HE- Midterms File Compilation PDF

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1M: CONCEPT OF TEACHINGHISTORICAL FOUNDATIONS OF THENURSE Health education has long been considered a standard care-giving role of the nurse. Patient teaching is recognized as an independent nursing function. Nursing practice has expanded to include education in the broad concepts of health and illn...

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HEALTH EDUCATION 1M: CONCEPT OF TEACHING HISTORICAL FOUNDATIONS OF THE NURSE •

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Health education has long been considered a standard care-giving role of the nurse. Patient teaching is recognized as an independent nursing function. Nursing practice has expanded to include education in the broad concepts of health and illness. American Hospital Association (AHA) – Patient’s Bill of Rights ensures that clients receive complete and current information. – Patient education was a significant part of Patient’s Bill of Rights. The Joint Commission (TJC) – Accreditation mandates require evidence of patient education to improve outcomes. Healthy People 2000, Healthy People 2010 and Healthy People 2020 established educational programs. Pew Health Professions Commission – put forth a set of health profession competencies for the 21st century – Many of the competencies dealing with teaching.

EVOLUTION OF THE ROLE OF NURSES -

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SEGADOR, ANDREA LUNHAYAN

TEACHING

In nursing, patient education has long been a major component of standard of care given by nurses. Florence Nightingale was the ultimate educator. National League of Nursing Education (NLNE), now the National League of Nursing (NLN) – observed in 1918 that the health teaching is an important function within the scope of nursing practice American Nurses Association (ANA) – responsible for establishing standards and qualifications for practice, including patient teaching. International Council of Nurses (ICN) – endorses health education as an essential component of nursing care delivery. State Nurse Practice Acts – Universally include teaching within the scope of nursing practice. – Nursing career ladders often incorporate teaching effectiveness as a measure of excellence in practice. Training of Trainers Clinical Instructors

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HEALTH EDUCATION 1M: CONCEPT OF TEACHING

PURPOSE, GOALS, AND BENEFITS OF CLIENT AND STAFF EDUCATION THE EDUCATION PROCESS •

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Purpose: To increase the competence and confidence of clients to manage their own selfcare and of staff and students to deliver high-quality care. Benefits of education to clients: Increases consumer satisfaction Improves quality of life Ensures continuity of care Decreases client anxiety Reduces incidence of illness complications Promotes adherence to treatment plans Maximizes independence Empowers consumers to become involved in planning their own care Benefits of education to staff: Enhances job satisfaction Improves therapeutic relationships Increases autonomy in practice Provides opportunity to create change that matters

SEGADOR, ANDREA LUNHAYAN

Definition of Terms: 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. Teaching/Instruction - A deliberate intervention that involves sharing information and experiences to meet the intended learner outcomes. Learning - A change behavior (knowledge, attitudes, and/or skills) that can be observed or measured, and that can occur at any time or in any place as a result 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.

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HEALTH EDUCATION 1M: CONCEPT OF TEACHING ASSURE MODEL A useful paradigm to assist nurses to organize and carry out the education process: Analyze the learner State the objectives Select instructional methods and materials Use instructional methods and materials Require learner performance Evaluate/Revise the teaching plan

EDUCATION PROCESS IS PARALLEL TO THE NURSING PROCESS

Nursing Process Appraise physical and psychosocial needs

Education Process ASSESSSMENT

Ascertain learning needs, readiness to learn, and learning styles

DIAGNOSIS

Develop care plan based on mutual goal setting to meet individual needs

PLANNING

Carry out nursing care interventions using standard procedures

IMPLEMENTATION

Perform the act of teaching using specific teaching methods and instructional materials

Determine physical and psychosocial outcomes

EVALUATION

Determine behavior changes (outcomes) in knowledge, attitudes, and skills

SEGADOR, ANDREA LUNHAYAN

Develop teaching plan based on mutually predetermined behavioral outcomes to meet individual needs

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HEALTH EDUCATION 1M: CONCEPT OF TEACHING BARRIERS TO TEACHING

CONTEMPORARY 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. ROLE OF THE NURSE AS EDUCATOR (CONT’D) ❖The partnership philosophy stresses the participatory nature of the teaching and learning process. ❖The new educational paradigm focuses on the learner learning. ➢ Instead of the teacher teaching ➢ The nurse becomes the “guide on the side.

Barriers to teaching are those factors impeding the nurse’s ability to optimally deliver educational services. Major barriers include: • •

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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 Environments not conducive to the teaching– learning process Absence of third-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

❖Nurse can act as facilitator, motivate individual to learn, create a positive environment for learning ❖Nurse can act as a coordinator of teaching effort and client advocate (Support) ❖The teaching role is a unique part of our professional domain.

