1. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Nursing Leadership & Management Patricia Kelly-Heidenthal 0-7668-2508-6

2. Delmar Learning Copyright © 2003 Delmar Learning, a Thomson Learning company Chapter 15 Patient Teaching

3. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company3 Objectives  Upon completion of this chapter, the reader should be able to: Identify five major steps of a teaching methodology. Explain three components of the analysis phase of teaching. Discuss at least two major theories of learning style. Explain the major learning domains. State the four components of a behavioral objective. Explain the relationship between terminal and enabling objectives.

4. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company4 Objectives Discuss the importance of Gagne’s events of instruction in planning a teaching session. Name two forms of evaluation and explain the goals of each. Construct behavioral objectives for a teaching session. Create a lesson plan for a teaching session.

5. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company5 Methodology  The teaching process is more effective when it follows a structured, standardized methodology.  A typical teaching methodology contains five major steps: Analysis Design Development Implementation Evaluation

6. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company6 Analysis  Context analysis aims to determine the situation that created the need for teaching and the overall type of instruction needed.  Learner analysis is the process of identifying the learner’s unique characteristics and needs, and the ways in which these can influence the teaching process.

7. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company7 Demographics  Many factors can influence the patient’s response to the health care environment and to learning. These include: Cultural background Language Generation Age Education Health care background Physiological condition

8. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company8 Learning Styles  A learning style is a particular manner in which a learner responds to and processes learning. Not everyone has the same learning style.

9. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company9 Learning Styles  Various theories of learning style exist. They generally fall into one of three categories: Perception: emphasize the way people’s senses affect learning; e.g., the visual-auditory-kinesthetic (VAK) model and Gardner’s multiple intelligences Information Processing: emphasize different styles in thinking; e.g., Kolb’s experiential learning style Personality: emphasize how personality differences affect learning; e.g., Myers-Briggs personality dichotomies

10. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company10 Content Analysis  During content analysis, the nurse identifies specific information that should be addressed by teaching.  Nurses can use learning taxonomies, or domains, to identify measurable types of learning.

11. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company11 Taxonomies of Learning  Cognitive: knowledge, or what the learner knows  Psychomotor: skill, or what the learner does  Affective: attitude, or what the learner feels/believes  Each taxonomy is organized into a hierarchy that progresses from simple to complex behaviors that can be observed and measured.

12. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company12 Design  During the design phase, the nurse organizes and structures the content identified in the analysis phase. The nurse accomplishes this by establishing objectives and by sequencing content.

13. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company13 Establishing Behavioral Objectives  Behavioral objectives state specific and measurable behaviors that should result from the teaching session.  They are based on behaviors identified in the taxonomies.  They define what the nurse will teach.  They provide the basis for patient evaluation.

14. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company14 Establishing Behavioral Objectives  An objective has four components: Audience Behavior Condition (optional) Degree

15. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company15 Terminal and Enabling Objectives  Each teaching session has a session goal; e.g., “Have the patient understand and demonstrate diabetic self- care.”  Terminal objectives identify major behaviors that contribute to achievement of the overall session goal.  Enabling objectives identify secondary behaviors that contribute to, or enable, achievement of terminal objectives.

16. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company16 Sequencing Content  Once the nurse identifies teaching content, he or she determines the order, or sequence, in which it should be presented.  There are various ways to sequence content: Chronological Procedural (step-by-step) Categorical Topical

17. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company17 Sequencing Content Parts to whole, or whole to parts General to specific, or specific to general Problem to resolution Known to unknown, or unknown to known Theoretical to practical, or practical to theoretical Simple to complex, or complex to simple

18. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company18 Development  During development, the nurse clarifies how to teach by determining the format, strategies, and resources to use.

19. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company19 Session Format  A common format is based on Gagne’s key events of instruction: Gain the learner’s attention. Inform the learner of the objectives. Review any prerequisite learning. Present the learning materials.

20. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company20 Session Format Guide the learner through the teaching. Have the learner demonstrate the learning. Provide the learner with feedback. Assess the learner’s performance. Review the learning and encourage the learner to use the learning in new situations.

21. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company21 Session Format  Other elements that are useful during teaching and that should be incorporated as part of the presentation format are: Repetition Interaction Presentation, performance, practice Variety

22. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company22 Strategies  Strategies identify the various ways in which teaching is presented.  Some examples of teaching strategies include lecture, group discussion, and role-play.

23. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company23 Media  Teaching can be presented through various media, such as written, visual, audio, video, computer-based or other material, or combinations of these materials.

24. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company24 Lesson Plan  A lesson plan is a document that provides the blueprint for the teaching session. It provides the necessary information for the nurse or other teacher to conduct the teaching session.

25. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company25 Lesson Plan  The lesson plan incorporates information such as: Learner analysis Context analysis Behavioral objectives Sequence of content Format Strategies Media Evaluation

26. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company26 Implementation  During the implementation phase, the nurse actually conducts the teaching, using the lesson plan as a guide.  During teaching, the nurse must be aware of and adaptable to conditions that may affect teaching. These include: Learning environment Patient’s condition Nurse’s teaching skills Nurse’s and patient’s communication skills

27. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company27 Evaluation  Evaluation is the process of determining the effectiveness of teaching. There are two major concerns of evaluation: Learner evaluation: did the patient learn what he or she was supposed to learn? Teaching evaluation: was the teaching presented in an effective manner?

28. Chapter 15Copyright © 2003 Delmar Learning, a Thomson Learning company28 Evaluation  In learner evaluation, the nurse determines—through testing, performance observance, or other means— how well the patient mastered the session’s behavioral objectives The goal is to make sure the patient has mastered the required behavior.  In teaching evaluation, the nurse or other staff interviews the learner and uses objective analysis to determine whether the manner of teaching was effective. The goal is to improve the quality of the teaching.