HEALTH EDUCATION MIDTERMS

MODULE 1
\ COVERAGE:
LESSON 1.1 COMMON TERMS IN
Lesson 1: Overview of Education in Health Care
1.1 Common terms in Teaching and Learning TEACHING AND LEARNING
Lesson 2: Hallmarks of Effective Teaching in Nursing
Lesson 3: Barrier to Education and Obstacles to
Learning EDUCATION PROCESS
It is a systematic, sequential, logical, scientifically
LESSON 1 OVERVIEW OF EDUCATION based, planned course of action consisting of two
IN HEALTH CARE interdependent operations; teaching & learning (APIE)
Assessment, Planning, Implementation, and Evaluation.
Florence Nightingale – the first Nurse Educator
 The founder of Modern Nursing and was the
ultimate educator NURSING PROCESS
 She develop the first school of Nursing. ADPIE – Assessment, Diagnosis, Planning,
 Devoted most of her career in teaching nurses, Implementation and Evaluation.
physicians, and health officials.
 Emphasized the importance of adequate TEACHING
nutrition, fresh air, exercise, and personal As one component of the educational process, it is a
hygiene to patients. deliberate, intentional act of communicating information
to the learner in response to identified learning needs
MID 1800 – Nursing was first acknowledged as a with the objective of producing learning to achieve
unique discipline, teaching has been recognized as an desired behavioral outcomes.
important role of nurses as caregiver.
Care of the Health Educating nurses
for professional LEARNING
Sick Promotion practice A change in the behavior (SKA) that can be observed or
EARLY 1900 – role of a nurse as teacher in disease measured and that can occur at any time or in any place
prevention in the community was clearly understood. as a result of exposure to environmental stimuli.

FOR DECADES – patient teaching has been recognized PATIENT EDUCATION

as an independent nursing function. A process of assisting people to learn health-related
behaviors that can be incorporated into everyday life
1918 – NLNE or National League of Nursing Education with the goal of optimal health and independence in self-
observed the importance of health teaching as a function care.
with the scope of nursing practice.

2 decades later – they recognized nurses as agents for the STAFF EDUCATION
promotion of health & prevention of illness in all setting. The process of influencing the behavior of nurses by
producing changes in their knowledge, attitudes, and
1950 – NLNE identified course content in nursing skills to help nurses maintain and improve their
school curricula to prepare nurses to assume to role as competencies for the delivery of quality care to the
teachers. consumer.

1993 – JCAHO established nursing standards for patient TEACHING PLAN

education.
Overall blueprint or outline for instruction clearly
defining the relationship between the essential
2006 – NLNE developed the 1st certified nurse educator
components of behavioral objectives, instructional
(CNE) exam.
content, teaching methods and tools, time frame for
teaching, and methods of evaluation that fit together in a
logical pattern of flow to achieve a predetermined goal.

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AVAILABILITY TO STUDENTS
 Physically helping students giving nursing care
 Appropriate amount of supervision
 Freely answering questions
 Resource person in RLE
LESSON 2: HALLMARKS OF
EFFECTIVE TEACHING IN NURSING LESSON 3: BARRIERS TO EDUCATION
AND OBSTACLES TO LEARNING
6 MAJOR CATEGORIES EFFECTIVE
BARRIERS TO TEACHING
TEACHING IN NURSING  Lack of time to teach
 Lack of competence and confidence with
PROFESSIONAL COMPETENCE teaching skills
 Lack or no motivation to teach
 Develops knowledge of the subject matter and
 Lack of financial support for educational
polishes skills throughout his career
program
 Expands through reading, research, clinical
 Lack of avenue for documentation
practice and continuing education.
OBSTACLES IN LEARNING
 Lack of time to learn
INTERPERSONAL RELATIONSHIPS WITH  Health condition of the patient; acute and
STUDENTS chronic illness
 Sensitive to the feelings and problems of  Low literacy
learners.  Negative influence of the hospital environment
 Respect for students, being fair.  Personal characteristics of a learner
 Creating atmosphere which students can ask  The extent of behavioral change
express ideas/feelings.  Lack of support and positive reinforcement
 Conveys a sense of warmth  Denial of learning needs
 Emphatic listening, acceptance, and honest  Poor healthcare
communication

