply with
instructions from the teacher to bring about change?
a. Interest and Commitment Strategy

c. Thinking-Practice Strategy
8. What is a research-based drug or medicine which requires

prescription from doctors?
a. Herbal medicines
b. Over-the-counter drugs
c. Regulated Drugs
d. Home remedies
9. What is that drug or medicine that do not require a physician's prescription?
a. Herbal medicines
b. Over-the-counter drugs
c. Regulated drugs
d. Home remedies
10. Which one is not used as health remedies used by Filipinos?
a. Company remedies
b. Traditional healing techniques
c. Supernatural healing or faith healers
d. Regulated drugs or medicines
Chapter 2 : CONCEPTS OF TEACHING AND LEARNING
"A teacher who does not have a sound philosophy in life is not capable of formulating a
sound concept of education."
-Loretta Heidgerken
Intended Learning Outcomes:
● At the end of this chapter, the student will be able to:

● Define the various concepts in the teaching and learning process;
● Differentiate education process from the nursing process;
● Explain the purposes and nature of the nursing process;
● Expound on the characteristics of the nursing process;
● Discuss the different steps of the nursing process;
● Explain the different implications of teaching on nursing practice.
DEFINITION OF TERMS
The following terms are defined for clearer understanding of meanings and use.
1. Education
Education is an interactive process of imparting knowledge through sharing, explaining,

clarifying and synthesizing the substantive content of the learning process in order to arrive at a
positive judgment and well-developed wisdom and behavior (Kozier: 2004).
Education is likewise an application of several teaching and learning principles which

comprise a body of knowledge and research findings ultimately meant to result in the formation
of expected behavior of an individual (Heidgerken: 1971). Education must provide adequate
learning opportunities which allow individual to an demonstrate lifelong values which enable her
to contribute fully to the development of a peaceful and just society.
"A truly educated person nowadays, needs broad general education and the
opportunity to study a small number of subjects in depth."
-Jacques Delors, UNESCO

2. Health
Health is a sense of being physically fit, mentally stable and socially comfortable. It
encompasses more than the state of being free of disease (Kozier: 2004). According to WHO,
health is a "state of complete physical, mental and social well-being and not merely the absence
of disease or infirmity." This encompasses the ability of an individual to perform tasks expected
even if some manifestations of illness are felt.
"Tomorrow will be the first day that we shall stand in the great work all by
ourselves, with no help, no funds back up us, and no one to create them. It's a perilous
situation - if we fail we are lost."
-Clara Barton
It is a condition that permits optimal functioning of the individual to live most and to serve
best in her personal and social relationship (Sharman: 1948).
Health for Hildegard Peplau is the process by which an individual strive for a stable
equilibrium and a forward movement of the personality. It is the ability of an individual to adapt
to constant change which will make life easier and faster. For Faye Abdellah, health means a
state when an individual has no unmet needs and no anticipated or actual impairment of the
body.
3. Learning
Learning is the acquisition of knowledge of all kinds such as abilities, habits, attitudes,
values and skills (Calderon: 1998) primarily to create change in an individual. It is a gradual,
continuous process throughout life.
4. Patient Teaching
Patient Teaching is a basic function of nursing, the concept of patient teaching is

perceived as a legal and moral requirement of licensed nursing personnel and defined as a
system of activities intended to produce learning and change in client health behavior (Nursing
Fundamentals: 2012).
It is a dynamic interaction between the nurse as the teacher and the patient as the
learner. The nurse provides all the needed information for patients or clients to acquire
knowledge, and the patient as the learner internalizes these information as basis for his daily
routines and activities for promoting and maintaining health.
5. Teaching
Teaching is the process of providing learning materials, activities, situations, and

experiences that enable the clients or learners to acquire knowledge, attitudes, values and skills
in order to facilitate self reliant behavior. Teaching is a consequential process, where the teacher
demonstrates and the learner appreciates what is shown and to internalize what is in seen and
felt.
THE EDUCATION PROCESS
The education process is and learning (Bastable: 2007). It is a cycle that involves a
teacher and a learner. A teaching-learning process occurs before the lesson begins and
continues after the last lesson ends. This includes the following:
1. Assessment
● It is a process which provides the nurse educator with information regarding the learners'
knowledge and skills needed to efficiently and effectively transfer knowledge and skills to
the learners.
● It also refers to the gathering of data about the learner or A group of learners'
demographic profile, skills and abilities needed in identifying the most appropriate
teaching strategy.
2. Planning
● It is a carefully organized written presentation of what the learner needs to learn and
how the nurse educator is going to initiate the teaching process.
● It includes culturally-relevant skills for the learner, the A goals of learning. type of
teaching-learning setting such as: classroom, laboratory, clinical, or ward setting.
● It indicates teaching timeline and specific sets of learner activities.
3. Implementation and Application of the Teaching Plan
● The point where the theoretical and practical aspects of the teaching-learning process
meet as the teacher applies the plan. .
● This includes procedures or techniques and strategies that the teacher will use to best
implement the plan.
4. Evaluation
● The measurement of the teaching-learning performance of both the teacher and the
learner.
● It is constructive and objective with the purpose of creating effective change in the
behavior of both the teacher and the learner in terms of input, process and output.
THE NURSING PROCESS
The nursing process provides the necessary tool to enable the nurse to render quality
nursing care to patients. It helps determine the clients' health needs. It emphasizes the need to
manage and maximize health by managing risk factors and encouraging healthy behavior.
The nursing process is a scientific and systematic, problem solving approach used to
identify, prevent and treat actual or potential health problems and promote wellness. It provides
framework in which nurses use their knowledge and skills to express human caring.
The nursing process is an orderly, systematic manner of determining the client's

problems, making plans to solve the problems, initiating the plan or assigning others to
implement the plan, and evaluating the extent to which the plan has effectively resolved the
problems identified (Kozier: 2004).
PURPOSES OF THE NURSING PROCESS
1. Provides a tool to enable the nurse to render quality-nursing

2. Helps identify the client's health care needs, and determine care to clients. priorities of care
and expected outcomes.
3. Establishes nursing intervention to meet client-centered goals.
4. Provides nursing interventions to meet the needs of clients.
5. Evaluates the effectiveness of nursing care in achieving client goals.

6. Achieves scientifically-based, holistic, and individualized care.
7. Takes the opportunity of working collaboratively with clients,and other members of the health
care team.
8. Achieves continuity of care to the clients.
NATURE OF THE NURSING PROCESS
1. The nursing process is dynamic and cyclic. Each step may be reviewed and revised
according to changing client responses to nursing interventions, which may require revisions in
the plan of care.
2. It is planned and goal-directed. The plan of care and nursing intervention is organized
carefully one to meet the client's goals of care.
3. It is an intellectual process. Nurses use knowledge in problem solving, decision-making and

critical thinking to assess their client's problems, plan their care, implement plans, and evaluate
the effectiveness of the care given.
CHARACTERISTICS OF THE NURSING PROCESS
1. Systematic
The nursing process has an ordered sequence of precise and accurate activities.
Preceding activities influence activities following them.
2. Dynamic
The nursing process provides active interaction and integration among activities. Current
activity is necessary to influence future activities.
3. Interpersonal
The nursing process ensures that nurses are client-centered rather than task-centered.
The nursing process encourages nurses to work and help clients use their strength to meet their
own needs.
4. Goal-directedt ut
The nursing process is a means for nurses and clients to work together in order to
identify specific goals related to wellness promotion, disease and illness prevention, health
restoration and coping with altered functioning.
5. Universally Applicable
The nursing process allows nurses to practice nursing with well or sick people, young or
old, regardless of race, creed or religion and in any practice setting.
STEPS IN THE NURSING PROCESS
Following are the steps in the nursing process (Kozier: 2004)
1. Assessment
Assessment includes gathering of data about the system, th individual, family, or

community and recording of all neede information. Data are gathered through interview, physiol
examination, research and review of records.
Purposes of Assessment
● Predict, detect, prevent, manage or eliminate health problems.

● Clarify expected outcomes.
● Develop specific plan.
● Review of Records. Nursing assessment involves data gathering about the patient from
a variety of sources.
● Initiates the intellectual process in sorting and classifying gathered data, recognizing
patterns and discrepancies comparing these with norms and identifying client response
to health problems that are amenable to nursing interventions (Kozier: 2004).
2. Planning
Planning is the formulation of the nursing care plan on which the nurse works with the
client to set goals and objectives and predict outcomes. Planning identifies nursing actions for
preventing correcting or relieving health problems and developing specif interventions as stated
in the nursing care plan.
Planning is done in order to:
● Detect, prevent and manage health problems.

● Promote well-being and anticipate potential problems.
● Allocate and utilize possible resources to achieve desired outcomes.
3. Implementation
Implementation is the actual performance of the plan. This helps determine client's progress
towards meeting expected outcomes and goals. Nurses document this plan in appropriate forms
such as nursing progress notes". They put the plan into action in order to:
● Assess appropriateness of intervention.

● Perform interventions.
● Make immediate changes.
● Chart and monitor progress of clients.
4. Evaluation
Evaluation involves the collection of pertinent and reliable data about the process ard
outcome of care. The quality of nursing care that is provided is analyzed and results are
compared with expected outcome criteria.
5. Documentation
Documentation establishes a written record of assessment, the care provided and the
patient's response which is an integral part of each step of the nursing process.
EDUCATION AND THE NURSING PROCESS DIFFERENTIATED
The education process is often confused with the process because both have the same
elements such as assessment, planning, implementation and evaluation. The two are however
different in terms of focus. nursing
Nursing process focuses on planning and implementation of care based on the
assessment and diagnosis of physical and psychosocial needs of a client, while the education
process focuses on the planning and implementation of teaching based assessment and
prioritization of learning needs, readiness to learn and learning styles of the learners. on the
Figure 2: Adapted from Bastable's Education Process Parallel's Nursing Process
IMPLICATIONS OF THE CONCEPTS OF TEACHING AND LEARNING IN NURSING

PRACTICE
Planning of patient care is a complex process involving several individuals. It is designed

to achieve specific goals like health promotion or improvement. Nursing is synonymous to "care"
where the nurse responsibility is beyond care for the patient by doing his or her clinical duties
such as giving comfort measures and administering treatment modalities. These include
cleaning of wounds, changing patient's clothes, ensuring that prescribed medicines are taken on
time with the accurate dosage among others (Creasia and Parker: 2007).
Nursing also means teaching the patient proper self-care, health promotion, illness or
disease prevention, factors affecting health and illness, and treatment options. Relatively, it is
important to have a clear understanding of the essence of teaching in the practice of nursing.
Teaching plays an essential role in the efficient and effective dissemination of information and in
developing practical clinical skills of students by means of demonstration, laboratory activities
and similar hands on exercises.
MEMORY AID
1. Definition of Terms
a. Education. An interactive process of imparting knowledge, through sharing, explaining,
clarifying and synthesizing the substantive content of the learning process, for the learner to
arrive at positive judgment and well-developed wisdom and behavior.
b. Health. A condition that permits optimal functioning of the individual, enabling her to live most
and to serve best her personal and social relationship (Sharman, 1948). c. Learning. Acquisition
of knowledge of all kinds, abilities, habits, attitudes, values and skills (Calderon: 1998) to create
change in an individual.
d. Patient teaching. Dynamic interaction between the nurse as the teacher and the patient as
the learner.
c. Teaching. The process of providing learning materials, activities, situations, and experiences
to enable clients or learners to acquire knowledge, attitudes, values and skills to facilitate self-
reliant behavior (Calderon: 1998).
f. Education Process. A systematic, sequential, logical, scientifically based, planned course of

action consisting of teaching and learning (Bastable: 2007). It is a cycle that involves the
teacher and the learners.
g. Nursing Process. This emphasizes the need to manage and maximize health by preventing
risk factors and by encouraging healthy behaviors.
2. Steps in the Education Process
a. Assessment. Gathering of data about the learner's demographic profile, skills, and abilities
needed in identifying the most appropriate teaching strategy for a particular learner.
b. Planning. A carefully organized written presentation of what the learner needs to learn and
how the nurse educator is going to provide the teaching.
c. Implementation and Application of the Teaching Plan. The point where theoretical and
practical aspects of the teaching-learning process meet as the teacher applies the plan to the
learners.
d. Evaluation. The measurement of teaching-learning performance of both teacher and

learners.
3. Steps in the Nursing Process
a. Assessment. Data collection and recording of all

information.
b. Planning. Setting priorities, goals and objectives and treatment options.
c. Implementation. Putting the plan into action.
d. Evaluation. Assessing the patient, if the desired outcomes have been met.
4. Difference between the Education Process and Nursing
Process
a. The nursing process focuses on planning implementation of care based on assessment and
diagnosis of the physical and psychosocial needs of a patient. and
b. The education process focuses on planning and implementation of teaching based on

assessment and prioritization of learner' needs, readiness to learn, and learning styles.
CRITICAL THINKING EXERCISES
1. Explain the relationship between education and health to affect learning behaviors.
2. How do teachers implement the educational process in order to create behavior change in
learners? Explain the strategies.
3. Differentiate education process and nursing process and cite specific examples.
4. How do education process and nursing process affect nursing practice?
PRACTICE TEST
1. Which of the following best defines Education?
relating to individual, community, and racial health.
b. A state of complete physical, mental, and social well-being that permits the optimal
functioning of an individual.
c. An interactive process of imparting knowledge, sharing, explaining, clarifying and

synthesizing the substantive content of the learning process in order to arrive at a
positive judgment and a well-developed wisdom and behavior.
d. Dynamic interaction between the nurse as a teacher and the patient as the learner.
2. Steps in the Education Process
a. Assessment. Gathering of data about the learner's demographic profile, skills, and
abilities needed in identifying the most appropriate teaching strategy for a particular
learner.
b. Planning. A carefully organized written presentation of what the learner needs to learn
and how the nurse educator is going to provide the teaching.
c. Implementation and Application of the Teaching Plan. The point where theoretical and
practical aspects of the teaching-learning process meet as the teacher applies the plan
to the learners.
d. Evaluation. The measurement of teaching-learning performance of both teacher and

learners.
3. Steps in the Nursing Process
a. Assessment. Data information. collection and recording of all information.

b. Planning. Setting priorities, goals and objectives and treatment options.
c. Implementation. Putting the plan into action.
d. Evaluation. Assessing the patient, if the desired outcomes have been met.
4. Difference between the Education Process and Nursing Process
a. The nursing process focuses on planning and implementation of care based on

assessment and diagnosis of the physical and psychosocial needs of a patient.
b. The education process focuses on planning and implementation of teaching based on
assessment and prioritization of learner' needs, readiness to learn, and learning styles.
Assessment of Learning Outcomes
1. Explain the relationship between education and health to affect learning behaviors.
2. How do teachers implement the educational process in order to create behavior change in
learners? Explain the strategies.
3. Differentiate education process and nursing process and cite specific examples.
4. How do education process and nursing process affect nursing practice?
PRACTICE TEST
1. Which of the following best defines Education?

b. A state of complete physical, mental, and social well-being that permits the optimal
functioning of an individual.
c. An interactive process of imparting knowledge, sharing explaining, clarifying and

positive judgment and a well-developed wisdom and behavior.
d. Dynamic interaction between the nurse as a teacher and the patient as the learner.
2. Health is basic to all individuals, which of the following best defines health?
a. Health is a condition that permits optimal functioning of the individual thus, enabling
him to live most and serve best in personal and social relationship.
b. An interactive process of imparting knowledge, sharing, explaining, clarifying and

positive judgment and well-developed wisdom and behavior.
c. The sum of all experiences which favorably influence habits, attitudes, and knowledge
3. Which of the following explains the meaning of Learning?
a. Learning is the acquisition of knowledge of all kinds, abilities, habits, attitudes, values
and skills to create change in an individual.
b. Learning is a condition that permits optimal functioning of the individual enabling him
to live most and to serve best in personal and social relationships.
c. Learning is an interactive process of imparting knowledge, sharing, explaining,

clarifying and synthesizing the substantive content of the learning process in order to
arrive at a positive judgment and well-developed wisdom and behavior.
d. Learning is the sum of all experiences which favorably influence habits, attitudes, and
knowledge relating to individual, community, and racial health.
4. Which of the following steps are not included in the educational and nursing process?
a. Assessment
b. Investment
c. Implementation
d. Evaluation
5. Which one refer to data collection and recording of information?
a. Assessment
b. Investment
c. Implementation
d. Evaluation
6. Which of the following is a means of putting the plan into action?
a. Assessment
b. Investment
c. Implementation
d. Evaluation
7. What is the way of assessing the client to determine if desired
outcomes have been met?
a. Assessment
b. Investment
c. Implementation
d. Evaluation
8. Which one focuses on planning and implementation of care?
a. Nursing process
b. Education process
c. Health education process
9. Which of the following do not explain the nature of the Nursing Process?
a. Dynamic and cyclical

b. Nurse-oriented activity
c. Planned and goal-directed
d. Critical thinking process
10. Which one focuses on the planning and implementation of teaching?

a. Nursing process
b. Education process
c. Health education process
Chapter 3 : ROLES AND RESPONSIBILITIES OF THE NURSE AS HEALTH EDUCATOR IN

TEACHING PATIENTS
"Teaching is not a matter of chance, it's a matter of choice. It is not something you
are destined or obliged to do but something you have chosen to do. Blessed are the
teachers for they are God's gift to everyone."
-William Jennings Bryan
At the end of this chapter, the student will be able to:
● Define a nurse educator in terms of his or her roles;

● Expound on the functions of the health educator;
● Explain the importance of patient teaching;
● Discuss the purposes of patient teaching;
● Explain the principles of patient teaching;
● Analyze the importance of therapeutic communication techniques to patient teaching;
● Discuss the guidelines of therapeutic communication techniques; and
● Discuss different ways of documenting patient teaching.
DEFINITION OF A NURSE EDUCATOR AND HER ROLES
The nurse educator is:
1. The primary source of knowledge of learners in nursing;
2. The primary catalyst for the learning process; and

3. A role model for learners,
4. An active facilitator, who demonstrates and teaches patient care to nursing students in the
classroom and clinical settings;
5. A source of health care information and care to clients and
6. Is diligent; keeps abreast of developments in his or her field through continuing education,
reading of nursing journals and online materials and active participation in workshops and
seminars.
FUNCTIONS OF A HEALTH EDUCATOR
A health educator is a practitioner professionally prepared in the field of health

education, who demonstrates competence in both theory and practice and accepts
responsibility in advancing the aims of the health-education process (De Young: 2003).
A health educator performs the following:
1. Collaborates with health specialists and civic groups in assessing community health needs
and availability of resources and services and in developing goals for meeting health needs of
clients.
2. Formulates operational plans and policies necessary to achieve health education objectives
and services.
3. Conducts and coordinates health needs assessment and other public health surveys.
4. Designs and conducts evaluation and diagnostic studies to assess the quality and
performance of health education programs.
5. Plans and implements health education and promotion programs such as training workshops,
conferences, and school or community projects.
6. Prepares and distributes health education materials, such as reports, bulletins, online
websites and visual aids like films, videotapes, photographs and posters.
7. Provides guidance to agencies and organizations in the assessment of health education

needs and in the development and delivery of health education programs.
8. Disseminates health program information to the public by preparing and issuing press
releases, conducting media campaigns, and or maintaining program-related websites.
9. Promotes and maintains cooperative working relationship with agencies and organizations
interested in public health care.
10. Provides and maintains health education libraries to provide resources for staff and
community agencies.
11. Formulates, prepares and coordinates grant applications and grant-related activities to
obtain funding for health education programs and related work.
12. Documents activities, records information such as number of programs completed, nursing
actions implemented, and individuals assisted.
13. Maintains databases, mailing lists, telephone networks, and other information to facilitate the
function of health education programs.
PATIENT TEACHING DEFINED
Patient teaching, as defined by the American Academy of Family Physicians, is the

process of influencing patient behavior and producing changes in knowledge, attitudes and
skills necessary in maintaining or improving health.
Patient Teaching is a holistic process with the goal of changing or affirming patient's
behavior to benefit health status. Patient teaching refers to only one component of patient
education process which is giving the patient healthcare information.
Patient teaching is more than imparting information. The skilled patient educator assists
the patient in interpreting, integrating, and applying the information given. Patient teaching ends
with an evaluation of patient learning. It is a process that occurs overtime, requiring an ongoing
assessment of patient's knowledge, attitudes and skills. Patient readiness or motivation to
change behaviors and the obstacles that the patient faces to make a behavioral change are
important factors to consider (Falvo: 2003).
PURPOSES OF CLIENT TEACHING
Nurse Educators teach clients in order to:
1. Increase clients' awareness and knowledge of their healstatus;

2. Increase client satisfaction:
3. Improve quality of life;
4. Ensure continuity of care;
5. Decrease patient anxiety;
6. Increase self-reliant behavior;
7. Reduce effectively the incidence of complication of illness;
8. Promote adherence to health care treatment plans;
9. Maximize independence in the performance of activities of daily living; and
10. Energize and empower consumers to become actively involved in the planning of their care
The role of nurses as health educators in turn enhance their job satisfaction when they
recognize that their teaching actions have the potential of forging therapeutic relationships with
patients, allowing for greater patient-nurse autonomy, raise their accountability for practice, and
create change that truly makes a difference in the lives of others.
THE ROLE OF THE NURSE IN CLIENT TEACHING
Health teaching is an essential role of today's nurses. Nurses care for their client,
prepare them for diagnostic procedures or surgery. Using knowledge of growth and
development, and from nursing theories, nurses teach individuals and their families at various
levels of understanding. Clients and their families need information as well as emotional support
so they can cope with the anxiety and uncertainty of client's illness. Nurses also work with the
client's significant others to prepare them to assume responsibility for care at home after the
client is discharged from the hospital.
Education is essential to promote health. The nurse applies the principles of teaching
and learning to change the behavior of clients and their family members.. Nurses motivate
clients and their families to take charge of and make responsible decisions about their own
health care. For teaching to be effective, it must incorporate the cultural and family values and
clients' health care beliefs.
FACTORS THAT INFLUENCE CLIENT'S LEARNING
There are several factors that influence learning at any age. They include the following:
1. Stage of Development. When teaching clients, teaching must be adapted to the client's
developmental level rather than their chronological age. Developmental level determines the
ability of the person to learn best, whether by reading printed materials, using computer-based
applications, watching videos, participating in group discussions, play or other methods.
Teenagers have different concerns from older adults. Parents and grandparents who must
assume long term care may often need more information that may not have existed during their
childhood years.
2. Cultural values. The nurse's teaching can be most effective if norms, traditions and cultural
beliefs are considered and incorporated into their teaching plan. People have difficulty
understanding the subject matter of what is being taught if they disagree with the topic and their
tendency to disregard if they could not reconcile such things with their personal realities.
3. Language used. The ability of the client to understand the language of teaching determines
how much they learn. Clients to whom English is not the primary language may not understand
the use of informal words or medical terms. The nurse must make sure that health instructions
must be understood and used by clients in their daily activities. Use clients' own language or get
an interpreter to help reach out to their understanding.
4. Physical environment. The nurse must consider privacy and confidentiality of information
when discussing sensitive issues such as sexuality, drug addiction or domestic violence, among
others. Focus group discussions can also facilitate interactive process regarding health
concerns or issues affecting all members of the group, like sharing experiences they can expect
while in the hospital or at home.
5. Previous experiences. Clients who had past experiences similar to the current health
problem may need less education since they became familiar with the health care activities,
they had been taught earlier. However, they may have additional concerns which requires more
health teachings.
6. Knowledge and skill of the teacher. The teacher must determine the objectives of the
subject matter to be taught. Develop a plan to meet the objectives, and gather all necessary
materials. The nurse must determine the best method to present the materials for the intended
audience and later summarize all information given in order for the client to develop a holistic
idea of the subject matter.
PRINCIPLES OF CLIENT TEACHING AND LEARNING
Education is essential to promote health. The nurse applies the principles of teaching
and learning to change the behavior of clients towards making responsible decisions about their
own health care. Applying the following principles will help nurses become effective teachers.
1. Assess teaching needs of the client, or teaching that is required in a particular situation.
2. Assess readiness of the client to learn and the relevance of the content must be considered in
order for learning to occur.
3. Assess what the client knows and begin from what she knows.
4. The nurse should consider language barriers, literacy, ethnic, or cultural background, age and
emotional status of the patient.Otherwise, teaching and learning can be difficult, placing the
patient at risk.
5. Interactive discussions increases learning. The client should be actively involved in the
teaching-learning process and not act as a passive listener or viewer. A discussion format in
which all can participate stimulates more learning than hearing a straight lecture.
6. Demonstrate tasks to be done for active practice. Repetition of skills increases retention and
promotes a feeling of competence.
7. Praises and positive feedback motivates learning. This is important when the client is trying to
master a task, such as capillary blood glucose test and self insulin injection for diabetic clients.
8. Role modeling is an effective method for demonstrating behavior. Nurses must be aware that
their behavior is scrutinized carefully at all times and that it may be copied later.
9. Conflicts and frustrations impede learning, and should be recognized by the nurse and
resolved for learning to progress.
10.Structured teaching and presentation of simple tasks must be done before complex tasks in
order to enhance learning. For example, the nurse teaches the client how to care for the
umbilical cord, which is simple task, before teaching how to bathe and shampoo the newborn,
which is more difficult for inexperienced parents.
11.A variety of teaching methods is necessary to illustrate concepts and maintain interest of
clients. Posters, videos, models, online and printed materials can supplement lectures and
discussion.
12.Present information in small segments over a period of time for better retention and
appreciation. Short hospital stay do not support this practice, making follow-up care particularly
important.
Complex procedures need to be taught well. Injection techniques, handouts, visual aids,
and actual equipment should be used. The client should demonstrate the learned procedure in
order that the nurse can evaluate the effectiveness of the teaching process. The substance or
content and skills taught should be documented in appropriate health records. Using these
principles ensures that the nurse meets the required standard of care in any nursing situation.
THERAPEUTIC COMMUNICATION
The nurse have to carry out many roles and one of the most important role required of
the nurse is the skill in therapeutic communication. Nursing care becomes personal, humane
and sensitive to clients' needs if the nurse can effectively communicate and reach out to clients.
In this way, therapeutic communication must be purposeful, goal directed and focused.
GUIDELINES FOR THERAPEUTIC COMMUNICATION
As the health professional who is close to the client, the nurse informs families of
treatments and procedures, making sure that the families understand the process and are
involved directly in making decisions and activities related to their care. The nurse should be
sensitive to the clients' values, beliefs and customs. The following are guidelines to therapeutic
communication.
1. A peaceful and calm environment provides privacy, reduces distractions and minimizes
interruptions.
2. Begin interactions by introducing oneself and nurse's role. This will describe the nurse's
purpose and sets the discussion process. For ex. "My name is Crestita Tan, I am here to
complete the health instructions that was started yesterday..
3. Therapeutic communication should be focused and directed towards meeting the needs of
clients. For example, Focusing interactions -"How do you feel about the treatment received
today? Redirect conversations- "Thanks for showing me the beautiful family pictures, I
understand you are having a bit of trouble with your kids'.
4. Communicate more powerful messages to the client through non-verbal behaviors rather than
spoken words.
● Eye movements and facial expressions can confirm, or contradict what is said.
● Repetitive hand gestures such as tapping the fingers or twirling hair may indicate
frustration. Body posture, stance and gait can convey energy,depression or discomfort.
● Voice tone, pitch, rate and volume may indicate joy, anger or fear.
● Grooming also conveys messages about the nurses' sel! image.
● Talking to a young child may require that the nurse sit or squat to get to the child's level.
5. Active listening requires that the nurse attend to what is being said as well as to the non
verbal clues. Behavior that convey the nurse's interest and sincere desire to listen and
understand which include the following:
● Eye contact signals readiness to interact.
● Calm and relaxed posture, with the upper portion of the body inclined toward the client.
● Encouraging non verbal cues such as nodding, smiling and leaning closer. Verbal cues
include "Go on, uh huh."Tell me about that," or "Can you give me an example."
● Touch can be a powerful response when words would break a mood or fail to convey the
depth of feeling experienced between client and nurse.
● Clarifying communication involves a unique process of the client receiving the message
as intended by the nurse. The nurse can ask questions if the meaning of the statement
is not clear. For instance, the nurse might say `` I'm not sure, I understand you."
● Emotions are part of communication, and nurses must often reflect feelings that are
expressed verbally and non verbally. The nurse might suggest, "You looked forward to
going home today but disappointed that you needed to stay longer for more diagnostic
workup."
● Cultural differences greatly influence communication. In some cultures such as Chinese

and Southeast Asian, prolonged eye contact is considered confrontational while Middle
Eastern or Native Americans are sometimes uncomfortable with touch or are disturbed
by unsolicited touching (Kozier 2008).However, Filipinos are very comfortable with touch
and the feelings of safety and security are enhanced by touch.
THERAPEUTIC COMMUNICATION TECHNIQUES
Therapeutic communication techniques involves responding as well as listening,

and the nurse must learn to use responses that facilitate rather than block
communication. Communication techniques focus on both content of the message and
the feelings that accompanies the message. These techniques include clarifying,
reflecting, being silent, questioning and directing. In addition, the nurse be aware of
blocks to communication such as conveying lack of interest, conveying sense of haste,
closed posture as in hands closed over chest, interruptions, providing false reassurance,
inappropriate self disclosure, giving unsolicited advice and failure to acknowledge
comments or feelings. (Wong et al 2010)
DOCUMENTATION OF CLIENT TEACHING
Communication among members of the health care team is essential if this is to

be coordinated and consistent to the principles of client teaching. Although
communication takes place through word of mouth, another method used is
documentation of patient teaching.
Such documentation not only communicates what is taught to the client but also
communicates the client's level of understanding, and further reinforcement of
information may be necessary (Le Fevre 2005). Such information prevents redundancy
and can assist in the evaluative process.
Characteristics of Documentation in Client Teaching
1. Covers all aspects of patient care;

2. Critical for communication among team members;
3. Provides a legal record;
4. Supports quality assurance efforts;
5. Promotes continuity of care; and 6. Facilitates reinforcement.
Good documentation reflects the following:
1. Initial assessment and reassessment of pertinent data;

2. Nursing diagnoses and client learning needs;
3. Interventions provided;
4. Client's response and outcomes of care;
5. Discharge plan of care; and
6. Ability of the client and family to manage needs after discharge
Review of the components of documentation system illustrates how

documentation of client teaching can be integrated into the patient record. The
components are as follows:
1. Admission Assessment
The nurse educator:

a. Make a complete patient profile and history.
b. Assesses the clients' functional ability to aid in the formulation of nursing diagnoses.
c. Identifies ways of individualizing teaching, such as the client's readiness, language,

and physical capability.
d. Designs assessment forms to high-risk patients, in order to pinpoint potential

problems that identify specific learning needs.
2. Problem List
a. The patient's chart has a list of actual and potential health problems identified
individually or collaboratively. It also includes medical and nursing diagnoses;
b. The nurse has to enter the data next to each problem as it is identified and when the
problem is resolved. Standardized care plans may be generated based on nursing
diagnoses.
3. Care Plan or Critical Pathway
An individualized care plan for each patient assessment of medical and nursing
diagnoses, patient goals, interventions and desired outcomes.
4. Flow Sheets (Optional)
Flow sheets contain observations and lists of patients name and data in a clear,
concise, check-off format to encourage fast and immediate documentation. Findings or
patient responses outside of normal limits must be recorded in the nurses' notes.
The method of charting assumes that all abnormal findings or variances are
charted, referred to as "charting by exception." If flow sheets are used to record patient
teaching, data entered should be the documentation of patient's understanding of what
was taught rather than the subject matter being taught.
5. Progress Notes
Narrative notes show the patient's progress perceived by all health care
professionals involved in patient care. Evaluation of the patient's responses to nursing
interventions should be evident. Every problem is referenced with a number
corresponding to the problem list.
Patient teaching can be effectively documented in the progress notes section of
the medical record. Patient teaching is a problem solving process hence, documentation
includes a clear statement of needs or problems, significant data and the plan of care. It
is also important to document the outcomes of care. Narrative notes also encourage
charting in patient's own words to illustrate outcomes of patient education and evidence
of individualized care.
6. Discharge Summary
Summaries or reports written at the time of discharge or transfer of the client to

another health care facility serve as needed source of information for other health care
providers about the patient's needs for reinforcement of health teaching and continued
learning. Notes and telephone consultations can be used to communicate assessments
and ongoing learning needs of clients to continuing care providers.
MEMORY AID
1. Functions of Health Educator
a. Collaborates with health specialists and civic groups in determining community health
needs, the availability of services, and goals for meeting needs.
b. Designs and conducts evaluation and diagnostic studies to assess the quality and
performance of health education programs.
c. Develops and implements health education and promotion programs such as training
workshops, conferences and school or community presentations.
2. Patient Teaching Defined
Patient teaching is the process of influencing patient behavior and producing

changes in knowledge, attitudes and skills necessary to maintain or improve health..
Patient teaching is also a holistic process with the goal of changing or affirming
patient behavior to improve health status. Patient teaching refers to only one component
of patient education process which is providing detailed information regarding health
status.
3. Purposes of Client Teaching is to:
a. Increase health awareness;

b. Increase client satisfaction;
c. Improve quality of life;
d. Ensure continuity of care;
e. Decrease patient anxiety;
f. Effectively reduce the incidence of illness and complications;
g. Further adherence to health care treatment plans;
h. Maximize independence in the performance of activities of daily living; and
i. Energize and empower consumers to become actively involved in planning
their care.
4. Principles of Client Teaching and Learning
a. Assess teaching needs of the patient or teaching that is required in a particular

situation;
b. Assess what the patient knows and begin from what she knows; and
c.Consider language barriers, literacy, ethnic and cultural background, age and
emotional status of the patient otherwise, teaching and learning can be impaired,
placing the patient at risk.
5. Characteristics of Documentation
a. Covers all aspects of patient care.

b. Critical in regard to communication among team members.
c. Provides a legal record.
d. Supports quality assurance efforts.
e. Promotes continuity of care.
f. Facilitates reimbursement.
6. Documentation Should Reflect the Following:
a. Initial assessment and reassessments of pertinent data.

b. Nursing diagnoses and patient learning needs. c. Interventions provided.
d. Patient's response and outcomes of care. e. Discharge plan of care.
F. Ability of the patient and family to manage needs after discharge.
7. Components of the Documentation System
a. Admission Assessment;
b. Problem List;
c. Care Plan or Critical Path Way;
d. Flow Sheets (Optional);
E. Progress Notes; and f. Discharge Summary

1. As nurse educator, you are tasked to provide health education to your group of clients.
In what way will you be able to accomplish the goals and objectives of health education?
2. Why is patient teaching necessary? Cite the principles of patient teaching which will
help the patient understand his or her health behavior.
3. What are the components of documentation? Why is documentation necessary in

patient teaching?
PRACTICE TEST
1. Which of the following is not a purpose of patient teaching?
a. Increase client satisfaction b. Improve quality of life

c. Ensure continuity of care
d. Increase patient anxiety
2. Which is not a part of the principles of patient teaching?
a. Assess the teaching needs of the patient, or the teaching that is required in a
particular situation.
b. Assess what the patient knows and start from there.
c. Nurse needs to consider language barriers, literacy, ethnic and cultural

background, age and emotional status of the patient;otherwise
d. To assess financial status of the patient.
3. What is the least characteristic of documentation?
a. It covers all aspects of patient care.

b. Critical for communication among team members.
c. Provides an illegal record.
d. Support quality assurance efforts.
4. Which of the following does not reflect Documentation ?

a. Accountability movement - This movement seeks to hold schools, teachers
and students responsible for learning.
b. Perceived lack of support Lack of support from society and insufficient

financial support from government and non government agencies hinders health
education programs.
c. Inadequate professional preparation - Lack of qualified health educators.
d. Lack of financial support.
5. What is the least component of the documentation system?
a. Admission assessment
b. Problem list
c. Care plan or critical pathway
D. Flow sheets
6. What contains a complete patient profile and history?
b. Problem list
d. Flow sheets
7. Where do list of actual and potential health problems appear?
b. Problem list
D. Flow sheets
8. What is individualized care plan for each patient mean?
b. Problem list
D. Bed sheets
9. Where do you find the list of observations?
a. Check list
b. Problem list
c. Flow sheets
d. Bed sheets
10. What do you call the summary or report written at the time of patient discharge
or transfer?
a. Check summary
b. Discharge summary
c. Billing statement
Chapter 4 : HALLMARKS OF EFFECTIVE TEACHING IN NURSING
"The greatest glory of being a teacher is not just simply to be recognized but rather the
appreciation of the heroic acts he has shared to humankind."
-Orison Sweet Marden
● Discuss the various hallmarks of good teaching;

● Explain the five major characteristics of an effective teacher;
● Identify and elucidate the qualities of an effective nurse educator;
● Enumerate essential teaching skills; and
● Describe the roles and functions of a teacher or nurse educator.
HALLMARKS OF GOOD TEACHING
Good teaching is a basic consideration of effective learning. Today's modern teacher of

nursing must possess a system of principles and critical thinking skills to guide her teaching
practices.
Application of teaching principles varies according to the teacher's level of competence

as they adjust to different levels of maturity, background experience, the objectives and interest
of the learners. Knowledge of nursing alone, and the skill of teaching will not necessarily help
the nurse become a good teacher if she is ignorant of the principles and the processes of
nursing education. It will not also help the nurse refine her techniques of teaching if she does
not understand human behavior.
A good teacher must adjust her teaching styles to individual differences, help students
integrate learning principles from the classroom to their related learning experiences (RLE) or
clinical setting and properly evaluate learning outcomes to determine if her knowledge and skills
are well understood by her students.
"Teaching is neither a routine nor a rule of thumb procedure but genuine

intellectual adventure when properly carried out."
1-Heiderken
CHARACTERISTICS OF AN EFFECTIVE TEACHER IN NURSING
As with any teacher, clinical instructors and classroom teachers in nursing must possess
certain qualities and responsibilities in order to properly perform their functions. Following are
some characteristics that teachers of nursing need (De Young: 2004).
1. Professional Competence
Competence refers to the teacher's adherence to personal and professional standard of

excellence and self-development through continuous education, skills enhancement and
keeping one updated with current trends and issues. The teacher possesses mastery of the
subject matter in terms of knowledge, skills and values in order to teach students efficiently and
effectively.
2. Interpersonal Relationship with Students
The teacher's ability to relate well with students and her personal interest in the learners.
Her sensitivity to their feelings and problems, respect for their rights, and fairness will make
learning a pleasant experience for both the teacher and students.
3. Personal Characteristics
The teacher's personal magnetism motivates students' interest to learn, her enthusiasm
to teach the subject matter and self-control a personal discipline of complying with the rules and
standards of teaching.
The teacher is patient in dealing with problems and conflict in teaching, possesses
flexibility in handling the subject matter, time schedules and students. She has a sense of humor
to enliven the discussions and to capture students' interest and a caring attitude that helps
foster healthy relationships with learners.
4. Teaching Practices
The teacher's ability and skill in utilizing appropriate methods and techniques in the
classroom and clinical teaching that sustains students' interest and desire to learn.
5. Evaluation Practices
The teacher has a clear communication of expectancies, timely feedback on student's

progress; correcting of students' errors tactfully, fairness in grading tests and grades pertinent to
the subject matter.
QUALITIES OF AN EFFECTIVE NURSE EDUCATOR
To be an effective teacher or nurse educator, one must possess both personal and
professional qualities that are essential in arousing
learners' interests and active (Heidgerken: 1971 and Clark: 2008). class or activity
participation
Personal Qualities
These are innate qualities that the teacher must possess. Her beliefs, values and traits
make her a great teacher such that the nurse educator:
1. Respects her student's maturity and sense of responsibility.
● Shows respect for his or her students by coming to class on time and prepared.
● Speaks politely and gently.
● Avoids useless repetitions and interspersion of irrelevant topics when lecturing.
● Gives her students freedom to choose their own topic of interest when selecting
a term paper within the area of medical-surgical nursing, maternal and child
nursing,among others.
2. Psychologically secure in her own abilities.
● Confident with the accuracy of her knowledge and skills.

