THE EDUCATION PROCESS
● "The role of the Educator is not primarily to
● Is a systematic, sequential, planned course
of action with TEACHING and LEARNING
as its two major interdependent functions
and the teacher and learner as the key
players involved.
KEY WORDS
● Teaching
o a deliberate intervention involving
the planning and implementation of
instructional activities and
experiences to meet the intended
learner outcomes based on the
teaching plan.
● Instruction
o is just one aspect of teaching which
involves communicating of
information about a specific skill.
● Learning
o is change in behavior (knowledge,
skills, and attitudes) that can occur
at any time or in any place as a
result of exposure to environmental
stimuli.
o it is also an action by which
knowledge, skills and attitudes are
consciously or unconsciously
acquired and behavior is altered
which can be seen or observed.
● Patient Education
o a process of assisting people to
learn health related behaviors which
can be incorporated into their
everyday lives.
● Instead of the “teacher teaching”, the
paradigm has shifted to focus on the
“learner learning”.
● Hence, the nurse needs to know not only
the subject matter but also her role in the
teaching learning process and the nature of
the learner.
PILLARS OF THE TEACHING - LEARNING
PROCESS
● Teacher
● Learner
● Subject Matter
teach, but to promote learning and to
provide for an environment conducive to
learning “to create the teachable moment
rather than just waiting for it to happen.
THE EDUCATION PROCESS
The education process is a systematic,
sequential, logical, scientifically based, planned
course of action consisting of teaching and
learning. It is a cycle that involves the teacher and
the learner.
● Assessment
o It is a process which provides the
nurse educator with information
regarding the students’ knowledge
and skills needed to transfer
knowledge and skills efficiently and
effectively to learners.
o Also refers to the gathering of data
about the learner's or group of
learner’s demographic profile, skills
and abilities needed in identifying
the most appropriate teaching
strategy.
● Planning
o A carefully organized written
presentation of what the learner
needs to learn and how the nurse
educator is going to initiate the
teaching process.
o It also includes culturally relevant
skills for the learner, the goals of
learning, type of teaching - learning
setting such as classroom,
laboratory, clinical, or ward setting.
o Indicates teaching timeline and
specific sets of learner activities.
● Implementation and Application of the
Teaching Plan
o Is the point where the theoretical
and practical aspects of the teaching
- learning process meet as the
teacher applies the plan.
o It includes procedures or techniques
and
 o strategies that the teacher will use to
best implement the plan.
● Evaluation
o is the measurement of the teaching -
learning performance of both the
teacher and the learner
o It must be constructive and objective
with the purpose of creating effective
change in the behavior of both the
teacher and the learner in terms of
input, process, and output.
BARRIERS TO EDUCATION
● Student Factors
o Physical Disability
o Negative Attitudes and Stereotypes
o Poverty
o Students' Capabilities, Personal
Beliefs and Values
o Students are More Likely to Drop out
of school If Schooling is Irrelevant to
Realities
● Institutional Factors
o Inadequate Physical Facilities and
o Funding
o Philosophy, Vision, Mission of
Schools
o Issues of Safety and Security Inside
and Outside the School
o Perceived Lack of Support
● Teacher Factors
o Teacher's Qualifications and Values
- education is also constrained by
the ability of the teacher to teach in
terms of her personality traits and
values, professional behavior, and
her outlook in life and in teaching.
o Knowledge, Skills and Values of the
Teacher - intellectual capabilities of
teachers facilitate cognitive learning
and stimulate student’s psychomotor
process. The teacher’s professional
values promote students’ ideals of
achievement and scholastic
mastery.
o Inadequate Professional Preparation
IMPLICATIONS OF THE CONCEPTS OF
TEACHING AND LEARNING TO NURSING
PROCESSES
● Nursing of patient care is a complex
process involving several individuals. It is
designed to achieve specific goals like
health promotion or improvement.
● Nursing is synonymus to “CARE” where a
nurse’s responsibility is beyond care for the
patient by doing their clinical duties such as
giving comfort measures, and administering
treatment modalities.
● NURSING also means teaching the patient
proper self-care, health promotion, illness or
disease prevention, factors affecting health
and illness, and treatment options.
● Relatively, it is important to have a clear
● understanding of the importance of teaching
in the practice of Nursing.
