OVERVIEW OF EDUCATION IN HEALTH CARE

HISTORICAL FOUNDATIONS OF THE NURSE EDUCATION ROLE

• Mid-1800's, the responsibility for teaching has been
recognized as an important role of nurses as caregivers focusing on the care of sick
people and promoting the health of well in public.
• FLORENCE NIGHTINGALE was the ultimate educator

PROMULGATING MANDATES AND STANDARDS

1. NLNE (NLN) National League for Nursing
1918-first observed health teaching as an important function within the scope of
nursing practice
1950-had identified course content in nursing school curricula to prepare nurses to
assume the role
2006-developed the first Certified Nurse Educator (CNE) exam

2. ANA (American Nurses Association)

-responsible for establishing standards and qualifications for practice including
patient teaching

3. ICN (International Council of Nurses)

-endorsed the nurse's role as patient educator to be an essential component of
nursing care delivery.

4. State Nurse Practice Act

-universally includes teaching within the scope of nursing practice

5. JCAHO (Joint Commission on Accreditation of Health Care Org)

-accreditation mandates require evidence of patient education to improve outcomes

6. AHA (American Hospital Association)

-Patient's bill of Rights ensures that client receives complete and current information

7. Pew Health Professions Commission

-puts forth a set of health profession competencies for the 21st century

THE LEGAL BASIS OF HEALTH EDUCATION IN THE PHILIPPINES

Philippine Constitution of 1987 Article 11, Section 15
"The state shall protect and promote the right to health of the people and instill
health consciousness among them."
Article 13, Section 11
"The state shall adopt an integrated and comprehensive approach to health
development which shall endeavor to make essential goods, health, and other social
services available to all the people at affordable cost."
R.A 9173 PHILIPPINE NURSING ACT OF 2002
Article 5, Section 25
"The nursing education program shall provide sound general and professional
foundation for the practice of nursing."

SOCIAL, ECONOMIC AND POLITICAL TRENDS AFFECTING HEALTH CARE

o Healthy People 2020
-a document that set forth national health goals and objectives for the next decade.
- Nurses, as the largest group of health professionals, play an important role in
making a real difference by teaching clients to attain and maintain healthy lifestyles.
 o The Institute of Medicine (2011) established recommendations designed
to enhance the role of nurses in the delivery of health care. This includes
nurses functioning to the full extent of their education and scope of practice.
Patient and family education is a key component of the nurse's role.
o Health providers are recognizing the economic and social values of reaching
out to communities, schools, and workplaces, all settings where nurses
practice, to provide public education for disease prevention and health
promotion.
o Politicians and healthcare administrators alike recognize the importance of
health education to accomplish the economic goal of reducing the high costs
of health services.
o Consumers are demanding increased knowledge and skills about how to care
for themselves and how to prevent disease.
o An increasing number of self-help groups exist to support clients in meeting
their physical and psychosocial needs
o The increased prevalence of chronic and incurable conditions requires that
individuals and families become informed participants to manage their own
illnesses.
o Advanced technology increases the complexity of care and treatment in home
and community-based settings.
o The use of online technologies in nursing education programs is increasing.

PURPOSES, GOALS AND BENEFITS OF PATIENT & NURSING EDUCATION

o The purpose of patient education is to increase the competence and
confidence of clients for self-management.
o Benefits of client education:
Increase consumer satisfaction
Improve quality of life
Ensure continuity of care
Decrease patient anxiety
Effectively reduce the complications of illness and the incidence of disease
Promote adherence to treatment plans
Maximize independence in the performance of activities of daily living
Health Education
"any combination of planned learning experiences based on sound theories that
provide individuals, groups, and communities the opportunity to acquire information
and the skills needed to make quality health decisions" (Joint Committee, 2001)

Health Promotion
"any planned combination of educational, political, environmental, regulatory, or
organizational mechanisms that support actions and conditions of living conducive to
the health of individuals, groups, and communities" (Joint Committee, 2001).
 Directed towards healthy individuals, or populations, focusing on the
prevention of the emergence of risk factors such as unhealthy lifestyle
behavior
 Behavior motivated by the desire to increase well-being and actualize human
health potential (Pender, Murdaugh, and Parsons)
 Not disease oriented
 Motivated by personal, positive approach" to wellness
 Seeks to expand positive health potential

Health Education/Promotion Settings

 Personal/Family Health
 School
  Worksites
 Communities
 State, Regional, or National Level
 Government
 Global/World
 Health care facilities
 Prisons
 Refugee camps etc.

Disease Prevention
-"the process of reducing risks and alleviating disease to promote, preserve, and
restore health and minimize suffering and distress" (Joint Committee, 2001)

Underlying Concept of Health Education

Health field concept (Lalonde, 1974)
 Human biology (heredity)
 Environment
 Lifestyle (health behavior)
 Health care organization

Prevention
- the planning for and the measures taken to forestall the onset of, a disease or
other health problem before the occurrence of undesirable health events.
- Historically, the health care field and services have focused on the treatment of
disease, not the prevention or onset of illness.

Why is this so?

-Prevention only accounts for expenditures for health. 1% of the nation's

Disease Prevention & Health Promotion

 Prevention saves LIVES
 Improves quality of LIFE
 Cost-effective

3 Levels of Prevention
o PRIMARY- directed towards AT-RISK individuals or in PREPATHOGENIC
STAGE. It deals with removal of risk factors or specific protection.
o SECONDARY- directed towards individuals with sub-clinical stage. It aims to
diagnose and treat.
o TERTIARY- directed towards individuals in pathogenic stage. It deals with the
reduction of magnitude and severity of the residual effects of communicable
and noncommunicable diseases.
UNIT 1.
HISTORY OF NURSING IN THE PHILIPPIINES

Early Beliefs, Practices and Care of the sick

 Early Filipinos subscribed to superstitious belief and practices in relation to health

and sickness
 Diseases, their causes and treatment were associated with mysticism and
superstitions
 Cause of disease was caused by another person (an enemy of witch) or evil
spirits
 Persons suffering from diseases without any identified cause were believed
bewitched by “mangkukulam”
 Difficult childbirth were attributed to “nonos”
 Evil spirits could be driven away by persons with powers to expel demons
 Belief in special Gods of healing: priest-physician, word doctors, herbolarios/herb
doctors

Early Hospitals during the Spanish Regime – religious orders exerted efforts to care
for the sick by building hospitals in different parts of the Philippines:
Hospital Real de Manila San Juan de Dios Hospital
San Lazaro Hospital Hospital de Aguas Santas
Hospital de Indios

Prominent personages involved during the Philippine Revolution

1. Josephine Bracken – wife of Jose Rizal installed a field hospital in an estate in
Tejeros that provided nursing care to the wounded night and day.
2. Rose Sevilla de Alvaro – converted their house into quanters for Filipino
soldiers during the Phil-American War in 1899.
3. Hilaria de Aguinaldo –wife of Emlio Aginaldo organized the Filipino Red Cross.
4. Melchora Aquino – (Tandang Sora) nursed the wounded Filipino soldiers, gave
them shelter and food.
5. Captain Salomen – a revolutionary leader in Nueva Ecija provided nursing
care to the wounded when not in combat.
6. Agueda Kahabagan – revolutionary leader in Laguna also provided nursing
services to her troops.
7. Trinidad Tecson (Ina ng Biak na Bato) – stayed in the hospital at Biac na Bato
to care for the wounded soldiers.

School Of Nursing
1. St. Paul’s Hospital School of Nursing, Intramuros Manila – 1900
2. Iloilo Mission Hospital Training School of Nursing – 1906
1909 – distinction of graduating the 1st trained nurses in the Phils. With no
standard requirements for admission of applicants except their “willingness to
work”

April 1946 – a board exam was held outside of Manila. It was held in the
Iloilo Mission Hospital thru the request of Ms. Loreto Tupas, principal of the
school.

3. St. Luke’s Hospital School of Nursing – 1907;opened after four years as a

dispensary clinic.
 4. Mary Johnston Hospital School of Nursing – 1907
5. Philippines General Hospital school of Nursing – 1910

College of Nursing
1. UST College of Nursing – 1st College of Nursing in the Phils: 1877
2. MCU College of Nursing – June 1947 (1st College who offered BSN – 4 year
program)
3. UP College of Nursing – June 1948
4. FEU Institute of Nursing – June 1955
5. UE College of Nursing – Oct 1958

1909 – 3 female graduated as “qualified medical-surgical nurses”

1920 – 1st board examination for nurses was conducted by the Board of Examiners,
93 candidates took the exam, 68 passed with the highest rating of 93.5%-Anna
Dahlgren

- theoretical exam was held at the UP Amphitheater of the College of Medicine

and Surgery. Practical exam at the PGH Library.

1921 – Filipino Nurses Association was established (now PNA) as the National
Organization Of Filipino Nurses

PNA: 1st President – Rosario Delgado

Founder – Anastacia Giron-Tupas

1919 – The 1st Nurses Law (Act#2808) was enacted regulating the practice of the
nursing profession in the Philippines Islands. It also provided the holding of exam for
the practice of nursing on the 2nd Monday of June and December of each year.

1953 –Republic Act 877, known as the “Nursing Practice Law” was approved.
 WEEK 1 : THE EDUCATION PROCESS
CONCEPTS OF TEACHING, LEARNING AND EDUCATION PROCESS
 Education Process: a systematic, sequential, planned course of action on the part of both
the teacher and learner to achieve the outcomes of teaching and learning (Step by
Step/Chronological)
 Teaching/Instructions: a deliberate intervention that involves sharing information and
experiences to meet the intended learner outcomes (Communicating/Imparting)
 Learning: a change in behavior (knowledge, skills, and attitudes) that can be observed and
measured, and can occur at any time or in any place as a result of exposure to
environmental stimuli (Enlightenment/Training)
 Patient Education: the process of helping clients learn health-related behaviors to achieve
the goal of optimal health and independence in self-care (Clinical Teaching)
 Staff Education: the process of helping nurses acquire knowledge, attitudes, and skills to
improve the delivery of quality care to the consumer (Proper Training)
ASSURE Model
• A useful paradigm to assist nurses to organize and carry out the education process.
Analyze the learner
State objectives
Select instructional methods and materials
Use teaching materials
Require learner performance
Evaluate/revise the teaching/learning process

