Steps in the learning process
Steps in the learning process introduces a teaching and learning cycle that focuses on the pre, intra and post learning phases. The importance of preparedness is discussed to ensure appropriate materials and resources are available in an organized environment which is conducive to learning.
After completing this lesson you will be able to:
Identify steps in the Learning process
Understand the importance of planning
Understand how to carry out a pre-evaluation of skills to assist diagnosis and lesson planning
Understand how to prepare the Lesson Plan
Understand the importance of post teaching and learning evaluation
Key elements in the learning process outlined are as follows:
Diagnosis and planning
The Lesson Plan
Evaluation of teaching and learning
Flexibility is discussed in terms of teaching plan and teaching approach where alternative teaching strategies can also be introduced and prove more effective in meeting the needs of the learner.
This flexibility enables the teacher to adjust delivery style, content or introduce new resources which will more effectively meet the learning needs of the client.
Assess the Patient's Learning Needs.
(1) Use all appropriate sources of information. Review the patient medical records. Read the history of medical problems as well as diagnoses, physical examinations, documentation of the nursing assessment, and the nursing interventions that have been performed. The patient and the family or support persons are the best source of needs assessment information.
(2) Identify the knowledge, attitude, or skills needed by the patient or family/support persons. Learning can be divided into three domains: cognitive, affective, and psychomotor. You may categorize learning that is planned for the patient into these three areas.
(a) Cognitive involves the storing and recalling of new knowledge and information.
(b) Affective learning includes changes in attitudes, values, and feelings.
(c) Psychomotor learning has occurred when a physical skill has been acquired.
(3) Assess emotional and experiential readiness to learn. Readiness is not the patient's physical ability to learn. The readiness to learn in an adult may be related to a social role. Being assured that they are partners in the teaching-learning process gives adult learners the sense of control that they are accustomed to in their daily living.
(4) Assess the patient's ability to learn. The teaching approach must be appropriate to the developmental stage of the learner. You should assess the patient's intellectual development, motor development, psychosocial development, and emotional maturity. Chronological age does not guarantee maturity.
(5) Identify the patient's strengths. Learning strengths are the patient's personal resources such as psychomotor skills, above-average comprehension, reasoning, memory, or successful learning in the past. For example, if the patient knows how to cook, this knowledge can be useful when learning about a special diet.
(6) Use anticipatory guidance. Anticipatory guidance focuses on psychologically preparing a person for an unfamiliar or painful event. When patients know what to expect, anxiety is reduced and they are able to cope more effectively.
b. Diagnose the Learning Needs. Be realistic. When a lack of knowledge, attitude, or skill hinders a patient's self-promotion of health, the nurse diagnoses the deficit. Confirm your diagnosis with the family. In addition, assess your own knowledge base and teaching skills. You teach information and skills to patients which you lack.
c. Develop a Teaching Plan. Planning ensures the most efficient use of your time and increases the patient's chances for learning. A teaching plan follows the steps of the nursing process.
(1) Develop measurable learner objectives for each diagnosis of a learning need.
(a) Identify short-term and long-term objectives.
(b) Prioritize the objectives.
(c) Determine who should be included in the teacher-learning process (family members, friends, or other support persons). For example, the person who cooks for the patient is asked to participate in any nutritional teaching.
(d) Include the patient in planning. Ask his permission to involve family members or others.
(2) Create a teaching plan. One nurse or several nurses can prepare and use a teaching plan. There are standardized teaching plans available for major topics of health teaching (some for computer use). Individualize the standardized plans to the patient's needs and abilities.
(a) Match content with the appropriate teaching strategies and learner activities. For example, content explaining why certain treatments and medications are needed may be matched with printed or audiovisual materials. Children respond well to teaching strategies that permit them to participate actively.
(b) Schedule teaching within the limits of time constraints. Shorter, more frequent sessions allow the patient to digest the new information and prevents him from becoming tired or uncomfortable due to his illness.
(c) Decide on group or individual teaching and formal or informal teaching. Some learner objectives are met more readily in a one-to-one encounter (i.e., colostomy care) while others are met more easily in a group discussion with other patients that have similar problems. Formal teaching is the planned teaching done to fulfill learner objectives. Informal teaching occurs during nursing interactions with the patient and his family. Informal teaching often leads to planned, formal sessions.
(d) Formulate a verbal or written contract with the patient. The contract is informal and is not legally binding; however, such an agreement serves to motivate both the patient and the nurse to attain the learning objectives. It points out the responsibilities of both the nurse (teacher) and the patient (learner). Whether verbal or written, the contract should not be intimidating, but viewed as an aid to learning. Failure to meet contracted objectives should be redirected into new learning and decision-making situations.
a. Implement the Teaching Plan. The implementation phase may be only a few minutes or the sessions may extend over a period of days, or perhaps months. Use interpersonal skills as well as effective communication techniques. Do not use technical and medical terms unless the patient has a medical background, but avoid a condescending attitude. Your attitude has a greater effect on the patient than any other factor. If the patient must learn special techniques or procedures, tell him or her that it takes time and practice to perform these new skills confidently. Review the contractual agreement before implementing the teaching plan.
Prepare the physical environment. It should be a nonthreatening atmosphere, free of distractions and interruptions. Ensure adequate space and lighting, comfortable chairs, good ventilation, and privacy.
(2) Gather all teaching aids: posters, printed material, audiovisual material, and equipment if needed.
(3) Deliver content in an organized manner using planned teaching strategies. If you are teaching a skill or procedure, follow the correct sequence so that the patient is not confused.
(4) Be flexible. Observe the patient for clues or additional assessment data that could alter the original teaching plan. Adapt or reorganize the teaching plan if necessary.
e. Evaluate the Teaching-Learning. Do not assume that learning has occurred without feedback. The key is to write measurable learner objectives in the teaching plan that describe the desired behavior.
(1) Evaluate whether learner objectives have been met. There are several ways to do this.
(a) Observation. Observe the patient to verify that he has put the information that he learned into practice.
(b) Patient's comments. The patient will usually state whether or not he or she understands the information being taught.
(c) Direct questions. Ask the patient a question requiring a response, which reflects his or her level of knowledge about the topic.
(d) Return demonstration. Have the patient perform the procedure as it was demonstrated. This is an excellent method of evaluating proficiency in psychomotor skills.
(2) Evaluate teaching. Immediately after each session, evaluate your teaching effectiveness.
(a) Quickly review how implementation of the plan went and mentally make note of both your strengths and weaknesses.
(b) Seek feedback from the patients. Use a simple questionnaire with space for comments but one, which requires only check marks to answer. The questionnaires may be more honest and helpful if anonymous.
(3) Revise the teaching plan. Evaluation may reveal that the teaching plan should be revised. Revision is part of the teaching-learning process; it is not an indication of failure. Make adjustments accordingly to meet the patient's needs.
(a) Alter the content and teaching strategies if the objectives were unrealistic, the content too complex, or the teaching strategy inappropriate.
(b) Employ motivational counseling if the patient is unwilling to participate in learning activities or to learn how to care for himself.
(c) Reschedule teaching sessions if the time and frequency of sessions affected the teacher-learner process.
(4) Document the teaching-learning process. Teaching is an important and required nursing responsibility; it must be documented in the patient's record.
(a) Include a summary of the diagnosed learning needs, the teaching plan, implementation of the plan, and evaluation results.
(b) Show evidence in the evaluation statement that learning has occurred, or how the problem was resolved if the patient or support person did not learn the material taught.
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