HEALTH EDUCATION Communication Approaches

What is health communication? a. Inform – new ideas introduced

b. Educate – explaining
- Science and art of using effective communication to c. Persuading – convincing argument
advance the health and wellbeing of people and d. Entertaining – attention of the audience is drawn to
population. the new idea
- It is a multidisciplinary field of study and practice
that applies evidence, strategy, theory and Methods
creativity to promote behaviors, policies and
practices that advance the health and wellbeing of a. Intrapersonal
people and populations. b. Interpersonal
c. Mass Communication
Purpose
Barriers to Effective Communication
 To have a dialogue with communities
 Influence decision-makers to adopt health- a. Competition for attention
promoting policies and laws. -Physical noise
 Raise awareness among decision makers. -Internal noise
 Ensures that the public gives support to b. Language differences and vocabulary uses.
government health-promoting activities. c. Age differences
d. Attitudes and beliefs.
 Communicate new laws and health policies to the
public. OVERCOMING BARRIERS TO EFFECTIVE
 Raise public awareness in order to mobilize COMMUNICATION
community participation.
 Develop community action in health issues. The sender must know his/her audiences

Types of Communication - Background

- Age and sex
A. One-way communication - Social status
- linear and limited - Education
B. Two-way communication
- Job/ Work
- Includes feedback from the receiver to sender.
- Interest
- Communication is negotiated.
- Language
Components of Communication
The message must be
- Source (sender)
- Timely
- Message
- Meaningful/ relevant
- Channel
- Applicable to the situation
- Receiver
- Feedback The audience must remove their own barriers. Members of
the audience could be:
Communication Process
- Non-listener type- who refuses to listen
Sender- the party sending the message to another party.
- Know-it-all type- thinks he/she knows the answer to
Also knows as the communicator or source. “Who” of the
everything.
process.
- Impatient type- who is relevant to sit and jumps to
Message- combination of symbols and words that the
conclusion
sender wishes to transmits to the receiver. “What” of the
- Negative personality- who enjoys saying no to
process.
Encoding- process translating the meaning to be everyone.
transmitted into symbolic form. Characteristics of Effective Communication
Channel- the means to deliver a message from sender to
receiver. “How” of the message. - All barriers are removed
Receiver- party that receives the message, a.k.a - The proper media has been chosen
audience/destination. - A good presentation has been made
Decoding- process carried out by the receiver when he Two-way communication has been established
converts the “symbols” transmitted by the sender into a form
that make sense to him. STAGES
Response- reaction of the receiver to the message. RECEIVER – REACH AUDIENCE – GAIN ATTENTION –
Feedback- the aspect of the receiver’s response that the MESSAGE UNDERSTOOD – ACCEPTANCE – BEHAVIOR
receiver communicates back to the sender. CHANGE – IMPROVEMENT IN HEALTH
Noise- factor that prevents the decoding of a message by
the receiver in the way intended by the sender. 7 THINGS TO CONSIDER WHEN COMMUNICATING
ABOUT HEALTH
Communication Sources
1. Trust
a. Informal sources (gossip) 2. Information
b. Formal sources (facts/by professionals) 3. Motivation
c. Impersonal sources (social media) 4. Environment
5. Capacity
6. Perception
 7. Response
BEHAVIORAL OBJECTIVES
TYPES OF OBJECTIVES
Educational objectives are used to identify the intended
outcomes of the education process, whether in reference to
an aspect of a program or a total program of study, that
guide the design of curriculum units.
Instructional objectives describe the teaching activities
and resources used to facilitate effective learning (Morrison,
Ross, & Kemp, 2004).
Behavioral objectives, also referred to as learning
objectives, make use of the
modifier behavioral or learning to denote that this type of
objective is action oriented rather than content oriented,
learner centered rather than teacher centered, and short-
term outcome focused rather than process focused.
Behavioral objectives describe precisely what the learner will
be able to do following a learning situation
CHARACTERISTICS OF GOALS AND OBJECTIVES
GOAL
- Final outcome of what is achieved at the teaching-
learning process.
- A statement that describes the ideal or ultimate
state of being at some future point in time.
- Long-term targets for both the learner and the
teacher.
OBJECTIVE
- a specific, single, unidimensional behavior.
- short term in nature and should be achievable at
the conclusion of one teaching session
- statements of specific, short-term behaviors that
lead step by step to the more general, overall long-
term goal.
Subobjectives
- may be written and reflect aspects of a main
objective. They, too, are specific statements of
short-term behaviors that lead to the achievement
of the primary objective. Objectives and
subobjectives specify what the learner will be able
to do as a result of being exposed to one or more
learning experiences.
WRITING BEHAVIORAL OBJECTIVES AND GOALS
According to Mager (1997), the format for writing concise
and useful behavioral objectives includes the following three
important characteristics:
1. Performance: Describes what the learner is expected to
be able to do or perform to demonstrate the kinds of
behaviors the teacher will accept as evidence that objectives
have been achieved. Activities performed by the learner may
be visible, such as writing or listing, or invisible, such as
identifying or recalling.
2. Condition: Describes the testing situation, resources,
assistance, or constraints under which the behavior will
occur, will be observed, or will be completed.
3. Criterion: Describes how well, with which level of
accuracy, or within which time frame the learner must be
able to perform for the behavior to be considered
acceptable; the standard, quality level, or amount of