● Does not minimize, exaggerate or deny his or her grasp of the subject matter or
her experiences in the field.
● Does not resort to the use of identification, rationalization or any other obvious
defense mechanism to camouflage any weakness.
3. Has a sense of humor.
● Expresses appropriate emotions with levity when the same is appropriate to the
subject matter discussed.
4. Has a well-balanced personality.

● Knows when to laugh or be serious.
● Has the ability to make her teaching truly meaningful to her students.
● Is enthusiastic in teaching the subject matter.
5. Is tolerant and fair to all her students.
6. Shows no partiality and is available to listen to students' problems.
7. Approachable, kind and patient.
8. Sincere in her efforts of educating the young and has passion for both nursing and the
learners.
9. Has leadership abilities.
10. The image of an ideal nurse with interest in each student.
"Nursing as both a profession and a scholarly discipline is rooted in knowledge of

nursing practice. Today nursing has evolved clearly as the discipline that focuses on
developing an understanding of the human processes that promotes health, and a caring
profession that incorporates an understanding of human experiences into health
practice."
-Sister Callista Roy
Professional Qualities
Character traits of teachers are enhanced and strengthened by their eclectic knowledge,
skills and values derived from years of professional training and experiences in various
situations. Their behavior is very much influenced by the knowledge, skills, and values they
have learned to love and practice in the course of their nursing career.
1. Teaches lessons that stimulate students to think and learn
● Presents meaningful and relevant ideas based on readings,researches,

experiences situations,or personal encounter in nursing
● Is abreast with current trends and issues in nursing practice.
● Must have a collage of information to serve as sources of knowledge in teaching
students.
● Capable of sharing her own relevant experiences in the field of nursing.
● Personal and professional experience is necessary in order for the teacher to
convey messages or transfer these to the learners.
● Intellectually and emotionally expressive.
● Speaks clearly and precisely.
● Speaks the language at the level of students' understanding
2. Gives clear and concise assignments
● Assignments are verbally explained for clarity of instruction and technicalities.

● Assignments are written on the whiteboard for student reference; their aims and
objectives, style or format, resources and benefits can give the students in terms
of knowledge, skills and values.
● Specific requirements which the paper has to meet are spelled out simply but
completely on the board. .
● Clearly indicates the specific time frame for completion and submission.
3. Encourages student feedback on assigned lessons and activities done
Welcomes students' questions, clarification, reflection, opinions, and input and analyzes
them in the context of the aims and objectives of prescribed requirements.
4. Presents a well-organized subject matter for students' easy understanding.
● Content of subject matter must be good and clear enough for students to see the
difference in their learning behavior from the past and the present. In this way, students
can rationalize what was learned, using the inductive or deductive approach.
● The nurse educator should prepare prior to class session the necessary materials
needed for students' understanding such as diagrams, charts or PowerPoint
presentations.
5. Provides her students with relevant clinical learning experience.
● The teacher must relate concepts with practical situations for clearer view of the subject
matter..
● Facilitates the students' use of knowledge acquired in class relative to nursing care of
patients in their related learning experiences.
6. Possesses mastery of the subject matter.
● The teacher must have adequate sources of information such as journals, books,
internet sources necessary to provide an in-depth analysis of concepts or events
discussed.
● The teacher has knowledge of past, present and future trends and issues of nursing
such as medical-surgical nursing or maternal and child nursing, among others.
7. Speaks clearly, audibly and fluently.
● The teacher has excellent written and oral communication skills.

● Able to speak English fluently and has broad vocabulary knowledge.
● Use her voice appropriately and moderately for audible understanding.
8. Shows professional decorum,dressed and poised, well-groomed, properly
● Observes proper posture whether standing or sitting, well groomed and properly
dressed, and wears clean, shiny shoes.
● Observes proper hygiene, tidy and presentable and is comfortable in her manner of
teaching.
9. Shows broad interests aside from teaching.
● Besides mastery of the subject matter, the teacher should also be familiar with fine arts
and other fields of learning, to elicit his or her ability to connect or relate one subject
matter to another.
10. Evaluates objectively student's performance.
The teacher has a structured and objective basis to evaluate student performance based on
prescribed criteria and competencies desired for each experience, course or learning
ESSENTIAL TEACHING SKILLS
The nurse educator must possess characteristics of an effective teacher. She must
possess the teaching the qualities and skills necessary to efficiently and effectively transfer
knowledge and skills to her learners. The following are the essential teaching skills:
1. Skills in Planning and Preparing the Lessons
A nurse educator must be capable in the choices of educational aims and learning
outcomes intended for the lesson and how best to achieve these, such as the following:
● The lesson plan has achievable and realistic objectives.

● Content, methods and structure selected are appropriate for a particular group of
students. .
● The lesson is planned, a continuation of the past and relates to future lessons.
● Materials, resources and aids are well-prepared and double checked before the class
begins.
● All planning decisions take into account the learning level of learners and the course
content.
● The lesson is designed to arouse student interest and elicit active class participation and
involvement.
2. Skills in Presenting the Lessons
Lesson presentation refers to ability of the teacher to engage students successfully in

the learning experience process : or successfully 'catch their the attention':
● The teacher is confident, relaxed, self-assured, purposeful,and shows interest in the

lesson.
● The teacher's instructions and explanations are clear.
● The teacher uses simple words in her lecture for better understanding of the lesson.
● A variety of learning activities are used to stimulate students' interest.
● Students are actively involved in the lesson and are given opportunities to organize their
own work.
● The teacher shows respect and encourages students to voice their opinions, ideas and
contribute much to their critical thinking skills and development.
3. Skills in the Organization and Management of Learning Activities
Management and organization of learning activities during the class should sustain
students' attention, interest and involvement in the topic of discussion.
● Class discussion is smooth and sets a positive mental process.

● Student's progress during the lesson is carefully monitored. .
● Constructive and helpful feedback is given to students to encourage them to study
harder in order to foster personal progress.
● Uses time management techniques.
● The pace and flow of the lesson is well-adjusted and maintained at an appropriate level
throughout the lesson.
4. Skills in Creating a Positive Climate in the Classroom

● Establishes and maintains positive attitude and motivation of students regarding the
lesson.
● Climate is purposeful, task oriented, relaxed, and with established sense of order.
● Students are encouraged to learn with emphasis on high positive expectations as
conveyed by the teacher.
● Teacher-student relationships are largely based on mutual respect and rapport.
● Feedback of the teacher contributes confidence and self-esteem to student self
● Classroom set-up is conducive to teaching and learning such as adequate space,
ventilation, teacher and students are audibly and visibly connected, with multimedia
facilities and away from public utility distractions.
5. Skills in Evaluating Student Performance
● Evaluation covers both formative and summative responses.

● Student's work and performance should be evaluated in a constructive and objective
manner and returned to students for review.
● Encourage students' feedback on assessments.
● Keep records of students' progress for future reference.
6. Skills in Evaluating Teaching Performance
● The teacher evaluates his or her own teaching practices for further professional
improvement.
● Various teaching strategies are used for different sets of lectures.
● Continuously updates lessons.
● Continuously improves her ways of teaching for better learning outcomes.
● Manages stress efficiently and effectively.
7. Skills in the Practice of Appropriate Authority
● Ability to impose discipline in his or her class.

● Able to establish her authority and maintain classroom order over her students.
● Establishes clear rules and expectations in regard to student behavior.
● Monitor student behavior and progress carefully.
● Take appropriate action for misbehaving students.
● Confrontations are avoided, and skillfully defused.
"Teachers are leaders who must be very clear about their own beliefs before they
are able to lead others. To be an effective leader, educator and influential role model, one
must clarify his or her values and goals and be aware of their influences on future
teachers or leaders."
-Billy Jean Brown

ROLES AND FUNCTIONS OF THE TEACHER OR NURSE EDUCATOR
Besides the usual roles of a teacher, a nurse educator assumes further responsibilities,
which includes three basic roles (Heidgerken: 1971, De Young: 2004):
1. Instructional Roles
● Planning and organizing courses. The instructional role of the teacher consists of the
following tasks:
● choice of learning outcomes.
● substantive content.
● teaching and learning activities for all types of educational settings.
● correlating these with other courses in the curriculum.
Example: Differentiate "needs and problems" of a client and cite specific examples.
● Creating and maintaining desirable group climate. This is essential in creating a

classroom climate conducive to effective teaching and learning.
Example: For each RLE group discuss and differentiate between client needs and
problems.
● Adapting teaching and preparation of instructional materials to varying interests, needs

and abilities of students. This addresses the issue of individual differences and levels of
student understanding.
Example: Present video, slides or PowerPoint depicting a client with needs and
problems.
● Motivating and challenging students to pursue and to sustain learning activities. This
should lead them towards acceptance of responsibility for their own learning and foster
critical thinking in analyzing nursing situations.
Example: Each RLE group presents their own interpretation and analysis of a certain film
and reconcile with the teacher's presentation of clients' needs and problems.
● Teaching involves a series of complex activities:

● Supplying needed information or telling students where these information may be
obtained;
● Explaining, clarifying and interpreting
● Demonstrating and explaining a procedure, process or exhibiting materials;
● Serving as a resource person for group projects or to individual students;
● Supervising student's performance in the classroom, the laboratory in their related
learning experiences (RLE) and other settings where students may acquire knowledge,
skills and desired professional values; and
● Evaluating all the planned teaching and learning activities and student outcomes related
to the courses assigned.
2. Faculty Roles
Besides classroom teaching, a nurse educator also assumes faculty roles such as the following:
● Chairman, secretary, or member of one or more committees.

● Counselor of students in academic or non-academic matters.
● Researcher, as a principal investigator or member of a research team.
● Resource person to groups inside or outside the institution,other schools and health
agencies.
● Representative to professional nursing organizations and other agencies.
● As public relations agent, she interprets the objectives and the policies of her institution
and helps in the recruitment, or support groups.
3. Individual Roles
A faculty member assumes personal
roles such that he or she is a member of a:
● Family;
● Church;
● Community; and
● Country as a citizen.
MEMORY AID
1. Five Major Characteristics of an Effective Teacher
a. Professional Competence
b. Interpersonal Relationship with Students
c. Personal Characteristics
d. Teaching Practices
2. List of Essential Teaching Skills
a. Skills in Planning and Preparing the Lessons

b. Skills in Presenting the Lessons
c. Skills in the Organization and Management of Learning Activities
d. Skills in Creating a Positive Climate in the Classroom
e. Skills in Evaluating Student Performance
f. Skills in Evaluating Teaching Performance
g. Skills in the Practice of Appropriate Authority
1. You are teaching nursing students in the classroom and in the clinical area. How can you be
effective to your students? What specific qualities do you need in order to create an effective
teaching and learning environment?
2. Differentiate between the personal and professional qualities of a good nurse educator.
3. What are the essential teaching skills you need to possess in order to create a climate of
change in a teaching and learning environment?
PRACTICE TEST
1. Which of the following refers to the teacher's personal standard of excellence?
a. Professional competence
b. Interpersonal relationship with students
c. Personal characteristics
d. Teaching practices
2. Which relates to the teacher's personal interest in the learners?
d. Teaching practices
3. What is meant by the teacher's mechanics, methods, skills in the classroom and clinical
teaching?
D. Teaching practices
4. Which one refers to the teacher's communication of expectations?

5. Which one refers to the ability of the teacher to select educational aims and learning
outcomes?
a. Lesson presentation
b. Planning and preparations skills
c. Lesson management
6. Which of the following refers to the ability of the teacher to engage the students in learning
experiences?
7. Which is the pace and the flow of the lesson that is adjusted and maintained at a level
throughout the lesson?
8. What refers to the ability of the teacher to evaluate his or her own teaching experience?
a. Evaluation of teaching performance

b. Student performance evaluation
c. Practices appropriate authority
9. What refers to an evaluation of student's work?
a. Evaluation of teaching performance

b. Student evaluation
10. Which one is the ability of the teacher to impose discipline on his or her class.?
a Evaluation of teaching performance

b. Student performance evaluation
Chapter 5 : PRINCIPLE OF GOOD TEACHING PRACTICE
"Teaching is not only in the content being learned but also involves guiding
students in learning how to learn and think about how to learn."
-J. L. Murphy.
● Discuss comprehensively the seven principles of good

● practices in teaching;
● Differentiate the different teaching principles;
● Analyze guidelines in the selection of teaching and learning methods; and
● Explain the different approaches to teaching skills.
PRINCIPLES OF GOOD TEACHING PRACTICES
Apart from the qualities a good teacher should possess, there are also ways the teacher
must practice to make a healthy and dynamic teaching-learning relationships. A good teacher
performs the following:
1. Facilitates student-teacher interaction to create a closer relationship between nurse

educators and learners.
2. Encourages cooperation among students to create an atmosphere conducive to

collaborative learning, such as forming study groups, and a variety of group projects.
3. Initiates active learning to enable students to actively criticize content they are learning by
talking about the material, writing about it, outlining it, applying it, asking questions about it and
reflecting on it.
4. Gives prompt feedback to enable students to react and understand what aspects of
learning they need to improve on and make needed adjustments in their learning styles.
5. Emphasizes the use of time in each task to ensure that students know how much time they
should spend in learning a particular material and encourage them to study and practice
seriously. Time management is the key towards efficient and effective study.
6. Communicates high expectations to challenge students Learners are motivated to meet

high expectations if they are given the support and encouragement they need.
7. Respects diverse talents and ways of learning by considering the fact that learners have
different learning styles. Thus, the teacher has to devise various teaching strategies and
assignments to meet the students' needs.
TEACHING PRINCIPLES
In teaching, principles may be classified into three major groups, namely (Bastable:
2007):
"The child's original nature is absolutely antecedent and inhal to all educational
activities and results
-Aven
1. Hereditary Endowments Principle
These refer to the nature of the child, his psychological and physiological qualities such
as reflexes, instincts, capabilities,impulses, temperaments, among others. Hereditary
endowments are the preliminary concern in all educational endeavors.
2. Teaching Process Principles
These refer to the techniques used with the student and the teacher working together
toward the accomplishment of goals or objectives of education. These include the following:
● The teacher and students; and

● The means used to stimulate, direct, guide, and encourage individuals to actively
participate in class activities.
Teaching involves the application of many laws and principles. True principles of
teaching, then, must explain the teaching process. They must show how the subject-matter is
organized and taught and how teaching results are achieved and evaluated. Improved methods
of teaching depend upon increased knowledge of principles to be applied. Principles serve as a
guiding philosophy for the selection and implementation of teaching and learning activities and
techniques.
3. Outcome Process Principles

Outcome process principles refer to educational aims, goals, objectives, outcomes,
purposes, or results of the learning process to which teaching and learning are directed.
"The true principle of teaching must explain the teaching process and its result
process."
-Bastable
The foregoing aims or objectives may be used as specific, intelligible principles or

guidance by those who seek to teach and learn effectively.
GUIDELINES IN THE CHOICE OF TEACHING AND LEARNING METHODS
Considering the socioeconomic, ethnic groups and cultural diversity among student
groups and the similarly diverse methods available to teach them, the teacher faces the
challenge of how to determine which methods are appropriate to facilitate students learning.
Below are guidelines in the choice of the most appropriate teaching method.
1. Methods should be suited to the objectives and content of the course.
● Note that teaching techniques vary from course to course and among units within a
course.
● If the objective of the course is to transfer knowledge through discussion, it is most

appropriate to conduct the lecture in a classroom setting.
● If the objective of the course is to transfer and enhance students' skills through
experience and self-discovery, the teacher may choose to conduct the class in a
laboratory or in a Related Learning Experience (RLE) setting.
● If the objective of the course is to involve students and share clinical experiences, the
teacher may choose to conduct ward classes and discussions experiences. Or other
related learning
What may be valid for one course may not be valid for another. However, there is no one
best method. Criteria in the choice of method(s) for a course is not so much the general
category of method out the precise type of learning inherent in the situation and the earning
outcomes desired.
2. Methods should be adapted to the capability of students.
● Maturity and receptiveness of students must be considered in the choice of teaching

method to be used.
● The teacher must be flexible in planning and teaching her courses.
● Conducting simple activities such as self- introduction or preparation of class roster will
help create a feeling of student identity, thereby arousing their learning interest.
● Teachers must continuously improve her teaching method.
3. Methods should be in accordance with sound psychological principles.
● Select appropriate teaching methods to adapt to individual differences and to make

learning more interesting and motivating to students.
● Use audio-visual aids to provide students with perceptual experiences which will help
concretize students' learning and help them develop concepts.
● Select and use methods that help students unify and integrate their learning
experiences.
4. Methods should suit the teacher's personality and capitalize on her special assets.
● There are individual differences among teachers just as there are among students.
● Teachers have different personality traits, some are serious, and some have a sense of
humor. Some are expressive, and others are analytical.
● Teachers express common values such as ideals, integrity, kindness, love of learning,
and respect for students.
● There is no one best personality for successful teaching.
● Teachers are unique and different from one another.
● They should not aspire for the impossible.
● Each teacher should develop her own style of teaching, adapting it to herself and
circumstances. However, this style of teaching must consider individual differences and
learning styles of the learners.
● The teacher should choose a method in which she can teach best.
5. Methods should be used creatively.
● Every teacher should create her own teaching method and use various available
techniques that suits her personality, style, and course objectives.
● .The teaching method used by a teacher should represent a composite style or quality of
teaching, a characteristic behavior which would reflect the teacher's values and
educational philosophy.
APPROACHES TO TEACHING SKILLS
As with theories and intellectual discussions, there several methods of are teaching
students skills or practical lessons (De Young, 2004).
1. Independent Learning
● The teacher initiates an active self regulated learning process among her
students. This provides the student with all the necessary instructional materials
and equipment for practicing and learning the skill by himself or herself.
● This includes the use of skills laboratory which the teacher should be prepared
for.
● A syllabus is developed with clear instructions on how learners should proceed
with the lesson.
● Background reading materials are identified and made available.
● Hardware and software must be selected and prepared for use.
● Supplies must be requested for and be made available beforehand.
2. Demonstration
● It is a method by which the teacher makes a direct display of the skills to be taught.
● Shows the student what they have to do, why they have to do it, and how to do it.
3. Simulations or Exercises
● It is meant to duplicate the real situation that requires the use of skills laboratory to give
students a realistic feel of the situation without subjecting them to risks that might be
involved.
● Students can practice skills using equipment in a virtual laboratory or situations derived
from related learning
● experiences. Students get a feel of how to use the equipment in a real situation involving
the needed skill.
Table 1: Elements of Effective Skill Demonstrations
Elements of Effective Skill Demonstrations
1. Assemble all equipment ahead of time.
2. Make sure all equipment are in working order.
3. Do a "dry run" of the procedure and time of the demonstration.
4. Arrange the environment to be as realistic as possible.
5. Perform the procedure in an orderly sequence.
6. When appropriate, give the rationale for your actions.
7. Refer to the handouts or textbooks to show fine points that may not be visible to the
audience.
8. Be sure to adhere to all relevant principles of good nursing care. For example, aseptic
technique, body mechanics, and patient privacy should be followed so learners see how to
incorporate them.
9. Consider performing the skill a second time or having a learner perform a demonstration
without any explanation, to show the flow
of the skill.
MEMORY AID
1. Seven Principles of Good and Effective Teaching Practices
a. Encourage student-faculty contact.

b. Encourage cooperation among students.
c. Encourage active learning.
d. Give prompt feedback.
e. Emphasize task time.
f. Communicate high expectations.
g. Respect diverse talents and ways of learning.
2. Types of Teaching Principles.
a. Hereditary Endowments Principles - Refer to the nature of the child, his or her
psychological and physiological qualities such as reflexes, instincts, capacities,
impulses, and temperaments, among others.
b. Teaching Process Principles - Refer to techniques used through which student and
teacher may work together toward the accomplishment of goals or objectives of
education.
c. Outcome Process Principles - Refer to the educational aims goals, objectives,

outcomes, purposes, or results of the educational scheme to which teaching and
learning are directed. Yout
3. Guidelines in the Choice of Teaching and Learning Methods
a. Suited to the objectives and the content of the course.

b. Adapted to the capability of the student.
c. In accordance with sound psychological principles.
d. Used creatively.
e. Suit the teacher's personality and capitalize on his or her special assets.
1. As nurse educator, explain the seven (7) principles of good teaching and cite specific
examples for each.
2. How do teaching principles affect the teaching and learning process?
3. In what way will the teaching methods guide the teacher for effective teaching learning
outcome?
4. Develop or formulate your own approaches to teaching students the needed skills in nursing
and explain why such approach is necessary.
PRACTICE TEST
Directions: Read each question carefully and encircle the letter of the BEST answer.
1. What is the best way for a closer relationship and enthusiasm between nurse educators and
learners?
a. Encourage student-faculty contact.

b. Encourage cooperation among students.
c. Encourage active learning.
d. Give prompt feedback.
2. Which one ensures students knowing how much time they should spend in learning a
particular material?
a. Give prompt feedback.

b. Emphasize time on task.
c. Communicate high expectations.
d. Respect diverse talents and ways of learning.
3. How could a nurse educator help challenge the learners?

a. Give prompt feedback.
b. Emphasize time on task.
c. Communicate high expectations.
d. Respect diverse talents and ways of learning.
4. Which one creates an atmosphere conducive to collaborative learning?
a. Encourages student-faculty contact.

b. Encourages cooperation among students.
c. Encourages active learning.
d. Gives prompt feedback.
5. What refers to the nature of the child, his or her psychological and physiological qualities?
a. Inherent endowment Principles

b. Hereditary endowment Principles
c. Natural endowment Principles
6. Which technique is used in enabling students and teachers to work together for the
accomplishment of the goals and objectives of education?
a. Encouragement Process Principles

b. Hereditary Endowment Principles
c. Teaching Process Principles
7. The educational aims, goals, objectives, outcomes, purposes or results of the educational
scheme to which teaching and learning are directed. Which principle is it referring to?
a. Input process principles

b. Internal process principles
c. Output process principles
D. Physical process principles
8. Which one provides the student with all the necessary instructional materials and equipment
for practicing and learning the skill?
a. Demonstration
b. Independent Learning
c. Simulations or Exercises
d. None of the Above
9. What is the method through which the teacher makes direct display of skills to be taught and
shows students what they have to do?

d. Physical process principles
10. What is meant to duplicate the real situation that requires the use of skills to give the student
a realistic feel of the situation, but without subjecting him or her to the risks that might be
involved?

d. Physical process principles
Chapter 6 : TEACHING STRATEGIES
"The greatest need... is the true spirit of service, that ideal of service for which our
Lady of the Lamp, Florence Nightingale, pleaded in a time when training schools were
not existing... The character and the ideals which the individuals bring to labor and to the
profession alone make possible... dignifying the laborer and enabling the profession."
-Lenah Sutcliff Higbre
● Discuss the different teaching strategics available to the nurse educator;

● Identify different traditional teaching strategies;
● Discuss activity-based teaching strategies;
● Explain the different computer teaching strategies;
● Discuss the concept of distance learning;
● Describe clinical teaching;
● Explain various guidelines in teaching psychomotor skills
TEACHING STRATEGIES
Following are various methods and strategies which a teacher may adopt to address
various learning needs (Clark: 2008).
"The teacher is the best audiovisual aid in teaching who influences the learners'
heart, mind and spirit for personal and professional development
-St. Thomas Aquinas
TRADITIONAL TEACHING STRATEGIES
1. Lecturing
Lecture is the most traditional method associated with teaching in which the teacher
simply conveys the knowledge to the students in a one-way channel of communication.
Lecturing can be an efficient means of introducing learners to new topics. It is used to

integrate and synthesize a large body of knowledge from several fields or sources and used to
clarify difficult concepts.
Advantages of the Lecture Method
● Having a specific period of time, it allows uniformity of knowledge to be learned

for all students in a class.
● It is economical and cost effective since only one is entrusted to deliver the topic.
● It helps develop students' listening abilities.
Disadvantages of the Lecture Method
● Few teachers are good lecturers who can deliver topics according to students'
level of understanding.
● By nature, the lecture method lends itself to the teaching of facts with little
emphasis placed on problem-solving, decision making, analytical thinking, and
transfer of learning.
● Not conducive to meeting students' individual learning needs since it is limited

only to a single approach of delivering the topic.
● Allows limited attention span on the part of the learner.
2. Discussion
Discussion retains some of the features of lecturing when the teacher still imparts the
lessons to the students through interaction. This time she gives them the opportunity to share
their insights or understanding of the topic. It may be formal or informal. It allows greater student
teacher interaction and or student to student interaction.
Discussion presupposes that the learners have already been introduced to a body of
information on which they can base their discussion. Its purpose is to give learners an
opportunity to apply principles, concepts, and theories, as well as clarify information and
concepts.
In a discussion approach, a topic is announced in advance and the class is asked to

take part in the discussion by reading a certain material or watching a videotape among other
activities.scy no
Advantages of the Discussion Method:
● Helps students learn the process of group problem solving.
● Supports students' ways to develop and evaluate their beliefs and positions.
● Can foster attitude change through understanding and allow students freedom to assert
their opinions or views hence, application of new knowledge takes place.
● Many students like and prefer this to other methods.
Disadvantages of the Discussion Method
● Students use more time to think and interact.

● Effective only in small groups.
● May not be an efficient way of communicating informative because sharing takes time to
settle specific topics for discussion.
● Useful only if the participants come prepared with the needed background information.
3. Question and Answer Techniques
The teacher initiates the learning process by asking students about their insights and
ideas regarding the subject matter. In this method, the teacher asks students what they
understand of the subject to determine what they have already learned and what they need to
learn.
Questioning is integral to teaching that is often taken for granted. Its use places learners
in an active role. It can be used to assess students' competencies and baseline knowledge to
find out what a group already knows about the subject in order to review its content.
Questioning can increase motivation of learners as it brings about eagerness to think

answers to questions asked. It can be used to guide learners' thought process and direct them
to a certain area of interest.
There are 7 types of questions, as follows:
● Factual questions. It demands simple recall or retrieval of information from observed

events.
● Probing questions. These are used when a teacher wants a learner to further explain an
answer, or dig deeper into the subject matter. Example: Reasons why fetal monitoring is
done during labor.
Teaching Strategies
● Multiple choice questions. These can be oral or written. They usually test recall of
learners and can be used to begin a discussion.
● Open-ended questions. These encompass all questions that require learners to
construct an answer.
Example: When should fetal monitoring be used?
● Discussion-stimulating questions. These are questions which help the discussion move
along for a clearer or better view of the subject matter. Example: What would be the
effect of fetal monitoring to both the mother and the fetus?
● Questions that guide problem-solving. The teacher needs to phrase and sequence
questions carefully in order to guide learners in problem-solving thinking process.
Example: What other options do we have aside from fetal monitoring?
● Rhetorical questions. It is sometimes appropriate to ask questions for which one expect
no answers at the time. Such questions can be used to stimulate thinking in the class
and may guide learners asking their own questions while studying a topic. What is used
as a rhetorical question in one session may become a source of discussion in a later
session. Example: In what way will fetal monitoring promote safe labor and/or predict
complications of labor?
It is important to note that the teacher should give some time for the learner to respond
to a certain question. Unexpected answers should not be rejected but rather processed by the
teacher until the learners have realized the acceptable answer.
4. Uses Audiovisual Aids
Using audiovisuals is traditional a reinforce teaching and method that can learning. It is
used as supplement to a lecture, as a prelude to discussion, or a part of questioning strategy
(Clark: 2008).
When used appropriately, audiovisuals can greatly enhance teaching and add to
students' interest and stimulates understanding of the subject matter in the classroom.
When not used appropriately, audiovisuals simply become time fillers and entertainment
which make learning insufficient or difficult
Types of traditional audiovisuals include:
● Handouts or printed materials used to help communicate facts, figures and concepts.
● Chalkboards or whiteboards are universally used in education and allow spontaneity in
classroom discussion.
● Overhead transparency is a sheet of acetate placed on overhead projector that enlarges
and projects the image onto a screen.
● PowerPoint slides are used to show words, concepts, for discussion, pictures or project
diagrams and charts.
● Videotapes are used to find meaning in case scenarios, biographic, clinical procedures,
or situations which the students need to reflect on to determine their relevance and
implications.
ACTIVITY-BASED TEACHING STRATEGIES
1. Cooperative Learning
In cooperative learning, students from one class are arranged into small groups to
facilitate the learning process.
It is based on the premise that Brainstorming learners help each other work together and
are responsible for not only their own learning but also for the learning of other group members
(Bradshaw and Lowenstein: 2007).
Cooperative learning involves
structuring small groups of learners who work together toward shared learning goals.
This may be done through brainstorming activities, demonstrations and return demonstrations
and group projects (Emerson: 2007).
The following strategies are examples of cooperative learning. These reading strategies are
considered to be very effective particularly in learning concepts in nursing.
● Jigsaw
● Think-Pain-Share
● Numbered-Heads Together
● Talking Chips
● Murder Script
Advantages of Cooperative Learning
● Group members learn to function as part of a team.

● Teaches or enhances social skills.
● Inculcates the spirit of team-building.
Disadvantages of Cooperative Learning
● Students who are fast learners may lag behind.

● Learning gap may exist between the fast and slow learners.
2. Writing to Learn
Writing to learn actively influences students' dispositions toward thinking and takes
active participation in learning. Writing serves as a stimulus of critical thinking by immersing
students in the subject matter for cognitive utilization of knowledge and effective internalization
of values and beliefs.
These activities include journal writing, journal papers, creative writing assignment,
research articles, paper critique, etc (Keating:2006).
"There is in nursing a power to create in a patient so strong a desire to live that

may become the one factor which decides the issue in the patient's struggle with
disease. The creative power of good nursing is vividly manifested to one who looks for
it."
-Mary Beard
3. Concept-mapping
Concept mapping lends visual assistance to students when asked to demonstrate their
thinking in a graphic manner to show interconnectedness of concepts or ideas. This helps
students see their own thinking and reasoning of a topic, to depict relationship among factors,
causes and effects. Students become more adept at creating and examining a map for
connections and using information (De Young: 2003).
4. Debate
Debate is a strategy that fosters critical thinking which requires in-depth recall of topics
for supporting evidence and for developing one's position in a controversial issue.
It encourages analytical skills, recognizes complex issues or concerns, permits students

to consider alternative options with freedom to change one's mind based on information, data
and enhances communication skills and listening skills.
5. Simulations
Simulations are practical exercises for the students representing controlled manipulation
of reality. These are exercises which learners engage in, to know the real world without the risks
of harm or injury and make learning enjoyable.
Simulations are intended to help learners in decision-making and problem-solving,

develop human interaction abilities and learn psychomotor skills in a safe and controlled setting.
They can be used to achieve various learning objectives. Simulations are used to evaluate
students' learning and competence.
There are four types of simulation techniques:
Simulation exercise. A controlled representation of a piece of reality that learners can

manipulate to better understand the real situation.
Simulation game. A game that represents real-life situations in which learners compete
according to a set of rules in order to win or achieve an objective.
Role-playing. A form of drama in which learners spontaneously act out roles through interaction
involving is problems or challenges in human relations.
Case study. An analysis of an incident or situation in which characters and relationships are
described, factual or hypothetical, events transpired and problems that need to be resolved or
solved.
6. Problem-based Learning
Problem-based learning is an approach to learning that involves confronting students

with real life problems which they are meant to solve on their own. It provides stimulus for
critical thinking and self taught content. It is based on the premise that students, working
together in small groups, will analyze a case, identify their own needs for information and solve
problems (Clark: 2008).
Table 2. Differences Between Problem-Base Learning And Simulation
PBL Simulation
● conducted in small groups. ● may be used by individuals ог groups.
● students using PBL have little ● Students using simulation have most
background knowledge of subject of the background knowledge they
matter. need to apply to the case.
● Cases are usually brief and problems ● Cases are usually brief and problems
are ill structured. are ill structured.
7. Self-learning Modules
Self-learning modules are completely doing away with traditional instruction. The student
is provided with the materials needed for the learning process without the intervention of the
teacher. They are also called self-directed learning modules, self paced learning modules, self-
learning packets, and individual learning activity packages.
Self-learning modules are done in a unit of nursing or instruction with a relatively low
student-to-teacher ratio, in which a single topic or a small section of a broad topic is studied for
a given period of time.
Components of a self-learning module consist of: introduction and instructions,

behavioral objectives, pretest, learning activities, self-evaluations, and post test.
COMPUTER TEACHING STRATEGIES
Computer teaching strategies are used to communicate information to students and

nurses in a time-saving way and to teach critical thinking and problem-solving process. These
provide simulations of reality, educate from a distance where students can study without going
to the school. They can provide instant feedback. which is effective in learning. They can also
individualize learning to an extraordinary degree time efficient and effective. However, they may
deprive students and teachers to interact and discuss topics face-to-face (Bradshaw and
Lowenstein: 2007).
a. Computer Assisted Instructions
Computer-based instruction (CBI) refers to virtually any kind of computer used in

educational settings including the following:
● drill and practice
● tutorials, simulations
● instructional management
● supplementary exercises
● programming and other applications
● database development
● writing using word processors
These terms refer either to stand-alone computer learning activities or to computer

activities which reinforce material introduced and taught by teachers.
Computer-assisted instruction (CAI) is a narrower term and most often refers to:
● Jasin drill-and-practice
● tutorial
● simulation activities offered either by themselves or as supplements to traditional,
teacher directed instruction
b. Internet
The internet is a worldwide and publicly accessible series of interconnected computer

networks that transmit data by packet switching using the standard Internet Protocol (IP). It is a
"network of networks that consists of millions of smaller domestic, academic, business and
government networks which together carry various information and internet based services,
such as electronic mail, online chat, file transfer, and the interlinked web pages, networking and
other resources of the World Wide Web or www (Wikipedia). In line with this is the proliferation
of online based "apps" and "social media" sites like Facebook, Twitter, Instagram, Youtube
among others, to disseminate information and serves as an alternative venue for sharing and
exchange of facts, experiences, opinions and ideas.
c. Virtual Reality
Virtual reality is a technology which allows the user to interact with a computer-simulated
environment, real or imagined. Most current virtual reality environments are primarily visual
experiences,displayed either on a computer screen or through special or stereoscopic displays.
Some simulations include additional sensory information such as sound through speakers or
headsets.
Simulated environment can be similar to the real world, for example, simulations for pilot
or combat training, or it can differ significantly from reality as in virtual reality (VR) games. In
practice, it is currently very difficult to create a high-fidelity virtual reality experience, due largely
to technical limitations on processing power, image resolution and communication bandwidth.
However, those limitations are expected to eventually be overcome as processor, imaging and
data communication technologies become more powerful and cost-effective over time.
Virtual reality is often used to describe a wide variety of applications, commonly
associated with its immersive, highly visual, 3D environments. The development of software,
graphics hardware acceleration, head mounted display, database gloves and miniaturization
have helped popularize the notion (Wikipedia).
DISTANCE LEARNING
This method includes computer learning and other ways of giving instructions to
students without the usual classroom setting, such as teleconferencing or use of telephone
techniques. It encompasses correspondence courses and courses delivered by satellite,
television and broadcasting, or telephone lines. It involves a two-way audio and video
technology (Bradshaw and Lowenstein: 2007).
Advantages in Distance Learning
● People from the rural areas or those who are homebound can have greater access to
information and even educational degrees.
● A larger variety of courses are accessible.

•Ability to learn on one's own time frame, the self-directed nature of the learning experience and
the opportunity to learn more about technology.
Disadvantages in Distance Learning
● There is lack of face-to-face contact or non-interactive process with the teacher.

● Technology problems which may be similar to systems shutting down and being
inaccessible.
● Some may not learn well with less structured educational experience.
● Others may struggle to use the technology while learning the content at the same time.
CLINICAL TEACHING
To improve and maintain a high standard of clinical instruction the teacher in nursing
should show academic excellence, concern and commitment. The future of nursing students
rests on the qualifications and competence of the nursing instructors (Emerson: 2007).
In developing a plan for clinical teaching, the learner's needs must be considered prior to
the formulation of course objectives and before the specific classroom content is developed.
Knowing the needs of students give direction for the teacher to develop a plan for teaching.
However, after the formulation of the program, course, and unit objectives, the instructor must
again evaluate student learning needs. The educator should do the following (De Young: 2003):
● Assess learning needs of students by pre-testing for incoming knowledge;

● Develop learning experiences based on desired results;
● Implement teaching strategies to meet learning needs; and
● Post-test students for outcome knowledge in planning for clinical teaching, the following
steps should be taken into consideration.
1. Diagnose student's needs, interest and abilities. This requires the necessity of
discovering the needs, interests and capabilities of students regarding the subject matter.
2. Set objectives and select content. It involves selecting learning materials appropriate for
the needs and interest of students and what they are expected to accomplish.
3. Prepare areas for learning and select appropriate teaching strategies. Once objectives
have been established, the teacher has to decide which clinical area and techniques will help
students achieve goals.
4. Plan instructional units and make lesson plans. This involves organizing information
about individual students objectives, materials, and techniques into a resource units that can
serve as reference for the teacher as she does her work from day to day.
5. Motivate students in guided learning activities. This involves techniques or ways by which
students may develop interest, desire to learn and planning interesting activities to achieve
desired objectives using appropriate techniques. This also includes measuring, evaluating or
grading student's performance and reporting student's progress.
6. Tasks that relate to plans focus on measuring, evaluating, grading and reporting
performance and progress. This involves development of student's plans for testing and
making judgments about students' performance. Actual evaluation should be part of each task
as a built-in mechanism to help modify previously prepared plans.
7. Put up plans for follow-up Lessons on materials that students have not learned well as
shown by the results of the evaluation should be followed up and monitored.
Clinical practice provides supplemental role to the knowledge learned or taught in the
classroom. In related learning experiences (RLE), students learn to apply theory and skills
conceptualized in the classroom and laboratory to real life situations, such as the following
1. Related Learning Experience (RLE) or Laboratory
RLE is an acronym for Related Learning Experience. This requires learning by doing.
Teachers guide students in acquiring knowledge and learning nursing skills. The teacher also
guides students in the formulation of nursing care plans and expectations upon completion of
the activity.
Related learning experiences take place in the laboratory, hospital, community, field
practice industry, schools, health care agencies, government and nongovernment organizations,
among others.
2. Models of Clinical Teaching
a. Traditional Model
The traditional model is the oldest and common model of clinical teaching. The clinical
instructor has the primary responsibility for instruction, supervision, and evaluation for a small
group of nursing students, usually eight to ten (8-10) students, and is on-site during the clinical
experience. The teacher selects clinical activities that best meet the students' needs and are
consistent with course goals and objectives (Emerson: 2007).
The clinical instructor has maximal control of both learning and evaluation. The instructor
presents both concepts and skills exactly as desired based on clinical focus and resource units
of concepts taken in the sense, classroom. They guide students' thinking and acting, assuring
accuracy and thoroughness. In a students are learning what they need to learn, at the level they
need to know it. Because of the direct instruction and supervision, when time comes for
evaluation, the faculty/clinical instructor theoretically has the needed information to provide the
best feedback for students.
b. Faculty directed Independent Experience Model
Faculty directed independent experience model is used in community-based settings

and to minimize the number of students requiring direct faculty supervision in acute or varied
settings. This is situated in large geographic area and the faculty are miles away from their
students, although remaining accessible through computer laptops and smartphones via chats
or online streaming, and making periodic visits to observe and interact with their students.
Examples of these are: school nursing clinics, out-patient, ambulatory care centers, day care
centers, orphanages, health care agencies, among others.
C. Collaborative Model
Collaborative models of clinical teaching address the fiscal issue concerning cost
associated with clinical instruction when student-faculty ratio is very high. This endeavors to
provide excellent role models of expert nursing practice. Hospital staff and clinical faculty share
the teaching role. Staff nurses also assumes the collaborative and preceptor role, hence, the
staff nurse must be knowledgeable about the nursing program and its curriculum, concepts to
be learned, procedures to be taught, teaching-learning strategies to be shared. methods of
evaluation and the theoretical foundations for clinical nursing education.
Following are Three Ways of Collaborative Teaching:

● Clinical teaching associate (CTA) model. Staff nurses work with the clinical faculty by
taking on certain functions with a predetermined number of students. They provide
students supervision while freeing the clinical faculty to fulfill other role obligations
(Stokes and Kost: 2005).
● Clinical teaching partner (CTP) model. A hospital-based clinical nurse specialist (CNS)
and an academic faculty member share in the management of a group of students in the
clinical setting. The CNS holds adjunct faculty an appointment with the academic
institution who should comply with clinical policies and procedures (Shah and
Pennypacker: 1992).
● Clinical educator/Paired model. This approach uses staff nurses but differ in the ratio
of students to educators. Student and clinical educator pairs are created. Faculty may
use this model on a 1- to 20- students per day basis with a selected number of students;
thus, freeing up time that can be used to work with other non-paired students (Stokes
and Kost: 2005). On the other hand, one faculty member may work with 8 to 10 pairs for
a full academic term. Faculty responsibility is to integrate theory and clinical practice,
cultivates deliberate reflection on practice problems and decision making and evaluates
students' progress in meeting defined goals (Roche: 2002).
d. Preceptor Model
An expert nurse in the clinical setting works with the student on a one-on-one basis.
Preceptors are staff nurses and other nurses employed by the clinical agency who can provide
on site clinical instructions for assigned students. The preceptor guides and supports learners
and serves as a role model.
Criteria for Choice of a Clinical Teaching Model
The following are the criteria in the choice of a Clinical Teaching Model
1. Educational philosophy of the nursing program.