SEGADOR, ANDREA LUNHAYAN

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HEALTH EDUCATION 1M: CONCEPT OF TEACHING 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 – Low literacy and functional health illiteracy – Loss of control, lack of privacy, and social isolation of hospital 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, fragmentation, and dehumanization of the healthcare system

THE CONCEPT OF TEACHING DEFINITION To communicate a skill or knowledge; to give instruction or insight – Webster A multi-faceted human activity for it involves a wide range of planning, strategies, interactions, organizational arrangement, and material resources that take place in teaching learning process. - Zulueta and Guimbatan (Filipino Authors) TEACHING MODEL BY GLASER Basic Teaching Model (Robert Glaser 1962)

Instructional Objectives

Entering Behavior

Instructional Procedures

Performance Assessment

The feedback loops – show how the information provided by performance assessment feeds back to each component.

SEGADOR, ANDREA LUNHAYAN

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HEALTH EDUCATION 1M: CONCEPT OF TEACHING TEACHING MODEL BY GLASER Instructional Objectives -

Goal

Entering Behavior -

What a student previously learned Intellectual ability Motivational status Certain social and cultural determinants of his learning ability

Instructional Procedures -

Test and observation used

FEEDBACK LOOP -

1. To meet the educational needs of clients 2. Increase likelihood of compliance 3. Ultimately improve health status 4. Can give effective health education for the general public 5. Help client understand the importance of Health Principles 6. Help client through education to assume self-reliance.

Teaching process

Performance Assessment -

IMPORTANCE OF TEACHING

Information provided by the performance assessment feedbacks to each adjustment. PRINCIPLES OF TEACHING

1. Good nurse-learner rapport 2. Effective communication technique 3. Learning needs of clients must be determined 4. Objectives serve as guide in planning and evaluating teaching 5. Planning time for teaching and learning 6. Control of environment 7. Learning principles must be appropriately applied 8. Teaching skill acquired through practice and observation 9. Evaluation

SEGADOR, ANDREA LUNHAYAN

ACTS OF A TEACHER INSTITUTIONAL ACTS – Acts that arise primarily because of the way the teacher’s work is organized by the institution of school (example: chaperoning, consulting parents, keeping reports) LOGICAL ACTS – Relating primarily to the element of thinking and reasoning (example: explaining, concluding, defining) STRATEGIC ACTS – terms that have to do primarily with teacher’s plan or strategy; way the material is organized or students are directed (example: motivating, counseling, encouraging, disciplining)

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HEALTH EDUCATION 2M: APPLYING LEARNING THEORIES TO HEALTHCARE CONCEPT OF LEARNING Learning - a change in behavior (knowledge , attitudes , and/or skills) that can be observed or measured, and that can occur at any time or in any place as a result of exposure to environmental stimuli (Musinki, 1999) -

is defined as a relatively permanent change in mental processing, emotional functioning, skill, and behavior as a result of exposure to different experiences.

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enables individuals to adapt to demands and changing circumstances and is crucial in Healthcare - whether for patients and families with ways to improve their health and adjust to their conditions, for students acquiring the information and skills necessary to become a nurse, or a staff nurses devising more effective approaches to educating and treating patients and one another in partnership.

LEARNING THEORIES Learning Theory - a coherent framework of integrated constructs and principles that describe, explain, or predict how people learn. - are the behaviorist, cognitive, social learning, psychodynamic, and humanistic learning theories.

Behaviorist Learning Theory - focus mainly on what is directly observed and measured. - to them, learning is a product of stimulus condition (S) and the responses (R) that follow. - views the learning as simple and ignores what goes inside an individual. - Learning is the acquisition of new behaviour through conditioning - 2 types of conditioning: 1. 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. 2. 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.

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HEALTH EDUCATION 2M: APPLYING LEARNING THEORIES TO HEALTHCARE Changing Behavior using 2. Information-Processing Operant Conditioning Perspective ● To increase behavior: - the way individuals perceive, - positive reinforcement process, store, and retrieve - negative reinforcement information from (escape or avoidance experiences determines how conditioning) learning occurs and what is ● To decrease behavior: - nonreinforcement learned. - punishment - organizing information and making it meaningful aids Cognitive Learning Theory the attention and storage - this theory stresses the process; learning occurs importance of what goes on through guidance, feedback, inside the learner. - the key to learning and changing and assessing and is the individual’s cognition correcting errors. (perception, thought, memory - focus on describing the way and ways of processing information is tracked, the information) sequence of mental - cognitive theorist maintain the operations, and the results reward is not necessary for learning. Learner’s goal and of operations. expectation are more important as these create disequilibrium, imbalance, and tension that 3. Cognitive Development forces them to act. Perspective - the cognitive learning theory has - learning depends on the a number of well known stage of cognitive perspectives. functioning, with qualitative, 1. Gestalt Perspective sequential changes in - perception and the perception, language, and patterning of stimuli thought occurring as (gestalt) are the keys to children and adults interact learning, with each learner with the environment. perceiving, interpreting, and - recognize the developmental reorganizing experiences in stage and provide her/his own way. appropriate experiences to - Learning occurs through encourage discovery. reorganization of elements to form new insights and understanding. 8 SEGADOR, ANDREA LUNHAYAN

