Learning Outcomes

1. Assess the learning needs of the individual client related to the

current health status in relation to the Augustinian value of
“commitment” and “competence
2. Assess with the individual and family one’s health status
competence in relation to the Augustinian value of “compassion”.
3. Apply evidence-based practices in health education in relation to
the Augustinian value of “competence ”.
4. Collaborate with other members of the health team in health
education activities in relation to the Augustinian value of
“community ”.
5. Engage in self-directed learning to enhance competence in health
education in relation to the Augustinian value of “Christ-
centeredness.”
6. Customize health education plan based on the culture, and value
of the clients in relation to the Augustinian value of “ conscience
Health Education Process
Teaching is an important aspect of the nurse’s professional role
(Andersson, Svanström, Ek, Rosén, & Berglund, 2015; Friberg,
Granum, & Bergh, 2012), whether it be educating patients and their
family members, colleagues, or nursing students.

The current trends in health care are making it essential that patients
be prepared to assume responsibility for self-care management
and that nurses in the workplace be accountable for the delivery of
safe, high-quality care (Hines & Barndt-Maglio, 2011; Lockhart, 2016;
Shi & Singh, 2015; U. S. Department of Health and Human Services
[USDHHS], 2015).
Health Education Process
“Patient education has been a part of health care since the first
healer gave the first patient advice about treating his (or her)
ailments” (May, 1999p. 3).
Although the term patient education was not specifically used,
considerable efforts by the earliest healers to inform, encourage, and
caution patients to follow appropriate hygienic and therapeutic
measures occurred even in prehistoric times (Bartlett, 1986).
Because these early healers—physicians, herbalists, midwives, and
shamans—did not have a lot of effective diagnostic and treatment
interventions, it is likely that education was, in fact, one of the most
common interventions (Bartlett, 1986).
Health Education Process
Nursing is unique among the health professions in that patient
education has long been considered a major component of standard
care given by nurses. Since the mid-1800s, when nursing was first
acknowledged as a unique discipline, the responsibility for teaching
has been recognized as an important role of nurses as caregivers.
The focus of nurses’ teaching efforts is on the care of the sick and
promoting the health of the well public.

For decades, then, patient teaching has been recognized as an

independent nursing function.

Nurses have always educated others—patients, families, colleagues,

and nursing students.
Purposes, Goals, and Benefits of Patient and Nursing Staff/Student Education
The purpose of patient education is to increase the competence and confidence of
clients for self-management.

The primary goal is to increase the responsibility and independence of clients

or self-care. This can be achieved by supporting patients through the transition from
being dependent on others to being self-sustaining in managing their own care and
from being passive listeners to active learners.
2000).
The benefits of client education are many (Abbott, 1998; Adams, 2010; Dreeben, 2010;
LiberateHealth, 2014; Wingard, 2005).

■ Increase consumer satisfaction

■ Improve the quality of life
■ Ensure continuity of care
■ Decrease patient anxiety
■ Effectively reduce the complications of
illness and the incidence of disease
■ Promote adherence to 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
In turn, the benefits to nurses in their role as educators may include the following
The education process is a systematic, sequential, logical, scientifically based,
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.

A. Theories and Principles of Learning

1. Characteristics of learning
a. Learning is unitary holistic.
b. Learning is individual and social.
c. Learning is self-active and self-initiating.
d. Learning is purposive and goal-oriented.
e. Learning is selective and creative.
f. Learning is influenced and is transferable
Major types of Learning
a. Ideational learning-carried out in the cognitive domain of the intellect
b. Skill learning or psychomotor learning- carried out in the conative or psychomotor domain.
c. Emotional learning- refers to mental states which are characterized by feelings and emotions.

Learning styles
a. Diverging- learners look at things from different perspectives, they are sensitive and prefer to watch rather than do things.
b. Assimilating – learning style that is concise and logical in its approach.
c. Converging- learners used their learning to find solutions to practical issues.
d. Accommodating – is a “hands-on” learning style.

