HEALTH EDUCATION Specific Objectives of

MA. RONILEA H. WAJE, RN, MAN, LPT Health Education

1. To make health an asset valued by the
What is Health Education?
community.
Process which affects changes in the health
2. To increase knowledge of the factors that
practices of people and in the knowledge and
affect health.
attitude related to such changes.
3. To encourage behavior which promotes
Teaching process providing basic knowledge
and maintains health.
and practice of health, to be interpreted into
proper health behavior. 4. To enlist support for public health
measures, and when necessary, to press for
 Process that informs, motivates, and
appropriate governmental action.
helps people to adopt and maintain
healthy practices and lifestyle. 5. To encourage appropriate use of health
services especially preventive services.
 Refers to the act of providing
information and learning experiences 6. To inform the public about medical
for purposes of behavior change for advances, their uses, and their limitations.
health betterment of the client.
Contents of Health Education
HISTORICAL FOUNDATIONS FOR
1. Personal hygiene
THE TEACHING ROLE OF NURSES
2. Proper health habits
Patient education has long been considered a
major component in the list of standard 3. Nutrition education
caregiving by the nurse. The focus of
4. Personal preventive measures
teaching efforts by nurses was not only on
the care of the sick, but also on educating 5. Safety rules
other nurses for professional practice.
6. Proper use of health services
Florence Nightingale, the founder of modern
7. Mental health
nursing, was the ultimate educator. Not only
did she develop the first school of nursing, 8. Sex education
but she also devoted a large portion of her
career to educating those involved in the 9. Special education (occupation, mothers)
delivery of health care. Principles of Health Education
Nightingale taught nurses, physicians, about 1. Interest.
the importance of proper conditions in
hospitals and homes to assist patients in 2. Participation.
maintaining adequate nutrition, fresh air,
3. Proceed from known to unknown.
exercise, and personal hygiene to improve
their well-being. 4. Comprehension.

Aims of Health Education 5. Reinforcement by repetition.

1. Health promotion and disease 6. Motivation.

prevention. 7. Learning by doing.
2. Early diagnosis and management. 8. People, facts and media.
3. Utilization of available health services. 9. Good human relations.
10. Leaders.
 Good Communication Technique
• Source credibility.
• Clear message.
• Good channel: individual, group & mass
education.
• Receiver: ready, interested, not
occupied.
• Feedback.
• Observe non-verbal cues.
• Active listening.
• Establishing good relationship.
Educator
Who can be an Educator?
• Personnel of health services.
• Medical students, nursing & social
work.
• School personnel.
• Community leaders & influential.
Requirements:
• Personality: popular, influential and
interested in work.
• Efficiency trained and prepared for the
job.
• Must show good examples.
Message
• What information to be communicated.
• Simple, at the level of understanding.
• Culturally accepted.
• Interested.
• Meet a felt need.
• Avoid technical jargon.
• Use audiovisual aids.
Communication Barriers
 Social and cultural gap between the
sender and the receiver
 Limited receptiveness of receiver
 Negative attitude of the sender
 Limited understanding and memory
 Insufficient emphasis by the sender
(health professional)
 Contradictory messages
 Health education without identifying
the “needs "of the community
BARRIERS TO EDUCATION AND
OBSTACLES TO LEARNING
1. Lack of time to teach is cited by nurses as
the greatest barrier to being able to carry out
their educator role effectively. Very ill patients
are hospitalized for only short periods of time.
Early discharge from inpatient settings with
one another in emergency, outpatient, and
other ambulatory care settings. In addition,
nurses’ schedules and responsibilities are
very demanding.
2. Many nurses and other healthcare
personnel are traditionally ill prepared to
teach. Studies have revealed that the
principles of teaching and the concepts of
learning are unclear to a large number of
practicing nurses. Many nurses admit that
they do not feel competent or confident with
regard to their teaching skills. Nursing
education has for years failed to adequately
prepare nurses for the role as educator,
either during basic training or afterward.
Although nurses are expected to teach,
content
3. Personal characteristics
Personal characteristics of the nurse
educator play an important role in
determining the outcome of a teaching–
learning interaction.
4. low priority was often assigned to patient
and staff education by administration and
supervisory personnel. However, budget
allocations for educational programs remain
tight and can interfere with the adoption of
innovative and time-saving teaching
strategies and techniques.

