Healthcare related health-education-2.pptx

Healthcare related

1. II. Health Education Process

2. A. Assessing the Learner 1.Determinants of Learning • Learning Needs • Readiness to Learn • Learning Styles The learner’s characteristics that will influence learning which an educator must be aware of are: ○Learning Needs ○The Learner’s Perceptual Abilities ○Motivational Abilities or Readiness ○Reading Abilities ○Developmental Stage -Learning Style/s -Physical Abilities

3. 3 factors that affect learning ●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

4. Learning needs ○It is the gap or difference between what someone knows and what someone needs to know due to lack of knowledge, attitudes or skills.

5. Assessing Learning Needs: Bastable, 2003 ●Identify the Learner ○who is the learner, is it an individual or a group, what are the learning needs? ●Choose the right setting ○establish a trusting environment by ensuring privacy and confidentiality especially if confidential information will be shared. ●Collect data on the learner ○by determining the characteristic learning needs of the target population ●Include the learner as a source of information ○allow the learner to actively participate in identifying his needs and problems. ●Include the members of the healthcare team ○collaborate with the other health care professionals who may have knowledge with the patient. ●Determine availability of educational resources ○the materials and equipment used to demonstrate procedures should be appropriate, available, affordable, easy and simple to manipulate by the learner ●Assess demands of the organization ○examine the organizational climate, philosophy, vision, mission, and the goals to know its educational focus. ○Its focus or emphasis will dictate the learning needs of its clients and staff.

6. Assessing Learning Needs: Bastable, 2003 ●Consider time-management issues ○allow learners to identify their learning needs ○Identify potential opportunities to assess the patient anytime, anywhere ○Minimize distractions/interruptions during planned assessment interview ●Prioritize needs ○based on Maslow’s Hierarchy of needs where the basic lower level of physiologic needs must first be met before one can move up the higher, more abstract level of needs. It follows a hierarchy. Abraham Harold Maslow (April 1, 1908 - June 8,1970) ○Was a psychologist who studied positive human qualities and the lives of exemplary people. ○1954, Maslow created the Hierarchy Needs and expressed his theories in his book, “Motivation and Personality”.

7. Criteria for Prioritizing Learning Needs (Health care Education Assoc., 1985) ● Learning needs that must be immediately met since they are life threatening or are needed for survival. ۰Ex. Patient with history of recent heart attack should be taught the signs and symptoms of an impending attack and what the emergency measure are or what medicines to take

8. Determinants of Learning CATEGORIES OF LEARNERS ACCORDING TO GROWTH AND DEVELOPMENT GROWTH- is tantamount of the word “increase” or the quantitative changes in terms of learning. Growth simply means the acquisition of more knowledge which often results in maturation, while development is the orderly, dynamic changes in a learner resulting from a combination of learning, experience and maturation. DEVELOPMENT - represents the quantitative changes in an individual as evidenced by their intellectual, emotional and physiological capabilities. This encompasses the ability of the body to function consistent with growth patterns. Hence, growth and development are intertwined or interrelated in order to proceed with normal maturation process.

9. Factors Influencing Intellectual Development 1.) Maturation – refers to the biological changes in individuals that result from the interaction of their genetic makeup with the environment. 2.) Experience – refers to observing, encountering or undergoing changes of individuals which generally occur in the course of time. Experiences make up the raw material that is the basis for both learning and development. 3.) Learning – is the acquisition of knowledge, abilities, habits, attitudes, values, and skills derived from experiences with varied stimuli.

10. The Characteristics and Developmental Milestones of Each Stage Includes the following: ❖ growth and development is a continuous process from conception till death. ❖ These stages are continuous rather than discrete hence, a child develops gradually, visibly and continually. ❖ while chronological ages are attached to stages of growth and development, the rate at which children pass through them differs widely, depending on individual maturation rates and their culture. ❖ while rate varies, all children must pass through each stage before progressing to another more complex development stage.

11. Intelligence the teacher’s primary consideration in evaluating the learning needs of her students is the individual’s capacity to acquire knowledge, ability to think, abstract reasoning and capability in solving problem which is explained by the following (Feldman:2004) • Intelligence is determined by genetics and environment. • Intelligence is measured based on the results of intelligence tests or aptitude tests • Students with high aptitude need less time and less instructional support

12. The teacher can adjust and adapt instructional approaches considering the difference in student’s ability (Chiatum and Hammond:2005),as follows: A.) FLEXIBLE TIME REQUIREMENTS An indicator of intellectual differences of learning for individuals is the time requirement to grasp comprehensively the subject well. This is equated with the students’ rate of growth and their readiness to learn.

13. B.) INCREASED INSTRUCTIONAL SUPPORT To help slow learners compensate for their relative deficiency in learning, there are a number of methods available to the teacher including the following: • The teacher’s instructional style or approach must be adjusted to students’ needs for learning without compromising the topic requirements for the course to be finished; • Support of fast learners is involved in helping the slow learners through peer tutoring and group activities; • Clarify and expand explanation of the subject matter before having students attempt to ask on their own; • Break lengthy assignments into shorter segments; and • Provide frequent feedback as students work through new materials

14. C.) STRATEGY INSTRUCTION • Research shows that student achievers are more likely to use strategies that make their learning more effective. These strategic learners analyze and break down tasks or problems into smaller units and formulate solutions to tasks and problems systematically. They are also able to differentiate important concepts from the less important. • Strategic learners employ strategies in order for them to work efficiently and effective to make their tasks easier (Quinn:2000)

15. D.) PEER TUTORING • It is said that student achievers are more equipped with the necessary knowledge and skills in facing challenges of learning. They can serve as sources of information for less able students.

