HEALTH EDUCATION HEALTH DEV’T- change in physical, psycho, social, spiritual, emotional constitution of

person which starts from conception to death

- application of HE concepts, principles, theories, strategies, methods & ethico-moral,
- study of changes in people as they age
legal & professional responsibilities of a nurse educator
Changes: Growth (Quantitative)- increase in size; acquisition of knowledge
- promote, maintain, enhance health, prevent illness, disability, premature death by
Development (Quali)- gradual changes in character by intellectual, emotional &
adoption of health behavior, attitudes, perspectives; draw health models from
physiological capabilities
biological, env, psychological, physical medical & paramedical sciences like nursing
- (William Grout) translation of known on health into desirable individual/community 2 major process in growth & dev’t
behavior by educational process” 1. LEARNING- permanent change in behavior due to experience
- (Thomas Wood) sum of experiences influencing habits, attitudes, knowledge relating 2. MATURATION- bodily changes genetically determined by heredity
to individual community & social health”. Major Learning Theories
- (Green et al, 1980) combination of learning experiences to facilitate voluntary
a. BEHAVIORIST
adaptations of behavior conducive to health “
- stimulus response theory simple stimuli w/pos & neg reinforcement to produce
- (WHO) consciously constructed opportunities for learning involving communication
learning responses; behavior is learned; learning is most influenced by env
to improve health literacy, improving knowledge, developing life skills which
are conducive to individual & community health - (John B. Watson) emphasized importance of observable behavior in study of human.
Defined behavior (muscle movement) associated w/Stimulus-Response psychology;
Purpose: Positively influence health behavior & perspectives to develop self-efficiency behavior results from conditional reflexes & all emotion/thoughts are product of
to adopt health lifestyles, resulting to healthy communities behavior learned by conditioning
Means of propagating Health Promotion & Disease Prevention
Learning- due to stimuli in env & learner’s response following “S-R MODEL of LEARNING”
Used to modify/continue health behaviors if necessary
Environment- env stimuli altered/response’s effects manipulated to bring behavior change
Provides health information & services
to be applied through practice/habit formation
Emphasize good health habits (integral aspect of culture, media, technology)
Means to communicate Vital Information to public Behavioral learning is based on:
Form of advocacy Respondent Conditioning
Importance a. Classical/Pavlonian- influences acquisition of new responses to env stimuli
- Empowers people to decide for options to choose to enhance quality of life - Neutral Stimulus: elicits unconditioned response by repeated pairing
- Enhances quality of life by promoting healthy lifestyles w/unconditioned stimulus
- Equips people w/knowledge & competencies to prevent illness, maintain health, Ex: Offensive odor (unc stimulus)  queasy feeling (uncon response)
apply first aid measures to prevent complications; improves health status Hospital (NS)+Offensive odor (UCS)  queasy feeling (UR)
- Creates awareness on importance of preventive/promotive care, reducing costs of pairings of hospital + offensive odors  queasy feeling
medical treatment/hospitalization Hopsital (CS)  Queasy feeling (CR)
b. Systematic Desensitization- repeated & gradual exposure to fear reducing stimulus
Characteristics
under relaxed/nonthreatening circumstances (SENSE OF SECURITY)
1. Directed at people directly involved w/health related situations
- used by psychologist to reduce fear
2. Lessons are repeated, reinforced, adaptable
3. Entertaining & attracts attention c. Spontaneous Recovery- applied in relapse prevention program (RPP)
4. Uses clear, simple language w/ local expression - although response may appear to extinguished, it may recover at any
5. Emphasizes short term benefit of action time when stimulus conditions are similar to initial learning experience
6. Provides opportunity for dialogue, discussion, learner participation & feedback - understand why it’s hard to completely eliminate addictive habits
8. Uses Demonstration to show benefits of adopting practices Operant Conditioning (Burhuss Frederick Skinner)- organism behavior & reinforcement
that follows after response
HEALTH- “ heal”, HAEL (whole) = “ THEORY OF HOLISM”; whole person & their
integrity, soundness/well- being; functions as a complete entity a. Reinforcement- responses closely followed by satisfaction becomes attached to
- (WHO, 1946) complete physical, mental, social, well-being situation, more to reoccur when the situation is repeated
Modern concept: Optimum Level Of Functioning (OLOF) individuals/families b. Thorndike’s Law of Effect- when specific responses are reinforced on proper
schedule, behaviors increase/decrease”
Factors: political, behavioral, hereditary, health care delivery sys, env, socioeconomic
c. Reward/Praise- encourage/motivated
dimensions: Positive reinforcement: verbal, nonverbal, citing in class/publishing
BROADER: Societal- link of health & way a society Is structured
Environmental health- physical environment where people live Classification of Educ Reinforces
INDIVIDUAL: Mental - + sense of purpose/belief own’s worth (reinforcement must be directly linked to learning tasks & student’s accomplished)
Spiritual- Supreme Being; practice moral principles & beliefs 1. Status indicators- appointment as peer tutor, having own space
Physical - state of body fitness/not being ill 2. Incentive feedback- increased knowledge of exam scores & individual contributions
3. Personal Activities- opportunity to engage in special projects, extra time off
Sexual – acceptance/ achieve satisfactory expression sexuality
Social - Support system available Negative Reinforcement
Emotional - Express feelings/develop & sustain relationship 1. Escape Conditioning- as unpleasant stimulus is applied, individual response that
causes uncomfortable behavior to cease.
“Being healthy means function well physically & mentally; express full range of
potentialities within env where one is living “ - Dubos & Dunn 2. Avoidance Conditioning- unpleasant stimulus is anticipated than being applied directly
Nonreinforcement
Principles & Theories in Teaching & Learning
(Skinner) simplest way to extinguish response is not to provide any reinforcement
TEACHING- (Bastable, 2019) share info/experiences to meet learner outcomes in
cognitive, affective, psychomotor domains acc to an educ  desirable behavior ignored lessen; if reinforcement is ineffective, punishment’s employed
LEARNING (Bastable, 2003) permanent change in mental processing, emotional  under punishment conditions, one cannot avoid unpleasant stimulus. If employed, it’s
functioning, behavior, social transaction skills due to experience administered immediately after response w/o distractions/means of escape Punishment
determined by person’s env/evolve from birth to death must be consistent at “highest” reasonable level
 punishment must not be prolonged/bring up old grievances/complain on misbehavior
Contribution of Learning Theories at every opportunity: “time out”; CARDINAL RULE (“punish behavior, not the person”)
- understand teaching process & learning; how we acquire knowledge & change how
we think, feel, behave b. COGNITIVE - mental processes/cognition occurs between stimulus & response
- helped health profs: employ sound method/rationales in HE efforts Cognitive-dwell on ability to solve problems than responding to stimuli
staff training & education; carry out HE promotion programs Cognition-more than knowledge acquisition; transfer of learning occurs when learner
- to understand learner’s nature, health prof must know: acts on info they get/applies it in situations
a. basic principles in dev’t & maturation of individual - involves person’s: Cognitive processes of perception, Thinking skills, Memory
Ways to process & structure formation: 4 sequential stages of cognitive dev’t
- Perceiving info; Interpreting it based on what is already known 1. Sensorimotor (infancy)- infants explore env & attempt to coordinate sensory info w/
- Reorganizing info to make new insight/understanding motor skills; learning depends on experience in beginning learned visually
- Stress importance of what goes on “inside” learner 2. Preoperational stage (early childhood 3-6 y/o)- able to mentally represent env,
 key to learning & changing is one’s cognition (Perception, thought, memory, ways of regard world from own egocentric perspective, understand symbolism
processing/structuring information) 3. Concrete Operational “ (Elementary, 6-12 y/o) - attend to more than 1 dimension at a
 to learn, one must change their cognition time, conceptualize relationship, operate on env
Perspectives 4. Formal Operation “ (Adolescence 12-18)- think abstractly, deal w/future, see
alternatives & criticize
1.Gestalt- perception importance in learning focusing on pattern/stimulus
- principal assumption: person perceive, interpret, respond to situation in own way  children absorb info as they interact w/ people & env, make their experiences fit w/
Principles what they already know (assimilation)/change their perception & interpretation in
keeping w/new info (accommodation)
a. Psychological organization- toward simplicity, equilibrium, regularity“
- simple/clear explanation of disease condition” What do cognitive theorist say on adult learning?
