DETERMINANTS OF LEARNING

Learning -learning is relatively a change in mental processing ,emotional functioning, and/or behavior as result of experience. Educators role in learning is primarily to assess the learner in relation to the three factors that affect learning.

Learning Needs, Styles, And Readiness to Learn

Learning Needs
Learning needs are gaps of knowledge that exist between a desired level of performance and the actual level of performance. A gap between what someone knows and what someone needs to know due to lack of knowledge, attitudes or skills.

Methods of Assessing Learning Needs

1. Informal Conversations or Interviews
-An interview is a conversation between two or more people where questions are asked by the interviewer to obtain information from the interviewee.

2. Structured Interviews
- The aim of this approach is to ensure that each interview is presented with exactly the same questions in the same order.

3. Written Pretests
- Can be given to identify the knowledge level of the potential learner and to help in evaluating whether the learner has taken place by comparing pretest with post-test scores.

4. Observations
- Observation is either an activity of a living being (such as a human), consisting of receiving knowledge of the outside world through the senses, or the recording of data using scientific instruments.

Steps in Assessing Learning Needs

Identify the Learner - Who is the learner? Choose the Right Setting - Establish a trusting environment. Collect Data on the Learner - Determine the characteristics of learning needs of the target population, patient, or any recipient of the learning material. Include the Learner as a Source of Information - Allow the learner to actively participate in the learning process.

 -Include Members of the Healthcare Team Collaborate with the members of healthcare professionals who may have insights or knowledge of the patient or learner. Determine Availability of Educational Resources - Use materials and equipments to help in the learning process. Assess Demands of the Organization - Examine the organizational situation; its philosophy, vision, mission, and goals to know what its educational focus is.

Consider time-management issues -allow learners to identify their learning needs; identify potential opportunities to assess the patient anytime, anywhere; and minimize distractions/interruptions during planned interviews. Prioritize needs -This may be based on Maslows hierarchy of needs where the basic lower level physiologic needs must first be met before one can move up to the higher, more abstract level of needs.

Maslows Hierarchy of Needs

Self Actualization

Self-Esteem Needs

Love and Belongingness Needs

Safe And Security Needs

Physiologic Needs -oxygen, foods, elimination, Temperature Control, Sex, Movement, Rest, and Comfort

Figure 2: Maslows Hierarchy of Needs in relation to Needs Assessment

Self actualization - Recognition and realization of ones potential, growth, health and autonomy Self-esteem needs - Sense of self-worth, self-respect, independence, dignity, privacy and self-reliance Love and belongingness needs - Affiliation, affection, intimacy, support reassurance Safety and security needs - Safety from physiologic and psychological threats, protection, stability Physiological needs - Oxygen, food, elimination, temperature control, sex, movement, rest, comfort

The Criteria for Prioritizing Learning Needs (Healthcare Education Association, 1985) are:

a. Mandatory learning needs that must be immediately met since they are life threatening or are needed for survival. EX.-a person with an impending heart attack should be taught of the signs and symptoms and emergency measures or what medicines to take to be prepared/stop the occurrence. b. Desirable- learning needs that must be met to promote well-being and are not life-dependent. EX.-patient with pulmonary tuberculosis should understand the importance of taking the medicines regularly until the regimen ends to be totally cured. c. Possible- nice to know learning needs which are not directly related to daily activities. EX.-an obese patient who just lost weight because of her diabetes may not necessarily need information on tummy tucking as a surgical or aesthetic procedure to remove sagging abdominal muscles. Her main concern is Diabetes Mellitus.