performance defined as satisfactorily demonstrating mastery.
It is the level of competence that a learner must achieve.
These three characteristics translate into the following
questions:
(1) What should the learner be able to do?
(2) Under which conditions should the learner be able to do
it?
(3) How well must the learner be able to do it?
A fourth component must also be included; it should
describe the “who” to ensure that the behavioral objective is
learner centered. An easy way to remember the four
elements that should be in a behavioral objective is to follow
the ABCD rule proposed by Smaldino, Lowther, and Russell
(2012):
A—audience (who)
B—behavior (what)
C—condition (under which circumstance)
D—degree (how much; how well; to what extent)
VERBALS WITH MANY OR FEW INTERPRETATIONS (CHECK
HERE: https://nursekey.com/behavioral-objectives/?
fbclid=IwAR1IZQU_GhCAxZGlrMDqTIEIjdXLWErdNT8uzjRhtL
2FN0afLBszkmaUAJ4)
COMMON MISTAKES WHEN WRIING OBJECTIVES
 Describing what the instructor rather than the learner
is expected to do
 Including more than one expected behavior in a single
objective (avoid using the compound word and to
connect two verbs—e.g., the learner will
select and prepare)
 Forgetting to identify all four components of condition,
performance, criterion, and the learner
 Using terms for performance that are subject to many
interpretations, not action oriented, and difficult to
measure
 Writing objectives that are unattainable given the
ability level of the learner
 Writing objectives that do not relate to the stated goal
 Cluttering objectives by including unnecessary
information
 Being too general so as not to specify clearly the
expected behavior to be achieved
If you use the SMART rule
Specific
Measurable
Achievable
Realistic
Timely
TAXONOMY OF OBJECTIVES ACCORDING TO
LEARNING OBJECTIVES
COGNITIVE (thinking domain)
- Learning in this domain involves acquiring
information and addressing the development of the
learner’s intellectual abilities, mental capabilities,
understanding, and thinking processes.
- Objectives in this domain are divided into six levels.
Knowledge level: Ability of the learner to memorize, recall,
define, recognize, or identify specific information, such as
facts, rules, principles, conditions and terms presented
during instruction.
- Commonly used verbs:
choose, circle, cite, count, define, identify, list, match, name,
outline, read, recall, repeat, report, select, state, tell, write
Comprehensive Level: Ability of the learner to
demonstrate an understanding of what is being
communicated by recognizing it in a translated form, such as
grasping an idea by defining it or summarizing it in his/her
own words.
- Commonly used verbs:
associate, describe, distinguish, estimate, explain, express,
generalize, give example, locate, recognized, review,
summarize
Application: Ability of the learner to use ideas, principles,
abstractions, or theories in particular and concrete situations,
such as figuring, writing, reading, or handling equipment
- Commonly used verbs:
Analysis level: Ability of the learner to recognize and
structure information by breaking it down into its separate
parts and specifying the relationship between the parts.
- Commonly used verbs: analyze, arrange, calculate, classify,
compare, conclude, contrast, determine, differentiate,
discriminate
Synthesis: Ability of the learner to recognize and structure
information by breaking it down into its constituent parts and
specifying the relationship between parts
- Commonly used verbs: categorize, combine, compile,
correlate, design, devise, generate, integrate, reorganize,
revise, summarize
Evaluation: Ability of the learner to judge the value of
something, such as an essay, design, or action, by applying
appropriate standards or criteria
- Commonly used verbs: appraise, assess, conclude, criticize,
debate, defend, judge, justify
Teaching in Cognitive Domain
- Lecture
- Group discussion
- One-to-one instruction
- Self-instruction activities – computer-assisted
instruction
- Verbal, written and visual tools
- Massed practice vs distributed practice
AFFECTIVE (feeling domain)
- Learners in this domain involves an increasing
internalization or commitment of feelings expressed
as emotions, interests, beliefs, attitudes, values and
appreciations
- Includes emotional and social development goals
- Educators use the effective domain to help learners
realize their own attitudes and values
- Beliefs: individual perceives as reality;
- Attitudes: feelings about an object, person or
event;
- Values- operational standards that guide actions
and ways of living
Receiving level
- Ability of the learner to show awareness of an idea or fact
or a consciousness of a situation or event in the
environment.
- Represents a willingness to selectively attend to or focus on
data to receive a stimulus.
- Commonly used verbs:
accept, admit, ask, attend, focus, listen, observe, pay
attention
Responding level
- Ability of the learner to respond to an experience, at first
obediently and later willingly and with satisfaction
- Indicates a movement beyond denial and toward voluntary
acceptance, which can lead to feelings of pleasure or
enjoyment resulting from some new experience.
- Commonly used verbs:
agree, answer, conform, discuss, express, participate, recall,
relate, report, state willingness, try, verbalize
Valuing level
- Ability of the learner to regard or accept the worth of a
theory, idea, or event, demonstrating sufficient commitment
or preference to an experience that is perceived as having
value.
-There is a definite willingness and desire to act to further
that value
- Commonly used verbs:
assert, assist, attempt, choose, disagree, follow, help,
initiate, join, propose, volunteer
Organization level
- ability of the learner to organize, classify, and prioritize
values by integrating a new value into a general set of
values; to determine interrelationships of values: and to
establish some values as dominant and pervasive.
- Commonly used verbs:
organizing, adhere, alter, arrange, combine, defend, explain,
express, generalize, integrate, resolve

