3 determinants of learning are(1) the needs of the learner, (2)the state of readiness to learn, (3) the preferred learning

styles for processing information.

The educator’s role in learning

Learning can be enhanced greatly by the educator serving as the facilitator in helping the learner become aware of what
needs to be known, the value of knowing, and how to be actively involved in acquiring information.

There is more of an opportunity to learn if the educator assesses the determinants of learning.

Assessment permits the nurse educator to facilitate the process of learning by arranging experiences within the
environment that assist the learner to find the purpose, the will, and the most suitable approaches for learning.

the educator plays a crucial role in the learning process by:

1. Assessing problems or deficits.
2. Providing important information and presenting it in unique and appropriate ways.
3. Identifying progress being made.
4. Giving feedback and follow-up.
5. Reinforcing learning in the acquisition of new knowledge, skills, and attitudes.
6. Evaluating learner’s abilities.
The educator is vital in giving support, encouragement, and direction during the process of learning.

Assessment of the learner

The effectiveness of nursing care clearly depends on the scope, accuracy, and comprehensiveness of assessment
prior to interventions.
Good assessments ensure that optimal learning will occur with the least amount of stress and anxiety for the learner.
Assessment prevents 1.needless repetition of known material, 2.saves time and energy on both learner and educator,
3.and helps establish rapport between the two parties.
Assessment phase provides the foundation for the rest of the educational process.
The following are important steps in the assessment of learning needs.
1. Identify the learner-who is the audience?
2. Choose the right setting-establishing a trusting environment will help learners feel a sense of security in
confiding information, believe their concerns are taken seriously and considered important and feel respected.
3. Collect data about the learner-once the learner is identified, the educator can determining characteristics needs
of the population by exploring typical health problems or issues of interest to that population.
4. Collect data from the learner-allow the patient and/or the family members to identify what is important to them,
what they perceive their needs to be, what types of support systems available, and what assistance this support
can provide.
5. Involve members of the health team-nurses are not the sole teachers, they must collaborate with the member
of the other members of the health team for a richer assessment of learning needs.
6. prioritize needs-Maslow's hierarchy of human needs may help the educator with prioritizing so that learner's
basic needs are attended to.
7. Determining availability of educational resources-a need may be identified, but it may be useless to proceed
with interventions if the proper educational resources are not available, are unrealistic to obtain, or do not match
the learner's needs.
8. Assess demands of the organization. This assessment will yield information that reflects the climate of
organization. The educator should be familiar with standards of performance required in various employee
categories, along with job descriptions and hospital, professional, and agency regulations.
9. Take time management issues into account-Close observation and active listening take time. Minimizing
interruptions and distractions during planned assessment interviews maximizes productivity.

Methods to Assess Learning Needs

1. informal conversation-learning needs will be discovered during impromptu conversations that takes place with other
health care team members involved in the care of the client, and between the nurse and the patient or his family.
2. Structured interviews-the structured interview is perhaps the most common form of needs assessment to solicit the
learner's point of view.
questions for the learner
• what do you think caused your problem?
• How severe is your illness?
• What does your illness/health mean to you?
• What do you do to stay healthy?
• What results do you hope to obtain from treatments?
• What are your strengths and weaknesses?
if the learner is a staff member
• what do you think are the your biggest challenges to learning?
• What skills do you need help in performing?
• What obstacles have you encountered in the past when you were learning new information?
• What do you see your strengths and weaknesses as a learner?
3. Focus groups. Involves getting together a small number (4-12) of potential learner to determine areas of educational
need by using group discussion to identify points of view.
4. Self-administered questionnaires. Checklist are one of the most common form of questionnaires. They are easy to
administer, provide more privacy, and yield easy to tabulate data.
5. Test. giving pretest before teaching is planned can help identify the knowledge levels of potential learners regarding a
particular subject to assist in identifying their specific learning needs.
Pretest results are useful to the educator after completion of teaching to determine whether learning has taken place by
comparing post test scores.
6. Observations. Learners who observe themselves performing a skill that is videotaped can more easily identify their
learning needs. The learner identifies what was done well and what could have been done better.
7. Patient's charts. Physician’s progress notes, nursing care plans, nurse's notes, and discharge planning forms can
provide information on the learning needs of clients. Also documentation by other members of the health team, such as
PT, social workers, respiratory therapist, and nutritionists, can yield valuable insights to the needs of the learner.
Assessing Learning Needs of Nursing Staff
Written job description-job description is required to effectively carry out job responsibilities can reflect the potential
learning needs of staff.
Formal and Informal Requests.
Staff will be asked for ideas for educational programs, which reflect what they perceive as needs.
Quality assurance Reports. Trends found in incident reports indicating safety violations or errors in procedures are a
source for establishing learning needs of staff that education can address.
• Chart audits- Trends in practice can be identified through chart auditing. “does the staff have a learning need in
terms of the actual charting?” “Is a new intervention being implemented?” “Does the record indicate some
inconsistency with implementation of an intervention?”
• Rules and Regulations- A thorough knowledge of hospital, professional, and healthcare requirements helps to
identify possible learning needs of staff.
4- step appraisal of needs by Panno(1992)
1. Defining the target population.
2. Analyzing learner and organizational needs.
3. Analyzing the perceive needs of the learner. and comparing these to the actual needs.
4. Using data to prioritize learning needs identified.
4 types of Readiness