Readiness to Learn

Readiness to Learn
When assessing readiness to learn, the health educator must: 1. determine what needs to be taught 2. find out exactly when the learner is ready to learn 3. discover what the patient wants to learn 4. identify what is required of the learner: a. what needs to be learned b. what the learning objectives should be c. find out in which domain of learning and at what level the lesson will be taught

5. determine if the timing (the point at which the nurse will conduct teaching) is right or proper 6. find out if the rapport or interpersonal relationship with the learner has been established (Hussey & Hirsch,1983) 7. determine if the learner is showing signs of motivation 8. assess if the plan for teaching matches the development level of the learner

Four Types of readiness to Learn (PEEK)

P=Physical Readiness
1. Measure of ability adequate strength, flexibility and endurance is needed to teach a patient how to walk on crutches and for him/her to be ready to learn while measures requiring visual and auditory acuity a patient also affect the learning readiness especially if the senses of sight and hearing are impaired. 2. Complexity of task the difficulty level of the subject or the task to be mastered; psychomotor skills require varying degrees of manual dexterity and physical energy output but once acquired or mastered; they are usually retained better and longer than learning in the cognitive and affective domains.

4. Health status Is the patient in a state of good health or ill health? Does he still have the energy or motivation to learn? 5. Gender studies show that men are less inclined to seek health consultation or intervention than women. Women, on the other hand, are more health conscious and receptive to medical care and health promotion teaching (Bertakis et al., 2000).

E=Emotional readiness
Anxiety level = may or may not be a hindrance to learning. Some degree of anxiety may motivate a person to learn but high or low degree of anxiety will interfere with readiness to learn. Support system a strong support system composed of the immediate family and friends, significant others, the community and church will give the patient increased sense of security and well-being while a weak or absent support system elicits sense of insecurity, despair, frustration and high level of anxiety. Motivation is strongly associated with emotional readiness or willingness to learn.

Risk-taking behavior are activities that are undertaken without much thought to what their negative consequence or effects might be. Frame of mind depends on what the priorities of the learner are in terms of his needs which will determine his readiness to learn. Development stage determines the peak time for readiness to learn or teachable moment (Tanner, 1989, Hansen & Fisher, 1998).

E = Experiential readiness
Experiential readiness refers to the previous learning experiences which may positively (if the experience is pleasant and appropriately reinforced) or negatively (if the learning experience has been unsatisfying, humiliating or frustrating) affect willingness to learn.

1. Level of aspiration depends on the short-term and long-term goals that the learner has set which will influence his motivation to achieve. 2. Past coping mechanism refer to how the learner was able to cope with or handle previous problems or situations and how effective were the strategies used. 3. Cultured background is important to assess and know from the patients own cultural perspective in order to determine readiness to learn. a. Awareness of the culture of the learner is of prime important. Knowledge of the concepts of transcultural nursing will be a great help. b. Find out also if the patient understands the language that is being used to communicate with him.

4. Locus of control refers to motivation to learn which maybe.

Internal locus of control or intrinsic (within the individual as he/she is driven by the desire to know or learn), or External locus of control or extrinsic ( motivation to learn is influence by others who encourage the learner to learn )

5. Orientation this refers to a persons point-of-view which maybe:

Parochial close-minded thinking, can conservative in their approach to new situations, less willing to learn new materials and have a great trust in the physicians. Cosmopolitan orientation Is a more worldly respective perspective and more receptive to new or innovative ideas like the current trends and perspectives in health education.

K. = knowledge Readiness
Knowledge Readiness refers to: 1. Present knowledge base- also referred to a stock knowledge or how much one already knows above the subject matter from previous actual or vicarious learning. 2. Cognitive ability- involve lower level of learning which includes memorizing, recalling or recognizing concepts and ideas the extent to which this information is process indicates the level at which the learner is capable of learning

The teacher must recognize cognitive impairment due to mental retardation require special techniques and strategies of teaching and the cooperation of the family must be enlisted especially in the south care activities of the client. Learning disabilities-and low- level reading skills will need special approaches to teaching and to prevent discouragement and bolster readiness to learn.

Prepared by:

Raymun Edward Laquian Janelle Faith Pueyo Leweyllyne Irish Amon BSN 2-C