16. E.) COOPERATIVE LEARNING • Studies showed that students who tutor less able students even benefit more than the less able students. Student tutors are able to recall their knowledge in tutoring and further enhance their skills in skill demonstrations (Bradshaw and Lowenstein:2007). Student tutors are able to enhance their social skills during cooperative learning activities.

17. 2.) MULTIPLE INTELLIGENCE The theory of multiple intelligences was proposed by Dr. Howard Gardner, professor of education at Harvard University. The theory states that the traditional concepts of intelligence, based on IQ testing, is far too limited. He thus, proposed 8 different intelligences: a .) Linguistic Intelligence or Word-Smart Verbal-linguistic intelligence has to do with words, spoken or written. Individuals with verbal-linguistic intelligence display a facility with words and languages and are typically good at: • Reading • Writing • Telling stories • Word memorization

18. b.) LOGICAL-MATHEMATICAL Students who have high logical-mathematical intelligence are good in: • Logical reasoning • Abstractions • Inductive and deductive reasoning, and numbers c.) SPATIAL This type of intelligent has to do with vision and spatial judgement. People with strong visual-spatial intelligence are good in the following. • Visual and mental manipulation of objects • Visual memory • Art and geographic directions.

19. d .) BODILY KINESTHETIC This intelligence has to do with movement. Individuals with this intelligence excel in: • Sports • Dance and • Other activities related to movement e.) MUSICAL Has to do with music, music composition, rhythm, and hearing. Individual with high musical intelligence are good in: • Singing • Musical composition and • Playing musical instrument

20. f.) INTERPERSONAL Good in interacting with others. They are usually extroverts sensitive to others needs, feelings, interest and motivations. They are good in: • Communication • Leadership • Negotiations and politics. g.) INTRAPERSONAL Has to do with introspective and self-reflective capacities. They are good in: • Psychology • Analysis • Philosophy and theology

21. h.) NATURALISTIC INTELLIGENCE Has to do with nature, nurturing and relating information to ones natural surroundings. They are usually good in: • Botany • Zoology • Metaphysics • Ontology • Astronomy • Environmental science

22. EPISTEMOLOGY is a concept that deals with the nature of knowledge, in particular, and the different aspects of which people “know”. This includes: • Conceptual Knowledge - consists of ideas or abstract understanding of an actual thing or event such as the shape of an apple. • Perceptual Knowledge – this is derived from one’s senses such as the color of an apple. • Intuitive Knowledge – the cognitive meaning of a thing independent of reason such as gut feeling or intuition.

23. AXIOLOGY - is a concept which relates to the ideas of right and wrong and the means by which the two are delineated. AESTHETICS – deals with beauty and ugliness. OTHER INTELLIGENCE- includes spiritual, existential and moral intelligence. • According to Gardner, existential intelligence is the capability to raise and reflect on philosophical questions about life, death and ultimate realities.

24. EMOTIONAL INTELLIGENCE Is a combination of competencies. This skill contributes to an individual’s capability to manage and monitor his or her own emotions, to correctly gauge the emotional state of others and to influence opinions (Caudron, 1999; Goleman, 1998)

25. Self-awareness - is the ability to recognize one’s own feeling as this happens, to accurately perform self-assessment and have self-confidence. It is the keystone of emotional intelligence . Self-management or Self-regulation - is the ability to keep disruptive emotions and impulses in check (self-control), maintain standards of honesty and integrity (trustworthiness), takes responsibility for one’s performance (conscientiousness), handle change (adaptibility), and be comfortable with novel ideas and approaches (innovation) Motivation - is the emotional tendency of guiding and facilitating the attainment of goals through: a.) Achievement drive to meet a standard of excellence

26. Motivation - is the emotional tendency of guiding and facilitating the attainment of goals through: a.) Achievement drive to meet a standard of excellence b.) Commitment or the alignment of goals with the group or organization. c.) Initiative to act on opportunities d.) Optimism or the persistence to reach goals despite set-backs.

27. Empathy - is the understanding of others by being aware of their needs, perspective, feelings, concerns, and sensing others developmental needs. Social skills - are fundamental to emotional intelligence. They include : • Influence, or the ability to induce desirable responses in others through effective diplomacy of persuading. • Communication or the ability to both listen openly and send convincing messages. • Leadership, or the ability to inspire and guide group and individuals. • Building bonds, or nurturing instrumental relationships. • Collaboration and cooperation with others towards a shared goal. • Create groups synergy, the ability to pursue collective goals.

28. SOCIOECONOMIC STATUS (SES) • Is a measure of a family’s position in society as determined by family income, its member’s occupation, and level of education. SES affects learning both at home and in school. • Poverty affects a learner’s well-being and quality of life. This is turn affects the student’s concentration, learning potentials, motivation, interest and participation in class.

