NCM 202- Health Education

2ns SEMESTER 2022

INSTRUCTOR: DR. Sam Migallos

Lesson 1

DEFINITION OF TERMS

Health- “hael” means WHOLE

Theory of HOLISM

-Whole person and his/ her integrity, soundness, or wellbeing and that the person
functions as a complete entity.

-We defined man as a biopsychosocial spiritual being.

DIMENSIONS OF HEALTH

● BRODER DIMENSIONS
a. Societal Health- A link between health and the way a society is structured.
b. Environmental Health- It refers to the physical environment where people
lived.
● INDIVIDUAL DIMENSIONS
a. Mental- A sense of purpose or belief of own’s worth
b. Spiritual- Supreme being, ability to put into practice moral principles and
beliefs
c. Physical- State of one body Fitness/ not being ill
d. Sexual- Acceptance of and ability to achieve satisfactory expression of one’s
sexuality
e. Social- Support system available

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 f. Emotional- Express one’s feelings appropriately/ develop & sustain a
relationship

HEALTH

A state of complete physical, mental and social well-being and not merely the absence of
disease and infirmity (WHO, 1946)

Modern Concept of Health

● “OLOF”- Optimum Level of Functioning of individuals, families & communities

Affected by Several Factors

● Political
● Behavioral
● Hereditary
● Health Care Delivery System
● Environmental
● Socio-Economic

Health Education

“Is the translation of what is known about heath into desirable individual and community
behavior by means of the educational process” -Wilson Grout

“Is the sum of experiences which favorably influence the habits, attitudes, and knowledge
relating to individual community and social health.”- Dr. Thomas Wood

“Any combination of learning experiences designed to facilitate voluntary adaptations of

behavior conducive to health”- Green, et al, 1980

-According to WHO, Health Education comprises consciously constructed opportunities for

learning involving some form of communication designed to improve health literacy,
including improving knowledge and developing life skills that are conducive to individual
and community health.

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-To promote, maintain and enhance one’s health, prevent illness, disability, and premature
death through the adoption of health behavior, attitudes, and perspectives. It draws health
models and theories from the biological, environmental, psychological, physical and
medical, and even paramedical sciences like nursing.

Purposes of Health Education

1. Aims to positively influence the health behavior and health perspectives of

individuals and communities for them to develop self-efficiency to adopt healthy
lifestyles resulting in healthy communities.
2. A means of propagating Health Promotion and Disease Prevention
3. It may be used to modify or continue health behaviors if necessary
4. Provides health information and services
5. Emphasizes good health habits and practices which is an integral aspect of culture,
media and technology
6. A means to communicate vital information to the public
7. A form of advocacy

Importance of Health Education

1. Empowers people to decide for themselves what options to choose to enhance

their quality of life
2. Enhances the quality of life by promoting healthy lifestyles
3. Equips people with knowledge and competencies to prevent illness, maintain
health or apply first aid measures to prevent complications or premature deaths
and improves the health status o individuals, families, communities, states, and the
nation.
4. Creates awareness regarding the importance of preventive and promotive care
thereby avoiding or reducing the cost involved in medical treatment or
hospitalization.

Characteristics of Effective Health Education

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 1. Directed at people who are directly involved with health-related situations and
issues.
2. Lessons are repeated and reinforced
3. Lessons are adaptable
4. Entertaining and attracts attention
5. Uses clear, simple language with local expression
6. Emphasizes short term benefit of action
7. Provides opportunities for dialogue, discussion, and learner participation and
feedback
8. Uses demonstration to show the benefits of adopting practices

Lesson 2 - Principles and Theories in Teaching and

Learning

TEACHING

“Sharing of information and experiences to meet intended learner outcomes in the

cognitive, affective, and psychomotor domains according to an education.” -Bastable, 2019

LEARNING

“Is relatively permanent change in mental processing, emotional functioning and/ or

behavior as a result of experience.”- Batable, 2003

“Lasting or permanent change in behavior as a result of experience which is primarily

determined or influenced by the environment where the person is situated.”

“It is a complex process which involved changes in mental processing, development of

emotional functioning and social transactional skills which develop and evolve from birth to
death.”

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CONTRIBUTION OF LEARNING THEORIES

1. Helped us understand the process of teaching and learning or how individuals

acquire knowledge and change the way they think, feel, and behave
2. Theories have helped health professionals to
a. Employ sound methods and rationales in their health education efforts
involving patients/clients
b. Staff training & education and in carrying out health education promotion
programs.
c. To understand the nature of the learner, the health professional needs to
know:
a. Basic principles are involved in the development and maturation of
the individuaHuman Development
- Is the dynamic process of change that occurs in the physical, psychological, social,
spiritual & emotional constitution and make-up of an individual which starts from
the time of conception to death ( from womb to tomb)
- It is the scientific study of the changes that occur in people as they age or grow in
years.