MODULE 2: LEARNING THEORY

PERSONAL CHARACTERISTICS
 Authenticity, enthusiasm, cheerfulness Learning Theory – a coherent framework of integrated
constructs and principles that describes, explain, or
 Self-control, patience, flexibility, sense of
predict how people learn. Rather than offering a single
humor
theory of learning, psychology provides alternative
 Good speaking voice, self-confidence and caring
theories and perspectives on how learning occurs and
attitude.
what motivates people to learn and change. Health
professionals, including nurses must demonstrates that
TEACHING PRACTICES they regularly employ sound methods and a clear
 Mechanics, methods, and skills in classroom and rationale in their education efforts, patient and family
clinical teaching. interactions, staff management and training, and
 Thorough knowledge of the subject matter continuing education and health promotion programs.
 Presents material in an interesting, clear, and TERMS RELATED TO LEARNING
organized manner.
 Good teaching style and strategies. THEORIES
 Teaches subject matter in a stimulating way, not
boring. LEARNING
A change in the behavior (SKA) that can be observed or
EVALUATION PRACTICES measured and that can occur at any time or in any place
 Communicates expectations as a result of exposure to environmental stimuli.
 Provides timely feedback on students’ progress Permanent change in mental processing, emotional
 Correcting students tactfully functioning, &/or behavior as a result of experience
 Fair in evaluating process
 Giving tests pertinent to the subject matter

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LEARNING THEORY o Ex. Listening to friends and relatives
A coherent framework and set of integrated constructs about hospital experiences.
and principles that describe, explain, or predict how - Discrimination learning
people learn. o Ex. Hospitalized a number of times.
- Spontaneous recovery
o Ex. Relapse prevention programs,
unhealthy habits, addictive behavior,
smoking, alcoholism, drug abuse.
Operant Conditioning
DEFENSE MECHANISM
- To increase the probability of a response:
Employed to protect the self when an individual's ego is o Positive reinforcement
threatened; short term use is a way of coming to grips o Reward conditioning
with reality, but long term reliance allows individuals to
o Negative reinforcement
avoid reality and may act as a barrier to learning and
- To decrease/extinguish the probability of a
transfer.
response:
o Non-reinforcement
HIERARCHY OF NEEDS o Punishment – punish the behavior not
Theory of human motivation based on integrated the person.
wholeness of the individual and levels of satisfaction of
basic human needs organized by potency.
COGNITIVE LEARNING THEORY
- Stage 1: Attention
RESPONDENT CONDITIONING - Stage 2: Processing
Also termed Classical or Pavlovian Conditioning. - Stage 3: Memory Storage
Emphasizes the importance of stimulus condition and - Stage 4: Action
the associations formed in the learning process,
whereby, without thought or awareness, learning takes
SOCIAL LEARNING THEORY
place when a newly conditioned stimulus (CS) becomes
associated with a conditioned response (CR). Albert Bandura
- Role modelling is the central concept
- Ex. Mentor of a less experienced nurse.
LEARNING THEORIES 4 Step of SLT Model
- Attentional Phase – observation of the role
model
BEHAVIORIST - Retention Phase – processing and
Watson and Pavlov/Guthrie (contiguity theorists) representation in memory.
- Learning is a permanent change in behavior - Reproduction Phase – memory guides
- Stimulus-response performance of model’s actions.
- Ex. Hot stove - Motivational Phase – influenced by vicarious
Thorndike and Skinner (reinforcement theorists) reinforcement and punishment. Covert cognitive
- Stimulus-response bonds are strengthened by activity, consequences of behavior and self-
reinforcement such as rewards & punishments. reinforcement and punishment.
- Behavior that is rewarded is more likely to
occur. PSYCHODYNAMIC LEARNING THEORY
Respondent Conditioning (Pavlovian)
Freud, Sigmund
- Emphasizes the importance of stimulus and
- Emphasizes the importance of conscious and
conditions and the associations formed in the
unconscious forces in guiding behavior,
learning process.
personality conflicts, and the enduring effects of
Systematic desensitization
childhood experience.
- Technique based on respondent conditioning to
- Defense mechanisms
reduce fear and anxiety
- Fearful individual are first taught relaxation
technique. HUMANISTIC LEARNING THEORY
- Treat drug addiction, phobias, tension headaches Maslow
and ADHD/Autism to swallow pills. - Maslow’s Hierarchy of Needs
- Stimulus generalization - Largely a motivational theory

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a. Provide appropriate information and
present it in unique ways
b. Identify progress of learning.
c. Give feedback and follow-up
d. Reinforce learning towards acquisition
of KAS
e. Evaluate learners’ abilities.