29. CULTURE Refers to attitude, values, customs and behavior patterns that characterize a social group. Influence’s school success, though the student’s attitude and values and ways of viewing the world that are held and transmitted by a culture (Brecken: 1994)

30. Culture influences the following: a.) Student’s Attitude and Values To become a good student, one must be able to adopt to the cultural values imposed by the school as a learning institution. This is often base on its mission, vision, objectives and goals whether it is secular or non secular institution. b.) Classroom Organization Student work and learn individually. Emphasis is placed on individual responsibility, which is often reinforced by grades and competition. Competition demands both success and failures, and the success of one student is tied to the failure of another.

31. c.) School Communication Cultural conflict in communication may occur in an institution with student from diverse ethnicities. Communication signals may not always have the same meaning to another student of a different ethnicity.

32. GENDER DIFFERENCES a.) Different treatment of Boys and Girls A baby girl is handled more delicately while a baby boy is seen as tougher and more hardly. In regard to discipline, fathers are rougher and physical with their sons compared to their daughters whom they tend to discipline verbally. b.) Stereotyping Boys and Girls Males are considered better in Mathematics while females are better in English. Female student who has potential in the field of Mathematics may be unable to explore their potential due to the belief that females are not good as males when it comes to numbers.

33. AT – RISK STUDENT Are those in danger of failing to complete their education. They have learning problems and adjustment difficulties. They often fail even though they have the capability to succeed.

34. CHARACTERISTICS OF AT – RISK STUDENTS BACKGROUND FACTORS: * Low SES – Minority * Inner City – English as a second language * Male – Separated families * Transience- the  quality  of being  transient  (=  temporary )

35. EDUCATIONAL PROBLEMS * High dropout rate – high-rate f drug use * Lower grades – Management problems * Retention in grade – low self-esteem * Low achievement – high criminal activity rates * Less involvement in extracurricular activities- Low test score * Low motivation – Dissatisfaction with and lack on interest in school * Poor attendance – High suspension rates

36. LEARNING NEEDS BASED ON MASLOWS HIERARCHY OF NEEDS Maslow’s Hierarchy of needs is divided into 2 categories: 1.) Deficiency Needs – those needs whose absence energizes or moves people to meet them. Until lower need is met, an individual is unlikely to move to a higher need. 2.) Growth Needs – needs “met”, as they expand and grow as people have experiences with them. This require people to indulge in activities that are physically and psychologically stimulating and enhances strength and vigor to proceed to a higher-level task.

37. OTHER LEARNING NEEDS 1.) The Needs for Competence a. Competence motivation is an inmate need in human beings. b. Competence motivation creates drive in oneself to master tasks and enhance skills c. Competence motivation is essential in coping with the fast-changing environment. 2.) The Need for Control and Self-Determination a. As stated in the Bible, man is a steward to God’s creation. Hence, there is need for control. b. Man continuously strives for competence and autonomy c. Teachers may satisfy a students need for control by encouraging inputs such as opinions, suggestion and criticism, among others, during class lectures and discussion. 3.) The Need To Achieve a. Achievement motivation is the drive to excel in learning tasks to experience pride in accomplishment. b. The need to achieve is balanced by the need avoid failure. c. Students with high need for achievement tend to be motivated by challenging assignments, high grading standards, explicit feedback and the opportunity to try to face challenges in life.

38. THE EDUCATOR’S ROLE IN LEARNING The learner—not the teacher—is the single most important person in the education process. Educators can greatly enhance learning when they serve as facilitators helping the learner become aware of what needs to be known, why knowing is valuable, and how to be actively involved in acquiring information ( Musinski, 1999 ).

39. The educator plays a crucial role in the learning process by doing the following: • Assessing problems or deficits • Providing important information and presenting it in unique and appropriate ways • Identifying progress being made • Giving feedback and follow-up • Reinforcing learning in the acquisition of new knowledge, skills, and attitudes • Evaluating learners’ abilities

40. The following are important steps in the assessment of learning needs: 1. Identify the learner . Who is the audience? If the audience is one individual, is there a single need or do many needs have to be fulfilled? Is there more than one learner? If so, are their needs congruent or diverse? The development of formal and informal education programs for patients and their families, nursing staff, or students must be based on accurate identification of the learner. For example, an educator may believe that all parents of children with asthma need a formal class on potential hazards in the home. This perception may be based on the educator’s interaction with a few patients and may not be true of all families.

41. 2. Choose the right setting . Establishing a trusting environment helps learners feel a sense of security in confiding information, believe their concerns are taken seriously and are considered important, and feel respected. Ensuring privacy and confidentiality is recognized as essential to establishing a trusting relationship.

42. 3. Collect data about the learner . Once the learner is identified, the educator can determine characteristic needs of the population by exploring typical health problems or issues of interest to that population. Subsequently, a literature search can assist the educator in identifying the type and extent of content to be included in teaching sessions as well as the educational strategies for teaching a specific population based on the analysis of needs. For example, Bibb (2001 ) collected data about a targeted patient population at one military treatment facility and found that education programs did not provide adequate support for the growing number of participants who were older and more chronically ill. Rutten, Arora, Bakos, Aziz, and Rowland (2005 ) studied patients with cancer to determine the characteristic learning needs of that population.