● Teaching plays an essential role in the
efficient and effective dissemination of
intervention and in developing practical
clinical skills of students by means of
communication.
EDUCATION AND NURSING PROCESS
DIFFERENTIATED
● Nursing Process focuses on the Planning
and Implementation of care on the
assessment and diagnosis of physical and
psychosocial needs of a client.
● While the Education Process focuses on the
Planning and Implementation of teaching
based on the assessment and prioritization
of student's needs, readiness to learn and
learning styles.
Reference: Tan, C. (2009) The Nurse as Health
Educator: Concepts, Principles and Strategies in
Teaching. 1st edition
THE NATURE OF THE LEARNER
HUMAN DEVELOPMENT
● is the dynamic process of change that
occurs in the physical, psychological, social,
spiritual, and emotional constitution and
make up of an individual which starts from
CONCEPTION to DEATH.
 ● Changes may entail:
o GROWTH - which is quantitative
involving increase in the size of the
parts of the body.
o DEVELOPMENT – which is
qualitative involving gradual changes
in character.
Two Major Processes that takes places during
growth and development:
● LEARNING - a complex process which
involves changes in mental processing,
development of emotional functioning and
social development skills which develop and
evolve from birth to death.
● MATURATION - includes bodily changes
which are primarily a result of heredity or
the traits that a person inherits from his
parents which are genetically determined,
preprogrammed inherited biological patterns
are reflected in maturation.
PERIODS OF LIFE SPAN DEVELOPMENT
● Prenatal Development - includes the time
from conception to birth, from single cell to
an organism complete with brain and
behavioral capabilities produced in 9
months (270-280 days or 40 weeks).
● Heredity is the sum total of characteristics
which are biologically transmitted thru
parents to offspring. These characteristics
are determined by the genes which are
made up of DNA which determine the
hereditary characteristics which are found in
the chromosomes.
● Chromosomes - are found in the nucleus of
each cell which contains the GENES.
Infancy
● Extends from birth up to 18 to 24 months,
characterized by time of extreme
dependence on adults, babyhood, and the
beginning of many psychological activities
like language, symbolic thought,
sensorimotor coordination, and social
learning.
● Sensorimotor development - head turns to
direction of touch, lifts chin and head, hold
head erect, reaches for objects, sits with
support, stands with help, crawls, and walks
with support.
Early Childhood
● begins from the end of infancy to about 56
years which is sometimes called " Preschool
Years”.
o Become more self-sufficient and
care for themselves.
o Develop school readiness skills like
identifying letters and following
instructions.
o Spend many hours in play with
peers.
How the child's Pre-school experiences affects his
growth and development:
● If physiological and psychological needs are
met, the child develops a healthy and
pleasant personality learns to communicate
and develop understanding of himself and
his environment the quality of the interaction
between the child and parents affects the
child's own attitude.
The relationship that the child has with the
"Significant Others" who are in constant touch and
contact with the child will determine the child's self-
esteem or self-concept like:
● if the child thinks he/she is loved through
the stimulation and nurturance that is given
to him/her, the child develops high self-
esteem which makes the child enthusiastic
and open to experiences.
● if the child feels not accepted and not cared
for, he /she develops confusion, fear, or
inferiority complex.
Middle and Late Childhood (School Age)
This is the period where:
● The fundamental skills of reading, writing
and arithmetic are mastered.
● When the child is formally exposed to the
world and its culture, he/she becomes more
achievement centered with increased self-
control.

Adolescence
● Marks the transition from childhood to early
adulthood; approximately from 10-12 years
and ending at 18-22 years old.
● Where full physical development is
achieved.
● Puberty - marked by the development of
sexual characteristics.
● Pursuit of independence and an identity is
prominent.
● Thoughts are more logical, abstract, and
idealistic.
● More time is spent outside the family.
● More marked internal than external
development during later adolescence.
● Spends more time with the physical looks
and improving appearance.
Early Adulthood
● begins in late teens or early twenties
through the thirties. It is a period of:
o establishing personal and economic
o independence
o career development
o selecting a mate
o intimate relationships
o starting a family
Middle Adulthood
● from 35-45 years old up to 65 years old. It is
characterized by:
o menopause for women
o climacteric or andropause for men
o time of expanding personal and
social involvement and
responsibility, assisting next
generation in becoming competent.
