Teaching and Learning: Exam Paper

# Teaching and Learning Teaching Learning **Erika Hill, MSN, FNP-C** *know & understand this topic. ## Remember the acronym: TEACH * **T**- Tune into the patient - make sure the patient is interested. * **E**- Edit patient information - make it understandable for the patient. * **A**- Act on every...

# Teaching and Learning Teaching Learning **Erika Hill, MSN, FNP-C** *know & understand this topic. ## Remember the acronym: TEACH * **T**- Tune into the patient - make sure the patient is interested. * **E**- Edit patient information - make it understandable for the patient. * **A**- Act on every teaching moment - Demonstrate * **C**- Clarify often – Ask questions, have them repeat back. * **H**- Honor the patient as a partner in the education process - This helps the patient be more compliant, allow them to have their own input. ## Explain the concept of teaching and learning. * **Teaching** – a planned method or series of methods used to help someone learn. * **Learning** – the process by which a person acquires or increases knowledge or changes behavior in a measurable way as a result of the experience. The image is of a road sign. One arrow is pointing to the left and says "TEACH", the other is pointing to the right and says "LEARN" ## Three Learning Domains (CPA) * **Cognitive**: storing and recalling of new knowledge in the brain * **Psychomotor**: learning a physical skill * **Affective**: changing attitudes, values, and feelings The image is of two venn diagrams one is labeled Psychomotor, Affective, and Cognitive the other is labeled Affective, Congitive, and Psychomotor. ## Discuss the exemplars of teaching and learning. * Consumer education/prevention * Consumer - an individual, a group of people, or a community that uses a service or commodity. * Client - an individual who engages the advice or services of another person who is qualified to provide this service. * Nurses teach a variety of clients/consumers in various settings (hospitals, primary care clinics, urgent care, managed care, the home, assisted living facilities & long-term care facilities. The nurse is in a position to promote healthy lifestyles through the application of health knowledge, the change process, learning theories, and the nursing and teaching process when teaching clients and their families. * Client educator * Providing client education is a major aspect of nursing practice and an important independent nursing function. * Client teaching - the process of influencing the client's behavior to effect changes in knowledge, attitudes, and skills needed to maintain and improve health. Educated clients experience better health and have fewer complications. ## Discuss the purposes of consumer education / prevention. Purposes of Consumer Education * Promotion of Health * We also promote vaccines. * Prevention of Illness The image is of an infographic labeled "HEALTHY HABITS TO PREVENT ILLNESS". There 4 components each with an image: "WASH YOUR HANDS"; "COVER NOSE & MOUTH"; "STAY HOME IF YOU'RE SICK"; "CALL YOUR DOCTOR IF SYMPTOMS PERSIST" ## Discuss the purposes of consumer education/ prevention. Aims of Teaching and Learning * Maintaining and promoting health * Preventing illness * Restoring health * Facilitating coping ## Explain the role of the nurse in consumer education/prevention. *Identify what the patient is willing to do.* * Establishing relationships and identifying readiness for change * Identifying opportunities, issues, and concerns * Establishing patient-centered goals * Creating the structure of the coaching interaction * Empowering and motivating patients to reach goals * Assisting the patient to determine progress toward goals ## Discuss the role of the client educator. * Never has the demand for quality education and counseling been greater. * Nurses who are skilled educators and counselors can improve clients' health and well-being and reduce the demand for professional services. The image is of a woman and man wearing scrubs. The are standing in front of what looks to be a hospital bed. The woman is holding a clipboard, and the man has a stethoscope around his next. The image include the text "CLIENT EDUCATION" and several + signs ## Discuss factors that affect the teaching/learning process. CULTURE * Develop an understanding of the patient's culture. * Work with multicultural team. * Be aware of personal assumptions, biases, and prejudices. * Understand the core cultural values of the patient or group. * Develop written material in patient's preferred language. * respect client's culture:* The image is of drawings of people from all cultures standing around planet earth. ## Discuss factors that affect the teaching/learning process. LIFESPAN * People learn throughout life, although what they learn and how leaning occurs change according to developmental states. * Three areas to consider when developing a teaching plan 1. Physical maturation 2. Psychosocial development 3. Cognitive Capacity The image is of silhouettes of people of all ages walking together left to right. 1st thing we want to do. ## Teaching Tips for Children * Establish trust. * Use a calm approach & provide a calm environment. * Involve parent or primary caregiver. * Provide for safety. * Address child by name. * Provide instructions at the child's level of understanding. * Allow time for questions from child or parent. * Address concerns or fears. * Allow time for the parent or child to practice the skill or task. * Provide feedback, praise & encouragement. * Reinforce teaching as needed. * Evaluate the effectiveness of the learning & teaching. * Document. * Visits - Have children visit the hospital & treatment rooms so they can see people dressed in uniforms, scrub suits, & protective gear. * Dress-up – Have children touch & dress up in the clothing they will see and wear. * Coloring Books – Use coloring books to prepare children for treatments, surgery, or hospitalization; shows what rooms, people, & equipment look like. * Story Books – Story books describe how the child will feel, what will be done, and what the place will look like. Parents can read these stories to children several times before the experience. Younger children like this repetition. * Dolls - To give them a sense of mastery of their situation, have them practice procedures that they will later experience on dolls or teddy bears. Custom dolls are often available for inserting tubes or giving injections. * Puppet Play – Puppets can be used in role-play situations to provide information & show the child what the experience will be like; they help the child express emotions. * Health Fairs – Fairs can educate children about their bodies & ways to stay healthy. Fairs can focus topics identified in the community as a concern ## Teaching Tips for Older Adults **Factors Influencing Learning