CHANGES IN HUMAN DEVELOPMENT

1. GROWTH-QUANTITATIVE, increase in size of body parts; acquisition of more

knowledge
2. DEVELOPMENT-QUALITATIVE, gradual changes in character; evidenced by
intellectual, emotional and physiological capabilities

2 MAJOR PROCESSES IN GROWTH AND DEVELOPMENT

1. LEARNING- any relatively permanent change in behavior brought about through

experience
2. MATURATION- bodily changes which are genetically determined by results of
hereditart or the traits a person inherits from parents.

MAJOR LEARNING THEORIES

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 A. BEHAVIORIST THEORIES OF LEARNING
B. COGNITIVE THEORIES OF LEARNING
C. SOCIAL LEARNING

BEHAVIORIST

Equated with stimulus response theories simple stimuli with Positive and Negative
reinforcement to produce learning responses. Behavior is learned and that learning is most
influenced through manipulation of the environment

John B. Watson

The proponent that emphasizes the importance of observable behavior in the study of
human beings. Defined behavior as muscle movement associated with the
stimulus-response psychology. He postulated that behavior results from a series of
conditional reflexes & that all emotions and thoughts are a product of behavior learned
through conditioning (de young, 2003)

LEARNING

A result of the conditions or stimuli in the environment and the learner’s response that
follow “ S-R Model of Learning”

ENVIRONMENT

Stimuli in the environment are altered or the effects or the consequences of a response is
changes/manipulated to bring about the intended change for behavior to be applied or
transferred through practice or formation of habits.

Much of the Behavioral Learning is based on:

1. Respondent Conditioning
2. Operant Conditioning

RESPONDENT CONDITIONING

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 A. Classical/Pavlonian

Process which influencles the acquisition of new responses to environmental stimuli:

Neutral Stimulus-Elicitts an unconditioned response through repeated pairing with an
unconditioned stimulus.

EXAMPLE:

Offensive odors (unconditioned stimulus)- queasy feeling (unconditional response)

Hospital (NS) + Offensive odors (UCS)------> Queasy feeling (UR)

(Several pairings of Hospital + offensive odors—--> queasy feeling

Hospital (CS)-----> Queasy feeling (CR)

B. Systematic Desensitization

Repeated and gradual exposure to fear reducing stimulus under relaxed and
nonthreatening circumstances= SENSE OF SECURITY, no harm to come

-USE BY PSYCHOLOGIST TO REDUCE FEAR

C. Stimulus Generalization

Apply to other similar stimuli what was initially learned. Discrimination learning develops
later when varied experiences eventually enable the individual to differentiate among
similar stimuli.

D. Spontaneous Recovery

Applied in relapse prevention programs (RPP) Although a response may appear

extinguished, it may recover and reappear at any time ( even years later) especially when
stimulus conditions are similar to those in initial learning experience it helps us understand
why it is so dificult to completely eliminate unhealthy habits and addictive behaviors such
smoking, alcoholism or drug abuse.

OPERANT CONDITIONING

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(Burhuss Frederick Skinner) Focuses on the behavior of the organism and the
reinforcement that follows after the response

REINFORCEMENTS

“Responses closely followed by satisfaction will become firmly attached to the situation and
therefore more likely to reoccur when the situation is repeated.”

THORNDIKE’S LAW OF EFFECT

When specific responses are reinforced on a proper schedule, the behaviors can be
increased or decreased

REWARD OR PRAISE

Encourage or to be motivated

EMPLOYING POSITIVE REINFORCEMENT

1. VERBAL WAYS
2. NON-VERBAL WAYS
3. CITING IN CLASS OR PUBLISHING

CLASSIFICATION OF EDUCATIONAL REINFORCES:

1. Status Indicators- appointment as peer tutor, having own space

2. Incentive feedback- Increased knowledge of exam scores, knowledge of individual
contributions
3. Personal Activities- Opportunity to engage in special projects, extra time off
4. Recognition (praise, certificate of accomplishment,pat on the back)
5. Tangible rewards (grades, food, prizes, citation)
6. School responsibilities ( opportunities for increased self-management,
participation in decision making)

REINFORCEMENT should be appropriate or directly linked to the learning

tasks and student’s accomplishment

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NEGATIVE REINFORCEMENT

1. Escape conditioning- As the unpleasant stimulus is applied, the individual responds

in some way that causes the uncomfortable behavior to cease.
2. Avoidance Conditioning- the unpleasant stimulus is anticipated rather than being
applied directly

NONREINFORCEMENT

Skinner maintained that the simplest way to extinguish response is not to provide any
reinforcement.

