CLIENT TEACHING

Objectives Identify the purposes of client teaching Compare the communication process with the teaching process Describe the domains of learning Differentiate those factors that determine readiness to learn from those that determine ability to learn Identify principles of effective teaching Apply client teaching in the nursing process Describe the importance of attention set, motivation, psycho social adaptation, developmental capability.

THE TEACHING-LEARNING PROCESS A planned interaction that promotes behavioral change that is not a result of maturation or coincidence

CLIENT TEACHING … Is done for a variety of reasons: To promote wellness To prevent illness To restore health To facilitate coping abilities

CLIENT EDUCATION May improve quality of care. May decrease the length of hospital stays. May decrease chance of hospital readmission. May improve compliance with treatment regimens.

FORMAL AND INFORMAL TEACHING Formal teaching–takes place at a specific time, in a specific place, and on a specific topic. Informal teaching–takes place any time, any place, whenever a learning need is identified.

LEARNING DOMAINS Cognitive–the acquisition of facts and data; used in decision making and problem solving. Affective–attitude changing, emotion, and belief; used in making judgments. Psychomotor–gaining motor skills; used in physical application of knowledge.

LEARNING PRINCIPLES Personality develops in orderly fashion from dependence to independence. Readiness is affected by developmental stage and sociocultural factors. Prior learning experiences are a foundation for further learning. Immediacy reinforces learning.

LEARNING PRINCIPLES INCLUDE: Relevance Motivation Readiness Maturation Reinforcement Participation Organization Repetition

LEARNING STYLES Visual learners–learn by processing information visually. Auditory learners–learn by listening to the words. Kinesthetic learners–learn by experiencing the information or by touching, feeling, or doing.

BARRIERS TO TEACHING LEARNING Environmental Sociocultural Psychological Physiological

TEACHING METHODS IN THE COGNITIVE DOMAIN Discussion Formal lecture Question-and-answer sessions Role play Games/computer activities

TEACHING METHODS IN THE AFFECTIVE DOMAIN Role play Discussion

TEACHING METHODS IN THE PSYCHOMOTOR DOMAIN Demonstration Supervised practice Return demonstration

LIFELONG LEARNING All people are capable of learning. Learning needs and abilities change throughout life. Teaching approaches must be altered depending on the client’s developmental stage and level of understanding.

TEACHING CHILDREN Readiness for learning varies during childhood depending on maturation level. Children learn primarily through play. Goals of educating children are to improve cooperation, prevent excessive anxiety, and hasten the recovery process.

TEACHING CHILDREN (continued)

TEACHING CHILDREN (continued) Ensure comfort. Encourage participation of caregiver. Assess child’s development level, readiness, and motivation. Assess child’s psychological status. Determine self-care abilities of the child. Use play, imitation, and role play. Removed “Considerations” from title – confusing to have so many slides with that title.

TEACHING CHILDREN (continued) Use various visual stimuli to share information and assess understanding. Use terms easily understood by child and caregiver. Provide frequent repetition, reinforcement. Develop realistic goals consistent with developmental level.

TEACHING ADOLESCENTS Adolescents are better able to understand relationships between things. Reading and comprehension ability have advanced. More complex information understood. Peer support through group meetings are often useful.

TEACHING ADOLESCENTS (continued) Respect the adolescent. Boost their confidence by seeking their input and opinions on health care matters. Encourage exploration of feelings. Be sensitive to peer pressure. Help them identify and build on their positive qualities.

TEACHING ADOLESCENTS (continued) Use language that is clear yet appropriate to the health care setting. Encourage independent and informed decision making by engaging them in problem-solving activities.

TEACHING OLDER ADULTS Many physiological changes accompany aging. Some older adults experience perceptual impairments in vision and hearing. Assess for and adjust teaching materials accordingly.

TEACHING OLDER ADULTS (continued) Ensure comfort. Assess developmental level, motivation, learning readiness. Assess for depression, anxiety, or denial. Determine client’s ability for self-care. Use words easily understood by client.

TEACHING OLDER ADULTS (continued) Avoid talking down to the client. Find time of day when client is most alert. Present material slowly using examples. Encourage client participation. Ask for feedback and actively listen. Provide frequent feedback.

TEACHING OLDER ADULTS (continued) Assess for perceptual impairments and individualize teaching strategies. For memory-impaired clients: Repeat material. Use different spoken words, pictures, written materials, and symbols.

TEACHING OLDER ADULTS (continued) For visually impaired clients: Use large-print materials. Furnish a magnifying glass. Be sure prescription eyeglasses are worn. Arrange adequate lighting and reduce glare.

TEACHING OLDER ADULTS (continued) For hearing-impaired clients: Face the client when speaking. Use short sentences, simple words. Use gestures and demonstration to reinforce verbal information. Eliminate distractions (activities, noises in environment) as much as possible.

PROFESSIONAL RESPONSIBILITIES Teaching: Required function in most states. One of the truly independent functions of nursing practice. Required by several accrediting bodies. Supports behavioral changes in the client.

SELF-AWARENESS An all-important first step in teaching. Staying both current in knowledge and proficient in skills is first step to maintaining efficacy and credibility as a teacher. Effective teaching is based on nurse’s ability to establish rapport with the client.

TEACHING-LEARNING AND THE NURSING PROCESS The teaching-learning process and the nursing process are interdependent. Both are dynamic and comprise the same phases: assessment, diagnosis, planning, implementation, and evaluation.

ASSESSMENT Consider: Actual learning needs. Potential learning needs. Ability and readiness to learn. Client strengths and limitations. Previous experiences.

NURSING DIAGNOSIS When lack of knowledge is the primary learning need, the diagnosis of Deficient Knowledge (specify) is applicable.

PLANNING Specific learning goals should include the following elements: Measurable behavioral change Time frame Methods and intervals for evaluation

PLANNING (continued) Consider the following: Why teach? What should be taught? How should teaching be done? Who should teach and who should be taught? When and where should teaching occur?

IMPLEMENTATION Get and keep the client’s attention. Stick to the basics. Use time wisely. Reinforce information.

EVALUATION A two-fold process: Determine what the client has learned. Assess the nurse’s teaching effectiveness.

EVALUATION OF CLIENT’S LEARNING The following strategies can be used to evaluate client learning: Asking questions Observation Return demonstration Written follow-up

EVALUATION OF TEACHING EFFECTIVENESS Evaluating teaching effectiveness can be accomplished through: Feedback from the learner Feedback from colleagues Self-evaluation