for Older Adults** * Sensory perception alterations (hearing, vision, touch) * Energy level - be calm * Memory - retaining * Response Time - may take longer * Cultural Background - respect it * Stress - be mindful. * Physical abilities - Allow time for practice & demonstration. * Establish trust. * Use a calm approach & provide a calm environment. * Pace the teaching against the energy level of the client & allow time for processing. * Direct teaching to level of understanding. * Use large print materials (at least 14 point font) * Use materials at a 5th -6th grade reading level. * Allow time to practice skills. Return demonstration to evaluate mastery. ## Barriers to Learning | Barrier | Explanation | Nursing Implications | | -------------------- | --------------------------------------------------------------------------------------- | ---------------------------------------------------------------------------------------------- | | Older Adults | Vision, hearing & motor control may be impaired. | Consider sensory & motor deficits & adapt teaching plan as needed. | | Children | Shorter attention spans and vocabulary differences. | Plan shorter & more active learning episodes. | | Culture/Religion | May be cultural or religious restrictions on certain types of knowledge (birth control information) | Assess client's cultural needs when planning learning activities. | | Physical Disability | Visual, hearing, sensory or motor impairments may interfere with a client's ability to learn. | Plan activities appropriate to the learner's abilities. (Audio learning for blind client; large print for vision impaired. | | Mental Disability | Impaired cognitive ability may affect the client's capacity for learning. | Assess capacity for learning & plan activities to complement client's ability. Teach complex learning to caregivers or family. | | Barrier | Explanation | Nursing Implications | | ---------------------------- | ----------------------------------------------------------------------------------------------- | --------------------------------------------------------------------------------- | | Acute Illness | Client requires all resources & energy to cope with illness. | Defer teaching until client is less ill. | | Pain | Pain decreases ability to concentrate. | Conduct pain assessment before teaching. | | Prognosis | Client can be preoccupied with illness & unable to concentrate on new information. | Defer teaching to a better time. | | Biorhythms | Mental & physical performances have a circadian rhythm. | Adapt time of teaching to suit client. Plan teaching session when client is most alert. | | Emotions (anxiety, denial, depression, or grief) | Emotions require energy & distract from learning. | Deal with emotions & possible misinformation first. | | Language | Client may not be fluent in nurse's language. | Obtain services of an interpreter. | ## Discuss factors that affect the teaching/learning process. Health Literacy Health Literacy is the ability to obtain, read, understand, and act on health information. Skills include performing Internet searches, reading health prevention pamphlets, measuring medication doses, and understanding and complying with verbal or written health care instruction. Over a third of US adults (77million people) have basic or basic health literacy and thus would have difficulty with common health tasks. Ask Me 3 Questions * What is my main problem? * What do I need to do? * Why is it important for me to do this? The image includes the text: * 1/2 of US adults have low health literacy. * 2/3 of older adults do not understand basic health information. * Patients with low health literacy cost four times as much as patients with high health literacy. ## Discuss factors that affect the teaching/learning process. Physical Limitations * Muscle Strength - Example: an older client who can't rise from a chair because of insufficient leg & muscle strength can't be expected to learn to lift him/herself out of a bathtub.Motor Coordination - Gross motor coordination is required for movements such as walking, & fine motor coordination is needed to eat with utensils. Ex: a client with a chronic disease that affects lower limbs will probably be unable to use a walker.Energy - Energy is required for most psychomotor skills, and learning these skills uses even more energy. People who are ill or older often have limited energy resources; learning & carrying out these skills must be timed for when the client's energy sources are at their peak.Sensory Acuity - Sight is used for most learning (walking with crutches, changing a dressing, or drawing medications into à syringe). Clients who have a visual impairment often need the assistance of a support person to carry out such tasks. ## Steps of the Teaching – Learning Process very important very close to nursing process. Assess Learning Needs & Learning Readiness->Diagnose the Learning Needs The process the moves: Diagnose the Learning Needs-> Develop LearnerOutcomes & Teaching Plan Develop LearnerOutcomes & Teaching Plan->Implement Teaching Plan& Strategies Implement Teaching Plan& Strategies->Evaluate Learning Evaluate Learning->Assess Learning Needs & Learning Readiness ## Comparison of the Teaching Process & the Nursing Process | Teaching Process | Nursing Process | | -------------------------------------------- | ----------------------------------------------- | | Collect data; analyze client's learning strengths & deficits. | Collect data; analyze client's strengths & deficits. | | Make an educational diagnosis. | Make nursing diagnosis. | | Prepare teaching plan: | Plan nursing goals/desired outcomes and select interventions. | | Write learning outcomes | | | Select content and time frame. | | | Select teaching strategies. | | | Implement teaching plan. | Implement nursing strategies. | | Evaluate client learning based on achievement of learning outcomes. | Evaluate client outcomes based on achievement of goal criteria. | ## Documentation * Documentation includes: * Summary of the learning need * The plan * The implementation of the plan * The evaluation results * Sample Documentation : PROBLEM: 04/11/2023 1430. Pt Found on floor in her room at beginning of this shift after attempting to go to restroom unassisted. Pt states she "wasn't sure if that light thing worked," referring to the call light. Assisted back to bed and assessed for injuries, none apparent. VS stable: BP 120/72, P 68, R 18, T 98.1. Alert and oriented x3. Instructed patient on the use of call light and demonstrated it works. Pt. Verbalizes understanding of the importance of calling for assistance before getting out of bed to prevent falls or injuries. PCA assisted client to restroom while nurse present and assisted back to bed. Side rails up x2, bed in the lowest position, call light within reach. -----------E. Hill, Hinds NS.