Note: A desirable behavior that is ignored may lessen as well if reinforcement is ineffective,
then punishment maybe employed

Under the punishment conditions, the individual cannot escape or avoid the unpleasant
stimulus. If employed, it should be administered immediately after the response with no
distractions or means of escape punishment must be consistent at the “highest”
reasonable level.

Punishment should not be prolonged or bringing up old grievances or complaining about

misbehavior at every opportunity

There should be a time out

CARDINAL RULE

“Punish the behavior, not the person.”

COGNITIVE THEORIES OF LEARNING

It stresses that mental processes or cognition occurs between the stimulus and the
responses

COGNITIVE

Dwell on the ability to solve problems rather than responding to stimuli

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COGNITION

More than knowledge acquisition. Transfer of learning occurs when the learner mediates
or acts on the information he/she gets or applies it in certain situations.

Involves intelligence which is the ability to solve problems or fashion products

Involves the individuals:

-Cognitive processes of perception

-Thinking Skills

-Memory

Ways of processing and structuring information like:

1. Perceiving the information

2. Interpreting it based on what is already known
3. Reorganizing the information to come up with new insight or understanding
4. Stress the importance of what goes on inside the learner
5. The key to learning and changing is individual cognition (perception, thought,
memory and ways of processing and structuring information)
6. To learn, individual must change their cognition

PERSPECTIVE OF THE COGNITIVE LEARNING THEORY

1. Gestalt- Emphasizes the importance of perception in learning which focuses on the

configuration or organization of a pattern or stimulus. A principal assumption is that
each person perceives, interprets, and responds to any situation in his/ her own
way.

PRINCIPLES

1. PSYCHOLOGICAL ORGANIZATION- is directly toward simplicity, equilibrium and

regularity, simple and clear explanation of disease condition

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 2. Perception is selective- no one can attend or pay attention to all the surrounding
stimuli at the same time
3. What individuals pay attention to or what they ignore may be affected by factors like
needs, personal motives, past experiences and the particular structure.

IMPLICATIONS

● Help health educator on how he/she approaches any learning situation with an
individual or group.
● One approach may be effective to a particular client but may not work with another.

2. INFORMATION-PROCESSING-Emphasizes the thinking processes like:

A. Thought
B. Reasoning
C. Way information is encountered and stored
D. Memory functioning

-Useful for assessing problems in acquiring, remembering and recalling information.

INFORMATION-PROCESSING MODEL OF MEMORY

1st stage: PAYING ATTENTION

Attention is the key to learning, if not attentive, explain at another time when one is
receptive and attentive

2nd stage: INFORMATION

It is important to consider the client’s preferred mode of sensory processing (visual,

auditory or motor manipulation)

3rd stage: INFORMATION IS TRANSFORMED AND INCORPORATED

Encoded briefly into short term memory, later disregarded or forgotten or stored
“strategies for storage are imagery, association, rehearsal and chunking

4th stage: ACTION OR RESPONSE

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Based on how information was processed and stored

Strategies

1. Have learners indicate how they believe they learn ( metacognition)

2. Ask them to describe what they are thinking as they are learning
3. Evaluate learner’s mistake
4. Give them close attention to their inability to remember or demonstrate information

NOTE: Forgetting or having difficulty in retrieving information from long term memory is a
major stumbling block in learning which may may occur because:

● The information has faded from lack of use

● Other information interfered with retrieval( what comes before or after learning
session may compound storage and retrieval)
● Individuals are motivated to forget for a variety of conscious or unconscious reasons

3. COGNITIVE DEVELOPMENT

Focuses on qualitative changes in perceiving, thinking, and reasoning as individuals mature

and grow.

PRINCIPAL ASSUMPTION

Learning is developmental, sequential, and active process that transpires as the child
interacts with the environment, makes discoveries about how the world operates, and
interprets these discoveries in keeping with what she/ he knows.

-Cognitions are based on how events are conceptualized, organized and represents within
each person's schema- a framework that is partially dependent on the individual’s stage of
cognitive stage of development and readiness to learn.