5. The lack of space and privacy.
The lack of space and privacy in the various
environmental settings where nurses are
expected to teach, and learners are expected
to learn is not always conducive to carrying
out the teaching–learning process. Noise,
frequent interferences, treatment schedules,
and the like serve to negatively affect
concentration and effective interaction.
6. Some nurses and physicians question
whether patient education is effective as a
means to improve health outcomes. They
view patients as disablements to teaching
when patients do not display an interest in
changing behavior, when they demonstrate
an unwillingness to learn, or when their ability
to learn is in question.
Obstacles to Learning
1. The stress of acute and chronic illness,
anxiety, sensory deficits.
2. The negative influence of the hospital
environment itself, resulting in loss of
control, lack of privacy,
3. Lack of time to learn due to rapid patient
discharge from care can discourage and
frustrate the learner, impeding the ability and
willingness to learn.
4. Personal characteristics of the learner
have major effects on the degree to which
predetermined behavioral outcomes are
achieved. Readiness to learn, motivation and
compliance, developmental-stage
characteristics, and learning styles are some
of the prime factors influencing the success of
educational endeavors.
5. The extent of behavioral changes needed,
both in number and in complexity, can
overwhelm learners and dissuade them from
attending to and accomplishing learning
objectives and goals.
6. Lack of support and ongoing positive
reinforcement from the nurse and significant
others serves to block the potential for
learning.
7. Denial of learning needs, resentment of
authority, and lack of willingness to take
responsibility (locus of control) are some
psychological obstacles to accomplishing
behavioral change.
8. The inconvenience, complexity,
inaccessibility, fragmentation, and
dehumanization of the healthcare system
often result in frustration and abandonment of
efforts by the learner to participate in and
comply with the goals and objectives for
learning.
Role of Educators as an
Independent Nursing Function
• Not primarily to teach, but to promote
learning & provide an environment
conducive to learning.
• Act as a facilitator (motivates individual to
learn)
• Serves as coordinator of teaching efforts
• 3-by ensuring consistency of information
Purpose, Goals & Benefits of
Patients & Staff Education
Increase the learner’s competence &
confidence of clients for self-management.
Goal: increase the responsibility &
independence of clients for self-care. What is
the single most important action of nurses as
caregiver?
Goal - if they can’t independently maintain or
improve their hx status-they can’t reach their
full potential. (SELF RELIANT)
Question - prepare pt & family of self-care
Our goal is to support patients through the
transition from being invalids to being
independent in care; from being dependent
recipients to being involved participants in the
care process; and from being passive
listeners to active learners. If clients cannot
independently maintain or improve their
health status when on their own, we have
failed to help them reach their potential. In
light of cost-containment measures by
healthcare agencies and despite the
sometimes-scarce resources available,
nurses continue to follow the goals of
involving patients in exploring and expanding
their self-care abilities through interactive
patient education efforts.
2. Improve Patient Outcomes
Goal: improve the quality of care delivered by
nurses & recognize the importance of lifelong
learning.
Goal-improving the nation’s health &
recognize the importance.
keep their knowledge & skill current/updates.
3. Increase Patient & Staff Satisfaction
-the benefits to nurses: ↑ job satisfaction,
enhanced patient-nurse autonomy, increased
accountability in practice, & opportunity to
create change.
-a change in behavior (ASK) that can be
observed or measured because of exposure
to environmental stimuli.
Patient Education: The process of helping
clients learn health-related behaviors to
achieve the goal of optimal health and
independence in self-care.
Staff Education: The process of helping
nurses acquire knowledge, attitudes, and
skills to improve the delivery of quality care to
the consumer.
Comparison of the Nursing Process
to Education Process
• Nursing process
-focuses on planning & implementation of
care based on the assessment & diagnosis of
the physical & psychosocial needs of the pt.

