Principles of Teaching in Medical Laboratory Science

Midterm Notes

PERSPECTIVES ON TEACHING AND LEARNING ROLE OF A HEALTH EDUCATOR

Concepts of Education In Relation to Health Care • Giver of Information

• Facilitator of learning
OVERVIEW OF EDUCATION ON HEALTH CARE
• Coordinator of teaching
• Health Education is a process concerned with • Client advocate
designing, implementing, and evaluating
EFFECTIVE TEACHER...ARE....
educational programs that enable families,
groups, organizations and communities to play ➢ Committed: That is, they don’t watch the clock,
active roles in achieving, protecting and they go the extra miles and work long hours.
sustaining health. ➢ Creative: Meaning they stimulate intellectual
• Its purpose is to contribute to health and well- inquisitiveness as well as exploratory and
being by promoting lifestyles, community critical thinking
actions and conditions that make it possible to ➢ Intuitive: Meaning the teacher is able to identify
live healthful lives the student’s predominant style of intelligence
• Education for health begins with people. It Aims and based on this knowledge, the teacher is able
is to develop a sense of responsibility in health to build on the student’s strength.
conditions for themselves
HALLMARKS OF GOOD OR EFFECTIVE TEACHING
1st Set: Mind Conditioning (JACOBSEN)

• We have just celebrated the International Professional Competence.....is evidenced by;

Teachers Day.......
A. Thorough knowledge of the subject matter and
• Is there any Teacher within your family?
proper demonstration of skills.
• How would you describe a teacher?
B. Reading, re-searching, undertaking Continuing
TEACHING Professional Education (CPE) and has clinical
practice and expertise.
• Is a deliberate Intervention involving the
planning and implementation of instructional Possession of skillful interpersonal relationships with
activities and experiences to meet the intended students which was rated as the most important;
learning outcomes based on teaching plan.
A. Takes personal interest in the welfare of the
LEARNING student
B. Is fair and just, especially in giving grades and
• Is a change in behavior (knowledge, skills and credits to students.
attitude) that can occur at any time or in any C. Is sensitive to their feelings and problems
place as a result of exposure to environmental D. Allows learner to freely express themselves and
stimuli. ask questions.
• It is an action by which knowledge, skills and E. Is accessible for conferences and consultations
attitudes are consciously or unconsciously F. Convey a sense of warmth
acquired and behavior is altered which can be
seen or observed. Desirable personal characteristics of teacher which
include charisma or personal magnetism, enthusiasm,
EDUCATION PROCESS cheerfulness, self – control, patience, flexibility, sense of
• Is a systematic, sequential, planned course of humor, good speaking voice, self-confidence, willingness
action with teaching and learning as its two to admit error or lack of knowledge, and a caring
major interdependent functions and the teacher attitude ( Korzybski, 1997 and Fan brother, 1996)
and learner as the key players involved. Teaching Practices which include;
(Bastable,2003)
A. Mechanics
INSTRUCTION B. Methods
• Is one aspect of teaching which involves C. Skills in the classroom and clinical practice
communicating information about a specific skill D. the teacher has thorough knowledge of the
(cognitive, affective, or psychomotor). subject matter
• This is sometimes interchangeably used with E. presents the materials in clear, interesting,
teaching. logical and organized manner.

Three Pillars of Teaching – Learning Process Evaluation Practices which include;

i. Teacher A. Clearly communicating expectations;

