PERSPECTIVE

ON
TEACHING
AND
LEARNING
 PURPOSE, BENEFITS, AND
GOALS OF PATIENT AND STAFF
EDUCATION
 PURPOSE

to increase the competence

and confidence of
clients for self-management.
 GOAL
transition

invalids -- independent
dependent -- participants
passive listeners -- active learners.
 BENEFITS

• Increase consumer satisfaction

• • Improve quality of life
• • Ensure continuity of care
• • Decrease patient anxiety
 BENEFITS

• • Effectively reduce the incidence

of complications of illness
• • Promote adherence to
healthcare treatment plans
 BENEFITS

. Maximize independence in the

performance of activities of daily living.

• Energize and empower consumers to

become actively involved in the planning of
their care
•Illness is a natural life
process, but so is
mankind’s ability to
learn.
 ROBIN ORR (1990)
“Illness can become an educational
opportunity
. .. A ‘teachable moment’ when ill
health suddenly encourages [patients]
to take a more active role in their
care”
Overall, patients are more
satisfied with care when they
receive adequate information
about how to manage for
themselves.
• Nurses play a key role in
improving the nation’s health,
and they recognize the
importance of lifelong learning to
keep their knowledge and skills
current (DeSilets, 1995).
• Our primary aims as educators

nourish clients as well as mentor staff.

We must value education and make it a

• priority for both our patients and our
fellow
colleagues
Education process

is a systematic,
sequential,
planned course of action
consisting of two
major interdependent
operation
1. teaching
2. learning.
 2 MAJOR PLAYER

TEACHER
LEARNER
EDUCATION PROCESS

VIS A VIS WITH

NURSING PROCESS
 Nursing Process Education Process
Appraise physical Ascertain learning needs,
and psychosocial ASSESSMENT readiness to learn, and learning
needs styles

Develop care plan Develop teaching plan based

based on mutual on mutually predetermined
goal setting to PLANNING behavioral outcomes to meet
meet individual individual need
needs
Perform the act of teaching
Carry out nursing
IMPLEMENTATION using specific instructional
care interventions methods and tools
using standard
procedures
Determine behavior
Determine physical changes
and psychosocial EVALUATION (outcomes) in knowledge,
outcomes attitudes, and skills
• Both processes provide
• a rational basis for nursing
practice rather than an
intuitive one.
 Difference….
NP focuses:
planning and implementation
of care based on the assessment and diagnosis
• of the physical and psychosocial needs of the
• patient,

• whereas ……

EP identifies
• instructional content and methods based
• on an assessment and prioritization of the client’s
learning needs, readiness to learn, and learning styles
• Both processes are
• ongoing, with assessment and
evaluation perpetually
• redirecting the planning and
implementation
phases of the processes.
 TEACHING
a deliberate intervention that involves
the planning and implementation of
instructional activities and experiences
to meet intended learner outcomes
according to a teaching plan.
 INSTRUCTION
a term often used interchangeably with
teaching.
- is one aspect of teaching.
- Component of teaching that involves the
communicating of information about a
specific skill in the
- 1. cognitive, 2. psychomotor, or 3. affective
domain.
 LEARNING
• defined as a change in behavior
(knowledge, skills, and attitudes)
that can occur
at any time or in any place as a
result of exposure to
environmental stimuli.
 SUCCESS …..
NE endeavors
• at teaching is measured not by how
much
content has been imparted, but rather
by how
much the person has learned.
 PATIENT EDUCATION……
PE a process of assisting people
• to learn health-related behaviors
(knowledge,
• skills, attitudes, and values) so that they
can incorporate those behaviors into
everyday
life.
 STAFF EDUCATION …….
by contrast, is the
• process of influencing the behavior
of nurses
• by producing changes in their
knowledge, attitudes, values, and
skills.
 ASSURE MODEL (Rega 1992)
assist nurses to organize and carry out the
education process:
• Analyze learner
• State objectives
• Select instructional methods and tools
• Use teaching materials
• Require learner performance
• Evaluate/revise the teaching and learning
process.
 Role of a Nurse as a Educator

• The role of educator is not primarily to

teach, but to promote learning and provide for
an environment conducive to learning—to
create the teachable moment rather than just
waiting for it to happen.
“ Teaching is not a matter
of chance, it’s a matter of
choice. It is not
something you are
destined or obliged to do
but something you have
chosen to do. Blessed are
the teachers for they are
God’s gift to everyone.”
• teacher becomes “the guide on
the side,” assisting the learner in
his or her effort to determine
objectives and goals for learning,
with both parties being active
partners in decision making
throughout the learning process.
• THE NURSE EDUCATOR IS:

• 1. PRIMARY SOURCE OF KNOWLEDGE OF

LEARNERS IN NURSING.