b. Perception is selective- no one can attend to all surrounding stimuli at same time - tho cognitive stages develop consequentially, some never reach operations stage. They
c. What individuals pay attention/ignore is affected by needs, personal learn better from concrete approaches to health education
motives, past experiences, particular structure - adult dev’tal psychologist & gerontologist proposed advanced stages of reasoning in
Implications adulthood beyond formal operations
- help health educator on how they approach learning situation w/ persons - older adults show advance level reasoning from their wisdom & life experience/reflect
- 1 approach may be effective to a client but may not work w/ another lower stages of thinking due to lack of education, disease, depression, medications
Benefits to healthcare
2. Information-Processing- emphasize thinking process (Thought, Reasoning, Way info
is encountered& stored, Memory functioning) - encourage recognition & appreciation of individuality & rich diversity in how people
learn/ process experiences
- to assess problems in acquiring, remembering, recalling info
Model of memory c. SOCIAL LEARNING
1st stage: PAYING ATTENTION - explain human behavior & changes as product of interaction between cognitive,
- attention is key to learning; if inattentive, explain at other time when receptive behavioral, envi determinants
2nd stage: INFORMATION - importance of env/situational determinants of behavior & continuing interaction.
- consider client’s mode of sensory processing (visual, auditory, motor manipulation) - assumes that all behavior patterns must be learned through:
3rd stage: INFORMATION IS TRANSFORMED & INCORPORATED TRADITIONAL LEARNING (by reinforcement) & OBSERVATIONAL LEARNING (by modeling)
- encoded briefly into short term memory, later forgotten/stored - behavior is shaped by expectations formed from experience/watching others
- “strategies for storage are imagery, association, rehearsal, chunking
- (Albert Bandura) env conditions shape behavior by learning behavior in return, shapes env
4th stage: ACTION/ RESPONSE
- based on how info was processed & stored
3 determinants how behavior (Bandura)
Antecedents -behavior based on past as we have seen it
Strategies Consequences- “ influenced by its results
1. Have learners indicate how they believe they learn (metacognition) Cognitive- “ is based on how we are motivated
2. Ask them to describe what they’re thinking as they are learning
Role Modelling- central concept; learning occurs by observation
3. Evaluate learner’s mistake
4. Give them attention to their inability to remember/demonstrate info Vicarious Reinforcement- view others emotion & determine whether role models are
rewarded/punished for their behavior
 Forgetting/difficulty in retrieving info from long term memory is major stumbling
block in learning which occur because: 4 Operations in Modeling
- info has faded from lack of use 1. Attentional Phase
- other interferes w/ retrieval (what comes before/after learning session may - observe role model “what person can do & what they can attend to”
compound storage & retrieval) - necessary condition for learning to occur; role models w/ high status & competence
- persons are motivated to forget for conscious/unconscious reasons more likely to be observed, although learner’s own characteristics (needs, self- esteem,
competence) may be more significant determiner of attention
3. Cognitive Dev’t- focus on quali changes in perceiving/thinking /reasoning as they
2. Retentional Phase
mature/ grow
- processing & representation in memory; “How experience encoded/retained in memory”
- p. assumption: learning is a developmental, sequential, active process that
- storage & retrieval of what was observed
transpires as child interacts w/ env, makes “discoveries” about how world
operates, interprets these in keeping w/ they know what she he knows. 3. Reproduction Phase
- cognitions are based on how events are conceptualized, organized, represented - memory guides performance of model’s action; “What behavior can be performed”
in person’s schema, partially dependent on one’’s stage of cognitive stage of - learner copies observed behavior
dev’t & readiness to learn - mental rehearsal, immediate reenactment, corrective feedback strengthened
reproduction of behavior
9 Events that activate learning w/cognitive processes (Robert Gagne, 1995)
4. Motivational Phase
1. Reception (gain learners’ attention) - influenced by vicarious reinforcement/punishment covert cognitive activity, consequences
2. Expectancy (Inform learners of objectives & expectations) of behaviour, self-reinforcement, punishment
3. Retrieval (Stimulate the learner’s recall of prior learning) - focus on whether learner is motivated to perform type of behaviour
4. Selective Perception (present info)
5. Semantic Encoding (Provide guidance to help learner’s understanding)
6. Responding (Have learner demonstrate knowledge & skills) LEARNING PRINCIPLES
7. Reinforcement (give feedback to learner) LEARNING- (Bastable) permanent change in mental processing, emotional functioning,
8. Retrieval (Assess learner’s performance) behavior as result of experience influenced by env
9. Generalization (work to enhance retention/transfer by application & practice) - change in mental processing, dev’t of emotional functioning, social transactional skills
Jean Piaget– cognitive dev’t theorist; observation of children’s perception & thought which develop & evolve from birth to death
processes at different ages contributed to recognition of: Env factors: Society & culture Structure or pattern of stimuli Feedback (in/correct)
- unique ways that youngsters reasons Effectiveness/credibility of role models & reinforcements
- changes in their ability to conceptualized Opportunities to process & apply learning to new situations
- limitations in understanding, communicating, performing Type, nature, level of motivation
Experiences facilitate/hinder learning process: Barriers to Education & Obstacles to Learning
a. teacher’s selection of learning theories & structuring/type of learning experience. BARRIERS TO EDUCATION OBSTACLES IN LEARNING
b. teacher’s knowledge of nature of learner, materials to be learned, teaching - hinder nurse’s ability to deliver educ services to - negatively affect ability of learner to attend &
method, communication skills, ability to motivate learner patient / family process info
1. STRESS OF ACUTE & CHRONIC ILLNESS,
c. teacher’s ability to relate new knowledge to previous experiences, values self 1. LACK OF TIME TO TEACH (greatest barrier):
ANXIETY, SENSORY DEFICITS, LOW
perception, learner’s readiness to learn a. short period of confinement
LITERACY ON PATIENTS
b. very demanding schedules of nurses
Common Principles of Learning (help motivate learner, de Young 2003) - result to diminished learner motivation &
c very demanding responsibilities
learning
a. Use senses 2. LACK PREPARATION OF NURSES TO TEACH
- med students are made to imitate procedures shown by CI (rolemodeling); graded a. lack knowledge on principles of teaching & 2. NEGATIVE INFLUENCES OF HOSPITAL
acc to skills they exhibited degree of comprehension of rationale behind steps. learning ENVIRONMENT ITSELF
- expected that by imitating, learners can retain 70% of lesson b. nurse don’t feel competent/confident (d/t - result to loss of control, lack privacy, social
- application of skills/knowledge in actual care of patients in hospital inadequate preparation for their roles as isolation
– learners will have 90% retention nurse educators)
3. PERSONAL CHARACTERISTICS OF
b. Actively involve clients in the learning process 3. LACK OF TIME TO LEARN
NURSE AS A TEACHER
- d/t rapid patient discharge can
- use interactive methods involving participation of learners - influence outcome of teaching learning
discourage/frustrate learner
- ex: Role-playing, case study, buzz session, QnA format, RD process
4. PERSONAL CHARACTERISTICS OF LEARNER
c. Provide env conducive to learning. 4. LOW PRIORITY GIVEN TO PT & STAFF
- readiness to learn, motivation, compliance,
- always consider comfort & convenience of learner EDUCATION BY ADMINISTRATION
developmental stage characteristics &
SUPERVISORY PERSONNEL
d. Assess extent to which learner is ready to learn learning styles)
- readiness to learn affected by: Emotional (anxiety, fear, depression) 5. EXTENT OF BEHAVIORAL CHANGE NEEDED
5. LACK OF SPACE & PRIVACY IN VARIOUS
Physical (pain, visual, auditory impairment, anesthesia) CAN OVERWHELM LEARNER & DISCOURAGE
ENVIRONMENTAL SETTINGS
THEM
e. Determine relevance of information RD
6. ABSENCE OF 3 PARTY REIMBURSEMENT
- anything perceived by learner to be useful will be easier to learn & retain 6. LACK OF SUPPORT & POSITIVE
TO SUPPORT PATIENT EDUC PROGRAMS
REINFORCEMENT FROM NURSE &
f. Repeat information continuous repetition RELEGATES TEACHING & LEARNING TO LESS
SIGNIFICANT OTHERS
THAN HIGH PRIORITY STATUS
- continuous repetition of info enhances learning.