3-after educating & improving pt’s condition • Education process

-increase job sates-----once recognize that -focuses on the planning & implementation of
their teaching actions have forge therapeutic teaching based on assessment &
rel. prioritization of pt’s learning needs, readiness
to learn & learning styles.
-create change to make a difference to the
lives of others ASSURE Model of Education
Process
Concepts of Teaching, Learning, &
Education Process • A- analyze the learner

• Education Process • S- state the objectives

-is systematic, sequential, logical, • S- select the instructional methods and

scientifically based, planned course of action
consisting of 2 major independent operations
(T & L).
• Teaching
- is a deliberate intervention that involves the
planning & implementation of instructional
activities & experiences.
- to meet intended learner’s outcome
accordingly to a teaching plan.
• Instruction
-is one aspect of teaching; a component of
teaching that involves communicating of
information
• Learning
materials
• U- use the instructional methods and
materials
• R- require learner performance
• E- evaluate the teaching plan and revise
as necessary
 The education process is a systematic,
sequential, planned course of action
consisting of two major interdependent
operations, teaching and learning. This
process forms a continuous cycle that
also involves two interdependent players,
the teacher and the learner.
 Together, they jointly perform teaching
and learning activities, the outcome of
 which leads to mutually desired behavior
changes.
 These changes foster growth in the
learner and, it should be acknowledged,
growth in the teacher as well.
 Thus, the education process should
always be a participatory, shared
approach to teaching and learning.
 A useful paradigm to assist nurses to
organize and carry out the education
process is the ASSURE model (Rega,
1993).
Role of the Nurse as a Health
Educator
• Giver of information
• Facilitator of Learning
• Coordinator of Teaching
• Client Advocate
Hallmarks of Effective Teaching in
Nursing
• Professional competence
-teacher who aims at excellence develops a
thorough knowledge of subject matter &
polishes skills throughout his career.
• Interpersonal Relationship w/ Students
-an effective teacher is skillful in IR. Skills
such as taking a personal interest in learners,
being sensitive to their feelings & problems,
conveying respect, alleviating their anxieties,
being fair, allows expressions of POV, allows
Q&A.
Hallmark-brand
6 major categories
1-Maintain and expands this knowledge
through reading, research, clinical practice, &
continuing education. How will you know if
competence is present: displays confidence
in his professional abilities, creative &
stimulating, can excite student interest, can
demonstrate clinical skills with expertise.
A teacher who portrays excellent clinical
skills, judgment, & honesty becomes a
positive role model for learners.
2-student-teacher relationship enhance
learning.
3 basic therapeutic approaches to maintain
learners’ self-esteem & minimize anxiety
empathic listening, acceptance (accept as
they are), honest communication (openness,
about the topic, his performance & abilities).
• Personal Characteristic
-qualities such as authenticity, enthusiasm,
cheerfulness, self-control, patience, flexibility,
and sense of humor, a good speaking voice,
self-confidence and caring attitude are all
desirable personal characteristics of
teachers.
1-student values these qualities because
they make learning more interesting, fun, or
pleasant
Are these qualities present to a teacher?
probably not.
They should aim for them because they as
well as their students will benefit from these
efforts