Late Adulthood
● Or senescence, begins from 65 to 80 years
old and lasting until death.
o time of adjustment to decreasing
strength and health.
o life review
o retirement
o adjustment to new social roles
o affiliations with members of one's
age group.
FOUR THEORIES OF HUMAN DEVELOPMENT
1. Psychosexual Development Theory
o Sigmund Freud - the Father of
Modern Psychology, believed that
human beings pass through a series
of stages that are dominated by the
development of sensitivity in a
particular erogenous zone or
pleasure, giving area in the body.
o The person must be able to resolve
the conflicts that each stage poses
before he can move on to the next
higher stage. Failure to resolve the
conflict results to frustration and the
individual may become so addicted
to the pleasure of a given stage that
he develops fixation and fails to
move on to the next higher stage of
development.
ERIKSON’S PSYCHOSOCIAL STAGES OF
DEVELOPMENT
o Each stage has a major developmental task
or dilemma that must be resolved ... the
individual is presented with a crisis he must
resolve.
o Crisis - a turning point, crucial period of
increased vulnerability and heightened
potential. The individual develops a “healthy
personality” by mastering life's outer and
inner dangers.
o Epigenetic principle - personality continues
to develop throughout the entire life span.
Each part of the personality has a particular
time in the life span when it must develop if
it is going to develop at all.
Eight Major Stages of Social -Emotional
Development
Infant: Trust vs. Mistrust
 ● needs of infant must be met by caretakers
who are responsive and sensitive... infants
must be cuddled and fondled.
o development of trust results into a
sense of safe and dependable place
o non-resolution may develop into
mistrust and fear of the future and a
suspicious mind.
Toddler: Autonomy vs. Shame and Doubt
● as a child begins to crawl, walk, and
explores his surroundings, the conflict is
whether to assert their wills or not.
o resolution: children acquire sense of
independence and competence
when parents are patients and
encouraging.
o Non-resolution: children develop
excessive shame and doubt when
parents are overprotective and
always curtail their child's freedom of
movement.
Pre-school: Initiative vs. Guilt
● development of mental and motor abilities
o resolution: children will develop
initiative if parents allow them
freedom to run, slide, play with other
children, go bike riding etc.
o non-resolution: children develop
sense of inadequacy and feel that
they are mere intruders or “istorbo”
and “pasaway"; they become
passive recipients of whatever the
environment brings.
School Age: Industry vs. Inferiority
● child's concern is how things work" and how
they are made.
o resolution: children gain a sense of
industry or accomplishment if their
efforts are recognized, rewarded,
and reinforced.
o Non-resolution: children acquire a
sense of inadequacy and inferiority
especially if parents/ teachers,
rebuff, ridicule, constantly scold or
ignore the child's efforts to improve.
Adolescence: Identity vs. Role Confusion
● Entering adolescence, children experience
psychological revolution" search for
answers to the questions “who am I”, “what
do I value”, “where am I headed in life?”,
trying on many new roles; and parent/teen
conflict usually occurs.
● resolution: establishment of an integrated
and coherent image of oneself as a unique
person resulting to a sense of centered
identity.
● Non-resolution: role confusion or negative
identity like “hoodlum” or delinquent.
Young Adulthood: Intimacy vs. Isolation
● Intimacy: the capacity to reach out and
make contact with other people; ability to
share with and care for another person
without fear of losing oneself in the process;
ex. Deep friendships and lasting
relationships
● Rejection: results to withdrawal, isolation,
and formation of shallow relationships.
Middle Adulthood: Generativity vs. Stagnation
● Generativity - entails selflessness; reaching
out beyond one's own concerns to embrace
the welfare of society and future
generations through creative or productive
work and caring for children.
● Stagnation - people are pre-occupied with
their material possessions or physical well-
being (self-centered, embittered individual)
Old Age: Ego Integrity vs. Despair
● towards twilight years, people tend to take
stock of their lives or do a self-accounting.
May result to sense of satisfaction with their
accomplishments or despair.
Piaget's Theory of Cognitive Development
● Universal Constructivist Perspective - the
child constructs reality by interacting with
the environment and that children have
 predictable qualitative differences in how
they think about things at different ages.
● All humans construct their understanding of
the world in predictable ways. Humans take
an active role in their own development by
acting on the physical environment.
Key Concepts
● Mental Structures - cognitive structures -
begins with reflexes in infancy evolving into
schemata and more complex structures
called operations.