ROLE OF THE NURSE AS EDUCATOR

 Nurses act in the role of educator for a diverse audience of learners-patients and their
family members, nursing students, nursing staff, and other agency personnel.
 Despite the varied levels of basic nursing school preparation, legal and accreditation
mandates have made the educator role integral to all nurses.
 Nurses function in the role of educator as:
- the giver of information
- the assessor of needs
- the evaluator of learning
- the reviser of appropriate methodology
  The partnership philosophy stresses the participatory nature of the teaching and learning
process.
CLIENT ADVOCATE
o ensuring that client's needs are met
o protecting the client's RIGHT
o by informing the pt about PT’S BILL of RIGHTS
o supporting the client's decision even if it conflicts with the nurse's preference
ROLE OF THE NURSE AS EDUCATOR IN HEALTH PROMOTION
 Facilitator of Change-initiates change or who assist others in making modifications in
themselves or in the system. (Advocate)
 Contractor-stating mutual goals to be accomplished, devising agreed-upon plan of action,
evaluating plan, and deriving alternatives; trust is key ingredient (SMART)
 Organizer-organizes learning situation through manipulation of materials and space,
sequential organization of content from simple to complex, and determining priority of
subject matter (Orderly, Structured, Efficient)
 Evaluator- measures learning of learners in the form of outcomes (Reviewer)
AREAS FOR CLIENT EDUCATION
 Promotion of Health-increasing a person's level of awareness, lifestyle modification, etc.
 Prevention of Illness/ Injury- Health Screening, Reducing health risk factors, first-aid,
safety, etc.
 Restoration of Health-information about tests, dx, tx, meds; self-care skills, etc.
 Adapting to Altered Health and Function- adaptations in lifestyle, grief and bereavement
counseling, etc.
HALLMARKS OF EFFECTIVE TEACHING IN NURSING
 Jacobson delineated 6 major categories of effective teaching in nursing:
1. Professional Competence
2. Interpersonal Relationships w/ Students
3. Teaching Practices
4. Personal Characteristics
5. Evaluation Practices
6. Availability to Students
PROFESSIONAL COMPETENCE
 The teacher who enjoys nursing, show genuine interest in patients, and displays confidence
in his or her professional abilities is rated high.
 The teacher who aims excellence develops a thorough knowledge of the subject matter and
polishes skills throughout his or her career (through reading, research, clinical practice, and
continuing education).
 Part of building TRUST is for the teacher to also admit to errors and weaknesses in practice,
if any.
INTERPERSONAL RELATIONSHIPS WITH STUDENTS
 An effective teacher is skillful in interpersonal relationships
 Taking a personal interest in learners, being sensitive to their feelings and problems,
conveying respect for them, alleviating their anxieties
  Being accessible for conferences, being fair, permitting learners to express differing points
of view, creating an atmosphere in which they feel free to ask questions, and conveying a
sense of warmth
 Students actually learn more in classrooms and clinical settings where teachers are student-
oriented and empathic
 3 basic therapeutic approaches:
-empathic listening
-acceptance
-honest communication
PERSONAL CHARACTERISTICS
 Authenticity, enthusiasm, cheerfulness, self-control, patience, flexibility, a sense of humor, a
good speaking voice, self-confidence, and a caring attitude are all desirable personal
characteristics of teachers.
TEACHING PRACTICES
 The mechanics, methods, and skills in classroom and clinical setting.
 Students value a teacher who has a thorough knowledge of the subject matter and can
present material in an interesting, clear, and organized manner.
EVALUATIVE PRACTICES
 Include communicating expectations, providing timely feedback on student progress,
correcting students tactfully, being fair in the evaluation process.
 Giving tests that are pertinent to the subject matter.
 Criteria for evaluation of clinical performance should also be made explicit and put in
writing.
AVAILABILITY TO STUDENTS
 Instructor is expected to be available to students when needed.
 Being there in stressful clinical situations, physically helping students give nursing care,
giving appropriate amounts of supervision.
BARRIERS TO TEACHING
 Barriers to teaching are those factors impeding the nurse's ability to optimally deliver
educational services.
 Major barriers include:
-lack of time to teach
-inadequate preparation of nurses to assume the role of educator with confidence and
competence.
-personal characteristics
-low-priority status given to teaching
BARRIERS TO EDUCATION
 environments not conducive to the teaching-learning process.
 absence of 3rd party reimbursement
 doubt that patient education effectively changes outcomes
 inadequate documentation system to allow for efficiency and ease of recording the quality
and quantity of teaching efforts.
OBSTACLES TO LEARNING
 Obstacles to learning are those factors that negatively impact on the learner's ability to
attend to and process information
 Major obstacles include:
-limited time due to rapid discharge from care
-stress of acute and chronic illness, anxiety, sensory deficits, and low literacy
-functional health illiteracy
 lack of privacy or social isolation of health-care environment
 situational and personal variations in readiness to learn, motivation and compliance,
and learning styles
 extent of behavioral changes (in number and complexity) required.
 lack of support and positive reinforcement from providers and/or significant others
 denial of learning needs, resentment of authority and locus of control issues
 complexity, inaccessibility, and fragmentation of the healthcare system.

WEEK 2 : 3 LEARNING THEORIES

PRINCIPLES OF LEARNING
 The principles of learning provide additional insight into what makes people learn most
effectively. The principles have been discovered, tested, and used in practical situations.
 Edward Thorndike has developed the first three laws and more had been added ever since.
 Principles of Learning:
1. Readiness 5. Recency
2. Exercise 6. Intensity
3. Effect 7. Requirements
4. Primacy 8. Freedom
Readiness
 Readiness implies a degree of preparedness, concentration and eagerness to learn.
Individuals learn best when they are physically, mentally, and emotionally ready to learn,
and do not learn well if they see no reason for learning. Getting students ready to learn,
creating interest by showing the value of the subject matter, and providing continuous
mental or physical challenge, is usually the instructor's responsibility.
Exercise
 The principle of exercise states that those things most often repeated are best remembered.
It is the basis of drill and practice. It has been proven that students learn best and retain
information longer when they have meaningful practice and repetition. The key here is that
the practice must be meaningful. It is clear that practice leads to improvement only when it
is followed by positive feedback.
Effect
 The principle of effect is based on the emotional reaction of the student. It has a direct
relationship to motivation. The principle of effect is that learning is strengthened when
accompanied by a pleasant or satisfying feeling, and that learning is weakened when
associated with an unpleasant feeling. , every learning experience should contain elements
that leave the student with some good feelings.
Primacy
 The state of being first, often creates a strong, almost unshakable, impression. Things
learned first create a strong impression in the mind that is difficult to erase. For the
instructor, this means that what is taught must be right the first time.
 Example, a student learns a faulty technique, the instructor will have a difficult task
correcting bad habits and "re teaching" correct ones. The student's first experience should
be positive, functional, and lay the foundation for all that is to follow. What the student
learns must be procedurally correct and applied the very first time.
Recency
 The principle of recency states that things most recently learned are best remembered.
Conversely, the further a student is removed time-wise from a new fact or understanding,
the more difficult it is to remember.
 Example, it is fairly easy to recall a telephone number dialed a few minutes ago, but it is
usually impossible to recall a new number dialed last week.
Intensity
 The principle of intensity implies that a student will learn more from the real thing than
from a substitute. For example, a student can get more understanding and appreciation of a
movie by watching it than by reading the script. Likewise, a student is likely to gain greater
understanding of tasks by performing them rather than merely reading about them.
Requirement
 The law of requirement states that "we must have something to obtain or do something." It
can be ability, skill, instrument or anything that may help us to learn or gain something. A
starting point or root is needed;
 Example, if you want to draw a person, you need to have the materials with which to draw,
and you must know how to draw a point, a line, and a figure and so on until you reach your
goal, which is to draw a person.
Freedom
 The principle of freedom states that things freely learned are best learned. Conversely, the
further a student is coerced, the more difficult is for him to learn, assimilate and implement
what is learned. Compulsion and coercion are antithetical to personal growth. The greater
the freedom enjoyed by individuals within a society, the greater the intellectual and moral
advancement enjoyed by society as a whole.
 Since learning is an active process, students must have freedom: freedom of choice, freedom
of action, freedom to bear the results of action these are the three great freedoms that
constitute personal responsibility. If no freedom is granted, students may have little interest
in learning.
Educational Implications
 Learning by doing is a good advice.
 One learns to do what one does.
 The amount of reinforcement necessary for learning is relative to the students' needs and
abilities.
 The principle of readiness is related to the learners' stage of development and their
previous learning
 The students' self-concept and beliefs about their abilities are essentially important.
 Teachers should provide opportunities for meaning and appropriate practice.
 Learning should be goal-directed and focused.
 Positive feedback, realistic praise, and encouragement are motivating to the teaching
learning process.
THREE MAJOR SCHOOLS IN LEARNING
1. Behavioral Theory – learning takes place when there is a change in behavior.
2. Field and Gestalt Theory – observational learning, imitation and modeling.
3. Cognitive Theory – learning by thinking, reasoning and transferring.
THEORIES OF LEARNING
 Learning theories are elaborate hypotheses that describe how exactly learning occurs.
DEVELOPMENTAL THEORIES OF LEARNING
 Learning is like a task an individual can accomplish as they mature mentally, emotionally,
and physically.
  Famous Developmental Theorists:
1. Daniel Levinson
2. Erik Erikson
3. Sigmund Freud
4. Jean Piaget
Daniel Levinson’s Theory of Adult Development
 development does not stop after adolescence but continues to evolve throughout life.
 development builds on foundations of family and work, religion, race, and social status are
variables in human development
 Levinson's theories differ slightly according to gender, as evidenced in his books "Seasons of
a Man's Life" and "Seasons of Woman's Life."
 A central difference is Levinson's idea of the "dream," which tends to be occupational for
men and based in either independence or family for women.

Erik Erikson's Theory of Psychosocial Development

 it focuses on adolescent development; development forms around the interaction of genetic,
psychological and cultural influences; placed more emphasis on the ego
 each developmental stage presents a challenge to overcome. The completion of or failure to
meet each challenge carries over to the next stage's task and each stage builds on the
successes and failures of previous stages, allowing the development of tasks early on to
affect personal qualities later in life.
Sigmund Freud's Theory of Psychosexual Development
 Freud believed that personality develops through a series of childhood stages during which
the pleasure-seeking energies of the id become focused on certain erogenous areas.
 If these psychosexual stages are completed successfully, the result is a healthy personality.
If certain issues are not resolved at the appropriate stage, fixation can occur. A fixation is a
persistent focus on an earlier psychosexual stage.