• Teaching Practices
-defines as the mechanics, methods, & skills
in classroom & clinical setting.
• Evaluating practices
-valued by students include clearly
communicating expectations, providing timely
feedback on student progress, correcting
students tactfully, being fair in the evaluation
process, giving test pertinent to subject
matter.
1-Students & colleagues value a teacher who
is knowledgeable & can present material in
an interesting clear & organized manner
2-if learners don’t meet the expectations of
teacher-student should be informed about it
-No learners should progress through an
entire teaching lesson to be told at the end
that she is not doing well.
-Superior learners should be told so
-criteria should be presented (PRS)
Teaching practices-JACOBSON defined TP
• Availability to Students
-CI should be available especially in clinical
courses. Should be available during stressful
clinical situations, physically helping students
give nursing care, give supervision, freely
answers questions, acting as resource
person during clinical learning experiences.
CI supervises more students during clinical
exposures - learners should be instructed of
what to do (preconference/morning rounds).
BARRIERS TO EDUCATION AND
OBSTACLES TO LEARNING
• Lack of time to teach
• Many nurses and other healthcare
personnel are traditionally ill prepared to
teach
• Personal characteristics
• Low priority
• The lack of space and privacy
• Some nurses and physicians question
whether patient education is effective as a
means to improve health outcomes.
LACK OF TIME TO TEACH is cited by
nurses as the greatest barrier to being able to
carry out their educator role effectively. Very
ill patients are hospitalized for only short
periods of time. Early discharge from
inpatient settings with one another in
emergency, outpatient, and other ambulatory
care settings. In addition, nurses’ schedules
and responsibilities are very demanding.
MANY NURSES AND OTHER
HEALTHCARE PERSONNEL ARE
TRADITIONALLY ILL PREPARED TO
TEACH. Many nurses and other healthcare
personnel are traditionally ill prepared to
teach. Studies have revealed that the
principles of teaching and the concepts of
learning are unclear to a large number of
practicing nurses. Many nurses admit that
they do not feel competent or confident with
regard to their teaching skills. Nursing
education has for years failed to adequately
prepare nurses for the role as educator,
either during basic training or afterward.
Although nurses are expected to teach,
content.
PERSONAL CHARACTERISTICS - Personal
characteristics of the nurse educator play an
important role in determining the outcome of
a teaching–learning interaction.
LOW PRIORITY was often assigned to
patient and staff education by administration
and supervisory personnel. However, budget
allocations for educational programs remain
tight and can interfere with the adoption of
innovative and time-saving teaching
strategies and techniques.
THE LACK OF SPACE AND PRIVACY in
the various environmental settings where
nurses are expected to teach, and learners
are expected to learn is not always conducive
to carrying out the teaching–learning process.
Noise, frequent interferences, treatment
schedules, and the like serve to negatively
affect concentration and effective interaction.
SOME NURSES AND PHYSICIANS
QUESTION WHETHER PATIENT
EDUCATION IS EFFECTIVE AS A MEANS
TO IMPROVE HEALTH OUTCOMES. They
view patients as disablements to teaching
when patients do not display an interest in
changing behavior, when they demonstrate
an unwillingness to learn, or when their ability
to learn is in question
LESSON 2: ETHICAL, LEGAL, AND
ECONOMIC FOUNDATIONS OF
EDUCATION
MA. RONILEA H. WAJE, RN, MAN, LPT