Learning is the single most important person is

education process.
Learning occurs without an educator. An educator
enhanced learning by facilitating education to occur.
MODULE 3: TYPES OF LEARNING AND
CHARACTERISTICS OF LEARNERS
ASSESSMENT OF THE LEARNER
TYPES OF LEARNING Knowing the characteristics of the learner.
a. Culture
SIGNAL LEARNING b. Literacy
c. Age
The person develops a general diffuse reaction to
d. Educational level
stimuli.
e. Health status
Example: Return Demonstration
f. Socio-economic

CHAINING
UNDERSTAND DETERMINANTS OF
Is the acquisition of a series of related conditioned
LEARNING
responses or stimulus response connections
Example: IV infusion backflow a. Learning needs – what learner need to learn.
b. Readiness to learn – when learner is receptive
to learning
RULE LEARNING c. Learning style – how learner best learn
Chain of concepts or a relationships between concepts
“If…then” relationship. Assessing learning needs will determine design of
instructional plan to address the need for cognitive,
CONCEPT LEARNING affective or psychomotor development of the learner.
Learning needs – gaps in knowledge that exist between
Learning how to classify stimuli into groups represented
the desired level of performance and actual level of
by a common concept.
performance.

VERBAL ASSOCIATION STEPS IN ASSESSMENT OF LEARNING

Process of learning medical terminologies like NEEDS
Appendectomy. 1. Identify the learner
2. Choose the right setting
PROBLEM SOLVING 3. Collect data on the learner
Must be able to recall and apply previously learned rules 4. Include learner as a source of information
that relate to the situation. 5. Involve members of healthcare team
6. Prioritize needs
7. Determine availability of educational resources
NURSE EDUCATOR’S ROLE IN 8. Assess demands of the organization regulations
LEARNING 9. Take time management issues into account
1. Assess the need of learner METHODS TO ASSESS LEARNING
2. Recognize factors involved in readiness to learn. NEEDS
3. Correlate teaching interventions with learning
styles to maximize opportunities for learning. The nurse educator must obtain objective and subjective
data from the learner.

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1. Informal conversation – impromptu - Risk taking behavior
conversations - Frame of mind
2. Structured interviews - Developmental stage
3. Focus groups – 4 – 12 (same age, gender, past E (Experiential)
experience) - Level of aspiration
4. Self-administered Questionnaires – self- - Past coping mechanism
assessment. - Cultural background
5. Tests – pre-tests - Locus of control
6. Observations - Orientation
7. Patient charts K (Knowledge Readiness)
- Present knowledge base
ASSESSING LEARNING NEEDS OF - Cognitive ability
NURSING STAFF - Learning disabilities
1. Written job descriptions – written description - Learning styles
effective nursing care necessary to provide Timing – the point in which teaching must take place;
services. anything affected by physical and psychological
2. Formal and informal request – results of staff comfort can affect learner’s ability and readiness to learn
perceptions on their learning needs. Learning style – refers to the ways individual process
3. Quality assurance reports – trends found in information
incidental reports indicating safety violations. IMPORTANT POINTS ON TIME
4. Chart audits – identify trends of nursing
practice. MANAGEMENT
5. Rules and regulations – educators monitor new 1. Do an initial assessment to prevent waste of time
rules or policies implementation and its from going back to discover obstacles that
implications to delivery of care. hamper progress.
6. Four step appraisal of needs (Panno, 1992) 2. Learners must be encouraged to offer
a. STEP 1 – define target population perceptions on their learning needs.
b. STEP 2 – Analyze learner and 3. Assessment can be made anytime and anywhere
organizational needs the educator has formal and informal contact
c. STEP 3 – Analyze the perceived needs with the learner.
of the learner and compare from actual 4. Informing in advance if the educator wishes to
needs. discuss problems or needs. This will make it
d. STEP 4 – Use data to prioritize learning easier for a person to sort things out and
need identified feelings.
Readiness to learn – time when the learner 5. Minimizing interruptions and distractions during
demonstrates an interest in learning information planned assessment interviews.
necessary to maintain optimal health.
- Nurse educators must think what needs to be LEARNING STYLES
learned? Learning style – refers to the ways individual process
- What is the learning objectives? information; or individual preferences to learn
- Which domain and at what level of learning Learning style models – are based from characteristics
objectives are these objective classified. that are biological in origin, and sociologically
- Thus, preventing the objectives to go beyond the developed as result of environment differences
learner’s readiness to learn.
4 Types of Readiness to Learn 6 LEARNING STYLE PRINCIPLES
P (Physical Readiness) 1. The style by which the teacher and student
- Measures of ability prefers to learn can be identified
- Complexity of task 2. Teachers need to guard against over teaching
- Environment effects their own preferred learning styles
- Health status 3. Teachers are most helpful when they assist
- Gender students in identifying and learning through the
E (Emotional Readiness) own style preferences
- Anxiety level 4. Students should have the opportunity to learn
- Support system through their preferred style
- Motivation