2. Philosophy of the faculty about clinical teaching.
3. Goals and intended outcomes of the clinical course and activities.
4. Level of nursing students.
5. Type of clinical setting.
6. Availability of preceptors, expert nurses, and other people in the practice setting to provide
clinical instruction.
7. Willingness of the clinical agency personnel and partners to participate in teaching students
and in other educational activities.
TEACHING PSYCHOMOTOR SKILLS
Teaching psychomotor skills is another aspect of teaching which, in the nursing

environment, is vital considering the hands-on nature of the nursing practice. This is action-
oriented and requires neuromuscular coordination. It promotes patient healing and/or comfort
(Gaberson and Oerman: 2007).
Following are vital considerations in teaching psychomotor skills. This must be:
● Appropriate for the objective of the course;

● Adapted to the capacity of students;
● According to sound psychological principles, motivation and interest of the students;
● Appropriate to the teacher's personality and capitalize on her special assets; and
● Creative and stimulates students interest to learn.
OTHER TEACHING STRATEGIES
1. Peer review assignments. Posting assignments via email, bulletin board among others.
Peer review assignments encourage students' feedback on each other's performance.
2. Informal socializing. Assisting students having difficulty to learn through social

communication or informal discussion of topics with the group.
3. Student presentations. Develop students' understanding of materials and actively engage

them in learning process through reporting, simulations, role playing, among others.
4. Structure seminar. A more formal example of a public tutorial which requires strict structured
program for interaction and tight linkaging to modules on specific topics for discussion.
5. Public tutorial. Allows students to interact with the staff and other students outside the
classrooms.
6. Reflective journals. Allows students to give their insights and perspectives on current issues
and events and share these with others for open discussions.
7. Peer learning groups. Allows students to help one another with assignments, problem-
solving and projects through discussion and sharing of knowledge and experiences.
8. Role playing. Students assume roles on specific issues to assess and to solve problems on
such issues as well as interactive discussions. This can be used to apply and test knowledge in
simulated situations.
9. Previous discussions. Provide basis for recall and insights on the topics discussed or
experienced. This also provide examples of teacher expectations to students.
10. Special interest groups. Self-selecting groups who choose to meet to discuss issues which
interest them.
11. Exercise in communication. The use of unique communication tools to exercise or

experience non verbal or facial expressions.
12. Brainstorming. Feeding ideas with no editing, non evaluated responses, create a space to
exchange ideas but no one criticizes anyone's ideas.
13. Real World references. Relate subject content to recent events geared towards students'
understanding of concepts and phenomenon "personal truths" by relating to their own "everyday
experiences". Ideas move from theory to reality.
14. Guest Lecturers. Gives students access to resources which maybe difficult to obtain.
Different points of views will reenergize the group for more discussion.
15. Authentic tasks. Similar to simulations used by professionals, computer simulation if not
done in reality maybe due to lack of access as consequence of realities.
16. Socratic dialogue. To reach consensus of ethical values in moral issues. Begin with a well
formulated question eliciting responses from the student, then eliciting further questions. Usually
time consuming and the facilitator dominates.
17. Small group work on comparative learning. This is team wide, collaborative discussion,
set-up discussion groups. A systematic pedagogical strategy that encourage students to
CLASSROOM MANAGEMENT
This refers to the operation and control of classroom activities, the mechanical aspects
of handling classes such as classroom policies and regulations for seating arrangement,
attendance, handling instructional materials and equipment and discipline during the class
period. The teacher who can manage the classroom well provides students with opportunities
for mental growth and development (Gregorio: 1981).
Principles of Classroom Management
The teacher, in order to manage the classroom well, must be able to do the following:
1. Design classroom activities appropriate to the course content or subject matter.
2. Orient the students on the first day of class regarding the internal policies on punctuality,
behavior, course requirements and criteria for grading and evaluation.
3. Comply with administrative policies on handling of teaching aids or materials and equipment.
4. Allow adequate student-teacher interaction to arouse enthusiasm.
5. Be more positive and optimistic in dealing with students particularly in citing practical
examples of learning principles
.
6. Sanction for misbehavior should be more constructive rather than destructive.
7. Come to class or to the clinical area on time and prepared with resources unit or clinical focus
so students are properly guided and directed.
8. Present the learning expectations or the do's and don'ts of learning.
9. Demonstrate to students' desired behavior which she wants her students to imitate.
10. Develop a sense of familiarization in order that everyone in the class has a feeling of
belongingness in sharing the same values and goals.
MEMORY AID
1. Traditional Teaching Strategies
A. Lecturing
B. Discussion
C. Questioning
D. Audiovisual use
2. Activity-Based Teaching Strategies
A. Cooperative Learning
B. Simulations
C. Problem-based Learning
D. Self-learning Modules
3. Computer Teaching Strategies unang gab
A. Computer Assisted Instructions add

B. Internet
C. Virtual Reality
4. Distance Learning. Course delivered by satellite, computers, or

A. Includes computer learning and other ways of giving instructions to students without
the usual classroom setting.
B. Involves a two-way audio and video technology.
5. Clinical Teaching. Students learning experiences with actual patient care activities.
A. Related Learning Experience (RLE) or Laboratory requires learning by doing.

Teachers guide students in acquiring knowledge and learning nursing skills. The teacher
also guides students in the formulation of nursing care plans and expectations upon
completion of the activity.
B. Traditional Model is the oldest and common model of clinical teaching where the
teacher selects clinical activities that best meet the students' needs and are consistent
with course goals and objectives.
C. Faculty-directed Independent Experience Model is used in community-based settings

and to minimize the number of students requiring direct faculty supervision in acute or
varied settings.
D. Collaborative Model addresses the fiscal issue concerning cost associated with
clinical instruction when student-faculty ratio is very high.
● Clinical teaching associate (CTA) model

● Clinical teaching partner (CTP) model
● Clinical educator/Paired model
E. Preceptor Model is clinical teaching that includes an expert nurse in the clinical setting
who works with the student on a one-on-one basis.
6. Teaching Psychomotor skills. Action-oriented learning with neuromuscular coordination.
7. Classroom Management. Operation and control of classroom activities. The mechanical

aspects of handling classes such as classroom policies and regulations for seating
arrangements, attendance, handling instructional materials and equipment and discipline.
Principles of Classroom Management:
a) Design classroom activities.

b) Orientation of students.
c) Compliance with administrative policies.
d) Adequate student-teacher interaction.
e) More positive and optimistic dealing with students. f) Sanctions for misbehavior.
g) Come to class or to the clinical area on time and prepared.
h) Present the learning expectations.
i) Demonstrate to students' desired behavior.
j) Develop a sense of familiarization.
1. You are teaching nursing students in various levels of competency. How would you qualify
appropriate teaching strategies per level to ensure learning?
2. Why is teaching strategies important in affecting learning?
3. Explain the difference between clinical teaching and classroom teaching.
PRACTICE TEST
1. What is the most traditional method associated with teaching in which the teacher simply
conveys knowledge to the students in a one-way channel of communication?
a Lecturing
b. Discussion
c. Questioning
d. Using Audiovisuals
2. The teacher initiates learning by sharing the lesson with the students through lecturing and
discussion of their insights and ideas. Which strategy is used?
a. Lecturing
b. Discussion
c. Questioning
d. Using
3. Which one retains some of the features of lecturing in that the teacher still imparts lessons to
the students through instruction? This time he or she gives them the opportunity to share their
insights or understanding of the topic, may be formal or informal.
a. Lecturing
b. Discussion
c. Questioning
d. Using audio-visuals
.
4. It is a way of teaching that can supplement other methods. Which one can be used as an
integral part of the lecture, or a prelude to discussion or part of a question.?
a. Lecturing
b. Discussion
c. Questioning
d. Using audiovisuals
5. Which strategy of learning is used when students are arranged into small groups to facilitate
the learning process?
a. Cooperative learning
b. Simulations
c. Problem-based learning
d. Self-learning modules
6. Which strategy of learning use practical exercises for students which show controlled
representations of reality?
b. Simulations
7. What is an approach to learning that involves confronting students with real-life problems
which are intended to solve on their own?
b. Simulations
8. It is completely doing away with traditional instruction. Which method is used when, the
student is provided with needed materials for the learning process without intervention?
b. Simulations
d. Self learning modules
9. It is a worldwide, publicly accessible series of interconnected computer networks that transmit

data through packet switching using the standard Internet Protocol (IP). Which technology is
used?
a. Virtual reality
b. Computer assisted learning
c. Internet
d. Distance learning
10. Which technology allows the user to interact with a computer simulated environment, real or
imagined?
a. Virtual reality
b. Computer assisted learning
c. Internet
Chapter 7 : BARRIERS TO EDUCATION
The ultimate measure of a person is not where one stands in moments of comfort
and convenience but where one controversy." stands in times of challenge and
-Martin Luther King, Jr.
● Discuss the different barriers to education;

● D Explain various obstacles to effective learning; and
● Differentiate between generational factors that can affect learning.
BARRIERS TO EDUCATION
Education demands a healthy environment conducive to effective assimilation of

knowledge and skills learned. However, some forces or barriers may exist to prevent or reduce
the students' ability to avail of their right to quality education.
Barriers to education can take a variety of forms. They can be physical, technological,
systemic, financial, or attitudinal, among others. The following appear to be the main barriers to
education concerning students, teachers and institutions.(Breckon: 1994):
1.Student Factors
a. Physical Disability
Students with disabilities continue to encounter physical barriers to educational services,
such as lack of ramps and/or elevators in multi-level school buildings, heavy doors, inaccessible
washrooms, and or inaccessible transportation to and from school, Students at the tertiary level
also experience difficulty in securing accessible students housing, communication.
transportation, facilities, and
b. Negative Attitudes and Stereotypes
Students with disabilities continue to face the negative attitudes of teachers and students
and stereotypes in the educational system. Lack of knowledge about and sensitivity to disability
issues on the part of some educators, staff and students make it difficult for students with
disabilities to cope, adapt and access educational services equally well.
c. Poverty
Sending students to school may result in the loss of family income or help at home. The
school may charge fees that the family cannot afford to meet such as requiring a uniform or
projects, and other contributions to school affairs that are beyond the family budget. When a
choice is to be made between sending a girl or a boy to school, the family puts its scarce
resources for the education of the girl or boy, believing that it is a better, long-term investment.
d. Students' Capabilities, Personal Beliefs, and Values.
Genetics and culture affect to a certain extent, the educative process. Students' genetic
endowment and cultural background termine the extent of substantive or curricular
comprehension and retention which may pose challenge to teachers, the school administrators
and the standards of education.
e. Students are More Likely to Drop out of School if Schooling is Irrelevant to Realities.
There is need for relevant curricula and materials for literacy and numeracy, along with
"facts and skills for life," which include education on rights, gender equality, health, nutrition,
sexually transmitted diseases (STDs like HIV/AIDS) and peace.
Hence, girls face more challenges when it comes to choice of a career which pose
economic implications to self, family and community. Females are generally absent, or
portrayed stereotypically in lessons. This is particularly true in areas traditionally regarded as
male dominated.
2. Institutional Factors
a. Inadequate Physical Facilities and Funding
Education is constrained by lack of adequate support and funding from educational

agencies and facilities in relation to the number of students admitted. The burden is greater
when there is also lack of library and laboratory facilities for student learning.
b. Philosophy, Vision, Mission of Schools
Schools have their own values, beliefs and practices regarding teaching and learning.
Schools may or may not adhere to the standards of education set by the state and the
accrediting body, hence students may leave school either well prepared or less prepared to face
the responsibility of working for a living.
c. The Legal Framework around Education can be Weak
Compulsory and or "free" education laws may not exist, or if there is one, it may not be
well enforced. Early marriage and pregnancy are widespread in many countries, yet most have
laws and policies that prohibit pregnant girls from attending school or returning to school after
the birth of their child. Worldwide, an estimated 50 million children are not registered at birth,
and the majority are female. This could mean that the lack of a birth certificate can prevent
admission of the child from school or eligibility to take examinations.
d. Issues of Safety and Security Inside and Outside the block School.
Parents may less likely allow their daughters to travel long distances to school because
of risks to their personal safety.
Physical violence in schools, particularly bullying and corporal punishment, affects boys
and girls. Girls are more likely to be victims of sexual violence, including rape.
The traditional gender divisions of labor are mirrored in school Girls may be made to do
school maintenance tasks at the expense of learning, and at times, are denied of physical
activities and exercises
There may not be adequate (or any) hygiene and sanitation facilities on or near school
premises. This can present a major problem particularly for adolescent girls.
The lack of female teachers, particularly as role models and possible confidantes, can
make female pupils feel less secure in the school environment.
Gender-based violence, including rape and early pregnancy, forced marriage and the
spread of HIV are among the problems for girls in refugee camps and schools.
Students in crisis and unstable situations are often denied their right to education when
they need the routine of schooling the most.
e. Accountability Movement
This movement seeks to hold schools, teachers, and students responsible for learning.
This may limit the ability of schools to meet societal standards due to external pressures and
intense expectations which may weaken the system.
f. Perceived Lack of Support
Some people oppose health education, particularly in schools. Some organizations may
distort the nature of health education, accusing the programs of destroying values developed at
home, encouraging promiscuity, and undermining religious training. Insufficient financial support
hinders health education programs.
3. Teacher Factors
a. Teachers' Qualifications and Values
Plog A Education is also constrained by the ability of the teacher to teach in terms of her
personality traits and values, professional behavior and her outlook in life and in teaching
(Gaberson and Oerman: 2007).
b. Knowledge, Skills and Values of the Teacher
Intellectual capabilities of teachers facilitate cognitive learning and stimulate students'

psychomotor process. Skills in teaching, manage students' creative imagination and promotes
psychomotor development. The teacher's professional values, promotes student ideals of
achievement and scholastic mastery. Lack of these in teachers could lead to intellectual
numbness and poor academic performance among students.
c. Inadequate Professional Preparation
Educators are often expected to teach health without any college coursework in the
discipline. Quality of teaching often suffers, despite no shortage of professionally prepared
health educators. This is a result of the "anyone can teach health" misconception and the lack of
administrative commitment.
d. Lack of Certification
Although many states mandate health instruction in schools, many do not require
instructors to be certified health educators. Locally however, teachers in nursing education
particularly those
handling professional courses are obliged to undergo extensive training and must be
skilled certified by an accrediting body before they are allowed to teach major nursing courses.
This skill certification requirement is an addendum to the Nursing Law (RA 9173) provisions
which require nurses to be holders of a Master of Arts in Nursing degree before they are given a
tenured status as faculty members in a college of nursing.
e. Encroachment of Other Discipline
Other disciplines have made significant inroads into the functions claimed by health
educators. This can be beneficial if those involved are willing to share responsibilities, expertise
and diverse approaches so representatives of different professions can collaborate effectively.
GENERATIONAL DIFFERENCES
Teaching and learning are very much influenced by the kind of generation a learner
represents. This is so because of the social and technological factors that emerge in that
particular time. Following are generational differences in relation to teaching and learning.
1. Baby Boomers (Current Workforce)
The end of World War II, social factors and experiences in life influence each generation.
Baby Boomers can be used as baseline to compare other generations. Baby boomers
experienced the development of slower peace hence, they are comfortable with delayed
gratification (Darling: 2002) but they want positive feedback because of their desire to do well.
Technology and education are overwhelming to this generation since it is not part of their early
educational experience.
As students, boomers usually need assistance in learning how to use computers and are
pressured by activities which require access
to web-based resources (Billinger: 2004). Baby boomers are more comfortable with traditional
pedagogy and expect teachers to do everything for them. They do not challenge the teacher.
The more structure the better for these boomers. However, they exert and answer responsibility
for their own learning. They strive for a permanent career on the same institution, with
organizational loyalty and commitment and expect financial remuneration and recognition
(Darling: 2002).
Baby boomers comprised the extended workforce. They are the dominant generation in many
practices today.
2. Emerging Workforce: Generation X
Men and women born between 1961to 1981 comprise generation X and are known as
the emerging workforce. Generation Xers are different from Baby boomers as they have grown
up to be the latchkey kids of working parents or single parent household. They have developed
high level of independence. When parent comes home, they became the center of attention,
consequently they developed high self-esteem seen by some as arrogance. They are creative
problem solvers but lack basic math skills and reading capabilities (Darling: 2002).
Characteristics of Generation X (1961 to 1981) (Adapted from Emerson: 2007)
● Independent self-serving learners

● Technologically liberal and dependent
● Excel at multitasking
● Adapt well to change
● Want flexibility, autonomy, and options on learning life
● Lack interpersonal skills
● Impatient with processes, outcome-oriented
● Expect immediate gratification bra
● Desire to be trusted for work performed
● Desire fun and balance of work and personal life
● Want to be lead, not managed
● Value money and material goods
● Daring and expect to be challenged
3. Newest Generation: Net-Gen , Generation Y or Millenials
Those are born after 1981 which is remarkably different from Baby boomers and
Generation X. They have tendency to focus on technology, social action, and globalization. They
are seemingly curious and creative, collaborative, intelligent, mobile, self-sufficient and power
strong. The net generation or millenials are said to comprise the ideal work force since they
embody some of the most positive attributes from their predecessors (Murray: 2004). They are
the generation to grow up in an entirely digital technological environment such as laptop
computers, digital cameras, smart phones, 3d printing, drones, holograms, and other gadgets
with access to the internet's worldwide network of communication and information resources.
This generation express their experiences, opinions, comments, ideas through the so-called
"social media" and other online apps like Yahoo, Google, Youtube, Facebook, Twitter,
Instagram, Web blogs and they are frequently referred to as "netizens". They are called "bathed
in bits" and totally unintimidated by technology.
Characteristics of the Net-Generation/Millenials (1981-2000 above) (Adapted from

Emerson: 2007)
● Technologically addicted
● Social inclusion and globalization
● Enhance diversity
● Curious and creative
● Possess a strong work ethic
● Collaborative team player
● Highly mobile
● Highly intelligent
● Optimistic
● Self-sufficient and assertive
● Respect and admire their parents
● Rule followers
● Anticipate multiple career changes
Implications of Generational Differences
The teacher of nursing must have the ability to personalize her approaches to students
in a learning environment which can contribute to the quality of teacher-student relationship and
for the overall value of the learning experience.
Ways of considering generational differences in teaching include:
1. Personal awareness of each faculty members;

2. Technological competence through training and assistance if available, to align self with the
three generations;
3. Design specific learning activities to motivate the students to learn best what their perceptions
and expectations about their career;
4. Computer and technology expertise, comfort with group and communication skills;
5. Encourage use of electronic media such as computers and portable references;
6. Talk about flexibility and variability of experiences and assignment;
7. Encourage balance from the beginning and let students identify the commitment outside the
school and what they can do to reduce stress;
8. Spell out expectations clearly for better understanding;
9. Develop general plan for providing feedback and discuss expectations;
10. Clarify use of technology;
11. Indicate sitting time with active time; and
12. Inject fun whenever appropriate.
MEMORY AID
1. Barriers to Education
a. Student Factors
● Physical disability
● Negative attitudes and stereotypes
● Family poverty
● Students' capabilities, personal beliefs and values
● Students are more likely to drop out of school if irrelevant to their needs and
realities.
b. Institutional factors
● Inadequate physical facilities and funding

● Philosophy, vision, mission of schools
● Legal frameworks around education can be weak.
● Issues of safety and security in and around school particularly affect girls.
● Accountability movement
● Perceived lack of support
c. Teacher factors
● Teachers' qualifications and values

● Inadequate professional preparation
● Lack of certification
● Encroachment of other disciplines
2. Generational Differences
a. Current workforce - Baby boomers

b. Emerging workforce - Generation X
c. Newest Generation - Net Gen/Millenials
1. There are several factors affecting students learning. How do student factors, institutional and
teacher factors limit learning abilities of students?
2. Compare and contrast the three (3) generations of learners.
3. As nurse educator, how will you prevent or limit barriers to learning? Cite situations or
examples to prove your point.
PRACTICE TEST
1. Which one refers to lack of adequate support from educational agencies and facilities in
relation to number of students admitted?
a. Inadequate physical facilities and funding

b. Physical disability
c. Family poverty
2. Which one refers to a situation wherein students stop going to school due to physical
disabilities?
a. Inadequate physical facilities and funding

b. Physical disability
c. Family poverty
3. Parents are less likely to allow their daughters to make their journey to school due to risks to
their personal safety. What are the parents concerned of?
a. Philosophy, vision and mission of the schools.

b. Students' capabilities, personal beliefs and values.
c. The legal frameworks around education can be weak.
d. Issues of safety and security in and around school particularly affect girls.
4. Schools have their own beliefs and practices regarding teaching and learning. Which one
refers to this?
a. Teacher qualifications and values.

b. Philosophy, vision, mission of the schools.
c. Students' capabilities, personal beliefs and values.
d. The legal frameworks around education can be weak.
5. What is constrained in education when the ability of the teacher to teach is affected by his or
her personality traits and values, professional behavior and outlook in life and in teaching?
a. Family poverty
b. Teachers' qualifications and values
c. Philosophy, vision, mission of schools
d. Students' capabilities, personal beliefs and values
6. Which one refers to the generation of learners who developed a high level of independence
but are sometimes seen as arrogant, creative and with high self esteem?
a. Baby Boomers
b. Generation X
c. Net Gen/Millenials
d. Old Generation
7. The teacher must be able to assess generational differences among learners. Which one is
the least to consider ?
a. Teacher awareness of student capabilities.

b. Motivate students by designing specific learning activities appropriate to their needs.
c. Discuss expectations and provide feedback.
d. Limit flexibility and variability of assignments.
8. Which among the barriers to education refers to genetics and culture affecting
comprehension and retention of knowledge learned?
a. Student factor
b. Institutional factor
c. Teacher factor
9. What is the least intellectual capability of teachers that facilitates the students to learn?
a. Cognitive learning
b. Psychomotor skills
c. Scholastic mastery
d. Intellectual numbness
10. Which of the following is a requirement for teachers in nursing education to teach locally,
only if they are?
a. Holders of a Bachelor degree

b. Underwent skills training and certified
c. Develop personal intent to teach
d. Invited by the school administration to teach
Chapter 8 : CURRICULUM PLANNING AND CONDUCTING CLASSES
"The work of nursing is difficult and exacting, and demands much practical
knowledge. The almost lack of such knowledge or training of any kind... renders it
impossible for us to teach in short time all that students should know."
-Emma Louise Warr

● Discuss curriculum planning and development;
● Explain the various purposes of the curriculum;
● Describe factors which can influence curriculum development;
● Differentiate types of curriculum preparation;
● Describe unitary teaching and unit teaching;
● Explain the elements and purposes of the daily plan;
● Describe the steps needed to develop a class plan;
● Explain the various criteria for selecting a textbook;
● Describe how to conduct a class; and
● Discuss the importance of evaluation.
CURRICULUM PLANNING AND DEVELOPMENT
Curriculum refers to a planned set of learning experiences that the educational institution
intends to provide its learners. Choices and decisions in the development of a curriculum is
based on the sociocultural, technological and economic changes in society as well
140-141
the criteria for the evaluation of the aims and purposes of the curriculum (Clark: 2008).
2. Educational Psychology
Educational psychology refers to the science which develops learning through

experimentation. It provides data from which the principles of learning are developed.
3. Society
Society serves as an important guide in the selection of educational objectives and the
development of the curriculum in nursing. Since people are the end-users of the product of the
curriculum, it makes sense that they respond to educational goals and objectives which also
serve as the source of efforts to revise, refine, or change the curriculum.
4. Students
The curriculum recognizes the importance of the individual needs of students as

persons. This includes the needs of the community from where the teaching learning process
takes place and the needs of the discipline through which the learners are to be trained and
developed.
5. Life Activities
Life activities refer to personal activities in which students engage information as a nurse
and as an individual. These activities include the following:
● Professional - activities specific to one's chosen career.
● Family -her role as a member of the family.
● Civic -her duty as a citizen.
● Leisure-her personal activities without responsibilities.
● Spiritual -her activities which relate to her creator or religious beliefs.
6. Knowledge
Ways of acquiring knowledge through the curriculum are identified in relation to two
roles: that of the "onlooker" and that of the "participant".
The onlooker is the individual who needs background knowledge to understand the
principles from a particular field of study or inquiry. The participant is a scholar of a particular
discipline who needs more mastery of the field where the curriculum is developed (Clark: 2008).
TYPES OF CURRICULUM PREPARATION
1. Foundational
Foundational preparation includes the liberal arts program which leads to the personal
development of the student. It provides principles in the basic disciplines upon which nursing
courses are formulated or built.
2. Professional
These are major courses in nursing and related fields including theoretical and related
learning experiences. These courses are specific to the nursing discipline which helps guide
and direct students in the acquisition of knowledge, skills and values to carry out their roles and
responsibilities as professional nurses.
144-145
ELEMENTS OF GOOD DAILY PLANNING
1. Course objectives. The plan should state clearly the desired outcomes to be achieved.
Objectives must be student centered and focused on terminal behavior desired to be achieved.
2. Related to previous work. The plan should relate each class session to the previous work of
the course. This serves as basis for coherence, consistency and continuity in the presentation of
the course or subject matter.
3. Selection and organization of the subject matter. The plan should provide for selection and
organization of the subject matter or its content, the knowledge component, and materials to be
used, such as textbooks, references and online resources.
GUIDEPOST FOR THE DEVELOPMENT OF THE DAILY CLASS PLAN
1. A Guide, Not a Crutch
The daily plan should serve as a guide for activities to be taken up for the day that will
make the student work together to achieve specific behavior change.
2. Continuous Growth
The daily plan should be the basis for continuous improvement and development of
teacher and student activities. It should not be used over and over again with the same content
but rather revised or modified according to the current trends or issues in the discipline.
3. Special Work
It should provide for students who need special projects considering individual
differences.
4. Daily Class Plans
These are specific activities consistent with the day's teaching objectives that should be
covered, so no topics are missed. There is a corresponding time allotted with specific reference
and evaluation materials.
5. Enthusiasm
The plan should arouse enthusiasm and motivation for the teacher and learner. Both
should share the same process and outcome objectives for the continuing improvement of
individualized learning.
SAMPLE CLASS PLAN
Title of Course Unit : Fundamentals of Nursing

VII Time Allotment: : Observation of Signs and Symptoms
18 hours Class : The Cardinal Symptoms: Temperature
1. Objectives of the Class:

A.
Central Objective: The student will acquire knowledge pertaining to vital signs by taking the
body temperature by axilla and to interpret and record results accurately.
148-149
● The cognitive domain which measures knowledge, comprehension, application, analysis,

synthesis and evaluation using oral tests.
Example: The learner decides how much insulin to take depending on the amount of
carbohydrate consumed.
● Psychomotor domain, measures the actual performance (skill) in doing a nursing

procedure where the learner can demonstrate what he or she has learned.
Example: The learner mixes two types of insulin in one syringe correctly.
● Affective domain, measures beliefs, attitudes, and values regarding the course given.
Example: A student accepts the responsibility of identifying his own learning needs.
c. Selecting content. Course content is usually prescribed in the curriculum. The teacher
provides the course description to guide her what to teach. The teacher has the discretion of
determining exactly what to include or exclude on a particular topic.
d. Organizing content. The course content must be designed and structured in a logical
sequence. A teacher can move from generalizations to specifics or vice versa. Lecture
discussion of topics must be prepared and organized in order to proceed smoothly and facilitate
clear understanding of the subject matter.
Example: Start a pre-op class for patients by talking about the effects of general anesthesia and
then, mention examples of anesthetic agents.
2. Select teaching methods.
Deciding which teaching method to use is not easy. Weston and Crenton (1986) believe
that the selection of teaching methods is one of the most complex part of teaching. The teacher
is faced with the dilemma of which strategies are the most appropriate way to teach a particular
topic. There are several factors to consider in the choice of the best teaching method to use (De
Young: 2003).
a. Objectives and the type of learning the teacher is trying to achieve.

Example: If the teacher wants to develop attitude, case study or role-playing may be
used.
b. Course content. The sub-feature and informative context of the subject matter to be taught
specific to what the students must learn.
Example: Ethical aspects of euthanasia could be handled through discussions or

audiovisuals.
C. Abilities and interests of the teacher. The teacher's comfort in teaching the topic that will
capitalize her strengths and personality.
d. Compatibility between teachers and teaching methods, between learners and learning
methods. Awareness of capabilities and background knowledge regarding the subject matter.
e. Number of students in the class. Having ten (10) learners versus thirty (30) learners will
obviously affect the way teachers teach. With small groups, cooperative learning can be
effective. Larger groups can have lectures, audiovisuals or case studies.
f.Educational resources available in an institution. Adequacy of classroom size, furniture,

lighting, ventilation,
152-153
19. Stay in one place or move once in a while rather than moving too fast around the room. Be
aware of your words, behavior or mannerisms.
20. Do not expect a student to look in more than one place at a time. Students' perceptual
ability is still limited only to what was learned. Allow students to grasp situations one step at a
time for gradual understanding and retention of knowledge imparted while staying focused on
the relevant matters that must be learned.
CRITERIA FOR TEXTBOOK SELECTION
One of the major sources for learning are textbook materials which help enhance or
strengthen the abilities of students to understand the subject matter. Textbooks provide specific
explanations and rationale of a particular topic. Theories and principles coming from previous
researches are all contained in the textbook. Thus, teachers must be able to select the best
textbook that are simple and meaningful which provide concrete explanations so students or
students can read and understand the subject matter thoroughly.
Following are basic guidelines in the selection of textbook materials for use of students:
1. Authoritative and Reliable. The author is well-prepared specialist, with a high degree of
academic achievements and broad experience in the field in which the textbook is written and
has a local and global perspective of issues and trends about the subject matter.
2. Revised Periodically For Updating Purposes. Textbooks must stay current. They should be
revised and refined consistent with the socio-technological needs and trends.
3. Mechanical Factors. A book should be presentable, legibly printed, is of appropriate size,

paper quality and available at a reasonable cost.
4. Purpose and objectives of the subject matter presented in the book should be well
explained and evident in the preface and introduction of the book. The book must be well
written in simple grammar, easily understood, coherent and consistent in its sequence of
presentation. There should be brief, concise and vivid discussions of meaningful events with
logical interconnection of topics to other themes and principles. This will help learners develop
understanding of sources of knowledge and generate ideal reflections of the subject matter in
line with the goals and objectives of the course.
5. Content. Textbooks should contain substantive information specific to the field of study for
validity and reliability.
Textbooks must be:
● Well organized and easy to understand;

● Scholarly in style and words used;
● Correlated with other courses in the curriculum; and
● Adequate in teaching and learning aids such as glossary, indices, table of contents,
references, illustrations, questions, problems and the like.
IMPLEMENTING TEACHING PROGRAMS
The skills of the teacher in the classroom and in students' related learning experiences
(RLE) are very crucial to student learning. Different teaching skills are needed depending on the
level of the student, the demands of the situation, and most importantly, the educational
philosophy of the teacher and the nursing program. Considering all teaching tasks, Emerson
(2007) posits that the teacher must be able to facilitate understanding of the goals of the
program together with the students and the client in a learning environment.
Both are engaged in a teaching and learning process each will be affected differently
and responds in ways students perceive and understand what is being taught to them.
The responsibility of the teacher is to prepare all student participants in the session and
to observe them sensitively during the process in anticipated environmental complexities. The
aim of clinical teaching is patient care and nursing efficiency. Students are learners and not
employees. Hence, learning takes precedence over the nursing task to be done and the
learning of students while doing the task is of paramount importance (White and Ewan: 1997).
Students must first be taught what specific needs and problem areas they need to attend
first. Prioritizing patient care needs is necessary for students to understand that patient safety
and security in terms of life-saving measures is the primary concern of nursing practice.
Following are examples of patient education programs specific to each developmental

stage.
1. Patient Education for Women
Consider the woman's role in the particular culture and her role in the community to
identify and highlight important patient education areas. Consider patient education on:
a. Pregnancy;
b. Childbirth;
c. Postpartum behavior;
d. Physical changes during and after pregnancy;
e. Child rearing; and
f. Family planning.
2. Patient EducationAdolescents for withFamilies
Conduct Home, Education, Alcohol and other drugs, Depression, Sex, and Suicide (HEADSS)
assessment.
Consider patient education on:

a. Personal hygiene;
b. Proper nutrition and lifestyle;
c. Effects of alcohol;
d. Effects of drugs; and
e. Sexually transmitted diseases (STD).
3. Patient Education For Senior Citizens
● Assess senior citizens for:
a. Depression,
b. Physical injury,
c. Loss of prestigious employment,
d. Status, and
e. Inability to sleep or problems with recurrent nightmares.
EVALUATION OF TEACHING AND LEARNING OBJECTIVES
These refer to changes in behavior expected as a result of selective learning

experiences. The purpose in educational objectives is to effect certain desirable changes in
student behavior.
The evaluation methods should be based on learning objectives focusing primarily on

knowledge, skills, personal and professional attributes that students have acquired from the
teaching and learning process. This is done through giving test, behavioral evaluation, or
graded assignments. (See Chapter 14 for the detailed discussions on evaluation.)
All teachers need to determine from time-to-time whether their teaching-learning

objectives are adequate which calls for periodic evaluation. The very act of choosing or rejecting
or even keeping an objective is an act of evaluation. Keating (2006) asserts that
evaluation defines the quality of learning experiences derived from teaching. A certain
degree of excellence must be achieved consistent with the standards by which learning is
measured compared with consumer expectations.
Evaluation of the adequacy of teaching and learning activities need to be part of the
teaching principles hence, the following must be taken into consideration:
1. Examining performance of students in various sessions. This can identify strengths and
weaknesses with respect to specific teaching-learning aims, suggests stronger or
diminished emphasis, or objectives. elimination of the aims or
2. Asking whether each teaching aim is reasonably attainable. Objectives may have to be
adjusted to meet the needs of different groups of students.
3. Considering the adequacy of students' prior knowledge and skills in relation to the
present course discussed.
4. Determining whether all of the stated teaching-learning objectives are realistic and
attainable.
A TASK FOR YOU:
1. Develop a patient education program in a specific area of interest.