43. 4. Collect data from the learner . Learners are usually the most important source of needs assessment data about themselves. Allow patients and/or family members to identify what is important to them, what they perceive their needs to be, which types of social support systems are available, and which kind of assistance these supports can provide. If the audience for teaching consists of staff members or students, solicit information from them as to those areas of practice in which they feel they need new or additional information. Actively engaging learners in defining their own problems and needs motivates them to learn because they are invested in planning for a program specifically tailored to their unique circumstances. Also, the learner is important to include as a source of information because, as noted previously, the educator may not always perceive the same learning needs as the learner.

44. 5. Involve members of the healthcare team . Other health professionals likely have insight into patient or family needs or the educational needs of the nursing staff or students as a result of their frequent contacts with both consumers and caregivers. Nurses are not the sole teachers of these individuals; thus they must remember to collaborate with other members of the healthcare team for a richer assessment of learning needs. This consideration is especially important because time for assessment is often limited. In addition to other health professionals, associations such as the American Heart Association, the American Diabetes Association, and the American Cancer Society are excellent sources of health information.

45. 6. Prioritize needs. A list of identified needs can become endless and seemingly impossible to accomplish. Maslow’s (1970 ) hierarchy of human needs can help the educator prioritize so that the learner’s basic needs are attended to first and foremost before higher needs are addressed. For example, learning about a low sodium diet cannot occur if a patient faces problems with basic physiological needs such as pain and discomfort; these latter needs must be addressed before any other higher-order learning can occur. Setting priorities for learning is often difficult when the nurse educator is faced with many learning needs in several areas. Prioritizing the identified needs helps the patient or staff member to set realistic and achievable learning goals. Choosing which information to cover is imperative, and nurse educators must make choices deliberately.

46. • Mandatory: Needs that must be learned for survival or situations in which the learner’s life or safety is threatened. Learning needs in this category must be met immediately. For example, a patient who has experienced a recent heart attack needs to know the signs and symptoms and when to get immediate help. The nurse who works in a hospital must learn how to do cardiopulmonary resuscitation or be able to carry out correct isolation techniques for self-protection. • Desirable Needs that are not life dependent but that are related to well-being or the overall ability to provide quality care in situations involving changes in institutional procedure. For example, it is important for patients who have cardiovascular disease to understand the effects of a high-fat diet on their condition. It is desirable for nurses to update their knowledge by attending an in-service program when hospital management decides to focus more attention on the appropriateness of patient education materials in relation to the patient populations being served. • Possible : Needs for information that is nice to know but not essential or required or situations in which the learning need is not directly related to daily activities. For example, the patient who is newly diagnosed as having diabetes mellitus most likely does not need to know about self-care issues that arise in relationship to traveling across time zones or staying in a foreign country because this information does not relate to the patient’s everyday activities. TABLE 4-1 Criteria for Prioritizing Learning Needs

47. 7. Determine availability of educational resources. The educator may identify a need, but it may be useless to proceed with interventions if the proper educational resources are not available, are unrealistic to obtain, or do not match the learner’s needs. In this case, it may be better to focus on other identified needs. For example, a patient who has asthma needs to learn how to use an inhaler and peak flow meter. The nurse educator may determine that this patient learns best if the nurse first gives a demonstration of the use of the inhaler and peak-flow meter and then allows the patient the opportunity to perform a return demonstration. If the proper equipment is not available for demonstration/return demonstration at that moment, it might be better for the nurse educator to concentrate on teaching the signs and symptoms the patient might experience when having poor air exchange than it is to cancel the encounter altogether. Thereafter, the educator would work immediately on obtaining the necessary equipment for future encounters.

48. 8. Assess the demands of the organization. This assessment yields information that reflects the climate of the organization. What are the organization’s philosophy, mission, strategic plan, and goals? The educator should be familiar with standards of performance required in various employee categories, along with job descriptions and hospital, professional, and agency regulations. If, for example, 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.

49. 9. Take time-management issues into account. Because time constraints are a major impediment to the assessment process, Rankin and Stallings (2005 ) suggest the educator should emphasize the following important points with respect to time management issues: • Although close observation and active listening take time, it is much more efficient and effective to take the time to do a good initial assessment upfront than to waste time by having to go back and uncover information that should have been obtained before beginning instruction. • Learners must be given time to offer their own perceptions of their learning needs if the educator expects them to take charge and become actively involved in the learning process. Learners should be asked what they want to learn first, because this step allays their fears and makes it easier for them to move on to other necessary content ( McNeill, 2012 ). This approach also shows that the nurse cares about what the learner believes is important.