● Schema - a mental concept formed through
experiences with objects and events
● Schemata - are building blocks of cognitive
structures.
● Operations - mental actions allowing
children to interact with the environment
using their minds and bodies: invariant
sequence where child must first develop
concrete operations before formal
operations.
● Organization - humans have natural and
innate tendency to organize their
relationship with the environment; people
organize activity lawfully, constructing a
reality that makes sense at that time.
Three Determinants of Learning
● Learning Needs - what the learner needs to
learn.
● Learning Readiness - when the learner is
receptive to learning.
● Learning Style - how the learner best learns.
Learning Needs
Methods in Assessing Learning Needs:
1. Informal conversations or interviews -
asking open ended questions.
2. Structured interviews - where the nurse
may ask the patient some predetermined
questions to gather information regarding
learning needs; the answers may reveal
uncertainties, anxieties, fear, unexpected
problems, and present knowledge base.
3. Written pretest - can be given to identify
the knowledge level of the potential learner
and to help in evaluating whether learning
has taken place by comparing the pretest
and post-test scores.
4. Observations of health behaviors over a
period of different times may help determine
established patterns of behaviors.
Steps in the Assessment of Learning Needs
1. Identify the learner.
2. Choose the right setting-establish a trusting
environment by ensuring privacy and
confidentiality especially if confidential
information will be shared.
3. Collect data on the learner-by determining
the characteristics learning needs of the
target population, patient, or any recipient of
the learning material.
4. Include the learner as a source of
information - allow the learner to actively
participate in identifying his needs and
problems.
5. Include members of the healthcare team-
collaborate with the other healthcare
professionals who may have insights or
knowledge of the patient or learner.
6. Determine the availability of educational
resources – use appropriate, available,
affordable, easy, and simple to manipulate
materials and equipment.
7. Assess demands of the organization -
examine the organizational climate, its
philosophy, vision, mission, and goals to
know its educational focus.
8. Consider time management issues -
allow learners to identify their learning
needs; identify potential opportunities to
assess the patient anytime, anywhere and
minimize distractions / interruptions during
planned assessment interviews.
9. Prioritize needs - this may be based on
Maslow's hierarchy of needs where the
basic lower-level physiologic needs must
first be met before one can move up to the
higher, more abstract level of needs.
Criteria for Prioritizing Learning Needs:
a. Mandatory - learning needs that must be
immediately met since they are life
threatening or needed for survival.
 Ex. Patient with history of recent
heart attack should be taught the signs and
symptoms of an impending attack and what
emergency measures are or what
medicines to take.
b. Desirable - learning needs that must be
met to promote wellbeing and are not life-
dependent.
Ex. Patient with pulmonary
tuberculosis needs to understand and
appreciate the importance of taking her
medicines regularly until the regimen ends
to be totally cured.
c. Possible - “nice to know" learning needs
which are not directly related to daily
activities.
Ex. An obese patient who just lost
weight because of her diabetes may not
necessarily need information on " tummy
tucking” as a surgical and aesthetic
procedure to remove the sagging abdominal
muscles. Her current mandatory learning
needs are related to her illness.
READINESS TO LEARN
In assessing readiness to learn, the health educator
must:
1. determine what needs to be taught.
2. find out exactly when the learner is ready to
learn.
3. discover what the patient wants to learn.
4. identify what is required of the learner.
a. what needs to be learned.
b. what the learning objectives should
be
c. find out in which domain of learning
and at what level the lesson will be
taught.
5. determine if the timing is right or proper.
6. find out if rapport or interpersonal
relationship with the learner has been
established.
7. determine if the learner is showing signs of
motivation.
8. assess if the plan for the teaching matches
the developmental level of the learner.
Four Types of Readiness to Learn
1. P= Physical Readiness
● measures of ability - adequate strength,
flexibility and endurance is needed to be
ready to learn.
● complexity of task - the difficulty level of
the subject or the task to be mastered.
● Environmental effects - refers to an
environment that is conducive to learning,
free from noise and other distractions which
may affect the physical readiness to learn.
● Health status - is the patient in a state of
good health or ill health? Does he still have
the energy or motivation to learn?
● Gender - studies show that men are less
inclined to seek health consultation or
intervention than women. Women on the
other hand, are more health conscious and
receptive to medical care and health
promotion teaching.