7. DENIAL OF LEARNING NEEDS, RESENTMENT
¨ applying info to different situation help in learning process 7. SOME NURSES & PHYSICIANS QUESTIONS
OF SUPERVISORY AUTHORITY, & LACK OF
EFFECTIVITY OF PT. EDUCATION AS MEANS TO
g. Generalize information WILLINGNESS TO TAKE RESPONSIBILITY
IMPROVE HEALTH OUTCOMES
¨ applying information to a number of situations - locos of control
8. CONTENT NEED TO BE STANDARDIZED,
h. Make learning a pleasant experience 8. INCONVENIENCE, COMPLEXITY,
TEACHING RESPONSIBILITIES NEED TO BE
- teacher give frequent encouragement, recognize accomplish, give positive feedback. INACCESSIBILITY, FRAGMENTATION, &
CLEAR; LINES OF COMMUNICATION MUST BE
DEHUMANIZATION OF HEALTHCARE SYSTEM
i. Begin w/what is known, moving toward unknown STRENGTHENED ON HEALTHCARE PROVIDERS
- present info in an organize manner 9. INADEQUATE TIME TO RECORD/
DOCUMENT PATIENT TEACHING
¨ start presentation w/info that learner already knows/ familiar with
j. Present info at appropriate rate
- pace where info is presented; too fast/ too slow
Learning to be Relatively Permanent
a. Organize Learning Experience (meaningful & pleasurable)
b. Practice/Rehearse New Info (mentally/physically)
c. Apply Reinforcement (reward) (make learner know learning has occurred)
d. Assess/Evaluate (use evaluation feedback to revise, modify, revitalize LE)

6 HALLMARKS OF GOOD/EFFECTIVE TEACHING IN NURSING (JACOBSEN)

1. PROFESSIONAL COMPETENCE
evidenced by: a. Thorough Knowledge (subject matter & proper demo of skills)
b. Read, Research, Undertake Continuing Prof Educ, w/Clinical Practice & Expertise
2. POSESSION OF SKILLFUL INTERPERSONAL SKILLS W/STUDENT-RATED AS MOST
IMPORTANT TO TEACHER
a. takes personal interest in welfare student b. Fair & Just
c. sensitive to feelings & problems d. Conveys respect to students
e. allows learner to freely express & ask questions
f. accessible for conference & consultations g. conveys a sense of warmth
3 basic approaches where instructor increase self-esteem & reduce anxiety:
a. empathic listening - seeing world through his/her own eyes
b. accepting learners as they are
c. communicating honestly w/students (Expectations, responsibilities)
 in performing duties as a mentor, teacher is guided by principle: “in loco parentis”

3. DESIRABLE PERSONAL CHARACTERISTICS OF TEACHER

(charisma/personal magnetism, enthusiasm, cheerfulness, self-control, patience ,
flexibility, sense of humor, good speaking voice, self-confidence, willingness to admit
error, caring attitude) (Kotzabassaki 1997 & Fanbrother, 1996)
4. TEACHING PRACTICES: mechanics, method, skills in classroom/clinical prac,
knowledge, present material in clear, logical, organized manner
5. EVALUATION PRACTICE
- clear communication of expectations; provide timely feedback on student progress
- correct students tactfully; being fair in evaluation processes
- give test pertinent to subject matter & assignments
6. AVAILABILITY TO STUDENTS IN LAB, CLINICAL, SKILLS APPLICATION AREA MOSTLY
MARKED BY STRESSFUL/CRITICAL SITUATIONS
 DEVELOPMENAL STAGES OF LEARNER PRECAUSAL THINKING - how preoperational children use own existing ideas to explain
cause & effect relationship
3 Orientations to Learning:
- make happen but unaware of causation bc of invisible physical &
Pedagogy - helping children to learn
mechanical forces
Andragogy –(Knowles, 1990) theory of adult learning; teaching adults
Geragogy -teaching older persons ANIMISTIC THINKING - endow inanimate objects w/life & consciousness
Artificialism- belief that env characteristics are attributed to human actions/ interv
3 Major Stage Range Factors in Learner Readiness
Transductive reasoning- child fails to understand true relationships of cause & effect.
Physical ⇆ Cognitive ⇆ Psychosocial Maturation
• very curious (whys, not with how?); fantasy & reality not differentiated
Contextual Influences Act & Interact to Produce Development
• limited sense of time but understands timing of familiar events
Normative Age- graded influences strongly related to chronological age • sexual identity; fear of body mutilation & pain
& same for all in a specific age group
egocentric causation - belief that illness is cause by own transgressions
Normative History - common to those in certain age cohort/generation due to being
• takes task for sake of involvement; excess energy & desire to dominate lead to frustration
exposed to similar historical circumstances
• interact w/playmates; role play is typical
Normative life events - unique pos/neg circumstances as turning points in lives that
causes them to change directions Teaching Strategies
• Allow express fear openly; choose words carefully in describing a procedure
INFANCY (0-12 mos) & TODDLERHOOD (1-2 y/o) Short-Term Learning
- highly complex field of growth & dev’t; focus of instruction for health is to parents
• give physical & visual stimuli; teaching session <15 min; sched is sequential at close interv
COGNITIVE DEV’T IN CHILDREN (JEAN PIAGET) • relate info needs to activities
Sensorimotor Period • encourage to participate in selecting in limited teaching -learning options
-coordination & integration of motor activities w/sensory perception ; end of 2nd • arrange small group sessions; give praise, approval, tangible rewards
year, “object permanence” • allow manipulate tools; story books to emphasize humanity of health care personnel
- motor act promotes understanding of world & awareness of selves & others reaction Long-Term Learning
in response to their own actions (Parent encouraged to create safe env)
• enlist help of parents who play vital role in modelling healthy habits
- toddler has basic reasoning, understands object permanence, has beginning of • reinforce pos health behaviors & acquisition of specific skills
memory, begin to develop elementary concept of causality
- limited ability to recall past/anticipate future MIDDLE & LATE CHILD (6-11)- Cognitive Stage: OPERATION
- “here & now” & little tolerance to delayed gratification Psychosocial stage: INDUSTRY vs INFERIORITY
- short attention span; easily distracted; not amenable to corrections, ask question
• learning w/enthusiastic anticipation; logical, rational, reason inductively & deductively
hallmark; curiosity; respond to simple step by step commands & obey directives
• can think more objectively, listen to others; use questioning selectively
- language skill is rapidly acquired; engage in fantasy & make-believe play
syllogistic reasoning- consider 2 premises & draw a logical conclusion from them
- limited understanding cause & effect; separation anxiety, feel insecure in an
unfamiliar env • understand cause & effect in concrete wayclings on to cherished beliefs
• can concentrate on extended periods; can tolerate delayed gratification
PYSCHOSOCIAL DEV’T IN CHILDREN (ERIK ERICKSON) • understand time, oriented to past & present; grasp & interest in future
Infancy- TRUST vs MISTRUST Toddlerhood- AUTONOMY vs SHAME & DOUBT • causal thinking - incorporate idea that illness is related to cause & effect
• gain awareness on unique talents & special qualities
- newly discovered independence expressed by negativism
• school env help dev’t of sense of responsibility & reliability
- express level of frustration & ambivalence by temper tantrums
- play is a parallel activity fears- failure of being left out of groups, illness, disability
Teaching Strategy Teaching Strategies
• patient educ for infancy & toddlerhood need not be illness-related • Hands on experience; explain illness, treatment plan, procedures in simple & logically
• less time in teaching parents about illness • teaching presented in concrete terms step by step
• more time in teaching normal dev’t, safety, health prom, disease prevention Short Term Learning
• 1st priority: assess child's anxiety level when child is ill • Allow to take responsibility for own health care; Teaching sessions to 30 min & 1 to 1