Jean Piaget's Theory of Cognitive Development

 Cognitive development is an orderly, sequential process in which a variety of new
experiences must exist before intellectual abilities can develop.
DEVELOPMENTAL THEORIES OF LEARNING: Behaviorism
 Learning is manifested by a change in behavior.
 Famous Behavioral Theorists:
1. B. F. Skinner
2. Ivan Pavlov
3. A. Bandura
4. Tolman
5. Guthrie
6. Hull
Behaviorism
 For behaviorism, learning is the acquisition of new behavior through CONDITIONING
 TWO TYPES OF POSSIBLE CONDITIONING:
1. Classical Conditioning By Ivan Pavlov
2. Operant Conditioning/ Radical Behaviorism By B.F. Skinner
CLASSICAL CONDITIONING
 a learning process that occurs through associations between an environmental stimulus
and a naturally occurring stimulus.
 behavior becomes a reflex response to stimulus
 Unconditioned Stimulus
-unconditionally, naturally, and automatically triggers a response. For example, when you
smell one of your favorite foods, you may immediately feel very hungry. In this example, the
smell of the food is the unconditioned stimulus.
 Unconditioned Response
-the unlearned response that occurs naturally in response to the unconditioned stimulus. In
our example, the feeling of hunger in response to the smell of food is the unconditioned
response.
 Conditioned Stimulus
-previously neutral stimulus that, after becoming associated with the unconditioned
stimulus, eventually comes to trigger a conditioned response. In our earlier example,
suppose that when you smelled your favorite food, you also heard the sound of a whistle.
While the whistle is unrelated to the smell of the food, if the sound of the whistle was paired
multiple times with the smell, the sound would eventually trigger the conditioned response.
In this case, the sound of the whistle is the conditioned stimulus.
 Conditioned Response
-learned response to the previously neutral stimulus. In our example, the conditioned
response would be feeling hungry when you heard the sound of the whistle.
OPERANT CONDITIONING
 method of learning that occurs through rewards and punishments for behavior
 an association is made between a behavior and a consequence for that behavior.
 Components of Operant Conditioning
1. Reinforcement - any event that strengthens or Increases the behavior follows
2. Punishment - presentation of an adverse event or outcome that causes a decrease in
the behavior it follows
  TWO KINDS OF REINFORCERS:
1. Positive reinforcers are favorable events or outcomes that are presented after the
behavior. A response or behavior is strengthened by the addition of something, such
as praise or a direct reward.
2. Negative reinforcers involve the removal of an unfavorable events or outcomes after
the display of a behavior.
 TWO KINDS OF PUNISHMENT:
1. Positive punishment- sometimes referred to as punishment by application, involves
the presentation of an unfavorable event or outcome in order to weaken the
response it follows.
2. Negative punishment- also known as punishment by removal, occurs when an
favorable event or outcome is removed after a behavior occurs.
DEVELOPMENTAL THEORIES OF LEARNING: HUMANISM
 learning is believed to be selfmotivated, self-initiated, and selfevaluated. Learning focuses
on selfdevelopment and achieving full potential;
 Famous Humanists:
1. Abraham Maslow
2. Carl Rogers
HUMANISM
 Abraham Maslow's Humanistic Theory of Learning:
- Human motivation is based on a hierarchy of needs.
- The purpose of learning is to bring about self-actualization
- Learning contributes to psychological health
  Carl Rogers' Theory of Experiential Learning:
- emphasized the inclusion of feelings and emotions in education
- People have a natural tendency to move toward self actualization.
- used the theory of self-concept, which he defined as an organized pattern of perceived
characteristics along with the values attached to those attributes.
- to promote growth and development, parents and authority figures should give a child
unconditional acceptance and love, which allows a child to develop self-acceptance and to
achieve self-actualization.
- developed a therapeutic approach called client centered therapy, in which the therapist
offers the client unconditional positive regard by supporting the client regardless of what is
said.
 ATTITUDES WHICH CHARACTERIZED A TRUE FACILITATOR OF LEARNING:
1. Realness-present genuineness
2. Prizing the Learner-acceptance and trust of each individual student.
3. Empathic Understanding
TYPES OF LEARNING
Signal Learning
o Conditioned response
o Simplest level of learning
o Person develops a general diffuse reaction to stimulus
o A nursing student may feel fear every time the term "RETDEM" is mentioned because he or
she has felt fear whenever an actual retdem was taken
Stimulus-Response Learning
o Involves developing a voluntary response to a specific stimulus or a combination of stimuli.
Chaining
o The acquisition of a series of related conditioned responses of stimulus-response
connections.
Verbal Association
o A type of chaining and is easily recognized in the process of learning medical terminology
o Ex: a nursing student already knows that the word thermal refers to temperature. The
instructor introduces the word "HYPERTHERMIA" and its definition. The student recognizes
that the syllable "THERM" connects the two words and thus finds it easier to learn the new
term because of a previous association.
Discrimination Learning
o To learn and retain large numbers of chains, the person has to be able to discriminate
among them
o Ex: a nursing student tries to learn a long list of drugs and their actions. Halfway down the
list, the learning of new chains interferes with the memory of old ones. If the student can
find a means of discriminating them between the drugs, maybe finding something unique or
noteworthy about each, retention will be increased.
Concept Learning
o Learning how to classify stimuli into groups represented by a common concept
o People learn concepts as they go through life
o Ex: a pt w/ a chronic wound infection who has to learn to empty a drain and change a
dressing has to learn about the concepts of infection and inflammation and the concept of
asepsis.
Rule Learning
o A rule can be considered a chain of concepts or a relationship between concepts.
o Rules are generally expressed as "If...then relationships
o If a learner does not learn and truly comprehend a lot of rules in a particular area of study,
she will have difficulty with the highest level of learning called PROBLEM SOLVING
o Ex: If you were a home care nurse teaching a wife to prevent decubitus ulcers in her
husband who has had a stroke recently, you would have to teach the rule that expresses the
relationship between pressure and ulceration. So, you would teach the wife that "If you
leave your husband in one position too long, then the pressure on a body part can cause
ulceration". "If your husband doesn't eat a balanced diet, he will be more prone to
ulceration"
Problem Solving Learning
o To solve problems, the learner must have a clear idea of the problem or goal being sought
and must be able to recall and apply previously learned rules that relate to the situation
o Process of formulating and testing hypothesis
o The nurse educator play an important role in PSL.
1. First, you can help the student define the problem and the goal
2. Second, you help the student recall the necessary rules by means of questions,
suggestions, or demonstration
o EX: suppose the student is planning care for a patient who has been stabilized after an
extensive myocardial infarction but is still on bed rest. As the instructor, you ask the learner
how he or she is going to prevent muscle weakness in this patient while also preventing
strain on the heart.
 WEEK 2 : DETERMINANTS OF LEARNING
Learner's Characteristics
 Culture- a set of shared norms and practices of a particular group that direct thinking,
decisions, and actions.
 Age-older adults usually need more time to learn
 Emotional Status- depression, stress, denial, fear, and anxiety can all impact the
effectiveness of learning
 Socioeconomic level- clients may not have the resources needed to comply with the medical
regimen prescribed
Adult Learners' Characteristics and teaching implications
The Nurse Educator's Role in Learning
For a nurse to carry his/her educative role well, s(h)e must identify:
the information learners need,
their readiness to learn,
their learning styles.
However, the learner remains the single most important person in the educative process.
 The educator provides support, encouragement and motivation during the learning process.
 The role of the educator is to enhance the learning process by serving as a facilitator. The
educator:
assesses the learner's deficits
presents appropriate information in unique ways.
identifies progress being made.
gives feedback
reinforces learning in the acquisition of knowledge, or performance of a skill
evaluates the learner's abilities
Assessment of the Learner
 Often patients with the same condition are taught with the same material and in the same
way. Is this problematic? Why?
Yes, because: The information given to the patient is neither individualized nor based
on the educational assessment
 Nurses, frequently and firstly, delve into teaching. Is this problematic? Why?
Yes, because: This approach neglects to address assessment of the learner as an
essential aspect of the instructional process.
  Nurses were always taught that their interventions are based on sound assessment, and the
same applies to the instructional process.
 Assessment of the learner includes attending to the three determinants:
- Learning needs (what the learner needs to learn)
- Readiness to learn (when the learner is receptive to learning)
- Learning style (how the learner best learns)

- Assessment of Learning Needs

 This must be examined first.
 Can we first assess readiness or learning style? Why?
No, because there is no need to assess readiness and the leaming style if learning
needs are not present
 Assessment is essential to determine learning needs so that an instructional plan can be
designed to address deficits in any of the educational domains (Cognitive, psychomotor,
affective)
 Not all individuals perceive a need for education. For example, in a survey of nurses'
knowledge and practice of blood transfusion in Jordan, 25 nurses (8%) had the perception
that they needed no further education in any of the areas related to blood transfusion,
although they had documented knowledge deficits.
 Consequently, assessment is used to identify and prioritize the needs and interests of the
learner.
 Learning needs: are gaps in knowledge that exist between a desired level of performance
and the actual level of performance.
IMPORTANT STEPS IN THE ASSESSMENT OF LEARNING NEEDS
1. Identify the learner.
 WHO IS THE LEARNER?
 Is there only one learner with a single need or many needs?
 Is there more than one learner with congruent or diverse needs?
2. Choose the right setting
 Establish trusting relationship through assuring privacy and confidentiality, so that
learners feel secure in confiding information and feel respected.
3. Collect data on the learner
 Determine characteristic needs of the audience by exploring typical health problems
or issues of interest.
 Subsequently, identify the type and extent of content to be included in the teaching
sessions.
4. Include the learner as a source of information
 Allow the learner to actively participate in the learning process.
 Allow the patient and/or family and staff members to identify what is important to
them.
 If the learners are staff members or nursing students, ask them about areas of
practice they feel they need new or additional information.
5. Involve members of the healthcare team
 Other healthcare providers may have insight into patient, family, nursing staff, and
nursing students educational needs. Because of their frequent contacts with them.
6. Prioritize needs
 A list of needs can become endless and seemingly impossible to accomplish.
 Using Maslow's hierarchy of human needs, an educator can prioritize identified
learning needs.
 The educator can then assist the learner to meet the most important basic need first.
 Prioritizing Learning needs
o Setting priorities for learning is often difficult when faced with many
learning needs in several areas. Learning must be prioritized based on the
criteria of
a. MANDATORY: Needs that must be learned for survival or situations in
which the learner's life or safety is threatened. For example, a patient with
recent heart attack needs to know the sign and symptoms and when to
seek medical help. The hospital nurse must learn cardiopulmonary
resuscitation.
b. DESIRABLE: Needs that are not life-dependant but are related to well-
being. For example, patients with cardiovascular disease need to
understand the effects of a high fat diet on their health.
c. POSSIBLE: Needs for information that are nice to know but not essential or
required. For example, a patient with diabetes mellitus dos not need to
know about travelling across time zones.