2. E = Emotional Readiness
● Anxiety level - a moderate level of anxiety
contributes to successful learning and is the
best time for learning, however too much
anxiety interferes with the learning ability.
o Fear greatly contributes to anxiety
and exerts negative effects on
readiness to learn whether it be in
the cognitive, psychomotor, or
affective domains of learning or even
lead a patient to deny his or her
illness.
● Support system
o a strong support system composed
of the immediate family and friends,
significant others, the community
and church will give the patient
increased sense of security and
well-being, while a weak or absent
support system elicits sense of
insecurity, despair, frustration and a
high level of anxiety.
o nurses who provide emotional
support to the patient and family
members go through what is termed
as “reachable moments” which allow
 opportunity for both nurse and client
to mutually share and discuss
concerns and possible solutions or
alternatives to care.
● Motivation
o is strongly associated with emotional
readiness or willingness to learn.
o A telling cue is when the learner
starts asking questions and showing
interests in what the teacher is doing
or saying.
● Risk-taking behavior
o are activities that are undertaken
without much thought to what their
negative consequences or effects
might be.
o the role of the health educator is to
develop awareness in the patient as
to how this can shorten his life span;
how to develop strategies to
minimize the risk; to recognize the
signs and symptoms of probable
disease state and what to do should
this worst-case scenario develop.
● Frame of Mind
o depends on what the priorities of the
learner are in terms of his needs
which will determine his readiness to
learn. An important consideration is
Maslow's hierarchy of needs as a
guide in identifying needs
prioritization.
● Developmental Stage
o determines the peak time for
readiness to learn or “teachable
moment “
3. E = Experiential Readiness
● refers to the previous learning experiences
which may positively affect willingness to
learn.
o Level of Aspiration - depends on
the short term or long-term goals
that the learner has set.
o Past Coping Mechanism - refers to
how the learner was able to cope
with or handle previous problems or
situations and how effective were
the strategies used.
o Cultural Background
o Locus of Control - refers to
motivation to learn which may
internal or external locus of control.
o Orientation - this refers to a
person's point-of view which may be:
▪ Parochial – close minded
thinking, conservative in their
approach to new situations,
less willing to learn new
materials and have great
trust in the physician.
▪ Cosmopolitan - more
worldly perspectives and
more receptive to new or
innovative ideas like current
trends.
4. K= Knowledge Readiness
● It refers to:
o Present Knowledge Base - also
referred to as stock knowledge, or
how much one already knows about
the subject matter from previous and
vicarious learning.
o Cognitive Ability - involves lower
level of learning which includes
memorizing, recalling, or recognizing
concepts and ideas and the extent to
which information is processed
indicates the level at which the
learner is capable of learning.
Principles of Learning (Motivation)
● Use several senses.
o When dealing with the question of
how much people are able to retain
what has been learned, it has been
shown that people retain:
▪ 10% of what they read.
▪ 20% of what they hear.
▪ 30% of what they see or
watch.
▪ 50% of what they see and
hear.
▪ 70% of what they say.
 ▪ 90% of what they say and presented to the learner…. are you
do. talking too fast or too slow about the
● Active Learner Involvement topic you are discussing?
o To actively involve the patients or
clients in the learning process. Use
more interactive methods involving
the participation of the learners like
role playing, buzz sessions, Q & A
format, case studies, small group
discussion, demonstration and
return demonstration.
● Conducive Learning Environment
o Always consider the comfort and
convenience of the learner
● Learning Readiness
● Relevance of Information
o Anything that is perceived by the
learner to be important or useful will
be easier to learn and retain.
● Repeat Information
o Continuous repetition of information
over a period of time enhances
learning; applying the information to
a different situation and asking the
learner to apply the information to
another situation or rewording it and
giving practical applications will help
in the learning process.
● Generalize Information
o Cite applications of the information
to a number of applications. Give
examples which will illustrate or
concretize the concept.
● Make Learning a Pleasant Experience
o Give frequent encouragement,
recognize accomplishments and
give positive feedback.
● Be Systematic
o Begin with what is known; move
towards the unknown. A pleasant
and encouraging learning
experience if information is
presented in an organized manner
and with information that the learner
already knows or is familiar.
● Be Steady
o Present information at an
appropriate rate. This refers to the
pace in which information is