1. Physical Readiness-
5 major components to physical:
1. measure of ability
2. Complexity of task
3. Environmental effects
4. health status
5. Gender
2. Emotional Readiness

Factors that need to be assessed:

1. Anxiety Level
Anxiety is a factor that influences the ability to perform at cognitive, affective, and psychomotor levels.
2. Support system
Social support is important in buffering the effects of stressful events. A strong positive support system can
decrease anxiety; while the lack of one can increase anxiety.
3. Motivation
There are many reasons why a learner may be motivated to learn, and almost any reason to learn is a valid one.
Prior learning experiences, whether they be past accomplishments or failures, will be reflected in the current level
of motivation demonstrated by the learner for accomplishing task at hand.
4. Risk-taking behavior
Taking risk is intrinsic in the activities people perform daily. Many activities are done without thinking about the
outcome.
The educator must be willing to teach these patients how to recognize certain body symptoms and then what to
do if they have them
5. Frame of mind
Involves concern about the here and now versus the future. If survival is of primary concern, then readiness to
learn will be focused on the present to meet basic human needs.
6. Developmental Stage
Each task is associated with human development produces a peak time for readiness to learn known as
reachable moment.
Adults can build on meaningful past experience and are strongly driven to learn information that will help them
cope better with real-life task.

3. Experiential Readiness

Experiential readiness refers to the learner's past experiences with learning and includes FIVE elements:
a. Level of Aspiration-the extent to which someone is driven to achieve is related to the type of short-and long-term
goals established by the learner.
b. Past Coping Mechanisms
Coping mechanism must be explored to understand how the learner has dealt with previous problems. Once these
mechanism are identified, the educator must determine if past coping strategies have been effective.
c. Cultural background
Building on the learner's knowledge base or belief system, rather than attempting to change it or claim it is wrong, will
encourage rather than dampen readiness to learn.
d. Locus of Control
Internal locus of control-when patients are internally motivated to learn.
External locus of Control- when patients are externally motivated to learn.
e. Orientation
Parochial orientation- a.)tend to be more close-minded in their thinking, b.)are more conservative in their approach,
c.)are less willing to learn new material, d.)and place the most trust in traditional authority figures such as the physician.
Cosmopolitan orientation- most likely have a worldly perspective in life due to broader experiences outside of there
spheres of influence. These individuals are more likely to be receptive to new ways of doing things

Knowledge Readiness

Knowledge readiness-refers to the learner's present knowledge base, the level of learning capability, and the preferred
style of learning.

a. Present knowledge base

How much someone already knows about a particular subject or how proficient that person is at performing a task is an
important factor to determine before designing and implementing instruction.
b. cognitive ability
The extent to which information can be processed is indicative of the learner's capabilities.
*Learner who is capable of understanding, memorizing, recalling, or recognizing subject material is functioning at a lower
level of cognitive domain.
* The learner who demonstrates problem solving, concept formation or application of information is functioning at a high
level of cognitive learning.
b. Learning and Reading Disabilities

Individuals with low literacy and learning disabilities become easily discouraged unless the teacher recognizes their
special needs and seek ways to help them accommodate or overcome their problems with encoding words and
comprehending information.

