Nurse Educator: Learning Determinants

• The nurse educator assesses learning determinants for effective delivery of student and staff education.
• Determinants addressed include learner's need, readiness, and preferred learning styles for information processing.

Educator's Role

• Educating is a critical intervention nurses perform.
• Nurses identify learner's needs, readiness, and learning styles.
• The learner is most important, not the educator.
• Educators act as facilitators to enhance learning, making learners aware of what needs to be known and why.
• Assessment permits facilitating learning by arranging experiences that assist the purpose, will, and suitable approaches for learning.
• Learners experience meaningful parts to reach potentials through manipulating the environment.
• An educator's roles:
• Assessing problems or learner abilities
• Providing best evidence information uniquely and appropriately
• Identifying progress
• Giving feedback and follow-up
• Reinforcing learning with new knowledge, skills, and attitudes
• Determining education's effectiveness
• Educators provide support, encouragement, and direction during learning.
• Educators facilitate home environment changes to minimize distractions.
• Educators identify optimal learning approaches based on individual needs, readiness and style.

Assessment

• Assessment of learner's needs, readiness, and learning styles is the first step in instructional design.
• This step is frequently neglected.
• Teaching commonly begins before addressing determinants.
• That information given is based on assessment nor individualized.
• Prior assessment individualizes teaching improving patient outcomes and satisfaction.
• Assessment validates learning need and approaches.
• Assessments ensure optimal learning with the least anxiety.
• It establishes communication prevents repetition, and saves time and energy.
• Focuses on what the learner feels is most important.
• Lack of time is the number one reason nurse educators skip the assessment phase.
• Nurses need to be skilled in conducting assessments in limited amount of time.
• Nurse educators must become acquainted and comfortable, with the assessment phase of instructional design.
• Attending to the three determinants is a part of assessment.
• Learning needs
• Readiness to learn
• Learning style

Assessing Needs

• Learning needs are gaps in knowledge between desired and actual performance levels.
• Gaps arise from lack of knowledge, attitude, or skill.
• Educators must identify learning needs first.
• Educators design instructional plans to address deficits in cognitive, affective, or psychomotor domains.
• By discovering what needs to be taught, educators can determine when and how learning can optimally occur.
• It has been noted that not every person knows they need education. The educator assists in identifying, clarifying, and prioritizing interests and needs.
• Information is used to set objectives and plan effective teaching approaches suitable to the learner's interests
• Differences exist in patient/professional perceptions of needs.
• Most learners can master a subject with sufficient time and support.
• Educators facilitate determination of learning needs as well as identify appropriate methods to ensure better understanding.
• Improved success in learning is witnessed by Roberts, Ingram, Flack, and Jones Hayes (2013) when they implemented this type of learning in a nursing education program.
• Steps for needs assessment:
• Identify the learner and audience considering the number of learners and congruent or diverse needs.
• Choose the right, trusting setting, ensuring privacy and confidentiality.
• Collect data about the learner, exploring typical health problems/interests.
• Collect data from the learner that defines needs in their own problems.
• Involve healthcare team members nurses are not the sole educators so collaboration is necessary.
• Prioritize needs such as addressing physiological needs before higher learning.
• Determine availability of resources considering that it may be useless to proceed with interventions if not available.
• Assess organization demands, the educator should be familiar with standards of performance for various categories.
• Account for time-management issues using close observations and active listening, give learners perceptions, conduct assessments anywhere with formal or informal contact.

Assessing Methods

• Educator gets objective data about learner.
• The following should be used in combination:
• Informal conversations: needs discovered during conversations
• Structured interviews: solicit learner's viewpoint using direct, predetermined questions, also allows nurse to pick up nonverbal cues
• Focus groups: small groups determine educational needs through group discussion
• Questionnaires: written responses provide privacy with easy-to-tabulate data
• Tests: pretests identify knowledge levels
• Observations: observing behavior can help determine an individual's understanding
• Documentation: initial assessments, nursing care plans, staff notes, and discharge forms provide valuable points

Nursing Staff Needs

• Methods to determine needs of Nursing Staff:
• Written job descriptions can reflect potential needs of staff.
• Formal and informal requests reflect what the staff perceives as needs.
• Quality assurance reports indicate safety violations or errors.
• Chart audits identify practice trends.
• Knowledge of rules helps identify possible learning needs of staff such as understanding new rules.
• Self-assessment involves assessing the needs of students and writing of self assessment.
• Gap analysis identifies differences between desired and actual knowledge.