• toddlers can understand procedures & interventions • use diagrams, model, picture, digital media as adjuncts to teaching methods
• parents must be present during formal & informal teaching & learning activities • Use analogies as an effective means of providing information
• health teaching must be in env familiar to child (home, daycare centers ) • give time for clarification, validation, reinforcement, nurturance, support
• develop rapport w/children by simple teaching for cooperation & involvement • employ group teaching sessions with others of similar age
• approach: WARM, HONEST, CALM, ACCEPTING, MATTER OF FACT
• warm voice tone, encouragement, word of praise, attracting children's attention Long Term Learning
• Help school-age acquire skills for assume selfcare; responsible for therapeutic treatment
Strategies for Short-Term Learning • Assist in learning to maintain own wellbeing & prevent illness from occurring
• read simple stories from books w/pics; dolls/puppets to act out feelings & behaviors
• simple audiotapes w/music & videotapes w/cartoon characters ADOLESCENCE (12-19)- Cognitive Stage: FORMAL OPERATION
• role play to bring child's imagination closer to reality - Psychosocial “ : IDENTITY vs ROLE CONFUSION
• simple, nonthreatening, concrete, explanations for visual & tactile experiences • transition from child to adult
• use teddy bear/ doll for child anticipate what experience will be like propositional reasoning – reason deductive & inductive; hypothesize & apply principle
• teaching sessions brief (< 5 min); of logic to situations never encountered
• cluster teaching sessions close together
egocentrism - obsessed of what they & others think are thinking
• explain things in straight forward & simple since children take literally & concretely
imaginary audience- explains pervasive self-consciousness
• Individualize pace of teaching acc to child's response & level of attention
personal fable - belief that they’re invulnerable
Strategies for Long Term Learning • indulge in comparing their self-image w/ ideal image
• focus on rituals, imitation, repetition of info by words & actions • demand personal space, control, privacy, confidentiality
• reinforcement for child to achieve permanence of learning through practice
• gaming & modelling to learn about world & test their ideas over time Teaching Strategies
• give privacy, understanding, honest, straightforward approach & unqualified
• parents as role models bc their values & beliefs to reinforce healthy behavior
acceptance in facing fear embarrassment, losing independence, identity, self control
EARLY CHILDHOOD (3-5)- Cognitive Stage: PREOPERATIONAL Short-Term Learning
Psychosocial: PYSCHOSOCIAL INITIATIVE vs GUILT • Use 1 to 1 instruction for confidentiality of sensitive info
• use symbols to represent; recalls past experiences, anticipates future events • Choose peer group discussion session & share decision-making
• classify objects, vaque understanding of relationships; egocentric • Give rationale for procedure; approach w/ respect, tact, openness, flexibility
• thinking remain literal & concrete • expect negative response, common when self-image & self integrity are threatened
• Avoid confrontation acting like authority
Long Term Learning DETERMINANTS OF LEARNING
• accept personal fable & imaginary audience as valid than challenging feelings of
- as gaps in knowledge between desired level of perf & actual performance
uniqueness, invincibility; allow them to test their own convictions
- as gap of what someone knows & what someone needs to know
- gap exist due to lack of knowledge, attitude, skills
YOUNG ADULTHOOD (20-40) (FORMAL OPERATION; INTIMACY vs ISOLATION) - 90-95% learners acc to educ psychology master a subject w/high success w/sufficient
• physical abilities at peak; body in optimal functioning time & appropriate types of help.
• cognitive capacity is fully developed, continue to gather new knowledge - teacher first discover learner needs & find means of instruction for learner to master
& skills from expanding reservoir of formal & informal experiences
1. Learning needs (what learner needs to learn)
• work to establish trusting, satisfying, permanent relationships w/others
2. Readiness to learn (when learner is receptive to learning)
Teaching Strategies 3. Learning style (how the learner best learn)
• Allow mutual collaboration in health decision making Steps in assessing Learner Needs
• Encourage to select what to learn & how materials are presented &indicators used to
1. Identify learner 6. Prioritize needs to know availability of educ resources
determine achievement
2. Choose right setting 7. Assess demands of organization
• do well w/ written patient education materials, audiovisuals, CAI’s to self-pace
3. Collect data on learner` 8. Take time – management issues into account
independent learning
4. Include learner as source of info 9. Prioritize needs
5. Involve members of health care team
MIDDLE AGED ADULT (41-64) (F OP; GENERATIVITY vs SELF-ABSORPTION/
STAGNATION Methods to Assess Learning Needs
• transition in young to older adulthood 1. Informal convo/interviews 6. Observation of behaviors
• adults realize that half of their potential life are spent; questions their level of 2. Structured interviews 7. Patients data
achievement & success 3. Focus group 8. Chart audits
• physiological changes (skin & muscle tone decrease, metabolism slows 4. Self- administered questionnaire 9. Formal and informal request
down, body wt increase, endurance/energy levels lessen, hormonal changes 5. Test (pre & post)
bring symptoms, hearing & visual acuity diminish) Readiness to Learn
dialectical thinking - search for complex & change understanding to find solutions - time when learner show interest to learning info to maintain optimal health/more skillful
Teaching Strategies - occurs when learner is receptive to learning & willing to participate in learning process
• Focus on maintain independence & reestablish normal life patterns - no matter how important info/how much educator feels recipient of teaching needs info,
• Assess positive & negative past experiences w/learning if learner is not ready, info is not absorbed
• Assess potential sources of stress caused by midlife crisis issues timing,- where teaching take place; important bc anything affecting physical/psychological
• Provide information to coincide with life concerns and problems comfort can affect learner’s ability & willingness to learn

OLDER ADULTHOOD (>65) (FORMAL OPERATION; EGO INTEGRITY vs DESPAIR) Types of Readiness to Learn (PEEK) (Lichtenthal)
Cognitive change: decreased thinking abstractly, process info P= Physical Readiness E= Emotional Readiness
• Measures of ability •Anxiety level
Decreased short term memory; Increase reaction time & test anxiety
•Complexity of task •gender •Support system •Motivation
Stimulus persistence (afterimage); focus on life experience •Env effects •Health status •Risk-taking behavior
Intellectual Ability •Frame of mind •Dev’t stage
• Crystallized Intelligence- absorbed in lifetime (vocabulary, general info, arithmetic), E= Experimental Readiness K= Knowledge Readiness
•Level of aspiration •Present knowledge base
- ↑ as person age, impaired by state
•Past coping mechanisms •Cognitive ability
• Fluid Intelligence- perceive relationships, to reason, & abstract thinking, ↓ as •Cultural background •Learning disabilities
degenerative changes occur •Locus of control •orientation •Learning styles
Sensory/Motor Deficit Learning Styles
- ways one process info; no learning style is better/worse than another
• Auditory change (hear loss in high pitched tones, consonant (S,Z,T,F, G), rapid speech
- accept style diversity to help educators create an atmosphere for learning offering
• Visual change (Farsighted, lenses turns opaque (glare problem), smaller pupil size, ↓
experiences that encourage to reach full potential
visual adaptation to darkness)