2. Conduct a class with a specific group of learners considering the following:
a. Planning sequence.
b. Select a teaching method.
c. Prepare an outline.
d. Implement the program.
e. Evaluate the program.
MEMORY AID
1. The Value and Purposes of a Curriculum
a. Intellectual development is conceived as mastery of subject matter for the main

purpose of building a storehouse of information, skills and values.
b. Intellectual development is conceived as directed toward the development of the

process itself. Mastery of subject matter in and of itself is secondary; it serves as a
resource for activities such as problem-solving, creative thinking, among others.
c. Intellectual development depends on the development of all aspects of personality.
d. Intellectual development for effective functioning in all areas of living is important to

life.
2. Factors Influencing Curriculum Development
a. Philosophy of Nursing Education

b. Educational Psychology
c. Society
d. The Student
e. Life Activities
F. Knowledge
3. Types of Curriculum Preparation
a. Foundational. It provides principles from the basic disciplines upon which the nursing
courses are built.
b. Professional. Includes courses in nursing and related fields.
4. Unitary Teaching
Unitary teaching is a teaching method aimed to facilitate and develop unitary learning
specific to what should be learned and expected or desired output.
5. Characteristics of Unit Planning and Teaching
a. Recognizes that learning takes place most effectively in terms of "wholes" rather than
of fractions.
b. Recognizes that learning is developmental.
c. Recognizes that learning takes place most effectively when there is an understanding
and acceptance of goals to be achieved and when there is full and free participation in
planning for the attainment of these goals.
d. Sees the need for providing measures recognizing individual the learner differences.
e. Recognizes that effective learning renders increasingly skilled in self-direction.
f. Provides a sound basis for evaluation.
6. Types of Unit Plans
a. Subject-matter units - emphasis is on the assimilation of knowledge.
b. Process units - emphasis is on the learner.
7. Daily Plan or Teaching Plan Defined
It is a plan that helps organize each class sessions and relates these to the development
of the total unit of work.
8. Purpose of the Daily Plan
To guide the teacher in the pursuit of teaching objectives and activities.
9. Elements of Good Daily Planning
a. Objectives. Embody the statement of outcomes to be achieved.

b. Relates to previous work. It is a continuation of previous work.
c. Selection and organization of the subject matter.
d. Should provide for the selection and the organization of subject matter.
10. Development of the Daily Class Plan
a. A guide, not a crutch

b. Continuous growth
c. Special work
d. Daily class plan
e. Enthusiasm
11. Criteria for Textbook Selection
a. Authoritative and reliable.

b. Revised periodically for updating purposes.
c. Mechanical factors.
d. Purpose and objectives of the book should be evident in the preface and introduction.
12. Implementing Teaching Programs:
a. Patient Education for Women

b. Patient Education for Families with Adolescents
c. Patient Education for Senior Citizens
13. Evaluating Teaching and Learning Objectives
a. Evaluates student performance in various sections.

b. Asking the question as to whether each aim is reasonably attainable.
c. Considering the adequacy of students' prior knowledge and skills to the course in
question.
d. Determining whether all of the stated teaching-learning objectives are in reality
being attained.
1. How is curriculum planning and development attained? Cite a philosophical view which you
think will answer the present educational needs of society.
2. Differentiate unitary teaching from daily planning.
3. What do you consider in planning and teaching in the classroom and RLE of students?
PRACTICE TEST
Directions: Read each question carefully and encircle the letter of the BEST answer
1. Which of the following is the least purpose of curriculum?
a. Intellectual development is conceived as a mastery of subject matter primarily for

building a storehouse of information, skills and values. b. Intellectual development is
directional which strengthens
critical thinking, problem-solving, and decision-making skills. c. Intellectual development

promotes all aspects of personality formation and transformation.
d. Intellectual development for selective functioning in all areas of living is important.
2. Which of the following factors have the least influence in curriculum development?
a. Philosophy of nursing education

b. Educational psychology
c. Society
d. The patient
3. What types of curriculum preparation which provide principles from the basic disciplines upon
which nursing courses are based?
a. Foundational
b. Professional
c. Principal
4. What method of teaching is planned to facilitate and attain unitary learning?
a. Unitary teaching
b. Unit teaching
c. Course teaching
d. Class teaching
5. Which of the following are the least characteristics of unit planning and teaching, which
recognizes that?
a. Learning takes place most effectively in terms of "wholes" rather than of fractions.
b. Learning is developmental.
c. Learning takes place most ineffectively when there is an understanding and
acceptance of goals to be achieved and when there is full and free participation in
planning for the attainment of these goals.
d. The necessity for providing for individual differences.
6. What types of unit plan which emphasizes the assimilation of knowledge?

a. Assimilation unit
b. Subject-matter units
c. Process units
7. What type of unit plan whose focus is on the learner?
a. Assimilation unit
b. Subject-matter units
c. Process units
8. Which one helps organize each class session and relates it to the development of the total
unit of work,?
a. Curriculum
b. Daily plan
c. Course outline
d. Syllabus
9. Which of the following states the outcomes to be achieved in learning?
a. Objectives
b. Related to previous work
c. Selection and organization of the subject matter
10. Which of the following is the least criteria for textbook selection?
a. Authoritative and reliable

b. Revised periodically for updating purposes.
c. Mechanical factors
d. Purpose and objectives of the book should not be evident in the preface and
introduction.
Part II
THE LEARNING PROCESS
Chapter 9 : Determinants of Learning
Chapter 10 Motivation in Learning

Chapter 11 The Learning Process
Chapter 12 Learning Practice Theories and Health
Chapter 13 Communication in Teaching and Learning Evaluating a Teaching Program
Chapter 14 What is a good nurse?
... A good nurse should be knowledgeable, honest in her with others, responsible and
compassionate... treat the patient with respect, enhance the patient's personhood,
nurses bring forth knowledge and skills and a responsible quality of presence to the
patients' bedside."
-Sister Rosemary Donley
A Task for You:
As a student of a nursing program, cite situations where you were motivated to learn. Cite
specific things to explain that situation.
Look at how communication process take place in your related learning experience. Present a
model to show the flow of communication in order for learning to occur.
Recall the way your teachers evaluate student performance, compare them with the
standards of evaluation.
Chapter 9 : DETERMINANTS OF LEARNING
"What we need is energy of purpose, enthusiasm, a spirit of service more

developed, and ambition to lift our profession in a height to which the eyes of the nation
shall look up and not down."
-Edith Augusta Draper
● Differentiate the various categories of learners;

● Discuss factors which can influence intellectual development;
● Describe the different stages of development;
● Identify individual differences in learning with respect to intelligence, socioeconomic
status, culture, gender differences and at-risk status;
● Describe learning needs based on Maslow's hierarchy hierarchy of needs to needs; and
● Explain of the implications of the hierarchy of needs to education.
CATEGORIES OF LEARNERS ACCORDING TO GROWTH AND DEVELOPMENT
Growth is tantamount to the word "increase" or the quantitative changes in terms of learning.
Growth simply means the acquisition of more knowledge which often results in maturation, while
development is the orderly, dynamic changes in a learner resulting
from a combination of learning, experience, and maturation (Eggen: 1994).
Development represents the qualitative changes in an individual as evidenced by their

intellectual, emotional and physiological capabilities. This encompasses the ability of the body to
function consistent with growth patterns. Hence, growth and development are intertwined or
interrelated in order to proceed with normal maturation process. @the
Factors Influencing Intellectual Development
Development of intellectual faculties is part of the qualitative change expected in an

individual as one goes through the process or stages of development. It requires several
complex factors to enable one to arrive at an expected learning behavior, habits and values in
life, glove
1. Maturation
Maturation refers to the biological changes in individuals that result from the interaction
of their genetic makeup with the environment. The genes of an individual provide the blueprint
for development; the environment interacts with these genes to influence rate and direction of
growth (Eggen: 1994).
2. Experience
"Without experience, growth is hampered

-Jean Piaget
Experience Refers To observing,encountering or undergoing changes of individuals

which generally occur in the course of time. This also involves feelings and emotions as the
learner interacts with the environment which accumulates in the body system and in turn
internalizes all these forming into ideas, assumptions and inferences explicitly manifested
through behavior change.
Experiences make up the raw material that is the basis for both learning and
development. Students construct their understanding of the world based on these experiences
(Bigge: 1982).
Note:
Experience with the physical world entails observation from which development may occur
through the acquisition of knowledge and analysis. It is just like comparing similarities and
differences between rectal and oral thermometers. One has to observe in order to accurately
differentiate the two apparatuses and make comparisons in terms of use and functions to
come up with precise description of purposes and indications.
3. Learning
Learning is the acquisition of knowledge, abilities, habits, attitudes, values and skills
derived from experiences with varied stimuli. It is the product of experiences and the goals of
education where students are trained to profess for further development. Learning ranges from
simple forms to more complex activities. acquired and assimilated, depending on interaction
between the learner's genetic make-up and the learning environment resulting in maturation and
development (Eggen:
CATEGORIES OF LEARNERS ACCORDING TO STAGES OF DEVELOPMENT
Conceptually, the stages of development best describe the ways students think about the world
and the use of information. Progress from one stage to another represents qualitative changes
in students' thinking. These stages of change are more analogous to the transformation of a
caterpillar to a butterfly than the slow and gradual accumulation of bricks to build a house
(Chiatum: 2004).
GROWTH AND DEVELOPMENT
The characteristics and developmental milestones of each stage, keep these ideas in
mind, such that:
a. Growth and development is a continuous process from conception till death.
b. These stages are continuous rather than discrete hence, a child develops gradually, visibly
and continually.
c. While chronological ages are attached to stages of growth and development, the rate at
which children pass through them differs widely, depending on individual maturation rates and
their culture.
d. While rate varies, all children must pass through each stage before progressing to another
more stage. complex development
"No one can skip any development stage"
-Piaget
The Cognitive Theory of Jean Piaget explains the developmental task each child passes
through during the growth and development process (Whaley and Wong: 2008).
Following are the learning tasks inherent in each stage:
1. Infancy. Sensorimotor Stage or Practical Intelligence (0-1 Year)
In the sensorimotor stage, a child first develops tuning sensory and motor capacities
such as sight and hearing. This is shown in their reflex behavior in response to the stimulus the
infants are in contact with. This means that their thinking is limited to how the world responds to
their physical actions.
An infant has no representations of objects in memory which literally means that any
object that is "out of sight" is "out of mind”.
2. Toddler. Preconceptual to Preoperational Stage (1-3 Years)
The preoperational stage is characterized by perceptual dominance. A child who can classify
objects into toys and non-toys performs a mental operation.
Preoperational stage refers to an incomplete stage of development. Many dramatic changes

occur in children as they pass through the preoperational stage, and a child at the end of the
stage is very different from one time at the beginning.
Example:
A child who can explain that dividing a cookie dough into little pieces does not result in any less
dough than before.
a. Language development also occurs at this stage.

b. Toddlers can formulate a number of concrete concepts.
c. Abstract concepts such as values remain beyond the grasp of the child's ability to understand.
Example:
A child riding with her parents in a car will look out of the window, point animatedly, and
say "truck", "horse", or "tree".
Seven Characteristics of Toddlers at the Preoperational Stage:
a. Egocentrism. The child is self-centered and very concerned with herself. She refuses to
accept someone else's opinion and thinks that what she says and does is the only thing that
exists. Hence, an egocentric child finds it difficult to understand other points of view. The child is
not yet capable to envision other than his or her own (Whaley and Wong: 2008).
Note:
A child who is in the preoperational stage does not have a grasp of abstract concepts such
situations from perspective as: faithfulness, charity, truth, among others.
b. Use symbols to represent objects.

c. Draw conclusions from obvious facts they see.
d. They are headstrong and negativistic, favorite word is "NO".
e. Active, mobile, and curious.
f. Rigid, repetitive, ritualistic and stereotyped.
g. Has poor sense of time.
Example:
A child with three candies will refuse to share these with his playmate despite his
parents' encouragement to practice sharing with others. This is because at this point, he or she
does not understand the values of sharing.
3. Preschooler. Perceptual tetultive Thought (3-7 years).
The child learns to accommodate more information and change their ideas to fit reality
rather than reasons. Their thinking is influenced by the following:
a. Centration. The tendency of the child is to focus on one perceptual aspect of an event to the
exclusion of all other aspects.
b. Non Transformation. The child is unable to mentally record the process of change from one
stage to another. Their sense of understanding is still not fully determined as the child is only
concerned with events at present.
c. Irreversibility. The child is unable to mentally trace a line of reasoning back to its beginning.
The child thinks primarily on the basis of their own perception of events.
d. Reasoning. Preoperational children do not use inductive or deductive reasoning. Problem

solving is based on what they see and hear directly rather than what they recall about objects
and events.
Example:
A child when reasoning deductively, concludes that the number of coins in the two rows
is the same; no coin has been added or taken away, hence, the number must be the same,
even if the bottom row is longer. A fourth grader given the problem simply says, "You just made
the row longer," or "You just spread the coins apart", reflecting her reasoning.
4. School Age. Concrete Operations Stage (7-11 Years)
The school age or the concrete operations stage marks the advancement in the child's
ability to think about the world around him. It is characterized by:
a. Able to discover concrete solutions to everyday problems.

b. Starting to overcome pre operational deficiencies.
c. Reasoning tends to be inductive.
d. Ability to think logically about concrete objects hence, they can form conclusions
based on reason rather than mere perception alone.
e. Aware of past, present and future time.
5. Pubescent or Adolescent. Formal Operational Thought (12. 18 Years)
a. Adolescents have logical thinking with ability to provide scientific reasoning.

b. They can solve hypothetical problems and causality.
c. Have mature thought.
Table 3. Piaget's stages of development and their

Stage Characteristics Example
Sensorimotor (0-1 year old) ● Goal directed ● Makes jack-in-the-ba

behavior pop up
Pre Operations (1-3 years ● Object permanence ● Searches for objects

old) ● Rapid increase in behind parent's back
language ability with ● "We go to the store
over generalized .Points out car
Language window and says
● Symbolic thought "truck!"
● Dominated by ● Concludes that all
perception water in a sink came
from the faucet
Perceptual Intuitive Thought ● Headstrong ● Can pour milk in a

(3-7 years old) ● Negativistic glass
● Active, mobile, ● Climb and pedal trike
curious ● Described as
● Ritualistic, stereotype noisy,stormy, rude
● Has poor sense of ● Indulge in card games
time
Concrete Operations (7-12 ● Operates logically ● Concludes that two

years old) with concrete objects on a
materials "balanced" scale have
● Classifies and serial the same mass, even
orders though one is larger
than the other
● Orders containers
according to
decreasing volume
Formal Operations (12-18 ● Solves abstract and ● Considers outcome of

years old) hypothetical problems WWII if the "Battle
● Thinks in combination against the Germans
with other objects or and Japanese had
things. been lost
● Systematically
determines how many
different sandwiches
can be made from
three different kinds c
meat, cheese, and
bread
CATEGORIES OF LEARNERS ACCORDING TO INDIVIDUAL DIFFERENCES
Regardless of the learner's age, gender, socio-economic status, religion, culture, among
others, it is impossible to conclude that a certain group of people is not entirely alike nor
individual differences exist (De Young: 2007).
As previously cited, every individual is unique and thus, a student is entirely different
from another student regardless of his or her demographic profile. It is therefore important for
the teacher to acknowledge these differences to be able to devise a teaching strategy most
suited to each of her students. In doing so, the teacher should consider the following aspects:
● Intelligence
● Multiple Intelligences Emotional Intelligence
● Socioeconomic Status
● Culture
● Gender differences At-risk Students
1. Intelligence
The teacher's primary consideration in evaluating the learning needs of her students is
the intelligence level of each one. Intelligence refers to aptitude or the person's capacity to
acquire knowledge, ability to think, abstract reasoning and capability in problem solving which is
explained by the following (Feldman: 2004):
a. Intelligence is determined by genetics and environment.

b. Intelligence is measured based on the results of intelligence tests or aptitude tests.
c. Students with high aptitude need less time and less instructional support.
The teacher can adjust and adapt instructional approaches considering the differences
in students' ability (Chiatum and Hammond: 2005), as follows:
● flexible time requirements

● increased instructional support
● strategy instruction
● peer tutoring
● cooperative learning
a. Flexible Time Requirements
An indicator of intellectual differences of learning for individuals is the time requirement

to grasp comprehensively the subject well. This is equated with the students' rate of growth and
their readiness to learn. Some students learn faster than other students, hence, a teacher
should design a teaching strategy that will address students' time requirements in terms of
learning.
To facilitate the process, a teacher may allow students who are slow learners to work on
alternative activities to provide more time for instruction. On the other hand, the teacher may
design extra activities such as free reading time, related learning experiences, computer
activities and other self enhancing activities for fast learners. These activities can further
enhance the students' knowledge, interests and skills in the subject matter.
b. Increased Instructional Support
To help slow learners compensate for their relative deficiency in learning, there are a
number of methods available to the teacher including the following:
● The teacher's instructional style or approach must be adjusted to students' needs for
learning without compromising the overall topic requirement for the course to be
finished;
● Support of fast learners is involved in helping the slow learners through peer tutoring and
group activities;
● Clarify and expand explanation of the subject matter before having students attempt to
ask on their own;
● Break lengthy assignments into shorter segments; and
● Provide frequent feedback as students work through new materials.
e. Strategy Instruction
Research shows that student achievers are more likely to use strategies that make their
learning more effective. These strategic learners analyze and break down tasks or problems into
smaller units and formulate solutions to tasks and problems systematically. They are also able
to differentiate important concepts from the less important.
Strategic learners employ strategies in order for them to work efficiently and effectively to
make their tasks casier (Quinn: 2000).
d. Peer Tutoring "Work smart. not hard"
It is said that student achievers are more equipped with the necessary knowledge and
skills in facing challenges of learning. They can serve as sources of information for less able
students.
e. Cooperative Learning
Studies showed that students who tutor less able students even benefit more than the
less able students. Student tutors are able to recall their knowledge in tutoring and further
enhance their skills in skill demonstrations. Student tutors are able to enhance their social skills
during cooperative learning activities.
2. Multiple Intelligences
The theory of multiple intelligences was proposed by Dr. Howard Gardner, professor of
education at Harvard University. The theory states that the traditional concepts of intelligence,
based on 1.0. testing, is far too limited. He thus, proposed eight different intelligences:
● Verbal-linguistic intelligence or "word smart .

● Logical-mathematical intelligence or "number/reasoning smart"
● Spatial intelligence or "picture smart"
● Bodily-Kinesthetic intelligence or "body smart"
● Musical intelligence or "music smart"
● Interpersonal intelligence or "people smart"
● Intrapersonal intelligence or "self smart"
● Naturalist intelligence or "nature smart"
● Other intelligences
a. Linguistic Intelligence or Word-smart
Verbal-linguistic intelligence has to do with words, spoken or written. Individuals with verbal
linguistic intelligence display a facility with words and languages and are typically good at:
● Reading,
● Writing,
● Story telling, and
● Word Memorization
They learn best by reading, taking notes, listening to lectures, discussion and debate.
They excel in negotiations, teaching and oration or persuasive speaking and learn foreign
languages easily.
Word smart individuals could become good lawyers, creative writers, and teachers,
among others.
b. Logical-Mathematical
Students who have high mathematical intelligence are good in:
● Logical Reasoning,
● Abstractions,
● Numbers
● Inductive and Deductive Reasoning, and
Individuals who have high logical-mathematical intelligence excel in commerce,

among others. the sciences, engineering, and
c. Spatial
This type of intelligence has to do with vision and spatial judgment. People with
strong visual spatial intelligence are good in the following:
● Visual and mental manipulation of objects,

● Visual memory,
● Arts, and
● Geographic directions
Spatial intelligent individuals may excel in the arts, engineering and architecture.
d. Bodily Kinesthetic
This intelligence has to do with movement. Individuals with this intelligence excel
in:
● Sports,
● Dance, and
● Other activities related to movement
These individuals have good muscle memory. However, this intelligence requires
skills and dexterity for motor movements for activities such as dancing, craft making, and
acrobatics, among others.Bodily-kinesthetic intelligent individuals could become good
athletes, actors, dancers, and craftsmen.
c. Musical
Musical intelligence has to do with music composition, rhythm, and music, hearing. One
learns best with music playing in the background and may memorizing information. Individuals
with high musical intelligence are good in: use songs in
● Singing,
● Musical composition, and
● Playing musical instruments
Individuals who have high musical intelligence could become musicians, singers,
composers, and conductors.
f. Interpersonal
People who have high interpersonal interacting with others. They are usually extroverts
sensitive to others' needs, feelings, interests and motivations. They learn best from group
activities. They are good in: work and
● intelligence are good in

● Communication,
● Leadership,
● Negotiations, and
● Politics
Individuals who have high interpersonal intelligence could become successful politicians,
social workers, human resource managers, salespersons, teachers, and counselors.
g. Intrapersonal
Intrapersonal intelligence has to do with introspective and self reflective capacities.

Individuals are usually introverts. They learn best when allowed to concentrate on the subject by
themselves and have a high level of perfectionism. They are usually good in:
● Psychology,
● Analysis,
● Philosophy, and
● Theology
Individuals who have high intrapersonal intelligence could become philosophers,

psychologists, and evangelists, among others
h. Naturalistic Intelligence
This intelligence has to do with nature, nurturing and relating information to one's natural
surroundings. Individuals with this type of intelligence have great sensitivity to nature and the
environment. It covers metaphysics, the origin and essence of things. the nature of man, among
others. They are usually good in:
● Botany
● Zoology
● Metaphysics
● Ontology
● Astronomy
● Environmental Science
Individuals who have high naturalistic intelligence could become successful naturalists,
environmentalists, veterinarians, farmers, gardeners, and scientists.
Figure 4: Multiple Intelligences. (Adapted from An Environmental Project by Adrienne and Mia
Bellanich, online)
**Epistemology is a concept that deals with the nature of knowledge, in particular, and the
different aspects of what people know. This includes:
● Conceptual knowledge. This consists of ideas or abstract understanding of an actual

thing or event such as the shape of an apple.
● Perceptual knowledge. This is derived from one's senses such as the color of an apple.
● Intuitive knowledge. The cognitive meaning of a thing independent of reason such as gut
feeling or intuition.
**Axiology is a concept which relates to the ideas of right and wrong and the means by which
the two delineated are
"Aesthetics deals with beauty and ugliness.
Other Intelligences include spiritual, existential and moral intelligence.
According to Gardner, existential intelligence is the capability to raise and reflect on

philosophical questions about life, death and ultimate realities.
3. Emotional Intelligence
Emotional intelligence is a combination of competencies. These skills contribute to an
individual's capability to manage and monitor his or her own emotions, to correctly gauge the
emotional state of others and to influence opinions (Caudron, 1999; Goleman, 1998). Goleman
describes a model of five dimensions (1995). Each area has its own set of behavioral attributes
as follows.
a. Self-awareness is the ability to recognize one's own feeling as this happens, to accurately
perform self-assessment and have self-confidence. It is the keystone of emotional intelligence.
Self-awareness and self-esteem
b. Self-management or self-regulation is the ability to keep disruptive emotions and impulses

in check (self-control), maintain standards of honesty and integrity (trustworthiness), take
responsibility for one's performance (conscientiousness), handle change (adaptability), and be
comfortable with novel ideas and approaches (innovation).
c. Motivation is the emotional tendency of guiding or facilitating the attainment of goals through:
● Achievement drive to meet a standard of excellence;

● B Commitment or the alignment of goals with the group or organization;
● Initiative to act on opportunities; and
● Optimism or the persistence to reach goals despite set backs.
include spiritual, existential and moral
d. Empathy is the understanding of others by being aware of their needs, perspectives,

feelings, concerns, and sensing others developmental needs.
e. Social skills are fundamental to emotional intelligence. They include:
● Influence, or the ability to induce desirable responses in others through effective

diplomacy of persuasion.
● Communication or the ability to both listen openly and send convincing messages.
● Leadership, or the ability to inspire and guide groups and individuals.
● Building bonds, or nurturing instrumental relationships.
● Collaboration and cooperation with others toward a shared goal.
● Create group synergy, the ability to pursue collective goals.
Researchers have found that the student's emotional awareness and ability to handle
feelings will determine her success and happiness in life. For teachers, this quality of "emotional
intelligence" means being aware of student's feelings and able to empathize and guide them.
For students, it includes the ability to control impulses, delay gratification, motivate themselves,
sensitivity to other people's feelings, and ability to cope with life's challenges.
4. Socioeconomic Status (SES)
Socioeconomic status is a measure of a family's position in society as determined by

family income, its member's occupation, and level of education. SES affects learning both at
home and in school.
Poverty affects a learner's well-being and quality of life. This in turn affects the student's
concentration, learning potentials, motivation, interests and participation in class.
5. Culture
Culture refers to attitudes, values, customs and behavior patterns that characterize a
social group. Like SES, culture als influences school success, through the students' attitudes
and values and ways of viewing the world that are held and transmitted by a culture.
Culture influences the following:
a. Students' Attitudes and Values
To become a good student, one must be able to adopt to the cultural values imposed by
the school as a learning institution. This is often based on its mission, vision, objectives and
goals whether it is a secular or non-secular institution.
Example:
A student with strong Islamic faith may find it difficult to adapt to a learning institution run
by Catholics where Christian values such as compulsory attendance to first Friday mass is
strictly imposed.
b. Classroom Organization
In most classrooms, students work and learn individually. Emphasis is placed on

individual responsibility, which is often reinforced by grades and competition. Competition
demands both successes and failures, and the success of one student is tied to the failure of
another.
c. School Communication
Cultural conflict in communication may occur in an institution with students from diverse
ethnicities. Communication signals may not always have the same meaning to another student
of a different ethnicity.
Example:
A common Filipino student may tap his friend's head or nape as a means of saying
"hello" or "hey there". If this is done to a fellow Filipino friend, it would mean nothing but a mere
act of friendliness. It would be disrespectful to do this to a Thai friend. This is because in their
culture, it would be disrespectful to tap or touch someone else's nape or head.
6. Gender Differences
a. Different Treatment of Boys and Girls
From the day they were born, male and female babies are treated differently. A baby girl
is handled more delicately while a baby boy is seen as tougher and more hardy. In regard to
discipline, fathers are rougher and physical with their sons compared to their daughters whom
they tend to discipline verbally.
b. Stereotyping Boys and Girls
This gender-based treatment extends up to the child's school years. Males are
considered better in Mathematics while females are better in English. This stereotyping
somehow has a subconscious effect on students. Female students who have the potential in the
field of mathematics may be unable to explore their potential due to the belief that females are
not as good as males when it comes to numbers (Simons: 1987).
It is important for the teacher to design his or he teaching strategy with careful
consideration of providing equi learning opportunities regardless of student gender.
All learners have the potential to excel in any field of learning regardless of gender.
-Simon
7. At-Risk Students
At-risk students are those in danger of failing to complete their education. They have
learning problems and adjustment difficulties. They often fail even though they have the
capability to succeed.
Table 4: Characteristics of at-risk students (adapted from Educational Psychology
Classroom Connections 2nd Edition.)
Teachers with at-risk students should design their teaching strategy in a way that would give
more structure and support to student's learning needs.
The following table presents suggestions on how to address the learning needs of at-risk
students:
Table 5: Effective Instruction for Students (adapted from Educational Psychology

Classroom Connections 2nd Edition).
Characteristic Description
Greater structure and support Course expectations need to be clearly laid

out, and assignments and grades need to be
designed to encourage achievement.
Active teaching The teacher needs to bring content personally
to students through interactive teaching rather
than depend on curriculum materials, such as
the texts or workbooks.
Instruction emphasizing student active Interactive teaching with high questioning

participation levels invites students to participate in
lessons. Open ended questions allow
successful responses and give students a
chance to explain their thinking.
More frequent feedback Student progress should be monitored

frequently through classroom questions,
quizzes and assignments.
Smaller steps with more practice Content should be broken down into smaller
steps, and student mastery should be
ensured before moving on to the next step.
Constant review of earlier materials provides
for overlearning.
Higher success rates Classroom questions, assignments, and

quizzes W should be designed to maximize
opportunities for success.
High expectations Teachers should assume that all students can

learn and emphasize higher order thinking in
all classes.
LEARNING NEEDS BASED ON MASLOW'S HIERARCHY OF NEEDS
Learning needs of students based on Maslow's hierarchy of needs is divided into two (2)
categories (Simons: 1987):
1. Deficiency needs
Deficiency needs are those needs whose absence energizes or moves people to meet
them. Until a lower need is met, an individual is unlikely to move to a higher need.
2. Growth needs
Growth needs are needs "met", as they expand and grow as people have experiences
with them. Growth needs require people to indulge in activities that are physically and
psychologically stimulating and enhances strength and vigor to proceed to a higher level task.
Implications of the Hierarchy of Needs to Education
a. Impoverished students who are unable to meet their bask needs such as food and enough
rest tend to have diminished motivation to learn.
b. Students who have a low sense of security tend to achieve less than those who have a high
sense of security.
c. Growth needs energize and direct student learning.
d. True motivation for learning develops only when students see the relationship between what
they are learning and their primary goals on rewards and punishments.
OTHER LEARNING NEEDS
1. The Need for Competence
a. Competence motivation is an innate need in human beings. An individual has the desire to
improve one's capability in performing tasks necessary for development.
b. Competence motivation creates drive in oneself to master tasks and enhance skills.
c. Competence motivation is essential in coping with the fast changing environment.
Growth Needs
Intellectual achievement
(knowing and understanding)
Self-esteem
(recognition and approval)
Deficiency Needs
Belonging
(love and acceptance from family and peers)
Safety
(freedom from emotional and physical threat)
Survival
(shelter, warmth, food, water)
Figure 6: Maslow's hierarchy of needs. Source: Adapted from Motivation and Personality
2nd Edition by Abraham H. Maslow. Copyright 1954 by Harper and Row, Publishers, Inc.
© 1970 by Abraham H. Maslow.
2. The Need for Control and Self- Determination
a. As stated in the Bible, man is a steward to God's creation. Hence, there is need for
control and temperance to do what is right to oneself and to others.
b. Man continuously strives for competence and autonomy.
c. Teachers may satisfy a student's need for control by encouraging inputs such as
opinions, suggestions and criticisms, among others, during class lectures and
discussions.
3. The Need To Achieve
a. Achievement motivation is the drive to excel in learning tasks to experience pride in

accomplishment.
b. The need to achieve is balanced by the need to avoid failure. c. Students with high
need to avoid failure tend to avoid challenging tasks.
d. Students with high need for achievement tend to be motivated by challenging

assignments, high grading standards, explicit feedback and the opportunity to try and
accomplish tasks as expected.
e. Students who do not want to fail, are motivated by simple assignments, liberal grading,
embarrassment due to failure. and
protection from
A Task for You:
1. Interview children in each stage of development. Compare their developmental tasks with the
cognitive theory of Jean Piaget.
2. Present a matrix of developmental tasks and cite differences.
MEMORY AID
1. Learners Are Categorized According to:
a. Growth and development

b. Stages of development
c. Individual differences
2. Growth and Development Defined:
a. Growth is the acquisition of more knowledge which often results in maturation.

b. Development is the orderly, dynamic changes in a learner resulting from a
combination of learning, experience, and maturation.
3. Factors Influencing Intellectual Development
a. Maturation - the biological changes in individuals that result

from interaction of their genetic make-up with the environment.
b. Experience refers to observing, encountering, or undergoing activities generally as
these occur in the course of time.
c. Learning is the acquisition of knowledge, abilities, habits,attitudes, values and skills.
4. Stages of Development
a. Infancy. Sensorimotor Stage (0-1 Year). Focuses on reflex behavior as a determinant

of sensory and motor capacities; thinking is limited and has no object in memory.
b. Toddler. Preoperational Stage (1-3 Years). Characterized by perceptual dominance. A

toddler who can classify objects into toys and non-toys while performing a mental
operation.
c. Pre-schooler. Perceptual Intuitive Thought (3-7 years). The child tends to

accommodate more information and change their ideas to fit reality.
d. School age. Concrete Operations Stage (7-11 Years). Advancement and the ability to
think logically and overcome pre operational deficiencies.
e. Pubescent or Adolescent. Formal Operational Thought (12-18 years). They have

logical thinking and scientific reasoning.
5. Aspects Influencing Individual Differences

a. Intelligence
b. Multiple Intelligences
c. Emotional Intelligence
d. Socioeconomic Status
e. Culture
f. Gender Differences
g. At-risk Students
6. Intelligence
Also known as "aptitude"
7. Theory of Multiple Intelligences
The theory proposes that the traditional notion of intelligence based on I.Q. testing, is far
too limited.
States Eight (8) various intelligences:
a. Verbal "word smart"

b. Logical-mathematical intelligence - "logical or number smart
c. Spatial intelligence - "picture smart"
d. Bodily-Kinesthetic intelligence - "body smart
e. Musical intelligence - "music smart"
f. Interpersonal intelligence - "people smart"
g. Intrapersonal intelligence - "self smart"
h. Naturalist intelligence - "nature smart"
8. Emotional Intelligence
The student's emotional awareness and ability to handle feelings indicates her success
and happiness in all walks of life.
9. Socioeconomic Status or SES
Is a measure of a family's societal position as determined by family income, its member's

occupation, and level of education which may affect a learner's learning potentials and
motivation.
10. Culture
The attitudes, values, customs, and behavior patterns that characterize a social group.
11. Gender Differences
Refer to the different treatment of boys from girls as imposed by cultural practices or society
itself.
12. At-Risk Students
These are students in danger of failing to complete their education even if they have the
learning potential and due to learning problems and adjustment difficulties.
13. Maslow's Hierarchy of Needs
Categorized into deficiency needs and growth needs.
14. Other Learning Needs
Includes the need for competence, the need for control and self-determination and the need to
achieve.
1. Differentiate between growth and development process. How does intellectual development
occur?
2. Children undergo fast rapid changes. How will a teacher cope and understand the needs of
the children as learners?
3. How do multiple intelligence differ with emotional intelligence in terms of changes and
performance?
PRACTICE TEST
1. Which one simply means the acquisition of more knowledge that often results in maturation?
a. Wisdom
b. Growth
c. Development
d. Experience
2. Which one refers to an orderly, dynamic changes in a learner resulting from a combination of
learning experience and maturation?
a. Learning
b. Experience
c. Development
d. Growth
3. What is that biological change in individuals that result from the interaction of their genetic
make-up with the environment?
a. Experience
b. Learning
c. Maturation
4. Which one is a process of observing, encountering, or undergoing things generally as these

occur in the course of time?
a. Experience
b. Learning
c. Maturation
5. What refers to the acquisition of knowledge, abilities, habits, attitudes, values and skills?
a. Experience
b. Learning
c. Maturation
6. Which one is characterized by perceptual dominance?
a. Preoperational stage
b. Sensorimotor stage
c. Concrete operations stage
7. What is the tendency of a learner to focus on one perceptual aspe of an event to the
exclusion of all other perspectives?
a. Learning
b. Egocentrism
c. Centration
8. Which of the following develops tuning sensory and motor capabilities, thinking that is limited
and has no object in memory?
c. Concrete operational stage
9. What is that ability to logically think in advance and the ability to overcome pre operational
deficiencies?
c. Concrete operational stage
10. What are the cultural practices of society where the treatment of boys compared to girls
differ?
a. Culture
b. Gender differences
c. Individual differences
d. At-risk students
Chapter 10 : MOTIVATION IN LEARNING
"Nursing is an art, and if it is to be made an art, requires as exclusive as devotion,

as hard a preparation as any painter's or sculptor's work for what is it having to do with
dry canvass or cold marble, compared with having to do with the living body... the temple
of God's spirit? It is one of the Fine Arts, the finest of the Fine Arts."
-Florence Nightingale
● Define motivation;
● Discuss the purposes of motivation;
● Differentiate the various types of motivation;
● Discuss Maslow's hierarchy of needs;
● Explain the theory of motivation; and
● Expound on the learners motivational factors.
After understanding the various means through which students learn, the teacher needs
to determine the best way to encourage her students to learn and keep them motivated
throughout the course or series of lessons being taught. It is only when the student remains
motivated that learning takes place.
MOTIVATION DEFINED
Motivation is a process by which an individual creates an inner drive to accomplish goals

or objectives. It is something within an individual such as need, idea, physiologic state, or
emotions that incite him or her to action.
Motivation influences an individual to act. It is a stimulus that causes man to act toward a
particular objective where previously there was little or no attraction to that objective (Bastable:
2004).
Motivation is the practical art of applying incentives and arousing interest for purposes of
causing a student to perform in a desired way. It means choosing a study material and
presenting them in a way that appeals to student's interests and causes them to willingly work
and complete this with sustained enthusiasm (De Young: 2003).
Motivation involves the use of various devices such as the offering of rewards or an
appeal or desire to excel (adapted from The Dictionary of Education: 2004).
In a sense, psychological motivation may be interrelated, regarded as an energized state

of an individual brought about by dynamic factors, be it intrinsic or extrinsic. Although maybe
difficult and often impossible to distinguish whether motivation is intrinsically or extrinsically
related.
The term "motivation" is used to refer to devices and activities that the teacher may
employ to bring about increased or active learning. In a strict sense, the teacher does not use
direct motivation, but rather she arranges the environment, utilizes activities and various devices
to help motivate students to learn.
PURPOSES OF MOTIVATION
● Teachers motivate their students to learn in order to:

● Arouse the desire to achieve a goal;
● Stimulate action to accomplish a particular objective;
● Cause a student to perform in a desired way;
● Arouse interest thereby making a student simply work; willingly and to complete tasks;
● Use various incentives such as the offering of rewards or an appeal in order to excel;
and
● Stimulate an individual to follow a certain direction desired for learning
TYPES OF MOTIVATION
1. Intrinsic Motivation
Intrinsic motivation occurs when the learner wants to learn for the sake of learning. It is based
on personal motives and consists of self-generated factors that influence individuals to behave
in a particular way, or to move to a particular direction. This involves factors such as:
● Heredity
● Intellectual abilities Instinctual drive
● Personal philosophy, vision and mission in Life
● Desire for recognition
● Desire to serve others
Intrinsic motivation creates a sense of responsibility or feeling that learning is important

and having control over one's own resources, autonomy or freedom to act, methods to use and
develop skills and abilities, interest and challenge in work and opportunities for advancement.
Students may be motivated to learn by understanding more their own strengths and
weaknesses as learners (Wizers: 2006) However, the influence of heredity and inherited traits,
interaction of personality and cognition affects maturation of learners to absorb more
information...
2. Extrinsic Motivation
Extrinsic motivation occurs when the learner wants to learn for reasons other than his or
her own personal interest. Extrinsic motivation is based on social motives which may include:
● Rewards such as increase in pay, praise or promotion, as well

● Punishments, such as disciplinary action, withholding pay and criticism;
● To please significant directly involved with the learner;
● A desire to compete with peer groups; and
● Recognition and celebration.
Extrinsic motivation is developed through the use of incentives which is an external

influence that moves a learner to act.
Both intrinsic and extrinsic forms of motivation are within learner. It is only the learner
who provides and activates these motivators. Intrinsic motivators end to have a deeper and
more long term effect than extrinsic motivators
MASLOW'S THEORY OF MOTIVATION AND NEEDS
In 1943, psychologist Abraham Maslow proposed the theory of motivation and needs.
According to this theory, people are motivated based on a variety of needs which he categorized
into five basic groups:
1. Physiologic needs
These are biological basic needs such as: food, clothing and shelter, among others.
Unless these needs are met, only then can an individual proceed to the next category of needs.
According to educational psychologists, the teachers' physiologic needs must be met in

order to efficiently and effectively transfer learning to a student. In the same manner students'
physiologic needs must be met in order to understand knowledge very well for learning to take
place. A student with an empty stomach may find it difficult to concentrate hence, learning is
hampered.
2. Safety needs
Teachers and students have inherent need to survive to protect themselves from any
health hazards or injury. This include having a protection plan for sickness through
environmental cleanliness, sanitation, waste management, clean air, and protection from fire
hazards, among others. Adults have little awareness of their security except in times of
emergency or periods of conflict in the social structure such as strikes or widespread rioting.
Children often display signs of insecurity such as separation anxiety and the need for safety like
being fed, cuddled, touched and talked to (Simons: 1987).
3. Social needs
Teachers and learners need a sense of belongingness, love and acceptance from significant
people such as family members, friends, and neighbors in the community. When social needs
are met, feelings of loneliness and alienation from others are easily overcome.
4. Esteem needs
Learners have the need for a stable, family-based, high level of self-respect and respect
from others. A teacher should be careful not to hurt her student's self-esteem by being more
friendly, tolerant and patient towards her students' mistakes and misbehaviors without
undermining the need for discipline and good manners. The teacher must also encourage her
students to strengthen their talents and capabilities, recognize their potentials and learn to
appreciate and value their work. The teacher should likewise plan remedial measures to change
students' weaknesses into strengths by helping them realize their weaknesses and to accept
change that would make it easy for both the teacher and the student to cope and adapt to each
others needs.
Self esteem can be raised by rewarding students for the good they have done. Giving a
student a verbal "pat-on-the-back" and a small present for a task that has been done correctly
serve to boost a student's morale self-concept (Niven: 2006).
5. Self-actualization needs
Self-actualization needs refer to the realization of success Maslow describes self-

actualization as an individual's need to be and do that which the individual was "born to do."
Maslow states that teachers should respond to the potentials of the learner to grow into
a self-actualizing individual of her own kind Points that teachers should address to help learners
respond to their self-actualization needs are the following (Simons: 1987):
1. To be authentic, aware of their inner selves and to listen to their inner-feeling voices.
2. To transcend their cultural conditioning and become world citizens.
3. To discover their vocation in life, their calling, fate or destiny, particularly in finding the right
career or mate.
4. Teach learners that life is precious, that there is joy to be experienced, and if people are open
to seeing the good side of life in all kinds of situations, it makes life worth living.
5. Accept the learner as she is and help her learn her inner nature. From real knowledge of
aptitudes and limitations they will know what to build upon, what potentials they really have.
6. Make sure that the learner's basic needs are satisfied, such as safety, belongingness and
esteem needs.
7. Refresh consciousness by teaching the learner to appreciate beauty and other good things in
nature and in life.
8. Teach learners that self-regulation is good, and complete abandonment is bad. It takes
control to improve the quality of life in all areas of living.
9. Teach learners to transcend and analyze problems and attend to serious problems in life.
These include the problems of injustice, of pain, suffering, and death.
10. Teach learners to make good decisions by giving them opportunities to practice and
experience problem solving using hypothetical situations in the clinical laboratory or in any
related learning experience.
Figure 7: Maslow's Hierarchy of Needs. (From
http://www.nscb.us.com/archives/Maslows.html)
MOTIVATIONAL FACTORS OF LEARNERS
Learners are people easily affected by several factors surrounding them, be they
intrinsic or extrinsic. The learning process is initiated and facilitated by these factors depending
on the strength to which these motivate or affect learning outcomes.
1. Psychosocial Needs
Psychosocial needs arise from the learner because she is part of a social setting.
Learning takes place within oneself, but enhanced when a learner is within a group of learners.
Like for example the difference in learning outcomes when a student does a home study
program, isolating herself from interacting with other students, compared to a student learning in
a regular class interacting with her classmates and teachers. These needs are not purely
biological but represent the educative forces which any social setting exercises on one's
physical and mental make-up.
To motivate learners to undergo the process of change and to meet their psychosocial
needs the teacher should be concerned with the following to initiate learning: (Heidgerken
(1971)
a. Security. A student's feeling of being safe and protected. It is a form of self-preservation and
therefore always present in some form of human behavior. A student learns best if she knows
that the learning environment is safe from risk factors such as fire, floods, collapsible buildings,
and burglars, among others.
b. Anxiety. This is a feeling of concern or worry about some anticipated event which seem to
involve some danger to the individual learning process such as assignments, and course
requirements, among others.
c. Frustration. A student has the feeling of being blocked or hindered to achieve a goal
because of some barriers or constraints in the learning process.
d. Independence. The need to achieve a status of self sufficiency, which arises from the
individuality of each person. Achieving selfhood is a strong and positive motivational force.
e. Actualization. This is the fulfillment of one's personality potential. It is an important

motivational force for man to aspire the best things in life for her and others to recognize their
capabilities and self-worth. Few men can achieve this status, some are constrained by
opportunities to excel both from within and outside the organization.
"What a man can be, he must be."
-Abraham Maslow
f. Assertion. The overt manifestation of one's personality to speak for oneself, her ideas,
opinions, and feelings in a respectful manner without creating enemies. Assertion also arises
from the basic need to display one's personality to oneself and others.
g. Achievement. The need to attain some worthwhile goals, the degree of which varies from
one person to another. Often, this need is described in terms of levels of aspiration, which are
determined largely by an individual's self-concept, her assessment of her own abilities, the
amount of effort she is willing to exert in trying to achieve a particular goal and her previous
success or failure in similar or related tasks.
h. Recognition. This refers to acknowledgement of one's achievement in some activity by

others. Ryan (2007) posits that recognition pleases an individual which inspires her to
accomplish tasks that benefit herself and others for a common good. The best example is
Florence Nightingale who is recognized as the Mother of Modern Nursing. Professionally,
Florence Nightingale standardized nursing practice, through her human touch and scientific
researches. Nightingale expanded the meaning and ideals of nursing to satisfy human needs of
caring, making nursing the most indispensable profession locally and globally.
"Recognition is one of the most powerful of all motivators."
-Ryan
i. Participation. It is sharing experiences and activities with others. Since man is a social being.
She has an inner need to be accepted as a member of the group.
j. Interest. This is a conscious awareness of an inner desire for some object which has concern
or importance to a person. Interests are closely allied to attitudes, but may be different in some
aspects, such that:
● They involve personal identification with the object, while attitudes do not.
● It is generally considered that interests are directed toward a class of objects, while
attitudes are oriented toward some specific objects.
● Interests may be instinctual or acquired, but attitudes are only acquired.
k. Religious need. The individual's inner requirement for God. Some scholars have long
recognized this need as one of man's most important needs. Modern psychologists like Jung,
also have testified to the crucial motivational role of man's religious needs. Other psychologists
denied its existence and substitute ideals in its place.
2. Incentives
Incentive refers to the use of praise, reproof, competition, knowledge of results, quizzes,
grades, among others, to initiate and sustain motivation.
The effect of these incentives on students is relative and varies widely according to the
needs of the individual learner and goal of learners, in general. However, caution is needed in
their use for they may become ends in themselves. Too many incentives may create complacent
behavior and overshadow the real meaning of responsibility which may also obscure
development and maturity.
a. Praise and Reproof
Everyone, regardless of an individual's demographic profile, psychologically craves for

recognition or approval from others which may encourage or discourage the individual to pursue
higher tasks
A number of studies attested the assumption of the effectiveness of praise and reproof in
motivating students to study and pursue behavioral modifications among learners.
According to Heidgerken, teachers must be very careful in the use of praise and reproof
because unwise use can create undesirable traits in students. Overuse can weaken their
effectiveness. The teacher should use praise and reproof to build a sense of achievement in the
students, this will give them a feeling of satisfaction because they have achieved a particular set
of objectives.
b. Competition
Competition is urging oneself to take action to achieve a certain objective in order to prove one's
capability or excellence. It entails motivating oneself to perform a task better than others.
However, an individual may choose to compete with others or with herself as a form of
motivation to improve or further enhance her knowledge and skills.
Following are three kinds of competition:
1. Competition wherein an individual is one of the group that competes with another
group;
2. Competition wherein an individual competes with other individuals in the same group;
and
3. Self-competition wherein an individual compete against her own record.
Competition can be held against absent or imaginary rivals. It can be intentional and
explicit, or implicit.
Unwise use of competition can create undesirable traits in students, such as fear,
aggression, frustration, and suppression and result in competition becoming the end instead of
the means for motivation.
Self-competition yields the greatest amount of learning. It is the fairest type because the
individual is not competing with someone of greater ability. Its power to stimulate does not wear
out, too.
"Instead of competition, some psychologists suggest the use of cooperation."
-Ryan
c. Knowledge of Progress
Students must be kept informed of their progress through self

evaluation, assignments, tests and examinations and through conferences with teachers. It
strengthens the learner's determination to reach the goal that she has set for herself. It is
important for a student to have knowledge of her progress because this may also motivate her
to strive harder and improve her knowledge or skills in certain areas of concern.
Studies show that students who are kept informed of their progress learn more readily
than those who are not well-informed of their progress.
d. School Marks
School marks stimulate school work to a greater degree than other forms of motivation. School
marks are used as basis for grading and offer a powerful stimulus to induce learning activities.
e. Exhibiting Good Works
Exhibiting good works often yields positive results. When a student knows that the best
work is to be exhibited, the desire to do better work is stimulated or created.
1. Game or Play
The desire to play, when properly stimulated and directed, will maintain interest and
facilitate learning. Play is an incentive for learning and a great factor in physical and mental
development. It develops personal discipline essential in doing mature roles and ensuring
responsibility.
g. Examination
Examination has a motivating value. Examination creates drive among students to

prepare and review in order to attain a passing mark which will spare her of embarrassment due
to failure.
h. Dean's List
To be in the Dean's list is a motivation itself. It gives a student sense of recognition and
pride. However, this type of motivation appeals only to bright students,
i. Emulation
Emulation as a school incentive was widely employed in the past (Gregorio: 1976). This
principle governing emulation should be to excel without hurting or degrading others. Emulation
is exemplified in cases where students are required by the teacher to do their test in oral or
written exercises. Students are praised and recognized for best and neat performance of
assigned tasks..
J. Material Rewards
The use of material rewards helps motivate students to learn. However, there are
drawbacks in the use of material rewards, such that:
● It is necessary to increase rewards periodically to sustain and maintain motivation to

learn.
● Students may think that the attainment of material reward is the primary goal, while
school learning becomes only an
● incidental means to an end which is quickly cast aside or ignored when the reward is
attained. . Other kinds of incentives maybe as effective or more effective and do not lead
to relegate learning to a secondary position.
k. Punishment
Punishment is used as a form of extrinsic motivation. Traditionally, punishment has been

assumed to accomplish the following:
● Teach the learner respect for authority.