Characterization level
- ability of the learners to display adherence to a total
philosophy or worldview, showing firm commitment to the
values by generalizing certain experiences into a value
system.
- Commonly used verbs: assert, commit, discriminate,
display, influence, propose, qualify, solve, verify
Teaching in the effective domain
- Role model
- Role play
- Simulation
- Gaming
- Questioning
- Case studies
- Group discussion
PSYCHOMOTOR (doing or skills domain)
- Acquiring fine and gross motor abilities such as
walking, handwriting, manipulating equipment, or
performing a procedure
- Psychomotor skill learning – complex process
demanding far more knowledge the suggested by
the simple mechanistic behavior approach
- The primary focus on the development of
manipulative skills
- Easy to identify and measure because they include
primary movement-oriented activities that are
relatively easy to observe.
Perception level: Ability of the learner to show
sensory awareness of objects or cues associated with
some tasks to be performed. This level involves reading
directions or observing a process with attention to steps
or techniques in developing a skill.
- Commonly used verbs: attend, choose, describe,
detect, differentiate, distinguish, identify, isolate,
perceive, relate, select, separate
Set level: Ability of the learners to exhibit readiness to
take a certain kind of action as evidenced by
expressions of willingness, sensory attending, or body
language favorable to performing a motor act.
- Commonly used verbs: attempt, begin, develop,
display, position, prepare, proceed, reach, respond,
show, start, try
Guided response level: Ability of the learners to exert
effort via overt actions under the guidance of an
instruction to imitate an observed behavior with
conscious awareness of effort. Imitating may be
performed hesitantly but with compliance to directions
and coaching
Complex overt response level: Ability of the learner
to automatically perform a complex motor act with
independence and a high degree of skill, without
hesitation and with minimum expenditure of time and
energy; performance of an entire sequence of a
complex behavior without the need to attend to details
- Commonly used verbs:
Guided response, mechanism, and complex overt
response: align, arrange, assemble, attach, build,
change, choose, clean, compile, complete, construct,
demonstrate, discriminate, dismantle, dissect, examine,
find, grasp, hold, insert, lift, locate, maintain,
manipulate, measure, mix, open, operate, organize,
perform, pour, practice, reassemble, remove, repair,
replace, separate, shake, suction, turn, transfer, walk,
wash, wipe
Adaptation level: Ability of the learner to modify or
adapt a motor process to suit the individual or various
situations, indicating mastery of highly developed
movements that can be suited to a variety of conditions.
Origination level: ability of the learner to create a
new motor act, such as novel ways of manipulating
objects or materials, as a result of an understanding of
a skill and a developed ability to perform skills.
Commonly used verbs: arrange, combine, compose,
construct, create, design, exchange, reformulate
- Dave’s System
Recognizes the level of skill attainment can be
achieved and attainment can be achieved and
refined over a period of months depending on the
frequency with which the learner uses certain skills
in practice.
Teaching of Psychomotor Skills
- Demonstrate
- Return Demo
- Simulation
- Self-instruction (videos, models, diagrams and
poster)
DEVELOPMENT OF TEACHING PLANS
TEACHING PLAN
→blueprint to achieve the goal and the objectives that have
been developed.
→indicate the purpose, content, methods, tools, timing, and
evaluation of instruction
→should clearly and concisely identify the order of these
various parts of the education process