Laws of learning
a. Law of readiness- states that one must be physically, emotionally, and mentally ready to learn.
b. Law of exercise – stresses the idea that repetition is basic to the development
of adequate response or outcome.
c. Law of effect- involves the learner’s emotional response to a stimulus.
d. Law of primacy – states that the state of first often creating a strong impression.
e. Law of intensity- states that if stimulus or experience is real, the more likely learning will occur.
f. Law of recency – states that information of skills most recently learned is best remembered.
ASSESSING THE LEARNER
Assessment of needs is the initial step in the educational process as it helps
validate the need for learning and the approach to be used in designing learning
experiences.
DETERMINANTS OF LEARNING
- Nursing assessment of needs, readiness, and styles of learning is the first and
most important step in instructional design—but it is also the step most often
neglected.
Learning Needs
- what the learner needs to know; to discover the extent of instruction.
- Defined as gaps in knowledge that exist between a desired level of performance
and the actual level of performance.
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.
2. Choose the right setting. Establish a trusting environment to assure privacy and
confidentiality to the learners.
3. Collect data on the learner. Once the learner is identified, the educator can determine
the 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 are usually the most
important
source of data in defining their own problems and needs.
5. Involve members of the healthcare team. 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.
6. Prioritize needs. Maslow’s (1970) hierarchy of human needs may help the educator
prioritize identified learning needs.
7. Determine the availability of educational resources.
8. Assess the demands of the organization.
9. Take time-management issues into account.
Methods to Assess Learning Needs:
1. Informal Conversations
- The nurse relies on active listening.
- Learners reveal information about their perceived learnings by posing open-ended
questions.
2. Structured Interviews
- Nurse asks direct and predetermined questions to gather information.
- Interviews yield answers that may reveal uncertainties, conflicts, inconsistencies,
unexpected problems, anxieties, fears, and present knowledge base.
3. Focus Groups
- Involve 4 to 12 potential learners, led by a facilitator, to identify different points of view or
knowledge about a certain topic.
4. Self-Administered Questionnaires
- One of the most common forms is the checklist which obtains the learner’s written
responses to questions about learning needs.
- Easy to administer, provide more privacy than interviews, and is easy to tabulate data.
5. Written Pretests
- Given before teaching to help identify the knowledge level of potential learners regarding a
particular subject and assist in identifying specific needs of the learner.
6. Observations
- Observing health behaviors in several different time periods can help to determine
established patterns of behavior.
7. Patient Charts
- Create patterns from physicians’ progress notes, nursing care plans, nurses’ notes, and
discharge planning forms that reveal learning needs.
Readiness To Learn
- When the learner is receptive to learning
- learner demonstrates interest in learning the type or degree of
information necessary to maintain optimal health or to become more
skillful in a job.
- It is the responsibility of the educator to discover through
assessment exactly when patients are ready to learn and what they
want to learn.
The health educator must:
• Adapt with the content to be learned to fit with what the learner is
ready to learn.
• Understand first what needs to be taught and be competent in
collecting and validating
information.
Done prior to the time when actual learning is to occur. If the learner is
not ready, the information will not be absorbed.
• Give thought as to what is required of the learner—that is, what
needs to be learned, what the learning objectives should be, and in
which domain and at what level of learning these
objectives should be classified.
Types of readiness to learn: (PEEK)
P = Physical Readiness
• Measure of ability. Measures the strength, flexibility, and endurance, as well as the
visual and auditory acuity to perform movements that affect the ability to learn.
• Complexity of task. The nurse educator must take into account the difficulty level of
the subject or task to be mastered by the learner. Variations will affect the extent to
which behavioral changes are necessary in the cognitive, affective, and psychomotor
domains.
• Environmental effects. An appropriate environment will help keep the learner’s
interest and attention in learning might as well avoid any types of interference such as
high levels of noise.
• Health status. Healthy learners have the energy available and present comfort for
learning. Learners who are acutely ill tend to focus their energies on the physiological
and psychological demands of their illness.
• Gender. According to research, women respond more to medical care and avoid risk to
their health than men. This behavior is thought to be socially induced because of the
