University of Belize

Teaching-Learning
Process

NURS 2051: Nursing Concepts

Teaching-Learning Process
Objectives
At the end of the lecture, students will be able to:
 Define teaching and Learning
 List the three theories of learning
 Describe the three domains of learning
 Describe various teaching methodologies for the three domains of learning and
teaching aids used
 Discuss factors that may affect the teaching-learning process
 Identify methods for evaluating learning
 Construct a teaching plan.
 What do you think client education entails?

The goal of educating others about their health is to assist individuals, families, or
communities in
achieving an optimal level of health.
Think about the four broad aims of Nursing Practice which are to
 promote health
 prevent illness
 restore health
 facilitate coping with disability or death.
 
First aid, avoidance of risk factors, stress management, hygiene, immunization, pre, and
postnatal care, exercise, nutrition, safety, screening etc…
Aim of nursing continues
Restoration of health:
 Disease condition, the origin of symptoms, prognosis, limitation on function,
A&P of the body affected, cause of the disease, medication, medical and surgical
interventions, limitation posed by the disease, etc…
Coping with impaired function:
Home care: medication, diet, activity, and self-help
Rehabilitation of remaining function: Physical therapies, occupational therapy,
speech therapy, etc.
Prevention of complication: Knowledge of risk factors, the implication of non-
compliance, environmental alteration
Introduction
 Teaching clients is one of the most important roles or aspects of nursing
practice. (independent nursing function).

 Client and family members have the right to health education so that they
will be able to make informed decisions about their health and lifestyle
(self and to aid their sick).

 Providing client education (information) is necessary to ensure continuity

of care from the hospital to one home.
Definitions related to the Teaching-Learning Process

Teaching-
Teaching Learning
Learning

Domains Curriculum
Teaching is deliberate intervention that involves the planning and
implementation of instructional activities and experiences to meet intended
learner outcomes according to a teaching plan

Learning can be defined as the relatively permanent change in an-

individual's behavior (knowledge, skill and attitude) that can occur at any time
or place as a result of consciously

Teaching-Learning process is the most powerful instrument of education to

bring about desired changes in the students.

Refers to a course of study at school, university and the subjects making up a

course.

It is an area of control or sphere of knowledge

Seven (7) principles of effective teaching-learning

1. Encourages Student-Faculty Contact

2. Encourages Cooperation among Students
3. Encourages Active Learning
4. Prompt Feedback
5. Emphasizes Time on Task
6. Communicates High Expectations
7. Respects Diverse Talents and Ways of Learning
PRINCIPLES OF LEARNING
Essential Aspects of the Teaching-Learning Process

Teacher’s Conceptual Student’s Conceptual

Knowledge Knowledge

Teacher’s Constructed Student Experimental

World Knowledge

Teaching PROCESS
Approaches, Attitudes, Behavior, Materials,
Modes of Learning
 TEACHING-LEARNING PROCESS

Interaction
It between the Reflection
Discussion Adaptation
consists between the learner and of the world on the
of 4 teacher and some aspect of by the learner's
teacher and performance
phases learner the world
action by the by both teacher
defined by the
learner and learner.
teacher
MODEL OF TEACHING-LEARNING SYSTEM

In this system, the relationship between learner and subject is close, all •
of them are in a dominant position.
*The role of the teacher is simply to provide a service to the learners’ work with the subject.
*This system is consistent with humanist approaches
Theories of Learning

Three main theories of learning are;

1. Behaviorism: learning is based on the individual’s behavior and response.
2. Cognitive: learning is a mental or intellectual or thinking process.
3. Humanism: focus on both the cognitive and affective (emotion, touching,
moving, etc..) qualities of the learner.
 Nurse application of Behaviorism
In applying this theory the nurse will :
 Provide sufficient practice time including both immediate and repeated testing
and return demonstration
 Provide opportunities for learners to solve problems by trial and error.
 Select teaching strategies that avoid distracting information and that evoke the
desired response
 Praise the learner for correct behavior and provide positive feedback at intervals
throughout the learning experience.
 provide a role model of desired behavior
 Nurse application of Humanism
In applying the theory the nurse will:
 Convey empathy in the nurse-client relationship
 Encourage the learner to establish goals and promote self-directed learning.
 Encourage active learning by serving as a facilitator, mentor, or resource for the
learner.
 Use active learning strategies to assist the clients’ adaptation to new behavior.
 Expose the learner to new relevant information and ask appropriate questions to
encourage the learners to seek answers.
 Assessment of Learning

