Study Guide 4 DETERMINANTS OF LEARNING

Topic Outline
1. Assessment of the learner
a. Learning needs
b. Readiness to learn Course Code and Title
c. Learning Styles

2. Behavior Change theories

Learning Objectives
After studying this module, you will be able to:
1. State the educator’s role in the learning process.
2. Identify the three factors that affect or what is termed “determinants of learning”
3. Describe the steps in assessment of learning needs, the criteria for patronizing learning needs,
4. Explain the methods that can be used to assess the learners needs.
5. Discuss the factors that need to be assessed in each of the four types of readiness to learn.
6. Describe what is meant by learning style
7. Discuss ways to assess learning styles.

Introduction
The role of educating can be one of the most challenging and essential interventions that a nurse performs. To do it well,
the nurse must identity the information learners need as well as consider their readiness to learn and their style of
learning.

Activating Prior Knowledge

What do you think you will have the most problem in learning?
What problems have you encountered to the past when you had to deal with a patient who had this illness?

1.1 Discussion of Key Concepts

ASSESSMENT OF THE LEARNER

The learner’s characteristics that will influence learning which can educator must be aware of are;
1. Learning needs
2. The learners perpectual abilities
3. Motivational abilities or readiness
4. Reading abilities
5. Developmental stage
1. Learning style
2. Physical abilities
Haggard (1989) states that the educator’s role in the learning process is primarily to assess the learner in relation to
the three factors that affect learning or what is termed as Determinants of Learning
A. Learning needs
B. Readiness (when the learner is receptive to learning)
C. Learning style (how the learner best learns)

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 I. LEARNING NEEDS
Are gaps in knowledge that exist between a desired level of performance and the actual level of
performance.
A. Identify the learner
B. Choose the right setting-establish a trusting environment
C. Collect data on the learner
D. Include the learner as a source of information
E. Include members of the health care team
Course Code and Title
F. Determine availability of educational resources
G. Assess demands of the organization
H. Consider time management issues
I. Prioritize needs

THE CRITERIA FOR PRIORITIZING LEARNING NEEDS (Healthcare Education Assoc.,1985)

1. Mandatory
2. Desirable
3. Possible (nice to know”

METHODS IN ASESSING LEARNING NEEDS

1. Informal conversations or interviews
2. Structured interviews
3. Written pretest
4. Observations of health behaviors over a period of different times.

QUESTIONS CAN BE ASKED LIKE BY THE FOLLOWING:

1. What learning theory will best meet the needs of the learner as an empowered individual or a critical thinker?
2. What will enable him to apply the knowledge, attitudes, skills and values to intelligently assess, analyze, plan and
execute decisions or solutions to daily problems or crisis situations?
3. What will empower him to appropriately and wisely make informed choices?

II. READINESS TO LEARN

Is the time when the patient is willing to learn or is receptive to information.

When 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
 What needs to be learned
 What the learning objectives should be
 Find out in which domain of learning and at what level the lesson will be taught

EXAMPLE: A procedure to be taught involves the psychomotor domain and will use strategies that will require the
learner to make a return demonstration to show acquisition of skills.
 Determine if the timing (the point at which the nurse will conduct teaching) is right or proper
 Find out if rapport or interpersonal relationship with the learner has been established (Hussey & Hirsch
,1983)
 If the learner is showing signs of motivation
 If the plan for teaching matches the developmental level of the learner

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transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of UCU, is strictly prohibited.
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 FOUR TYPES OF READINESS TO LEARN (PEEK) (LIGHTTENTHAL, 1990)
1. P=PHYSICAL READINESS
A. Measures of ability -adequate strength, flexibility and endurance is needed t teach a patient how to walk on
crutches and for him/her to be ready to learn while measures requiring visual and auditory acuity of a patient
also affect the learning readiness especially if the senses of sight and hearing are impaired.
B. Complexity of task -the difficulty level of the subject or the task to be mastered: psychomotor skills require
varying degrees of manual dexterity and physical energy output but once acquired or mastered, they are usually
retained better and longer than learning in the cognitive and affective domains.
C. Environmental effects -refers to an environment that is conducive to learning, free from Course
noiseCode and Title
and other
distractions which may affect the physical readiness to learn.
D. Health status -is the patient in a state of good health or ill health? Does he still have the energy or motivation to
learn?
E. Gender -studies show that men are less inclined to seek health consultation o intervention than women.
2. E- EMOTIONAL READINESS
A. ANXIETY level – may or may not be a hindrance to learning. Some degree of anxiety may motivate a person
to learn but or low degree of anxiety will interfere with readiness to learn.
B. A moderate level o anxiety contributes to successful learning and is the vest time for learning (Bastable,2003)
C. Support system
D. Nurses who provide emotional support to the patient and family members go through what is termed as
reachable moments
E. Motivation
F. Risk taking behaviors
G. Frame of mind
H. Developmental stage
3. E- EXPERIENTIAL READINESS
A. Level of aspiration
B. Past coping mechanism
C. Cultural background