Three Major Reasons
1. To direct the teacher to look at the relationship between
each of the steps of the teaching process to make sure that
there is a logical approach to teaching.
2. To communicate in writing exactly what is being taught,
how it is being taught and evaluated, and the time allotted
to meet each of the behavioral objectives.
3. To legally document that an individual plan for each
learner is in place and is being properly implemented.
Teaching plan should incorporate the following eight basic
elements (Ryan & Marinelli, 1990):
1. Purpose (the why of the educational session)
2. Statement of the overall goal
3. List of objectives
4. An outline of the content to be covered in the
teaching session
5. Instructional method(s) used for teaching the related
content
6. Time allotted for the teaching of each objective
7. Instructional resources (materials/tools and
equipment) needed
8. Method(s) used to evaluate learning
TEACHING METHODS
LECTURE
 highly structured method by which the educator
verbally transmits information directly to a group of
learners for the purpose of instruction
 one of the oldest and most often used approaches to
teaching
 Minimal exchange between the educator and the
learner
 if a lecture is well organized and delivered effectively,
it can be a very useful method of instruction -(Bain,
2004; Bartlett, 2003; Brookfield, 2006; Woodring &
Woodring, 2014)
 ideal way to provide foundational background
information as a basis for follow-up group discussions
 summarize data and current research findings not
available elsewhere -(Boyd, Gleit, Graham, &
Whitman, 1998; Brookfield, 2006)
 supplemented with instructional materials, such as
printed handouts and audiovisual tools
 three main parts: introduction, body, and conclusion-
(Miller & Stoeckel, 2016; Woodring & Woodring,
2014)
5 Approaches to the Effective Transfer of Knowledge
during a Lecture- Silberman (2006)
- Use opening and summary statements
- Present key terms
- Offer examples
- Use analogies
- Use visual backups
GROUP DISCUSSION
- learners get together to actively
exchange information, feelings, and opinions
with one another and with the educator.
- Broad active teaching method – incorporate
other specific type of instruction, such as guided
learning, collaborative learning, small-group
learning, team-based learning, cooperative learning,
case, studies and seminars.
- lead to deeper understanding and longer retention
of information, increased social support, greater
transfer of learning from one situation to another,
more positive interpersonal relationships, more
favorable attitudes toward learning, and more
active learner participation learner-centered as well
as subject centered
Team-based learning
✓innovative and newly popular teaching method ✓offers
educators structured, student-centered learning environment
-(Mennenga, 2012)
✓meant to enrich the students’ learning experience through
active learning strategies
✓uses a structured combination of pre-class preparation,
individual and group readiness assurance tests, and
application exercises - (Mennenga, 2012).
Cooperative learning
✓choice for transmitting foundational knowledge
✓distinguished by the educator’s role, in which the educator
is the center of authority in the class, with group tasks
usually more closed ended and often having specific answers
(Conway, 2011)
✓highly structured group work focusing on problem solving
that leads to deep learning and critical thinking.
Case study
✓offers learners an opportunity to become thoroughly
acquainted with a patient situation before discussing patient
and family needs and identifying health-related problems
✓lead to the development of analytical and problem-solving
skills, exploration of complex issues, and application of new
knowledge and skills in the clinical practice arena
✓Increase learner motivation and engagement and help to
develop reading, writing, and listening skills as learners work
on teams to make decisions based on their problem-solving
skills -(Bonney, 2015; Brattseva & Kovalev, 2015)
Seminars
✓Interactions in seminar groups are stimulated by the