A. DEFINITION OF ETHICS, MORALITY

AND THE LAW
- Are formal rules that govern how we
behave as members of society.
Law: Outlines a basic standard of behavior
necessary for our social institutions to keep
functioning. It is necessary to make some
laws in order to succeed and to treat people
equally.
- Guiding principles inherited from
family, community, or culture.
Morality: A coherent, consistent account that
has been refines through history. Refers to
private, personal standards of what is right
and wrong.

aims to answer, “What should I do”?

• “ethicos” which means

the
MORAL DUTY
• Standard to examine
moral life
It is defined as the philosophical
(normative and theoretical) science that
deals with the morality of human conduct.

1. People’s decisions shaped by their values,

principles, and purpose.
– is a discipline that systematically examines
life’s big questions through critical reasoning,
logical argument, and careful reflection
Ethical decision is one made based on
reflection about the things we think are
important and that is consistent with those
beliefs.
2. Moral duties: we are ought to do this (our
actions), we are ought to do what is right, it is
our duty to do what is right
Standard to examine moral life: this means it
is the standard, the end point of all the
decision, the standard of all the things that we
do.
MORALS – “moralis” – social consensus
specific ways of accomplishing ethical
principles.
Social consensus which means which one
ought to do, that everyone agree that is the
right thing to do, right or wrong.
Specific ways are the ways that you do, for
you to accomplish ethics since it is the
standard to moral life.
Differentiated View of Ethics,
Morality and Law
1. Natural law (basis)
2. Deontological (Golden Rule)
3. Teleological (greatest good for the
greatest number)
1.Natural law theory is a legal theory that
recognizes law and morality as deeply
connected, if not one and the same.
Morality relates to what is right and wrong
and what is good and bad. Natural law
theorists believe that human laws are defined
by morality, and not by an authority figure,
like a king or a government. Therefore, we
humans are guided by our human nature to
figure out what the laws are, and to act in
conformity with those laws.
2.Deontology (or Deontological Ethics)
-is an approach to Ethics that focuses on
the rightness or wrongness of actions
themselves, as opposed to the rightness or
wrongness of the consequences of those
actions (Consequentialism) or to
the character and habits of the actor (Virtue
Ethics).
Deontologists believe that the goal of moral
philosophy should be to figure out the “rules”
for living a moral life and that once people
know those rules, they should follow them.
The word deontology derives from the Greek
words for duty (deon) and science (or
study) of (logos)
Deontology is a school of moral philosophy in
which ethical behavior equals following rules.
Deontologists believe that the goal of moral
philosophy should be to figure out the “rules”
for living a moral life and that once people
know those rules they should follow them.
“The Golden Rule” (do unto others as you
would have them do unto you) is an example
of deontology; it’s a moral rule meant to be
followed in all situations, for everyone to live
moral lives.
B. ETHICAL AND LEGAL FOUNDATIONS
OF PATIENT EDUCATION
Evolution of Ethical/Legal Principles in
Health Care
Charitable Immunity
Cardozo Decision of 1914
A. Informed consent
B. Right to self-determination
Charitable Immunity
-an immunity from civil liability and
particularly as regards negligent torts that is
granted to a charitable or nonprofit
organization. The legal doctrine of charitable
immunity holds that a charitable organization
is not liable under tort law.
Charitable Immunity Act
has been construed to immunize a church
from a personal injury claim by a church
member who trips and falls while exiting the
church after attending services. [Thomas v.
Second Baptist Church of Long Branch, 337
N.J. Super. 173 (App.Div. 2001)]
CARDOZO DECISION
A. Informed Consent: the right to full
disclosure; the right to make one’s own
decisions.
 B. Right to self-determination: the right to
protect one’s own body and to
determine how it shall be treated.
1914: Justice Benjamin Cardozo, informed
consent ruling
In a lawsuit involving the Society of NY
Hospital, Justice Benjamin Cardozo ruled:
“Every human being of adult years and sound
mind has a right to determine what shall be
done with his own body, and a surgeon who
performs an operation without his patient’s
consent commits an assault.”
C. ECONOMIC FACTORS INFLUENCING
PATIENT EDUCATION