● Block undesirable responses.
● Force the learner to do something he was not ready to do or did not want to do.
● Set an example for potential offenders.
● Make the student pay attention to class work.
● Motivate students to learn assigned material.
These however, may block students desire to pursue life's goals since it imposes a self-
threatening behavior derived from external forces, hence, may impair learning. However, for
some cases, punishment may work; depending on the way it is carried out and as perceived by
the learner.
IMPORTANCE OF MOTIVATION IN LEARNING
The purpose and importance of motivation in learning should be clearly understood by

the teacher. The fundamental aims of motivation are as follows (De Young: 2007):
1. To stimulate and facilitate learning activity.
2. Learning is an active process and students need to be motivated and guided toward desirable
ends.
3. Learning is self-initiated, but it must be aided by motives or incentives so that the learner will
persist in the learning activity.
4. A definite motive or incentive is valuable in all work, as motives and incentives will prepare
the students to learn.
5. The greater the readiness to learn, the greater attention will be given to work on hand and the
sooner the desired result will be achieved.
6. It is important to get the learner into a state of readiness to learn for it increases alertness,
vigor and wholeheartedness of learning.
7. One sure way to operationalize the law of effect is to assist the learner in achieving ends and
purposes which she desires to attain.
The real problem in motivating students for schoolwork is how to discover values strong
enough to stimulate students to effectively give their best efforts. The value that appeals
strongly to one individual may have little or no appeal to another individual. Moreover, the value
that appeals to an individual at one time may not appeal as strongly at another time. Hence, the
teacher must be continually alert to perceive these differences and fluctuations. Since no two
learners react the same way, motivation for learning must vary for every individual (Turney:
1931)..
Understanding of the nature of motivation in learning is important, because:
1. Motivation determines, not only the intensity of the effort to learn, but also the extent to which
this effort is made as an activity of the total personality.
2. Motivation of learning activities helps the student concentrate on what she is doing, thereby
gaining satisfaction.
3. Continuous motivation is needed to help learners concentrate on the lessons to be learned.
ASSESSING MOTIVATION AMONG LEARNERS
Student motivation is markedly influenced by the learning goals established and the
feedback provided. Both the teacher and students work to accomplish the goals and feedback
can be pursued to meet the needs of each student. To maximize the effectiveness of the
learning process, the teacher needs to carry out brief motivational assessment of students
(Bastable: 2003).
Both internal and external factors affect individual learners' motivation. These factors can
be positive, serving to encourage motivation or negative impeding a desired outcome in
individual. Redenson (2001) sees motivational assessment of the a given learner to be integral
to successful teaching. Following are aspects of assessing students' motivation:
1. Previous learning experiences, like positive and negative outcomes and processes;
2. Personal attitudes and beliefs about learning like reasons taking up nursing;for
3. Readiness to learn such as interest in the subject and impact of external factors such as
family life;
4. Availability of resources to support learning, such as library, laboratories, computer access,

social support, financial resources; and
5. Level of anxiety where moderate levels of anxiety enhances motivation while high levels of
anxiety impede it.
"The two major factors in school achievement are intelligence and motivation, and
that the latter is more important".
-Turney
MEMORY AID
1. Motivation Defined
a. Motivation is the process which creates an inner drive within an individual to seek
goals or objectives.
b. Motivation influences an individual to act.
2. Purposes of Motivation
a. To arouse for desire to achieve a goal.

b. To stimulate action toward a particular objective.
c. To cause a student to perform in a desired way.
d. To create interest thereby cause a student to do the work at hand and willingly
complete it.
e. To use various devices such as offering rewards or an appeal with the desire to excel.
f. To push an individual to a certain direction.
3. Types of Motivation:
a. Intrinsic motivation develops when the learner wants to learn for the sake of learning
which is based on personal motives or intentions.
b. Extrinsic motivation develops when the learner wants to learn for reasons other than
learning which is based on environmental social motives.
4. Maslow's Theory of Motivation and Needs

Maslow states that people are motivated based on a variety of needs which is categorized into
five basic groups:
a. Physiological Needs
b. Safety Needs
c. Social Needs
d. Esteem Needs
e. Self-actualization Needs
5. Motivational Factors of Learners
a. Psychosocial Needs
b. Incentives
c. Knowledge of Progress
d. School Marks
e. Exhibiting Good Works
f. Game or Play
g. Examination
h. Dean's List
i. Emulation
j. Material Rewards
k.Punishment
PRACTICE TEST
1. What is a process which creates an inner drive in an individual to seek goals or objectives?
a. Education
b. Learning
c. Incentives
d. Motivation
2. Which one occurs when the learner wants to learn for the sake of learning based on personal
motives or intentions?
a. Intrinsic motivation
b. Internal motivation
c. Extrinsic motivation
d. External motivation
3. People are motivated based on a variety of needs and categorized into five basic groups.
Which theory does this refers to?
a. Kohler's Motivation Theory

b. Maslow's Hierarchy of Needs.
c. Maslow's Wants Theory
d. Kohler's Needs Theory
4. What needs arise in an individual because he or she is in a social setting?
a. Psychosocial needs
b. Incentives
c. Knowledge of progress
d. School marks
5. Which refers to the use of praise, reproof, competition, knowledge of results of quizzes,
grades, among others?
a. Incentive
b. Knowledge of Progress
c. School mark
d. Exhibiting good works
6. Which stimulates schoolwork to a greater degree than the other forms of motivation?
a. School marks
b. Exhibiting good work
c. Game or play
d. Examination
7. What creates a drive among students to prepare and review in order to get passing marks?
a. School marks
b. Exhibiting good works
c. Game or play
d. Examination
8. What refers to the use of material rewards to motivate students to learn?
a. Dean's list b. Emulation

c. Material reward
d. Punishment
9. What is used as a form of extrinsic motivation?
a. Dean's list
b. Emulation
c. Material reward
D. Punishment
10. Which statements show the least value of motivation to learning?
a. To stimulate and facilitate learning activity.
b. Learning is an active process that needs to be motivated and guided toward desirable
ends.
c. Learning is not self-initiated, but it must be aided by motives or incentives for the
learner to persist in doing the learning activity.
d. A specific motive or incentive is valuable in all work, as motives and incentives make
for readiness.
Chapter 11 THE LEARNING PROCESS
"Life is hard, don't try to do it alone... Everybody needs people to talk with, to
laugh with... to cry with. People who believe in you. People who'll keep believing in you."
-Virginia Cassady Clinton Kelley
● Describe learning as a process; Discuss the different stages of learning;

● Expound on the learning process; and
● Discuss the role of the teacher to improve students' perceptual ability.
LEARNING AS A PROCESS
Although there are a number of different learning theories, there considerable agreement
among educators that learning is essentially a changed behavior brought about by exposure to
various stimuli and that certain elements must be accomplished for learning to take place.
However, each theory places emphasis on different aspects of learning. Teaching precedes
learning which is initiated by a process or activities and is the central focus of a nurse educator
to create change in the learners. Following is the learning process:
1. Learning occurs from the point-of-view of the end-result or outcome of teaching.
Learning is manifested through change in behavior according to what is acceptable,

consistent with the nursing discipline, and which learning is applied for..
Results or outcomes of behavioral change, such as concepts, skills and attitudes, are
described rather than the ongoing process of learning (Davis: 2006).
2. Learning as a process is more concerned with what happens during the course of
learning than in the end-results of learning.
Emphasis of the learning process is on the dynamics of learning, the sequence and the
pattern of change of behavior in the individual and group of learners.
The learning process determines the level of interest and understanding of the different
aspects of the learning situation which causes the learner to react, organize and pattern her
behavior during a learning activity.
3. Learning is also described as a function.
Function emphasizes certain critical aspects of learning, such as motivation, retention,

transfer and other ongoing activities involved in the learning process. The learner gets involved
in a series of mental activities that will work out to grasp comprehensively all the concepts
taught. In this aspect, the learner undergoes the process of unlearning, relearning, and learning.
STAGES OF LEARNING
A teacher must understand the stages of teaching and learning in order to provide
enough time and resources for training students so that the level of knowledge desired can be
achieved. It is important to include in the learning plan the identification of available training
resources and acquiring outside resources when needed. The following stages and
characteristics of learning were adapted from the theory of Dreyfus as cited by Patricia Benner
(Tomey and Aligood: 2007):
1. Novice
a. Has awareness of the subject area, but only in terms of abstract concepts and ideas;
b. Possesses little to no ability to put ideas into practice in a reliable way; and
c. Follows a set of rules without regard for context in learning
2. Advanced Beginner
a. Has attained marginal learning to an acceptable performance level after coping with
real experiences;
b. Begins to understand the scope of the subject area and acknowledge her lack of
knowledge about the discipline; and
c. Able to apply tools, processes, and principles in contexts similar to well defined cases
they have studied.
b. Competent
a. Attained learning after exposure to a working knowledge of a number of areas making

up the subject;
b. New skills and capabilities are internalized with the ability to go beyond rule-bound
procedures in a more complex setting ; and
c. Capable of adapting their learning to varying situations analyzing changed
circumstances and choices of alternatives.
c. Proficient
a. Has gained from experience in different situations;

b. Tools and concepts have been internalized and can be applied to a variety of
situations without much effort; and
c. Has an intuitive, holistic grasp of a situation without having to ignore the problem prior
to determining a solution.
d. Expert
a. Has fully internalized both perception and action into their normal work processes.
THE LEARNING PROCESS
The elements of the learning process consist of setting goals, selecting appropriate
stimuli, perceiving, responding to stimuli, determining consequence and integrating learning
experiences (Wiggens: 2006).
1. Goal
The teacher must set long-term goals with his or her students. This can be achieved
through a long term process of teaching and learning such as to acquire nursing knowledge,
professional values and skills. This is followed by specifying learning objectives that requires
short term activities to motivate students to learn and ultimately achieve the goal.
The teacher can help the student by:
a. Being available for guidance and as a resource person to the student; and
b. Encouraging the student to apply problem solving and"critical thinking" to a given
situation.
2. Stimuli
Stimuli increase the ability of the student to recognize the patient's specific needs in
relation to the overall problem of the patient.
The teacher can help the student reach his or her goals by:
a. Helping the student identify patient needs; and

b. Selecting and arranging a learning situation which will give the student:
● The maximum opportunity to learn,

● To identify, analyze, and meet nursing problems and
● To motivate a patient to develop self-reliant behavior.
3. Perception
Perception is making the student is capable to appraise nursing situations using her
senses and forming insights by:
a. Observing the patient's physical and psychological condition;

b. Reading the patient's chart and nurses notes; and
c. Talking with the patient and her doctor, and other personnel involved in patient care
and finally, her instructor.
The teacher can help the student improve perceptual ability through:
a. Assisting the student in discussing the patient's problem.

b. Providing the necessary cues, to analyze patient needs and problems.
c. Identifying and interpreting the patient's nursing needs, and
d. Directing her attention to critical elements regarding nurse patient relationship.
4. Response
Response refers to the ability of the student to identify patient care needs and formulates
an appropriate nursing care plan. She also takes effort to communicate with her patients to
disseminate information through health teaching regarding nursing care needs and home care.
The teacher can help the student respond well to patient care needs through:
a. student's nursing care plan,

b. Helping her decide priorities of care,
c. Giving support and encouragement,
d. Helping student realize that the nursing problem may require different approaches
before it can be solved; and
e. More time may be needed before very tangible results can be obtained.
The teacher should help the student formulate long-term planning and facilitate students'
understanding while giving her support to attain immediate success in her nursing career.
The student in turn should recognize that assisting the patients is not sufficient; she may
have to apply further nursing theories and techniques to encourage the patient to work and
negotiate with her son the final goal of patient care is attained
5. Consequence
Consequence refers to the outcome of nursing care rendered by the student to the
patient, the expected effects, the side effects or adverse reactions to nursing interventions.
Nature of Consequences:
a. There is a rewarding or satisfying response to the student, when health of the patient
progresses or made comfortable while in her state of illness. A dissatisfying response occurs, on
the other hand, if the patient does not respond to treatment or does not seem to improve in
health.
b. A rewarding or satisfying response to the student, if much learning was attained while
meeting the nursing needs of the patient. The student may still gain nursing knowledge and
experience from every nursing measure she used but did not meet patients' needs.
In this situation, the student confirms her response to her nursing care plan; who is to
make a breakthrough in terms of patient care. This in turn encourages her to continue caring for
her patient. The positive response of the patient to nursing care which encourage self-reliant
behavior may also provide meaningful experience for the student which motivates her further to
perform well in the clinical area.
Note:
The student's response to a given situation through her nursing care plan is a result of
her perception and analysis of the situation.
6. Integration
In Integration the student utilizes personal knowledge and experiences to solve current
problems. She may also make use of other courses offered throughout the curriculum as basis
for designing her nursing care plan.
The teacher can help the student integrate past learning by:
a. Encouraging the student to examine past nursing knowledge and experiences for
validity and reliability of learning:
b. Identifying what nursing care measures were done to the patient; and
c. Making conscious use of the nursing knowledge and the skills she had acquired in
nursing for a particular patient and or other patients.
By assigning the patient to the student, the teacher indicates her confidence in the
student's ability to integrate and transfer her knowledge of principles and skills that she had
acquired in past learning experiences. The teacher is also able to judge the student's level of
learning and readiness to apply her knowledge and skill to various complex situations.
MEMORY AID
1. The theory of the learning process states that:
a. Learning occurs from the point-of-view of the end-result or outcome of teaching.

b. Learning is more concerned with what happens during the course of learning than the end-
results of learning.
c. Learning can also be described as a function.
2. Stages of Learning
a. Novice - the learner has awareness of the subject area but only in terms of abstract
concepts.
b. Advanced Beginner - has attained marginal learning to an acceptable performance
level after coping with real experiences.
c. Competent - has attained a working knowledge after exposure to a number of areas
making up the subject.
d. Proficient has an intuitive, holistic grasp of the situation without having to ignore the
problem prior to determining a solution.
e. Expert has fully internalized both perception and action into their actual work
situations.
3. Goal-set of long term process of learning.
4. Stimuli- increase the ability of the student to recognize the patient's specific needs in relation
to the overall problem of the patient.
5. Perception - the ability of the student to assess nursing situations.
6. Response- the student selects and identifies patient care needs and formulates an
appropriate nursing care plan.
1. How do learning processes take place? Cite specific examples that will translate the process
into actual situations..
2. Present your own personal views regarding the stages learning characterized by Patricia
Benner. of
3. Provide concrete situations to clarify the elements of the learning process.
PRACTICE TEST
1. All of the following describe the theory of the learning process, except: Which one is not
included?
a. Learning occurs from the point-of-view of the end-result or outcome of teaching.

b. Learning is more concerned with the end-results of learning than with what happens
during the course of learning.
c. Learning can also be described as a function.
d. All of the above
2. What is the stage of learning when the learner has awareness of the subject area but only in
terms of abstract concepts?
a. Novice
b. Advanced beginner
c. Competent
d. Proficient
3. What is the stage of learning when the student has an intuitive, holistic grasp of the situation
without having to ignore the problem prior to determining a solution?
a. Novice
c. Competent
d. Proficient
4. What is the stage of learning when the student has attained marginal learning to an
acceptable performance level after coping with real experiences?
a. Novice
c. Competent
d. Proficient
5. What is the stage of learning when the student has attained after to a working knowledge of a
number of areas making up the subject?
a. Novice
c. Competent
d. Proficient
6. What is the stage of learning when the student has fully internalized both perception and
action into their normal work processes?
a. Novice
c. Expert
d. Intermediate)
7. Which one requires a long term process of learning before one can achieve what is desired?
. Response
8. What increases the ability of the student to recognize the patient's specific needs in relation
to the overall problem of the patient?
a. Goal
b. Stimuli
c. Perception
d. Response
9. What is that ability of the student to assess the nursing situation using her senses and
insights?
a. Goal
b. Stimuli
c. Perception
d. Response
10. When the student selects and identifies patient care needs and formulates an appropriate
nursing care plan. What learning process takes place?
a. Goal
b. Stimuli
c. Perception
d. Response
Chapter 12 THEORIES AND PRINCIPLES OF LEARNING
“It is rewarding in the sense of having shared the results of your work and efforts
with colleagues of having contributed in some small way to the nursing profession and
having learned much about yourself in the process."
-Mary Jane Morrow Ward
● Discuss the different principles of learning.

● Identify and explain the characteristics of learning.
● Differentiate the major types of learning:
● Discuss the various aspects of skill development;
● Explain the conditions of learning:
● Discuss the various styles of learning;
● Explain some of the important laws related to learning, and
● Discuss major learning theories.
THEORIES OF LEARNING AND THEIR IMPLICATIONS
Learning theories are guidelines or principles that direct an individual to understand the
meaning of an event or situation. Theories provide basic knowledge that underpin the teaching
learning process. Theories and practice are interrelated. They explain the relationship of each
other since without theories, there can be no practice and practice can be irrelevant without
theories.
Although transition from theory to practice is difficult, a little critical thinking and reflective
thought, reveals that the study of human learning theory, types of learning, and forces that
influence learning can provide guidelines for practice and help teachers establish the conditions
necessary to achieve learning outcomes.
Over the years, theories of learning and the study of specific factors and conditions that
influence learning have universal applicability. In addition,(White 1991) learning principles have
been generated for particular age groups. A teacher who makes decisions based on these
principles is using the best available techniques to guide professional teaching behavior. She
has a chance of interacting effectively with learners than one who is not willing to apply the
principles. The following principles of learning are supported by empirical evidence and have
broad applicability to all types of learners, yet modification based on individual differences and
particular circumstances would be useful.
BASIC PRINCIPLES OF LEARNING
In order for learning to take place and goals be achieved, certain guidelines or principles
are enumerated the following basic principles of learning (Hoozer 1987):
1. Satisfying Stimulus.
If response to a stimulus is satisfying to oneself, the tendency for this is to be repeated

under similar circumstances. The behavior is reinforced, developed, and internalized.
"Reward is more effective than punishment in changing behavior. However, there

should be a slow shift away from extrinsic to intrinsic reward"
-Hoozer
2. Reinforcement.
Immediate, positive, tangible or intangible reinforcement through praise, reward, or

recognition are major conditions for successful behavioral change.
Negative reinforcement slows down the rate at which behavior occurs but does not
eliminate it. However, frequent negative reinforcement may either suppress or demotivate the
learner causing unhealthy behavior or impaired learning process.
Response to learning is strengthened by multiple and consistent reinforcement. The

shorter the time interval between response and reinforcement to learning, the more effective is
the reinforcement in building stronger response. However, overuse of repetition or reinforcement
can lead to students' loss of interest and will not by itself establish association or connection to
learning.
3. Overlearning.
Overlearning increases memory and improves learning performance. Frequent
application of the learned principles into practice strengthens the learning process and can
easily be internalized and shown in students' attitude and behavior.
4 Verbal and Non-verbal Associations.
A critical prerequisite to behavior change is the establishment of verbal and nonverbal

connections. Knowledge put into practice provides a significant meaning of interrelationships
between what is real and what is ideal.
Forgetting occurs because of interference of new learning experiences with previously

acquired ones. Previous practices may be replaced by current trends which makes previous
knowledge irrelevant.
5. Cognitive-perceptual readiness and internal motivation
These are mandatory conditions for behavioral change. The student who has the desire
to learn regarding the subject matter makes comprehension and retention easy, whereas,
students who are not interested to learn make teaching and learning difficult.
"Learning depends on the learner's state of readiness or predisposition toward

learning.
-Hoozer
6. The Ordering of Information
This influences the ease with which learning takes place Systematic and dynamic
presentation of subject matter consistent with students' readiness to learn motivate active and
productive learning process.
7. Stimulus-response associations and discrimination abilities
These are prerequisites to chained behaviors. However, connection or association

cannot be established by mere repetition of a response.
"If as teachers, you have been helping students develop their skills that would
make them independent learners, you are doing well because you have prepared them
for life in the knowledge arena in which we all now have
-ICE-UNESCO
8. Cognitive Constructs
The cognitive constructs of perceptual imagery and recognition of features, such as

form, spatial arrangement, texture, and so on are prerequisites to concept formation.
9. Multiple discrimination and generalisation responses
Students observe and analyze events and its relevance to current practice, retains those
that are useful and eliminates those that are not. These can be done through active sensory,
cognitive and emotional participation and direct physical involvement in learning process.
10. Previous Knowledge
Prerequisites to principles of learning and perception are concept acquisition, and recall of
previous knowledge learned, while Prerequisites problem-solving behaviors to are perception,
association, discrimination, concept formation, generalization, recall and selection responses.
11. Critical thinking skills
Some cognitive, affective, and psychomotor behaviors can be acquired, strengthened or

weakened by observing and imitating the actions of others. The use of critical thinking skills is a
prerequisite to acquiring these cognitive psychomotor skill. This include the process of
perceptual awareness, reception, memory, recall, discrimination, association, generalization,
chaining, and decision-making responses. Psychomotor behaviors include affection and
cognition, while Cognitive knowledge, include comprehension, application, analysis, and
synthesis responses which precede evaluation responses.
12. Flexibility and adaptation
Flexibility is the ability of students to change and allow for more ways to expand the
learning process. Adaptation to change to suit oneself into different events and situations in
order to speed up the learning process. Developing general patterns of personal, social, and
emotional adjustment include affecting, receiving, responding. valuing, and organization
responses.
13. Feedback
Feedback about performance, which includes why and of how topics learned improves learning.
If feedback is given too late, it will have little value. Crucial conditions for behavioral change
include being assertive, sharing, active, overt, short periods of practice and periods of rest,
positive reinforcement, and corrective feedback.
14. Balanced growth and development patterns
Learning can be enhanced by matching learning activities with the learner's level of
development, cognition, abilities, styles, strengths, modalities, and preferences (Emerson:
2007).
A combination of all these principles of learning facilitates the students understanding

and internalizing the learning process.
The Five (5) Processes of Learning (International Commission on Education for the 21st
Century, UNESCO: 1996)
1. Learning is a treasure within.
It stresses that each individual must be equipped to seize learning opportunities

throughout life, both to broaden his knowledge, skills and attitude, and adapt to a changing
complex and interdependent world.
2. Learning to know.
This is less concerned with the acquisition of structured knowledge but more with the
mastery of learning tools. This emphasizes the integration of broad general knowledge with in-
depth analysis of selected number of causes.
"Learning to know is the passport to lifelong education"
-UNESCO, 1996
Concentration, meaning skills and thinking ability is something learners learn first from
their parents and then from their teachers The process encompasses both practical problem-
solving and abstract thinking.
Learning to know the students' needs and to develop learn-to learn skills include:
● Learning to read with comprehension

● Listening
● Observing
● Asking questions
● Data gathering Note taking
● Assessing, processing, selecting and using domains
To facilitate the learning process, the teacher should assume the role of a:
● Facilitator
● Catalyst Monitor
● Evaluator
"A truly educated person nowadays, needs broad general knowledge and the
opportunity to study a small number of subjects in-depth."
-UNESCO, 1996
3. Learning to do.
The acquisition of competence that enables a student to deal with a variety of situations
and work in teams or groups. This further improves knowledge, life skills, personal qualities,
aptitude and attitude.
Learning to do requires a skillful, creative and discerning application of knowledge. An

individual must learn how to think creatively, critically, and holistically and how to deeply
understand the information received.
"We must continually upgrade knowledge and skills to maintain competitive edge"
-UNESCO, 1996
Education must contribute to the holistic development of the individual's:
● Mind
● Body
● Intelligence
● Sensitivity
● Aesthetic sense
● Personal responsibility
● Spiritual values
4. Learning to live together in peace and harmony.
Learning is a dynamic, holistic and lifelong process through which mutual respect,
understanding, caring and sharing. compassion, social responsibility, solidarity, acceptance and
tolerance of diversity among individuals and groups are internalized. To practice together the
solving of problems and work towards a just and free, peaceful and democratic society, this is
addressed through the following efforts:
● Develop broader or better perceptions of attitude toward self and others;

● Professional behavior and interactions with others;
● Understand others' history, traditions and spiritual values; and
● A spirit of respect for the values of pluralism and peace.
"Peace must begin with each one of us. Through quiet and serious reflections on
its meaning, new and creative ways can be formed to foster understanding, friendship
and cooperation among all people."
-Javier Perez de Cuellar UN Secretary General
5. Learning to be.
The aim of education is the complete fulfillment of man, understanding the complexities of
personality, expressions and commitments as an individual, member of a family and community,
citizen and producer, inventor of techniques and creative mentors. Learning to be is anchored
on:
● Self knowledge and relationship with other people;

● Successful personal experience and personality training;
● Highly individualized process and interactive social experiences;
● Freedom of thought, judgment, feeling and imagination to develop talents to keep control
of their lives, and
● Conscientization which is the process of being aware of contradictions existing within
oneself and in society and gradually being able to bring about personal and social
transformation.
"Concern with developing the imagination and creativity should also restore the
value of oral culture and knowledge drawn from the learner's experiences"
-UNESCO, 1996
Learning is social because it takes place in a group as some type of response to the
social environment of the individual. Some learners have high intellectual ability while others
low; some are able to express themselves comfortably, others have difficulty in self expression;
some are leaders in group activities, others only tend to follow; some are slow and deliberate to
action, others are quick, active and fast-moving; some are social, others shy and retiring, some
are definitely mechanical, others are aesthetic and find security and affection in family and
friends. Others seek to satisfy these needs through their classmates and teachers. Simply
expressed, individuals differ from one another and so are their learning capabilities.
Factors which can give rise to differences numerous among individuals are but among
important are the following: the most
● Heredity and genetic factors which influence personality development to a great extent;
● Family upbringing and religious orientation;
● Educational opportunity to become intellectually prepared,responsible, socially aware of
his personality;
● Health which includes the physical, psychological and social wellness;
● Nourishment that enables the mind and body to grow and develop;
● Work experience, and
● Environmental factors.
Since meaningful learning can proceed only by means of the learner's own purposes,
aptitudes, abilities and activities, it is necessary for the teacher to assess individual differences
of the learner in each teaching-learning situation (Bastable: 2007). These differences have to be
recognized since learning and society's achievements come from diverse capacity, interest and
viewpoint of individuals.
There are many differences among individual learners, requiring all students to learn the
same amount, at the same time, with the same degree of behavior expected of them. Hence,
good teaching must consider individual differences among learners and provide them a variety
of learning experiences to elicit individualized and meaningful response to every situation.
3. Learning in Self-active and Self-initiating
Self-activity is a universal basic principle of learning which states that an individual can
learn only through her own reactions to situations based on her capabilities to understand and
internalize such situations. There can be no learning where there has been no self-initiating
activity. Hence, a student learns through her own effort and activities.
Learning is also a personal process. A student draws inferences from factual data
through his senses. Every individual must develop her own habits of learning because a teacher
cannot fully hand over her learning habits and her knowledge or skills to her students. The
teacher can only demonstrate her learned habits or behavior and her skills while a student
imitates or patterns her behavior from what she sees or hear from her teacher (Boiser: 2005).
The role of a teacher is to guide and direct the students' self activity so that learning can
be efficient and effective. If students are not properly directed, self-activity is wasteful and
ineffective (Clark: 2008). Self-activity should be considered when the teacher selects the type of
learning activities for the students. The teacher should remember that:
a. Self-activity must be psychologically sound.
b. Expected learning outcomes of self-activity is paramount rather than mere
expenditure of energy.
c. A student may spend so much time and energy on the activities of learning and still
does not learn much.
d. The choice of learning activities must be consistent with the goals and objectives of
these activities. The two are inseparable.
4. Learning is Purposive and Goal-oriented
Learning is both active and purposeful. Goals and objectives should be set for every
learning situation. Goals are determined directly by motives and indirectly by incentives
(Emerson: 2007) Motives, which may take a variety of forms, are physical and psychological
conditions, within the person that disposes him or her to act in certain ways. It energizes
behavior and arouses activity.
Goal-setting is directed toward short-term and long-term goals:
a. Short-term goals are related to the specific tasks or immediate tasks to be

accomplished; while the
b. Long-term or ultimate goal is the sum total of all short-term goals and activities
that should be accomplished to meet the desired change expected in an
individual.
Both immediate and long-term goals should be defined clearly and explicitly for the
learner to gauge her performance based on the goals set for each task (Nivsen: 2006).
Selection of goals by the learner is influenced by the following factors:
a. Religion or the learner's spiritual orientation

b. Philosophy, beliefs, and practices in life
c. Culture and values
d. Environmental conditions
5. Learning is Selective and Creative
Human learning is both selective and creative. The decision of what is to be learned is
made by the learner in terms of how important it is in her eyes and to others.
Learning is a process of personal choice-making by deciding for oneself what she is to

believe and what she is to do with his or her life. A student creates herself by bringing out her
own potentialities into actualities. A student learns only what she chooses to learn.
The learner has the ability to change her responses and create new forms of responses.
She responds primarily to the environment that she creates for herself. Her perceptions will
influence her behavior in ways that are consistent with the social norms that she creates.
Learning, then, is not merely duplication of an act performed by someone else nor
merely summing up of previous knowledge and experiences, but a creative synthesis of all the
knowledge and experience aspired by the learner.
6. Learning is Influential and Transferable
Transfer affects the extent of all learning activities, meaning that whatever is learned in
one context or situation applies or affects another context or situation making learning broader
and expansive.
The extent to which transfer of learning occurs depends on the following:
a. The intellectual ability and the background experience of the learner.

b. Her personal philosophy goals and objectives in life.
c. The relationship between the activities of the learner and the goals set.
d. The learner's approach that facilitates understanding and memory.
e. The solutions to problems through personal or professional ways.
Transfer of learning seldom takes place automatically. It must be planned for and worked
at continuously by both the teacher and the student. Transfer of learning depends on the
understanding of the concepts and ideas presented. Understanding of whatever was learned
depends on the relationships of concepts which have been generalized by the learner and her
solution to practical problems (Heidgerken: 1987 and Boiser: 2005).
True learning affects the behavior of the individual which is shown through obvious
modifications and change consistent with the
standards set for learning and in response to a real or practical needs of the learner.
MAJOR TYPES OF LEARNING
There are major types of learning that students may elicit during the process (Eggen:
1994). These include:
1. Ideational Learning
Ideational learning is pursued in the cognitive domain. This indicates the following:
a. Cognition
Cognition refers to processes through which an individual obtains knowledge about
anything by perceiving, remembering discriminating, integrating, abstracting, generalizing,
evaluating, imagining, thinking, problem-solving, and creating
Note:
Remembering is included in the concept of cognition because whatever information is acquired
must be remembered. Otherwise, cognition failed to occur.
The learner acquires knowledge and information through which she forms concepts,
sees relationships and arrives at generalizations.
The terms used to describe the products of ideational learning are knowledge and
understanding such as facts concepts, meanings, generalizations and principles.
b. Perception
Perception refers to the source of all concepts which initiates mental activity. It begins
from "sensation" of all the stimulus surrounding the learner and environment. the learning
Perception is the immediate conscious reaction of the organism to the stimulation of a sense
organ. Perception is also the mental process through which various stimuli interpreted.
Perception and sensation occur simultaneously. One perceives while the other senses;
the something that is immediately present to the senses and gets stored in the memory, to be
recalled in the future while developing concepts (Gaberson and Oerman: 2007). process of
interpreting or giving meaning
*All perception to sensation results in the formation of has its origin in percepts. A
percept is a mental picture of sensation.
-Eggen
c. Concept
Concept refers to an idea or a mental image which makes reflective thinking possible. It
is a building block of theories through which knowledge is formed. Concepts can either be:
● Abstract concepts. These are very complex concepts and require more than one term to
convey their meaning (e.g. man or nursing).
● Concrete concepts. These are simple and realistic concepts. It illustrates simplicity of a
thing. (e.g.Joseph a student).
d. Principle
Principle is a form of generalization that implies action. It is a statement that explains a

large number of related phenomena which may serve as a guide to action.
Cognitive abilities include the process of perceiving well judging, and integrating
complex phenomenon. This is followed by continuing perception of something, as differentiation
and judgment of such phenomenon (Eggen: 1994 and Davis: 2006). In the choice and
statement of objectives, the teacher of nursing must realize that the learner:
● Develops specific understanding of patient problems.