Educational Learning Domains of Learning

Domain of Domain of Domain of

Specific Intermediate General
Practical Communication Intellectual
Objectives Objectives Objectives
(Psychomotor) (Affective) (Cognitive)
Learning Domains
Learning occurs in three domains:
Bloom’s (1956) three learning Domains
1. Cognitive 2. Psychomotor 3. Affective
Cognitive: Thinking/understanding Domain (has to do with storing and
recalling new knowledge).
E.g. A client stated how sugar affects her blood glucose
Behavioral Hierarchy
involves six intellectual abilities and thinking process= Remembering
(simplest), Understanding, Applying, Analyzing, Evaluating, and Creating
(most complex).
Bloom’s Taxonomy: Cognitive
BLOOMS TAXONOMY: PSYCHOMOTR
 Psychomotor Domain (motor skills)
This is when a physical skill has been learned. This involves acquiring skills
that require the integration of mental and muscular activity.

Behavioral Hierarchy
• Perception (simplest): be aware of objects or qualities through the use of senses
e.g. a mother identifies the pitch of her baby’s cries as a cue
• Set: readiness to take a particular action e.g. post-crash the individual uses the
best judgment to get around in a wheelchair. The client performs regular
exercises to facilitate recovery from the sustained injury
• Guided response: under the guidance of an instructor
Psychomotor
• Mechanism: gained confidence and skill in performing the behavior (more
complex skill). Has more steps than a guided response. E.g. the client is able to
fill the insulin syringe with different insulin dosage
• Complex overt response: performing a motor skill involving a complex
movement pattern e.g. paralyzed person does catheterization without a urinary
infection
• Adaptation: change a motor response to unexpected problems or a new situation
• Origination (most complex): creating new movement patterns. person act on
existing psychomotor skills and abilities. E.g. person with a motor deficit must
learn to dress, eat, walk, etc…
Verb Used: Assembles, calculate, changes, demonstrate, measures, moves,
organizes, shows
Bloom’s taxonomy: Affective
 Affective Domain (Attitude)

Deals with the expression of feelings and acceptance of attitudes, opinions,

and values.
Behavioral Hierarchy
 Receiving (simplest): willingness to attend to another word e.g. listen to
you explaining a surgical procedure
 Responding: actively participating through listening and reacting verbally
or non-verbally. E.g. the client asks what the incision will look like post-
surgery.
 Valuing: attaching worth to an object or behavior
 Organizing: developing a value system by identifying and organizing
values and resolving conflicts
Affective Domain
 Characterizing (most complex): acting and responding with a consistent value
system. E.g. a client assumes a normal lifestyle after having her breast removed
and is able to discuss positive self feeling with others

• E.g. The client accepts and understands the reason for her scheduled
hysterectomy.

Verbs used: Accept, attends, chooses, discusses, display, initiates, joins,

participate, uses, appreciate, understand, express, relates.
 Basic Learning principles

To teach effectively and efficiently you must first understand how

people learn. This depends on the following:

1. The motivation to learn

2. Ability to learn
3. Learning environment
 Teaching Methodology

Cognitive Domain includes:

1. Discussion: involve the nurse and one client or nurse with several clients.
2. Lecture: More formal method of instruction because it is controlled by the
teacher.
3. Question and answer: designed specifically to address the client or client’s
concern.
4. demonstration and return demonstration
5. Roleplay: allows the client to actively apply knowledge in a controlled
situation
 Teaching Methodology

Psychomotor Domain
1. Demonstration: provides a presentation of procedures or skills by a
nurse
e.g. Nurse demonstrates to the client how to self-administer S.Q insulin.