• ↓peripheral perception; Distorted depth perception 6 Learning Style Principles
• Yellowing lenses (distorts low tone colors blue, green, violet) 1. Style how teacher prefers to teach & style how student prefers to learn can be identified
• Fatigue/ ↓ energy levels; Pathophysiology (CHRONIC ILLNES) 2. Teachers must guard against overteaching by own preferred learning styles
Psychosocial Change: ↓ risk taking; Selective learning; Intimidated by formal learning 3. Teachers are most helpful when they assist students identify & learn own style
4. Students must have opportunity to learn through own preferred style
Cognitive Change: Use concrete example; brief explanation; relevant/meaningful info 5. Students is discourage to diversify their style preference
Build on past life; Allow time for processing /response (slow pace) 6. Teacher can develop specific learning acts that reinforce each modality/style
Present concept at time; use verbal exchange/coaching
Info repetition & reinforcement; avoid written exams Learning Style Model
Establish retrieval plan (clues); encourage active involvement Kolb’s (management expert from Case Wester Reserve Uni) Learning Styles
Use analogies to illustrate abstract info - knowledge is transformational process that continuously created & recreated
Sensory/Motor Deficit - learning is continuous process grounded in reality that learner is not blank state—every
• Speak slowly, distinctly; low-pitched tones; visual aid for verbal instruction learner approach a topic to be learned w/preconceived ideas
• Avoid glares used soft white light; sufficient light; use white bg & black print KOLB’S THEORY ON LEARNING STYLE
• large letter & well-spaced print; no color-coding w/pastel blue, green, purple, yellow - learning is a cumulative result: past experience, heredity, demands of present env
• ↑ safety precautions/provide a safe env - factors combine to diff individual orientations to learning
• Ensure accessibility & fit of prostheses (glasses, hearing aid) - by knowing each learner’s preferred style educator is better equipped to assist learners in
• Keep session short; frequent rest periods extra time to perform refine/modify preconceived ideas so that real learning can occur
• Establish realistic short term goals
Cycle of learning (4 modes which reflect 2 major dimensions of perception & processing)
Psychosocial: time to reminisce; identify & present pertinent material
Kolb’s Learning Style Inventory
informal teaching sessions; show relevance of info daily life
Assess resources positive learning; identify past positive experiences
1. CONVERGER (learns by AC & CE)- works when given practical application/concept; GARDNER’S 7 TYPES OF INTELLIGENCE (HOWARD G.) (children’s learning style)
prefer experiment w/ new simulations, lab assignment DOMAINS OF FACETS OF INTELLIGENCE
 LEARNS BEST by DEMONSTRATION-RD, handout, illustration. INTELLIGENCE & BRAIN (Feature, aspect,
2. DIVERGER (stresses CE & RO)- feel oriented; work in groups to gather info, listen AREAS characteristics)
w/open mind; learn best when allowed to observe & collect. 1. VERBAL / LINGUISTIC
 LEARNS BEST by GROUP DISCUSSION & BRAINSTORMING SESSIONS - Understand word order &
meaning
3. ACCOMODATOR (CE, AE): impatient w/ people; risk-taker, trial & error, acts on - Reading, writing, speaking - Deals w/ written & spoken - convince, verbal debate
intuition, instinct than LOGIC; “HAND-ON”; ACHIEVER - Broca’s area (left side) language - explain in words; teach
 LEARNS BEST by ROLE PLAYING, GAMING & COMPUTER SIMULATIONS - use & meaning of language - enjoy verbal jokes
- creative writing & poetry
4. ASSIMILATOR (AC, RO)- abstract ideas than people, inductive reasoning, create
appreciation
theoretical models; integrate idea & actively apply it; LOGICAL thinking.
2. LOGICAL / MATHEMATICAL
 LEARN BEST by LECTURE, 1-TO-1 DIRECTION, READ MATERIALS/SELF-INSTRUCTION - Pattern recognition
- make prediction, estimate,
GREGORC COGNITIVE STYLES MODEL - Calculations, problem- - inductive & deductive
inductive & deductive reasoning
- discern relationships &
Anthony F. Gregorc, Ph. D., solving, logical reasoning & reasoning
connection, complex. calculation,
- phenomenological researcher, consultant, President of Gregorc Associates, Inc. analysis, statistics - abstraction & discernment of
scientific reasoning
- internationally recognized for his work in learning styles in 1969 w/intro of Energic - both sides of brain numerical pattern
- experiments, seek explanations
Model of Styles, which evolved into Mind Styles Model in 1984 - categorize info
- computer programming
Theory Behind the Model
3. SPATIAL / VISUAL
- Gregorc's Mind Styles model- organized way to consider how mind works
- recognize object relationship
Model in space
- Arts, crafts, maps, - visualize object to create
- sense of direction
- identify 4 sets of dualities (situation w/2 parts complimentary/opposed each other) geometry, design internal images
- find way around
- mind has mediation abilities of: - right side brain - transform images
- draw, paint, sculpt; color
- form & rotate mental pics
1. Perception- way one receives incoming stimulus in continuum from abstractiveness - discrimination, visual perspective
to concreteness taking, active imagination
2. Ordering of knowledge – how we arrange & systematize incoming stimuli in 4. MUSICAL / RHYTHMIC
- understand music structure
a scale ranging sequence to randomness which affects how we learn
- appreciation, vocal, - sensitive to rhythm & beat - create melody/rhythm,
4 combinations of strongest perceptual & ordering ability: Instrumental, composition, - recognize tonal patterns pitch - sense melody of tone
rhythm & appreciation of musical - play instrument
1. CONCRETE SEQUENTIAL (CS)- learners like highly structured, learning env w/o
- right side of brain expression - repeat a tune0\
interruptions; concrete learning tools (visuals) focus on - recognize composers
details; interpret words literally 5. BODILY / KINESTHETIC
2. ABSTRACT RANDOM (AR)- holistic thinker, learn from visual stimuli; prefer busy, - absorb & process knowledge - Hand- eye coordination
unstructured learning env; focus on personal relationship by - Mimetic (imitate/impersonate)
- Athletics, dance, act,
3. ABSTRACT SEQUENTIAL (AS)- holistic thinkers & need consistency in learning env; Bodily sensation speed, agility & strength
manual dexterity, exercise
- learn by body language - endurance, work w/ tools
don’t like interruptions; good verbal skills; rational & logical - basal ganglia & cerebellum
& physical - need for constant movement &
4. CONCRETE RANDOM (CR)- intuitive, trial & error learning, looks for alternatives movement exercise
 No one is "pure" style: w/unique combination of natural strengths & abilities 6. INTERPERSONAL INTELLIGENCE
- verbal/ nonverbal communic
- Community service, role - discern underlying intentions,
play, conflict behavior, perspectives, empathy
- communication &
resolution, leadership, - work cooperatively
Interpersonal relationship
teamwork - sensitive to moods, motives
- prefrontal lobes feelings
- leading; make & keep friends
7. INTRAPERSONAL INTELLIGENCE
- related to inner thought - accurate self- perception, self-
- Journal, personal
process (reflection, reflective, self- directed
assessment, reflection,
metacognition; spiritual - sense of values, intuitive,
goal setting, progress report
awareness/dev’t & self- independent, awareness,
- prefrontal area
knowledge expression
 EDUCATION PROCESS Major factors in Selecting Teaching Method
- (Bastable, 2003) systematic, sequential, planned action w/ teaching & learning 1. Audience characteristics (size, diversity, learning style preferences)
as its 2 major interdependent functions & teacher & learner as key players involved 2. Educator’s expertise as teacher 5. Cost effectiveness
3. Objectives of learning 6. Setting for teaching
