PERSPECTIVE ON TEACHING AND LEARNING

LESSON I Concepts of Teaching, Learning, Education process vis-a –vis Nursing process, historical foundation for
the teaching role of the nurse

LESSON II Good teaching

LESSON III Barriers to education and Obstacles to learning

Concepts of Teaching, Learning, Education process vis-a-vis Nursing process, historical foundations for the
teaching role of the nurse
A. Overview of Education on Health Care

Health Education

Is a process concerned with designing, implementing and evaluating educational programs that enable families, groups,
organizations and communities to play active roles in achieving, protecting and sustaining health.

Any combination of learning experiences designed to facilitate voluntary adaptations of behavior conducive to health.

Purpose: to contribute to health and well being by promoting lifestyles, community actions and conditions that make it
possible to live healthful lives

Recent development: highlight the important role of education in helping the patients and their families assume
responsibility for self care management

With the current 3rd party payor system; nurses are expected to be the prime movers in delivering high quality,
effective and efficient nursing care and patient education which will result to shorter hospital confinement and
continuation of recovery and rehabilitation through home care or community-based nursing care.

 Education for health begins with people.

 Hopes to motivate them with whatever interests they may have in improving their living condition
 In communicable disease control, health education commonly includes an appraisal of what is known by a
population about a disease, an assessment of habits and attitudes of people as they relate to spread and
frequency of the disease and the presentation of specific means to remedy observed deficiencies.

B. Concepts Teaching, Learning and education Process

Education Process
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.

Teaching
Is 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
One aspect of teaching which involves communicating information about a specific skill
Sometimes used interchangeably with teaching
 Learning

 Is a change in behavior that can occur at any time or in any place as a result of exposure to
environmental stimuli.
 An action by which knowledge, skills and behaviors are consciously or unconsciously acquired and
behavior is altered which can be observed or seen

Patient education

A process of assisting people to learn health related behaviors which can be incorporated into their everyday
lives.

Staff education

 Nurse as a health educator faces is the need to be knowledgeable about the principles of teaching and
learning.
 Teacher teaching paradigm has shifted to focus on the learner learning.
 Nurse needs to know not only the subject matter but also her role in the teaching learning process and
the nature of the learner.

Three Pillars of Teaching Learning Process

1.Teacher

 The vital role of the teacher is motivating students to learn

 Inspiring them to get out of their comfort zones, to stretch and develop the 98% portion of their brain which is
still untapped and unused.

2.Learner

3.Subject-matter

Comparison of Nursing Process and Education Process Similarities (Bastable)

1. Both consist of the basic elements of assessment, planning, implementation and evaluation.
2. Logical, scientifically based frameworks for nursing processes providing for the rationale basis for
nursing practice rather than an intuitive one
3. Both are methods for monitoring and judging the overall quality of nursing interventions based on
objective data and scientific criteria.
Differences between Nursing Process and Education Process
Differences

 Nursing Process focuses on planning and implementation of care based on assessment and
diagnosis of the patient’s physical and psychosocial
 Education process Identifies instructional content and method based on the assessment of the
client’s learning needs, readiness to learn and learning styles.
Outcomes

 Nursing process - When the physical and psychosocial needs of the client are met
 Education process -When changes in knowledge, attitudes and skills occur
ASSURE Model as Education Process Paradigm

Is a guide to assist teachers in making instructional materials

A – analyze the learner; identify who your learners are based on

1. General characteristics ( age, highest educational attainment or grade level, socioeconomic factors, ethnicity
and culture)

2 . Specific learner competencies like knowledge, skills and attitudes regarding the topic

A . Information processing habits

 Analytical/global
 Focused/non-focused
 Reflective/impulsive
 narrow/broad
 categorization
 tolerant/intolerant of incongruities

B . Motivational factors

 Attention span
 Factors which may interfere with learning like anxiety, depression

C .L earning styles

Refer to perceptual preferences and strengths like visual, auditory, tactile and kinesthetic.

S – state the objectives using SMART base on the course syllabus

S – select the instructional media and materials by:

a. Selecting the available materials

b. Modifying existing materials
c. Designing, revising or making new materials
U – use the materials and the instructional media by:

a. Reviewing the materials and maximizing the use of the materials

b. Practicing the use of the materials and the instructional media
c. Preparing the classroom, equipment and facilities
d. Presenting the materials using your skills and teaching styles
R – require learner participation by preparing activities that will encourage students to respond and actively
participate; the teacher should give appropriate feedback to the students’ responses.