7. Determine availability of educational resources

 After identifying a need, it may be useless to proceed with the intervention if proper
educational resources are not available.
 For example, if an asthmatic patient needs to learn how to use a ventolin inhaler,
that learning cannot occur if this equipment is not available for demonstration/
return demonstration.
 8. Assess Demands of the Organization
 The educator must be familiar with standards of performance required in various
employee categories, along with the job descriptions, and hospital, professional, and
agency regulations.
 For example, if the organization is focused on health promotion versus trauma care,
then there likely will be a different educational focus or emphasis that dictates
learning needs of both consumers and employees.
9. Take Time-Management Issues into Account
 Time-constraints are major impediment to assessment process
 Allow learners to identify their learning needs
 Identify potential opportunities to assess the patient anytime, anywhere;
 Minimize distractions/ interruptions during planned interviews
METHODS TO ASSESS LEARNING NEEDS
1. Informal conversations or Interview
 An interview is a conversation between two or more people where questions are
asked by the interviewer to obtain information from the interviewee
 Often, learning needs are identified during informal talk with other healthcare
providers, and between the nurse and the patient/ family.
2. Structured interviews
 The aim of this approach is to ensure that each interview is presented with exactly
the same questions in the same order
 The nurse asks the patient direct and often predetermined questions.
 Establishing trust, using open-ended questions, quiet environment, and allowing the
patient to state what his learning needs are merit attention.
3. Focus groups
 The educator gets together 4-12 learners to determine areas of educational need.
 The educator leads the discussion and asks open-ended questions.
4. Self-administered questionnaires
 the learner's responses to questions about learning needs can be obtained by self-
administered questionnaires.
 These are easy to administer and provide more privacy than interviews.
5. Tests
 Written pre-tests given before teaching can help identify the knowledge level of
learners regarding a particular subject matter and assist in identifying a specific
needs of learner.
 Tests are useful as they prevent the educator from repeating already known
material.
6. Observation
 Observation is either an activity of a living being (such as a human), consisting of
receiving knowledge of the outside world through the senses, or the recording of
data using scientific instruments
 Watching a learner perform a skill more than once is an excellent way of assessing
psychomotor need.
  Educators can assess whether all steps are performed correctly.
- Readiness to Learn
 It is the time when the learner demonstrates an interest, willingness, and ability to learn the
type or degree of information necessary to maintain optimal health or to become skillful in
a job. When assessing readiness to learn, the health educator must:
1. Determine what needs to be taught
2. Find out exactly when the learner is ready to learn
3. Discover what the patient wants to learn
4. Identify what is required of the learner:
a. what needs to be learned
b. what the learning objectives should be
c. find out in which domain of learning and at what level the lesson will be taught
5. Determine if the timing (the point at which the nurse will conduct teaching) is right
or proper
6. Find out if the rapport or interpersonal relationship with the learner has been
established (Hussey & Hirsch, 1983)
7. Determine if the learner is showing signs of motivation
8. Assess if the plan for teaching matches the development level of the learner
FOUR TYPES OF READINESS TO LEARN (PEEK)
P – hysical
E – motional
E – xperiental
K – knowledge
Physical readiness
 Does the learner have enough strength and ability to walk on crutches?
 Is the environment calm and conducive to learning?
1. MEASURE OF ABILITY → adequate strength, flexibility and endurance is needed to teach
a patient how to walk on crutches and for him/her to be ready to learn while measures
requiring visual and auditory acuity a patient also affect the learning readiness
especially if the sense of sight and hearing are Impaired.
2. COMPLEXITY OF TASK → the difficulty level of the subject or the task to be mastered;
psychomotor skills require varying degrees of manual dexterity and physical energy
output but once acquired or mastered; they are usually retained better and longer than
learning in the cognitive activity.
3. HEALTH STATUS → Is the patient in a state of good health or ill health? Does he still
have the energy or motivation to learn?
4. GENDER → studies show that men are less inclined to seek health consultation or
intervention than women. Women, on the other hand, are more health conscious and
receptive to medical care and health promotion teaching (Bertakis et al., 2000).
Emotional readiness
 Fear contributes to anxiety and negatively affects readiness to learn.
 A nursing student may not master a skill because of fear of harming a patient or of failure to
perform correctly
  ANXIETY LEVEL - may or may not be a hindrance to learning. Some degree of anxiety may
motivate a person to learn but high or low degree of anxiety will interfere with readiness to
learn.
 SUPPORT SYSTEM - a strong support system composed of the Immediate family and friends,
significant others, the community and church will give the patient increased sense of
security and well-being while a weak or absent support system elicits sense of Insecurity,
despair, frustration and high level of anxiety.
 MOTIVATION - is strongly associated with emotional readiness or willingness to learn.
 RISK-TAKING BEHAVIOR - are activities that are undertaken without much thought to what
their negative consequence or effects might be.
 FRAME OF MIND - depends on what the priorities of the learner are in terms of his needs
which will determine his readiness to learn.
 DEVELOPMENT STAGE - determines the peak time for readiness to learn or teachable
moment
Experiential readiness
 refers to the previous learning experiences which may positively (If the experience is
pleasant and appropriately reinforced) or negatively (if the learning experience has been
unsatisfying, humiliating or frustrating) affect willingness to learn.
 The educator, before starting teaching, should assess whether past learning experiences
were negative or positive in overcoming problems.
 A learner who had negative learning experience is not likely to be motivated to change
behavior or acquire new behaviors.
1. Level of aspiration = depends on the short-term and long-term goals that the learner
has set which will influence his motivation to achieve.
2. Past coping mechanism = refer to how the learner was able to cope with or handle
previous problems or situations and how effective were the strategies used.
3. Cultured background=is important to assess and know from the patient's own cultural
perspective in order to determine readiness to learn.
a. Awareness of the culture of the learner is of prime important. Knowledge of the
concepts of transcultural nursing will be a great help.
b. Find out also if the patient understands the language that is being used to
communicate with him.
4. Locus of control = refers to motivation to learn which maybe
a. Internal locus of control or intrinsic (within the individual as he/she is driven by
the desire to know or learn), or
b. External locus of control or extrinsic (motivation to learn is influence by others who
encourage the learner to learn)
5. Orientation this refers to a person's point-ofview which maybe:
a. Parochial close-minded thinking, conservative in their approach to new situations,
less willing to learn new materials and have a great trust in the physicians.
b. Cosmopolitan orientation = Is a more worldly perspective and more receptive to
new or innovative ideas like the current trends and perspectives in health education
Knowledge readiness
 The educator needs to find out how much a learner knows about a topic and how proficient
in performing a task.
 Knowledge Readiness refers to:
1. Present knowledge base = also referred to as stock knowledge or how much one already
knows above the subject matter from previous actual or vicarious learning.
2. Cognitive ability involve lower level of learning which includes memorizing, recalling or
recognizing concepts and ideas the extent to which this information is process indicates
the level at which the learner is capable of learning
 The teacher must recognize cognitive impairment due to mental retardation require special
techniques and strategies of teaching and the cooperation of the family must been listed
especially in the self - care activities of the client.
 Learning disabilities- and low-level reading skills will need special approaches to teaching
and to prevent discouragement and bolster readiness to learn
LEARNING PRINCIPLES TO USE IN MOTIVATING LEARNERS
Learning Principles
1. Use several senses
2. Actively involve the patients or clients in the learning process
3. Provide an environment conducive to learning
4. Assess the extent to which the learner is ready to learn
5. Determine the perceived relevance of the information
6. Repeat information
7. Generalize information
8. Make learning a pleasant experience
9. Begin with what is known; move toward what is unknown
10. Present information at an appropriate rate

WEEK 2 : LEARNING STYLES

LEARNING STYLES
 According to Ellis (1985), the way a person prefers to receive, store and retrieve material is
known as a person's preferred learning style.
 overall patterns that provide direction to learning and teaching.
 Styles influence:
- How students learn
- How teachers teach
- How the two interact
Why Is It Important to Know Students' Learning Styles?
 Students process information differently
 If educators teach exclusively to one style student's comfort level may be diminished.
 If only taught in one style students may lose mental dexterity to think in different ways
 Meet the learning needs of all students
Learning Styles: Sensory Learning Modalities
 Visual
 Auditory
 Kinesthetic
 Tactile
The Visual Learner
Characteristics
 Process material when it is presented in a visual manner.
Illustrations
Graphs
Images
Demonstrated
 Memory
 Doodles
 Difficulty with verbal instructions,
 Remembers faces but not names
Teaching Strategies
 Handouts
 Text Illustrations
 Power point
 Worksheets
Auditory Learner
Characteristics
 Process information via spoken words.
 May prefer to read aloud.
 Difficulty with written instructions.
 Remember by listening, especially with music
 Write lightly and it is not always legible
Teaching Strategies
 Dialogue
 Group Collaboration/Study Groups
 Lectures
 Allow for recordings
 Review directions
The Kinesthetic Learner
Characteristics
 Processes information best when they can manipulate or "touch" the material
 Enjoys activities.
 Works through a problem
 Poor spellers
 Remember what was done
 Doesn't "hear things as well
  Touch is important
 Attacks things physically - fight, hit, pound
 Impulsive
Teaching Strategies
 Activities
 Role Playing
 Demonstrations
 Games
 Computer Simulations and Applications
TACTILE - (small motor learning)
 .Most of the same traits as kinesthetic
 Note: Kinesthetic and tactile learners have the most difficulty learning to read
 Note: All children are very kinesthetic to age 6
LEARNING STYLES : DUNN AND DUNN’S

LEARNING STYLES : THE MYERS-BRIGGS TYPE INDICATOR (MTBI)

KOLB’S EXPERIENTIAL LEARNING MODEL
GREGORIC STYLE DELINEATOR
4MAT SYSTEM

GARDNER’S EIGHT(9) TYPES OF INTELLIGENCE

THE DREYFUD MODEL
Health Education:
Fesanmie D. Amarillo
Learning Outcomes

At the end of the unit, the student will be able to:

a. Identify the different types of teaching strategies and be
able to differentiate each.
b. Demonstrate the different teaching strategies
c. Simulate health teaching incorporating different teaching
strategies and concept of health education.

College of Nursing 1
 TEACHING STRATEGIES AND
METHODOLOGIES FOR TEACHING &
LEARNING
I.Traditional Teaching strategies

Lecturing

Discussion

Questioning

Using audio-visuals
II. Activity based strategies

Cooperative learning

Simulations

Problem based learning

Self-learning modules
III. COMPUTER COMPUTER-ASSISTED INTERNET VIRTUAL REALITY
TEACHING INSTRUCTIONS
STRATEGIES

IV. DISTANCE INTERACTIVE CLASSES VIA

LEARNING TELEVISION INTERNET
 V.Teaching Assessment of
psychomotor Approaches pscyhomotor
skills skills learning

VI. Clinical Purpose of Models of clinical

Teaching clinical laboratory teaching

Preparation of Conducting a
clinical clinical laboratory
instruction research
I. TRADITIONAL

1 Lecturing
2. Discussion
3. Questioning
4. Using Audio-visual
1. LECTURING
TYPES OF LECTURES
1. TRADITIONAL ORAL ESSAY
➢ The teacher is the orator and ONLY speaker
➢ Expositions done on topic – inspirational or information

2. PARTICIPATORY LECTURE
> Begins w/ brainstorming from what students read
3. LECTURE W/ UNCOMPLETED HANDOUTS
➢ Resembles traditional oral essay but w/ handouts (blank
spaces)

4. FEEDBACK LECTURE
> Consists of mini-lectures interspaced w/ 10 minute small
group discussions
5. MEDIATED LECTURE – uses media such as
films, slides or Web based images + traditional
lecture
PURPOSES OF
LECTURES
1. Efficient means of introducing learners to new
topic and sets the stage of learning
2. Stimulates learner’s interest
3. Helps to integrate and synthesize a large
body of knowledge
4. For clarification of difficult parts (arrythmia,
acid-base balances)
5. To advance knowledge when textbooks are
not available
ADVANTAGES OF LECTURING
1. It is economical. Great deal of information
– shared.
2. Supplies and textbooks become true to life
→ ‘theater’
3. Teacher serves as model → students see a
‘creative mind at work’
4. Helps students develop their listening
abilities
DISADVANTAGES OF LECTURING
1. Puts learners in the PASSIVE ROLE of a
sponge
2. Focuses on the TEACHING OF FACTS
with little focus on Problem Solving, Decision
Making , analytical thinking or transfer of
learning → results in SURFACE learning
3. Does not meet student’s individual learning
needs
4. Student’s have little attention time span
(15 minutes)
ORGANIZING LECTURES
• Take time to plan for the objective of a
lecture
• Make an outline
→ HEIRARCHICAL/CLASSICAL
LECTURE
• Ex. Research Design
Ex.
• Research Design
I. Why we need different research design
II. Research Design:
A. Research (clinical trials)
> Quasi-experimental
> Pre-experimental
B. Correlation
> Ex-post facto
> Restrospective

III.Validity and Reliability of Design

DELIVERING THE LECTURE
 Planyour delivery
 Rehearse
 Consciously think of the delivery →
to maximize effectiveness
2. DISCUSSIONS
TYPES OF DISCUSSIONS
1. FORMAL DISCUSSIONS
➢ Announced topic
➢ Reading, watching movie – done in advance

2. INFORMAL DISCUSSIONS
➢ Spontaneous
PURPOSES &
ADVANTAGES
1. Learns problem solving method (groups)
2. Opportunity to apply principles,
concepts & theories
3. Clarifies information & concepts
4. Assists to evaluate beliefs/positions
(professional, societal or ethical issues)
> change in attitudes & values
DISADVANTAGES
1. Takes a lot of time
2. One person/few participants
(monopolies)
3. Gathering of uninformed opinions
DISCUSSION TECHNIQUES
1. Make expectations clear.
➢ ‘Students know exactly what they have
to do for discussion’ Ex. Chapter to
read, watch a video

2. Set ground rules.

> Limitations (e.g. time, no. of speakers,
interruptions during speech)
3. Arrange physical space.
➢ Circle sitting arrangement

4. Plan a discussion starter.

➢ Ask participants to come up with opening
questions
➢ Study questions – handed out prior to meeting
5. Facilitate, do not discuss.
➢ Refrain from talking. Watch group progress.
Keep everyone engage in discussions.

6. Encourage quiet members to

participate.
➢ Make eye contact and smile.
➢ Give direct, simple questions: “Mary, what do
you think?”
7. Don’t allow monopolies.
➢ Eye contact.
➢ Be blunt when needed.. “We’ve been hearing a
lot fro Sarah. Now, let us hear of the rest of
you think.”
8. Direct the discussion among group
members.
> Leaders facilitate.
9. Keep the discussion on track.
➢“We seem to have strayed a little fro our
topic. Let’s pick up on the last topic that
Lot was talking about.”
10. Clarify when confusion reigns.
> Recording may help the group. Let them
learn the act of clear self-expression.
11.Tolerate some silence. Silence
gives everyone a chance to think.