• 2. PRIMARY CATALYST FOR THE LEARNING

PROCESS.

• 3. ROLE MODEL FOR LEARNERS.

4. ACTIVE FACILITATOR, WHO DEMONSTRATES AND
TEACHES PATIENT CARE TO NURSING STUDENTS IN
THE CLASSROOM AND CLINICAL SETTINGS.

5. SOURCE OF HEALTH CARE INFORMATION AND

CARE TO CLIENTS

6. DILIGENT: keep abreast of developments in his

field or her field through continuing education
FUNCTION OF HEALTH EDUCATOR

• 1. COLLABORATES WITH HEALTH SPECIALIST

AND CIVIC GROUPS IN ASSESSING
COMMUNITY HEALTH NEEDS AND
AVAILABILITY OF RESOURCES AND SERVICES
AND IN DEVELOPING GOALS FOR MEETING
HEALTH NEEDS OF CLIENTS.
• 2. FORMULATES
OPERATIONAL PLAN AND
POLICIES NECESSARY TO
ACHIEVE HEALTH
EDUCATION OBJECTIVES
AND SERVICES.

• 3. CONDUCTS AND
COORDINATES HEALTH
NEEDS ASSESSMENT AND
OTHER PUBLIC HEALTH
SURVEYS.
• 4. DESIGNS AND CONDUCTS
EVALUATION AND
DIAGNOSTIC STUDIES TO
ASSESS THE QUALITY AND
PERFORMANCE OF HEALTH
EDUCATION.

• 5. PLANS AND IMPLEMENTS

HEALTH EDUCATION AND
PROMOTION PROGRAMS
SUCH AS TRAINING
WORKSHOPS,
CONFERENCES, AND SCHOOL
OR COMMUNITY PROJECTS
• 6. PREPARES AND
DISTRIBUTES HEALTH
EDUCATION MATERIALS, SUCH
AS REPORTS, BULLETINS,
ONLINE WEBSITES AND
VISUAL AIDS LIKE FILMS,
VIDEOTAPES, PHOTOGRAPHS
AND POSTERS.

• 7. PROVIDES GUIDANCE TO
AGENCIES AND
ORGANIZATION
• 8. DISSEMINATES
HEALTH PROGRAM
INFORMATION TO THE
PUBLIC BY PREPARING
AND ISSUING PRESS
RELEASES,
CONDUCTING MEDIA
CAMPAIGNS AND
MAINTAINING
PROGRAM-RELATED
WEBSITES.
• 9. PROMOTES AND
MAINTAINS COOPERATIVE
WORKING RELATIONSHIP
WITH AGENCIES AND
ORGANIZATIONS INTERESTED
IN PUBLIC HEALTH.

• 10. PROVIDES AND

MAINTAINS HEALTH
EDUCATION LIBRARIES TO
PROVIDE RESOURCES FOR
STAFF AND COMMUNITY
AGENCIES.
• 11. FORMULATES,
PREPARES AND
COORDINATES GRANT
APPLICATIONS AND
GRANT-RELATED
ACTIVITIES TO OBTAIN
FUNDING FOR HEALTH
EDUCATION
PROGRAMS AND
RELATED WORK.
12. DOCUMENTS
ACTIVITIES, RECORDS
INFORMATION SUCH
AS NUMBER OF
PROGRAMS
COMPLETED, NURSING
ACTIONS
IMPLEMENTED, AND
INDIVIDUALS ASSISTED.
• 13. MAINTAINS
DATABASES, MAILING
LISTS, TELEPHONE
NETWORK AND
OTHER INFORMATION
TO FACILITATE THE
FUNCTION OF
HEALTH EDUCATION
PROGRAMS.
 FACTORS THAT INFLUENCE CLIENTS
LEARNING
• 1. STAGE OF DEVELOPMENT
• 2. CULTURAL VALUES
• 3. LANGUAGE USED
• 4. PHYSICAL ENVIRONMENT
• 5. PREVIOUS EXPERIENCES
• 6. KNOWLEDGE AND SKILL OF THE TEACHER
 FACTORS THAT INFLUENCE CLIENTS
LEARNING