3 Pillars of T/L Process  TEACHER, LEARNER, SUBJECT MATTER 4. Potential for achieving learning outcomes 7. Evolving technology
EDUCATION PROCESS
- ascertain learning needs, readiness to learn, learning styles A. TRADITIONAL TEACHING STRATEGIES
ASSESSMENT
- provide info, gather data LECTURE- highly structured method where educator verbally transmits info directly for
- develop teaching plan based on mutually predetermined purpose of instruction; one of oldest & most used approach
behavior outcomes to meet needs - medieval Lt “legree” (to read)
PLANNING
- organize written presentation of what we need to know & -useful to describe patterns, highlight main ideas, present unique way of seeing info
how educator initiate learning process - ideal way to give foundational bg info as basis for follow-up group discussion
- perform act of teaching using specific instruction - summarize data & current research findings not available elsewhere
IMPLEMENTATION
- apply teaching plan
- determine behavior change/outcome in KS 5 Approaches to Effective Transfer of Knowledge in Lecture (Silberman, 2006)
EVALUATION - Use opening & summary statements: at beginning of lecture, present major points to
- measure T/L performance
help learners become oriented to subject & at end give conclusions to remind on main
points
4 Dimensions of Educative Process - Present Key terms: reduce major points to key words as verbal cues/memory jogs
• SUBSTANTIVE / CURRICULAR - Offer examples: real life illustrations of the ideas
• PROCEDURAL / METHODOLOGICAL - Use analogies: compare presented content to knowledge that learners already have
• ENVIRONMENTAL / SOCIAL - Use visual backups: use media to help learners see & hear what is being said
• HUMAN RELATIONS
3 main parts of lecture
1. INTRODUCTION - overview of behavioral objective & explain why objectives are signif
2. BODY- actual delivery of topic content being addressed
- educator can enhance presentation effectiveness by combining it w/other methods
3. CONCLUSION – summarize info; educator can review major concepts presented; try to
leave some time for QnA
Variables of Speech (Jacobs, 2009)
1. Volume 3. Pitch/tone 5. Enunciation 7. Avoid annoying habit (ums)
2. Rate 4. Pronunciation 6. Proper grammar
Body language
- demonstrate enthusiasm
- Make frequent eye contact w/audience
- Use posture & movement (confidence, professionalism)
- gestures (avoid repetitive moves. head & hands to emphasize points & keep attention)
ASSURE MODEL AS EDUCATION PROCESS PARADIGM Other points to consider:
Analyze learner - Nervous/inexperienced educator’ should practice and outline just key points
- identify by: general characteristics & specific learner competencies - Must address a large audience as if speaking to an individual listener
- Move around stage - Keep within time allotted
a. Info-processing habits (analytical/global, focused/non-focused, reflective/ impulsive,
- Vary presentation style & voice tone - Use audiovisual material
narrow/broad, categorization, tolerant/intolerant of incongruities
b. Motivational factors: attention span which interfere w/earning (anxiety, depression) General Guidelines in developing PPT (DeGolia,2016; Evans,2000)
3. learning styles visual, auditory, tactile - Don’t put all content, only the key concepts - Use largest font possible
- don’t exceed 25 words per slide - Do not overdo animation
State objectives
- Choose color w/ high contrast between backgrounds & text if presenting in large room
- use SMART based on course syllabus
- Use graphics to summarize important points
Select
- instructional media & materials by: a. select available materials Major Advantage & Limitation of Lecture
b. modifying existing materials ADVANTAGE
c. designing, revising, making new materials - Efficient, cost effective for transmit many info to large audience at reasonable time frame
Use - describe pattern, highlight main idea, summarize data, present unique way to view info
- material/ instructional media by: a. review materials & maximize use materials - effective approach for cognitive learning esp at lower levels of cognitive domain
b. practice use of materials & instructional media - provide foundational bg info as basis for subsequent learning (group discussion)
c. prepare classroom, equipment, facility - Easily supplemented w/ printed handouts & other audio visual tools to enhance learning
d. present materials using skills & teaching styles LIMITATIONS
Require - Ineffective in influencing affective psychomotor skills
- learner participation by prepare acts encouraging students to respond & actively - doesn’t provide stimulation/participatory involvement of learners
participate; teacher give appropriate feedback to students’ responses. - Instructor centered
- doesn’t account for indiv diff in background, attention span, learning style
Evaluate & Revise
- All learners have same info regardless of cognitive ability, learning need, stages of coping
- to evaluate presentation effectivity:
- diversity in groups makes it challenging/impossible for teacher to reach all learner equally
a. Was visual material help me to make a clear, coherent, interesting presentation?
b. Was it able to help me meet objectives of lesson?
DISCUSSION
c. Was it able to help learners/trainees meet objectives of lesson?
Group Discussion- formed when >2 persons are gathered to discuss/resolve an issue
- problem under guidance of its members
- 10-20 members ideal for nsg seminars (larger group = less it can accomplish)
TEACHING STRATEGY & METHODLOGY FOR TEACHING & LEARNING Group Conference/Post Clinical Nsg Conference
TEACHING METHOD - student can compare notes/ experiences & help each in to identify alt ways of solving nsg
- way info is taught to bring learner into contact w/what to be learned (lecture, demo) problem
Instructional material- object/vehicle to transmit info that supplement act of teaching
Audience Response System (ARS)
- adjuncts to communicate info by complementing teaching method (book, vids)
Purpose
1. Give learners chance to apply principles & concepts of previously introduced body of
knowledge & transfer it to new situation
2. To clarify info & concept (muddy points)
3. Enable students to learn process of group problem-solving
Techniques
- Properly instruct student on what to do, see, read so they effectively participate
- set ground rules like time limit and decorum
- Physical arrangement
- Plan a discussion starter (Question to elicit topics for discussion)
4 Discussion Leadership Skills to keep Discussion on Track
 Focusing  Refocusing
 Change focus (if topic is sufficiently discussed) Skills in Preparing & Classifying Behavioral Objectives
 Recapping (brief summary of what group has done) - function of educator’s role, whether teach patients in health care settings, staff nurses
in service, & continue educ programs, teaching students in academic situations
What to Avoid/Discussion Stoppers
1. Insufficient wait time - impatient teacher doesn’t give sufficient time to students
types of Objectives
2. rapid reward - rapid acceptance of correct response preventing answer expansion
EDUCATIONAL - identify intended outcomes of educ process by referring to program
3. programmed answer - put words into student’s mouth
aspect/totality of study that guide design of curriculum units
4. Nonspecific feedback question – give vague, global diffuse questions not foster
INSTRUCTIONAL - describe the teaching activities, specific content areas, and resources
discussion
used to facilitate effective instruction
5. Teacher’s ego stroking – don’t’ appreciate student’s views & observations
BEHAVIORAL/LEARNING- use modifier behavioral/ learning to denote that this type is
6. Low level questions
action originated than content-oriented, learner centered than teacher-
7. Intrusive questions - asking questions that invades person’s privacy
centered, & short term outcome-focused than process- focused.