● Acquires a particular nursing skill.
● Design solutions to meet the patient needs and problems, implement solutions
effectively and make decisions. efficiently and
● Develops a professional attitude.
This should be kept in mind when stating objectives for teaching and in evaluating
learning outcomes.
Teachers can help students learn concepts by:
a. Providing opportunities for appropriate intellectual and sensory experiences such as in their
related learning experiences (RLE); and
b. Guiding students in identifying concepts implicit to their learning experiences. Many audio-
visual media, if properly used, offer excellent opportunities for teachers to provide such
experiences.
When concepts are adopted and formed through ready-made memorization, these
concepts have no roots in student's experiences and convey little meaning to them, and are
likely to be forgotten soon.
2. Skill or Psychomotor Learning
Skill learning is pursued and developed in the cognitive and psychomotor domain. It
refers to refined pattern of movement of performance based on integrated perceived demands
of the situation. It is not a mere action or doing a thing but a unified, organic whole movement or
total act of the learner. It implies a learned response to a situation (O'Connor: 2006).
Some skills, such as nurse-patient interaction, are strong in emotional components.
Others, like charting or documentation, may be developed with little emotional involvement.
Skills also vary in extent of psychomotor and perceptual involvement.
Scrubbing of the hands before surgery is heavily motor and low perceptual, whereas
entering into a therapeutic relationship with a psychiatric patient is highly perceptual and low
motor (Wiggens: 2006).
Factors that contribute much to skilled student performance are as follows (De Young:
2003):
● Strength of character and enthusiasm on the subject matter;

● Reaction time and acceptability in doing the task on hand;
● Speed, diligence and perseverance;
● Precision in dealing with techniques and procedures;
● Consideration given to shortcoming through allowance for revision or modification; and
Flexibility in doing the task according to intensity and magnitude.
3. Emotional Learning
Emotional learning refers to a mental state which is characterized by certain feelings and
emotions. The end-products of emotional learning which determine the character of the
student's motive power are the following (Feldman: 2004):
a. Emotion and Will
Emotion and will are the ability to accept and cope with rejection and still continue
performing tasks to achieve a specific set of goals.
The best way to develop the emotional-type of learning is to secure proper balance
between emotion and control of
emotion by will. Self-control is required to control emotions by will.
To develop self-control, the teacher must constantly demonstrate to students the

desirability of doing or acting in the light of thought, principles and purposes, rather than mere
impulses from within and unpredictable circumstances from without (Kolsenick: 1963).
b. Attitudes
Attitude refers to a disposition, readiness, inclination, or tendency to act toward a

specific goal in a particular way. Attitudes may be strong or weak, for or against, depending on
the or pain reactions as a result of the stimulus.
Attitude is a feeling rather than an overt action. Attitudes consist of doubt; finding favor or
antagonistic feelings towards something, among others (Eggen: 1994).
c. Values in Emotional Learning
Values are learned through observation, simulations and significant and reliable
information necessary for adaptation. These are differentiated from other skills and knowledge
since it is concerned about the appreciation of learning that is made to exist in a given situation
or in a given experience.
It is this recognition of value that distinguishes appreciative learning different from motor
or ideational learning. While knowledge and skills possess no value in themselves, they may be
pursued quite independently from any recognized value (Preddy: 1997).
The best and most effective learning requires motivation and valuing of the topics taught
or experienced.
Appreciation is a core value attached to nature, material things, aspects of art,

processes, techniques, conduct, and social institutions, among others.
Appreciation develops as a result of emotional experience which is more significant than

pleasurable satisfactions. Appreciation is both intellectual and emotional, if these emotions are
considered as part of the recognized value integrated into one's culture and beliefs (Quinn:
2000).
In other words, appreciation implies that emotional and intellectual experience have a
richer meaning for improving the level of understanding and practical meaning of these, to
appreciate the value of what is being learned.
a. Ideals in Emotional Learning
Ideals are attitudes which function as driving forces in the realm of human conduct.
Ideals are formed from ideas or previous knowledge learned. Ideals are standards that are the
object of desire. They determine what an individual believes in, accomplishes, or become
throughout her entire life.
ASPECTS OF SKILL DEVELOPMENT
Skill development is a process requiring in depth knowledge and appreciation of what is

learned. Skill development is acquired through form and execution (Gaberson: 2007).
1. Form
Form is the manner in which movements are carried out. It can be best learned by
listening to directions, explanations reading instructions demonstrations. and or seeing
"Students can only learn by purposeful activity; that is, they learn by doing."
-Heidgerken
Imitation whether subtle or conscious, is valuable in learning skills. A nurse educator

should always remember that students tend to imitate the type of nursing practice they are
exposed to. For example, a staff nurse doing nursing care to her patients as seen by the
students will be construed as the correct way of doing the procedure. Hence, the student will
most likely imitate the performance of that certain procedure.
Attention refers to the amount of focus or concentration given to a certain situation. It is

an important factor in the development of form.
The teacher must be patient when teaching her students. because it involves many
trials. He or she should consider individual differences among students.
2. Execution
Execution is the actual performance of the skill. This partly or entirely eliminates excess
movements, and emphasizes timing, force and coordination. To produce effective learning of
execution, form must have been accomplished before initiating execution. This includes the
following:
a. Accuracy and Speed
As to form and execution of perceptual-motor skills, it is of particular importance that

proper emphasis be placed on correct actions, accuracy and speed.
Correct and accurate motions are of primary importance and should receive greater
emphasis than speed. Teachers must differentiate between accuracy and speed. Accuracy must
be first developed and maintained. Once learned, then speed comes next. Accuracy cannot be
superimposed by speed. Once speed is introduced, accuracy diminishes.
Similarly, speed is associated with efficiency or time factor component while accuracy is
to effectiveness or quality factors component of doing nursing care activities, although both are
important tools in doing nursing care activities.
However, quality or effectiveness of care takes precedence over all other factors. For
example, a patient needs a cleansing enema prior to gastrointestinal series or Barium enema at
8 o'clock in the morning. A clear return flow is necessary even if there is time delay in the
diagnostic procedure.
b. Practice
Practice is absolutely necessary in the development of a skill. Practice alone, does not
make for perfection but it is the attitude of the learner that can develop and improve the skill and
prevent errors. Practice reinforces learning, but is not learning itself.
Practice produces learning if it is directly proportional to the following:
1. Information obtained as basis to guide and direct the learner in what to prioritize.
2. Efforts done and sustained in several occasions of learning in order to develop the
mastery of doing a particular activity.
Length of the practice periods and the extent of practice vary in accordance with these 3
criteria:
1. Complexity of the skill;

2. Ability of the learner; and
3. Attention and effort used by the learner.
Time management is necessary in determining the amount of practice to be

accomplished for a specific task, hence, the length of time needed for:
1. The specific task to be done is commensurate with profitable effort spent; and
2. The practice yields expected output.
Standards of time are necessary because too much practice may result in indifference of
the learner to a certain task. Short periods of intense practice distributed throughout in a long
period of time generally bring better results than long periods of practice crowded within a short
period of time.
Much of nursing practice depends on skills, such as psychomotor, verbal, social, and
mental skills. Hence, the nurse educator should constantly keep these principles in order to
guide her students to develop the skills.
To guide teachers in their teaching skills, they should possess the following:
1. Right attitude to the skill to be learned with proper mind set;

2. Clear perception of the needed skill;
3. Correct start which focuses on form before
speed;
4. Conscious desire toward good results with sustained and intense effort;
5. Ability to always practice in specific situations;
6. Ability to practice in short, intense manner distributed over a relatively long period of
time; and
7. Ascertain knowledge of results and correction of errors.
CONDITIONS OF LEARNING
This theory stipulates that there are different types or levels of learning. The significance
of these classifications is that each type of learning requires different types of conditions. Gagne
(2002) identifies five major categories of learning as follows:
1. Verbal information. The ability of the student to express her ideas, thoughts, or actions;
2. Intellectual skills. This include learning to analyze and synthesize situations in order to plan
for alternative solutions to identified problems,
3. Cognitive strategies. The student recognizes learning experiences best suited to her own
needs and makes use of resources to strengthen and develop thinking.
4. Motor skills. These are actions done corresponding to what is thought about and what is
learned, and
5. Attitudes, feelings and emotions. This is evoked or facilitated by the learning stimuli that can
further help determine the significance and meaningfulness of a learning situation.
Different internal and external conditions are necessary for each type of learning. For
example, for cognitive strategies to be learned, there must be a chance to practice developing
new solutions to problems; to learn the right attitudes, the learner must be exposed to a credible
role model or persuasive arguments.
Gagne suggests that learning tasks requiring intellectual skills can be organized in a
hierarchy according to complexity, as follows:
● Recognition of stimulus;
● Generation of response;
● Following procedure;
● Use of terminologies;
● Discrimination;
● Concept formation;
● Rule application; and
● Problem solving
The primary significance of the hierarchy of intellectual skills is to identify prerequisites

that should be completed to facilitate learning of each level. Prerequisites are identified by doing
a task analysis of a learning-training task to be done. Learning priorities provide a basis for the
sequencing of instruction.
Furthermore, the theory outlines nine instructional events and their corresponding
cognitive processes:
● gaining attention (reception)
● informing learners of the objective (expectancy)
●
● stimulating recall of prior learning (retrieval)

● presenting the stimulus (selective perception)
● providing learning guidance (semantic encoding)
● eliciting performance (responding)
● providing feedback (reinforcement)
● assessing performance (retrieval)
● enhancing retention and transfer (generalization)
Example:
The example below illustrates a teaching sequence or steps corresponding to the nine
instructional events for the objective of recognizing the relevance of the nursing process,
situations requiring these activities:
1. Gain attention: show the various components of the nursing process.
2. Identify objective: pose question: "What is the nursing process?
3. Recall prior to learning: review definitions of nursing care process.
4. Present stimulus: give definition of nursing process.
5. Guide learning: show example of how to formulate a nursing diagnosis.
6. Elicit performance: ask students to explain the components of the nursing process.
7. Provide feedback: check all examples if correct or incorrect.
8. Assess performance: provide scores and remediation.
9. Enhance retention/transfer: show pictures of objects and ask students to identify the
components of the nursing process.
LEARNING STYLES
Knowing the student's learning style enables the teacher to orient the students to the
prefe.red method. The teacher then makes adjustment while giving more emphasis on style that
fits the given situation best and the students' learning style preferences.
(Kyriacon: 1991). Using these ideas, Kolb describe learning as stream of interconnectedness
occurring in stages, such as the following (Bradshaw and Lowenstein: 2007):
● Concrete experience or factual exposure to an event or situation.

● Observation and reflection on the experience derived from that situation.
● Conceptualization; such as coming up with ideas taken from the same situation.
● Generalization or generate knowledge applicable in a variety of settings.
Kolb further went to identify four (4) basic learning styles which include the following:
Four Learning Styles:
1. Divergers
Divergers look at situations or events from different perspectives. They prefer concrete
experience and reflective observations. They are sensitive, and prefer to watch rather than do.
They tend to gather information and use imagination to solve problems. They are best at
viewing concrete situations and giving several different viewpoints rather than viewing abstract
situations. Hence, the teacher must provide concrete examples when discussing concepts,
theories, or principles of nursing practice for better understanding and processing of learning
outcomes.
Learners perform better in situations that require idea generation such as brainstorming,
research, experiments, among others. They are interested in people, and tend to be
imaginative, emotional, and strong in the arts. They prefer to work in groups, to listen with an
open mind and to receive personal feedback.
2. Assimilators
Assimilators are learners who are more concise and logical in their approach. They
prefer abstract conceptualization and reflective observations. Ideas and concepts for these
learners are more important than concrete situations. They require good clear explanation
rather than practical opportunity.
Learners excel in understanding wide-ranging information and organizing this in a clear

logical way. Learners with this style are more attracted to logically sound theories than
approaches based on practical value. Theorists are likely assimilators.
3. Convergers
Convergers are more concerned with problem-solving and uses this learning style in
finding solutions to practical issues. They prefer technical tasks, and are less concerned with
people and interpersonal aspects. They are best in finding practical uses for ideas and theories,
which they use for problem-solving and decision-making.
These learners are more attracted to technical tasks and problems than social or
interpersonal issues. This learning style enables those who use it to specialize and engage in
technologically oriented activities. People with this style like to experiment with new ideas, to
simulate, and apply learning to practical situations.
4. Accommodators
Accommodators have a 'hands-on' learning experience that relics on intuition rather than
logic. Learners use other people's analysis, and prefer to take a practical, experiential approach.
They are attracted to new challenges and experiences, and to carrying out plans. They
commonly act on 'gut instinct rather than logical analysis.
They tend to rely on others for information than do their own analysis.
This learning style is prevalent and useful in roles requiring action and initiative. People
with an accommodating learning style prefer to work in teams to complete tasks. They set
targets and work actively or trying different ways of achieving an objective.
The average learning styles of nursing students are predominantly in the converging
category with the tendency toward accommodating style. Among the nursing faculty, however,
the average style is that of diverging which is more concrete to reflective observations
(Bradshaw and Lowenstein: 2007).
LAWS OF LEARNING
Edward L. Thorndike postulated several "Laws of Learning," applicable to the learning

process. However, the "laws" do provide the teacher with insights into the learning process that
can assist them in providing rewarding experience to the learners (Eggen: 1994).
The first three are the basic laws of learning the law of readiness, the law of exercise,
and the law of effect. The other three laws were added later as a result of experimental studies:
the law of primacy, the law of intensity, and the law of recency.
1. Law of Readiness
The Law of Readiness states that in order to learn, one must be physically and mentally
ready to receive a learning stimuli. Therefore, a learner must be physically, emotionally, and
mentally ready when engaging in learning activities to efficiently and effectively absorb new
knowledge and enhance skill. Readiness may be achieved if a learner is able to satisfy her
basic needs first as stated in Maslow's hierarchy of needs.
2. Law of Exercise
The Law of Exercise stresses the idea that repetition is basic to the development of
adequate responses because tasks most often repeated are easiest remembered and
practiced.
The mind can rarely recall new concepts or practice after a single exposure, but every time it is
practiced, learning continues and is enforced and strengthened.
"Students who study religiously perform better than those who procrastinate and cram."
-Eggen
As was previously discussed, "practice does not necessarily result in perfection" of a

skill. However, short but frequent practices may yield better results than a one-time long practice
crowded in a short period of time. Similarly, mastery of a subject matter can not be achieved
over night. It has to be learned, repeated, and practiced continuously in bits and pieces.
3. Law of Effect
The Law of Effect involves the emotional reaction of the learner which states that:
a. Learning is more effective when there is a feeling of satisfaction, pleasantness, or

reward which accompanies the result of the learning process.
b. Learning is strengthened when accompanied by a pleasant or satisfying feeling and

that it is weakened when associated with an unpleasant experience.
4. Law of Primacy
The Law of Primacy states that being first often creates a strong, almost unshakeable
impression. The first lessons learned create a strong impact on the learners memory and
understanding. An incorrect lesson learned by a learner is difficult to correct. Therefore, a
teacher must always ensure that lessons taught are precise and accurate.
5. Law of Intensity
The Law of Intensity states that if the stimulus or experience is real, intense and vivid,
the more likely learning will occur. A practical and dramatic or exciting learning experience
teaches more than a routine or boring experience.
6. Law of Recency
The Law of Recency states that information or skills most recently learned are best
remembered, while the things learned some time ago are less remembered.
Practicing a skill or a new concept just before using it will ensure a more effective
performance. Instructors recognize the law of recency when they plan a lesson summary or a
conclusion of the lecture. The teacher should repeat, restate, or reemphasize important matters
at the end of a lesson to make sure that the learners remember them instead of inconsequential
details.
LEARNING THEORIES
It is important for a teacher to familiarize herself with the various learning theories. This
way, she would be able to develop a teaching style appropriate for her personality and her
students' learning ability based on her knowledge of the learning theories. Theories also explain
the role of the teacher and the learner as they respond to various stimuli for effective learning to
take place.
Stimulus Response theories are equated with the behavioral modification theory. These
theories use simple external stimuli in observing the subject's learning responses to both
positive and negative reinforcement, and how these responses may change over a period of
time depending on the stimulus applied.
On the other hand, cognitive theories dwell on the learner's ability to solve problems
rather than simply responding to stimuli. According to this theory, the learner may develop
solutions to problems based on past experiences, and with additional experience and
knowledge, they may further develop new ways of solving problems at hand.
Behavioral learning theories explain the meaning of behaviorism to greatly influence the
education process. The principles of behaviorism was originally derived from observation of
learning in animals. Behaviorists presented a variety of principles but they all shared a common
framework. The fundamental premise of behaviorism are that all behavior is learned and that
learning is most influenced through manipulation of the environment in which it occurs and the
rewards provided to encourage it. (Bravagart and Bravagart: 2003; Vandeveer and Norton:
2005).
Social learning theories explain human behavior and their changes as a product of
interaction between cognitive, behavioral and environmental determinants, where people can
affect their environments as much as environment affect people (Jarvis: 2005).
The following are the Learning Theories
1. Stimulus Response
a Ivan Pavlov Classical Conditioning Theory
In the 1900's Russian physiologist Ivan Pavlov, was studying the saliva's role in the
digestive tract with his dogs as his subjects. To get his dogs to salivate, Pavlov presented them
with food.
After working with a particular dog for a few days, Pavlov noticed that the dog would
salivate even before being presented with food. The dog drooled every time Pavlov entered the
room.
Classical conditioning investigated the capacity of animals to learn new stimuli and
connect them to natural reflexes which allowed non-natural cues to elicit a natural reflex.
In another experiment, Pavlov used to ring a bell as a neutral stimulus. The dogs could
care less about the bell and nothing happened. Then Pavlov would feed his dogs, food being
the unconditioned stimulus, and the dogs would drool, presenting the unconditioned response,
which is salivation.
Pavlov repeated the procedure several times by ringing the bell and feeding the dogs. After a
period of time, the dogs would start to salivate at the sound of the bell alone.
Pavlov then concluded that the dogs were classically conditioned to salivate at the sound of the
bell. Pavlov's bell now became a conditioned stimulus because it elicited salivation, the
conditioned response. The dogs had associated the ringing of the bell, even without the original
stimulus, with feeding.
Factors Affecting the Conditioned Stimulus and Response

Relationship:
a. Frequency of conditioned and unconditioned stimulus pairings. Pavlov's bell which elicited
salivation of the dog was the conditioned stimulus.
b. Timing of stimulus presentation. There was salivation of the dog before the food was
presented.
c. Similarities between one type of conditioned stimulus and another.

Pavlov further found that conditioned responses could be eliminated gradually; a
process he referred to as extinction.
In extinction, Pavlov rang the bell repeatedly and failed to feed his dogs, until they
eventually learned to disassociate the ringing of the bell with food.
However, extinct conditioned responses could reappear after a rest period if the
conditioned stimulus was again applied which Pavlov referred to as spontaneous recovery.
b. Edward Thorndike's Connectionism Theory
American educational psychologist Edward L. Thorndike posited the first scientific theory
of learning, his theory of connectionism.
He focused on the effects of reward and. punishment, success or failure, and

satisfaction or annoyance on the learner.
He disregarded the idea that the mind was a separate entity, placing it in the total
response of the learner to his environment. He discarded the idea that man was either sinful or
good and that he was completely modifiable..
According to Thorndike, man was simply a mass of "original tendencies" that could be
exploited for either good or evil, depending on what learning took place. His three major laws of
learning provided the following basic principles of the connectionism theory:
1. The law of exercise or repetition
States that "the more often a stimulus-induced response is repeated, the longer it will be
retained."
Example: A nurse develops the expertise if he or she repeatedly handles actual delivery
cases.
2. The law of effect
States the pleasure-pain principle: A response is strengthened if followed by pleasure

and weakened if followed by displeasure.
Example: Self-injection of insulin to patients with Diabetes Mellitus will increase the pleasure in
injecting self if he or she is relieved of hyperglycemia.
3. The law of readiness

States that because of the structure of the nervous system, certain conduction units, in a
given situation, are more predisposed to function than other parts of the body system.
Example:
Age and developmental tasks proceed simultaneously such that reading and writing skills can
only be developed at 6 or 7 years of age.
c. B.F. Skinner's Theory of Operant Conditioning
Skinner described the effects of the consequences of a particular behavior on the future
occurrence of that behavior as "operant conditioning".
There are four types of Operant Conditioning,namely:
a. positive reinforcement;
b. negative reinforcement;
c. punishment; and
d. extinction
Positive reinforcement such. as reward or recognition strengthens behavior. A student

who is praised or rewarded with high grades after doing very well in class will perform better
than those who are not praised.
Negative reinforcement such as punishment and extinction weakens behavior. A student

who is discouraged to proceed in doing a new task will not develop self-initiating activities.
Figure 9: Skinner's Theory of Operant Conditioning
In one of Skinner's experiments, a hungry rat presses a bar in its cage and receives
food. This is a positive reinforcement that strengthens the behavior of the rat of pressing the bar
to receive food.
Then, another rat is placed in a cage and immediately receives a mild electrical shock on
its feet. This is a negative reinforcement which weakens the behavior of the rat of pressing the
bar to receive food but instead receives electric shock.
Punishment weakens a particular behavior through the consequence of experiencing a

negative condition. Extinction weakens a particular behavior through the consequence of not
experiencing either a positive or a negative condition. Positive reinforcement conditions the
mouse to find the end of the maze. The mouse is rewarded with food when it reaches the first
turn in the maze (A). Once the first kind of behavior becomes ingrained, the mouse turn
Example:
A rat presses a bar in its cage and nothing happens, neither a positive nor a negative condition.
The rat presses the bar again and again nothing happens. The is not rat's behavior of pressing
the bar is weakened by the rewarded until it consequence of not experiencing anything positive
or makes the second stopping anything negative.
(B). After Many times through the maze, the mouse must reach the end of the maze to receive
its reward (C). Skinner's research on operant conditioning led him to conclude that simply
rewarding small acts could condition complex forms of behavior (Encarta).
d. John Watson's Behaviorism Theory
John B. Watson pioneered the behaviorism theory. Behaviorism originated in the field of
psychology. Its concepts and methods are used in education.
Concepts of Behaviorism
1. Behaviorism is naturalistic.
Behaviorism states that the material world is the ultimate reality, and everything can be
explained in terms of natural laws.
Man has no soul and no mind, but only has a brain that responds to external stimuli.
"Man is stripped of his responsibility, freedom, and dignity, and is reduced to a

purely biological being, to be shaped by those who are able to use the tools of
behaviorism effectively".
-John Watson
2. Man is nothing more than a machine.
States that man responds to conditioning process and responds accordingly the way the
mind perceives the stimulus.
3. Men are "biological machines" whose minds do not have any influence on their
actions.
According to Skinner, the mind and mental processes are "metaphors and fictions" and
that "behavior is simply part of the biology of the organism."
4. Behaviorism teaches that we are not responsible for our actions.
Since men are mere machines, then anything done by men is inevitable.
5. Behaviorism is manipulative.
Behaviorism predicts and controls human behavior by controlling rewards and

punishment. One can shape the behavior of another individual.
e. Edwin Ray Guthrie's Contiguity Theory
Edwin Ray Guthrie's law of contiguity states that combination of stimuli which has a
accompanied a movement will on its recurrence tends to be followed by that movement
(Guthrie, 1952).
According to Guthrie, learning was based on a stimulus-response association. He

believed that movements were small stimulus- response combinations and when combined,
would make up an action.
Guthrie posited further that some behavior involved repetition of movements and what was
learned were movements, not behaviors. These movements in turn, formed a series referred to
as habit.
Guthrie rejected the law of frequency but strongly believed in one-trial learning.
One-trial learning means that a stimulus pattern gains its full associative strength on the
occasion of its first pairing with a response. He did not believe that learning as dependent on
reinforcement. He also rejected the idea of reinforcement because it occured after the
association between the stimulus and the response. Contiguity theory implies that forgetting is a
form of retroactive or associative inhibition.
Associative inhibition occurs when one habit replaces another due to some stronger
stimuli. Guthrie stated that forgetting was due to interference because the stimuli became
associated with new responses.
The Guthrie-Horton experiment, as shown in Figure 10 illustrates the associative theory

of learning. Guthrie-Horton used a glass paneled box which allowed them to photograph the
cats' movements. The box was constructed so that the cat could open the door by touching a
post.
It took approximately 15 minutes for the cat to touch the post. The second time, the cat
had the tendency to duplicate its first behavior. The photographs showed that the cats repeated
the same sequence of movements associated with their previous escape from the box which
showed an example of stereotyped behavior.
Figure 10: Guthrie's Theory of Contiguity

2. Cognitive Theories on Learning
a. Kohler's Insight Theory
The German-American psychologist Wolfgang Kohler, argued that animals did not learn
everything through a gradual trial-and-error process, or stimulus-response association. He
suggested that animals solved problems by
understanding, like human beings, and were capable of insight learning. Köhler also
discovered with von Restoff the isolation effect in memory which contributed to the theory of
memory and recall, and developed a non-associationist theory of the nature of associations He
used a 'dynamic' model of human behavior which emphasized the active role of organization in
perception.
Wolfgang Köhler conducted experiments on chimpanzees and recorded their ability to

devise and use simple tools to solve problems.
Sultan was a chimpanzee in one of Kohler's experiments. He was placed in a room

where bananas were too high for him to reach.
The solution to the problem lay with the boxes that were strewn around the room.
Sultan stacked the boxes on top of each other and...climbed the platform to reach the
bananas.
b. Kurt Lewin's Field Theory
Kurt Lewin emphasized the meaning of human behavior in terms of the forces and
tension that moved men to action in his field theory.
Lewin concluded that individual behavior was always oriented toward a particular goal.
The Field Theory States that:
1. Behavior must be derived from a totality of coexisting facts.
These coexisting facts make up a "dynamic field," or the state of any part of the field
depends on every other parts of it. Human behavior depends on the present field rather than on
the past or the future. This field is the life space, which contains the person's psychological or
behavioral environment. The psychological environment is the environment as the person
perceives and understands it.
2. The Zelgarnik Effect.
Lewin's student, Bluma Zeigarnik, carried out an experiment on waiters and waitresses
of a particular café in Berlin where orders were not written down but merely kept. in mind or
remembered.
However, after the customers paid their bills the waiters and waitresses barely
remembered their customers' orders which came to be known as the Zeigarnik effect. Thus,
knowledge learned through hearing alone cannot be remembered after a series of time have
elapsed since it happened. Memory of events can happen if learning is reinforced by note
taking, demonstration and other audio visual materials.
C. Jerome Brunner's Discovery Theory
Jerome Brunner and his discovery learning theory is an inquiry-based, constructivist

learning theory. This takes place in problem solving situations where the learner draws on her
own past experiences and existing knowledge to discover facts and relationships and new truths
to be learned.
● The constructive learning theory proposes the following:

● Encourages active engagement to a certain activity.
● Promotes motivation and interest to learn.
● Promotes autonomy, responsibility, independence.
● Development of creativity and problem solving skills. Initiated a tailored learning
experience.
Critics have sometimes cited disadvantages of this theory as follows:

● It creates cognitive overload; .
● May develop potential misconceptions; and
● Teachers may fail to detect problems and misconceptions regarding the subject learned.
d. Rumelhart's Schema Theory
According to David Rumelhart "a schemata theory is basically a theory about

knowledge." It is about how knowledge is represented and how that representation facilitates
the use of such knowledge in certain ways."
Rumelhart focused on the form of the schema theory and on representation and reuse.
Schema is a form of retrieval structure, identifying elements from their earlier experience which
can be reused in current situation (Gleitman: 2000). Part of what guides the comprehension and
any later memory information are schemata (Brewer and Nakamura: 1984; Rumelhart: 1980;
Thorndyke: 1984).
The construct of schema refers to knowledge structures or frameworks that organize an

individual's memory for people and events. The schema is a general mental construct that acts
on all forms of information, irrespective of the model: visual or auditory, linguistic or
nonlinguistic, to which it is exposed. An individual holds mental schemata based on past
experiences.
e. David Ausubel's Assimilation Theory
David P. Ausubel, a psychologist, focused on presentational methods of teaching in the

acquisition of subject matter in the curriculum.
Ausubel came up with the assimilation theory, which states that the "most meaningful
cognitive learning occurs as a result of interaction between new information and the individual's
relevant cognitive structures that he or she already possesses or have previously acquired."
Ausubel (1978) distinguishes between types of learning by using a model consisting of

two dimensions of learning, one on the continuum from rote to meaningful learning, and the
other on the continuum from reception to discovery learning.
Ausubel also drew a distinction between psychology and educational psychology.

According to Ausubel, psychology is concerned with problems of learning while educational
psychology is an applied science concerned with the aspects of learning that can effectively
bring about assimilation of organized body of knowledge.
Ausubel posits that knowledge dimensions consist of four quadrants:
● Meaningful reception learning. The learner understands, assimilates and practices what
was learned.
● Rote reception learning. The learner repeats from memory what was learned after
constant attention to meaning.
● Meaningful discovery learning. The learner perceives the significance of knowledge
learned. Rote discovery learning.
● The learner discerns new facts, however needs to identify its meaning to present events.
Types of Meaningful Learning
1. Representational or Vocabulary Learning Vocabulary learning consists of learning single

words or what is represented by them.
2. Concept Learning
Defined as 'objects, events, situations or properties that possess common attributes and are
designated by some signs or symbols.
Ausubel identified two types of concept acquisition:

a. Concept formation. Develops in young children which occurs from objects seen and heard. b.
Concept assimilation which develops in school children and adults with empirical reasoning and
logical implications of events leading towards knowledge acquisition and application.
3. Propositional Learning
In this form of learning, it is not simply the meaning of single words that is learned, but
the meaning of sentences that contain composite ideas. Syntax and grammatical rules must
also be understood.
Ausubel points out that there is a difference between meaningful learning and the
learning of meaningful material. In order for materials to be learned meaningfully, it is necessary
to meet three criteria:
● In the case of meaningful learning, the student must adopt an appropriate learning 'set'
to learn the task meaningfully, as opposed to rote or fashion learning.
● The learning task itself must have logical meaning, in that relates to the student's own
cognitive structure in a sensible way.
● The student's own cognitive structures must contain specifically relevant ideas with
which the new material can interact.
Example:
The student may adopt a set to learn the material in a word for-word fashion, in which
case the new material would be linked to the existing structure in a simple, arbitrary way without
any real interaction. Such linkage prohibits the direct use of existing knowledge and in addition,
the word-for-word nature of learning will place limits on the amount of material that can be
learned and retained. Ausubel considers that pure rote learning plays little part in everyday
classroom learning beyond elementary school level.
3. Social Theories
Albert Bandura's Social Learning Theory
Albert Bandura states that learning involves functionalism, interactionism, and significant
symbolism. He stressed that individuals were capable of self-regulation and self-direction.
Bandura describes the social process, as one of reciprocal determination and that
'people are not simply reactors to external influences'. The theory of reciprocal determinism
means that the individual and environmental influences are interdependent. Motivation to learn
arises, or fails to, in a social context of mutual expectation by teachers and learners (Jarvis:
2003).
Social learning theory explains human behavior in terms of continuous reciprocal
interaction between cognitive, behavioral, and environmental influences.
Bandura proposed the Conditions Necessary for Effective Modeling
a. Attention
Attention refers to the individual's focus or concentration. This is affected by various

factors which increase or decrease the amount of attention paid to a particular learning stimulus.
For example, doing one task at a time according to priority to ensure efficient and effective
accomplishment of tasks. Focusing and attention in doing a task promotes better acquisition of
knowledge and enhance skills development.
b. Retention
This refers to the amount of information remembered including symbolic coding, mental
images, cognitive organization, symbolic recall and motor rehearsal. This is also directly related
to focusing and attention to the information observed.
c. Reproduction
Reproduction is the replication of an image including physical capabilities, and self-

observation.
d. Motivation
Motivation is the determination to find a reason to learn or imitate. This includes the past
such as in traditional behaviorism; promised as in imagined incentives and vicarious motivation
as in seeing and recalling the reinforced model.
MEMORY AID
1. Characteristics of Learning
a. Learning is unitary holistic.

b. Learning is individual and social.
c. Learning is self-active and self-initiating.
d. Learning is purposive and goal-oriented.
e. Learning is selective and creative.
F. Learning is influence and is transferable.
2. Major Types of Learning

a. Ideational Learning - carried out in the cognitive domain of the intellect.
b. Skill Learning or Psychomotor Learning - carried out in the conative or psychomotor
domain.
c. Emotional Learning - refers to mental states which are characterized by feelings and
emotions.
3. Conditions of Learning
Stipulates that there are several types or levels of learning.
4. Learning Styles
a. Diverging learners look at things from different perspectives, they are sensitive and
prefer to watch rather than do things..
b. Assimilating - learning style that is concise and logical in its approach.
c. Converging learners use their learning to find solutions to practical issues.
d. Accommodating- is a "hands on" learning style.
5. Laws of Learning
a. Law of Readiness states that one must be physically, emotionally, and mentally ready
to learn.
b. Law of Exercise - stresses the idea that repetition is basic to the development of
adequate response or outcome.
C. Law of Effect - involves the learner's emotional response to a stimulus. d. Law of
Primacy - states that the state of being first often creates a strong impression.
e. Law of Intensity-states that if stimulus or experience is real the more likely learning will
occur.
f. Law of Recency - states that information or skills most recently learned are best
remembered.
6. Learning Theories
a. Stimulus Response Learning Theories
1. Classical Conditioning Theory - Proposes the capacity of animals to learn new stimuli and
connect them to natural reflexes.
2. Connectionism Theory Focuses on rewards punishment, success.
3. Operant and Conditioning Effects or consequences of a particular behavior.
4. Behaviorism Theory Mature world is the ultimate reality and that everything can be explained
by natural laws.
5. Contiguity Theory Movements combinations of are stimulus response that would make up an
action.
b. Cognitive Theories
1. Insight Theory
2. Field Theory
3. Discovery Theory
4. Schema Theory
5. Assimilation Theory
c. Social Learning Theory. Learning involves functionallam, interactionism, and significant

symbolism.
1. Cite specific learning conditions or situations where each learning theory can be applied.
2. Relate various learning styles to teaching students in the classroom and clinical area. Cite
situations.
3. How do the different learning theories differ from one another, in terms of meaning and
applications?
III. PRACTICE TEST
1. What is the type of learning that is carried out in the cognitive domain of the intellect?
a. Ideational learning
b. Skill learning or psychomotor learning
c. Emotional learning
2. Which type of learning refers to mental States which are characterized by feeling and
emotion?
b. Skill learning or psychomotor learning
D. None of the above
3.What type of learning is carried out in the conative or psychomotor domain?
b. Skill or psychomotor learning
4. What principle stipulates that there are several types or levels of learning?
a. Principles of learning
b. Stages of learning
c. Laws of learning
d. Conditions of learning
5. What type of learner looks at things from different perspectives?
a. Diverging
b. Assimilating
c. Converging
d. Accommodating
6. Which type of learner who has a "hands on" learning style?
a. Diverging
b. Assimilating
c. Converging
d. Accommodating
7. Which type of learners who use their learning to find solutions to practical issues?
a. Diverging
b. Assimilating
c. Converging
d. Accommodating
8. Which type of learning style is concise and logical in approach?
a. Diverging
b. Assimilating
c. Converging
d. Accommodating
9. It states that one must be physically, emotionally, and mentally ready to learn. Which law is it
referring to?
a. Law of readiness
b. Law of exercise
c. Law of effect
d. Law of primacy
e. Law of intensity
10. Which law stresses the idea that repetition is basic to the development of an adequate
response to a stimulus?
a. Law of readiness
b. Law of exercise
c. Law of effect
d. Law of primacy
e. Law of intensity
Chapter 13 EDUCATION COMMUNICATION IN TEACHING AND LEARNING
"A commitment to lifelong learning is the mark of a truly professional person. He

devotes time and attention to learning how to learn, learn how to be selective and
recognizes that learning requires work."
-Signe Scott Cooper
● Explain the different roles of communication in the teaching and learning process;
● Describe the various elements of communication;
● Discuss factors that can influence effective communication;
● Differentiate the types of communication;
● Identify the relevance of communication to teaching and learning.
The clinical practice setting provides students and teachers with opportunities to share a
common goal of what to teach and what to learn. This depends on the ability of both students
and teachers to share their insights and their values regarding nursing experience through
effective communication process.
The teacher's ability to motivate the learners and to ensure that the learners properly
absorb the lessons being taught is directly related to the teacher's communication abilities, both
in terms of her knowledge and skills. The teacher's ability to personally talk to her students
during the course of the lesson can help identify problems arising from the discussions.
Concerns of both the teacher and learners can be managed through professional relationship
and open communication process.
ROLE OF COMMUNICATION IN TEACHING AND LEARNING PROCESS

Nursing education process is complex, with the components al intimately interconnected.
One of its most critical components is effective communication.
Communication presents a variety of meanings to people. In an educational setting, it can be

defined as (Rosengren: 2000):
1. Anything that conveys a message. It carries a message from one person to another.
2. It means interacting with one another to simply assume the role of another person and secure
a common experience.
3. The ability to understand and find meaning into the message sent for appropriate response.
4. Effective communication requires knowledge of the subject matter, the theories, and the
stimuli to which other persons will respond or react.
Developments in communication very much influence the efficiency and effectiveness of

the teaching and learning process. Communication embodies the instructional process which is
the heart of education, and instructional materials give shape and substance to the curriculum,
control its contents which significantly affect the teaching-learning process. Hence,
communication lends support to the development of effective "instructional materials (Devin:
2006).
Studies show that a variety of communication tools were used as an aid to teaching. of
the following: The traditional mode of communication
1. Print supplemented by motion pictures

2. Slides or films, and
3. Radio and disk recordings
Modern mode of communication includes the media such as:
1. Television/Radio
2. Programmed machine teaching
3. Language laboratories
4. Computers/Internet/Social Media
5. PowerPoint Presentations
6. Blackboard settings
Current instructional media, are not merely aids to teaching, but they can also store and
disseminate information in ways never achieved before; perform functions which were for a long
time the exclusive domain of the teacher; illustrate, discuss, analyze, present content, form
concepts, and build generalizations; and even systematically prescribe areas for student's
inquiry. These new capabilities of teachers in nursing in the classroom and in the clinical setting
need re-examination and possibly reformulation in order to appropriately utilize communication
strategies specific to the subject content taught (Young and Paterson: 2007).
Active communication process enables the teacher to present facts, design concepts,
and guide students in their related learning experience with a view of accomplishing the
objectives for learning. Furthermore, active communication can help the teacher do the following
(Lewis: 1993):
● Works with individual students and gain attention.
● Directs their learning to transfer meaning from one area to another.
● Uses machines for presentation of much of the factu materials and routine exposition.
● Points out further references.
● Asks critical questions and
● Encourages students to accept increasingly higher levels responsibility for their own
learning or educational growth
Everything that goes on in the teaching-learning situation whether in the classroom, in

the clinical setting, in the home such in the community health nursing, is in some way a form d
communication. Furthermore, the teacher of nursing must be concerned with the teaching of
basic communication skills between:
1. Patient and nurse;

2. Nurse and family;
3. Nurse and doctor; and
4. Nurses and other health care personnel
ELEMENTS OF COMMUNICATION
There are 4 major elements essential to the process of human communication such as source,
message, channel or a transmitter and receiver (Kozier: 2005):
1. The Source
In a teaching-learning situation, the teacher is the "source" of communication by

originating or perceiving an idea or purpose which she wants to communicate in order to
produce a particular response in the learner. All information originates from the teacher as a
"source.
The purpose then must be encoded or transformed into message which can be
transmitted. The teacher may directly encode her message through perceiving, thinking,
reasoning, judging. speaking, writing, drawing, gesturing, demonstrating, etc., into iconic or
digital signs designed to attain desired response from the students.
Factors Influencing Effective Communication:
a. Communication Skills
● The ability of the source to clearly convey her message whether written or oral.
b. Knowledge The
● Source is equipped with sufficient information or has mastery of the subject which will
help communicate her efficiently and effectively. message
c. Attitudes
● In conveying her message, the source uses various communication techniques such as
gestures or body language, facial expression and voice modulation, among others.
d. Social Status The source chooses the appropriate diction and set of words in conveying her
message depending on the type of recipient of the message.
Example:
During an immersion in rural areas. a nursing practitioner must use common words or native
dialect/language in order to be able to efficiently and effectively disseminate health information
to the public.
Verbal skills constitute the primary communication skills in a teacher. These are
generally classified as (Kozier: 2005):
a. Speaking and writing;

b. Listening and reading;
C. Intellectual abstracting skills- such as perceiving,memorizing, reasoning, judging;
d. Attitude toward the subject being taught; and
e.Learners and the teacher himself or herself.
The teacher who lacks self-confidence, does not respect students or is bored with the
subject matter, blocks the communication process and creates negative impact on the listener.
Conversely, if she has self-confidence, respects her students, shows interest and enthusiasm
for her subject, communication takes place more smoothly.
2. The Message
The goal, intent or purpose to be communicated by the teacher is expressed through the
form of a message. In reality, the message is a physical form of words; it is the translation of
ideas, the purposes and intentions of the teacher (Clark: 2008).
The purpose of communication may be to inform, persuade or entertain. The message

intended to inform a person may not really inform that person because she already has the
information, however, the same message may inform and entertain at the same time the
intended recipients of such message.
A teacher communicates to her students not only the intended message but certain
aspects of personality and feelings of which she is unaware of. This "selective inattention" on
the part of the teacher creates what has been frequently called the "arc of distortion" between
the speaker and the listener.
In other words, the speaker (a source) always communicates a least two things the
intended, as well as the unintended. If these two messages are inconsistent, the listener or the
receiver may wonder which of them should determine his or her response. The arc distortion is
further complicated by the listener's own "selective inattention." It may well be that the receiver
hears the speaker saying something that she did not communicate. One way of reducing the
"arcs of distortion" on the part of both listener and speaker is to have
the receiver "feedback" to the sender what she thinks she was saying (Falvo: 2003). The
form or structure and content of the message will be influenced by the purpose and the intent of
the source and by the type of channel selected to transmit the message.
3. The Channel
To encode the purpose of the source into a message, a channel is needed. In the case of face-
to-face communication, the encoding function is channeled directly by the intellectual, the
sensory and the motor skills of the source, such as vocal mechanism for oral communication,
the muscle system for the written word or the drawing of pictures, posture and gestures and
facial expressions for nonverbal communication. These messages are then transmitted from the
source through a channel.
When the teacher transmits the desired message through other means than her own
vocal mechanism, the various media, usually described as audio-visual media, are used. A
chalkboard may be used to encode and transmit the message by means of her own hands. In
case of demonstration, one's hands and voice may be used.
4. The Receiver
In the teaching-learning situation, the student for whom the message is intended is
considered the receiver in the communication process. The student who is the receiver
interprets the message by listening attentively, reading, logical reasoning and judging what is
perceived to be the message. Only then can the message be responded to.
The knowledge that the receiver brings to the particular communication situation also
influences students' response to it. If the message is coded in a language she does not
understand, or in terms of concepts beyond her understanding she will not be able to respond
accordingly.
TYPES OF COMMUNICATION
1. Verbal or Oral Communication
The basis for verbal communication is the interaction or oral between individuals. This is
usually done face-to-face. Individuals may now use modern communication. technologies such
as the internet live chat or telephone technologies in oral or verbal communication.
The key components of verbal communication consists of sound, words, speaking and
language (Kozier: 2004).
2. Nonverbal
Nonverbal communication does not use words but rather mon of actions through signs,
facial expressions and other body languages or movements. This is commonly done and
observed as she performs her daily activities with or without conscious knowledge.
Nonverbal communication is used more often because it utilizes the five (5) senses
which include:
a. Sight
Visual observation communicates many information. A nurse attending to a patient may

observe another irritable patient in line. This catches her attention thus, she works faster so she
can attend to the next patient.
b. Audition
Most human communication is mostly received through eyes and ears. Although people
readily recognize the importance of the ear for verbal communication, less attention is paid to
the functions of the ears in nonverbal communication. Physiologically, the ear is not only one
sense organ but two, such as one function is hearing; and the other one is the detection of the
rotation and tilting of the head which is necessary in the maintenance of body balance.
The ear has a remarkable ability to distinguish certain sounds, even against a
background of a chaotic noise.
c. Gustation
The sense of taste is closely allied with the sense of smell, so. much so that without it people
are unable to taste various foods.
The manner in which people serve food can communicate social and economic status, such
that:
● There are individuals who still use their fingers instead of utensils to pick up their food.
● Most eat with silver or more recently, with stainless steel utensils. People likewise spend
a great deal of time choosing, China glassware, among others.
● All of these utensils signify wealth, gentleness, or a current fad. People who entertain
others generally use their best China, linens, and silver, and serve special foods, not
only to convey their desire to please their guests, but also in many instances, to display
their "good taste" as well as economic standing. These all can have high communicative
value.
d. Olfactory
The sense of smell, is a distance receptor. An example of non verbal olfactory

communication is when one smells a smoke from afar. The smell of smoke will alert a person of
a possibility of fire and thus, take immediate action.
e. Touch
The sense of touch is a close receptor using hand and body contact that conveys
warmth, feelings, desires, intentions, quality of expression, gratitude or sympathy to another
person. It indicates the kind of message one needs to relay to someone in order to elicit
response. Touch is one of the most positive means of contact and communication. It can be a
friendly and pleasant way of treating people, a casual, non verbal expression that signify
meaning and candor.
RELEVANCE OF COMMUNICATION TO TEACHING AND LEARNING
Many factors influence the effectiveness of any particular communication, some of which
are (De Young: 2004):
1. Knowledge;
2. Ability;
3. Experience;
4. Attitude; and
5. Sociocultural status of both source and receiver.
These foregoing concepts which apply to human communication wherever and for
whatever purpose, apply equally to the teaching learning situation in nursing such as the
classroom, the clinical setting, the public health agency, the family home, and other clinical
settings.
"The more the teacher knows about the nature of communication process, its
components, the condition which facilitates it, the better are the chances for effective
teaching and learning."
-Wiggins
Teaching is significantly communication. Good teaching requires a teacher experienced with:
1. Old or new ideas;