D. Locus of control
E. Orientation
1. Parochial
2. Cosmopolitan orientation
4.K-KNOWLEDGEREADINESS
A. Present knowledge base
b. Cognitive ability

III- LEARNING STYLES

Is characteristics of the cognitive, affective, and physiological behaviors that serve as relatively stable indicators of how
learners perceive, interact with, and respond to the learning environment. Learning style also represents both inherited
characteristics and environmental influences. As a result of our hereditary equipment, most people develop learning
styles that emphasize some learning abilities over others. (Dunn,1990)

MOTIVATION AND BEHAVIOR OF THE LEARNER (Bastable ,2003)

The term motivation comes from the latin word “movere” which means to move or se t into motion.
It is also defined as a “psychological force that moves a person to some kind of action. (Haggard ,1989)

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 MOTIVATION is the willingness of the learner to embrace learning, with readiness as evidence of motivation.
(Redman ,2001)

BEHAVIOR CHANGE THEORIES

Health behavior frameworks or principles can be used to facilitate motivation or promote compliance to a health regimen
or program. They can help the nurse/midwife educator to maintain desired behavior or promote behavior change
(Bastable, 2003).
Among these are the Health Belief Model, Health Promotion Model, Self -efficacy theory, and Precede-Proceed Model
which were all discussed in Chapter II of this book. Course Code and Title
Learning Assessment of Clients
A. LITERACY AND READABILITY
LITERACY- is defined as the ability of adults to read, understand and interpret information written at the eight-
grade level or above; the relative ability of persons to use printed and written material commonly encountered in
daily life.
B. THREE FACTORS to consider in assessing levels of literacy; (Bastable, 2003)
1. reading or word recognition
2. Readability
3. Comprehension

C. Clues manifested by patients with low literacy (De young, 2003)

1. Not even attempting to read printed material
2. Asking to take PEMs (printed educational materials) to discuss with significant others
3. Claiming the eyeglass ewer left at home
4. Stating they can’t read something because they are too tired or don’t feel well.
5. Avoiding discussion of written material or not asking any questions about it
6. Mouthing words as they try to read

Two tests which is most often used to measure patient literacy related to the basic reading skill of decoding words.
1. REALM
2. WRAT

TEACHING STARTEGIES FOR LOW LITERATE PATIENTS (BASTABLE, 2003)

1. Establish a trusting relation before beginning the teaching-learning process
2. Use the smallest amount of information possible by teaching only what the patient needs to learn.
3. Make points of information as vivid and as explicit as possible.
4. Teach one step at a time.
5. Use multiple teaching methods and tools requiring fewer literacy skills
6. Allow patients to restate information in their own words and to demonstrate any procedure that is being taught.
7. Keep motivation high
8. Build in coordination with procedure by using the principles of;
9. Use repetition to reinforce information

DEVELOPING PRINTED EDUCATIONAL MATERIALS

A. ORGANIZATIONAL FACTORS
1. Include a short but descriptive title
2. Use brief headings and subheadings
3. Incorporate only one idea per paragraph and be sure that the first sentence is the topic sentence
4. Divide complex instructions into small steps
5. Consider using a question / answer format
6. Address no more than three or four main points