8. Judgmental response to student’s answers
- described precisely what learner will be able to do following
9. Cut student off - state that problem will be discussed later lesson/not enough time
10. Create a powerful emotional atmosphere & ignore feelings/responses
Distinction between Goals & Objectives
QUESTIONING FACTORS GOALS OBJECTIVE
- teacher is probing/inquiring as feedback mechanism to find if they understood RELATIONSHIP TO TIME - achieved realistically in a - short term achieved after
Types of Question few days, weeks, months 1 teaching session/shortly
1. Factual/descriptive - answered from memory/description (who, what, when, where) after several sessions
2. Higher order- stimulate students to establish relationships, compare-contrast, make LEVEL OF SPECIFICITY - final outcome to achieve - Specific, single, concrete, 1D
inferences than merely defining them after teaching & learning behavior
3. Clarifying- illuminating, revealing, informative, enlightening process - intended result of instruction
- referred as learning - describe precisely what learner
done in 5 ways: a. Ask clarifying questions for more info or more meaning outcome, are global & can do after instruction
Ex . Tell me more about statement you just made broad in nature - Lead step by step to more
b. Ask student to justify responses general, overall long-term goal
ex: Why are you in favor of parliamentary government? Points to Remember
c. Refocusing - it’s necessary to have both goals & objectives to accomplish something
Ex. How does statement made by Susan relate to what Lily just said? - Objectives must be achieved before goals can be reached
d. Prompt student like suggesting/giving a hint or reminder - “ “ “ observable & measurable
Ex. You said that turning patient every 2 hrs prevent decubitus ulcer. - “ can be thought as advanced organizers (statements informing learner of what’s
What is the rationale for that ? expected from cognitive, affective, psychomotor perspective prior to meeting goal
Redirect the question - “ are derived from goal & must be consistent & related to goal.
Ex. Melissa said that necrosis is one of the possible causes of - “ & goals forms a map providing direction (objectives) as how to arrive at specific
decubitus ulcer. Can you give another contributory factor ? destination (goal)
- Goal & objectives must be a mutual decision on both the teacher & learner
USING AUDIOVISUALS - “ “ must clearly written, realistic, learner centered
- greatly enhance teaching; stimulate students interest & participation - “ “ must be directed to what learner is expected to do; not what teacher teaches
Traditional: 1. Handouts 4. Illustrations
2. Chalkboards/whiteboards 5. Slides
3. Overhead transparencies 6. Videotape Importance of Using Behavioral Objectives
 keep educator’s thinking on target & learner centered
INTERACTIVE LECTURE  Communicates to learner & health care team plan for teaching and learning
- mixture of lecture & audiovisuals  Helps learners understand what’s expected so they keep track of their progress
Ex. Combination of lecture/discussion, film showing, board work  Force educators to select & organize educ materials so they’re not lost in content &
forget learner’s role in process
BEHAVIORAL OBJECTIVES & TEACHING PLANS  Encourage educators to evaluate motives for teaching
- before decision is made in about selecting content to be taught/choosing methods &  Tailors teaching to learner’s unique needs
instructional material used to change learner behavior, educator decide what learner  Creates guideposts for teacher evaluation & documentation of success/failure
is expected to accomplish.  Focus attention on what learner will come away w/once teaching-learning process is
- Pre-requisite in formuSlating behavioral objectives: identify learner needs completed, not on what is taught
20th century - noted educators & educ psychologist developed approaches to writing &  Orient teacher & learner to end results of educational process
classifying behavioral objectives  Makes it easier for learner to visualize performing required skill

Bloom, Englehart, Furst, Hill, & Krathwohl (1956) ROBERT MAGER (1997)- showed 3 other major advantages in writing clear objectives:
- devised taxonomic system to categorize obj of learning acc to hierarchy of behaviors  give solid foundation for selection/design of instructional content, method, materials
- based on original work of Bloom, et.al (1956) & Anderson et al. (2001) proposed a  provide learners w/ways to organize their efforts to reach their goals
revision in initial taxonomy for learning, teaching, & assessing behaviors  help determine whether an objective has been met

Taxonomy- ordering of behaviors based on type & complexity

- level of knowledge to be learned, behaviors most relevant & attainable, (LINTE REFER TO THE PDF DON’T CONTINUE!!! ywa)
sequencing of knowledge & experiences for learning from simple to most complex
 CLINICAL TEACHING Ward orientation is given to students as short assignment where they’re:
- teaching of nsg students in hospital/clinical setting - assigned to a patient to do initial assessment - familiarization of routine activities
- used of the bedside records - getting to know the staff members
Purpose of Clinical Laboratory
1. Clinical setting offers students opportunity to apply theoretical concept, rationale, II. STUDENT ASSESSMENT - in terms of ff:
procedure, propositions learned in classroom - what they know - their strengths and limitations - barriers to learning
2. Skills learned in nsg laboratory are perfected in clinical area - positive influences - perception of teaching-learning situation
3. Skills of observation, problem-solving, decision-making are refined & honed in
clinical setting III. DAILY ACTIVITIES
4. Students are helped by CI how to organize all data that they can compile & a. Making students assignments
intellectual & psychomotor skills must perform individual- 1 student is assigned to > 1 patients, limited to aspects of care/total care
5. Cultural competence (can interact meaningfully properly comfortably & effectively dual- st is assigned to >1 px clients along w/another student or staff member
w/culturally diverse patient) will be developed advantage: Decreased anxiety for st.n; fosters truly supportive relationship, staff member
6. Learn socialization skills, which behavior/values are acceptable or unacceptable, serve as role model
where responsibility & accountability for is demanded & expected. alternative assignment- st as helper in hospital who works in a supportive capacity w/
other students in their individual assignments /patients
Models of Clinical Teaching
Preceptorship- preceptor = tutor”; formal arrangement; pairs student (novice) & staff
1. 1 CI is incharge of 8-12 students in clinical area based on requirements by CHED: member (experienced nurse) (mentor) serve as a mentor
ratio of student to clientele depends upon obj & capacity of student
b. Posting these assignments in a predetermined location
LEVEL 1st Sem 2nd Sem c. Helping students to learn
II 1:1 1:2
III 1:2-3 1:3-4
Conducting Clinical Laboratory Session
IV 1:5 1:6
Teacher activities include:
Prescribed faculty-student ratio: LEVEL 1st Sem 2nd Sem
PRECONFERENCE -work w/student in preparation of clinical experience; 1 format includes
II 1:8 1:8
a combined use of:
III 1:10-12 1:10-12
IV 1:12-15 1:12-15 case-study method- info obtained by student on client treatment & diagnosis
2. Students are retained in nsg skills lab until they’re proficient in nsg procedure skill nursing care plan- focuses on individualized patient care based on nsg diagnosis
3. Clinical nsg course occurs in classroom area before students are sent to clinical area basic info in relation to client:
Preparation for Clinical Instruction a. Definition of diagnosis and its related pathophysiology
b. Past or planned surgical procedure
1. Choosing clinical & community agency sites
c. Treatments require and identifying related nursing responsibilities
2. Staff as student role models & partners of CI (as members of teaching hospital)
d. Describe med (action, desired effects, dosage range, side effects, major implications)
3. Accessibility and safety of the site
e. Describe diagnostic test (normal values, what’s tested, variations, nsg responsibility)
4. Drawing up a contract between school and the agency

Final Preparation for Clinical Instruction PRACTICE SESSIONS- work w/students at time of actual px care, teacher must provide
I. STUDENT ORIENTATION- includes an overview of: support & supervision yet allow st freedom to practice skills & decision-making
basic policies and procedures physical set up and facilities Working w/student during follow-up activities which include:
admin staff done by (guided tour & group orientation conference w/chief nurse) A. Post-care conference- give ideal time to point theory application to practice group
Group orientation activity: specific objectives; course requirements problem solving & evaluate nsg care; 1-2 share experiences w/members
Accepted st behavior, decorum, expectations B. Log & Diaries- st use reflection to think experiences & communicate w/instructors
 CI must be guided by CLINICAL TEACHING PLAN, handouts, written guidelines C. Nursing Care Plans
D. Nursing/walking rounds -before enter px room, assigned student already informs
Content/Format of Teaching Plan group on px & diagnosis. student interacts w/patient & others observe
1. Description of learners 2. Focus of Clinical Experience 3. Setting - CI point equipment & procedure (rest of discussion occurs in
4. Briefing/Orientation: learning objectives, requirements, specific activities corridor/post-conference, never inside px room)
nature of evaluation, grading system E. Shift Report-st.n listens/asked to give account of what happened during shift.
