1. Assessment of the learner

2. The importance of assessment of the learner may seem self-evident, but often only lip service is given to this phase on the educational process.
Determinants of Learning
The first and the most important step in instructional design:
1. Nursing Assessment of Needs
2. Readiness
3. and Styles of Learning
The effectiveness of nursing interventions clearly depends on the scope, accuracy, and comprehensiveness of assessment prior to interventions.

3. Many factors must be considered with respect to the three determinants of learning, and assessment of all three should be based on theories, concepts, and principles.
Assessment prevents needless repetition of known material, saves time and energy on the part of both the learner and the educator, and helps to establish rapport between the two parties.

4. Assessment of the learner
Determinants of 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)

5. Assessing learning needs
Of the three determinants, learning needs must be examined first because there may be no reason to assess readiness o learn or learning styles if, by chance, learning needs are non – existent.
Assessment is essential to determined learning needs so that an instructional plan can be designed to address deficits in any of the cognitive, affective, or psychomotor domains.
The purposes of assessing learning needs are to discover what has to be taught and to determined the extent of instruction or if instruction is necessary at all.

6. Learning needs
Are defined as gaps in knowledge that exist between a desired level of performance and the actual level of performance.
A learning need is the gap between what someone knows and what someone needs to know.
Such gaps exist because of a lack of knowledge, attitude, or skill.

7. The important steps in the assessment of learning needs
1. Identify the learner
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 post partum mothers need a formal class on safety issues for the newborn .
His perception may be based on the educator’s interaction with one patient and may not be true of all post partum mothers.

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

9. 3. Collect data on 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.
4. Include the learner as a source of information
Learners themselves are usually the most important source of needs assessment data.
Actively engaging learners in defining their own problems and needs allow them to learn in the process and also motivates them to learn because they have an investment in planning for a program specifically tailored to their unique circumstances.

10. 5. Involve members of the healthcare team
Other healthcare professionals may have insight into patients or family needs or the educational needs of the nursing staff or students as a result of their frequent contacts with consumers as well as caregivers.
Nurses are not the sole teachers, and they must remember to collaborate with other members of the healthcare team for a richer assessment of learning needs.

11. 6. Prioritize needs
A list of needs can become endless and seemingly impossible to accomplish.
Maslow’s (1970) hierarchy of human needs may help the educator prioritize identified learning needs.
The educator can then assist the learner the to meet the most basic need first.

12. 7. Determined availability of educational resources
A need may be identified, 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
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 exchange than to cancel the encounter altogether.
Thereafter, the educator would work immediately on obtaining the necessary equipment for future encounters.

13. 8. Assess demands of the organization
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.

14. 9. Take time – management issues into account
Because time constraints are a major impediment to the assessment process, suggest the educator should emphasize some important points with respect to time-management issues:
Although close observation and active listening take time, it is much more efficient and effective to do a good initial assessment than to have to waste time going back to discover the obstacles to learning that prevented progress in the first place.
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.

15. Assessment can be made anytime and anywhere the educator has formal or informal contact with learners. Informing someone ahead of time that the educator wishes to spend time discussing problems or needs gives the person advanced notice to sort out his or her thoughts and feelings. Minimizing interruptions and distractions during planned assessment interviews maximizes productivity such that the educator might accomplish in 15 minutes what otherwise might have taken the educator an hour in less directed, more frequently interrupted circumstances.

16. Readiness to learn
Can be defined as the time when the learner demonstrates an interest in learning the type or degree of information necessary to maintain optimal health or to become more skillful in a job.
Readiness to learn can be determined by the learner’s characteristics as follows:

17. 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

18. Physical Readiness Measures of Ability
If the task requires gross movements using the large muscles of the body, then adequate strength, flexibility, and endurance must be present.
Complexity of Task
In learning to perform a skill, the nurse educator must take into account the difficulty level of the subject or task to be mastered by the learner.
Environmental Effects
An environment conducive to learning will help to keep the learner’s attention and stimulate interest in learning.