posing of questions by the educator
✓consists of several sessions facilitated by an educator,
discuss questions and issues that emerge from assigned
readings on a topic of practical relevance (Jaarsma et al.,
2009)
✓designed so that each learner reads an assignment and
considers questions prior to the discussion; with such
preparation, all learners can actively participate in the
discussion
✓active engagement of sharing ideas and thoughts provides
the learners with a deeper understanding of the content
ONE TO ONE INSTRUCTION
 formal or informal
 involves face-to-face delivery of information
 designed to meet the needs of an individual learner
 process of mutual interchange between the patient
and the health professional
 requires interpersonal skill and sensitivity on the part
of the educator and the ability to establish rapport
with the learner -(Falvo, 2010; Gleasman-
DeSimone, 2012)
 15 to 20 minutes and the educator offer information
in small, bite-sized portions to allow time for
processing.
 instructions should be specific, and time should be
given for an immediate response from the learner,
followed by direct feedback from the educator.
 giving learners the opportunity to state their
understanding of information allows the educator to
evaluate the extent of learning.
 teach-back or tell-back strategy that asks learners to
restate in their own words what they understood
should always be used by the educator to be sure
patients heard and interpreted the information
correctly and completely.
DEMONSTRATION AND RETURN DEMONSTRATION
 Demonstration – shows the learner how to
perform a certain skill
 Demonstration – provides educators with the
opportunity to model their commitment to a
learning activity, builds credibility, and inspires
learners to achieve a level of excellence
(Brookfield, 2006).
 Return demonstration – learner is carried out as
an attempt to establish competence by
performing a task with cues from the educator as
needed key to performing is practice, practice, and
practice.
GAMING
 requiring the learner to participate in a competitive
activity with preset rules (Allery, 2004)
 goal is for learners to win a game by applying
knowledge and rehearsing skills previously learned
 challenge the learner’s ability to use higher order
thinking and problem- solving strategies (Jaffe,
2014)
 “Gamer Generation” Or “Net Generation”
 stimulate enjoyment of learning, increase active
participation and engagement of learners, provide
variety from a teaching/learning perspective,
enhance skill acquisition, and improve problem-
solving abilities (Jaffe, 2014; Raines, 2010)
 improve recall and long-term retention of
information (Allery, 2004; Beylefeld & Struwig,
2007; Blakely, Skirton, Cooper, Allum, & Nelmes,
2008; O’Leary, Diepenhorst, Churley-Strom, &
Magrane, 2005)
SIMULATION
 trial-and-error method of teaching whereby an
artificial experience is created that engages the
learner in an activity that reflects real-life conditions
but without the risk-taking consequences of an
actual situation
 highly innovative – teach health professionals about
the complex world of health care in their respective
disciplines in an effective, efficient, safe, and high-
quality fashion
 technique, not a technology, to replace or amplify
real experiences with guided experiences that
replicate substantial aspects of the real world in a
fully interactive manner” - Gaba (2004)
ROLE PLAY
✓helps learners to explore their own and others’ feelings
✓gain insight into their values, attitudes, and beliefs
✓develop problem-solving and decision-making skills
✓explore a topic in more depth ✓develop a better
understanding of interpersonal relationships
ROLE MODEL
 use of self as a role model is often overlooked as a
teaching method
 Preceptors and mentors are excellent examples of
experienced health professionals who, through use
of role model, guide, support, and socialize
students and novice practitioners in their transition
to a new level of functioning (Doherty, 2016)
SELF INSTRUCTION
 provide or design instructional activities that guide
the learner in independently achieving the
objectives of learning