50. • Assessment can be conducted anytime and anywhere the educator has formal or informal contact with learners. Data collection does not have to be restricted to a specific, predetermined schedule. With patients, many potential opportunities for assessment arise, such as when giving a bath, serving a meal, making rounds, and distributing medications. For staff, assessments can be made when stopping to talk in the hallway or while enjoying lunch or break time together. • Informing a patient ahead of time that the educator wishes to spend time discussing problems or needs gives the person advance notice to sort out his or her thoughts and feelings. In one large metropolitan teaching hospital, this strategy proved effective in increasing patient understanding and satisfaction with transplant discharge information ( Frank-Bader et al., 2011 ). Patients and their families were informed that a specific topic would be discussed on a specific day. Knowing what to expect each day allowed them to review the appropriate handouts ahead of time and prepare questions. It gave patients and family members the time they needed to identify areas of confusion or concern.

51. • Minimizing interruptions and distractions during planned assessment interviews maximizes productivity. In turn, the educator might accomplish in 15 minutes what otherwise might have taken an hour in less directed, more frequently interrupted circumstances.

52. METHODS TO ASSESS LEARNING NEEDS Informal Conversations Often learning needs are discovered during impromptu conversations that take place with other healthcare team members involved in the care of the client and between the nurse and the patient or his or her family. The nurse educator must rely on active listening to pick up cues and information regarding learning needs. Staff can provide valuable input about their learning needs by responding to open ended questions.

53. METHODS TO ASSESS LEARNING NEEDS Structured Interviews The structured interview is perhaps the form of needs assessment most commonly used to solicit the learner’s point of view. The nurse educator asks the learner direct and often predetermined questions to gather information about learning needs. As with the gathering of any information from a learner in the assessment phase, the nurse should strive to establish a trusting environment, use open-ended questions, choose a setting that is free of distractions, and allow the learner to state what are believed to be the learning needs.

54. METHODS TO ASSESS LEARNING NEEDS Structured Interviews Interviews yield answers that may reveal uncertainties, conflicts, inconsistencies, unexpected problems, anxieties, fears, and present knowledge base. Examples of questions that nurse educators can ask patients as learners are as follows: • What do you think caused your problem? • How severe is your illness? • What does your illness/health mean to you? • What do you do to stay healthy? • Which results do you hope to obtain from treatments? • What are your strengths and limitations as a learner? • How do you learn best? If the learner is a staff member or student, the following questions could be asked: • What do you think are your biggest challenges to learning? • Which skill(s) do you need help in performing? • Which obstacles have you encountered in the past when you were learning new information? • What do you see as your strengths and limitations as a learner? • How do you learn best? These types of questions help to determine the needs of the learner and serve as a foundation for beginning to plan an educational intervention.

55. METHODS TO ASSESS LEARNING NEEDS Focus Groups Focus groups involve getting together a small number (4 to 12) of potential learners ( Breitrose, 1988 ) to determine areas of educational need by using group discussion to identify points of view or knowledge about a certain topic. With this approach, a facilitator leads the discussion by asking open-ended questions intended to encourage detailed discussion. It is important for facilitators to create a safe environment so that participants feel free to share sensitive information in the group setting ( Shaha, Wenzel, & Hill, 2011 ). In research focus groups, having a facilitator who is not known to members of the group can help to prevent feelings of coercion or conflict of interest. This also should be the case for focus groups assessing learning needs, because participants may fear that sharing information about their areas of weakness may be held against them in the future. The groups of potential learners in most cases should be homogeneous, with similar characteristics such as age, gender, and past experience with the topic under discussion. However, if the purpose of the focus group is to solicit attitudes about a particular subject or to discuss ethical issues, for example, it may not be necessary or recommended to have a homogeneous group. Focus groups are ideal during the initial stage of information gathering to provide qualitative data for a complete assessment of learning needs and can be a rich source of information when exploring sensitive nursing issues ( Papastavrou & Andreou, 2012 ).

56. METHODS TO ASSESS LEARNING NEEDS Self-Administered Questionnaires Nurse educators can obtain learners’ written responses to questions about learning needs by using survey instruments. Checklists are one of the most common forms of questionnaires. They are easy to administer, provide more privacy compared to interviews, and yield easy-to-tabulate data. Learners seldom object to this method of obtaining information about their learning needs. Sometimes learners may have difficulty rating themselves and may need the educator to clarify terms or provide additional information to help them understand what is being assessed. The educator’s role is to encourage learners to make as honest a self-assessment as possible. Because checklists usually reflect what the nurse educator perceives as needs, a space should be provided for the learner to add any other items of interest or concern. One example of a highly reliable and valid self-assessment tool is the Patient Learning Needs Scale ( Redman, 2003 ). This instrument is designed to measure patients’ perceptions of learning needs to manage their health care at home following a medical or surgical illness ( Bubela et al., 2000 ).