2. Return demonstration: permits the client to perform skill as the nurse observes
e.g. Patient demonstrates to the nurse how she will administer her S.Q insulin.
Teaching Methodology

Affective Domain

1. Role Play: allows expression of values, feelings, and attitudes

2. Discussion: allows the client to acquire support from others in a group and
permits the client to learn from other experience
Teaching Aids

1. Printed materials: must be easily readable for the learner e.g. brochures or
pamphlets etc..
2. Physical objects: Use of models
3. Audiovisuals: Must be easy to read and visible
4. Photographs: they must accurately portray details of the real items
Teaching Process
Steps
1-Assessment: This involves collecting data to analyze clients learning strengths and deficits
(what are the client’s needs).
So you looking to identify:
learning needs
Motivation
Ability to learn
Teaching resources from the client
Family learning environment
Medical record
Nursing History
literature
 So where is the data collected from?
1. Nursing history provides clues to learning needs.
Elements include:
a) Age: health teaching content. Observing children play. The older adult may
have a recall or psychomotor limitation.
b) Client understanding and perception of health promotion: deficit
knowledge or misinformation about current health problems etc... (home care-
the nurse can educate on community resources and services).
c) Health beliefs and practices: important to consider before teaching.
d) Cultural factors: discuss the client’s perspective on illness and therapy.
Assessment

e) Economic factor: affordability of required equipment or tools.

f) Learning style
g) Support system
2. Physical assessment
3. Motivation
4. Readiness to learn
5. Health literacy
Teaching Process cont’d

2- Make an educational Diagnosis: identify the client’s learning needs based on

the three learning domains.

For example when writing a nursing diagnosis of knowledge

When writing a nursing diagnosis where the learning need is a primary concern
use the following label: Deficient Knowledge or Knowledge deficit

One Client Goal must be: Client will acquire knowledge about----
 Teaching plan

3- Planning: Develop a teaching plan:

Write learning outcomes (learning objectives):
*select which learning domain will be used in teaching.*choose verbs that
are specific to the domain.
Observable or measurable content
Timing or condition under which the objective is measured
 Components of the Teaching Plan
• Aim
• Objectives
• Time
• Date
• Venue
• Number of Participants
• Level of Participants
• Methodology
• Teaching Aids
• Scientific principle
• Objectives – with content
• Evaluation
Teaching plan cont’d

Select content and time frame: what is the information the client will need to
meet the learning objectives successfully?
E.G At the end of 20 minutes client will be able to:
1. Verbalize drug dosage
2. Explain his disease condition
3. Demonstrate the use of an insulin syringe

Select teaching strategy: What are you going to use to teach the client (method)
 Teaching Process

4- Implement the teaching plan: carry out the actual teaching (Include family and
others as necessary).

5- Evaluation: Determine how you are going to evaluate the client outcome
(question and answer, return demonstration, etc).
Outcome not met
Revise the teaching plan if learning objectives were not met
Alter content and teaching strategies
Reschedule teaching session
Evaluating Learning

Learning is not complete until the nurse evaluates the outcomes of the
Teaching-learning process.
Cognitive Domain: Questioning

Psychomotor: return demonstration

Affective: Client response

 Documentation
Provides a legal record and communicate the teaching to other health professional.
What to document?
1.Diagnosed learning needs
2.Learning outcomes
3.Topic taught
4.Need for additional teaching
5.Resources provided

e.g. Deficient knowledge related to self-administration of S.Q insulin. The client demonstrates the

appropriate technique for self-administration of S.Q insulin. States that she was nervous at first, but

now is confident. More education on identifying the required units to be administered is necessary. The

client was provided steps to administer S.Q insulin and guidelines on how to identify insulin dosage.
Factors Affecting Learning
Age and Developmental Stage

• This influence the client’s ability to learn

• Factors associated with client readiness to learn to include physical,
cognitive, and psychosocial maturation.
• E.g. children usually take longer to learn because they lack the personal
experience to relate the information given in comparison to an adult.
 Factors Affecting Learning
Readiness (physical, emotional, cognitive): is demonstrated by the behaviors
or cues (desire or willingness)that reflect the learner’s motivation to learn at a
specific time.
 Time is very important because it will prevent the learner from gaining
knowledge if the time is inappropriate (e.g. if the patient is in pain or is
emotionally upset).