E – evaluate and revise…..to evaluate the effectivity of the presentation, the following questions may be asked:

Was the visual material able to help me make a clear, coherent and interesting presentation?
Was it able to help me meet the objectives of the lesson?
Was it able to help learners/trainees meet the objectives of the lesson?
To fulfill the role of educator==must have a solid foundations in the principles of learning and special
training in instructional skills.
LUKER & CARESS

Article on “Rethinking patient education”

Suggested that it is unreasonable to expect every nurse to teach when they have only had basic nursing education.

The minimum qualification for nurse educators should be a BSN degree. Educator’s role should be delegated to nurses
with master’s degree.

HISTORICAL FOUNDATIONS FOR THE TEACHING ROLE OF NURSES

 1800 – nursing was given recognition as a discipline

 Health education became a unique and independent function of a nurse
 Regarded as the period of Educated nursing
 Initiated by Florence Nightingale = mother of mother nursing and founder of the 1st school of nursing.

Initiated by Florence Nightingale = mother of mother nursing and founder of the 1st school of nursing.

 Taught about clean, ventilated and well lit environment in the hospital and at home in assisting the patients to
get well and improve their sense of well being
 Founded the Florence School of Nursing at St Thomas Hospital in London ( June 15, 1860)
 Trained and taught nurses, physicians and health officials on the importance of manipulating the
environment==patient’s recovery and healing process
 Books: Notes on Nursing and Notes on Hospitals

Early 1900

The importance of education in the promotion of health and prevention of illness was recognized and practiced by the
public health nurses.

Today - Teaching is included within the scope of nursing practice responsibilities

Lesson 11
Good Teaching
The Role of the Nurse as a Health Educator

 Giver of information
 Facilitator of learning
 Coordinator of learning
 Client advocate

The health educators have an obligation to 2 principles in implementing the strategies and methods:

 The people have the right to make decisions affecting their lives
 There is moral imperative to provide people with all relevant information and resources possible to make their
choice freely and intelligently ( Cottrell, Girvan, Mckenzie)

Effective Teaching in Nursing

Learners can always identify the best teacher who is also the most effective and the worst who is also the weakest ( de
Young, 2003)

Effective teacher – possesses certain qualities, characteristics and attitudes which makes them one of the most
approachable and respected members of the faculty
Effective Teachers according to Flowers (CCI)

1 . Committed- they don’t watch the clock, they go extra mile and work long hours.

2. Creative – they stimulate intellectual inquisitiveness, exploratory and critical thinking.

 What distinguishes a great teacher from ordinary or average mentor

 sunsparing gift of self and their capacity for caring for their students ( Rodden)
 always awaken the students to their awareness of their greater potential.

3.Intuitive- able to identify the student’s predominant style of intelligence and based on this knowledge, the teacher is
able to build on the student’s strength.

 In evaluating teacher effectiveness

 there is no one style, skill or technique that is effective for all learners and all teaching situations.
 There is always a combination or a composite styles that will eventually distinguish the effective and efficient
from the ordinary, run- of the mill instructor.

SIX HALLMARKS OF GOOD AND EFFECTIVE TEACHING (JACOBSEN) (TAPPED)

T -Teaching practices:

a. Mechanics
b. Methods
c. Skills in the classroom and clinical practice
d. Has thorough knowledge of the subject matter
e. Presents the materials in clear, interesting, logical and organized matter

A - Availability to students especially in the laboratory, clinical and other skills application areas

P - Professional Competence evidence by

a. Through knowledge of the subject matter and proper demonstration skills

b. Reading, researching, undertaking continuing professional education and has clinical practice and
expertise.
P - Possession of skillful interpersonal relationships with students which was rated as the Most important. The teacher:

C – conveys a sense of warmth

A - Allows learner to freely express themselves and ask questions
R – respect , fair and just to students in giving grades and credits
E – easily accessible for conferences and consultations
S - sensitive to student’s feelings , problems, interest, and welfare