12. Summarize when appropriate.

3. QUESTIONING
➢Can be a teaching strategy
➢Ask questions → higher order thinking
FUNCTIONS OF QUESTIONS
1. Places the learners in an active role
➢ Simple recall
➢ Helps students analyze concepts
➢ Evaluate worth of ideas
➢ Speculate “if”

2. Assesses baseline knowledge →

retention
3. Helps review content – enlightens gray
areas

4. Motivates students
➢ Stimulates thinking & curiosity

5. Guides learner’s thought process

LEVELS OF QUESTIONS
1. According to WINK classification
A. CONVERGENT Qs
➢ specific, usually short & unexpected answers

PURPOSE -- recall and integrate information

Ex. What happens to the bronchioles when a client
has pneumonia versus an asthma attack?
B. DIVERGENT Qs
➢ Generates new ideas, draws implications,
formulates a new perspective

Ex. What might happen if you relocate an

elderly person with dementia to another type
of residence where he or she is presently
living?
2. According to BARDEN

A. LOWER-ORDER QUESTIONS
➢ Recall information, read or memorize

B. HIGHER-ORDER QUESTIONS
> Requires comprehension and critical thinking
TYPES OF QUESTIONS
1. FACTUAL QUESTIONS
➢ Requires simple recall questions
➢ Assess learner’s understanding
➢ To check if students are listening

2. PROBING QUESTIONS
➢ Seeks further explanation
➢ Ex. “Can you explain that?”
3. MCQs
➢ Tests recall or used to begin a discussion

4. OPEN-ENDED QUESTIONS
➢ All questions that request learners to construct an
answer
➢ Ex. “When shall you use clean versus sterile dressing
technique?”
5. DISCUSSION-STIMULATING Qs
➢ Uses various questions to promote the topic
➢ Ex. “Do you agree with John’s position?”

6. QUESTIONS THAT GUIDE PS

➢ Guides learners through problem solving thinking
➢ Ex. “What information do you need to have before
we can solve this problem?”
7. RHETORICAL QUESTIONS
➢ Stimulatesthinking
➢ Guides learners into asking some of their own
questions
QUESTIONING TECHNIQUES
➢ Supportive teachers → promote questioning

1. Prepare some questions ahead of time

➢ Match with objectives

2. State questions clearly and specifically

> Ex. “Can you give me an example of how respnodeat
superior can be practiced?”
3. Tolerate some silence.

4. Listen carefully to responses.

➢ Don’t interrupt.

5. Use the “beam, force, build” technique.

➢ BEAM – send Q to the class
➢ FORCE – call one student at a time
➢ BUILD – redirect the question to other students
6. Provide feedback.
➢ Allow a few seconds of silence and ask, “Can
anyone add to the answer?”

7. Handle wrong answers carefully.

➢ “I am sorry Edward but it’s not quite it.”
➢ “Yvette, you are correct in saying that ____,
but that is not the best way to go.”
STIMULATING LEARNERS TO ASK QUESTIONS

Learners should be rewarded for Thinking is driven not by answers

asking good questions. by good questioning.
HOW TO ENGAGE?

Thank or praise the student for asking questions. Talk to the whole class not only the questioner.
This keeps the whole class / group involved.
4. USING VISUAL AIDS
➢Can enhance teaching
➢Can add interest to the classroom
ISSUES

Correct choice?
Available?
Effective?
FACTORS TO CONSIDER: SELECTING MEDIA
1. Learning objectives
➢ Opt for variety

2. Availability of materials / technical

assistance

3. Level, ability & number of students

TYPES OF TRADITIONAL AUDIOVISUALS
1. HANDOUTS

Printed materials – communicate facts, figures, concepts

Saves a lot of time for information

2. CHALKBOARDS/ WHITEBOARDS

Useful for mathematical problems

3. OVERHEAD TRANSPARENCIES (OHP)

Saves time, helps organize and illustrates content

Costly

4. SLIDES

> Used to show pictures, project diagrams, charts and

word concepts
ADVANTAGES OF SLIDES:
Affordable
Easy to store
Easy to update/ recognize
DISADVANTAGES OF SLIDES:
Costly projector bulbs – don’t last long
5.VIDEO TAPES (modern video recording)
➢ In-house filming, video-clips
➢ Used during: 1) role playing; 2) communication; 3)
counseling skills

ADVANTAGES OF VIDEOTAPES:
➢ Provides personal touch
➢ Standardized exposure – in spite of distance
➢ Used at learner’s own pacing
DISADVANTAGES OF VIDEOTAPES
➢ Costly
➢ Communication is one way – learner’s become
passive
 SUMMARY: INTERACTIVE LEARNING

➢Combine variety of techniques

➢Change tactics every 15 to 20 minutes to recapture student’s interest
II. ACTIVITY BASED TEACHING STRATEGIES

1. Cooperative learning
2. Simulations
3. Problem based learning
4. Self-learning modules
STRENGTH:

 Studentsare involved in creating and

storing up knowledge for themselves
1. COOPERATIVE LEARNING

Learners are aware that

Small groups of learners
they are responsible not
→ work together
only for their own learning
toward achieving shared
but also for that of the
learning goal
others in the group.
TYPES OF COOPERATIVE LEARNING GROUPS
A. FORMAL COOPERATIVE
LEARNING GROUP
➢ Done in traditional class / distance
learning groups
➢ Individual or group accountability
➢ Most useful in group setting
B. INFORMAL COOPERATIVE LEARNING GROUP

Can be used in any setting

Helps the members to understand and clarify

misconceptions as well as to share experiences
C. BASE COOPERATIVE LEARNING GROUP

surveys/focus groups Applied easily to new staff

orientation or preceptor programs
ADVANTAGES OF COOPERATIVE LEARNING

Promotes critical thinking

– varied positions → Enhances social skill.
discussions --?

Helps address learning Members learn to

needs & learning styles function as a team.
DISADVANTAGES OF COOPERATIVE LEARNING

> Does not cover all content/ topics in syllabus

 2. SIMULATIONS
➢Controlled representations of reality
➢Exercises that learners engage in to learn in the real world
PURPOSES & USES OF SIMULATIONS
1. Enhances DM & PS skills
2. Enhances interaction abilities
3. Helps student learn psychomotor skills
in a safe and controlled setting
4. Chance to apply theories & principles
in practice
5. Achieves learning objectives –
communication skills
6. Ensures attitudinal change
➢Helps discover factors affecting people &
situations (exercise, game, role-playing)
7. Helps in mastery of skills
8. Helps evaluate learning (simulation
tests)
ROLE OF EDUCATOR IN SIMULATION LEARNING
1. Planner – read carefully, assign reading
2. Facilitator – introduce activity,
moderator
3. Debriefer – summarize what happened,
let learners explain what they did and
why, point out principles and theories
applied
TYPES OF SIMULATIONS
1. SIMULATION EXERCISE
➢ Focuses on process learning
Ex. Earthquake drills, fire drills

2. SIMULATION GAMES
> Focuses on CONTENT / PROCESS learning
TYPES -- SIMULATION GAMES
A. CONTENT LEARNING
➢ Focuses on teaching / reinforcing factual
information (ex. Crosswords, word games,
bingo gaes)

B. PROCESS LEARNING
> Emphasizes problem solving & application of
information (ex. Sim City)
ADVANTAGES OF SIMULATION GAMES

Teaches facts & Stimulates learning –

application of information makes learning fun

Increases interaction
Helps to evaluate learning
among learners
DISADVANTAGES OF SIMULATION GAMES

Waste of time

Unprofessional

Teachers dislike competition which

games promote
3. ROLE PLAYING
➢ Form of drama – spontaneous acting out of
roles (interaction)
➢ Lasts for 3 to 5 minutes (illustrates one aspect
of human relationship)
➢ Expression of non-verbal and verbal behavior,
response patterns and implementation of
principles
4. CASE STUDIES
> An analysis of an incident or situation on
which characteristics and relationships are
described, factual or hypothetical events
transpire, and problems need to resolved or
solved
Steps to follow in case studies:

Develop Select Develop Develop Lead

Develop Select a Develop the Develop the Lead the group
objectives – situation – characters. discussion discussion.
What do you Choose a topic questions.
want learners to & a scenario
learn? that fits the
objectives &
concept you
want to apply.
Note: There is NO ONE RIGHT ANSWER to
a case. Many problems are so complex that
they have a variety of resolutions rather than a
solution.
 3. PROBLEM BASED LEARNING

➢Involves confronting students w/ real life situations – enhances CT & DM

POINTS IN PBL!
 SMALL GROUPS → ANALYZE THE CASE
→ IDENTIFY THEIR OWN NEEDS
FOR INFORMATION
→ SOLVE PROBLEMS.
 OUTPUT
➢ Students will become GOOD PROBLEM SOLVERS in
their future work
➢ Students become LIFE LONG LEARNERS
DIFFERENCES
PBL CASE STUDIES
> Conducted in small groups > Used by individuals/groups

> Students have little background > Students have most of the
knowledge of the subject matter background learning theory to apply
to the case.

> Cases are usually brief & presenting > Cases are often long & detailed, and
problems are ill-structures their problems are well-defined.
Example of PBL
A small community hospital is confronted with a
severe nursing shortage. They are considering a
change in the nursing delivery system to a
model that involves cross training of personnel
and increased use of assistive personnel.
Rumors about a change began to circulate
around the hospital and many staff seem
unhappy.
Identified issues by the group
NURSING How often do they
SHORTAGES occur?

How severe do they

What causes them?
get?

What past solutions

have been tried and
do they work?
II. NURSING CARE DELIVERY SYSTEM
a. What is this one called?
b. Is it being used anywhere?
c. How would it work?
d. What might cross-training involve?
e. Are there published job descriptions
for assistive personnel?
 ➢Also known as
A. SELF-DIRECTED LEARNING MODULES
B. SELF-PACED LEARNING MODULES
C. SELF-LEARNING PACKETS
D. INDIVIDUALIZED LEARNING ACTIVITY
PACKAGES

4. SELF-LEARNING MODULES
DEFINITION OF SELF-LEARNING MODULES
A self-contained unit or package of study
materials for use by an individual
 Audience where this WORKS BEST:
Adult learners
Principles in handling adult learners:
1. Adults are self-motivated to learn
(relevant)
2. Adult’s prior experience is a resource
for further learning.
3. Adults are problem focused and readily
learn material they can use to solve
problems.
COMPONENTS OF SELF-LEARNING MODULES
Introduction and instructions

Behavioral objectives

Pretest

Learning activity

Self-evaluation

Posttest
TIPS
1. INTRODUCTION & INSTRUCTIONS
➢ Topic for module – single topic
Ex. Problem of elimination – divide this into urinary
elimination and intestinal elimination

2. BEHAVIORAL OBJECTIVES
➢ Expected of the learner
➢ Objectives – over-all objectives / specific
3. PRETEST
➢ Optional
➢ Pretest – diagnostic test / assesses prerequisite
knowledge
➢ helps evaluate which sections of the module to
skip and which ones need to be studied in
depth
4. LEARNING ACTIVITIES
➢ Most creative portion
➢ Designed to help meet objectives
➢ Must appeal to people – diff. learning styles
Ex. Attending short lectures, speeches, demo
Watching a video or slide
Using a computer program
4. SELF-EVALUATION TOOLS
➢ Assesseshow the students are achieving the
objectives

5. POSTTEST
➢A self quiz (MCQ or short answer questions)
➢ Retake is okay
➢ Determines mastery
DEVELOPING A MODULE
 Takes time (weeks/months)
 Begin with the body (behavioral objectives,
pretest, learning activity, self-evaluation,
posttest)
 Last to write – introduction & instructions
 PILOT TESTING – have one or two people
work at the module for feedback (e.g. unclear
objectives etc)
ADVANTAGES OF SELF-LEARNING MODULES
 Very flexible – do it at your own pacing,
done independently
 Individualized approach – helps students
 Sparks interest in teaching – creativity
 Standardized
 Reduces travel time
Reduces costs
DISADVANTAGES OF SELF-LEARNING MODULES

May lead to further

Miss interactions with
procastination – lack of
people
structures and deadlines

Takes many hours to design

Promotes dishonesty
and test
IV. COMPUTER TEACHING STRATEGIES

1.Computer Aided Instruction

2. Computer Managed Instruction
3. Internet
1. COMPUTER-AIDED INSTRUCTION
LEVELS OF Computer Aided Instruction
1. Drill and Practice
➢ Recognition and application of information
Ex. Drugs names and actions

2.Tutorials
➢ Useful teaching material at the rule/concept level
➢ Forces teachers from learning some basic material
3. Games
➢ Game mode can teach

4. Simulation
➢ Provides off real world experiences
➢ Provides chances to learn how to solve clinical
problems
5. Multimedia presentations
➢ Alsocalled hypermedia
➢ Older form: Interactive videodisc (IVD) program
EVALUATING SOFTWARE: CRITERIA
Accuracy – Up to date?