57. METHODS TO ASSESS LEARNING NEEDS Tests Giving written pretests before teaching is planned can help identify the knowledge levels of potential learners regarding a particular subject and assist in identifying their specific learning needs. In addition, this approach prevents the educator from repeating already known material in the teaching plan. Furthermore, pretest results are useful to the educator after the completion of teaching when pretest scores are compared with posttest scores to determine whether learning has taken place. The Diabetes Knowledge Test is an example of a tool used to assess learning needs for self-management of diabetes ( Panja, Starr, & Colleran, 2005 ). When investigating this tool, researchers compared patients’ diabetes knowledge with their glycemic control. Their findings demonstrated that an inverse linear relationship exists between performance on this diabetes test and HbA1c values. This test is available from the Michigan Diabetes Research and Training Center ( www.med.umich.edu/mdrtc/profs/survey.html#dkt ). Redman (2003 ) describes this and many other measurement instruments for patient education that measure knowledge and learning assessment. The educator must always consider the reported characteristics of the self administered questionnaire or test before using it. Specific criteria to consider include what the purpose of the tool is (i.e., if it is relevant to what the nurse educator plans to assess), whether the results will be meaningful, whether each of the measured constructs is well defined, whether adequate testing of the instrument has been conducted, whether the instrument has been used in a similar setting, and whether the instrument has been used with a population similar to the educator’s. The educator needs to consider the purpose, conceptual basis, development, and psychometric properties when evaluating the adequacy of any questionnaire or test ( Waltz, Strickland, & Lenz, 2005 ).

58. METHODS TO ASSESS LEARNING NEEDS Observations Observing health behaviors in several different time periods can help the educator draw conclusions about established patterns of behavior that cannot and should not be drawn from a single observation. Actually watching the learner perform a skill more than once is an excellent way of assessing a psychomotor need. Are all steps performed correctly? Does the learner have any difficulty with manipulating various pieces of equipment? Does the learner require prompting? Learners may believe they can accurately perform a skill or task (e.g., walking with crutches, changing a dressing, giving an injection), but by observing the skill performance the educator can best determine whether additional learning may be needed. Learners who can observe a videotape of themselves performing a skill can more easily identify their learning needs. In this process, which is known as reflection on action ( Grant, 2002 ), the learner identifies what was done well and what could have been done better in his or her actual performance. Landry, Smith, and Swank (2006 ) provide evidence to support this method of assessing learning needs in their study measuring mothers’ critiques of their own videotaped responsive behaviors in the home setting that would facilitate their infants’ development.

59. METHODS TO ASSESS LEARNING NEEDS Documentations Initial assessments, progress notes, nursing care plans, staff notes, and discharge planning forms can provide information about the learning needs of clients. Nurse educators need to follow a consistent format for reviewing charts so that they review each chart in the same manner to identify learning needs based on the same information. Also, documentation by other members of the healthcare team, such as physical therapists, social workers, respiratory therapists, and nutritionists, can yield valuable insights with respect to the needs of the learner.

60. Assessing the Learning Needs of Nursing Staff WRITTEN JOB DESCRIPTIONS A written description of what is required to effectively carry out job responsibilities can reflect the potential learning needs of staff. Such information forms the basis for establishing content in an orientation program for new staff, for example, or for designing continuing education opportunities for experienced staff members.

61. Assessing the Learning Needs of Nursing Staff FORMAL AND INFORMAL REQUESTS Often staff are asked for ideas for educational programs, and these ideas reflect what they perceive as needs. When conducting a formal educational program, the educator must verify that these requests are congruent with the needs of other staff members.

62. Assessing the Learning Needs of Nursing Staff QUALITY ASSURANCE REPORTS Trends found in incident reports indicating safety violations or errors in procedures are a source of information in establishing learning needs of staff that education can address.

63. Assessing the Learning Needs of Nursing Staff CHART AUDITS Educators can identify trends in practice through chart auditing. Does the staff have a learning need in terms of the actual charting? Is a new intervention being implemented? Does the record indicate some inconsistency with implementation of an intervention?

64. Assessing the Learning Needs of Nursing Staff RULES AND REGULATIONS A thorough knowledge of hospital, professional, and healthcare requirements helps to identify possible learning needs of staff. The educator should monitor new rules of practice arising from changes occurring within an institution or external to the organization that may have implications for the delivery of care.

65. FOUR-STEP APPRAISAL OF NEEDS Panno (1992 ), expanding on Knox’s (1974 , 1977 , 1986 ) interest in teaching related to adult development and learning, describes a systematic approach for assessing the learning needs of staff nurses and the organizations in which they practice. Knox’s interpretation of how adults learn has important implications for the development and coordination of education programs that are responsive to the backgrounds and aspirations of various adult learners. Panno’s four steps in assessing learning needs are as follows: 1. Define the target population 2. Analyze learner and organizational needs 3. Analyze the perceived needs of the learner and compare them to the actual needs 4. Use data to prioritize identified learning needs

66. READINESS TO LEARN Readiness to learn can be defined as the time when the learner demonstrates an interest in learning the information necessary to maintain optimal health or to become more skillful in a job. Often, educators have noted that when a patient or staff member asks a question, the time is prime for learning . Readiness to learn occurs when the learner is receptive, willing, and able to participate in the learning process. It is the responsibility of the educator to discover through assessment exactly when patients or staff are ready to learn, what they need or want to learn, and how to adapt the content to fit each learner.

