HISTORICAL FOUNDATIONS FOR THE TEACHING ROLE OF NURSES Patient education has long been considered a major component in the list of standard care-giving by the nurse. The focus of teaching efforts by nurses was not only on the care of the sick, but also on educating other nurses for professional practice. Florence Nightingale, the founder of modern nursing, was the ultimate educator. Not only did she develop the first school of nursing, but she also devoted a large portion of her career to educating those involved in the delivery of health care. Nightingale taught nurses, physicians, about the importance of proper conditions in hospitals and homes to assist patients in maintaining adequate nutrition, fresh air, exercise, and personal hygiene to improve their well-being.

Education in health care is a topic of almost interest in every setting in which nurses practice. The current trends in health care that nurses in the workplace be accountable for the delivery of high-quality care. The focus is on outcomes—whether it be that the patient and his or her family have learned essential knowledge and skills for independent care. With changes It is necessary for nurses in the role of educators to understand the forces, both historical and present-day, that have influenced and continue to influence their responsibilities in practice, with teaching being a major aspect of the nurse’s professional role

In 1995, the Health Professions Commission, influenced by the dramatic changes currently surrounding health care, published a broad set of competencies that it believes will mark the success of the health professions in the twenty-first century. Most recently, the Commission (1998) released a fourth report as a follow-up on health professional practice in the new millennium. Numerous recommendations to the health professions have been proposed by the Commission. More than one half of them refer to the importance of patient and staff education and to the role of the nurse as educator. Among the recommendations, the Commission has addressed the need to:

Provide clinically competent and coordinated care to the public • Involve patients and their families in the decision-making process regarding health interventions • Provide clients with education and counseling on ethical issues • Expand public access to effective care • Ensure cost-effective and appropriate care for the consumer • prevention of illness and promotion of healthy lifestyles for all population

PURPOSE, BENEFITS, AND GOALS OF PATIENT AND STAFF EDUCATION Current and continuously improving patient and staff education programs are an integral part of today’s system of healthcare delivery to the public. The purpose of patient education is to increase the competence and confidence of clients for self-management. Our goal is to support patients through the transition from being invalids to being independent in care; from being dependent recipients to being involved participants in the care process; and from being passive listeners to active learners. If clients cannot independently maintain or improve their health status when on their own, we have failed to help them reach their potential. In light of cost-containment measures by healthcare agencies and despite the sometimes scarce resources available, nurses continue to follow the goals of involving patients in exploring and expanding their self-care abilities through interactive patient education efforts

Benefit of HE Increase consumer satisfaction Improve quality of life Ensure continuity of care Decrease patient anxiety Effectively reduce the incidence of complications of illness Promote adherence to healthcare treatment Plans Maximize independence in the performance of activities of daily living. Energize and empower consumers to become actively involved in the planning of their care

THE EDUCATION PROCESS DEFINED The education process is a systematic, sequential, planned course of action consisting of two major interdependent operations, teaching and learning. This process forms a continuous cycle that also involves two interdependent players, the teacher and the learner. Together, they jointly perform teaching and learning activities, the outcome of which leads to mutually desired behavior changes. These changes foster growth in the learner and, it should be acknowledged, growth in the teacher as well. Thus, the education process should always be a participatory, shared approach to teaching and learning.

Education, as the broad umbrella process, includes the acts of teaching and instruction. Teaching is a careful intervention that involves the planning and implementation of instructional activities and experiences to meet intended learner outcomes according to a teaching plan. Instruction. a component of teaching that involves the communicating of information about a specific skill in the cognitive, psychomotor, or affective domain. Teaching and instruction are often formal, structured, organized activities prepared days in advance, but they can be performed informally on the spur of the moment during conversations or incidental encounters with the learner. Whether formal or informal

A useful paradigm to assist nurses to organize and carry out the education process is the ASSURE model (Rega, 1993). The abbreviation stands for: • Analyze learner • State objectives • Select instructional methods and tools • Use teaching materials • Require learner performance • Evaluate/revise the teaching and learning process.

ROLE OF THE NURSE AS EDUCATOR Although all nurses are able to function as givers of information, they posed the following questions: • Is every nurse adequately prepared to assess for learning needs? • Can every nurse determine whether information given is received and understood? • Are all nurses capable of taking appropriate? action to revise the approach to educating? the client if the information is not comprehended?

BARRIERS TO EDUCATION AND OBSTACLES TO LEARNING Lack of time to teach is cited by nurses as the greatest barrier to being able to carry out their educator role effectively. Very ill patients are hospitalized for only short periods of time. Early discharge from inpatient settings with one another in emergency, outpatient, and other ambulatory care settings. In addition, nurses’ schedules and responsibilities are very demanding.

2. Many nurses and other healthcare personnel are traditionally ill prepared to teach. Studies have revealed that the principles of teaching and the concepts of learning are unclear to a large number of practicing nurses. Many nurses admit that they do not feel competent or confident with regard to their teaching skills. Nursing education has for years failed to adequately prepare nurses for the role as educator, either during basic training or afterward. Although nurses are expected to teach, content

3. Personal characteristics Personal characteristics of the nurse educator play an important role in determining the outcome of a teaching–learning interaction.

4. low priority low priority was often assigned to patient and staff education by administration and supervisory personnel. However, budget allocations for educational programs remain tight and can interfere with the adoption of innovative and time-saving teaching strategies and techniques.

5. The lack of space and privacy The lack of space and privacy in the various environmental settings where nurses are expected to teach and learners are expected to learn is not always conducive to carrying out the teaching–learning process. Noise, frequent interferences, treatment schedules, and the like serve to negatively affect concentration and effective interaction.

6. Some nurses and physicians question whether patient education is effective as a means to improve health outcomes. They view patients as disablements to teaching when patients do not display an interest in changing behavior, when they demonstrate an unwillingness to learn, or when their ability to learn is in question.

Obstacles to Learning 1. The stress of acute and chronic illness, anxiety, sensory deficits. 2. The negative influence of the hospital environment itself, resulting in loss of control, lack of privacy, 3. Lack of time to learn due to rapid patient discharge from care can discourage and frustrate the learner, impeding the ability and willingness to learn. 4. Personal characteristics of the learner have major effects on the degree to which predetermined behavioral outcomes are achieved. Readiness to learn, motivation and compliance, developmental-stage characteristics, and learning styles are some of the prime factors influencing the success of educational endeavors.

5. The extent of behavioral changes needed, both in number and in complexity, can overwhelm learners and dissuade them from attending to and accomplishing learning objectives and goals. 6. Lack of support and ongoing positive reinforcement from the nurse and significant others serves to block the potential for learning. 7. Denial of learning needs, resentment of authority, and lack of willingness to take responsibility (locus of control) are some psychological obstacles to accomplishing behavioral change. 8. The inconvenience, complexity, inaccessibility, fragmentation, and dehumanization of the healthcare system often result in frustration and abandonment of efforts by the learner to participate in and comply with the goals and objectives for learning.

Dr. Areefa Al-Bahri The End of Lecture Thanks alot