Economic Factors of Patient Education:
Justice and Duty Revisited
Challenge for health care providers:
efficient & cost-effective patient education
legal responsibility of all nurse’s little
preparation on pre-licensure level.
Financial Terminology
 Direct Costs
• Fixed Costs
• Variable Costs
 Indirect Costs
 Cost Saving, Benefit and Recovery
 Direct Costs: those that are tangible and
predictable, such as rent, food, heating,
etc.
• Fixed Costs: those that are stable and
ongoing, such as salaries, mortgage,
utilities, durable equipment, etc.
 Variable Costs: those related to
fluctuation in volume, program
attendance, occupancy rates, etc.
 Law of demand and supply
 Med’s dosage required and quantity.
 frequency of changing bed linens
 Attendance =rehab therapy
 Occupancy rates= stay of
hospitalization
 Indirect Costs: those that may be fixed
but not necessarily directly related to a
particular activity, such as expenses of
heating, lighting, housekeeping,
maintenance, etc.
 Cost Savings: money realized through
decreased use of costly services,
shortened lengths of stay, or fewer
complications resulting from preventive
services or patient education.
 Cost Benefit: occurs when the institution
realizes an economic gain resulting from
the educational program, such as a drop
in readmission rates.
 Cost Recovery: occurs when revenues
generated are equal to or greater than
expenditures
Government Regulations &
Professional Standards
National Commission for the Protection
of Human Subjects of Biomedical and
Behavioral Research
National Commission for the Protection of
Human Subjects of Biomedical and
Behavioral Research was the first public
national body to shape bioethics policy in
the United States.
Formed in the aftermath of the Tuskegee
Experiment scandal, the Commission was
created in 1974.
The Commission had four goals
that it needed to analyze:
1. the boundaries between biomedical and
behavioral research and what the
accepted and routine practices of
medicine were,
2. assessing the risks and benefits of the
appropriateness of research involving
human subjects,
3. determining appropriate guidelines for
how human subjects can be chosen for
the participation in such research and;
4. defining what informed consent is in
each research setting
2. Philippine Nurses Association’s Code
of Ethics for Nurses with Interpretative
Statements
The Code of Ethics for Nurses with Interpretive
Statements provides a framework for nurses to
use in ethical analysis and decision-making.
What is the Code of Ethics for Nurses in the
Philippines?
The Filipino registered nurse, believing in the
worth and dignity of each human
being, recognizes the primary responsibility to
preserve health at all cost. This responsibility
encompasses promotion of health, prevention of
illness, alleviation of suffering, and restoration of
health.
Code of Ethics for Nurses in the Philippines was
devised as a guide for carrying out nursing
responsibilities which would tackle difficult issues
and decisions that a profession might be facing,
and give clear instruction of what action would be
considered ethical or right in the given
circumstance.
The Code of Ethics for Registered Nurses in the
Philippines is promulgated by the Board of
Nursing (BON) and was consulted with accredited
professional organizations like the Philippine
Nurses Association. It also coincides with the
ideals of Republic Act No. 9173 or the “Philippine
Nursing Act
Government Regulations &
Professional Standards
Patient’s Bill of Rights
1. Right to Appropriate Medical Care
and Humane Treatment
2. Right to Informed Consent
3. Right to Privacy and Confidentiality.
4. Right to Information
5. The Right to Choose Health Care
Provider and Facility.
6. Right to Self-Determination
7. Right to Religious Belief
8. Right to Medical Records
9. Right to Leave
10. Right to Refuse Participation In
Medical Research.
11. Right to Correspondence and to
Receive Visitors.
12. Right to Express Grievances
13. Right to be Informed of His Rights
and Obligations as a patient
Application of Ethical and Legal
Principles
1. Autonomy
2. Veracity
3. Confidentiality
4. Non-malfeasance
– Negligence
–Malpractice
–Duty
5. Beneficence
6. Justice
Definition of Ethical Principles
1. Autonomy: the right of a client to self-
determination
2. Veracity: truth telling; the honesty by a
professional in providing full disclosure to
a client of the risks and benefits of any
invasive medical procedure
3. Confidentiality: a binding social contract
or covenant to protect another’s privacy; a
professional obligation to respect
privileged information between health
professional and client.