ii. Subject-Matter B. providing timely feedback on student’ s progress
iii. Learner C. correcting the students tactfully
D. being fair in the evaluation process
Principles of Teaching in Medical Laboratory Science
Midterm Notes
E. giving tests that are pertinent to the subject BARRIERS TO EDUCATION
matter and assignments.
- Lack of time to teach ( greatest barrier) due to;
Availability to students especially in the laboratory, a. Short period of confinement
clinical and other skills application areas which are b. Very demanding schedule
mostly marked by stressful and / or critical situations or c. Demanding responsibilities
scenarios. - Lack of preparation to teach
a. Lack of knowledge on principles of
Important Characteristics of a Teacher
teaching and learning
A. TEACHER CLARITY- DEALS WITH BEHAVIORS b. New teachers dont feel confident
THAT TEACHERS USED TO MAKE WHAT IS TO BE regarding their teaching skills
LEARNED AS INTELLIGIBLE, COMPREHENSIBLE - Personal characteristic of the teacher
AND LEARNABLE AS POSSIBLE. - Low priority given to patient and staff education
❖ A CLEAR TEACHER IS ONE WHO LOGICALLY by the administration.
ORGANIZES INSTRUCTION, EXPLAINS WHAT - Lack of space and privacy in various
TO BE LEARNED, USES SIMPLE TERMS IN environmental setting is not always conducive
PRESENTING NEW MATERIALS, to teaching and learning process.
CONSTANTLY ASSESSES WHETHER STUDENT - Absence of third-party reimbursement to
CAN UNDERSTAND AND FOLLOW THE support patient education programs relegates
TEACHERS TRAIN OF THOUGHT, USES teaching & learning to less than high priority
EXAMPLE, WHEREVER POSSIBLE, AND USES status.
REPETITIONAND SUMMARIZATION. - Content needs to be standardized; teaching
B. TEACHER STYLE INVOLVES INTERPERSONAL, responsibilities needs to be made clear.
PROFESSIONAL AND PERSONAL ASPECT OF - Inadequate time to record/document patient
GOOD TEACHING. teaching.

Seven Principles of Good Teaching in Undergraduate THE INFLUENCE OF EDUCATION ON HEALTH: AN

Education EMPIRICAL ASSESSMENT OF OECD COUNTRIES FOR THE
PERIOD 1995–2015
1. Encourage Interaction between the teacher and
the learner, which refers to effective teacher Using empirical data from the OECD and the
characteristic. World Bank for 26 OECD countries for the years 1995–
2. Elicit cooperation among the students to do 2015, we identify patterns/associations between
collaborative l earning through study groups, education and health indicators. By incorporating pre-
undertaking group projects and Other group and post-educational attainment indicators, we highlight
activities. the dual role of education as both a driver of opportunity
3. Students should engage in active learning, where as well as of inequality.
they can proactively manipulate the content of
Adults with higher educational attainment have
what they are learning, by talking about the
better health and lifespans compared to their less
materials, writing about it, making an outline
educated peers. We highlight that tertiary education,
about it, applying it, asking questions, acting it
particularly, is critical in influencing infant mortality, life
out or just reflecting about it.
expectancy, child vaccination, and enrollment rates. In
4. Giving prompt feedback, related to class
addition, an economy needs to consider potential years
recitations, quizzes, major exams or other
of life lost (premature mortality) as a measure of health
written works and projects serves as a reward
quality.
or positive reinforcement for a job well done and
for any commendable behavior or attitude We bring to light the health disparities across
exhibited by the learner. countries and suggest implications for governments to
5. Emphasizing time on task where the teacher target educational interventions that can reduce
makes sure that the students know how much inequalities and improve health. Our country-level
time they should spend learning. this refers to findings on NEET (Not in Employment, Education or
proper, effective, and intelligent time Training) rates offer implications for economies to
management. address a broad array of vulnerabilities ranging from
6. Communicating higher expectations-refers to unemployment, school life expectancy, and labor market
the challenge that the teacher gives to the discouragement. The health effects of education are at
student and the students response to rise up the the grass roots-creating better overall self-awareness
challenge. on personal health and making healthcare more
7. Respecting the diverse talents and ways of accessible.
learning, since learners have different learning
Impact of Education on Individuals’ Ability to Navigate
styles.
Health Care:

Achieving positive health outcomes in today’ s

care environment requires a variety of factors to come
Principles of Teaching in Medical Laboratory Science
Midterm Notes
together that may be affected by educational experience. It is the process by which individuals gain
attainment and a combination of soft and hard skills. new knowledge or skills and change their thoughts,
feelings, attitudes, and actions. Although people in every
Patients benefit from the ability to understand
culture have beliefs about how teaching and learning
their health needs, follow or read instructions, advocate
should occur, there are several major theories of learning
for themselves and their families, and communicate
that have been tested with research. Learning allows
effectively with health providers. A systematic review of
individuals to adapt to demands and changing
health literacy and health outcomes found that
circumstances and is crucial in health care—whether for
individuals with low health literacy had poorer health-
patients and families struggling with ways to improve
related knowledge and comprehension, ability to
their health and adjust to their medical conditions, for
demonstrate taking medications properly, and ability to
students gaining the information and skills necessary to
interpret medication labels and health messages. They
become a healthcare professional.
also had increased hospitalizations and emergency care,
decreased preventive care, and, among the elderly, Learning Theory:
poorer overall health status and higher mortality
A coherent framework of integrated constructs and
For example, low literacy and low levels of other principles that describe, explain, or predict how people
basic skills such as listening and numeracy have been learn. It is a logical framework describing, explaining, or
associated with greater difficulty in asthma care in predicting how people learn. Whether used singly or in
adults. People with higher levels of efficacy may be combination, learning theories have much to offer the
quicker to adopt innovative strategies and act on health practice of health care. Increasingly, health
knowledge professionals.

In a review of the impact of patient -This chapter reviews the psychological and motor
socioeconomic status on patient-physician learning theories that are useful to health education and
communication, Willems et al (2005) concluded that clinical practice. Behaviorist, cognitive, and social
communication is influenced in part by patients ’ learning theories are most often applied to patient
communicative ability and style, which depend largely education as an aspect of professional nursing practice.
on education and other personal attributes. Education This chapter also treats psychodynamic and humanistic
contributes to more active communication, such as perspectives as learning theories because they
expressiveness and asking questions. In response, encourage a patient-centered approach to care and add
physicians tend to communicate less to patients who much to our understanding of human motivation and
seem less educated and to provide care that is more emotions in the learning process. Emotions and feelings,
directive and less participatory (Willems et al., 2005). it is argued, are critical to understanding learning
(Goleman, 1995)
Impact of Education on Personal Health Behaviors
Contribution of learning theories:
Adults with higher levels of education are less
likely to engage in risky behaviors, such as smoking and • It provide information and techniques to guide
drinking and are more likely to have healthy behaviors teaching and learning
related to diet and exercise.
• Can be employed individually or in combination
The impact of education on health behaviors
• Can be applied in a variety of settings as well as
likely stems from education’ s impact on skills as well as
for personal growth and interpersonal relations
socioeconomic status. Examining competing
explanations for the education gradient in health This section summarizes some of the basic principles of
behaviors, Cutler and Lleras-Muney (2010) find the following:
evidence for the importance of resources, cognitive
ability (especially how one processes information), and • Behaviorist Learning Theory
social integration.
• Cognitive Learning Theory
Education offers opportunities to learn more
• Social Learning Theory
about health and health risks, both in the form of health
education in the school curriculum and by giving • Humanistic Learning Theory
individuals the health literacy to draw on, later in life,
and absorb messages about important lifestyle choices • Psychodynamic Theory of Learning
to prevent or manage diseases. People who are more BEHAVIORIST LEARNING THEORY
educated tend to be more aware of health risks and may
be more receptive to health education campaigns. Cc Behaviorism refers to the school of psychology founded
by John B. Watson based on the belief that behaviors
Applying Learning Theories to Healthcare Practice can be measured, trained, and changed. Behaviorism
Learning: was established with the publication of Watson's classic
paper "Psychology as the Behaviorist Views It"
A relatively permanent change in mental processing,
emotional functioning, and behavior as a result of Behaviorism, also known as behavioral psychology, is a
theory of learning based upon the idea that all behaviors
Principles of Teaching in Medical Laboratory Science
Midterm Notes
are acquired through conditioning. Conditioning occurs especially useful in teaching people to reduce their
through interaction with the environment. Behaviorists anxiety or break bad habits.
believe that our responses to environmental stimuli
Operant conditioning
shape our actions
focuses on the behavior of the organism and the
According to this theory ,behavior can be studied in a
reinforcement that occurs after the response. A
systematic and observable manner with no
reinforcer is a stimulus or event applied after a response
consideration of internal mental states. It suggests that
that strengthens the probability that the response will be
only observable behavior should be considered as
performed again. Praise, hugs, money, and prizes are
cognition, emotion and moods are too subjective.
examples of positive reinforcers. When specific
To encourage people to learn new information or to responses are reinforced on the proper schedule,
change their attitudes and responses, behaviorists behaviors can be either increased or decreased.
recommend altering conditions in the environment and
There are many different types of positive reinforcers
reinforcing positive behaviors after they occur.
Motivation is explained as the desire to reduce some that can be used to increase behaviors, but it is
important to note that the type of reinforcer used
drive (drive reduction), such as the desire for food,
security, recognition, or money. This is why individuals depends on the individual and the situation
who are satisfied or who have what they want may have Natural reinforcers
little motivation to learn new behaviors or change old
behaviors. Getting behavior to transfer from the initial occur directly as a result of the behavior. For example, a
learning situation to other settings is largely a matter of student studies hard, pays attention in class, and does
practice (strengthening habits). their homework. As a result, they get excellent grades.