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 7. Reinforce main points with a summary at the end
B. LINGUISTIC FACTORS
1. Keep the reading level at grade 5 or 6 to make the material understandable to most low literate patients.
2. Use mostly one or two syllable words and short sentences.
3. Use a personal and conversational style.
4. Define technical terms if they must used..
5. Use words consistency throughout the text.
6. Avoid the use of idioms which may mean different things to different people.
7. Use of graphics and language that are culturally acceptable and age relevant for the intended
Courseaudience.
Code and Title
8. Use active rather than passive voice;
9. Incorporate examples and simple analogies to illustrate concepts.
C. APPEARANCE FACTORS
1. Avoid a cluttered appearance by including enough white space
2. Include simple diagram or graphics that are well labeled
3. Use upper- and lower-case letters.
4. Use 10-14 point in a plain font
5. Place emphasized words in bold or underline them, but do not use capitals because they are difficult to read
6. Use list when appropriate
7. Try to limit line length to not more than 50 to 60 characters

Activity (can also be Critical Thinking and Review Questions)

ACTIVITY 1: Matching Type: Match column A to Column b. Write the letter of the correct answer.

A B.
1. Learning needs A. How the learner best learns
2. Readiness B.factors that influence learning
3. Learning style C. moment wen learner is receptive to information
4. Determinants of Learning D. gaps in knowledge
5. Readiness to learn E. when the learner is receptive to earning
6. Motivation F. learning needs that must be met immediately
7. Desirable needs G. the force that compels a man to action
8. Possible needs H. nice to know learning
9. Mandatory needs I. learning needs that are not life dependent
10. Locus of control J. motivation to learn

ACTIVITY 2: CRITICAL THINKING EXERCISES

1. In assessing the learning needs of a client, the literacy level is taken into account.
a. Define literacy
b. Discuss the factors to consider in assessing literacy level.
2. How would you know if your patient is literate or not? What are some clues indicating low literacy level?

ACTIVITY 3: CASE SCENARIO

Your client Manang Luisa. a 60-year-old farmer from Binalonan , Pngasinan who was diagnosed with
Hypertension ( 180/mmhg) and Pulmonary Tuberculosis . Ask the students to depict this scenario through
sociodrama or role-playing covering the following points;

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transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of UCU, is strictly prohibited.
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 1. Present 5 out of the 9 teaching strategies for low -literate patients that you will apply to give health teachings to Manong
Luis.

2. In making a discharge plan for the abovementioned patient using the 4 guidelines, Identify at least three health care
needs of Manong Luis.

3. Identify at least three goals of care that you will mutually set with Manong Luis.
Course Code and Title

Interactive Link
e-book of Pilliteri

Everyday Connection
Synchronous and Asynchronous online learning

Summary
Genetic disorders are those resulting from distortion in the structure or number of genes or chromosomes. Genetics, the
study of gene variation, includes examining how and why such disorders occur.
A Phenotype is a person’s outward appearance. Genotype refers to the actual genes composition.
A person’s genome is the complete set of genes present. A karyotype a graphic representation of the chromosomes
present.
A person is homozygous for a trait if he or she has two like genes for the trait. A person is heterozygous if he or she has
two unlike genes for the trait.
Mendelian laws predict the likely incidence of recessive or dominant diseases.
Genetic counselling can be a role for nurses with advanced preparation and education.
An assessment of genetic disorders consists of a health history, physical examination and screening and diagnostic
studies such as first trimester screening cfDNA testing, CVS, and Amniocentesis.

All information contained in this module are property of UCU and provided solely for educational purposes. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or
transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of UCU, is strictly prohibited.
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 Readings and References

Explore these additional resources to enhance learning for this chapter:

• Student resources on the Point, including answers to the What If . . . and Critical
Thinking Care Study questions, http://thepoint.lww.com/Flagg8e
• Adaptive learning powered by PrepU, http://thepoint.lww.com /prepu
Armitage, S. (2016). Cord blood banking standards: Autologous versus altruistic.
Course Code and Title
Frontiers in Medicine, 2, 94.
Check, J. H., Wilson, C., Levine, K., et al. (2015). Improved implantation and live
delivered pregnancy rates following transfer of embryos derived from donor oocytes
by single injection of leuprolide in mid-luteal phase. Clinical and Experimental
Obstetrics & Gynecology, 42(4), 429–430

All information contained in this module are property of UCU and provided solely for educational purposes. Reproduction, storing in a retrieval system, distributing, uploading or posting online, or
transmitting in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise of any part of this document, without the prior written permission of UCU, is strictly prohibited.
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