9 EVENTS THAT ACTIVATE EFFECTIVE LEARNING WITH CORRESPONDING

COGNITIVE PROCESSES (Robert Gagne, 1995)

1. Gain the learners attention (reception)

2. Inform the learners of the objectives and expectations ( expectancy)

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 3. Stimulate the learner’s recall of prior learning (retrieval)
4. Present information ( selective perception)
5. Provide guidance to facilitate learner’s understanding ( semantic encoding)
6. Have the learner demonstrate the knowledge and skills ( responding)
7. Give feedback to the learner ( reinforcement)
8. Assess the learner’s performance ( retrieval)
9. Work to enhance retention and transfer through application and varied practice (
generalization)

JEAN PIAGET

Best known cognitive development theorist. His observation of children’s perception and
thought processes at different ages contributed much to the recognition of:

-Unique ways that youngsters reasons

-The changes in their ability to conceptualized

-The limitations in understanding, communicating, and performing

FOUR SEQUENTIAL STAGES OF COGNITIVE DEVELOPMENT

1. Sensorimotor (infancy)

Infants explore their environment and attempt to coordinate sensory information with
motor skills. Learning depends on what is experienced in the beginning which can be
learned through visual pursuits.

2. Preoperational stage (early childhood 3-6 years old)

Able to mentally represent the environment, regard the world from their own egocentric
perspective and come to grips with symbolism

3. Concrete Operational stage (6-12 years old- Elementary)

Able to attend to more than one dimension at a time, conceptualized relationship and
operate on the environment

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 4. Formal Operational stage (12-18 years- Adolescence)

Teenagers begin to think abstractly, able to deal with the future and can see alternatives
and criticize

According to this view:

Children take in information as they interact with people and environment and either make
their experiences fit with what they already know (assimilation) or change their perception
and interpretation in keeping with new information (accomodation)

What do cognitive theorists say about adult learning?

1. Although the cognitive stages develop consequentially, some adults never reach the
operations stage. They learn better from explicitly concrete approaches to health
education.
2. Adult developmental psychologists and gerontologists have proposed advanced
stages of reasoning in adulthood belong to formal operations.
3. Older adults may demonstrate an advance level of reasoning derived from their
wisdom and life experience, or hey may reflect lower stages of thinking due to lack
of education, diseases, depression, extraordinary stress or medications.

SIGNIFICANT BENEFIT TO HEALTH CARE:

Encouragement of a recognition and appreciation of the individuality and rich diversity in

how people learn and process experiences

SOCIAL LEARNING

Explain human behavior and their changes as a product of interaction between cognitive,
behavioral and environmental determinants

Emphasize the importance of environmental or situational determinants of behavior and

their continuing interaction.

Assumes that all actual behavior patterns must be learned through TRADITIONAL
LEARNING (By reinforcement) and OBSERVATIONAL LEARNING (By modeling).

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Behavior is shaped by people’s expectations; these expectations are formed from
experience and by watching other persons.

“Environmental conditions shape behavior through learning and the person’s behavior in
return, shapes the environment.”- Albert Bandura

ACCORDING TO ALBERT BANDURA- 3 DETERMINANTS OF HOW BEHAVIOR

OCCUR

1. ANTECEDENTS- behavior on the past as we have seen it

2. CONSEQUENCES-behavior is influenced by its results
3. COGNITIVE- behavior is based on how we are motivated

Role Modeling

It is the central concept of the theory much of the learning occurs by observation-watching
other people discerning what happens to them

VICARIOUS REINFORCEMENT

Involves viewing other people’s emotion and determining whether role models are
rewarded or punished for their behavior

FOUR OPERATIONS INVOLVED IN MODELING

1. ATTENTIONAL PHASE

Observation of role model “what a person can do and what he/she can attend to. A
necessary condition for any learning to occur. Research indicate that role models with
height status and competence are more likely to be observed, although the learner’s own
characteristics ( needs, self-esteem, competence) may be the more significant determiner
of attention

2. RETENTIONAL PHASE
● Processing and representation in memory
● How experience is encoded or retained in memory
● Involve storage and retrieval of what was observed

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 3. REPRODUCTION PHASE
● Memory guides performance of model’s action
● What behavior can be performed
● Learner copies the observed behavior
● Mental rehearsal, immediate reenactment and corrective feedback strengthened
the reproduction of behavior
4. MOTIVATIONAL PHASE
● Influenced by vicarious reinforcement and punishment covert cognitive activity,
consequences of behavior and self reinforcement and punishment
● Focuses on whether the learner is motivated to perform a certain type of behavior

Lesson 3

Learning

● Is relatively permanent change in mental processing, emotional functional and /or

behavior as a result of experience (Bastable, 2003)
● A lasting or permanent change in behavior as a result of experience which is
primarily determined or influenced by the environment where is person is situated.
● It is a complex process which involves changes in mental processing,
development of emotional functioning and social transactional skills which
develop and evolve from birth to death