2. Directions or demonstrations;
3. Intercommunication between teacher and students;
4. Mutual sharing of experiences; and
5. Continual feedback or reciprocal response adjustments.
MEMORY AID
1. Elements of Communication
a. Source
b. Message
c. Channel or a transmitter
d. Receiver
2. Factors Influencing Effective Communication
a. Communication Skills Ability of the source to clearly convey his or her whether written
or oral.
b. Knowledge - Knowledge of the source conveys adequate information or mastery of

the subject which helps communicates messages efficiently and effectively.
c. Attitudes- The source uses various communication techniques such as gestures or
body language, facial expression and voice modulation, among others in conveying his
message.
d. Social Status - The source chooses appropriate diction or set of words in conveying
messages depending on the type of recipient of the message.
3. Types of Communication
a. Verbal or oral communication

b. Nonverbal communication
1. Create a situation where the elements of communication process are at play. Determine how
information flow in the process and cite effects or distortions.
2. Illustrate verbal and non-verbal communication and cite its differences in conveying the
message.
3. Explain a situation which makes use of the five (5) senses in transmitting messages.
PRACTICE TEST
1. What is the ability of the source to clearly convey his or her message whether written or oral?
a. Knowledge
b. Communication skills
c. Attitude
d. Social status.
2. Which one indicates that the source is equipped with sufficient information or mastery of the
subject which will help him or her communicate his or her message efficiently and effectively?
a. Knowledge
c. Attitude
d. Social status
3. The source uses various communication techniques such as gestures or body language,
facial expression and voice modulation, among others in conveying his message. Which one is
it referring to?
a. Knowledge
c. Attitude
d. Social status
4. Which appropriate diction or set of words do the source convey his message depending on
the type of the one who receives the message?
a. Knowledge
c. Attitude
d. Social status
5. Which of the following is a factor that influences communication?
a. Source
b. Message
c. Channel or a transmitter
d. All of the above
Chapter 14 : EVALUATING THE TEACHING PROGRAM
"The significant problems we face cannot be at the same level of thinking we were
at when we created them."
-Albert Einstein
● Define evaluation;
● Discuss the purposes of evaluation to patient teaching and student learning;
● Explain the different criteria for the selection of evaluation tools;
● Describe the process of evaluation; and
● Differentiate among the types of evaluation.
The heart and soul of nursing education is the clinical program where nursing knowledge
is shaped into professional practice. Integrating previous experience into the teaching role can
be very beneficial to a nurse educator.
Examining teaching through the lens of student perspectives enables the teacher to tap
how students experience the teaching learning process. The growth of teachers depends on the
extent of their responsiveness to change that lies ahead. The expression of student
perspectives can be an outcome of the teaching program.
EVALUATION DEFINED
Evaluation is a process of ascertaining or judging the value of something through careful

appraisal. It is a means of helping an individual or group of individuals to be self-directing. It
assists in the establishment of specific goals and objectives, which in turn serve as criteria for
judging desirable changes (Gregorio: 1971).
Evaluation is done every day. It is the way through which an individual expresses her
likes and dislikes, and by it, she determine what is of value and what is not.
Evaluation involves measurement or appraisal of an activity in terms of a particular

standard. Evaluation involves a continuous process of gathering data and recording, assembling
and interpreting information for purposes of creating change that will promote better
performance or accomplish desired objectives (Levine and Feldman: 2006).
Evaluation in nursing requires assessment of the cognitive outcomes of knowledge and

understanding a delineation of what is and what shall be. It requires evaluation of student's
personal traits, since nursing is a personal service, one in which interpersonal relationships are
important and personality plays a vital role in establishing effective relationships with patients
(O'Connor: 2006).
Evaluation uses skills for appraisal purposes to determine one's strengths and
weaknesses and how far a nurse performs efficiently and effectively to meet desired goals and
objectives of care.
Evaluation is based on principles. The first principle is that anything that exists at all
exists in some amount and therefore can be measured. The second principle is that the worth or
value of a teaching method, a learning method and materials of instruction is not known until
their effect is measured (De Young: 2004).
FUNCTIONS OF EDUCATIONAL EVALUATION
Assessing learning is a formative feedback that is done to find out what and how well
patients are learning, what a nurse is teaching without giving a grade. While evaluating is a
process of measuring the extent of learning and assigning a grade. Evaluation may include
formative and summative feedback (Bradshaw and Lowenstein: 2007). Evaluation further aims
to:
1. Improve educational program;
2. Achieve educational goals;
3. Motivate and guide the learning activities of the individual learners;
4. Motivate the teacher to evaluate critically her teaching practices, the student's learning
effectiveness and her own personal goals; and
5. Motivate the teacher to work together for the improvement of the curriculum and the
educational program.
Specifically, evaluation is an integral tool in nursing education to guide its progress

(Clark: 2008). This will help determine the following:
1. The level of knowledge and understanding of the student in her classes at various
times during the semester;
2. The level of the student's clinical performance at various stages;
3. Awareness of the specific difficulties of individual students, or of an entire class, as a
basis for further teaching;
4. Diagnose each student's strengths and weaknesses and to suggest remedial
measures which may be needed;
5. Encourage students' learning by measuring their achievement.and them of their
success,
6. Help students acquire the attitude, and skills in self-evaluation;
7. Help students become increasingly self-directing in their study;
8. Provide the additional motivation for examinations that offer opportunity to practice
critical thinking, the application of principles, the making of judgments among others
Estimate the effectiveness of teaching and learning techniques of subject matter and of
instructional media in reaching goals and objectives of the course; and
9. Gather information needed for administrative purposes, such as selecting students for
honors, courses, placement of students for advanced standing, writing recommendation,
meeting graduation requirements, among others.
"What of the future? It is to a very large extent in our own hands. We will make
many errors but as long as we know our goal and keep it ever in mind, our future is
bright and secure."
-Lyle Morrison Creelman
EVALUATION PROGRAM FOR TEACHERS OF NURSING COURSES
The evaluation program should reflect the following:
1. The educational objectives

2. Teaching and learning procedures
3. Student progress
4. Learning outcomes
CRITERIA FOR SELECTION OF EVALUATIVE DEVICES
1. Sampling of the objectives
All of the objectives in each course should be tested. The teacher who has defined
carefully and clearly the behaviors implicit in the educational objectives will be aware of all the
objectives as basis for developing good tests,
2. Sampling of the content
Since it is not possible for the teacher to test the extent of student knowledge on all of
the course content, the teacher must resort to sampling of the content. The teacher must make
certain that there are enough items representative of the range of the course content taught
emphasizing what the students "must know" rather than the "nice to know" component of the
course.
3. Validity
The validity of the test is the degree or extent to which it measures what it intends to
measure. The degree to which a test measures anything and measure it accurately, is the
reliability of the test. What is intended to measure' is the criterion for the relevance of the test.
4. Reliability
The reliability of a test cannot be determined by examining the test. It must be

determined through application and statistical computation.
5. Practicality
It refers to the development of evaluation devices capable of being administered and

scored with reasonable ease and within the limits of time and of the resources imposed by
circumstances.
6. Usefulness
Tests are used for various purposes, besides providing basis for students' grades and
diagnosing of students' abilities in measuring speed, power and comprehensiveness, and for
many other purposes.
STEPS IN EVALUATION
1. State objectives. Progress can be measured if direction is clear,
2. Define changes in behavior as expected of the educational outcomes.
3. List and briefly describe situations that give opportunity for the expression of desired behavior
of the learner.
4. Develop appropriate and systematic means of eliciting kinds of behavior implied in objectives
to be evaluated.
5. Decide on ways of recording and summarizing behavior such as scoring, rating, or describing
behavior and the basis for evidence collected.
6. Check validity, reliability, and difficulty of the measures used.
7. Establish conditions that permit the student to give her best performance.
8. Assign scores on the basis of the foregoing steps.
9. Develop methods of interpretation.
EVALUATIVE DEVICES
1. Essay Examinations
Essay examinations refer to the subjective type of evaluation in which students are given
questions requiring critical analysis of situations based on concepts or principles learned.
Although time consuming to score, essay type of questions lend the learners to testing the
highest level of thinking, particularly analysis, synthesis, and evaluation of given situation
(Emerson: 2007).
2. Objective Examinations
Objective examinations consist of a large number of questions and statements.

Students' answers are indicated by marking the correct response to a particular question in a
prescribed manner. The questions are in objective form, and the examinations are usually
printed, photocopied or mimeographed and a copy is given to each student (De Young: 2003).
Objective tests are more reliable than the essay or other types because they are free
from personal opinion in scoring.
a. Multiple choice questions. These are challenging to create but are easy to score.
Literature examinations are made of multiple choice items. These could help students
get familiar with the type of test and determine the level of knowing, recall, and beyond
recall.
b. True or false questions. This is designed to test the learner's ability to identify the
correctness of the statement of facts or principles but limited to test the lowest level of
knowing, knowledge and comprehension.
c. Matching questions. This is used to test the lowest level of knowing which is useful in
determining the learner recall of the memorized relationship between two things such as
terms and definitions, dates or events.
They can be scored in less time than the subjective tests. However, using this type of
evaluation have some disadvantages since they provide little or no opportunity to measure
students' ability to organize and to express her thoughts. More time is required to prepare good
objective type of questions than essay questions.
3. Objective Problem-Situation Test
The objective problem-situation test describes a situation, not previously presented to the
student with sufficient detail to point out the problem involved.
Following are advantages in the use of objective problem situation tests:
● Used to represent patterns of behavior that constitute nursing competence;

● Less time consuming for the student to answer;
● Useful to determine the students' ability to apply principles to new or related situations;
and
● Can analyze easily the type of errors made by students in the use of basic principles and
concepts.
However, there are also disadvantages of objective problem situation tests which are the
following:
Time consuming to prepare,
Requires great skill to prepare valid, reliable problem situations, and
Requires considerably more space than objective tests.
4. Standardized Tests
These are tests and scales that have met the criteria of testing There are three types of
standardized tests:
Intelligence tests. This type of test attempts to indicate the capacity, the brightness or native
intelligence of students compared to the norm of her age.
Prognostic tests. These are tests intended to discover the possibilities of a student's success
in a particular area.
Achievement tests. These tests are designed to indicate the accomplishment of the student in
the particular subject areas of the curriculum.
5. Rating Scales
A rating scale is a standardized method of recording interpretations of behavior.

Students are rated on a scale from low to high with respect to a particular or specific unit.
EVALUATING PATIENT LEARNING
Assessing and evaluating patients' learning is a crucial point in teaching. Knowing the
extent of what people learn will make all efforts of teaching meaningful and worthwhile.
Following are few techniques for feedback on patient's learning (De Young: 2003).
1. Ask the patient to read pamphlets or brochures and fact sheets summarizing what the nurse
have taught. Repeat important information.
2. Interview patients with thorough observation, discussion and gesturing can elicit adequate
response and understanding of the information taught.
3. Determine change of patient behavior related to health care practices.
Example: Teach mother how to bathe a newborn. She may be able to repeat what was taught
about bathing and can answer the question asked by the nurse.
4. Do a return demonstration to determine skills learned and collect evidence of teaching

effectiveness.
5. Document the teaching information and evidences of what the patient has learned. This is
done for legal and accreditation or audit purposes.
"To evaluate a successful or unsuccessful approach (with a patient) take into

account the general aim of the situation. Did it seem satisfactory? Was cooperation
easily established? Did the results appear good? Did you have an inner feeling that
things went smoothly? If you think it may have been unsatisfactory look at yourself..."
-Marguerite Lucy Mafreda
To determine what clients have learned is a gauge of teaching effectiveness of the nurse
which requires expertise in terms of knowledge, skills, and professional attitude.
EVALUATING STUDENT LEARNING

Teachers are required to evaluate student's work as well as performance in tests.
Judgments and ratings must consist of oral reports, term papers, and book reports, among
others. The following are criteria to determine effectiveness of student learning (Clark: 2008):
1. Major elements and sub-elements concerning the rating.

2. The relative importance of each element.
3. The range of scale used.
4. Test blueprint. A chart that spells all the contents about the level of knowledge to be
tested. de op al
Type of Student Evaluation
The teacher is key to the choice of evaluation method that guide the processes of
instruction and assessment of outcomes. Students are important part of the evaluation process
and should be part of the planning process (Keating: 2006).
The following are types of evaluation:
1. Formative process evaluation
Formative evaluation measures or evaluates the processes and progress, along with the
goal and objective, the level of students' learning and progress of the educational program. It is
the on-going feedback given to the learners throughout the learning process (De Young: 2003).
This will help the learners identify the strengths and weaknesses in order to find solutions for
improvement. This may be graded or non-graded. A written formative evaluation rate is also
called as anecdotal records or clinical progress notes. Example: Course evaluation, student
achievement, satisfaction index
"Practice is the absolute primary function of our profession
-Frances Reiter
2. Summative or outcome or end-point evaluation
Summative evaluation is given at the end of the learning experience in order to assess
whether the learner has achieved the objectives and is ready to move on to the next experience.
Clinical or related learning experience (RLE) evaluation in nursing always involves summative
evaluation.
This is similar to goal-based evaluation which compares the results of the student
performance to the overall goals of the program. This will determine the students level of
achievement and extent to which learning outcome has been met (Gaberson and Oerman:
2007). Learners are informed of the behavior expected of them to achieve a certain grade.
Grading is less subjective when criteria are spelled out and each learner is held to that
standard.
Example: To prepare caring and competent professional nurses to meet the health care needs
of the population.
This measures the graduate nurse care of clients and their level of competency. Success
rates of graduates, clinical performance and leadership roles is shown in the results of the
summative or outcome evaluation.
Framework for Evaluative Measurement
Student performance is reviewed and evaluated using instruments as basis for

measurement. measurement (Burns and Grow: 2005). It is a referencing
1. Norm-referenced measurement
Norm-referenced measurement is applied to clinical evaluation, where each student's
performance is measured against that of the other students in the clinical group. It is a norm or a
standard measure for all the students in the clinical course or a program.
2. Criterion-referenced measurement
In criterion-referenced measurement, the learner is compared to a well-defined or

predetermined criteria of performance standard that has been delineated in terms of goal
behaviors. It measures the cognitive, psychomotor, and affective attributes that are required for
nursing students in the clinical practice. Emphasis of evaluation is placed on the application of
knowledge and skills in nursing practice
Evaluative Data Sources
The teacher may obtain data from different sources for use in formal evaluation.
Meaningful input from different sources as possible not only enhances the credibility of the
evaluator but it provides better description of students entire learning experiences (Emerson
2007)
The following are sources of evaluation of student performance:
1. Faculty observation
2. Written assignments of students
3. Students clinical records
4. Oral communication with peers patients clinical instructors other members of the
health team
5. Self-evaluation.
6. Agency personnel
7. Other members of the health team.
EVALUATING THE TEACHER
Teachers need feedback from their learners in order to determine their own strengths
and weaknesses. An appraisal of their teaching performance through varied means will ensure
efficient and effective teaching performance (Clark: 2008). The following are ways to measure
teaching performance:
1. Tape and Video Recording
Tape or video recording may be done during one or two class sessions and used as the
means for evaluating the behavior of both teacher and students.
2. Peer Evaluation
Peer evaluation is done by having a colleague sit in several classes of a teacher or any
colleague being evaluated. She later gives in objective appraisal of strengths and weaknesses
observed on her colleague. Specific criteria based on the role and functions of the teacher are
made as basis for peer evaluation.
3. Student Evaluation of Teaching Effectiveness
Students are the recipients or end-users of teaching. They are the clients through which
teachers are made. Hence, student surveys are considered as the primary sources for teachers
to improve or enhance teaching effectiveness. Opinions may vary depending on students
experience and capability.
4. Teacher Self-evaluation
This is the teacher's introspective analysis of her own teaching effectiveness. Her
personal knowledge, capabilities and limitations to teach would somehow lead her to reflect on
her chances for change and improvement.
CRITERIA FOR SELF-EVALUATION OF TEACHING WITH SPECIAL REFERENCE TO
CHOICE OF LEARNING EXPERIENCES
Related Learning Experiences (RLE) are vital to students development of professional attitudes.
The acquisition of knowledge, skills, and values is derived from varied sources. However, it
should focus on educational philosophy and course objectives (Gaberson and Oerman: 2007).
The criteria for evaluating the learning experience include the following, such that
learning experiences should be:
1. Consistent with the philosophy of the educational institution and lead to the attainment of the
proximate aims of the curriculum.
2. Consistent with the aims of a democratic society.
3. Course objectives and the goals of the curriculum will be attained.
4. Motivate students at appropriate times and in a manner that will stimulate curiosity and
challenge them to continue efforts for improvement.
5. Varied and flexible enough to adapt to individual student's ability and educational background.
6. Lead to the development of independent thinking, good judgment, intellectual

resourcefulness, self discipline, and integrity of purpose and mastery of various areas of
knowledge and skills.
7. Well-arranged for purposes of correlation, continuity and integration of theory and practice.
8. Offer the students enough opportunities for self-activity so that knowledge is attained, skills
are acquired, and desirable attitudes become habitual.
9. Emphasize on the relative importance of the various learning experiences.
10. Cooperatively planned activities and evaluated by the teacher and students throughout the
course.
Teaching and Assessing Skills Learned
The teacher assesses students' ability to perform skills adequately and describe how
they can be refined following these Mages (Keating: 2006):
1. Demonstration. The teacher demonstrates skills at normal speed without making

comments regarding performance.
2. Deconstruction. The teacher demonstrates with accompanying comments or
suggestions for improvement. an
3. Comprehension. The teacher demonstrates accompanying comments and suggestions for

the learners.
4. Performance. The learner demonstrates the skill with accompanying comments or

clarifications
(Peyton: 1998). 2006).
5. Practice is the most effective way to move from consciously incompetent to consciously
competent (Levine and Feldman for improvement 2006).
"Whatever you do whether it's weedin' the sweet potatoes or pickin' the black-
eyed-peas always remember to do the best job you can. Get all the education you can-
you'll have to work hard for it, maybe fight for it but an education is worth working' and
fightin' for."
-Frances Reed Elliot Davis
MEMORY AID
1. Evaluation Defined.
Evaluation is the process of ascertaining or judging the value of something through

careful appraisal. It is a means to help an individual or group become self-directing. Evaluation
helps establish specific goals, which in turn serve as criteria for judging desirable changes.
2. Functions of Educational Evaluation
a. Improve the educational program;

b. Achieve educational goals;
c. Motivate and guide the learning process of individual student
d. Motivate the teacher to evaluate critically her teaching
practices, the student's learning effectiveness and her own personal goals; and e.
Motivate the faculty to work together for the improvement of the curriculum and the educational
program as well as of individual courses.
3. Purposes of Evaluation
Evaluation serves to:
a. Determine the level of knowledge and understanding of the student in her classes at
various times during the semester;
b. Assess the level of the student's clinical performance at various stages;
c. Become aware of the specific difficulties of individual students, or of the entire class,
as basis for further teaching,
d. Diagnose every student's strengths and weaknesses and to suggest needed remedial
measures;
e. Encourage students' learning by measuring their achievement and informing them of

their success;
f. Help students acquire the attitude of and skills in self evaluation;
g. Help students become increasingly self-directing in their pursuit of knowledge;
h. Provide more examinations and opportunities to practice critical thinking, the

application of principles and the making of judgments, among others;
i. Estimate the effectiveness of teaching and learning techniques of subject content and
use of instructional media in reaching goals of the course; and
j. Gather information needed for administrative purposes, such as choice of students for
honors, courses, placement of students for advanced standing, writing recommendation
and meeting graduation requirements, among others.
4. Steps in Evaluation
a. State objectives. Progress cannot be measured unless direction is clear.
b. Define change of behavior expected of educational outcomes.

c. List and briefly describe situations that give opportunity for the expression of the
behavior desired.
d. Develop appropriate and systematic means of eliciting kinds of behavior implied in
objectives to be evaluated.
e. Decide ways of recording and summarizing (scoring, rating, describing) behavior and
the basis of evidence gathered.
f. Check validity, reliability, and difficulty of the measures used g. Establish conditions
that permit the student to give her the best performance.
h. Assign scores on the basis of the foregoing steps.

i. Develop methods of interpretation.
5. Criteria For Selection of Evaluative Devices
a. Sampling of the objectives

b. Sampling of the content
c. Validity
d. Reliability
e. Practicality
f. Usefulness
6. Widely Used Evaluative Devices
a. Essay examinations
b. Objective examinations
c. Objective problem-solving situations
d. Standardized tests
e. Rating scales
7. Evaluating the Teacher
a. Tape and video recording

b. Observation by a colleague
c. Student opinion
d. Teacher self-evaluation
1. How is evaluation applied in the teaching and learning process?
2. Give specific nursing situation and apply the steps of the evaluation process.
3. Differentiate evaluation of patient teaching, student learning and teacher's

effectiveness in teaching
4. What are the different evaluation tools to effectively create student learning?
PRACTICE TEST
1. Which is not a function of educational evaluation?

a. Evaluation and improvement of the educational program.
b. Achievement of educational goals.
c. Motivation and guidance of the students learning.
d. Motivation of the parents to evaluate critically teaching practices, the student's
learning effectiveness and her own personal goals.
2. Which is the least purpose of evaluation?
a. To determine the level of knowledge and understanding of the
student in her classes at various times during the semester. b. To become aware of the specific
difficulties of individual students, or of an entire class, as basis for further teaching. c. To
diagnose each student's strengths and weaknesses and to suggest remedial measures that
may be needed.
d. To determine the student's capacity to pay school fees.
3. Which is not part of the evaluation process?
a. Stating objectives.
b. Defining changed in behavior expected as educational outcomes
c. Listing and briefly describing situations that give opportunity
for the expression of the behavior desired.
d. Developing inappropriate and systematic means of eliciting kinds of behavior implied
in objectives to be evaluated.
e. Deciding on ways of recording and summarizing behavior and the basis of evidence
collected.
4. What is the form of evaluation that consist a large number of objective questions and
statements?
a. Objective examinations
b. Objective problem-solving situations
c. Standardized test
d. Rating scale
5. What is this form of evaluation that describes a situation, not previously presented to the
student with sufficient detail to point up the problem involved?
d. Rating scale
6. What are tests and scales that have met the criteria for testing?
c. Standardized rest
d. Rating scale
7. Which one is considered a standardized method of recording and interpreting behavior?
D. Rating scale
8. Which one refers to introspective analyses of one's own teaching practices?
a. Teacher self-evaluation
b. Tape and video recording
c. Student opinion
D. Observation by a colleague
CONCLUSION
The ongoing social transformation in society at large and the health care system
specifically escalate the need for modifications of how nursing students learn to practice clinical
nursing. As part of the development of an academic career, every nurse educator has the
obligation to contribute in some way to strengthen nursing education. Participating in the
process requires curiosity and enthusiasm in learning. Nurse educators must talk and listen
critically, read and share their experiences and insights in nursing practice to all those under
their care.
It is essential for nurse educators to rethink clinical education in order to design new
methods that responds to student needs to learn and prepare graduates for today's health care
environment [National League for Nursing: 2003). To accomplish this, nurse educators must
examine their teaching behavior behind how they teach, talk with and listen to one another
among the faculty, clinicians, preceptors, researchers, and most especially their students from
whom they can best learn how to teach.
As educators, nurses must make an effort to help raise students' standards of performance and
apply evidence-based practice which enhances the use of the best evidences to justify a
particular teaching practice, professional judgment and academic intervention considering the
needs of learners. Evidenced-based teaching also requires research to identify knowledge gap
and resolve these by identifying areas of innovation. As teachers grow professionally, they
should keep watch of the future of nursing education.
Trends for follow-up in the future of nursing education:
1. Changing and diversifying demographics

2. Technological explosion
3. Globalization of the world economy
4. The era of educated consumers, alternative therapies and genomics and palliative
care
5. Shift to population-based care and increased complexity inpatient care
6. The cost of health care and challenges of managed care
7. Impact of health policies and regulations
8. The growing need for interdisciplinary education and collaborative practice
9. Current nursing demands and opportunities for lifelong learning and workforce
development 10. Significant advancements in nursing science and research
[Adapted from: The Future of Nursing Educators: Ten Trends to Watch. Nursing and Health
Care Perspectives. Vol 21.No. 1, 2000. National League for Nursing (Nursing Education
Perspectives) Cited by Emerson: 2007]
"Nursing is not for everyone. It takes a very strong, intelligent and compassionate
person to take on the ills of the world with passion and purpose and work to maintain the
health and well being of the planet. No wonder we're exhausted at the end of the day"
-Donna Wilk Cardillo
GLOSSARY
Adolescence marks the transition from childhood to early adulthood; approximately from 10-12
years and ending at 18-22 years old.
Advanced beginner already has enough experience to grasp aspects of a situation but not
within the context of the situation. and
Analysis is the ability of the leaner to recognize, examine, scrutinize structure information by
breaking it down into its constituent parts and specifying the relationship between parts.
Andragogy is the art and science of helping adults learn.
Anxiety is a generalized feeling of discomfort or unpleasantness.
Application is the learner's ability to use or relate ideas, concepts, abstractions and principles
in particular and concrete situations like figuring, writing, reading or handling equipment.
Assessment is designed to help the teacher find out how much and how well the students are
learning.
Behavioral or learning objectives are action-oriented rather than content oriented and
learner-centered rather than teacher-centered. Behavioral refers to a person's level of
functioning and is affected by certain habits, their lifestyle, health care and child rearing
practices which are determined by one's culture and ethnic heritage.
Classical or Pavlovian conditioning is a process which influences the acquisition of new
responses to environmental stimuli.
Competencies refer to various skills like intellectual abilities, social and physical skills and other
special abilities.
Competent is characterized by considerable conscious and deliberate planning which
determines the important aspects of present and future situations.
Comprehension is the ability of the learner to understand or appreciate what is being
communicated by defining or summarizing it in his or her own words.
Core competency standards gauge the minimum knowledge, skills and attitudes that a
graduate nurse possesses to be able to provide efficient and quality nursing care in her level as
a beginning nurse practitioner.
Crisis is a turning point, crucial period of increased vulnerability and heightened potential.
Demonstration is a method where the process of doing a procedure is shown and the skills or
techniques are practiced through return demonstration.
Development is a qualitative term involving gradual changes in character. Discipline is a branch
of knowledge or instruction.
Early adulthood begins in late teens or early twenties through the thirties.
Early childhood begins from the end of infancy to about 5-6 years which is sometimes called
"pre-school years".
Educational or instructional objectives are used to identify the intended outcomes of the
education process.
Educator is a specialist in the theory and practice of education.
Emotional health is the ability to express one's feelings appropriately and to develop and
sustain relationships.
Encoding strategies are experiences that are retained and categorized by the individual.
Environmental health refers to the physical environment where people live it involves housing,
transport, sanitation, pollution and pure water facilities.
Environmental influences include the menace of pollution, communicable diseases due to
poor sanitation, poor garbage collection, smoking, utilization of pesticides, lack or absence of
proper and adequate waste and sewerage disposal system and management, urban/rural
milieu,noise, radiation, air and water pollution..
Epigenetic principle is a principle which views personality as it continues to develop
throughout the entire life span.
Evaluation is the learner's ability to judge, assess or appraise the value, significance,
importance of something like an essay, design or action using appropriate standards or criteria.
Expert nurse does not rely anymore on the analytical principles of rules, guidelines, and
maxims to connect her understanding of the situation to an appropriate action
Facebook a corporation and online social networking headquartered in Menlo Park, California,
in the United States. Its service website was launched on February 4, 2004, by Mark
Zuckerberg with his Harvard College roommates and fellow students Eduardo Saverin, Andrew
McCollum, Dustin Moskovitz and Chris Hughes After registering to use the site, users can
create a user profile, add other users as "friends", exchange messages, post status updates
and photos, share videos, use various apps and receive notifications when others update their
profiles.. Facebook had over 1.18 billion monthly active users as of August 2015.
Film-showing is a medium of instruction where the learner uses his/her senses of sight,
hearing, touching, smelling and even tasting
Focusing is concentrated effort or attention that is given to a particular or thing
Game is any event or activity conducted in accordance with rules that involves varying degrees
of chance or luck and one or more players who compete task
Goal is the final outcome or what is achieved at the end of the teaching learning process.
Group conferences, following clinical experiences, are also known as post clinical nursing
conferences.
Group discussion is formed when more than two persons are gathered to discuss or resolve
an issue, problem or idea under the guidance of one of its members.
Growth is quantitative involving increase in the size of the parts of the body. Health care
delivery system is focused on the promotive, preventive, curative and rehabilitative aspects of
care.
Health education is a process concerned with designing, implementing and evaluating
educational programs that enable families, groups, organizations and communities to play
active roles in achieving. protecting and sustaining health.
Health education plan emphasize a phase of the behavior-change process that is related to
the client's health needs/ problems.
Hereditary refers to the understanding of genetically influenced diseases and genetic risks. It
includes congenital defects, strengths, and health risks which can be familial, ethnic or racial.
Heredity is the sum total of characteristics which are biologically transmitted thru parents to
offspring.
Infancy extends from birth up to 18 or 24 months Instagram is an online mobile photo-sharing,
video-sharing, and social networking service that enables its users to take pictures and videos,
and share them either publicly or privately on the app, as well as through a variety of other
social networking platforms..
Instagram was created by Kevin Systrom and Mike Krieger, and launched in October 2010 as a
free mobile app. The service rapidly gained popularity, with over 100 million active users as of
April 2012 and over 300 million as of December 2014.
Instruction is just one aspect of teaching which involves communicating of information about a
specific skill (cognitive, affective or psychomotor). It is sometimes used interchangeably with the
word teaching
Intuitive means the teacher is able to identify the student's predominant style of intelligence
and based on this knowledge, the teacher is able to build on the student's strength.
Knowledge is the ability to memorize, recall, define, recognize or identify specific information
like facts, rules, principles, conditions and terms.
Late adulthood, or senescence, begins from 65 to 80 years of age and lasting until death.
Learning is a change in behavior (knowledge, skills and attitudes) that can occur at any time or
in any place as a result of exposure to environmental stimuli.
Learning needs are what the learner needs to learn.
Learning readiness refers to when the learner is receptive to learning. Learning style is how
the learner best learns.
Learning theory is a coherent framework and set of integrated constructs and principles that
describe, explain or predict how people learn, how learning occurs, and what motivates people
to learn and change.
Lecture is a highly structured method where the teacher acts the resource person and
transmitter of knowledge and information to the learners.
Maturation includes bodily changes which are primarily a result of heredity or the traits that a
person inherits from his parents which are genetically determined.
Mental health refers to the positive sense of purpose and underlying belief in one's own worth
(self-esteem) like feeling good and feeling able to cope.
Mental structures begin with reflexes in infancy evolving into schemata and more complex
structures called operations.
Middle adulthood begins from 35- 45 years old up to 65 years old.

Millennials (also known as the Millennial Generation or Generation Y)-are the demographic
cohort following, Generation X. There are no precise dates when the generation starts and
ends; most researchers and commentators use birth years ranging from the early 1980's to the
late 2000's
Motivation is strongly associated with emotional readiness or willingness to learn
Netizen is a portmanteau of the words Internet and citizen as the net. It describes a person
communities or the Internet in general. The term commonly also in "citizen of actively involved in
online implies an interest and active engagement in improving the Internet, making it an
intellectual and a social resource, or its surrounding political structures, especially in regard to
open access, net neutrality and free speech.
Novice stage of skill acquisition is characterized by a person who lacks background experience
of the situation he or she is involved in Educator nurse who teaches and prepares registered
nurses (RN) for entry into practice positions. They can also teach in various patient care settings
to provide continuing education to licensed nursing staff.
Nurse Educators teach in graduate programs at Master's and doctoral level which prepare
advanced practice nurses, nurse educators, nurse administrators, nurse researchers, and
leaders in complex healthcare and educational organizations.
Objective is a statement of specific and short-term behavior.
Operant condition was developed by B.F. Skinner which focuses on the behavior of the
organism and the reinforcement that follows after the response.
Operations are mental actions allowing children to interact with the environment using their
minds and bodies; invariant sequence where child must first develop concrete operations before
formal operations.
Organization refers to the innate ability of humans to organize their relationship with the
environment; people organize activity lawfully. constructing a reality that makes sense at that
time.
Patient education is a process of assisting people to learn health-related behaviors
(knowledge, skills, attitudes, values) which can be incorporated into their everyday lives.
Pedagogy is the art and science of helping children learn.
Physical health refers to the state of one's body like its fitness and not being ill.
Political factors involve power and authority to regulate the environment or social climate.
Examples of this include safety, oppression, people empowerment.
Prenatal development includes the tire from conception to birth, from a single cell to an
organism complete with brain and behavioral capabilities produced in 9 months (270-280 days
or 40 weeks).
Primary health care is a partnership approach to the effective provision of essential health
services that are community-based, accessible, acceptable, sustainable and affordable.
Profession is defined as "an occupation that properly involves a liberal, scientific, or artistic
education" (Landau, 1979).
Proficient nurse already has a holistic view of a particular situation; the nurse's performance is
guided by maxims by this stage.
Psychology is the study of self.
Puberty is marked by the development of sexual characteristics (breast enlargement,
development of pubic and facial hair, deepening of the voice), production of sex hormones and
physical capability of reproduction, onset of menarche or menstruation.
Reinforcers are events that strengthen responses and increase the grasped or understood the
lesson or the matter being discussed probability of its recurrence.
Questioning is a situation where the teacher is probing or inquiring from the student as a
feedback mechanism to find out if they have already
Role is defined as a function, responsibility, job, duty, task, position, or behavior that includes
accountability and responsibility for the position that one holds.
Schema is a mental concept formed through experiences with objects and events.
Schemata are building blocks of cognitive structures. School-age is the period from 6 to 11
years. This period is called elementary school year.
Sexual health refers to the acceptance of and the ability to achieve a satisfactory expression of
one's sexuality.
Social health involves the support system that is available from family members and friends.
Having friends to talk to and being involved with activities in the community or school
contributes to social health.
Social media are computer-mediated tools that allow people or companies to create, share, or
exchange information, career interests, ideas, and pictures/videos in virtual communities and
networks. Social media is defined as "a group of Internet-based applications that build on the
ideological and technological foundations of Web 2.0, and that allow the creation and exchange
of user-generated content. "Social media has been broadly defined to refer to the many
relatively inexpensive and widely accessible electronic tools that enable anyone to publish and
access information, collaborate on a common effort, or build relationships.
Societal health is the link between health and the way a society is structured. This includes the
basic infrastructure necessary for health and the degree of integration or division within the
society.
Spiritual health is the recognition of a Supreme Being or Force and the ability to put into
practice one's moral principles or beliefs.
Subjective values are what a person considers as worth having or accomplishing.
Synthesis is the learner's ability to put together or merge parts and elements into a unified
whole by creating a unique product or output that is written, oral, pictorial.
Taxonomy is a classification, categorization or arrangement of things based on their
relationship with one another.
Teaching is a deliberate intervention involving the planning and implementation of instructional
activities and experiences to meet the intended learner outcomes based on the teaching plan.
Twitter is an online social networking service that enables users to send and read short 140-
character messages called "tweets". Registered users can read and post tweets, but those who
are unregistered can only read them. Users access Twitter through the website interface, SMS
or mobile device app Twitter Inc. is based in San Francisco and was created in March 2006 by
Jack Dorsey, Evan Williams, Biz Stone, and Noah Glass and launched in July 2006. The service
rapidly gained worldwide popularity, with more than 100
million users posting 340 million tweets a day in 2012. The service also handled 1.6 billion
search queries per day.
Word of mouth is the most influential way of transmitting information especially of oral
traditions which are usually conveyed by means of puppets or puppet shows, dramatization, or
sociodrama, role-playing.storytelling, music and songs.
Youtube is a video-sharing website headquartered in San Bruno, California, United States. The
service was created by three former PayPal employees in February 2005. In November 2006, it
was bought by Google for US$1.65 billion. YouTube now operates as one of Google's
subsidiaries. The site allows users to upload, view, rate, share and comment on videos, and it
makes use of WebM, H.264/MPEG-4 AVC, and Adobe Flash Video technology to display a wide
variety of user-generated and corporate media video. Available content includes video clips, TV
clips, music videos, movie trailers and other content such as video blogging, short original
videos, and educational videos
Appendix A : STUDENT BILL OF RIGHTS
The following Student Bill of Rights and Responsibilities was adapted by the NSNA House of
Delegates in April, 1975, ur
1. Students should be encouraged to develop the capacity for critical judgment and engage
independent search for truth. in a sustained and
2.The freedom to teach and the freedom to learn are inseparable facets of academic freedom:
students should exercise their freedom with responsibility.
3. Each institution has a duty to develop policies and procedures which provide and safeguard
the students' freedom to learn. Under no circumstances should a student be barred from
4. admission to a particular institution on the basis of race, creed, sex, or marital status.
5. Students should be free to take reasoned exception to the data or views offered in any course
of study and to reserve judgment about matters of opinion, but they are responsible for learning
the content of any course of study for which they are enrolled.
6. Students should have protection through orderly procedures against prejudices or capricious
academic evaluation, but they are responsible for maintaining standards of academic
performance established for each course in which they are enrolled.
7. Information about student views, beliefs, and political associations which instructors acquire
in the course of their work should be considered confidential and not released without the
knowledge or consent of the student.
8. The student should have the right to have a responsible voice in the determination of his/her
curriculum.
9. Institutions should have a carefully considered policy as to the information which should be a
part of a student's permanent educational record and as to the conditions of its disclosure.
10. Students and student organizations should be free to examine and discuss all questions of
interest to them, and to express opinions publicly and privately.
11. Students should be allowed to invite and to hear any person of their own choosing, thereby
taking the responsibility of furthering their education.
12. The student body should have clearly defined means to participate in the formulation and
application of institutional policy affecting academic and student affairs.
13.The institution has an obligation to clarify those standards of behavior for which it considers
essential to its educational mission and community life.
14. Disciplinary proceedings should be instituted only for violations of standards of conduct
formulated with significant student participation and published in advance through such means
as a student handbook or a generally available body of institutional regulations. It is the
responsibility of the student to know these regulations. Grievance procedures should be
available for every student.
15. As citizens and members of an academic community, students are subject to the obligations
which accrue them by virtue of this membership and should enjoy the same freedom of
citizenship.
16. Students have the right to belong or refuse to belong to any organization of their choice.
17. Students have the right to personal privacy in their living space to the extent that the welfare
of others is respected.
18. Adequate safety precautions should be provided by schools of nursing, for example, to and
from student dorms,
19. adequate street lighting, locks, etc. Dress code, if present in school, should be established
by student government in conjunction with the school director and faculty, so the highest
professional standards possible are maintained, but also taking into consideration points of
comfort and practicality for the student.
20. Grading systems should be carefully reviewed periodically with students and faculty for
clarification and better student-faculty understanding.
Appendix B : FILIPINO PATIENT BILL OF RIGHTS
As per Benate Bill 812 Introduced by the Hon. Sen. Ramon "Bong" Revilla, Jr. July 3, 2007
EXPLANATORY NOTE
It is a declared policy of the State to ensure and protect the rights of patients to decent,
humane and quality health care. Further, the State shall adopt an integrated and comprehensive
approach to health and development which shall endeavor to make essential goods, health and
other social services available to the people at affordable costs. The State shall likewise
endeavor to provide free medical care to pauper.
Therefore, this proposed Magna Carta of Patients Rights shall provide patients the
following basic rights: right to proper and appropriate medical care and humane treatment, right
to informed consent; right to privacy and confidentiality; right to information; right to choose
physician and health care provider, right to self determination; right to religious belieб right to
medical records; right to leave, right to refuse participation in medical research; right to
correspondence and to receive visitors; right to express grievances; right to be informed of his
rights and obligations as a patient. With rights come responsibilities. As we seek to improve our
patients, we also envision to make them more responsible citizens of this country. In view of the
foregoing, immediate approval of this measure is earnestly sought.
AN ACT DECLARING THE RIGHTS AND OBLIGATIONS OF PATIENTS AND