Learning Styles

Learning styles refers to the ways in which learners most effectively perceive, process, store, and recall what they are
attempting to learn and how they prefer to approach different learning tasks.

No learning style is either better or worse than another. Given the same content, most learners can assimilate information
with equal success, but how they go about mastering the content is determined by their individual style.

6 Learning Style Principles

1. Both the style by which the educator prefers to teach and the style by which the learner prefers to learn can be
identified.
2. Educators need to guard against relying on teaching methods and tools that match their own preferred learning style.
3. Educators are most helpful when they assist learners in identifying and learning through their own style preferences.
4. Learners should have the opportunity to learn through their preferred style.
5. Learners should be encouraged to diversify their style preferences.
6. Educators can develop specific learning activities that reinforce each modality or style.

left hemisphere
1. thinking is critical, logical, convergent, focal.
2. prefers talking and writing
3. responds to verbal instructions and explanations
4. recognizes, remembers names
5. relies on language in thinking and remembering

right hemisphere
1. thinking is creative, intuitive, divergent, diffuse.
2. synthesizing
3. prefers drawing and manipulating objects.
4. responds to written instructions and explanations.
5. recognizes/remembers face
6. relies on images in thinking and remembering.
Field-Independent/Field-Dependent Perception

A field-independent person perceives items as separate or differentiated from the surrounding field. They are 1. less
sensitive to social cues,2. are not affected by criticism,3. favor an active participant role,4. and are eager to test out their
ideas or opinions in a group.

Field-dependent individuals are 1. more externally focused and are socially oriented,2. more aware of social cues, 3.
able to reveal their feelings, 4. and are more dependent on others for reinforcement.

Dunn and Dunn Learning Styles

The researcher identified the five basic stimuli that affect a person's ability to learn:
a. environmental element
b. emotional elements
c. sociological patterns
d. physical elements
e. psychological element
1. Environmental elements

a. sound- individuals react to sound in different ways. Some need complete silence, and still others require sound in their
environment for learning.
b. light- Some learners work best under bright light, whereas other need dim or low lighting.
c. temperature- some learners have difficulty thinking or concentrating if a room is too hot.
d. design- Dunn and Dunn established that when learners are seated on wooden, steel, or plastic chairs, 75% of the total
body weight is supported on only four square inches of bone. The results is fatigue, discomfort, and the need for frequent
body position changes.
2. The Emotional Elements

a. motivation or the desire. Unmotivated learners need short learning assignments that enhance their strengths.
Motivated learners are eager to learn and should be told exactly what they are required to do.

b. Persistence-learners differ in their preference to complete tasks in one setting or to take a periodic breaks and return
to the task at a later time.

Giving learners objectives and time interval for completion, those with long attention span can get the job done in a block
of time, while those with short attention span can take the opportunity for breaks without feeling guilty or rushed

c. responsibility-involves the desire to do what the learner thinks is expected.

Learners with low responsibility scores usually are nonconforming. (they do not like to do something because someone
ask them to do it.)Educator should give them choices and select different ways to complete the assignment.

d. Structure-refers to either the preference for specific directions, guidance, or rules prior to carrying out assignments/ or
the preference for doing assignment without structure in the learner's own way.

3. Sociological elements

a. Learning alone-some learners prefer to study by themselves, whereas others prefer to learn with a friend or colleague.