67. Take Time to Take a PEEK at the Four Types of Readiness to Learn P = Physical Readiness • Measures of ability • Complexity of task • Environmental effects • Health status • Gender E = Emotional Readiness Anxiety level • Support system • Motivation • Risk-taking behavior • Frame of mind • Developmental stage E = Experiential Readiness • Level of aspiration • Past coping mechanisms • Cultural background • Locus of control • Orientation K = Knowledge Readiness • Present knowledge base • Cognitive ability • Learning disabilities • Learning styles

68. DIFFERNCE BETWEEN THE EDUCATION PROCESS AND THE NURSING PROCESS 🞆 A) THE NURSING PROCESS- focuses on planning and implementation of care based on assessment and diagnosis of the physical and psychosocial needs of the patient. 🞆 B) THE EDUCATION PROCESS- focuses on planning and implementation of teaching based on assessment and prioritization of learner’s needs, readiness to learn and learning style.

69. STEPS IN EDUCATION PROCESS 🞆 ASSESSMENT- Gathering of data about the learners demographic, profile, skills and abilities needed in identifying the most appropriate teaching strategy for a particular learner. 🞆 PLANNING- A carefully organized written presentation of what the learner needs to learn and how the nurse educator is going to provide the teaching. 🞆 IMPLEMENTATION- An application of the teaching plan- the point where theoretical and practical aspects of the teaching –learning process meet as the applies the plan to the learners. 🞆 EVALUATION- The measurement teaching-learning performance of both teachers and learners.

70. 🞆 EDUCATION PROCESS - is a systematic, sequential, logical, scientifically based planned course of action consisting of teaching and learning. It is a cycle that involves a teacher and a learner. A teacher – learner process occurs before the lesson begins and continues after the last lesson ends.

71. BARRIERS TO EDUCATION -Martin Luther King, Jr. 🞆 Education demands a healthy environment conducive to effective assimilation of knowledge and skills learned. However, some forces or barriers may exist to prevent or reduce the students ability to avail of their rights to quality education. 🞆 Barriers to education can take a variety of Forms. They can be physical , technological, systemic, financial, or attitudinal, among others. Following appear to be main barriers to education concerning students and teachers . (Brekon1994)

72. 1. Student Factors a. Physical disability- students with disability continue to encounter physical barriers to educational services, such as lack of ramps and/or elevators in multi-level school buildings, heavy doors, inaccessible washrooms, and or inaccessible transportation to and from school. Students at the tertiary level also experience difficulty in securing accessible students housing, transportation, facilities, and communication. b. Negative attitudes and stereotypes- students with disabilities continue to face the negative attitudes of teachers and students and stereotypes in the educational, staff and access educational services equally well.

73. 1. Student Factors c. Poverty - sending students to school may result in the loss of family income or help at home. The school may charge fees that the family cannot afford to meet such as requiring uniform or projects, and other contributions to school affairs that are beyond the family budget. When a choice is to be made between sending a girl or a boy to school, the family puts its scare resources for the education of the boy, believing that is a better, long -term environment. d. Student’s Capabilities, Personal Belief and Values- Genetics and culture affect too much extent, the educative process. Students’ genetic endowment and cultural background determine the extent of substantive and curricular comprehension and retention which may pose challenge to teachers, the school administrators and the standards of education.

74. 1. Student Factors e. Students are More Likely to Drop out School if Schooling is Irrelevant To Realities- There is need for relevant curricula and materials for literacy and numeracy, along with “facts and skills of life” which include education on rights, ender quality, health, nutrition, sexually, transmitted diseases and peace.

75. 2. Institutional factors a. Inadequate Physical Facilities and Funding- Education is constrained by lack of adequate support and funding from educational agencies and facilities in relation to the number of students admitted. The burden is greater when there is also lack of library and laboratory facilities for student learning. b. Philosophy, Vision, Mission of Schools- Schools have their own values, beliefs and practices regarding teaching and learning. Schools may or may not adhere to the standard of education set by the state and the accrediting the body, hence students may leave school either well prepared or less prepared to face responsibility of work living.

76. 2. Institutional factors c. The Legal Framework around Education- Early marriage and pregnancy are widespread in many countries, yet most have laws and policies that prohibit pregnant girls from attending school or returning to school after the birth of their child. This could mean that the lack of birth certificate can prevent admission of the child from school or block eligibility to take examinations. d. Issues of Safety and Security Inside and Outside the School e. Accountability Movement This movement seeks to hold schools, teachers, and students responsible for learning. This may limit the ability of schools to meet societal standards due to external pressures and intense expectations which may weaken the system.

77. 3. Teachers Factors a . Teachers qualifications and values- education is also constrained by the ability of the teacher to teach in terms of her personality traits and values, professional behavior and her outlook in life teaching. (Gaberson and Oerman:2007) b. Knowledge, Skills, and Values of the Teacher Intellectual capabilities of teachers facilitate cognitive learning and stimulate students’ psychomotor process. Skills in teaching manage students’ creative imagination and promotes psychomotor development. The teacher’s professional values, promotes student ideals of achievement and scholastic mastery. Lack of these in teachers could lead to intellectual numbness and poor academic performance among students.

78. 3. Teachers Factors c. Inadequate Professional Preparation Educators are often expected to teach health without any college coursework in the discipline. Quality of teaching often suffers, despite no hostage of professionally prepared educators. This is a result of the “any one can teach health” misconception and the lack of administrative commitment. d. Lack of Certification- teachers in nursing education particularly those handling professional courses are obliged to undergo extensive training and must be skilled certified by an accrediting body before they are allowed to teach major nursing courses.