attention paid to increase a healthier lifestyle as well as the gender roles in the home
and the workplace.
E = Emotional Readiness
• Anxiety level. Anxiety levels greatly influence the performance of cognitive, affective,
and psychomotor levels. It may or may not hinder an individual in learning and
performing new skills.
• Support system. Composed of family, friends, significant others who increase
security and emotional readiness. A strong support system decreases anxiety, while
the lack of one increases anxiety levels.
• Motivation. Motivation together with interest and emotional readiness piques the
learner to achieve a task leading to meaningful teaching-learning experiences. The
level of motivation is related to what an individual expects from oneself.
• Risk-taking behavior. Developing strategies to reduce the risk in the choices requires
decisions among the worst, best, and most probable case scenarios until it is
recognized as an acceptable choice.
• Frame of mind. Meeting basic human needs such as food, warmth, comfort, and
safety as well as psychosocial needs of acceptance and security to determine his or
her readiness to learn.
• Development stage. Readiness to learn is associated when a child reaches the peak in
human development to be able to cope better with real-life tasks and apply
knowledge based on past experiences.
E = Experiential Readiness
- refers to the learner’s past experiences with learning and willingness to take risks in
overcoming problems and accomplishing new tasks.
• Level of aspiration. Short- or long-term goals established by the learners influence
their motivation to pursue an output and achieve satisfaction.
• Past coping mechanism. Coping mechanisms are identified how it was dealt in the
past and determine the effectivity even in present learning situations.
• Cultured background. To assess and acknowledge different cultural perspectives in
determining the readiness to learn.
• Locus of Control. A learner’s motivation to learn; comes in two types:
‣ Internal locus of control - patients are internally motivated to learn; ready to learn
when they feel a need to know about something.
‣ External locus of control - externally motivated; someone must encourage them to
learn something.
• Orientation. A person’s point of view; two types:
‣ Parochial orientation - close-minded, conservative in their approach to new
situations,
less willing to learn new material, and place more trust in physicians.
‣ Cosmopolitan orientation - have a worldly perspective, receptive to new ideas and
opportunities to learn new ways of doing things.
K = Knowledge Readiness
- learner’s present knowledge base, the level of learning capability, and the preferred
style of learning.
• Present knowledge base. Amount of knowledge an individual already has and proficiency
in performing tasks.
• Cognitive ability. The learner’s extent of processing information by understanding,
memorizing, recalling, and material recognition (which are considered at a lower level of
learning) until able to demonstrate problem-solving, concept formation, and application of
information.
• Learning disabilities. Deficits caused by mental retardation may require special or
innovative approaches to instruction to sustain readiness to learn.
• Learning styles. Assessing the learner’s preferred learning style in which one may learn
best will help the educator provide teaching methods or materials that meet the needs of
learners as well as increase their readiness to learn.
Determinants of learning
Learners are categorized according to :
a. Growth and development
b. Stages of development
c. Individual differences
Growth and development defined:
a. Growth is the acquisition of more knowledge which often results in
maturation.
b. Development is the orderly, dynamic changes in a learner resulting from a
combination of learning, experience, and maturation.
Factors influencing intellectual development.
a. Maturation- the biological changes in individuals that result from the interaction
of their genetic make-up with the environment.
b. Experience refers to observing, encountering, or undergoing activities
generally as they occur in the course of time.
c. Learning is the acquisition of knowledge. Abilities, habits, attitudes, values
STAGES OF DEVELOPMENT
a. Infancy. Sensorimotor stage. (0-1 year). Focuses on reflex behavior as a
determinant of sensory and motor capacities; thinking is limited and has
no object in memory.
b. Toddler. Pre-operations stage. (1-3 years). Characterized by perceptual
dominance. A toddler can classify object into toys and non- toys while
performing a mental operation.
c. Pre-schooler. Perceptual intuitive thought (3-7 years). The child tends to
accommodate more information and change their ideas to fit reality.
d. School-age. Concrete operations stage (-7-11 years). Advancement and
the ability to think logically and overcome preoperational deficiencies.
e. Pubescent or Adolescent. Formal operational thought (12-18 years). TheY have
logical thinking and scientific reasoning
Aspects influencing individual difference
a. Intelligence
b. Multiple intelligence
c. Emotional intelligence
d. Socioeconomic status
e. Culture
f. Gender differences
g. At-risk students
6. Intelligence Also known as “Aptitude’