• When learners prefers to be with groups, group discussion and role playing may facilitate learning.
• When learners prefers to be with groups, group discussion and role playing may facilitate learning.
• For learners who prefers to be alone, self-instruction, one-to-one interaction, or lecture-type methods are best
approaches.
b. Presence of an Authority Figure
• Some learners feel more comfortable when someone with authority or recognized expertise is present during
learning.
• Others become nervous, feel stifled, and have trouble concentrating.
c. Variety of Ways
• Some learners are flexible and can learn as well alone as they can with authority figures and peer groups.
• These learner are versatile in their style of learning and would benefit from having different opportunities.
4. Physical Elements
Perceptual Strengths-four types of learners are distinguished in this category:
• 1. those with auditory preference, who learn best while listening to verbal instruction.
• 2. those with visual preference, who learn best from reading or observation
• 3. those with tactile preferences, who learn best when they can underline as they read, take notes when they
listen.
• 4. those with kinesthetic preferences, who absorb and retain information best when allowed to perform whole
body movement or participate in real-life experiences.
b. Intake
• Some learners need to eat, drink, chew, or bite objects while concentrating. Others prefer no intake until after they
have finished studying.
c. Time of Day
• Some learners perform better at one time of day than another. the four time-of-day preferences are on a
continuum. The educator needs to identify these preferences with an effort toward structuring teaching and
learning to occur during the times that are most suitable for the learner.
• early morning learners- their ability to concentrate and focus energies on learning is high in the early hours of
the day.
 • late-morning learners- their concentration and energy curve peaks around noontime, when their ability to
perform is at it's height.
• afternoon learners-their concentration and energy curve is highest in the mid-to-late afternoon, when
performance is at it's peak.
• evening learners-their ability to concentrate and focus energies is greatest at the end of the day.
d. Mobility-refers to how still the learner can sit and for how long a period of time.
• Some learners need to move about, while others can sit for hours engaged in learning.
• For those who require mobility, it is necessary to provide opportunity for movement by assigning them to less
restrictive sections of the room
The Psychological Elements
a. Global vs. Analytic
• Some learners are global in their thinking and learn best by obtaining meaning from a broad , overall concept
before focusing on the details.
• Other learners are analytic in their thinking and learn sequentially in a step-by-step process.
b. Hemispheric Preference
• Learners who possess right-brain preference tend to learn best in environments that have low illumination,
background music, casual seating, and tactile instructional resources.
• Learners with left-brain preference require an opposite environment of bright lighting, quiet setting, formal
seating, and visual or auditory instructional resources.
c. Impulsivity versus Reflectivity
• Impulsive learners prefer opportunities to participate verbally in groups and tend to answer questions
spontaneously and without consciously processing their thinking.
• Reflective learners seldom volunteer information unless they are asked to do so, prefer to contemplate
information , and tend to be uncomfortable participating in group discussion
Jung and Myers-Briggs Typology
• Myers and Briggs identified 16 personality types, each with its own strengths and interest.
• People can be classified into the 16 personality types by using the following four constructs:
• People can be classified into the 16 personality types by using the following four constructs:
1. Extraversion-introversion (E-I) reflects orientation to either the outside world of people and things or to the inner
world of concepts and ideas.
• Individuals who prefer extraversion operate comfortably and successfully by interacting with things external to
themselves, such as other people, experiences, and situations.
• They like to clarify thoughts and ideas through talking and doing. Those who operate more comfortably in an
extrovert way think aloud.
• Those with a preference for introversion are more interested in the internal world of their hearts, minds, and souls.
They like to brew over thoughts and actions, reflecting on them until they become more personally meaningful.
• Those who operate comfortably in an introvert way are often thoughtful, reflective, and slow rto act because they
need more time to translate internal thoughts to the external world.
2. Sensing-Intuition(S-N)

• Describe perception as coming directly through the five senses or indirectly by way of the unconscious.
• People who prefer sensing experience observe what is real, what is factual, and what is actually happening.
• People who prefers intuition tend to read between the lines, focus on meaning, and attend to what might be.
• This kind of perception leads them to examine problems and issues in creative and original ways.
3. Thinking-feeling (T-F) is the approach used by individuals to arrive at judgments through objective versus subjective
processes.

• Thinking types analyze information, data, situations, and people and make decisions based on logic. They are
careful and slow in the analysis of the data. They trust objectivity and put faith in logical predictions and rational
arguments.
• In feeling preference, the approach to decision-making takes place through a subjective, perceptive, emphatic,
and emotional perspective.
• Individuals who prefer feeling search for the effect of a decision on themselves and others.
• Circumstantial evidence is extremely important, and these individual see the world as gray rather than black and
white.
4. Judging-perceiving (J-P)

• an individual comes to a conclusion about or becomes aware of something through a preference of judging,
which is the desire to regulate and bring closure to circumstances in life through their preference of perceiving.