PRINCIPLES AND STRATEGIES OF TEACHING IN MEDICAL LABORATORY SCIENCE

CHARACTERISTICS OF THE LEARNER

Motivation and Behavior of the Learner

Learning Principles

 Use several senses

o Students learn more when information is delivered in a variety of ways rather than in only one way.
o Students retain:
 10% of what they read
 26% of what they hear
 30% of what they see
 50% of what they see and hear
 70% of what they say
 90% of what they say as they do something
o Learning is more likely to occur if people are allowed to practice what they are being taught.
o In any educational situation where it is appropriate, time should be planned for practicing what is being
taught.
 Actively involve the learners in the learning process
o Relates to the teaching methods used, that is, whether they are passive or active.
o Passive methods:
 Lecture, videos, and print materials
o Learning is much enhanced if more active methods are used. The more interactive the educational
experience, the greater the likelihood of success.
 Discussion, role-playing, small group discussion, and question and answer
 Provide an environment conducive to learning
o Environmental factors can make a huge difference in the outcome or success of an educational intervention.
o Learning takes place best when people are comfortable and extraneous interference is kept to a minimum.
 Assess the extent to which the learner is ready to learn
o In general, people learn only if they are emotionally and physically ready.
o Anxiety about the condition, fears or concerns about the effect of the condition on others, depression,
beliefs, family dynamics, and educational level can all hamper the learning process.
o The first step in the educational process is to assess readiness for learning.
o In situations where the client or the student is not ready, the educational process may need to be adjusted.
 Determine the perceived relevance of the information
o Adults are generally willing to learn if they perceive the information or skill being taught as relevant to
their lives.
o Armed with information about perceived relevance, you can address or correct any misperceptions. This
can be done by including examples and discussion of the practical application of the information.
 Repeat information
o Repetition enhances learning.
o When new information is presented, it should be presented several times and in a variety of ways.
 Rewording of information
o Particularly important when the information is complex or completely new.
 Generalized information
o Information is more readily learned if it is applied to more than one situation.
o Using a variety of examples to demonstrate application of the information in a number of different situations
promotes learning.
 PRINCIPLES AND STRATEGIES OF TEACHING IN MEDICAL LABORATORY SCIENCE

 Make learning a pleasant experience

o This can be accomplished through frequent encouragement and positive feedback.
o People usually enjoy learning, and learning is enhanced, when obvious progress is being made.
o Frequent recognition of accomplishment, even for seemingly small successes, can go a long way toward a
successful education intervention.
 Begin with what is known; move toward what is unknown
o Information should be presented in an organized fashion.
o It should begin with the basics or general information that is known and move toward new information, or
that which is unknown.
 Present information at an appropriate rate
o The rate at which you should teach new information depends on a host of things including, but not limited
to:
 The time frame available
 Physical limitations of the learners
 Education level
 Prior experience or familiarity with the information

Motivation and Behavior Change Theories

 Used by educators to plan and implement the most effective educational intervention possible.
 Theory: a set of interrelated concepts, definitions, and propositions that presents a systematic view of events or
situations by specifying relations among variables in order to explain and predict the events of the situation.

 Health belief model

o Most commonly used theory in health education.
o It explains behavior or predicts whether behavior change will occur on the basis of a set of beliefs or
perceptions. These perceptions are the individual client’s beliefs about:
 The seriousness of the illness
 This is either an illness he or she has just been diagnosed with, is at risk for, or one that
needs to be prevented, as in the case of complications from failure to follow medical
treatment.
 His or her susceptibility to the illness
 Belief of personal risk or threat of a particular health problem.
 If the perception is that there is great risk of developing or contracting a particular disease,
then the likelihood of changing behavior to avoid or prevent this disease from occurring is
increased.
 The benefits of changing to a new behavior
 Derived from following the prescribed course of action.
 Impacted by the extent to which the health problem is perceived as being serious and the
extent to which the person believes he or she is at risk.
 Barriers in making changes
 Factors that prevent the adoption of a new behavior.
 Include the perception that a treatment is expensive, painful, not effective, embarrassing,
or inconvenient.
 These beliefs may stem from misconceptions, lack of information, previous experience, or
hearsay.
 In order for a behavior to be adopted, barriers must be addressed and removed.
 PRINCIPLES AND STRATEGIES OF TEACHING IN MEDICAL LABORATORY SCIENCE