• 1. STAGE OF DEVELOPMENT
• Must be adapted to the
developmental level rather than
their chronological age.
• - ability to learn best
 FACTORS THAT INFLUENCE CLIENTS
LEARNING
• 2. CULTURAL VALUES

• - norms , tradition and cultural beliefs are

incorporated on their teaching plan.
 FACTORS THAT INFLUENCE CLIENTS
LEARNING
• 3. LANGUAGE USED

• - ability of the client to understand the

language of teaching determines how much
they learn.
 FACTORS THAT INFLUENCE CLIENTS
LEARNING
• 4. PHYSICAL ENVIRONMENT

• - nurse must consider privacy and

confidentiality of information when discussing
sensitive matters.
 FACTORS THAT INFLUENCE CLIENTS
LEARNING
• 5. PREVIOUS EXPERIENCES
• - client with may need less education since
they were familiar with the health care
activities that had taught earlier.
 FACTORS THAT INFLUENCE CLIENTS
LEARNING
• 6. KNOWLEDGE AND SKILL OF THE TEACHER
• - determine the objectives of the subject
matter to be taught.
Principles of client teaching
and learning
 Principles of client teaching and learning

• 1. assess teaching needs of the

client, or teaching that is required in
a particular situation.
• 2. assess readiness of the client to learn
and the relevance of the content must
be considered in order for learning to
occur.

• 3. Assess what the client knows and

begin from what she knows.
• 4. The nurse should consider language
barriers, literacy, ethnic or cultural
background, age and emotional status of the
patient.

• 5. Interactive discussion increases learning.

• 6. Demonstrate tasks to be done for active

practice.
• 7. Praises and positive feedback motivates
learning.

• 8. Role modeling .

• 9. Conflicts and frustrations impede learning,

and should be recognized by the nurse and
resolved learning to progress.
• 10. structured teaching and presentation of
simple tasks must be done before the complex
tasks.

• 11. Variation in teaching methods is necessary

to illustrate concepts and maintain interest of
clients.

• 12. Present information in small segments over

a period of time for better retention and
appreciation.
 BARRIERS TO EDUCATION AND
OBSTACLES TO LEARNING
• Barriers to education are those factors
impeding the nurse’s ability to deliver
educational services.

• Obstacles to learning are those factors that

negatively affect the ability of the learner to
attend to and process information.
 Barriers to Education
• 1. Lack of time to teach is cited by nurses
as the greatest barrier to being able to
carry out their educator role effectively.

• 2. Many nurses and other healthcare

personnel are traditionally ill prepared to
teach.
 Barriers to Education
• 3. Personal characteristics of the
nurse educator play an important
role in determining the outcome
of a teaching–learning
interaction.
 Barriers to Education
• 4. Until recently, low priority was
often assigned to patient and
staff education by administration
and supervisory personnel.
• 5. The lack of space and privacy in the
various
environmental settings where nurses are
expected to teach and learners ar expected
to learn is not always conducive to carrying
out the teaching–learning process.
• 6. An absence of third-party
reimbursement to support patient
education programs relegates teaching
and learning to less than high-priority
status.
• 7. Some nurses and physicians
question whether patient education
is effective as a means to improve
health outcomes.
• 8. There are a multitude of
healthcare providers covering much
of the same content, but not
necessarily with consistency.
• 9. The type of documentation system
used by healthcare agencies has an
effect on the quality and quantity of
patient teaching recorded.
 Obstacles to Learning

• 1. The stress of acute and chronic

illness, anxiety, sensory deficits, and
low literacy in patients are just a few
problems that can diminish learner
motivation and interfere with the
process of learning.
 Obstacles to Learning

• 2. The negative influence of the

hospital environment itself, resulting
in loss of control, lack of privacy, and
social isolation, can interfere with a
client’s active role in health decision
making and involvement in the
teaching–learning process.
 Obstacles to Learning

• 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.
 Obstacles to Learning

• 4. Personal characteristics of the

learner have major effects on the
degree to which predetermined
behavioral outcomes are achieved.
 Obstacles to Learning

• 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.
 Obstacles to Learning

• 6. Lack of support and ongoing

positive reinforcement
• from the nurse and significant others
• serves to block the potential for
learning.
 Obstacles to 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.
 Obstacles to Learning

• 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
Obstacles to Learning