Easy to use – computer friendly?

Design –Interactive?

Appearance – Graphics? Animation & sound?

Feedback – rationale?

Cost-effectiveness – price? Discounts?

2. COMPUTER-MANAGED INSTRUCTION
 Any system of record keeping
 Use of authoring systems –
pre-developed software packages that
guide the educator the process of
development of CAI
 3. THE INTERNET

> A mammoth complex of computer connections across continents, connecting

many millions of computers
1. EMAIL (electronic)
➢ Greater collaboration between teachers vs.
students and between students vs. students
➢ Source of peer support
➢ Means to seek referrals, for consultation and for
post-discharge follow-up

EX. LIST SERVS – a group of people who have similar

interests and want to share information and experience
regarding their interest in a type of discussion groups
 2. NEWS GROUPS
➢ Discussionsgroups of people with same interest
➢ Messages appear in general mailbox

Ex. Sci.med.nursing – group discussing all kinds of

nursing issues (needs a news render softward)
➢ Also used for online support groups
Ex. Groups for caregivers of Alzheimer’s disease
3. World Wide Web
➢ A collection of “documents” found on Web pages
➢ A place to find specialized knowledge and multimedia
presentations
Ex. MEDLINE – for National Library of Medicine

Criteria to choose WWW site

1. Purpose – audience?
2. Currency
3. Credibility
4. Content accuracy
5. Design
ADVANTAGES IN HOSPITAL USE
➢ Provides home-based care support for the
chronically ill
➢ Tool for patient care management – part of
hospital information system
➢ Provides patient teaching
➢ Supports mastery learning
> Maximizes time on task and helps develop
overlearning (beyond mastery, responses
becomes automatic)
> Provides instant feedback
> Develops cognitive residues (skills in
researching → skills in managing information)
> Promotes interactivity, institutional
consistency, individualized instruction, time
efficiency and cost-effectiveness (savings)
DISADVANTAGES
1. High-cost → initial outlay for hardware and
software
2. Negative effect → personal and professional
communication
Proverbs 6:13

Give instructions to a wise man, and

he will be yet wiser: teach a just man,
and he will increase learning.
Health Education:
Fesanmie D. Amarillo
Learning Outcomes
At the end of the Unit, the student will be able
to:
Create a teaching plan using appropriate
objectives and taxonomy.

College of Nursing 1
Planning & Conducting
Classes
 Decisions to Make
● What would I include in each class and what
should I leave out?
● What methods should I use in the
classroom?
● How do I know how long it will take to teach
this amount of material?
● How can I keep learners interested and
make sure they learn?
Before entering a classroom…
● the teacher needs to:
1. Develop a Course Outline or Syllabus
2. Formulate Course Objectives
3. Select and Organize Content
4. Choose Teaching Methods
5. Choose Textbook/ References
6. Design Assignment
7. Conduct Class and Evaluate Learning
Developing a Course Outline or Syllabus
● a legally-binding contract between teacher
and learners.
● To protect yourself legally , you may also
include a statement at the end of the outline
that states changes in course material or
evaluation may be necessary at times, but
that the learners will be notified in
writing of any changes.
 Course Outline or Syllabus
● Two fundamental criteria:
1. It should include all the information that
students need to have at the beginning of
the course.
2. It should include all the information that
students need to have in writing.
 Course Outline or Syllabus
● BASIC PURPOSES
✓ Describe the course, its goals, and its objectives.
✓ Describe the structure of the course and its
significance within the general program of study
✓ Discuss what mutual obligations students and
instructors share.
✓ Provide critical logistical and procedural
information --what will happen, when, and where.
Course Outline or Syllabus
● Course outline include:
✓ The name of the course.
✓ The name of instructor.
✓ A one- paragraph course description.
✓ A list of course description.
✓ Teaching methods to be used.
✓ The method of evaluation.
Course Outline or Syllabus
● Kinds of Syllabi
✓ Content-based- What the instructor will teach
✓ Process-based- How the instructor will teach
✓ Outcomes-based- What the student will learn
 (Holmes, 1990) Write
objectives that have
Formulating Objectives meaning, not just for
you but also for the
● WHY we do need objectives? learners. They should
reflect what the learner
a. to guide your selection and is supposed to do with
handling of course materials
what is taught.
b. to help you determine whether
the people in the class have
learned what you have tried to
teach
c. Are essential from the learner’s
perspective. It guides the
students in their studying.
d. To justify the budget of the
learning program.
 Formulating Objectives
● They must receive objectives that communicate
clearly what they will be expected to know and do
with the course material.
Sample Objectives:
✓ Explain the rationale for people’s use of defense mechanisms.
✓ Analyze in a given situation which defense mechanisms are
being used by an individual.
● Course objectives should be designed to be achievable by
most or all learners. If the objectives are unrealistic, either
because the teacher’s expectations are too high or because
the needed learning experiences are inaccessible, they are
worthless.
 Taxonomy of Objectives
● (Bloom, 1984) 3 Learning Domains:
1. Cognitive (knowing)
-Knowledge, comprehension, application, analysis,
synthesis, evaluating
2. Psychomotor (doing)
-You can observe what learners are actually doing when
they perform a skill
-Ex. “will correctly mix two types of insulin in one syringe”
3. Affective (feeling, valuing)
-Related to beliefs, attitudes, values
Wording of objectives
● Goal:" Recognize the parameters of effective
hemodialysis"
● Objectives: The nurse will list and explain, with
95% accuracy, the parameters by which effective
hemodialysis is measured"
The objectives characteristics
S SPECIFIC

M Measurable

A Achievable

R Realistic

T Timelines
 Behavioral Verbs Useful for Writing Objectives
● Cognitive Domain
Knowledge Define, delineate, describe, identify, list, name, state
Comprehension Classify, discuss, estimate, explain, rephrase, summarize
Application Adjust, apply, compute, demonstrate, generate
Analyze, compare, contrast, critique, defend,
Analysis
differentiate
Synthesis Create, develop, propose, suggest, write
Evaluation assess, choose, conclude, defend, evaluate, judge
Behavioral Verbs Useful for Writing Objectives

Psychomotor Domain Arrange, assemble, calibrate, combine,

copy, correct, create, demonstrate, execute,
handle, manipulate, operate, organize,
position, produce, remove, revise, show,
solve
Affective domain Accept, agree, choose, comply, commit,
defend, explain, influence, integrate,
recommend, resolve, volunteer
 Following the 3 domains of learning by
Bloom, Create your own Objectives…
EXAMPLE
At the end of the class, the student will be able to:
COGNITIVE: apply all the concepts and steps in
planning and conducting classes in his/ her
teaching demonstration.
PSYCHOMOTOR: create a syllabus of his/ her
selected topic for teaching demonstration.
AFFECTIVE: value the significance and importance
of learning the concepts and steps in planning
and conducting classes
 Selecting Content
● How much time you can devote to the topic.
● The kind of background the students have.
● What you need to include from a text book.
 Selecting Content
● Content is prescribed by the curriculum of the
school, health agency, or proprietary agency for
which the educator works.
● More often, someone’s files contain previous
course outlines or course objectives to guide the
instructor in deciding what to teach.
● It is generally left to the instructor’s discretion to
determine exactly what to include on a particular
topic and what can safely be skipped over.
Selecting Content
● Give yourself time to discuss the meaningfulness
of the subject and cover important points
without getting bogged down in details that the
learners will never remember.
● rehearse your content orally in front of a mirror.
Organizing Content
● Headings
● Subheadings
● Should follow a logical consequences (moving
from general to specific) or (from Simple to
complex)
Organizing Content
● The way in which class content is organized can
make all the difference between sessions that
are enjoyable and smooth running and those in
which students are irritated and grumbling.
● Nothing is more distressing than trying to take
notes from a lecturer who skips all over a topic
with no apparent rhyme or reason.
 Selecting Teaching Methods
● Factors Affecting Choice of Method
✓ Objectives and type of learning you are trying to achieve
✓ Course content
✓ Choice of teaching strategy
✓ Compatibility between teachers and teaching methods and
compatibility between learners and teaching methods
✓ The number of people in class
✓ Resources of institution
Selecting Teaching Methods
● In nursing the teaching methods selected should
therefore emphasize students activity: Case
study, discussion, Simulations, Role- playing,
Cooperative learning, Computer use.
● Number of people in the class. With high number
modules, computer programs or handout with
explanation is greatly useful. With small group,
brain storming, role- playing, and cooperative
learning.
Selecting Teaching Methods
● The Effectiveness of teaching methods
depend on the out come criterion. If the
criterion is the acquisition of knowledge
may be lecture is useful. While acquisition
of doing objectives it is useful to use
training sessions.
 Choosing A Textbook
● Courses are often built around the content
and approach of a textbook.
● Texts provide a stable and uniform source
of information for students to use in their
individual study, and teachers expect
students to use the book extensively.
Choosing A Textbook
Process of Textbook Selection:
1. Talk to publishers’ representatives or call
publishers for review copies.
2. Try to put yourself in the student’s place and
decide whether students would see the book
as interesting, appealing, well-organized,
and well written.
 Choosing A Textbook
Considerations:
✓ Content scope and quality
✓ Credibility and authorship
✓ Format
✓ Issues like cost, permanency, quality of
print
✓ The way in which the book will be used
 Choosing A Textbook
● Considerations:
✓ Quality of writing
✓ How the book organized and the graphics that were
included.
✓ Include introductions to chapters.(give an overview
to content)
✓ Keywords in bold face is favorite.
✓ Summaries at the end-of- chapter.
✓ Study questions, charts, tables, and pictures also
reflect the quality of the text.
 Choosing A Textbook
● Actual textbook selection
1. Begin with preface to the book
2. Examine some of the chapters
3. Examine the books appearance
Using a Textbook
1. Assign pages for homework
2. Use information from assigned reading as a basis
for a classroom discussion
3. Do the assigned reading yourself, explain in
advance how to read material(Guided Reading)
4. Help students get the most out of their reading by
assigning short passages to read before class
(Discovery Questions)
Planning Assignments
1. Term paper- a.k.a topic paper, research paper,
position paper
○ 10 – 15 pages long
○ Scholarly form
2. Assign short essay to analyze particular problem
3. Nursing care plan
4. Case Method Discussion (presentation).
 Conducting a Class
● The first class
✓ Reading names and getting correct pronunciation.
✓ Introduce self
✓ Establish pleasant atmosphere
✓ Communicate your expectations for the course
✓ Review syllabus or outline
✓ Cover general classroom rules
✓ Talk about why they should learn this information
Conducting a Class
● The first class (cont…)
✓ Ensuring that every one gets the handouts.
✓ A little humor is useful
✓ Communicate your expectations for the course.
✓ Try to whet the learners appetite for what is to
come.
 Conducting a Class
● Subsequent Classes
✓ gain and control attention of the learners
before teaching
✓ assess the learners backgrounds and
progress on the course
✓ Do not assume that learners already know
about the subject
Health Education:
Fesanmie D. Amarillo
Learning Outcomes

At the end of the Unit, the student will be able

to:
Identify ways to evaluate effectiveness of
a.

health education

College of Nursing 1
Assessment and
Evaluation
Assessing and evaluating learning are
just as important as the teaching
process.