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5. Students should be encouraged to diversify their DUNN AND DUNN LEARNING STYLE
style preferences INVENTORY
6. Teachers can develop specific learning activities
Environmental Elements
that reinforce each modality or style
- Sound, light, temperature, seating design
LEARNING STYLE MODELS AND Emotional Elements
- Motivation, conformity/responsibility, task
INSTRUMENT
resistance, structure
Sociological Elements
RIGHT BRAIN/LEFT BRAIN AND WHOLE - Alone, pair, peer, group, authority, variety
BRAIN THINKING Physiological Elements
- Intake, time and day, mobility, auditory, visual,
Left brain – logic, analysis, sequencing, linear,
tactual, kinesthetic
mathematics, language, facts, think in words, words of Psychological Elements
songs, computation.
- Analytic, global, impulsive, reflective
Right brain – creativity, imagination, holistic thinking,
intuition, arts, rhythm, non-verbal, feelings,
visualization, tune of songs, and daydreaming.

MYERS-BRIGGS TYPE INDICATOR

FIELD INDEPENDENT AND DEPENDENT
Extroverts – energized by people, enjoy a variety of
LEARNERS tasks, a quick pace, and are good at multitasking.
Field Dependent Learners Sensors – realistic people who like to focus on the facts
- They find it difficult to restructure new and details. They apply common sense and past
information and forge links with prior experience to find practical solutions to problems.
knowledge. Thinkers – tend to make their decisions suing logical
- Their personalities show a greater social analysis, objectively weigh pros and cons, and value
orientation. honesty, consistency, and fairness.
- They experience surroundings in a relatively Judgers – tend to be organized and prepared, like to
global fashion, passively conforming to the make and stick to plans, and are comfortable following
influence of the prevailing of the field or most rules.
context. Introverts – often like working alone or in small groups,
- they demonstrate fewer proportional reasoning prefer a more deliberate pace, and like to focus on one
skills task at a time.
- they prefer working in groups Intuitives – prefer to focus on possibilities and the big
- they struggle with individual elements picture, easily see patterns, value innovation, and seek
- They are externally directed creative solutions to problems.
- They are influenced by salient features Feelers – tend to be sensitive and cooperative, and
- They accept ideas as presented. decide based on their own personal values and how
Field Independent Learners others will be affected by their actions.
- They are able to recognize information to Perceivers – prefer to keep their options open like to be
provide a context for prior knowledge able to act spontaneously and like to be flexible with
- They are influenced less by social reinforcement making plans.
- They experience surroundings analytically, with
objects experienced as being discrete from their
backgrounds. KOLB’S LEARNING STYLE INVENTORY
- They demonstrate greater proportional reasoning
skills.
- They prefer working alone
- They are good with problems that require taking
elements out of their whole context
- They are internally directed
- They are individualistic
- They accept ideas strengthened through analysis.