 each self-study module usually focuses on one

topic, and the independently achieving the
objectives of learning

 self-study module hallmark of this format is an

independent study

 self-study also can be an effective adjunct for

introducing principles and step-by-step guidelines
prior to the demonstration of a psychomotor skill

 minicourse, self-instructional package,

individualized learning activities, self-directed
learning, and programmed instruction
INSTRUCTIONAL MATERIALS
- Reinforce information.
- Stimulate a learner’s senses as well as add
variety, realism, and enjoyment to teaching.
- Helps retain knowledge more effectively.
TYPES OF INSTRUCTIONAL MATERIALS
WRITTEN MATERIALS
Handouts- leaflets, books, pamphlets, brochures, and
instructions sheets are the most widely used and most
accessible type of tools for teaching.
Printed materials- the most common form of teaching aid
because of the distinct advantages they provide to enhance
teaching and learning.
Commercially Prepared Materials
- may or may not be produced in collaboration with health
professionals, which raises the question of how factual and
understandable the information may be.
main advantage – readily available and can be obtained in
bulk for free or at a relatively low cost.
disadvantages – cost, accuracy and adequacy of content,
and readability of the materials.
Self-Composed Materials
✓visual supplement to oral instruction of patients and
families in various healthcare settings, and they are a
common format for communicating health information to
patients
✓independent source of information or can be used along
with other instructional methods and materials. ✓passive
instructional medium, but if posters are designed and used
properly, the message conveyed is brief, constant, and
interactive for teaching and learning
✓visual stimulation, it is meant to attract attention
Audiovisual Materials
✓support and enrich the education process by stimulating
the senses of seeing and hearing, adding variety to the
teaching–learning experience, and instilling visual memories,
which have been found to be more permanent than auditory
memories
✓Audiovisual elements→ increase understanding and
retention of information as well as satisfaction with care by
combining what people hear with what they see
✓multimedia learning → two or more types of learning
modes (e.g., audio, visual, or animation) that can be
accessed via a computer to engage the learner in the
content
✓Blended learning→ combines e-learning technology with
more traditional instructor- led teaching methods, such as a
lecture or demonstration.

✓save costs or to tailor content to specific audiences

✓fit the institution’s policies, procedures, and equipment

DEMONSTRATION MATERIALS

Models
- three-dimensional objects – allow the learner to
immediately apply knowledge and psychomotor skills by
observing, examining, manipulating, handling, assembling,
and disassembling them while the teacher provides
feedback.

3 TYPES OF MODELS –Babcock and Miller (1994) ✓Replicas

– resemble
exact copy constructed to scale that resembles the features
or substance of the original object. The dimensions of the
reproduction may be decreased or enlarged in size to make
demonstration easier and more understandable.

✓Analogues – act like

- same properties and performs like the real object
- effective in explaining and representing dynamic systems
- human patient simulator

✓ Symbols – stands for

- Written words, mathematical signs and formulas, diagrams,
cartoons, printed handouts, and traffic signs are all examples
of symbolic models that convey a message to the receiver
through a visual image or association.

Displays
✓whiteboards, posters, storyboards, flip charts, and bulletin
boards
✓convey simple or short messages and to clarify, reinforce,
or summarize information on important topics and themes.

Posters
✓use the written word along with graphic illustrations.