If we teach but have no way of knowing

if students are learning , we may find
that we have wasted a lot of time.

Thus, it is important to focus on HOW

and WHEN to ASSESS and
EVALUATE LEARNING
ASSESSMENT of
LEARNING
• -- formative feedback that is done
simply to find out what and how
students are learning what
teachers teach, without any
intent to give a grade.

EVALUATION of
LEARNING
• -- include the process of
measuring the extent of learning
and assigning a grade.
• -- may incorporate formative and
summative feedback
Classroom
Assessment
 CATs
• Classroom Assessment Techniques
• In-class, anonymous, short,
nongraded exercises that provide
feedback for both teacher and learner
about the teaching-learning process
• PURPOSE: to provide teachers quick
and timely feedback about the
effectiveness of his or her teaching
and the state of student learning,
 Advantages of Using CATs

• Gaining insight into student learning while

there is still time to make changes
• Demonstrating to learners that the teacher
really cares if they are succeeding
• Building rapport w/ learners
• Spending only short amounts of time to gain
valuable information
• Using the flexibility of CATs to adapt to the
needs of individual classes
• Helping learners to monitor their own learning
• Gaining insight into your own teaching
Disadvantages of Using
CATs
• Although they take little time,
they do take some class time
away from other activities
• Can be overused to the point of
frustration of the learners
• Provide negative feedback for the
teacher
• Likely to point out weaknesses in
your teaching process or in your
style
Classroom Assessment
Techniques (CATs)
Commonly Used
CATs
•

•
One-Minute Paper
• Often called Minute Paper
• Used in the last 2 or 3 minutes of class period.
• the learners are asked to write, on a half sheet of
paper, answers to the following 2 questions:
-- “What was the most important thing you learned
today?”
-- “What important point remains unclear to you?”
• PURPOSE: not just to find out of there are points that
need to be reemphasized or clarified but also to help
learners develop metacognitive skills, analysis, and
synthesis skills
Muddiest Point
• Simply ask the learners: “What
was the MUDDIEST point in today’s
class?”
• Information the teacher gains
from this exercise will help not
only the learners in the class but
also future learners.
• The teacher discovers areas in
which learners struggle the most
and finds better ways to deal with
the content in the future
 Directed Paraphrasing
• Requires learners to put into their own
words something they have just learned
• Can be used in classroom, as
assignment, or with patient teaching
• Provides valuable feedback on learner
understanding and their ability to
translate information
• Useful for nurses for they often have to
translate medical information into
layman’s terms, that would be
understandable to a person w/ low
literacy or to a 6-yr old child
 Application Cards
• Ask the learners to take a few minutes and write
on an index card at least one possible
application of this content/ topic to the real
world
• You can then read the responses, if the group is
small, or share the best ones in class, or shuffle
the cards and give them out to class and have
the learners read those that they feel are good
examples of applications
• Helps learners to apply the theoretical material
they are being taught and see the immediate
relevance of what they are learning
Background Knowledge
Probe
• Used before teaching new content to discover
what the learners already know about the
material
• An ungraded pretest
• Hand out a few written questions for students to
fill in or choose the answers, or you can write the
questions on the board or transparency and have
the learners write the answers on their paper
 Misconception/
Preconception Check
• Helps expose mistaken ideas/ misconceptions/
incorrect preconceptions that may hinder learning
• Think about misconceptions you have heard about
in the past
• For example: many people have misconceptions on
mental illness; you can ask: “Can people who are
clinically depressed become less depressed by
trying very hard to feel happier?” then ask “How
did you come by the information you gave for the
previous question?”
• Sharing the answers and discussing them can be a
powerful way to start the topic
 Self-Confidence Surveys
• Allow learners to express their possible
lack of confidence in learning certain
context or skills
• Learners may be self-confident in many
areas but feel insecure in some.
• May involve developing a short survey w/
5 or 6 questions and Likert-type
measurement scale
-- “How confident do you feel in converting
fractions to decimals?” Very Confident,
Somewhat Confident, Not very Confident,
not confident at all.
 Additional Used CATs
• Empty Outlines
• One-Sentence Summary
• Student-Generated Test
Questions
• Group Work Evaluation
• Assignment Assessments
• How Am I Doing?
 Empty Outlines

Following a class, the

instructor hands out an
Helps the learners recall
empty or partially empty
the main points of the
outline of the content and
class
asks students to complete
it in a short amount of time
 One-Sentence Summary
• Ask learners to identify the answers
to “Who does what to whom, when,
where, how and why?” at the end of
the class
• Then they write a sentence that
summarizes this key information.
• Assesses knowledge and ability to
summarize key points
Student-Generated Test
Questions
• Have learners write a few test
questions (at home) for the class and
answer them
• Gives insight into what content
students see as important, their
knowledge of the answers, and what
they consider fair questions
• May actually use some of the
questions on an exam
Group Work Evaluation
• Use a questionnaire to obtain
students’ reactions to group work
(cooperative learning)
• Helps both students and teacher
to identify early problems in the
group process and plan
intervention
Assignment Assessments
• After assignments are
completed, ask learners to
assess the value and the pitfalls
of the assignments and how
they can be improved as
learning devices
How Am I Doing?
• Early in the course, ask learners
to answer a few questions about
how well you are teaching and
meeting their learning needs
• May use some of the same
questions you would ask at the
end of the course, but doing so
earlier gives you time to make
desired changes
Evaluation of Learning
Evaluation Methods
• Based on learning objectives
• By giving a test, a behavioral
evaluation, or a graded
assignment
• Good examination planning
involves test blueprint or table
of specifications
Multiple-Choice Questions

• Multiple-choice format
• Challenging to create, easy to
score, and can be scored by
computer
• Less subjective than essay
• NLE is MCQ
• Highest levels of knowing and
critical thinking may not be
tested by this means
Multiple-Choice:
Comprehension
Which parameter is most important for
a nurse to report when implementing
postural drainage?
a. Frequency of oral hygiene
b. Number of times the patient coughed
c. Amount of sputum expectorated
d. Change in respiratory depth
Multiple-Choice:
Application
• An immobilized alert patient is developing
atelectasis. What should the nurse do first with this
patient?
a. Oral suctioning
b. Postural drainage
c. Pursed-lip breathing
d. Coughing and deep breathing
 Multiple-Choice:
Evaluation
An orthopneic patient is placed in high Fowler’s
position. What data would indicate the need to
reassess the situation and maybe reposition the
patient?
a. Coughing and expectoration
b. Inability to rest
c. Decreased use of accessory muscles
d. Increased chest expansion
 Multiple-
Choice
Questions
 True or False Questions
• Designed to test a learner’s ability to
identify the correctness of statements
of fact or principle
• Limited to testing the lowest levels of
knowing, knowledge and
comprehension
• Weakness: learner has 50/50
chance of guessing the right answer
• Word the statement so that it is clearly
true or false, not ambiguous
 Matching Questions
• Test knowledge, the lowest level of knowing
• Useful in determining whether learners can recall
the memorized relationships between 2 things such
as dates and events, structures and functions, and
terms and their definitions
• Premises usually on LEFT, responses on RIGHT
• Items on the list should be homogenous
• Number of responses should exceed the number of
premises to avoid answering by elimination
• Indicate whether a response can be used more than
once
• Double matching items can be designed to increase
level of difficulty
• A=apothecaries’ ____1. dr. _____a. 15 gr
• M=metric ____2. oz. _____b. 1000cc
• H=household ____3. T _____c. 4 cc
____4. kg. _____d. 100gm
____5. L _____e. 30 cc
____6. gm _____f. 15 cc
_____g. 2.2 lb
_____h. 4 dr
 Essay-Type Questions
• Time-consuming for test takers to
answer, thus limiting the amount of
knowledge sampling you can
accomplish in a short time
• Time-consuming to score
• Test highest levels of knowing especially
analysis, synthesis, and evaluation
• Types: Short-answer questions
(restricted response items) & Full essay
questions (extended response
questions)
 Describe two situations that
demonstrate the application of
the law of supply and demand.
Example of Do not use those examples
discussed in class.
Restricted
Response State the main differences
between the Vietnam War and
previous wars in which the
United States has participated.
Examples of Extended Response Essay
Questions

• Compare developments in international relations in the

administrations of President William Clinton and President
George W. Bush. Cite examples when possible.
• Imagine that you and a friend found a magic wand. Write a story
about an adventure that you and your friend had with the magic
wand.
 Suggestion For Scoring
Essay Question
• Chose either the analytical or holistic
(global-quality) method.

Analytical Scoring:
• This scoring method requires that the
instructor develop an ideal response
and create a scoring key or guide. The
scoring key provides an absolute standard
for determining the total points awarded
for a response. Student responses are
compared to the scoring standard and not
to the responses of their classmates.
 Holistic Scoring:
Suggestion
For Scoring The reader forms an impression of
the overall quality of a response
Essay and then transforms that
Question impression into a score or grade.
The score represents the quality of
a response in relation to a relative
standard such as other students in
the class.
Suggestion For Scoring Essay Question
• Score the responses question-by-
question rather than student-by-
student.
• Disassociate the identity of
students from their responses
during the grading process.
• Determine in advance what
aspects of the response will or
will not be judged in scoring.
 1. What was the most
important thing you learned
today?

2. What important point

remains unclear to you?
EVALUATING LEARNER
PROGRESS
 Why is Evaluation needed?

Learners need to hear the feedback and

judgment of their work.

They need to know how they are doing at

one level before progressing to the next.