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anchored in feelings. Often these types of learners will
direct attention to information that has personal meaning
to them. Learning can be enhanced by color, music,
picture, drawings, symbols, poetry, and humor. Learners
like a busy environment and likely ask questions during
discussion. Learning is achieved in groups, with
opportunity for discussion and question and answer.

Concrete Random Learners

Tend to seek alternatives and create choices where none
existed before. The learners are inquisitive and will
question motives. Attentions is focused on the process
and the CR individual will make intuitive leaps or
insights. The “why” is more important than “how”. CR
learner does not like detail and has difficulty in step-by-
step learning.

4MAT SYSTEM
Mc Carthy (1981) developed a model from previous
research on learning style and brain functioning. It is a
GREGORC STYLE DELINEATOR combination of Kolb’s model and right/left brain
Anthony Gregorc (1982) functioning.
- Identified learning style using four dualities: Learning process – is a natural sequence from type 1-4.
perception, ordering, processing, and relating educators can address all four types of learning styles by
- This is an instrument designed to assess person’s teaching sequentially. Learners can work with their own
learning style by using set of words that are strongest learning style.
ranked with the use of scores derived from each
of the four patterns.
- According to Gregorc, learning style consists of
distinctive and observable behavior that
provides cues about the mediation abilities of
individuals.
FOUR LEARNING PATTERNS

- Type 1 – Engage in the right brain by sensing

Concrete Sequential Learners and feeling their way through an experience.
Operate in a highly structured, conservative manner in They eventually move on the left-brain to
which specific details and time schedules are critical. analyze what they have experience. (Why is this
Objectives are important, as well as clear beginning and important?)
end. The learner can tolerate interruption during the - Type 2 – Learner begins with the right brain to
performance of the skill. make observations and integrate data with
present knowledge. Learners then engage the
Abstract Random Learners left-brain to think about new theories and
Value relationships over time-bound structures. They concepts relative to these observations. (What is
think in global terms, and their thinking process is

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it I am supposed to be learning? And “What is Considerate, traditional, indirect type
the relationship?”)  Can instinctively read other's emotion, and
- Type 3 – Begin with the left brain by working respond friendly by natures.
with defined concepts, then shifting to the right  Although not very into taking initiatives in
brain to experiment with what has to be learned. moving forward, but this person will always take
(“How does this work? How can I figure this a step back in supporting others.
out?”)  Stable personality and considerate, give others a
- Type 4 – Learner begins with the left brain by being protected feeling.
analyzing the practicality of what has been  But the weakness is they cannot say no;
learned. They move to the right brain to show regardless how unwilling they are, they will take
mastery through application and the sharing of care of others.
findings with others. (“If I learn this what I do
with this?”)
RIGHT AND RIGHT
Loves challenges, Straightforward type.
GARDNER’S SEVEN TYPES OF
 Once they decided on one thing, will take action
INTELLIGENCE right away.
Howard Gardner (1983) – developed a theory focused  Very curious, and love challenges.
on seven types of intelligence. It was found useful in  Dare to face dangers without thinking through
looking at styles of learning among children. (sometimes foolishly).

 Their weakness is they don't listen to others, will

filter in only what they want to hear in a
conversation, and very subjective.
 However, because of their straightforward
attitude, they tend to be fairly popular.

LEFT AND LEFT

Dedicated, cold, perfectionist type
 Very logical in all aspects. The only way to
defeat (or win over) him/her is through reasons.
 Has a lot of prides, and feeling strongly about
doing the right thing?
 If they are your friends, they are very
trustworthy.
 However, if they are your opponents, they will
VARK LEARNING STYLE be very tough to deal with. Because they can be
very 'anal' as a perfectionist, they usually leave a
bad impression of being hard to deal with when
first met.

LEFT AND RIGHT

Likes to take care of others, leader type
 Has a cool and keen observation ability to see
through situations, yet still can be considerate in
other’s needs.
 Because of their cool and calm nature, and
strong sense of responsibility, they tend to
INTERPRETATION OF LEFT AND become head of a group.
 Popular among people. However, they may not
RIGHT BRAIN PERSONALITY
be able to help themselves in meddling because
they want to take care of others too much.
RIGHT AND LEFT  Very concerned about how others view them,
and always on alert.

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