There are two ways to change behavior and encourage Social reinforcers
learning using the behaviorist principles of respondent
involve expressing approval of behavior, such as a
conditioning and operant conditioning.
teacher, parent, or employer saying or writing, "Good
RESPONDENT CONDITIONING job" or "Excellent work."

First identified and demonstrated by Russian Tangible reinforcers

physiologist, Ivan Pavlov, respondent conditioning (also
involve presenting actual, physical rewards such as
termed classical or Pavlovian conditioning) emphasizes
candy, treats, toys, money, and other desired objects.
the importance of stimulus conditions in the environment
While these types of rewards can be powerfully
and the associations formed in the learning .
motivating, they should be used sparingly and with
A neutral stimulus (NS)—a stimulus that has no caution.
particular value or meaning to the learner—is paired
Token reinforcers
with a naturally occurring unconditioned or unlearned
stimulus (UCS) and unconditioned response (UCR) . are points or tokens that are awarded for performing
After a few such pairings, the neutral stimulus alone (i.e., certain actions. These tokens can then be exchanged for
without the unconditioned stimulus) elicits the same something of value.
response. Often without thought or awareness, learning
occurs when the newly conditioned stimulus (CS) COGNITIVE LEARNING THEORY
becomes associated with the conditioned response (CR) It focuses on what goes on inside the mind of the learner.
EXAMPLE: Someone without much experience with Cognitive theory is assumed to be made up of a number
hospitals (NS) may visit a relative who is ill. While in the of sub theories and is widely used in education and
relative’s room, the visitor may smell offensive odors counseling. According to this perspective, for individuals
(UCS) and feel queasy and light-headed (UCR). After to learn, they must change their perceptions and
this initial visit and later repeated visits, hospitals (now thoughts and form new understandings and insights. The
the CS) may become associated with feeling anxious individual largely directs the learning process by
and nauseated (CR), especially if the visitor smells organizing information based on what is already known,
odors similar to those encountered during the first and then reorganizing the information into a new
experience understanding.