To determine how well the objectives are

met.
 Formative and Summative Evaluation
➢ Formative

...is the ongoing feedback given to the learner

Choices to be throughout the learning experience
Made ...helps identify strengths and weaknesses
Regarding ...prevents learners from being surprised at the end
with the judgment of their performance
Evaluation
➢ Summative
...summary evaluation given at the end of the
learning experience
...to assess whether the learner has achieved the
objectives
Choices to be Made Regarding
Evaluation

Norm-Referenced and Criterion-Referenced Evaluation

➢ Norm-referenced
...learner is compared to a reference group of learners, therefore,
evaluation and grading are relative to the performance of the group

➢ Criterion-referenced
...compares the learner with well-defined performance criteria rather
than comparing him/her with other learners
Choices to be Made Regarding
Evaluation
Grading Systems

2 most common options for grading:

➢ Assigning letter grades
➢ Pass/Fail or Satisfactory/Unsatisfactory approach
 ➢ Use of the nursing process
➢ Use of health-promoting strategies
➢ Psychomotor skills
Behaviors to ➢ Organization of care
➢ Maintaining patient safety
be Evaluated
➢ Ability to provide rationale for
nursing care
➢ Ability to individualize care planning
and intervention
 ➢ Therapeutic communication
➢ Ability to work with a
Behaviors to professional team
be Evaluated ➢ Professional behaviors
➢ Written documentations of
care
 Direct observation

Broad questions asked to the patients

Sources of
Evaluation Learner self-evaluation

Data Agency staff

Written work and college laboratory work

performed by the learner
Clinical evaluation tools
 Clinical Evaluation Tools
1. The items should derive from the
course or unit objectives
2. The items must be measurable in
some way
3. The items and instructions for use
should be clear to all who must use
the tool
4. The tool should be practical in
design and length
5. The tool must be valid and reliable
 “The mediocre teacher tells.
The good teacher explains. The
superior teacher demonstrates.
The great teacher inspires.”
― William Arthur Ward
“In learning you will teach,
and in teaching you will
learn.”
― Phil Collins
Health Education:
Fesanmie D. Amarillo
Learning Outcomes

At the end of the unit, the student will be able to:

a. Appreciate different learning needs of each

developmental stage.
b. Correlate previous knowledge on developmental
milestone and theories in health education.
c. Use appropriate technology for effective and efficient
health education activities

College of Nursing 1
Review the Stages of Development

➢ Infancy
➢ Toddler
➢ Pre-schooler
➢ School Age
➢ Teenager
➢ Young Adult
➢ Middle-Aged Adulthood
➢ Older Adulthood
Consider the Generational Styles and Culture
Health Education:
Fesanmie D. Amarillo
Learning Outcomes

At the end of the Unit, the student will be able

to:
a. Prepare printed educational material
b. Critic printed education materials using
readability measurement tools.

College of Nursing 1
Literacy and Readability
 Definition of Terms
• Literacy: the ability of adults to read, write,
and comprehend information at the 8th-
grade level or above.
• Illiteracy: the total inability of adults to
read, write, and comprehend information.
• Low Literacy: the ability of adults to read,
write, and comprehend information
between the 5th- to 8th-grade level of
difficulty. Also synonymous with the terms
marginally literate or marginally illiterate.
 Definition of Terms
• Health Literacy: the ability to read,
interpret, and comprehend health
information to maintain optimal wellness.
• Functional Illiteracy: the inability of
adults to read, write, and comprehend
information below the 5th-grade level of
difficulty in order to use information as it
is intended for effective functioning in
today’s society.
• Readability: the ease with which written or
printed information can be read.
 Definition of Terms
• Comprehension: the degree to
which individuals understand
and accurately interpret what
they have read.
• Numeracy: the ability to read and
interpret numbers.
• Reading: the ability to transform
letters into words and pronounce
them correctly (word
recognition).
 Literacy Relative to Oral
Instruction

• Little attention has been paid to

the role of oral communication in
the assessment of illiteracy.
• Iloralacy: the inability to
comprehend simple oral language
communicated through speaking
of common vocabulary, phrases,
or slang words.
 Literacy Relative to
Computer Instruction

• The ability to use computers for

communication is an increasingly
popular issue with respect to literacy
of learner.
• As an educational tool, the potential
for computers is increasingly being
realized and appreciated by
healthcare providers.
• Computers are used to convey as well
as to access information.
 Literacy Relative to
Computer Instruction

• The opportunity to expand the

knowledge base of learners through
telecommunications requires nurse
educators to attend to computer
literacy levels.
• The negative effects of illiteracy and
low literacy in the use of computers is
similar to the literacy issues with the
use of printed materials and oral
instruction.
 Trends associated with literacy problems

• A rise in the number of immigrants

• The aging of our population
• The increasing complexity of information
• The added number of people living in
poverty
• Changes in policies and funding for public
education
• Disparity of opportunity between minority
versus non-minority populations
 Those at Risk

• The economically disadvantaged

• The elderly
• Immigrants (particularly illegal ones)
• High-school dropouts
• Racial minorities
• The unemployed
• Prisoners
• Inner city and rural residents
• Those with poor health status
 Myths, Stereotypes and
Assumptions
• Myth #1: People who are illiterate
have below normal IQ’s.
• Myth #2: People who are illiterate can
be recognized by their appearance.
• Myth #3: The number of years of
schooling completed correlates with
literacy skills.
• Myth #4: People who are illiterate
come from similar socioeconomic,
racial, and ethnic minority
backgrounds.
• Myth #5: People who are illiterate
freely admit to having problems with
reading, writing and comprehension.
Assessment: Clues to look
for
• Most people with limited literacy
abilities are masters of concealment.
• Possible signs of poor or nonexistent
reading ability include:
✓ reacting to complex learning
situations by withdrawal or
avoidance
✓ using the excuse of being too busy,
not interested, too tired, or not
feeling well enough to read
instructional materials
✓ claiming they lost, forgot, or broke
their glasses
 Assessment: Clues to look
for
✓ surrounding themselves with books,
magazines, and newspapers to give
the impression that they are able to
read
✓ insisting on reading the information
at home or with a spouse or friend
present
✓ asking someone to read information
for them
✓ becoming nervous when asked to
read
✓ acting confused or talking out of
context about the topic of
conversation
Assessment: Clues to look
for
✓ showing signs of frustration
when attempting to read
✓ having difficulty following
directions
✓ listening and watching
attentively to try to memorize
information
✓ failing to ask questions
✓ revealing a discrepancy between
what they hear and what is
written
Impact of Illiteracy on Motivation and Compliance

Characteristics of thinking:
People with poor literacy skills think in
very concrete, specific, and literal terms
disorganization of thought
limited perception of ideas
slow rate of vocabulary and language
development
poor problem-solving skills
difficulty analyzing and synthesizing information
difficulty formulating questions
struggles when handling more than one piece of
information at a time
Readability of Printed
Education Materials
(PEMs)
• Research findings indicate that most PEMs are
written at grade levels that far exceed the
reading ability of the majority of patients.
• The readability level of PEMs is between the
10th and 12th grade, yet the average reading
level of adults falls between the 5th and 8th
grade.
• People typically read at least two grades below
their highest level of schooling.
• PEMs serve no useful teaching purpose if
patients are unable to understand them.
Measurement Tools to
Test Readability

• The most widely used standardized

readability formulas rate high on
reliability and predictive validity.
• Formulas evaluate readability levels
using the average length of sentences
and the number of multisyllabic words in
a passage.
• Computerized readability analysis has
made evaluation of written materials
quick and easy.
 1. Spache Grade-Level Score: This
formula is unique because it
evaluates materials written for
children at elementary grades 1–3
(kindergarten level through third
Readability grade).

formulas
2. Flesch-Kincaid formula: Measures
materials written between the 5th-
grade and the college level.
 Comprehension Tests
• Cloze Procedure: Specifically
recommended for assessing
health literature. Every 5th word
is systematically deleted from a
portion of a text and the reader
has to fill in the blanks with the
appropriate words.
• Listening Test: A passage,
selected from instructional
materials written at
approximately the 5th-grade
level, is read aloud and then the
listener is asked questions on
key points relevant to the
content.
 Reading Skills Tests

• 1. WRAT (Wide Range Achievement Test):

Measures the ability of a person to
correctly pronounce words from a
graduated list of 100 words. It tests
word recognition, not vocabulary or
comprehension of text material.
• 2. REALM (Rapid Estimate of Adult Literacy
in Medicine): Measures a person’s
ability to read and pronounce
medical and health-related
vocabulary from three lists
graduated in order from the most
simple words to the most complex
words.
 Reading Skills Tests

• 3. TOFHLA (Test of Functional Health Literacy in

Adults): Measures literacy skills using actual
hospital materials.
• 4. LAD (Literacy Assessment for Diabetes):
Specifically developed to measure word
recognition in adults with diabetes.
• 5. SAM (Instrument for Suitability Assessment of
Materials): Includes evaluation criteria to
identify deficiencies in such factors as content,
literacy demand, graphics, layout, typography
and cultural appropriateness of print,
illustration, video, and audio instructional
materials.
 Steps to Take Prior to
Writing or Rewriting a
Text
• Decide on what the learner should do or
know (the outcome to be accomplished).
• Choose information that is relevant and
needed to achieve behavioral objectives.
• Select other forms of media to supplement
written information.
• Organize topics into logically sequenced
chunks of information.
• Determine the reading level of material
and write the text 2 to 4 grades below the
average reading grade-level score of the
intended audience.
Simplifying Readability of
Printed Education
Materials
• Elements such as technical format,
concept demand, legibility, literacy level,
and accuracy and clarity of a message
also affect the readability of printed
materials.
• To reduce the discrepancy between the
literacy demand of written materials and
the reader’s actual reading and
comprehension skills, the nurse educator
must attend to basic linguistic,
motivational, organizational, and content
principles.
Techniques for Writing
Effective Educational
Materials
• Write in a conversational style with an
active voice using the personal pronouns
“you” and “your.”
• Use short, familiar words with only one
or two syllables.
• Spell words rather than using
abbreviations or acronyms.
• Use numbers and statistics only when
necessary.
Techniques for Writing
Effective Educational
Materials

• Keep sentences short, preferably 20

words or less.
• Define any technical or unfamiliar
words.
• Use words consistently throughout text.
• Use advance organizers.
• Limit use of connective words.
• Make the first sentence of a paragraph
the topic sentence.
Techniques for Writing
Effective Educational
Materials
• Reduce concept density by limiting
each paragraph to a single message
or action.
• Include a summary paragraph to
review key points of information.
• Use a question-and-answer format to
present information simply and in
conversational style.
• Allow for plenty of white space for
ease of reading and to reduce density
of information.
Techniques for Writing
Effective Educational
Materials
• Design layouts that give
direction to the reader.
• Select simple type style (serif)
and large font (14–18 print
size). Avoid using italics and all
CAPITAL letters.
• with bold type or underlining.
Highlight important ideas or
words
• Use color to emphasize key
points and to organize topics.
 Techniques for Writing
Effective Educational
Materials
• Limit length of document to cover
only essential information.
• Select paper with non-glossy
finish and color that contrasts
with typeface. (Black print or
white is easiest to read.)
• Use bold line drawings and
simple diagrams for clarity of
message.
 A. Organizational Factors
1. Include a short but descriptive title
2. Use brief headings and subheadings
Developing 3. Incorporate only one idea per paragraph
Printed and be sure that the 1st sentence is the
topic sentence
Educational 4. Divide Complex Instructions into small
Materials steps
5. Consider using a question/answer
format
6. Address no more than three or four main
points
7. Reinforce main points with a summary at
the end.
 B. Linguistic Factors
1. Keep the reading level at grade 5-6 to
Developing make the material understandable to
Printed most low literate patients
Educational 2. Use mostly one or two syllable words
and short sentences
Materials 3. Use a personal and conversational
style. “You should weight yourself
everyday” is preferable to “patients
with congestive heart failure should
measure body weight everyday”
 C. Appearance Factors:
1. Avoid a cluttered appearance by including enough
white space
Developing 2. Include simple diagrams or graphics that are well
labelled
Printed 3. Use upper – and Lower-case letters. All capitals are
Educational 4.
difficult for everyone to read
Use 10- to 14-point type in a plain font (serif is
Materials preferred)
5. Place emphasized words in bold or underline them,
but do not use capital because they are difficult to
read.
6. Use lists when appropriate.
7. Try list when appropriate
8. Try to limit line length to not more than 50-60
characters
Teaching Strategies for
Low-literate Learners

• Establish a trusting relationship.

• Use the smallest amount of
information to achieve behavioral
objectives.
• Make points of information vivid
and explicit.
• Teach one step at a time.
• Use multiple teaching methods and
tools.
Teaching Strategies for Low-
literate Learners

• Give learners the chance to restate

information in their own words and to
demonstrate procedures.
• Keep motivation high by using praise and
rewards.
• Build in coordination of information and
procedures by using techniques of
tailoring and cuing.
• Use repetition to reinforce information.
THE END