HEALTH EDUCATION 2M: APPLYING LEARNING THEORIES TO HEALTHCARE 4. Social Constructive Perspective - a person’s knowledge may Social Learning Theory - most learning theories assume not necessarily reflect that an individual must have reality, but through direct experience to learn. collaboration and - learning is often a social process negotiation, new and significant others provide understanding is acquired. compelling examples or role - learning is development models for how to think, feel and act. - assimilation, ● Role modeling - is a central accommodation, & concept of the social learning construction are part of theory. learning - Example: A more - learning is heavily experienced nurse with influenced by the culture desirable professional attitude and behavior is and occurs as a social sometimes used as a process in interaction with mentor for less others. experienced nurse. - a learner constructs new ● Vicarious reinforcement - involves knowledge by building on determining role models are internal representations of perceived as rewarded or punished for their behavior. existing knowledge through personal interpretation of experience. 5. Social Cognition Perspective - an individual’s perceptions, beliefs, and social judgements 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. 9 SEGADOR, ANDREA LUNHAYAN

HEALTH EDUCATION 2M: APPLYING LEARNING THEORIES TO HEALTHCARE Psychodynamic Learning Theory - concepts: stage of personality development, conscious and unconscious motivations, ego-strength, emotional conflicts, defense mechanisms - it is largely a theory of motivation that stresses emotions rather than cognition or response. - the central concept of this theory is that behaviour may be conscious or unconscious and that individual may or may not be aware of their motivations and the reason why they feel, act and the way they do it. - According to this theory, the most primitive source of motivation comes from ID and is based on basic needs, impulses and desires we are born. This includes the desire to pleasurable things in life, including sex, as well as the aggressive and destructive impulses or death wishes. - To change behavior, work to make unconscious motivations conscious, build ego-strength, and resolve emotional conflicts.

Humanistic Learning Theory - learning occurs on the basis of a person’s motivation, derived from need, the desire to grow in positive ways, self-concept, and subjective feelings. - learning is facilitated by caring facilitators and a nurturing environment that encourage spontaneity, creativity, emotional expression, and positive choices. - Maslow made major contribution to this theory as he identified the hierarchy of needs, which play an important role in human motivation. - an assumption of the hierarchy is that basic-level needs must be met before individuals can be concerned with learning. Thus, patient who are hungry, tired, and in pain need to have these issues resolved before showing interest about medications.

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HEALTH EDUCATION 2M: APPLYING LEARNING THEORIES TO HEALTHCARE - the ultimate control over learning rests with the learner, COMMON PRINCIPLES OF but effective educators LEARNING influence and guide the process so that learners 1. How does learning occur? advance in their knowledge, - learning is an active process perceptions, thought, that takes place as individuals emotional maturity, and interact with their environment behavior. and incorporate new information or experiences 3. What helps ensure that learning with what they already know becomes relatively permanent? or have learned. Factors in the - first, the likelihood of learning environment that affect is enhanced by organizing the learning include the society learning experience, making it and culture, the structure or meaningful and pleasurable, pattern of stimuli recognizing the role of - learners often have a preferred emotions in learning, and by mode for takings in pacing the presentation in information (visual, motor, keeping with the learner’s auditory, or symbolic) ability to process information. - learning is an individual matter - second, practicing (mentally - a critical influence on whether and physically) new knowledge learning occurs in motivation or skills under varied conditions strengthens learning. 2. What kinds of experiences - third issue concerns facilitate or hinder the learning reinforcement. Although process? reinforcement may or may not - the educator exerts a critical be necessary, some theories influence on learning through have argued that it may be role modeling, the selection of helpful because it serves as a learning theories, and how the signal to the individual that learning experiences is learning has occurred. structured for each learner. - fourth consideration involves - acknowledge the need to whether learning transfers recognize and relate the new beyond the initial educational information to the learner’s setting. past experience.

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HEALTH EDUCATION 2M: APPLYING LEARNING THEORIES TO HEALTHCARE DOMAINS OF LEARNING Taxonomy - A taxonomy is a way to categorize things according to how they are related to one another. - divided into 3 categories or domains: C.A.P 1. Cognitive Domain 2. Affective Domain 3. Psychomotor Domain Cognitive domain - It is known as the “thinking” domain. - learning in domain involves acquiring information and addressing the development of the learner’s intellectual abilities, mental capacities, understanding and thinking process (Eggen & Kauchak, 2012) Affective domain - is known as the “feeling” domain. - learning in this domain involves an increasing internalization or commitment to feelings expressed as emotions, interests, beliefs, attitude, values, and appreci...