ESTABLISHING A GRIEVANCE MECHANISM FOR VIOLATIONS THEREOF AND FOR
OTHER PURPOSES.
Be enacted by the Senate and House of Representatives of the Philippines in Congress

assembled:
Title I
Title and Declaration of Policies
Section 1. Short Title. This Act shall he known as the "Magna Carta of Patient's Rights and
Obligations."
Section 2. Declaration of Policy. It shall be the policy of the State to protect and promote the
right to health of the people and instil health and consciousness among them. It shall likewise
be the policy of the State for Congress to give the highest priority to the enactment of measures
that protect and enhance the right of all people to human dignity. Towards this end, the State
shall ensure, provide and protect the rights of patients to decent, humane and quality health
care.
Title II Definition of Terms
Section 3. Definition of Terms. As used in this Act, the following terms are defined as follows:
1. Advance Directive is a document with written instructions made by a person before

he/she reaches the terminal phase of a terminal illness or a persistent vegetative state and
incapable of malting decisions about medical treatment when the question of administering the
treatment arises. It includes, but is not limited to, a health care proxy or a living will. It is
preferably, a duly notarized document executed by a person of legal age and of sound mind,
upon consultation with a physician and family members. It directs health care providers to
refrain from providing extraordinary measures when the person executing such directive
reaches the terminal phase of his terminal illness.
2. Emergency - an unforeseen combination of circumstances which is unanticipated and

episodic; life-threatening, and there is disability of function which calls for immediate medical
intervention to preserve the life and limb of a person and/or patient as may be determined by a
responsible health care worker.
3. Health Care -measures taken by a health care provider or that are taken in a health care
institution in order to determine a patient's state of health or to restore or maintain it.
4. Health Care Institution a site devoted primarily to the maintenance and operation of facilities
for the prevention, diagnosis, treatment, and care of individuals suffering from illness, disease,
injury, or deformity if in need of medical and nursing care.
5. Health Care Professional/Practitioner any physician, dentist, nurse, pharmacist or

paramedical and other supporting health personnel, including, but not limited to, medical and
dental technicians and technologists, nursing aides, therapists, nutritionists trained in health
care and/or duly registered and licensed to practice in the Philippines as well as traditional and
alternative health care practitioners.
6. Health Maintenance Organization - any entity licensed by the appropriate government

regulatory agency which arranges for coverage designated health services needed by plan
members for a fixed prepaid premium.
7. Human Experimentation the physician's departure from standard medical practice of

treatment for the purpose of obtaining new knowledge or testing a scientific hypothesis on
human subjects.
8. Indigent Patient -a patient who has no visible means of income or whose income is
insufficient for the subsistence of his family.
9. Informed Consent the voluntary agreement of a person to undergo or be subjected to a

procedure or other bodily intervention based on his understanding of the relevant consequences
of receiving a particular treatment, as clearly, truthfully and reasonably explained by the health
care provider in a manner and language understandable to the patient. Such permission must
be in writing.
10. Mass Media embraces means of communication that reach and influence large numbers
of people, including print media, especially newspapers, periodicals, and popular magazines,
radio, television, and movies, and involved in the gathering, transmission and distribution of
news, information, messages, signals and all forms of written, oral and visual communications.
11. Media Practitioner any person who is engaged in the practice of mass media.
12. Medically Necessary- a service or procedure which is appropriate and consistent with
diagnosis and which, using accepted standards of medical practice, could not be omitted
without adversely affecting the patient's condition.
13. Patient a person who avails himself or herself of health and medical care services or is
otherwise the subject of such services
14. Public Health and Safety - the state of well-being of the population in general, the protection
of which may require the curtailment or suspension of certain rights of patients.
15. Terminal Care is an array of services offered by a team of doctors, nurses, therapists, social
workers, clergy and volunteers which provide active total care directed at maintaining or
improving the comfort of a person suffering from terminal illness, including the management of
pain and physical symptoms, and the provision of spiritual, psychological and emotional support
for the person and his family in an institution, a hospital or at the patient's home. Care does not
hasten nor postpone death. It affirms life and regards dying as a normal process. Care
continues so that the remaining life can be lived to the West until a dignified and peaceful death
comes in the terminal phase of the person's illness.
16. Terminal Illness is an illness or condition resulting in death within the foreseeable future.
17. Terminal Phase is the stage of terminal illness when there is no real prospect of recovery or
remission of symptoms on either a permanent or temporary basis.
18. Traditional and Alternative Health Care the sum total of knowledge, skills and practices on
health care, other than those embodied in biomedicine, used in the prevention, diagnosis and
elimination of physical or mental
19. Traditional and Alternative Health Care Practitioner Provider - a person who practices other
forms of non-allopathic, occasionally nonindigenous or imported healing methods, such as
reflexology. acupuncture, massage, acupressure, chiropractic, nutritional therapy, and other
similar methods.
20. Unwarranted Public Exposure a situation where the patient is subjected to exposure, private
or public, either by photography, publication, videotaping. discussion, TV broadcasting or radio
broadcasting, or by any other means that would otherwise tend to reveal his person or identity
and circumstances under which he has or will be under medical or surgical treatment without his
or her consent.
Title III
Declaration of Rights
Section 4. The Rights of Patients. The following rights of the patient shall be respected by all
those involved in his care:
1. Right to Appropriate Medical Care and Humane Treatment. Every person has a right to
health and medical care corresponding to his state of health, without any discrimination and
within the limits of the resources, manpower and competence available for health and medical
care at the relevant time. The patient has the right to appropriate health and medical care of
good quality. In the course of such care, his human dignity, convictions, integrity, individual
needs and culture shall be respected.
If any person cannot immediately be given treatment that is medically necessary he shall,
depending on his state of health, either be directed to wait for care, or be referred or sent for
treatment elsewhere, where the appropriate care can be provided. It the patient has to wait for
care, he shall be informed of the reason for the delay. Patients in emergency shall be extended
immediate medical care and treatment without any deposit, pledge, mortgage or any form of
advance payment for treatment.
2. Right to Informed Consent. The patient has a right to a clear, truthful and substantial
explanation, in a manner and language understandable to the patient, of all proposed
procedures, whether diagnostic, preventive, curative, rehabilitative or therapeutic, wherein the
person who will perform the said procedure shall provide his name and credentials to the
patient, possibilities of any risk of mortality or serious side effects, problems related to
recuperation, and probability of success and reasonable risks involved:
Provided, That, the patient will not be subjected to any procedure without his written informed
consent, except in the following cases:
a. in emergency cases, when the patient is at imminent risk of physical injury, decline or
death if treatment is withheld or postponed. In such cases, the physician can perform any
diagnostic or treatment procedure as good practice of medicine dictates without such consent;
b. when the health of the population is dependent on the adoption of a mass health
program to control epidemic;
c. when the law makes it compulsory for everyone to submit to a procedure;
d. when the patient is either a minor, or legally incompetent, in which case, a third party
consent is required;
e. when disclosure of material information to patient will jeopardize the success of

treatment, in which case, third
party disclosure and consent shall be in order; f. when the patient waives his right in writing.
Informed consent shall be obtained from a patient concerned if he is of legal age and of sound
mind. In case the patient is incapable of giving consent and a third party consent is required, the
following persons, in the order of priority stated hereunder, may give consent:
i. spouse;
ii. either parent;
iii. guardian
If a patient is a minor, consent shall be obtained from his parents or legal son or
daughter of legal age; brother or sister of legal age, or guardian. If next of kin, parents or legal
guardians refuse to give consent to a medical or surgical procedure necessary to save the life or
limb of a minor or a patient incapable of giving consent, courts, upon the petition of the
physician or any person interested in the welfare of the patient, in a summary proceeding, may
issue an order giving consent.
3. Right to Privacy and Confidentiality. The privacy of the patients must be assured at all
stages of his treatment. The patient has the right to be free from unwarranted public exposure,
except in the following cases:
a. when his mental or physical condition is in controversy and the appropriate court, in its
discretion, orders him to submit to a physical or mental examination by a physician; b. when the
public health and safety so demand; and
c. when the patient waives this right. The patient has the right to demand that all
information, communication and records pertaining to his care be treated as confidential. Any
health care provider or practitioner involved in the treatment of a patient and all those who have
legitimate access to the patient's record is not authorized to divulge any information to a third
party who has no concern with the care and welfare of the patient without his consent, except:
a. when such disclosure will benefit public health and safety; of
b. when it is in the interest of justice and upon the order a competent court; c. when the
patients waives in writing the confidential nature of such information;
d. when it is needed for continued medical treatment or advancement of medical science

subject to de identification of patient and shared medical confidentiality for those who
have access to the information.
Informing the spouse or the family to the first degree of the patient's medical condition
may be allowed; Provided, That the patient of legal age shall have the right to choose on whom
to inform. In case the patient is not of legal age or is mentally incapacitated, such information
shall be given to the parents, legal guardian or his next of kin.
4. Right to Information. In the course of his/her illness and hospital care, the patient or his/her
legal guardian has a right to be informed of the result of the evaluation of the nature and extent
of his/her disease, any other additional or further contemplated medical treatment on surgical
procedure or procedures, including any other additional medicines to be administered and their
generic counterpart including the possible complications and other pertinent facts, statistics or
studies, regarding his/her illness, any change in the plan of care before the change is made, the
person's participation in the plan of care and necessary changes before its implementation. the
extent to which payment maybe expected from Philhealth or any payor and any charges for
which the patient may be liable, the disciplines of health care practitioners who will furnish the
care and the frequency of services that are proposed to be furnished.
The patient or his legal guardian has the right to examine and be given an itemized bill of the
hospital and medical services rendered in the facility or by his/her physician and other health
care providers, regardless of the manner and source of payment. He is entitled to a thorough
explanation of such bill. The patient or his/her legal guardian has the right to be informed by the
physician or his/her delegate of his/her continuing health care requirements following discharge,
including instructions about home medications, diet, physical activity and all other pertinent
information to promote health and well-being.
At the end of his/her confinement, the patient is entitled to a brief, written summary of the course
of his/her illness which shall include at least the history, physical examination, diagnosis,
medications, surgical procedure, ancillary and laboratory procedures, and the plan of further
treatment, and which shall be provided by the attending physician. He/she is Der likewise
entitled to the explanation of, and to view, the contents of the medical record of his/her
confinement but with the presence of his/her attending physician or in the absence of the
attending physician, the hospital's representative.
Notwithstanding that he/she may not be able to settle his accounts by reason of financial
incapacity, he/she is entitled to reproduction, at lesser expense, the pertinent part or parts of the
medical record the purpose or purposes of which he shall indicate in his/her written request for
reproduction. The patient shall likewise be entitled to medical certificate, free of charge, with
respect to his/her previous confinement. The patient has likewise the right not to be informed, at
his/her explicit request.
5. The Right to Choose Health Care Provider and Facility - The patient is free to choose the
health care provider to serve him as well as the facility except when he is under the care of a
service facility or when public health and safety so demands or when the patient expressly or
impliedly waives this right. The patient has the right to discuss his condition with a consultant
specialist, at the patient's request and expense. He also has the right to seek for a second
opinion and subsequent opinions, if appropriate, from another health care provider/practitioner.
6. Right to Self-Determination. The patient has the right to avail himself/herself of any
recommended diagnostic and treatment procedures. Any person of legal age and of sound mind
may make an advance written directive for physicians to administer terminal care when he/she
suffers from the terminal phase of a terminal illness: Provided, That
a. he is informed of the medical consequences of his choice; b. he releases those involved in

his care from any obligation relative to the consequences of his decision; c. his decision will not
prejudice public health and safety.
7. Right to Religious Belief. The patient has the right to refuse medical treatment or
procedures which may be contrary to his religious beliefs, subject to the limitations described in
the preceding subsection: Provided, That such a right shall not be imposed by parents upon
their children who have not reached the legal age in a life threatening situation as determined by
the attending physician or the medical director of the facility.
8. Right to Medical Records. The patient is entitled to a summary of his medical history and
condition; He has the right to view the contents of his medical records, except psychiatric notes
and other incriminatory information obtained about third parties, with the attending physician
explaining contents thereof. At his expense and upon discharge of the patient, he may obtain
from the health care institution a reproduction of the same record whether or not he has fully
settled his financial obligation with the physician or institution concerned.
The health care institution shall safeguard the confidentiality of the medical records and o
likewise ensure the integrity and authenticity of the medical records and shall keep the same
within a reasonable time as may be determined by the Department of Health. The health care
institution shall issue a medical certificate to the patient upon request. Any other document that
the patient may require for insurance claims shall also be made available to him within a
reasonable period of time.
9. Right to Leave. - The patient has the right to leave a hospital or any other health care
institution regardless of his physical condition: Provided, That
a. he/she is informed of the medical consequences of his/her decision;
b. he/she releases those involved in his/her care from any obligation relative to the
consequences of his decision; c. his/her decision will not prejudice public health and safety.
No patient shall be detained against his/her Will in any health care institution on the sole basis
of his failure to fully settle is financial obligations. However, he/she shall only be allowed to leave
the hospital provided appropriate arrangements have been made to settle the unpaid bills:
Provided, farther, that unpaid bills of patients shall be considered as lost income by the hospital
and health care provider/practitioner and shall be deducted from gross income as income loss
for that particular year.
10. Right to Refuse Participation in Medical Research. The patient has the right to be
advised if the health care provider plans to involve him in medical research, including but not
limited to human experimentation which may be performed only with the written informed
consent of the patient. Provided, further, That, an institutional review board or ethical review
board in accordance with the guidelines set in the Declaration of Helsinki be established for
research involving human experimentation: Provided, finally, That the Department of Health
shall safeguard the continuing training and education of future health care provider/practitioner
to development of the health care delivery in the country. ensure the
11. Right to Correspondence and to Receive Visitors. The patient has the right to
communicate with relatives and other persons and to receive visitors subject to reasonable
limits prescribed by the rules and regulations of the health care institution.
12. Right to Express Grievances. The patient has the right to express complaints and
grievances about the care and services received without fear of discrimination or reprisal and to
know about the disposition of such complaints. The Secretary of Health, in consultation with
health care providers, consumer groups and other concerned agencies shall establish a
grievance system wherein patients may seek redress of their grievances. Such a system shall
afford all parties concerned with the opportunity to settle amicably all grievances.
13. Right to be Informed of His Rights and Obligations as a Patient. Every person has the
right to be informed of his rights and obligations as a patient. The Department of Health, in
coordination with health care providers, professional and civic groups, the media, health
insurance corporations, people's organizations, local government organizations, shall launch
and sustain a nationwide information and education campaign to make known to people their
rights as patients, as declared in this Act. Such rights and obligations of patients shall be posted
in a bulletin board conspicuously placed in a health care institution. It shall be the duty of health
care institutions to inform patients of their rights as well as of the institution's rules and
regulations that apply to the conduct of the patient while in the care of such institution.
Section 5. Societal Rights of Patients. In addition to the individual rights of patients, the patient
has likewise their societal rights. Following are the societal rights of patients:
1. Right to Health. "The patient has the right to regain and/or acquire the highest attainable
standard of health, in a non discriminatory, gender sensitive, and equal manner, which
health authorities and health practitioner must progressively contribute.
2. Right to Access to Quality Public Health Care. The patient has the right to functioning public
health and health care facilities, goods and services and programs needed and sufficient
quantity. They shall likewise be provided with health facilities and services with adequate
provision of essential drugs, regular screening programs, appropriate treatment of prevalent
diseases, illnesses, injuries and disabilities, including provision of public health insurance.
Towards this end, the government shall, as far as practicable, approximate the international
standard allocation for the health sector as set by World Health Organization.
3. Right to Healthy and Safe Workplace. The patient has the right to a healthy natural workplace
environment with adequate supply of safe and potable water and basic sanitation, industrial
hygiene, prevention and reduction of exposure to harmful substances, preventive measures for
occupational accidents and diseases, and an environment that discourages abuse of alcohol,
tobacco me, drug use and other harmful substances.
4. Right to Prevention and Education Programs. The patient has the right to prevention and
education programs on immunization, on the prevention, treatment and control of diseases, for
behavior-related concerns, for disaster relief and emergency situations during epidemics and
similar health hazards.
5. Right to Participate in Policy Decisions. The patient has the right to participate in policy
decisions relating to patient's right to health at the community and national levels.
Title IV Declaration of Obligations
Section 6. The Obligations of Patients. Patients shall at all times fulfil their obligations and
responsibilities regarding medical care and their personal behavior.
1. Know Rights. - The patient shall ensure that he/she knows and understands what the
patients' rights are and shall exercise
those rights responsibly and reasonably.
2. Provide Accurate and Complete Information. The patient shall provide, to the best of his
knowledge, accurate and complete information about all matters pertaining to his/her health,
including medications and past or present medical problems to his/her health care provider.
3. Report Unexpected Health Changes. It shall be the duty of every patient to report unexpected
changes to his/her condition or symptoms, including pain, to a member of the health care team.
4. Understand Purpose and Cost of Treatment. The patient shall ensure that he/she
understands the purpose and cost of any proposed treatment or procedure before deciding to
accept it. He/she shall notify the health care provider or practitioner if he/she does not
understand any information about his/her care or treatment. The patient shall insist upon
explanations until adequately informed and consult with all relevant persons before reaching a
decision.
5. Accept Consequences of Own Informed Consent. The patient shall accept all the
consequences of the patient's own informed consent. If he/she refuses treatment or do not
follow the instructions or advice of the health care provider or practitioner, he/she must accept
the consequences of his/her decision and thus relieve the health care provider or practitioner of
any liability.
6. Settle Financial Obligations. The patient shall ensure that financial obligations of his/her
health care are fulfilled as promptly as possible, otherwise, he/she shall make appropriate
arrangements to settle unpaid bills in the hospital and/or
professional fees of the health care provider through post-dated checks or promissory notes or
any similar medium.
7. Relation to Others. The patient shall so conduct himself or herself so as not to interfere with
the well-being or rights of other patients or providers of health care. He/she shall act in a
considerate and cooperative manner, respect the rights and property of others and follow the
policies and procedures of the health care establishment.
8. Exhaust Grievance Mechanism. - The patient shall first exhaust the grievance mechanism
provided in this bill before filing any administrative or legal action.
Title V
Grievance Mechanism
Section 7 Mediation. Any written complaint arising from violation of any of the right of patients
under Section 4 of this bill shall first be submitted for mediation. There shall be two (2) types,
namely: hospital-based grievance mechanism and out-of-hospital based grievance mechanism.
The Hospital-based Grievance Committee shall be composed of a grievance officer appointed
and designated permanently by the hospital who shall act as Chairperson and two (2)
physicians agreed upon by both parties, as members. For out-of hospital grievance mechanism,
the Committee shall he composed of the Local Health Officer as Chairperson and the Barangay
Human Rights Action Officer and representative each from the Philippine Medical association,
the Council of Health Practitioner Association and the Philippine Institute of Traditional and
Alternative Health Care, as members.
For this purpose, the Department of Health shall ensure the establishment of these
Grievance Committees. The hearing procedure shall not be adversarial in nature. The patient
and the health care provider or practitioner shall be given the opportunity to discuss the cause
of complaint and effort shall be made for its settlement. No monetary compensation shall be
involved during this stage and neither shall a legal counsel be present at this stage. The parties
to the complaint shall be bound by the rules on confidentiality.
The aggrieved party shall be given thirty (30) days from occurrence of incident to file his/her
written complaint to the appropriate grievance mechanism. Upon receipt of written complaint,
the Chairperson shall give due notice to the respondent. Upon receipt of the written complaint
and due notice to the respondent, the Grievance Committee shall be given thirty (30) days to
resolve the said complaint. Otherwise, the complainant shall have the option proceed to the no
fault arbitration process or to file administrative and legal action under existing laws.
Section 8. No-fault Arbitration Process- If and when the complaint is not resolved through
mediation within the prescribed period, the complainant has the option to file a case for
settlement at the no-fault arbitration process. However, only complaints arising from treatment-
related physical injuries shall proceed to this arbitration process.
The No-Fault Arbitration Committee shall be a five-man peer review team composed of
physicians. The claimant and health care provider may choose one physician-member each of
the peer review team. The peer review team may come out with a decision based on
documentary evidence including depositions. However, hearings may be held to gather
testimony. Within thirty (30) days from receipt of the complaint, the Committee shall make a
decision. All decisions shall be appealable to the Court of Appeals.
Compensation shall be limited to actual monetary loss only. It will not cover for "pain and
suffering" or other explicitly non-monetary losses. A Health-Provider Compensation Fund shall
be established in all health facilities by health provider associations/organizations or when not
possible, through the Philippine Health Insurance Corporation. The funding shall come from
assessments paid by the health care providers. For this purpose, the Philippine Health
Insurance Corporation shall ensure the establishment of this Fund.
Section 9. Prescriptive Period. The time during which the case is submitted for mediation shall
toll the running of the prescriptive period for the filing of a civil or criminal case under the
Revised Penal Code or any administrative case under existing laws.
Title VI Miscellaneous Provisions
Section 10. Inclusion in School Curriculum, Licensure Examinations and Training - The
provisions of this Act shall be considered in medical and medical-related school curriculum and
licensure examinations, including trainings and seminars of traditional and alternative health
care providers or practitioners.
Section 11. Rules and Regulations The Secretary of Health, in consultation with the Philippine
Medical Association, the Philippine Hospital Association, the Philippine Institute of Traditional
and Alternative Health Care, Philippine Health Insurance Corporation and concerned private
agencies, non-governmental organizations and people's organizations shall promulgate such
rules and regulations as may be necessary for its implementation within One Hundred Eighty
(180) days from the effectivity of this Act.
Section 12. Repealing Clause All Acts, Executive Orders, Rules and Regulations, or parts
thereof that are inconsistent with the provisions of this Act are hereby repealed or modified
accordingly.
Section 13 Effectivity This Act shall take effect fifteen (15) days after the date of its publication
in at least two (2) major newspapers of general circulation.
Appendix C : PRINCIPLES OF CRITICAL THINKING
Founding principles from the National Council for Excellence in Critical Thinking
1. There is an intimate interrelation between knowledge and thinking.
2. Knowing that something is so is not a matter of believing that it is so; it also entails being
justified in that belief (Definition: Knowledge is justified true belief).
3. There are general as well as domain specific standards for the assessment of thinking. 3.
4. To achieve knowledge in any domain, it is essential to think critically.
5. Critical thinking is based on articulable intellectual standards and hence is intrinsically subject
to assessment by those standards.
6.Criteria for the assessment of thinking in all domains are based on such general standards as:
clarity, precision, accuracy, relevance, significance, fairness, logic, depth and breadth,
evidentiary support, probability, and predictive or explanatory power. These standards, and
others, are embedded not only in the history of the intellectual and scientific communities but
also in the self-assessing behavior of reasonable persons in everyday life. It is possible to teach
all subjects in such a way as to encourage the use of these intellectual standards in both
professional and personal life.
7. Instruction in critical thinking should increasingly enable a student to assess both his or her
own thought and action and that of others by reference, ultimately, to standards such as those
mentioned above. It should lead progressively, in other words, to a disciplining of the mind and
to a self chosen commitment to a life of intellectual and moral integrity.
8. Instruction in all subject domains should result in the progressive disciplining of the mind with
respect to the capacity and disposition to think critically within that domain. Hence, instruction in
science should lead to disciplined scientific thinking; instruction in history should lead to
disciplined historical thinking, and in a parallel manner in every discipline and domain of
learning.
9. Disciplined thinking with respect to any subject involves the capacity on the part of the thinker
to recognize, analyze, and assess the basic elements of thought: the purpose or goal of the
thinking; the problem or question at issue; the frame of reference or points of view involved;
assumptions made; central concepts and ideas at work; principles or theories used; evidence,
data, or reasons advanced; claims made and conclusions drawn; inferences, reasoning and
lines of formulated thought; and implications and consequences involved.
10. Critical reading, writing, speaking, and listening are academically essential modes of
learning. To be developed generally they must be systematically cultivated in a variety of subject
domains as well as with respect to interdisciplinary issues. Each are modes of thinking which
are successful to the extent that they are disciplined and guided by critical thought and
reflection.
11. The earlier that children develop sensitivity to the standards of sound thought and
reasoning, the more likely it is that they will develop desirable intellectual habits and become
open-minded persons responsive to reasonable persuasion.
12. Education in contrast to training, socialization, and indoctrination implies a process

conducive to critical thought and judgment. It is intrinsically committed to the cultivation of
reasonability and rationality.
Appendix D : NURSES CODE OF ETHICS
PROMULGATION OF THE CODE OF ETHICS FOR REGISTERED NURSES
WHEREAS, the Board of Nursing has the power to promulgate a Code of Ethics for Registered
Nurses in coordination and consultation with the accredited professional organization (Sec. 9,
(g). Art. III of R.A. No. 9173, known as the "Philippine Nursing Act of 2002);
WHEREAS, in the formulation of the Code of Ethics for Registered Nurses, the Code of Good
Governance for the Professions in the Philippines was utilized as the principal basis therefore:
All the principles under the said Code were adopted and integrated into the Code of Ethics as
they apply to the nursing profession;
WHEREAS, the promulgation of the said Code as a set of guidelines, regulations or measures
shall be subject to approval by the Commission (Sec. 9, Art. II of R.A. No. 9173); and
WHEREAS, the Board, after consultation on October 23, 2003 at Iloilo City with the accredited
professional organization of registered nurses, the Philippine Nurses Association, Inc (PNA),
and other affiliate organizations of Registered Nurses, decided to adopt a new Code of Ethics
under the afore-mentioned new Law;
EOW, THEREFORE, the Board hereby resolved, as it now resolves, to
promulgate the hereunder Code of Ethics for Registered Nurses:
ARTICLE I PREAMBLE
SECTION 1. Health is a fundamental right of every individual. The Filipino registered nurse,
believing in the worth and dignity of each human being, recognizes the primary responsibility to
preserve health at all cost. This responsibility encompasses promotion of health, prevention of
illness, alleviation of suffering, and restoration of health. However, when the foregoing are not
possible, assistance towards a peaceful death shall be his/her obligation.
SECTION 2. To assume this responsibility, registered nurses have to gain knowledge and
understanding of man's cultural, social, spiritual, physiological, psychological, and ecological
aspects of illness, utilizing the therapeutic process. Cultural diversity and political and socio
economic status are inherent factors to effective nursing care.
SECTION 3. The desire for the respect and confidence of clientele, colleagues, co-workers, and
the members of the community provides the incentive to attain and maintain the highest
possible degree of ethical conduct.
ARTICLE II
REGISTERED NURSES AND PEOPLE
SECTION 4. Ethical Principles
1. Values, customs, and spiritual beliefs held by individuals shall be respected.
2. Individual freedom to make rational and unconstrained decisions shall be respected.
3. Personal information acquired in the process of giving nursing care shall be held in strict
confidence.
SECTION 5. Guidelines to be observed: REGISTERED Nurses must
1. consider the individuality and totality of patients when they administer care.
2. respect the spiritual beliefs and practices of patients regarding diet and treatment.
3. uphold the rights of individuals.
4. take into consideration the culture and values of patients in providing nursing care. However,
in the event of conflicts, their welfare and safety must take precedence.
ARTICLE III
REGISTERED NURSES AND PRACTICE
1. Human life is inviolable. of nursing practice.
2. Quality and excellence in the care of the patients are the goals 3. Accurate documentation of
actions and outcomes of delivered care is the hallmark of nursing accountability.
SECTION 7. Guidelines to be observed:
REGISTERED Nurses must
1. know the definition and scope of nursing practice which are in the provisions of R. A. No.
9173, known as the "Philippine Nursing Act of 2002" and Board Res. No. 425, Series of 2003,
the "Rules and Regulations Implementing the Philippine Nursing Act. of 2002", (the IRR).
2. be aware of their duties and responsibilities in the practice of their profession as defined in
the "Philippine Nursing Act of 2002" and the IRR.
3. acquire and develop the necessary competence in knowledge, skills, and attitudes to
effectively render appropriate nursing services through varied learning situations.
4. if they are administrators, be responsible in providing favorable environment for the growth
and Registered Nurse in their charge.
5. be cognizant that professional programs for specialty developments of certification by the

BON are accredited through the Nursing Specialty Certification Council (NSCC).
6. see to it that quality nursing care and practice meet the optimum standard of safe nursing
practice.
7. insure that modification of practice shall consider the principles of safe nursing practice.
8. if in position of authority in a work environment, be normally and legally responsible for

devising a system of minimizing occurrences of ineffective and unlawful nursing practice
9. ensure that patients' records shall be available only if they are to be issued to those who are
professionally and directly involved in their care and when they are required by law.
SECTION 8. Ethical Principle

Registered Nurses are the advocates of the patients: they shall take appropriate steps to
safeguard their rights and privileges.
Guidelines to be observed:
1. respect the "Patients' Bill of Rights" in the delivery of nursing care.
2. provide the patients or their families with all pertinent information except those which may be
deemed harmful to their well-being.
3. uphold the patients' rights when conflict arises regarding management of their care.
SECTION 10. Ethical Principle

Registered Nurses are aware that their actions have professional, ethical, moral, and legal
dimensions. They strive to perform their work in the best interest of all concerned.
SECTION 11. Guidelines to be observed: REGISTERED Nurses must:
1. perform their professional duties in conformity with existing laws, rules, regulations.
measures, and generally accepted principles of moral conduct and proper decorum.
2. not allow themselves to be used in advertisement that should demean the image of the
profession (i.e. indecent exposure, violation of dress code, seductive behavior, etc.).
3. decline any gift, favor or hospitality which might be interpreted as capitalizing on patients.
4. not demand and receive any commission, fee or emolument for recommending or referring a
patient to a physician, a co-nurse or another health care worker; not to pay any commission, fee
or other compensations to the one referring or recommending a patient to them for nursing care.
5. avoid any abuse of the privilege relationship which exists with patients and of the privilege
access allowed to their property. residence or workplace.
ARTICLE IV
REGISTERED NURSES AND CO-WORKERS
SECTION 12. Ethical Principles The Registered Nurse is in solidarity with other members of
the healthcare team in working for the patient's best interest.
The Registered Nurse maintains collegial and collaborative working relationship with colleagues
and other health care providers.
1. maintain their professional role/identity while working with other members of the health team.
2. conform with group activities as those of a health team should be based on acceptable,
ethico-legal standards.
3. contribute to the professional growth and development of other members of the health team.
4. actively participate in professional organizations.
5. not act in any manner prejudicial to other professions, 6. honor and safeguard the reputation
and dignity of the members of nursing and other professions; refrain from making unfair and
unwarranted comments or criticisms on their competence, conduct, and procedures; or not do
anything that will bring discredit to a colleague and to any member of other professions. 7.
respect the rights of their co-workers.
ARTICLE V
REGISTERED NURSES, SOCIETY, AND ENVIRONMENT
The preservation of life, respect for human rights, and promotion of healthy environment shall
be a commitment of a Registered Nurse.
The establishment of linkages with the public in promoting local, national, and international
efforts to meet health and social needs of the people as a contributing member of society is a
noble concern of a Registered Nurse.
SECTION 15. Guidelines to be observed: REGISTERED Nurses must
1. be conscious of their obligations as citizens and, as such, be involved in community

concerns.
2. be equipped with knowledge of health resources within the community, and take active roles
in primary health care.
3. actively participate in programs, projects, and activities that 2respond to the problems of
society.
4. lead their lives in conformity with the principles of right conduct and proper decorum.
5. project an image that will uplift the nursing profession at all times.
ARTICLE VI
REGISTERED NURSES AND THE PROFESSION
SECTION 16. Ethical Principles:
Maintenance of loyalty to the nursing profession and preservation of its integrity are ideal.
Compliance with the by-laws of the accredited professional organization (PNA), and other
professional organizations of which the Registered Nurse is a member is a lofty duty.
Commitment to continual learning and active participation in the development and growth of the
profession are commendable obligations.
Contribution to the improvement of the socio-economic conditions and general welfare of nurses
through appropriate legislation is a practice and a visionary mission.
Registered Nurses must

1. be members of the Accredited Professional Organization (PNA)
2. strictly adhere to the nursing standards
3. participate actively in the growth and development of the
4. strive to secure equitable socio-economic and work conditions
nursing profession. in nursing through appropriate legislation and other means.
5. assert for the implementation of labor and work standards.
ARTICLE VII
ADMINISTRATIVE PENALITIES, REPEALING CLAUSE, AND EFFECTIVITY
SECTION 18. The Certificate of Registration of Registered Nurse shall either be revoked or
suspended for violation of any provisions of this Code pursuant to Sec. 23 (f), Art. IV of R. A. No.
9173 and Sec. 23 (1), Rule III of Board Res. No. 425, Series of 2003, the IRR.
SECTION 19. The Amended Code of Ethics promulgated pursuant to R. A. No. 877 and P.D.
No. 223 is accordingly repealed or superseded by the herein Code.
SECTION 20. This Code of Ethics for Nurses shall take effect after fifteen (15) days from its full
and complete publication in the Official Gazette or in any newspapers of general circulation.
Done in the City of Manila, this 14th day of July, 2004.
(original signed)
EUFEMIA F. OCTAVIANO
Chairman
(original signed)
LETTY G. KUAN Member
(original signed)
FLORENCE C. CAWAON
Member
ATTESTED:
(original signed)
(original signed)
REMEDIOS L. FERNANDEZ
Member
(original signed)
ANESIA B. DIONISIO
Member
CARLOS G. ALMELOR
Secretary, Professional Regulatory Boards
APPROVED:
(original signed)
ANTONIETA FORTUNA-IBE
Chairperson
(original signed)
AVELINA A. DELA REA
Commissioner
(original signed)
LEONOR TRIPON-ROSERO
Commissioner

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THE NURSE AS HEALTH EDUCATOR:

CONCEPTS, PRINCIPLES AND

SECOND EDITION 2017

CRESTITA B. TAN, RN, RM, MAN, PHD

APD EDUCATIONAL PUBLISHING HOUSE 526-528 UNITED NATIONS AVENUE, ERMITA,

Chapter 1: OVERVIEW OF EDUCATION ON HEALTH CARE AND CHANGE 7

Chapter 2 : CONCEPTS OF TEACHING AND LEARNING 26

Chapter 3 : ROLES AND RESPONSIBILITIES OF THE NURSE AS HEALTH EDUCATOR IN

Chapter 4 : HALLMARKS OF EFFECTIVE TEACHING IN NURSING 51

Chapter 5 : PRINCIPLE OF GOOD TEACHING PRACTICE 63

Chapter 6 : TEACHING STRATEGIES 72

Chapter 7 : BARRIERS TO EDUCATION 91

Chapter 8 : CURRICULUM PLANNING AND CONDUCTING CLASSES 101

Chapter 9 : DETERMINANTS OF LEARNING 115

Chapter 10 : MOTIVATION IN LEARNING 139

Chapter 11 THE LEARNING PROCESS 154

Chapter 12 THEORIES AND PRINCIPLES OF LEARNING 163

Chapter 13 EDUCATION COMMUNICATION IN TEACHING AND LEARNING 198

Chapter 14 : EVALUATING THE TEACHING PROGRAM 207

Appendix A : STUDENT BILL OF RIGHTS 229

Appendix B : FILIPINO PATIENT BILL OF RIGHTS 230

Appendix C : PRINCIPLES OF CRITICAL THINKING 242

Appendix D : NURSES CODE OF ETHICS 243

Intended Learning Outcomes

● Differentiate education, health, and health education

Although flexibility is important, today's teacher of nursing must have an established

HEALTH EDUCATION DEFINED

THE PROCESS OF HEALTH EDUCATION

1. It is a planned opportunity of learning through information about health guided by specific

2. It occurs in a specific setting.

3. It is a program of series or events that introduces concepts at appropriate learning levels.

6. It includes interaction between the qualified educator and learner.

1. Be aware of the values of health;

PURPOSE OF HEALTH EDUCATION

1. A Means of Propagating Health Promotion and Disease Prevention

Health education describes the interrelationship of the learner's mental, emotional,

2. Used to Modify or Continue Health Behaviors as Necessary

Health education provides information on injury prevention and management strategies

3. Provides Health Information and Services

5. A Means to Communicate Vital Information to the Public

6. It is also a form of Advocacy

Health education evaluates the effectiveness of various methods of teaching to express

TYPES OF HEALTH EDUCATION

DIMENSIONS OF THE HEALTH EDUCATION PROCESS

● substantive or curricular dimension

1. Substantive or Curricular Dimension

Substantive or curricular dimension also refers to providing opportunities for nursing

2. Procedural or Methodological Dimension

Procedural or methodological dimension consists of strategies or methods of teaching

a. Choice of the most appropriate methods in helping the students learn;

3. Environmental or Social Dimension

a. The classroom, equipped with audio-visual materials;

4. Human Relations Dimension

a. The learners who are the recipients of knowledge.

ASPECTS OF HEALTH EDUCATION

The behavioral sciences which incorporate psychology, sociology and cultural

a. Psychological predispositions: such as attitudes, knowledge, beliefs, skills, and experiences;

Behavior change is a desired outcome of health education; hence primary behavioral