o Cues to action are essentially prompts that trigger people to do something about their unhealthy behavior.
 Reminder cards, billboards, educational information, and posters
o Educational interventions depend on the combined perception of severity and susceptibility as the force that
leads one to act. The perceived benefits of the proposed behavior minus the barriers lead to the course of
action.

 Transtheoretical model/Stages of change theory

o Useful when the targeted behavior change is the discontinuation of an unhealthy behavior.
o Postulates that people go through stages before a change in behavior occurs.
o Stages:
 Precontemplation
 No serious thought is given to changing the behavior in the next six months.
 This could be because the person is unaware that the behavior is unhealthy, or he or she is
uninvolved, meaning that the person knows that the behavior needs to be changed, but does
not see it as being very important.
 The person is undecided in thinking about the positives and negatives of changing the
behavior.
 Educational interventions targeting individuals in this stage should be focused on
increasing awareness, increasing the perception of seriousness of the unhealthy behavior,
and highlighting the benefits of adopting the new behavior.
 Contemplation
 At least aware of the need to change their behavior and are thinking about making a change
in the next six months.
 Weighing the pros and cons of the new behavior.
 This stage can last for long periods, and when it does, it is termed behavioral
procrastination.
 People progress from precontemplation stage to contemplation stage when the perceived
benefits of change (pros) increase. The focus of educational needs should be on the positive
aspects or benefits of the new behavior.
 Preparation or planning
 People plan to make the behavior change in the immediate future.
 The plan of action or means by which they will implement the change has been identified.
 People in this stage are most receptive to health education interventions that are action
oriented.
 These clients are ready to change.
 Many people have already begun trying the new behavior.
 Action
 The person is actively involved in the behavior change or in adopting the new behavior.
 Action is necessary for behavior to change.
 Maintenance
 It begins after six months of adherence to the new behavior.
 It is a period of constant attention to the new behavior to prevent relapse.
 Sustaining the new behavior can be difficult especially when there are cues in the
environment that can trigger the old behavior.
 Termination
 Behavior change has been completed and maintenance comes to an end when temptation
in problematic situations is no longer a threat and the ability to resist relapse has developed.
 New behavior has become a habit, and they require no further intervention.
 PRINCIPLES AND STRATEGIES OF TEACHING IN MEDICAL LABORATORY SCIENCE

 Theory of reasoned action

o Proposes that adoption of a new behavior results from individual intention to engage in the behavior.
o Intention is the extent to which a person is ready to engage in a particular behavior or the likelihood that a
person will engage in a particular behavior. Intention comes from attitudes people have toward the behavior
and subjective norms.
o Attitude toward the behavior is determined by beliefs about the outcome or attributes of the behavior.
o The subjective norm is determined by normative beliefs or by whether important others approve or
disapprove of the targeted behavior. Important others may be family members or significant others. It is
important to determine who the “important others” are for each individual.
o Behavior change will result if a person intends to change. If the behavior is seen as being good, and if the
significant others believe the behavior is good.
o The key to using this theory effectively is to address the variables needed to ensure behavioral intention.