5. Schedule of Activities (week) - Evaluation of student learning & performance in clinical setting
- teacher give feedbacks & suggestions about performance

OBJECTIVES
Factors in Selecting
a. Course objectives as compass to guide teacher w/topics, subtopics, approach, strategy,
requirement, material
b. time allotted for each topic
c. Avoid cramming info & detail; give st opportunity to recite/discuss lessons
Selecting Teaching Methods
- objectives & type of learning - course content - ability & interest of teacher
6. Activities - st learning need & style - # of students in class
Most common teaching methodology
- Lecture/discussion - computer assisted program - role-playing
- one-on-one discussion - modules
- simulation & games - projects
Behavioral Objectives
- act as guide/compass of educator in planning, implementation, evaluation of teaching &
learning outcomes
GOAL OBJECTIVE Evaluation of Patient Learning
- broad - specific - most important outcome is CHANGE in health-related behavior
- general intention - precise - test psychomotor skills
- intangible - tangible - interview px/discussion & questioning
- abstract - concrete  nurse document health teachings to px learning (legal & accreditation purposes)
- cant be validated as is - can be validated Evaluation in Healthcare Education
GOAL- describes in broad terms what learner will do 1. PROCESS/FORMATIVE EVALUATION
Ex: students will gain appreciation & understanding of value of HE to px care world - adjustment made in educ activity as soon as needed
OBJECTIVE- specific & measurable describing learner will know/able to do - “how can teaching be improved to facilitate learning?”
Ex: St will be able to construct a syllabus utilizing institutional format in 1 hour. 2. CONTENT EVALUATION
- to find if learner acquired knowledge & skills taught by RD/cognitive test
function - “were specific objectives met?”
1. Stating obj- gives direction for CI to follow/what to do; guide to select subj, teaching
3. OUTCOME/SUMMATIVE EVALUATION
method, material in instruction; give criterion for evaluating student outcome
- determine effect of teaching effort & sum up event as result of educative process
Elements: 1. PERFORMANCE (What)- st expected to do after learning - “was teaching appropriate?” “did individual learn?”
2. CONDITION (Circumstance)- where student will be able to perform 4. IMPACT EVALUATION
3. STANDARD (level)- of acceptable performance - determine effect of educ program on institution & is it worth continuing
3-Part Method of Objective Writing - focus on goal of course; most extensive & time intensive
5. PROGRAM EVALUATION
- assist audience to judge & improve worth of program
- focus on overall goals than objectives in all aspects of educ activity (learner, teacher)
Techniques of Assessment
ONE MINUTE PAPER- used in last 3 min of class where teachers asks learner to write in ½
sheet of paper answer of 2 question (Angelo & Cross, 1993)
- “what was most important thing you learned today?”
MUDDIEST POINT (Mosteller,1989)
- teacher ask “what was muddiest/most unclear point in today’s lesson?”
ex: After 20 min session, st will be able to identify 3 of 4 symptoms of hypoglycemia.
DIRECTED PARAPHRASING
Writing Objectives (ABCD’s) - require st to “state in own words” what just learned to show level of understanding &
Audience- who is this aimed at? ability to translate info
Behavior- what do you expect them to do? (overt, observable behavior) APPLICATION CARDS
Condition- how? under what circumstance will learning occur? - st note on index card 1 possible application of any principle recently taught
Degree- how much must a specific set of criteria be met
Evaluation of Student Learning
Characteristics of Learning Objectives
MULTIPLE-CHOICE QUESTION
1. It’s always expressed in terms of learner, not what CI/program will do for st - flexible format to measure knowledge, skills, ability, value, thinking skill.
 Student-focused Outcome - consist of item # w/question where st select answer from multiple
- objective: give st knowledge about how library works
- better obj: After research course, student will be able to demonstrate knowledge
on how library works by finding 10 sources for research
2. It’s precise & supports only 1 interpretation
 stating Instructional Objectives- explain scientific method & applies it effectively
- “explains & applies” (avoid more than 1 verb. St may able
to do one but not the other stem- where st respond option- choices to choose key- correct/best choice
3. distracters- incorrect/less appropriate choice
 Observable, measurable obj- obj: st will know on nsg procedures FUNDA subject TEST FOR COMPREHENSION
better obj: After lecture demo, st will be able to return - CI conducting health ed class on group of no read, no write peasants, percentage of
demonstrate nsg procedures in FUNDA w/100% accuracy teaching is remembered if you ask them to actually perform proper way of handwashing
4. It specifies conditions under which behavior is performed 10, 30, 70, 20, 90, 50%
 After lecture demo, students will be able to RD nsg procedures w/100% accuracy TEST FOR APPLICATION
5. It specifies criteria for accomplishment; reflect learning/dev’t that st can accomplish - best site for administering vit K injection to newborn is: gluteus minimus, deltoid muscle,
gluteus maximus, vastus lateralis
Well-written: After class on hypertension, px will be able to state 3 cases of high BP
Poorly-written: Px will be able to prepare menu using low-salt foods. TEST FOR EVALUATION
- orthopedic px is in high fowler’s pos. What data states need to reassess situation?
a. coughing & expectoration c. Decreased use of accessory muscle
b. inability to rest d. increased chest expansion
EVALUATION & ASSESSMENT
Guidelines in Answering MCQ Types
ASESSMENT- help teacher find how much & how well students are learning - avoid negative stems bc it makes question more confusing
- approach measuring educ effectiveness to give feedback w/o giving grade - when using “except”, it must be uppercase/underline
EVALUATION- consider/examine teaching/learning process in healthcare educ to judge - “all of the above”/”none of the above” must be used sparingly
value, quality, importance of endeavor. - use only 3 options than include nonsense distracter
- data are gathered & summarized deal w/how effective are teachers teaching ex: which of assessment findi
& basis is by grades
TRUE-FALSE QUESTION
Factors making Evaluation Difficult - test lowest level of learning which are knowledge & comprehension w/limited use for nsg
1. DIFFERENCES between simulated setting where mistakes are committed as part of exam but used to test px learning/ancillary staff learning
learning experience & reality setting where mistake is fatal since people’s lives are
MATCHING QUESTION
at stake
- lowest level knowing; test knowledge on recall of relationship in 2 things (date-event,
2. TIME of more than few days lapsed between practice in simulated setting in nsg lab structure-function, term-definition)
& actual perf in clinical area - set as 2 lists w/premises on left & answer on right. # response must exceed # premises
ESSAY TYPE QUESTION
- highest level of knowing, analysis, synthesis, evaluation but used sparingly bc it’s
time-consuming to answer & to score
2 Approaches in Scoring Essay Question
Point/Analytic Method- CI makes list of elements included & assign points
ex: In 20 pt essay, elements & points might appear as:
- discuss 3 most important factors in educative process (10 pts)
- compare & contrast roles of teacher & learner in traditional vs contemporary
methods of teaching (10 pts)
Rubric Method- rubric: set of printed rules; class/category of things
- include quali (character, standard, property of something) rating scale
(holistic method scoring) where CI’s concern is whether points of argument are
clearly defined & defensible; if writing is clear & grammatically correct & if relevant
facts are included