79. Generational differences - teaching and learning are very much influenced by the kind of generation a learner represents. this is so because of the social factors that emerge in that particular time. following are generated differences in relation to teaching and learning. 1. Baby boomers (Current Workforce) *Individuals born at the end of Word War II where social factors and experiences in life influence these generation. *baseline to compare other generation *experienced the development of slower peace *needs assistance in learning how to use computers are pressured by activities which require access to web-based resources. *more comfortable with traditional pedagogy *do not challenge the teacher *exert and answer responsibility for their own learning *strive or permanent career on the same institution, with organizational loyalty and commitment and except financial remuneration and recognition *dominant generation

80. 2. Emerging workforce : Generation X *men and women born between 1961 to 1981 compromise generation X and are known as the emerging workforce *have grown up to be the latchkey kids of working parents or single household *developed high level of independence *developed high self-esteem *creative problem solvers but lack basic math skills and reading capabilities Characteristics of Generation X (1981) (Adapted from Emerson: 2007) *Independent self-serving learners *Technologically liberal and dependent *Excel at multitasking *Adapt well change *Want flexibility, autonomy, and options on learning life *Lack interpersonal skills

81. Characteristics of Generation X (1981) (Adapted from Emerson: 2007) *Impatient with processes, outcome-oriented *Expect immediate gratification *Desire to be trusted for work performance *Desire fun and balanced of work and personal life *Want to be lead, not managed *Value money and material goods *Daring and except to be challenged

82. 3. Newest Generation: Net-Gen *individuals born after 1981 *have tendency to focus on technology, social action and globalization Characteristics of the Net Generation (1981-2002) *Technologically addicted *Social inclusion and globalization *Enhance diversity *Curious and creativity *Possess a strong work ethic *Collaborative team player

83. Characteristics of the Net Generation (1981-2002) *Highly mobile *Highly intelligent *Optimistic *Self-sufficient and assertive *Respect and admire their parents *Rule followers *Anticipate multiple career changes differences

84. WAYS OF CONSIDERING GENERATIONAL DIFFERENCES IN THE TEACHING INCLUDE: Personal awareness of each faculty members Technological competence through training and assistance if available, to align self with the three generation Design specific learning activities to motivate the students to learn best what their perceptions and expectations about there career. Computer and technology expertise, comfort with group and communication skills Encourage use of electronic media such as calculator and portable references. Talk about flexibility and variability of experiences and assignment Encourage balance from the beginning and let students identify the commitment outside the school and what they can do to reduce stress. Spell out exceptions clearly for better understanding Develop general plan for providing feedback and discuss expectations Clarity use of technology Indicate sitting time with active time Inject fun whenever appropriate

85. CONCEPTS OF TEACHING AND LEARNING 🞆 EDUCATION- An interactive process of imparting knowledge, through sharing, explaining, clarifying and synthesizing the substantive content of the learning process, for the learner to arrive at positive judgment and well developed wisdom and behavior. 🞆 HEALTH - A condition that’s permit optical functioning of the individual, enabling her to live most and to serve best her personal and social relationship. 🞆 LEARNING- Acquisition of knowledge of all kinds, abilities, habits, attitudes, values and skills to create change in an individual. 🞆 PATIENT TEACHING- Dynamic interaction between the nurse as the teacher and the patient as the learner. 🞆 TEACHING - The process providing learning materials, activities, situations and experiences to enable the clients or learners to acquire knowledge, attitudes, values and skills to facilitate self-reliant behavior. 🞆 EDUCATION PROCESS - A systematic, sequential, logical, scientifically based, planned course of action consisting of teaching and learning. It is a cycle that involves the teacher and the learner.

86. 🞆 NURSING PROCESS- This emphasizes the need to manage and maximize health by preventing risk factors and by encouraging healthy behaviors Purposes of nursing process 🞆 Provides a tool to enable the nurse to render quality-nursing care to clients. 🞆 Helps identify the clients health care needs and determine priorities of care and expected outcomes. 🞆 Establishes nursing interventions to meet the client-centered goals. 🞆 Provides nursing interventions to meet the needs of clients. 🞆 Evaluates the effectiveness of nursing care in achieving client goals. 🞆 Achieves scientifically- based holistic and individualized care. 🞆 Takes the opportunity of working collaboratively with clients and other members of the health care team. 🞆 Achieves continuity of care to the clients.

87. 🞆 PLANNING - setting priorities, goals and objectives and treatment options. 🞆 PLANNING IS DONE INORDER TO : 🞆 Detect, prevent and manage health problems, promote well-being and anticipate potential problems, allocate and utilize possible resources to achieve desired outcomes. 🞆 * IMPLEMENTATION - Putting the plan into action 🞆 Assess appropriateness of interventions, perform interventions, make immediate changes, chart and monitor progress of the clients. 🞆 * EVALUATION- Assessing the patient, if the desired outcomes have been met. 🞆 * DOCUMENTATION - A written record of assessment, the care provided and the patient’s response which in an integral part of each step of the nursing process.