 Social cognitive theory

o Behavior is the result of an interaction among the person, the environment, and the behavior itself. A change
in one of these factors changes all of them, a phenomenon called reciprocal determinism.
o To elicit behavior change or motivation requires that one or more of the person, environment, or behavior
factors be modified.
o Factors:
 Anticipated outcomes of engaging in the behavior
 Attitude toward the expected outcomes of the behavior is a personal factor that also plays
a role in determining whether a new behavior is adopted. Outcome expectation may be
influenced by past experiences, observation of others, and through word of mouth or
hearing about others in similar situations. These expectations may be realistic or unrealistic
when based on misinformation or lack of information.
 Expectancies or incentives
o The value a person places on the outcomes that also influences compliance with or
adoption of a new behavior.
o The extent to which the new behavior is seen as positive—the behavior is valued—
affects the likelihood that it will be adopted.
o Positive expectancies are a motivating force and an incentive to adopt the behavior.
 Learning by observing others
 By providing opportunities for the client to watch others perform the targeted behavior and
mimic or copy it, the personal factor may change and may result in the adoption of the new
behavior.
 Self-efficacy
 The person’s belief in his ability to perform to perform the new behavior, may also lead to
behavior change.
 By providing opportunities for clients and students alike to increase their perception of
ability, a stronger sense of self-efficacy can occur and perhaps a greater likelihood of
changing behavior
 Self-control
 Characteristics of the behavior also affect whether it will be adopted. The extent to which
the learner has control over the behavior may be an important factor in its adoption.
Allowing the learner to set his own goals, when feasible, may be the most important
determinant. This allows for a sense of control over the situation, provides parameters
against which success can be measured, and improves the likelihood of a successful
educational intervention.
 PRINCIPLES AND STRATEGIES OF TEACHING IN MEDICAL LABORATORY SCIENCE

o The environment in which the behavior change takes place is also vital.
 Encompasses more than the physical surroundings
 Entails the social environment (family, friends, peers, colleagues)
o Understanding the importance of the interrelationship among the person’s beliefs, attitudes, and
environment will go a long way in enabling the desired change in behavior to occur.

 Self-efficacy theory
o A very powerful determinant of health behavior.
o A determinant of motivation.
o The stronger someone’s belief in his or her ability to accomplish something, the more effort the person will
exert to learn it and the longer he will persevere.
o Proposes that behavior change occurs because of the expectations or expected result of the new behavior
and one’s belief about his ability to perform a specific behavior in a specific situation.
o Four sources:
 Performance accomplishments
 Learning that occurs through personal mastery of a particular skill or task.
 Most powerful sources of efficacy expectations
 Vicarious experience
 Learning through observation
 The people or events being observed are called models.
 Modeling enables people to learn by watching, through demonstration.
 Verbal persuasion
 Involves acting as the coach and providing encouragement
 Physiological state

 Attribution theory
o Predicts that when people have an emotional reaction to a particular event or outcome, they will try to figure
out why it happened.
o The explanation or the cause of the outcome is the attribution.
o People want to understand what causes events in their lives so that they may either repeat them if the
outcome was positive or avoid or change if the outcome was negative.
o Causes or attributions dimensions:
 Locus of causality
 Whether the cause is internal or external.
 Does the cause come from within the person or from external sources?
 Controllability
 The extent to which the attribution can be affected by the person, or how much control the
person has over the cause.
 Stability
 The extent to which the cause is consistent.

 Behavior theory—behavior modification

o First proposed by B.F. Skinner (1938)
 Based on the premise that behavior occurs because of its consequences (i.e., reinforcements or
rewards).
 Changing the consequences, then, can change behavior.
 The consequences of a behavior can be a positive reinforcer (wanted) or a punishment (unwanted).
 Positive rewards strengthen behavior, but punishment does not necessarily eliminate it.
o A reinforcement given immediately following the target behavior is more powerful than one that is delayed.
 PRINCIPLES AND STRATEGIES OF TEACHING IN MEDICAL LABORATORY SCIENCE

o Behavior, according to this theory, does not entail reasoning, thought, or knowledge but only external
immediate rewards.
o Because behavior modification does not provide clients with information, skills, or reasons so that they
may change behavior on their own, there is the risk that these types of interventions directly manipulate
behavior. To address this concern, obtain informed consent from the client before the intervention. By doing
so, the client is making the decision to engage in an intervention designed to change his behavior.