Readiness to Learn

• Critical to know readiness to learn.
• Readiness to learn is when the learner demonstrates interest in learning.
• Learners must be receptive, willing, and able to participate.
• Educator must discover when patients/staff ready, what they need, and how to adapt content.
• The tasks require understanding, applying methods used previously.
• Educator must perform these tasks before the actual learning time.
• Needs and objectives must be determined.
• Time/timing is important and an integral part in the teaching that should take place.
• This requires knowing the learner's physical and psychological comfort.

PEEK Readiness

• Before teaching the educator must PEEK:
• Physical: abilities, complexity, environmental effects, status, gender
• Emotional: anxiety, support, motivation, risk-taking, mind, stage
• Experiential: aspiration, coping, background, locus
• Knowledge: present, ability, disabilities, styles
• To ensure that the subject teaching is relevant and applicable to their everyday concerns.
• Physical readiness involves considerations of abilities, complexity, health status, gender, and environmental effects.
• Ability requires motor movement, strength, sensory acuity, and endurance.
• Complexity involves cognitive, affective, and psychomotor domains.
• Health status including one's energy levels and comfort is important.
• Environmental demands involve noise, reactions to stimuli, and safety.
• Emotional readiness Includes anxiety level influencing person's ability to perform.
• A moderate anxiety levels is best for success.
• Support system influences emotional readiness, members home available.
• Motivation will the person's willingness to take action.
• Risk-taking behavior
• Frame of mind
• Developmental stage

Experiential Readiness

• Experiential readiness includes level of aspiration, past coping mechanisms, cultural background, and locus of control.
• Level of Aspiration: To what extent someone is driven to achieve type of short/long-term goals set.
• Past Coping: Mechanisms that learners have used to understand how they have dealt with previous problems.
• Cultural Background: Educator to know cultural sensitivity.
• Locus of Control: internal or external.

Knowledge Readiness

• Encompasses knowledge base, cognitive ability, learning disabilities/reading problems, and learning style.

Learning Styles

• Learning styles refer to how learners most efficiently perceive, store, process, and recall information.
• Knowing, how a learner learns and likes to learn, selects appropriate teaching approaches.
• Understanding each model enables better personalization.
• It can enable the educator to tailor teaching to different styles, readiness for the learner rises.

Learning Models

• Three ways to determine learning style is observation, interviews, and questionnaires.

Brain Thinking

• Right-brain/left-brain and whole-brain thinking adds to understanding related brain functions.
• Learners can use both sides, connector between corpus callosum and two hemispheres.
• There's no correct way to process but each gathers sensory information and handles it differently.
• One may take over or the task may be divided.
• Hemisphere is linked to the style or the way the person finds information to solve problems.

Field Learning

• Field-independent/field-dependent perception identifies two styles of cognitive learning that are based on how learners process/structure information.
• Field-independent are separate from the surrounding field and internally referenced.
• Field-dependent are influenced or immersed in surrounding field and externally focused.

Dunn and Theory

• Created that individuals learn in different ways.
• Model includes environmental factors, patterns, and physiological and environmental elements.

Jung/Myers Theory

• Jung and Myers-Briggs typology explains similarities/differences by attitudes along with mental functions.
• Two categories for attitudes/perception: Extraversion (E) & Sensing (S).
• Myers' terms for judgment: Thinking (T) vs Feeling (F), judging or perceiving.

Kolb Framework

• Kolb's experiential framework is a transformational process created/recreated.
• It includes modes reflecting dimensions of perception/processing.
• Perception: concrete experience vs abstract conceptualization
• Processing: reflective observation vs active experimentation.
• The individual demonstrates one 4 types, four, but can be one: Diverger, assimilator, converger, or accommodator.

MAT System

• Is model based on research and brain functioning.
• McCarthy recognizes four types/learners:
• Why (Imaginative)
• What (Analytical)
• How (Common sense)
• What if (Dynamic)

Intelligence Types

• Gardner recognizes eight types, all possessed albeit with proportions.
• Also Existential, which seems possess ability to contemplate questions beyond sensory data.

VARK Types

• Fleming and Mill recognizes four preferences.
• Visual
• Aural
• Read/write
• Kinesthetic

Evidence State

• Interwoven from well researched
• Level- evidence study design
• Quality-Concern with bias
• Strength-Precision