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Teaching-Learning Process in Nursing
E. Heim, FA09
RANC Objectives
Identify the components of the teachinglearning (T-L) process.
 Describe potential barriers to the learning
process.
 Compare and contrast barriers and
facilitators of the teaching-learning process.
 List strategies to motivate learners.
 Describe methods to evaluate learning.

Teaching Plan
Improve quality of care
 Reduce HC costs
 Keep pts better informed about their Tx plan

T-L: Standard of Care
Nurse Practice Act
 American Nurses Association (ANA)
 Joint Commission

Assess learning needs
 Provide education: Speak Up “Know Your Rights”
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initiative (2007): http://www.jointcommission.org/PatientSafety/SpeakUp/
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http://www.jointcommission.org/NR/rdonlyres/58A5230D-3E58-48D8-8114-C95AF53ECA27/0/Speakup_Rights.pdf
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Pain
Plan of care
Meds
Nutrition
Med equipment
Success = Collaboration
What is the T-L Process?

Teaching

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An interactive process that
promotes learning
Learning

The purposeful acquisition
of knowledge, skills,
behaviors, & attitudes
Who do we Teach?

Educational Needs vary:
Disabled
 Children
 Older Adults
 Cultures
 Clients
 Families
 Other nurses even!

Why do we educate clients?
To help individuals, families, or communities
achieve optimal levels of health
 Client education includes:

Maintenance & promotion of health and
illness prevention
 Coping with impaired functioning
 Restoration of health

Role of the Nurse in
Teaching and Learning
Teach information the client & family needs to
know in order to make informed decisions
regarding their care.
 Determine what clients need to know.
 Identify when clients are ready to learn.

Components of T-L process

Communication
(Table 25-1)
 Verbal, non-verbal

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Domains of Learning
(Box 25-3)
 Cognitive, Affective, & Psychomotor

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Basic Learning Principles
(p368-Table & Box)
 Motivation, Ability, Environment

Communication in T-L Process
T-L closely parallels communication process.
 Depends in part on effective interpersonal
communication.
 The learning objective describes what the
learner will be able to accomplish after
instruction is given.

Domains of Learning

Cognitive
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Includes all intellectual behaviors & requires thinking
Acquiring knowledge through a series of steps
Affective
 Includes feelings, opinions, values, appreciation,
enthusiasms, motivations, & attitudes
 The “receiver” that responds and values in a
characteristic & organized manner
Psychomotor

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Involves acquiring skills that require integration of
mental and muscular activity
Perceiving, practicing, doing, and imroving
Basic Learning Principles
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Motivation to Learn

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Ability to Learn

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Addresses pt’s desire or willingness to learn
Physical & cognitive abilities, developmental
level, physical wellness, thought processes
Learning Environment

Facilitates attention to instruction
Motivating Learners

Motivation: the force that causes a pt to behave in a
particular way
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Social— Need for connection, approval or self-esteem
Task mastery— Need for achievement & competence
Physical— Need to return to former level of normalcy (“survival mode”)
Compliance: adherence to prescribed Tx
Self-efficacy: person’s belief in their ability to successfully
do the task

Verbal persuasion, vicarious experience, enactive mastery
experience, physiological & affective states.
Assess motivation:


Ask questions to ID and define motivation.
What are their motivational factors?
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Behavior (attention span, memory, ability to concentrate)
Health beliefs & sociocultural background
Perception of severity of Dx & benefits/barriers to Tx
Perceived ability to perform health behaviors
Desire to learn attitudes about HC providers
Learning style preference
What event led to the “now” part and what do they want
to do about it?
Ability to Learn
Physical strength, movement, dexterity &
coordination
 Fatigue, electrolyte levels, oxygenation
status, blood glucose level
 Sensory deficits
 Reading level
 Developmental level
 Cognitive function
 Pain, fatigue, anxiety

Resources for Learning
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Social network: family, friends, & pt

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Financial or material resources

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Computer, car, insurance
Learning Skills

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HIPAA
ADHD, “learner-type”, math skills. literacy
Printed material that matches reading level

Functional illiteracy:
• Inability to read above a 5th grade level

Culturally sensitive: language, pictures, etc
Facilitators & Barriers
developmental
culture
spirituality
Plan
Teach
coping ability
environment
physical conditions
The Patient
social
Adapt
Evaluate
motivation
emotions
learning styles
Integrating: Nursing Process
& Teaching Process
A relationship exists.
 The nursing & teaching process
are not the same.
 The nursing process requires
assessment of all data.
 The teaching process focuses on
the client’s learning needs &
ability to learn.
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Assessment

Assess factors that influence content,
ability to learn, & resources available:
Expectation of learning
 Learning needs
 Motivation
 Teaching environment
 Health literacy and learning disability

Nursing Diagnosis
Select the Nursing Dx that best reflects the
assessed learning
 Clarifying the Dx by domain to help focus on the
subject matter & teaching methods.

Cognitive: Knowledge deficit: Signs of hypoglycemia
 Affective: Noncompliance R/T fear of pain
 Psychomotor: Ineffective therapeutic regimen R/T
dexterity difficulties secondary to Carpal Tunnel
Syndrome
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Planning: Goals/Outcomes

Determine specific goals & expected outcomes
that guide the choice of teaching strategies &
approaches with a client:
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Be realistic
Set priorities.
Select timing to teach.
Avoid “overload”
Define measurable goals
Organize the teaching material.
Goal Ex: “demonstrates” or “verbalizes”
Implementation
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Maintain learning attention and participation.
Build on existing knowledge.
Select teaching approach.
Incorporate teaching with nursing care.
Select appropriate instructional methods.
Illiteracy & other disabilities.
Cultural diversity.
Using different teaching tools.
Special needs of children and older adults (p379)
Patient Teaching
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Approaches
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Telling
Participating
Entrusting
Reinforcement
Methods
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One-on-one
Group
Preparatory instruction
Demonstrations
Analogies
Role play simulation
Teaching while “Doing”
More effective if tied to the “problem”
 Application of theory to practice

Evaluation of Learning
Methods to Evaluate
Learners
Determines whether the client has
learned the material
 Helps to reinforce correct behavior &
change an incorrect behavior
 Success depends on the client’s
performance of expected outcomes

“demonstrates”
 “verbalizes”
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Success!
Document
 Supports TJC standards of care, QI
efforts, & allows for reimbursement
 Written care plans
 Teaching flow sheets
 Ask questions to verify understanding of
teaching

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Realistic goals? Value the info? Barriers?
Any problems or questions?
The End

eheim productions 