Example
• Sharing of personal data like payroll
details not unless she will share,
• bank details,
• medical records,
• sharing info without permission like
ppt presentations
• Another one is discussing case in
public places,
Another example in school the
examination papers should be kept
 and shredded before disposal and so
on.
4. Non-malfeasance: the principle of doing
no harm
A. Negligence: the doing or non-doing of
an act, pursuant to a duty, that a
reasonable person in the same
circumstances would or would not do, with
these actions or nonactions leading to
injury of another person or his/her
property. Example of negligence
Burn due to hot water bag
Automobile accident (drivers should drive
carefully)
Dog bites
C. Malpractice: refers to a limited class
of negligent activities that fall within the
scope of performance by those
pursuing a particular profession
involving highly skilled and technical
services.
D. Duty: a standard of behavior; a
behavioral expectation relevant to
one’s personal or professional status
in life.
5. Beneficence: The principle of doing
good; acting in the best interest of a client
through adherence to professional
performance standards and procedural
protocols.
6. Justice: Equal distribution of goods,
services, benefits, and burdens regardless
of client diagnosis, culture, national origin,
religious orientation, sexual preference
and the like.
D. FUTURE DIRECTIONS FOR PATIENT
EDUCATION
Legality of Patient Education and
Information
 Patients’ Bill of Rights
 Joint Commission on Accreditation of
Healthcare Organizations
 State Regulations
 Federal Regulations
Documentation of Patient
Education
“… probably the most undocumented skilled
service….” (Casey, 1995)
JCAHO - Joint Commission on Accreditation
of Healthcare Organizations
Third-Party Reimbursement: insurance
companies, Medicare and Medicaid
programs, or “private pay”
Respondent Superior: The employer may
be held liable for the negligence or other
unlawful acts of the employee during the
performance of his or her job-related
responsibilities.
Program Planning and
Implementation
1. Revenue Generation
2. Relationship of Costs and Outcomes
a. Cost-Effectiveness Analysis
b. Cost-Benefit Analysis
Revenue Generation: profit realized when
fees for an educational program exceed the
aggregate costs of program preparation and
delivery.
Cost-Effectiveness Analysis: refers to
determining the economic value of an
educational offering by making a comparison
between two or more programs, based on
reliable measures of positive changes in the
behaviors of participants as well as evidence
of maintenance of these behaviors, when a
real monetary value cannot be assigned to
the achievement of program outcomes.
Cost-Benefit Analysis: the relationship (ratio)
between actual program costs and actual
program benefits, as measured in monetary
terms, to determine if revenue generation
was realized.
State of the Evidence
1. Legal and ethical issues
 2. Documentation of practice
3. New technologies
4. Health related outcomes
5. Economic implications
1. What are some legal and Ethical Issues
in healthcare?
There are 5 Ethical Issues in Healthcare
1. Do-Not-Resuscitate Orders.
2. Doctor and Patient Confidentiality.
3. Malpractice and Negligence.
4. Access to Care.
5. Physician-Assisted Suicide.
Future directions for patient education
2. Documentation Practice (take note of
your nursing process)
• Proper documentation in a patient's
chart tells a chronological story about
their care and health status.
• It allows for all team members to
remain updated and connected on the
plan of care for patients and how the
patient is responding to that plan.
3. New technologies
• Technologies such as podcasts and
videos with flipped classrooms, mobile
devices with apps, video games,
simulations (part-time trainers,
integrated simulators, virtual reality),
and wearable devices (google glass)
are some of the techniques available
to address the changing educational
environment.
4. Health Related Outcomes.
• Safety of care, patient experience,
effectiveness of care, safety of care,
using research in nursing practice
5. Economic implications
• Why is education considered
economic?
• Because Education tends to raise
productivity and creativity
Applying Learning Theories to
Healthcare Practice
MA. RONILEA H. WAJE, RN, MAN, LPT
CONTRIBUTION OF LEARNING THEORIES
 Provides information and techniques to
guide teaching and learning
 Can be employed individually or in
combination
 Can be applied in a variety of settings
as well as for personal growth and
interpersonal relations
LEARNING THEORIES
BEHAVIORIST THEORY
Concepts:
 Environmental stimulus conditions
 Reinforcement promotes changes in
responses
 To change behavior
 Change the stimulus conditions in the
environment and the reinforcement
after a response
Behaviorist Dynamics Motivation:
drives to be reduced, incentives
Educator:
 Active educator role
 Manipulates environmental stimuli and
reinforcements to direct change
Transfer:
 Practice and provide similarity in
stimulus conditions and responses
between learning and new situations
Respondent Conditioning
- Learning occurs as the organism
responds to stimulus conditions and
forms associations.
- A neutral stimulus is paired with an
unconditioned stimulus–unconditioned
response connection until the neutral
 stimulus becomes a conditioned
stimulus that elicits the conditioned
response
Operant Conditioning
- Learning occurs as the organism
responds to stimuli in the environment
and is reinforced for making a
particular response.
- A reinforcer is applied after a response
strengthens the probability that the
response will be performed again
under similar conditions.
Changing Behavior Using Operant
Conditioning
To increase behavior:
 positive reinforcement
 negative reinforcement
(escape or avoidance conditioning)
Gestalt Perspective
To decrease behavior
 non reinforcement punishment
Advantages of Behaviorism
• Highly structured situations
• Skills training in which steps and
sequences can be clearly delineated
Disadvantages of Behaviorism
• Instruction is mechanistic
• Minimizes student involvement in
learning
• Inappropriate for complex mental
processes, problem-solving, and
critical thinking
2. COGNITIVE THEORY
Concepts:
 cognition, gestalt, perception,
developmental stage, information-
processing, memory, social
constructivism, social cognition,
attributions
 To change behavior, work with the
developmental stage and change
cognitions, goals, expectations,
equilibrium, and ways of processing
information
Motivation:
 goals, expectations, disequilibrium,
cultural and group values
Educator:
 Organize experiences and make them
meaningful
 Encourage insight and reorganization
within learner
Transfer:
 Focus on internal processes and
provide common patterns with a new
situation
 Perception and the patterning of
stimuli (gestalt) are the keys to
learning, with each learner perceiving,
interpreting, and reorganizing
experiences in her/his own way
 Learning occurs through the
reorganization of elements to form new
insights and understanding
Information-Processing Perspective
 The way individuals perceive, process,
store, and retrieve information from
experiences determines how learning
occurs and what is learned.
 Organizing information and making it
meaningful aids the attention and
storage process; learning occurs
through guidance, feedback, and
assessing and correcting errors.
 Focus on describing the way
information is tracked, the sequence of
mental operations, and the results of
operations.
Cognitive Development Perspective
 Learning depends on the stage of
cognitive functioning, with qualitative,
 sequential changes in perception,  Motivation: compelling role models
language, and thought occurring as perceived to be rewarded, self-system
children and adults interact with the regulating behavior, self-efficacy
environment.
 Transfer: similarity of setting,
 Recognize the developmental stage
feedback, self-efficacy, social
and provide appropriate experiences
influences
to encourage discovery.
Social Constructivist Perspective
 A person’s knowledge may not
necessarily reflect reality, but through
collaboration and negotiation, new
understanding is acquired.
 Learning is development.
 Assimilation, accommodation, &
construction are part of learning.
 Learning is heavily influenced by the
culture and occurs as a social process
in interaction with others.
 A learner constructs new knowledge
by building on internal representations
of existing knowledge thru personal
interpretation of experience.
 An individual’s perceptions, beliefs,
and social judgments are affected
strongly by social interaction,
communication, groups, and the social
situation.
 Individuals formulate causal
explanations to account for behavior
that have significant consequences for
their attitudes and actions (attribution
theory).
SOCIAL LEARNING THEORY
 Concepts: role modeling, vicarious
reinforcement, self-system, self-
regulation
 To change behavior, utilize effective
role models who are perceived to be
rewarded, and work with the social
situation and the learner’s internal self-
regulating mechanisms.
 Educator: model behavior and
demonstrate benefits; encourage
active learner to regulate and
reproduce behavior