JUDITH M. WILKINSON LESLIE S. TREAS KAREN BARNETT MABLE H. SMITH FUNDAMENTALS OF NURSING Copyright © 2016 F.A. Davis Company Chapter 19: Teaching & Learning

Copyright © 2016 F.A. Davis Company Teaching Skills and Nursing Practice Why do nurses need teaching skills? Teaching clients is part of independent nursing practice. ANA standard related to promoting health demands skill in teaching clients.

Copyright © 2016 F.A. Davis Company Teaching Skills and Nursing Practice (cont’d) Why do nurses need teaching skills? (cont’d) – Clients/families need information for decision making. – Shorter hospital stays increase need for teaching about home-care needs. – Teaching facilitates compliance and shortens hospital stays and medical complications. – Teaching empowers clients and families.

Copyright © 2016 F.A. Davis Company Teaching Process that involves a teacher and a learner Interactive Involves planning and implementing instructional activities Requires good communication skills

Copyright © 2016 F.A. Davis Company Teaching (cont’d) Includes providing activities that allow clients to learn Goal of teaching activities: to meet learner outcomes Remember that maintaining behaviors that are safe is okay Negotiate to mitigate behaviors that may cause harm, either potential or actual Restructure what is detrimental to health and wellness

Copyright © 2016 F.A. Davis Company Who and What Do Nurses Teach? Who? Single client Families, caregivers Groups of clients Peers Nursing assistive personnel (NAP) Nursing students New employees

Copyright © 2016 F.A. Davis Company Who and What Do Nurses Teach? (cont’d) What? Disease information Information about medications Procedures/psychomotor skills Disease prevention and health promotion Clinical processes

Copyright © 2016 F.A. Davis Company Learning Change in behavior, knowledge, skills, or attitude Learning occurs as a result of planned or spontaneously occurring situations, events, or exposures

Copyright © 2016 F.A. Davis Company Learning (cont’d) Goal-oriented, intended, and deliberate, involving motivation to learn (conscious) Without active participation in the learning process (subconscious) Active process involving more than giving of information

Copyright © 2016 F.A. Davis Company The Three Domains of Learning Cognitive Storage and recall of information (e.g., facts about a disease)

Copyright © 2016 F.A. Davis Company The Three Domains of Learning (cont’d) Psychomotor “Hands-on” skill Requires thinking and doing (e.g., self- administration of insulin)

Copyright © 2016 F.A. Davis Company The Three Domains of Learning (cont’d) Affective Changing feelings, beliefs, attitudes, and values (e.g., changing a belief about diet)

Copyright © 2016 F.A. Davis Company Factors That Affect Client Learning Motivation – Assess desire to learn – Mild anxiety helps! Readiness to learn – Physical condition – Emotions Timing – Is pain controlled? – Is fatigue an issue? Active involvement – Can the person participate? Feedback given – Positive reinforcement Repetition – Repeat at least 3 times – Takes time to make new things a habit Learning environment

Copyright © 2016 F.A. Davis Company Factors That Affect Client Learning (cont’d) Scheduling of the session Amount and complexity of content Teacher/learner communication Belonging to a special population Developmental stage Culture Health literacy

Copyright © 2016 F.A. Davis Company Components of a Learning Assessment Assess client’s Learning needs/knowledge level Health beliefs and practices Physical and emotional readiness Ability to learn – What language is preferred for verbal and written instructions? Literacy level Health literacy Ability to see, feel, hear, grasp Learning style Time constraints Available resources – Support system is of minimal concern; address if barriers manifest themselves

Copyright © 2016 F.A. Davis Company Components of a Teaching Plan Teaching plan Teaching strategies: method used to present the content being taught Content: all information needed to reach your intended goal Scheduling and sequencing: how to organize and sequence information Instructional material: materials/tools used to present

Copyright © 2016 F.A. Davis Company Examples of Teaching Strategies Group discussion Demonstration/return One-to-one instruction and mentoring Audiovisual materials Printed materials Role-modeling Online sources of information

Copyright © 2016 F.A. Davis Company Evaluating Learning Tests and written exercises Oral questions Interviews Questionnaires

Copyright © 2016 F.A. Davis Company Evaluating Learning (cont’d) Checklists Direct observation of performance Client report Client records

Copyright © 2016 F.A. Davis Company Think Like a Nurse A client with brain injury needs to learn how to administer insulin. Another learner, who must learn to change a wound dressing, has attention deficit-hyperactivity disorder (ADHD). How do you think this client’s health status might affect motivation to learn? How do you think this client’s health status might affect the ability to be actively involved in the learning?

Copyright © 2016 F.A. Davis Company Think Like a Nurse (cont’d) What approaches or changes might you need to make in The learning environment? The timing of the teaching session? The use of repetition? Your communication? The amount and complexity of content presented in a session? Your use of feedback? The amount of teacher support?