Active Involvement: If the learner participates in planning and discussion,

learning becomes faster, and retention is better and more meaningful.
Factors Affecting Learning
Passive learning, such as listening to a lecturer or watching a film, does
not foster optimal learning.
Learning is facilitated when the client is interested and actively involved.

Relevance: must be personally relevant to the client because learning is more

easily when they can connect the new knowledge with what they already know.
Hence, nurses need to know the relevance of learning with the client through the
learning process
Factors Affecting Learning
Simple to complex learning: material should be from simple to complex. This help
the learner to understand new information, assimilate it with previous learning,
and form a new understanding (must assess client level of education).

Repetition: of key concepts and facts facilitate retention of newly learned

materials.

Timing: time between learning and activities should be short. The longer the time
interval, the easier it is to forget that which was learned.
Factors Affecting Learning

Environment: reduce distraction and provide physical and psychological

comfort these will optimize learning.
E.g. glaring light, loud noise (can interfere with thinking and listening), hot room
temperature, privacy, seating arrangement (necessary when choosing the
setting).
Consideration: nurses can teach when visitors are not around.

Cultural Aspect: this includes language and values. Western medicine may
conflict with a client’s cultural healing beliefs and practices.
 Factors Affecting Learning
Psychomotor Ability: be aware of the client’s ability to carry out skills, because
psychomotor ability can be affected by health.
E.g. patient who has severe osteoarthritis of the hand may not be able to self-administer
insulin.

Physical abilities important for psychomotor skills

 Muscle: strength must be assessed
 Motor coordination: assess gross motor and fine motor
 Energy: assess the client’s level of energy and when it’s at its peak.
 Sensory acuity: sight, hearing, and touching are often necessary for educating
clients.
 Factors Affecting Learning
Motivation: to learn you must have the desire. This will influence how quickly and
how much a person learns.
 Persons who are motivated recognize and believe the need will be met through
learning.
 Sometimes clients need relevant information before they can see the need to be
motivated.
 Offer continuing support and encouragement.
 Demonstrate a positive attitude toward the client.
 Assist the client to identify the benefits of changing behavior.
 Factors Affecting Learning

Feedback: the client needs to know about his performance in reaching the desired goal.

 Support the desired behavior through praise

 positively worded correction
 Suggesting alternative methods is positive feedback.

Nonjudgmental: learning is best when an individual feels that they are accepted and
will not be judged.
 COMPARISON BETWEEN EDUCATION PROCESS AND NURSING PROCESS: SIMILARITIES

• They consist of the four basic elements of (assessment, planning, implementation, and
evaluation).
• They are logical, scientifically-based frameworks for nursing.
• They provide a rationale basis for nursing practice rather than an intuitive
(spontaneous) one.
• They are methods for monitoring and judging the overall quality of the educational
process and nursing interventions based on objective data, and scientific criteria.
• If the outcomes in either process are not achieved, as determined by evaluation, the
nursing process or the education process can and should begin again through
reassessment, re-planning, and reimplementation
COMPARISON BETWEEN EDUCATION PROCESS AND NURSING PROCESS: DIFFERENCES

Elements Nursing Process Education Process

Assessment Appraise physical and Ascertain (determine) learning needs
psychological needs. readiness (willing) to learn and learning
styles.

Planning
Develop care plan based on Develop teaching plan based on
mutually goal setting to meet mutually predetermined behavioral
individual needs. outcomes to meet individual needs.
Implementation
Carryout nursing care Perform the act of teaching using
interventions using standard specific instructional methods and.
procedures. tools
Evaluation
Determine physical and Determine behavioral changes (outcomes)
psychological outcomes. in knowledge, attitude and practical
skills.
 References
Berman, A., & Snyder, S.J. (2012) Kozier & Erb’s Fundamentals of nursing: Concepts, process, &
practice. (8th ed.). New Jersey: Pearson Education

Berman, A., Snyder, S.J., Frandsen, G. (2016). Kozi fundamentals of nursing:

Concepts, process, & practice (10th ed.). Pearson Education Limited.

Potter, P.A. & Perry. A.G. (2005). Fundamentals of nursing. (6th ed.). St. Louis, MI: Mosby.