Respondent conditioning According to this theory ,the key to learning and

changing behavior is the individual cognition
highlights the importance of what is going on in the ,metacognition(perception, thoughts, memory and ways
environment in health care. Often without thinking or of processing and structuring information)
reflection, patients and visitors make associations as a
result of their hospital experiences, providing the basis To change behavior, work with the developmental stage
for long-lasting attitudes toward medicine, healthcare and change cognitions, goals, expectations, equilibrium,
facilities, and health professionals. Principles of and ways of processing information.
respondent conditioning may be used to get rid of or
eliminate a previously learned response, which is
Principles of Teaching in Medical Laboratory Science
Midterm Notes
SOCIAL LEARNING THEORY available to either the role model or the learner.
Nevertheless, in many cases, whether the model is
Most learning theories assume the individual must have
viewed by the observer as rewarded or punished may
direct experiences in order to learn. According to the
have a direct influence on learning. This relationship may
social learning theory, much of learning occurs by
be one reason why it is difficult to attract health
observation— watching other people and determining
professionals to geriatric care. Although some highly
what happens to them. Learning is often a social
impressive role models work in this field, geriatric health
process, and other individuals, especially significant
care is often accorded lower status with less pay in
others, provide compelling examples as role models for
comparison to other specialty areas
how to think, feel, and act
-It emphasizes the importance of the individual and the
According to this theory , learning is heavily influenced individual's perceptions of his/her personal capabilities
by the culture and occurs as a social process in
as key determinants of successful outcomes. Self-
interaction with others. efficacy theory, and the broader social cognitive theory
A person’s knowledge may not necessarily reflect in which self-efficacy is encompassed, therefore clearly
reality, but through collaboration and negotiation, new endorses a democratic ideal that suggests that all
understanding is acquired. individuals are competent and capable of being
successful, provided they have the opportunities and
Social learning theory is largely based on the work of self-efficacy necessary to pursue their goals.
Albert Bandura (1977, 2001), who mapped out a
perspective on learning that includes consideration of Factors that may influence learning
the personal characteristics of the learner, behavior Consistency.
patterns, and the environment. In early discussions of
this theory, Bandura emphasized behaviorist features The model (the person the learner is imitating) behaves
and the imitation of role models; later, the focus shifted in a way that is consistent across situations
to cognitive considerations, and more recently,
Identification:
Bandura’s attention has turned to the impact of social
factors and the social context within which learning and The learner can identify with the model
behavior occur. According to Bandura, personality is
shaped by interaction among cognitive factors, Rewards/punishment.
behaviors, and environmental factors. This interaction is
We can learn from the consequences of the model’s
termed reciprocal determinism.
behavior. (vicarious learning)
Cognitive factors §
Liking:
Our dispositional factors: beliefs, expectations, values,
The more we like the model, the more likely we are to
intentions, social roles, emotional makeup and biological
imitate his or her behavior
and genetic influences
BOBO DOLL THEORY
Behavioral factors §
§Children watched a model being aggressive to a bobo
Our skills, practice and self-efficacy § Self efficacy:
doll
Similar to confidence. The belief that one is capable of
performing a certain behavior to attain a certain goal §Children imitated the model were aggressive to the
bobo doll
Environmental factors §
• As a matter of fact, the Bobo doll experiment is
Our social, political, and cultural influences and personal
the empirical demonstration of one of his most
learning experiences
famous theories: Social Learning Theory. This
Role modeling theory states that humans mostly learn by being
in contact with their social environment. By
is a central concept of the social learning theory. As an observing others, we acquire certain knowledge,
example, a more experienced nurse who demonstrates skills, strategies, beliefs, and attitudes.
desirable professional attitudes and behaviors
sometimes serves as a mentor for a less experienced HUMANISTIC LEARNING THEORY
nurse, while medical students, interns, and residents are
Underlying the
mentored by attending physicians.
humanistic learning
Vicarious reinforcement theory is the assumption
that each individual is