19. Health status
Assessment of the learner’s health status is important to determined the amount of energy available as well as present comfort level --- both of these factors heavily influence one’s readiness to learn.
Gender
Research has indicated that women are generally more receptive to medical care and take fewer risks to their health than men.
This difference may arise because women traditionally have taken the role of caregivers and therefore are more open to health promotion teaching.

20. Emotional Readiness Anxiety level
Anxiety is a factor that influences the ability to perform at a cognitive, affective, and psychomotor level.
Depending on the level of anxiety, it may or may not be a hindrance to the learning of new skills.
Fear is a major contributor to anxiety and thus negatively affects readiness to learn in any of the learning domains.
Support system
The availability and strength of a support system also influence emotional readiness and are closely tied to how anxious someone might feel.

21. Motivation
The motivation and interest on the part of the learner to achieve a task also led to more meaningful teaching --- learning experiences.
Risk – Taking Behavior
Educator’s can, however, help nurses and other healthcare providers learn how to take risks.
First, the decision has to be made to take the risk.
The next step is to develop strategies to minimize the risk.
The learner then needs to develop a worst, best, and most probable case scenario.
Lastly, the learner must decide whether the worst – case scenario developed is acceptable.

22. Frame of mind
Frame of mind involves concern about the here and now.
If survival is of primary concern, then readiness to learn will be focused on meeting basic human needs.
Physical needs such as food, warmth, comfort, and safety as well as psychosocial needs of feeling accepted and secure must be met before someone can focus on higher learning.
Developmental Stage
Each task associated with human development produces a peak time for readiness to learn, known as a ‘ teachable moment”.
They see learning as relevant when they can apply new knowledge to help them solve immediate problem.

23. Experiential readiness
Level of aspiration
The extent to which someone is driven to achieve is related to the type of short- and long-term goals established, not by the educator, but by the learner.
Past coping mechanisms
The coping mechanisms someone has been using must be explored to understand how the learner has dealt with previous problems.
Cultural Background
Knowledge on the part of the educator about other cultures and being sensitive to behavioral differences between cultures are important to avoid teaching in opposition to cultural beliefs.

24. Locus of control
Internal locus control
-they are ready to learn
External locus control
-they are externally motivated --- then someone other than themselves must encourage a feeling of wanting to know something.
Orientation
The tendency to adhere to a parochial or cosmopolitan point of view is known as orientation.

25. Knowledge readiness Present knowledge base
How much someone already knows about a particular subject or how proficient that person is at performing a task is important factor o determined before designing and implementing instruction.
Cognitive ability
The extent to which information can be processed is indicative of the level at which the learner is capable of learning.

26. Learning disabilities
Other than those deficits and low-level reading skills are not necessarily indicative of an individual’s intellectual abilities but will require special or innovative approaches to instruction o sustain or bolster readiness to learn.
Learning styles
A variety of preferred styles of learning exist, and assessing how someone leans best will help the educator to select teaching approaches accordingly.

27. Learning styles Refers to the ways individuals process information.
Each learner is unique and complex, with a distinct learning style preference that distinguishes one learner from another.

28. Six learning style principles
1.Both the style by which the teacher prefers to teach and the style by which the students prefers to learn can be identified.
Identification of different styles offers specific clues as to the way a person learns.
2. Teachers need to guard against over teaching by their own preferred learning styles.
Nurse educators need to realize that just because they gravitate to learning a certain way, it does not mean that everyone else can or wants to learn this way.

29. 3. Teachers are most helpful when they assist students in identifying and learning through their own style preferences.
Making learners aware of their individual style preferences will lead to an understanding of which teaching – learning approaches work best for them.
4.Students should have the opportunity to learn through their preferred style.
The nurse educator can provide the means by which each learner can experience successful learning.

30. 5. Students should be encouraged to diversify their style preferences.
Today, learners are constantly faced with learning situations where one approach to learning will not suffice if they are to reach their fullest potential.
6. Teachers can develop specific learning activities that reinforce each modality or style.
Nurse educators must become aware of various methods and materials available to address and augment the different learning styles.

31. Source : Nurse as Educator by Susan B. Bastable