Theory of multiple intelligence

The theory proposes that the traditional notion of intelligence based on I.Q.
testing is far too limited.
8 various intelligence
a. Verbal – word smart
b. Logical-mathematical intelligence – logical or number smart
c. Spatial intelligence – picture smart
d. Bodily-kinesthetic intelligence –body smart
e. Musical intelligence- music smart
f. Interpersonal intelligence- people smart
g. Intrapersonal- self smart
h. Naturalist intelligence- nature smar
Barriers to teaching are those factors impeding the nurse’s ability to optimally deliver
educational services.
Major barriers include:
•lack of time to teach
•inadequate preparation of nurses to assume the role of educator with confidence and
competence
•personal characteristics
•low-priority status given to teaching
Barriers to Education
•environment not conducive to the teaching-learning process
•absence of 3rd party reimbursement
•doubt that patient education effectively changes outcomes
•inadequate documentation system to allow for efficiency and ease of recording the quality
and quantity of teaching efforts
Obstacles to Learning
Obstacles to learning are those factors that negatively impact the learner’s ability to attend
to and process information.
Major obstacles include:
•limited time due to rapid discharge from care
•stress of acute and chronic illness, anxiety, sensory deficits, and low literacy
•functional health illiteracy lack of privacy or social isolation of healthcare environment
•situational and personal variations in readiness to learn, motivation and compliance, and
learning styles
•extent of behavioral changes (in number and complexity) required lack of support and
positive reinforcement from providers and/or significant others
•denial of learning needs, resentment of authority, and locus of control issues
•complexity, inaccessibility, and fragmentation, of the healthcare system
Principles of good teaching practices
1. Seven principles of good and effective teaching practices
a. Encourage student-faculty contact.
b. Encourage cooperation among students.
c. Encourage active learning
d. Give prompt feedback.
e. Emphasize task time.
f. Communicate high expectations.
g. Respect diverse talent and ways of learning.

TYPES OF TEACHING PRINCIPLES

a. Hereditary endowment principles –refer to the nature of the child, his or her psychological and
physiological qualities such as reflexes, instincts, capacities, impulses, and temperaments among others.
b. Teaching process principles – refer to the technique used through which student and teacher may work
together towards the accomplishment of goals or objectives of education.
c. Outcome process principles – refer to educational aims, goals, objectives, outcomes, purposes or
results of the educational scheme to which teaching and learning are directed.

Guidelines in the choice of teaching and learning methods

a. Suited to the objective and content of the course.
b. Adapted to the capability of the student.
c. In accordance with sound psychological principles.
d. Used creatively.
e. Suit the teacher’s personality and capitalize on his or her special assets
Learning Styles
- ways of an individual to process information.
Types of Learning Styles:
VARK learning style was introduced by Neil D. Flemming and Coleen E. Mills in 1992.
V - Visual
• Information was depicted through meaningful symbols, illustrations, charts, diagrams,
photos or videos;
• Process information as a whole than by piece;
• Best described as visual learners.
A - Auditory
• Process information through hearing;
• Opt to take down notes during class, therefore less engaged in their class;
• Learn best through discussions in groups and reading their written work aloud to
themselves helps them to think it through.
R - Reading/Writing
• Learns best from the information presented in class in form of handouts or PPT presentations;
• Encourage taking down notes during lecture hours which helps in processing information
and recalling it afterward.
K - Kinesthetics
• Also called tactile mode;
• Learners are hands-on and active in participating in lessons physically which brings out
the best in their educational process;
• Engages all senses in the process of learning;
• Strive in skill-based activities.