is another concept from social learning theory and unique and that all
involves viewing other people’s emotions and individuals have the
determining whether role models are perceived as desire to grow in a
rewarded or punished for their behavior. Reward is not positive way.
always necessary, however, and a learner may imitate Unfortunately, say the humanists, positive psychological
the behavior of a role model even when no reward is growth may be damaged by some of society’s values
Principles of Teaching in Medical Laboratory Science
Midterm Notes
and expectations (e.g., males are less emotional than behavior (Hilgard & Bower,1966; Slipp, 2000). Largely a
females, some ethnic groups are inferior to others, theory of motivation that stresses emotions rather than
making money is more important than caring for cognition or responses, the psychodynamic perspective
people), and by adults’ mistreatment of their children emphasizes the importance of conscious and
and one another (e.g., inconsistent or harsh discipline, unconscious forces in guiding behavior, personality
humiliation, and belittling, abuse and neglect). conflicts, and the enduring effects of childhood
experiences. As Pullen (2002) points out, negative
Humanistic theory is especially compatible with nursing’s
emotions are important to recognize and assess in
focus on caring and patient-centeredness—an
nurse–patient-physician–family interactions, and
orientation that is increasingly being challenged by the psychodynamic theory can be helpful in this regard.
emphasis in medicine and health care on science,
technology, cost efficiency, for-profit medicine, Principles of Learning
bureaucratic organization, and time pressures. Like the
1. Focusing
psychodynamic theory, the humanistic theory is largely
2. Organization
a motivational theory. From a humanistic perspective,
3. Repetition
the motivation to act stems largely from each person’s
4. Association
needs, feelings about the self, and the desire to grow in
5. Learner control
positive ways. Remembering information and
6. Imitation
transferring learning to other situations are helped by
7. Active participation
encouraging curiosity and a positive self-concept, as
8. Motivation
well as having open situations where people respect
9. Individual styles
individuality and freedom of choice. Under such
10. Spacing
conditions, flexibility in problem-solving and creativity
is enhanced.
Laws of learning By Edward Torndike (1932)
To summarize, humanistic theory suggests the following
1.) Law of effect
principles of learning:
▪ Learning is strengthened when accompanied by
• Focus on the learner’s desire for positive growth, a pleasant or satisfying feeling.
subjective feelings, needs, selfconcept, choices in life, ▪ Learning is a weaken when associated with an
and interpersonal relationships. unpleasant feeling.
▪ Learning takes place properly when it results in
• The teacher’s role is to assess and encourage changes satisfaction and the learner derives pleasure out
in the learner’s needs, selfconcept, and feelings by of it.
providing support, freedom to choose, and opportunities 2.) Law of exercise
for spontaneity and creativity ▪ Things most often repeated are best
Applying Learning Theories to Health Care remembered
▪ Students do not learn complex task in a single
In practice, psychological learning theories can be used session.
singly or in combination to help nurses and other health 3.) Law of Readiness
professionals teach patients or themselves to acquire ▪ Individuals learn best when they are physically,
new information and alter behavior. As an example, mentally and emotionally ready to learn
patients undergoing painful procedures are first taught 4.) Law of primacy
relaxation exercises (behaviorist) and while ▪ Things learned first create a strong impression
experiencing pain or discomfort are encouraged to "What is THOUGHT must be RIGHT the FIRST
employ imagery, such as thinking about a favorite, TIME."
beautiful place or imagining the healthy cells gobbling up 5.) Law of recency
the unhealthy cells (cognitive). Staff members are highly ▪ Things most recently learned are best
respectful, upbeat, and emotionally supportive of each remembered
patient (humanistic) Waiting rooms and lounge areas 6.) Law of intensity
for patients and their families are designed to be ▪ The more intense the material taught the more it
comfortable, friendly, and pleasant to facilitate is likely learned
conversation and interaction, while support groups may 7.) Law of freedom
help patients and family members learn from one ▪ Thing freely learned are best learned
another about how to cope with illness or disability and
how to regulate their emotions so that their health is not
further compromised (social learning).

PSYCHODYNAMIC LEARNING THEORY

Although not typically treated as a learning theory,

some of the constructs from psychodynamic theory
(based on the work of Sigmund Freud and his followers)
have significant implications for learning and changing