Introduction to the Practical Nurse as Teacher
Teaching refers to activities by which specific objectives or desired behavior changes are achieved. It is an interactive process between the teacher and one or more learners. Patient teaching is inherent to the role of nursing by virtue of the nurse's position at the bedside. Shorter hospital stays which require patients to manage convalescence at home, and emphasis on health promotion and health maintenance rather than on treatment alone, have increased the need for health teaching by nurses.
Understand the general facts related to patient teaching
Identify the three types of learning
Cite the principles for effective Teaching and Learning
Facts related to patient teaching
Patient teaching is a function of nursing and a legal requirement of nursing personnel. Teaching is considered a function of nursing. In some states teaching is included in the legal definition of nursing, making it a required function of nursing personnel by law.
Patient teaching is defined as a system of activities intended to produce learning. These activities should help the patient meet individual learning objectives. If they do not, the patient's need should be reassessed and the activities replaced by others. For example, explanation alone may not teach a diabetic patient how to prepare the syringe for an injection. Actually preparing the syringe may be more effective.
Patient teaching is a dynamic interaction between the nurse (teacher) and the patient (learner). Both the teacher and the learner communicate information, emotions, perceptions, and attitudes to the other.
Before learning can occur, a relationship of trust and respect must exist between the teacher and learner. The learner trusts the teacher to have the required knowledge and skills to teach and the teacher respects the learner's ability to reach the goals. This relationship is enhanced by communication that is continuous and reciprocal, once mutual trust and respect have been established.
The goal of patient teaching is the patient's active participation in health care and his compliance with instructions. Once the nurse begins instructing a patient (or family/support persons), the teaching process should continue until the participants reach the goals, change the goals, or decide that the goals will not help meet the learning objectives.
TYPES OF LEARNING UNIT
Three domains, or types of learning, have been identified as cognitive, affective, and psychomotor.
• The cognitive domain includes intellectual skills such as thinking, knowing, and understanding. When the patient stores and recalls information, he is using the cognitive domain. For example, after attending classes on the low sodium diet a patient states how salt affects the blood pressure.
• The affective domain includes feelings, emotions, interests, attitudes, and appreciations. An example would be a patient's acceptance of having a colostomy and maintaining his self-esteem.
• The psychomotor domain involves motor skills. An example would be a patient demonstrating clean technique when changing her dressing.
PRINCIPLES FOR EFFECTIVE TEACHING-LEARNING
Nurses should include each of these three domains in patient teaching plans.
The teaching-learning process is facilitated by the existence of a helping relationship.
A helping relationship exist among people who provide and receive assistance in meeting a common goal. The relationship is established as a result of communication.
The communication is continuous and reciprocal.
• Nurses in the role of teachers must be able to communicate effectively with individuals, with small groups, and in some instances with large groups.
• Knowledge of the communication process is necessary for the assessment of verbal and nonverbal feedback.
• A thorough assessment of clients and the factors affecting learning helps to diagnose their learning needs accurately.
• The teaching-learning process is more effective when the client is included in the planning of learner objectives.
• Unless the client values these objectives, little learning is likely to occur.
• The implementation of a teaching plan should include varied strategies for sensory stimulation, which apparently promote learning.
• Relating new learning material to clients' past life experiences is effective in helping to assimilate new knowledge.
• Proposed behavioral changes must always be realistic and explored in the context of the client's resources and everyday life-style.
• Careful attention should be paid to time constraints, scheduling, and the physical environment.
• Learner objectives provide the basis for evaluating whether learning has occurred.
• When learning objectives have not been met, careful reassessment provides ideas for changing the teaching plan for subsequent implementation.
These basic principles are effective guidelines when applied in situations in which the teaching-learning process is used by nurses to meet the needs of clients.