ENVIRONMENTAL FACTORS AFFECT LEARNING

1. Society and Culture

2. Structure or pattern of stimuli
3. Effectiveness or credibility of role models and reinforcements
4. Feedback (correct & incorrect responses)
5. Opportunities to process and apply learning to new situations
6. Type, nature, and level of motivation

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Experiences facilitate or hinder the learning process:

a. Teacher’s selection of learning theories and structuring or type of learning

experience.
b. Teacher’s knowledge of the nature of the learner, materials to be learned
● Nature of the learner
● Materials to be learned
● Teaching methods
● Communication skills
● Ability to motivate the learner
c. Teacher’s ability to relate new knowledge to previous experiences, values
self-perception and learner’s readiness to learn

Common Principles of Learning

● Help motivate the learner

1. Use several senses

● Students in medical courses are made to imitate the procedures that are
demonstrated by the instructors (role-modeling)
● They are graded according to the skills they exhibited and degree of comprehension
of the rationale behind the steps
● It is expected that by imitating, learners would be able to retain 70% of the lesson

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Application of the skills and knowledge in the actual care of patients in the hospital

-Learners will have 90% Retention

2. Actively involve the patients or clients in the learning process:

● Use interactive methods involving the participation of the learners
● Ex. Role-playing, case studies, buzz session, Q & A format, small group discussion,
demonstrated and RD
3. Provide an environment conducive to learning
a. Always consider the comfort and convenience of the learner
4. Assess the extent to which the learner is ready to learn
a. Readiness to learn is affected by factors
i. Emotional( anxiety, fear & depression)
ii. Physical ( pain, visual or auditory impairment, anesthesia)
5. Determine the relevance of the information
a. Anything that is perceived by the learner to be important or useful will be
easier to learn and retain.
6. Repeat the information
a. Continuous repetition of information enhances learning
b. Applying the information to a different situation help in the learning process
7. Generalize the information
a. Applications of the information to a number of situations
8. Make learning a pleasant experience
a. Teacher must
i. Give frequent encouragement
ii. Recognize an accomplishment
iii. Give positive feedback
9. Begin with what is known, moving toward the unknown
a. Present information in an organized manner
b. Start your presentation with information that the learner already knows or is
familiar with
10. Present information at an appropriate rate

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 a. The pace in which information is presented
b. Too fast or too slow

Learning to be relatively permanent

1. Organize learning experience- Meaningful & pleasurable

2. Practice or rehearse New Informtaion (mentally or physical)
3. Apply Reinforcement- rewards/recognition-make learner know learning has
occurred
4. Assess or evaluate- use evaluation feedback to revise, modify revitalize or revamp
the Learning Experience

Lesson 4

Six Hallmarks of Good or Effective Teaching in Nursing (JACOBSEN)

1. Professional Competence is evidenced by

a. Thorough knowledge (subject matter and proper demonstration of skills)
b. Reading, researching, undertaking continuing professional education and has
clinical practice and expertise
2. Possession of skillful interpersonal skills with student-rated as the most important
teacher:
a. Takes personal interest in the welfare of the student
b. Fair and just
c. Sensitive to their feelings and problems
d. convey s respect to the students
e. Allows learners to freely express themselves and ask questions
f. Accessible for conference and consultations
g. Conveys a sense of warmth

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Three basic approaches by which instructor can increase self-esteem
and reduced anxiety are through:

A. Empathetic listening-seeing the world through his/her own eyes

B. Accepting the learners as they are
C. Communicating honestly with your students (expectations

Note: In the performance of the duties and responsibilities as a mentor, the teacher
is guided by the principle of “in loco parentis”

3. Desirable personal characteristics of the teacher which includes charisma or personal

magnetism, enthusiasm, cheerfulness, self-control, patient, flexibility, sense of
humor, good speaking voice, self-confidence, willingness to admit error or lack of
knowledge and a caring attitude

4. Teaching practices which include:

● Mechanics
● Methods
● Skills in the classroom and clinical practice
● Thorough knowledge of the subject matter
● Presents the materials in clear, interesting, logical and organized manner.

5. Evaluation practices which include:

● Clearly communicating expectations

● Providing timely feedback on student progress
● Correcting the students tactfully
● Being fair in the evaluation processes
● Giving test that are pertinent to the subject matter and assignments

6. Availability to students especially in the laboratory, clinical and other skills application
area which are mostly marked by stressful and or/ critical situations

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BARRIERS TO EDUCATION AND OBSTACLES TO LEARNING

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