3 Basic approaches by which the instructor can increase self- esteem and reduce anxiety:

oEmpathic listening- by listening to the learner and seeing the world through his own eyes.
oAccepting the learners as they are whether you like them or not; avoid imposing your own prejudices or
standards.
oCommunicating honestly with your students by letting them know your expectations and their
responsibilities.
In loco parentis

 gives the teacher the right to exercise the parental role in the absence of the real parents.
 Allows the teacher to impose appropriate disciplinary measures for minor offenses.
E - Evaluation practices
a. Clearly communicating expectations
b. Providing timely feedback on student progress
c. Correcting the students tactfully
d. Being fair in the evaluation processes
D - Desirable personal characteristics of the teacher which includes:
-Charisma or personal magnetism
-Enthusiasm
-Cheerfulness
-Self-control
-Patience
-Flexibility
-Sense of humor
-Good speaking voice
-Self-confidence
-Willingness to admit error or lack of knowledge
-Caring attitude

OTHER IMPORTANT CHARACTERISTICS OF A TEACHER

1.Teacher clarity
 One who logically organizes instruction
 explains what is to be learned
 uses simple terms in presenting new materials
 assesses whether student can understand and follow the teacher’s train of thought
 uses examples
 uses repetition and summarization
 Behavior= to make what is to be learned as intelligible, comprehensive and learnable as possible
2.Teacher style involves
Interpersonal
Professional
Personal and
a. Blend of form or content= combination of ways : talking, walking, relating and thinking,
scholarliness, intelligence and sincerity
c. A pleasant speaking voice
d. Use of a variety of teaching strategies, jokes and humor
e. Good timing= the teacher knows how to adapt the speed of delivery for the individual
learners and knowing when they are ready for a new material, when to stop and when to shift gears. b.
Teaching persona= ability to stimulate the student’s interest and enthusiasm for the subject
Seven Principles of Good Practice Teaching in the Undergraduate Education (Clickerin & Cameson)

1. encourage interaction between the teacher and the learner

 refers to effective teacher characteristics
 what the teacher do to motivate the student to participate and ask questions

2.elicit cooperation among the students to do collaborative learning

study groups
 undertaking group projects/activities
 students learn more collaboratively than competitively.

3.Students should engage in active learning where they can pro-actively manipulate the content of what they
are learning by

 talking about the material

 writing about it
 making an outline about it
 asking questions about it
 acting it out or just reflecting upon it.

4. Giving prompt feedback related to :class recitations, quizzes,major exams or other written works and
projects serves as a reward or positive reinforcement for a job well done and for a commendable behavior or
attitudes exhibited by the learner.

5. Emphasizing time on task where the teacher makes sure that the student knows how much time they
should spend learning on a particular material and by using time efficiently.
Refers to a proper effective and intelligent time management.

6. communicating higher expectations which refers to the challenge that the teacher gives to the student and
the student’s response to rise up to that challenge with the teacher’s encouragement and support.

7.Respecting the diverse talents and ways of learning- learners have different learning styles, use different
teaching strategies, approachable and methods.

LESSON 111

BARRIERS TO EDUCATION

1. Lack of time to teach

2. Ill prepared to teach
3. Relegated to low-priority status
4. Low priority of administration and supervisory personnel on patient and staff education
5. Lack of space and privacy in the hospital setting
6. Absence of 3rd party reimbursements to support patient education programs
7. Nurses and physicians question whether patient education is effective as a means to improve health
outcomes.
8. Overlapping of functions – There are a multitude of healthcare providers covering much of the same
content, but not necessarily with consistency.
9. Inadequate recording of patient education -- The type of documentation system used by healthcare
agencies has an effect on the quality and quantity of patient teaching recorded .

BARRIERS TO LEARNING
1.Personal characteristics of the learner
Readiness to learn
Motivation
Compliance
Developmental-stage
Learning styles
2.Lack of time to learn due to rapid patient discharge
3.Lack of support and ongoing positive reinforcements from nurse and S.O.
4.Extent of behavioral changes needed (number and complexity)

APPLYING LEARNING PRINCIPLES AND THEORIES OF LEARNING TO HEALTHCARE PRACTICE

March 6-19, 2024

LESSON 1

PRINCIPLES OF LEARNING

LEARNING

is a relatively permanent change in mental processing, emotional functioning and or behavior as a result of
experience.
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.

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.

HOW DOES LEARNING OCCUR?

 Interact with his/her environment and incorporates or applies new information or experiences to what
he/she already knows or has planned.

Factors affecting Learning:

1.Society and culture
2.Structure or pattern of the stimuli
3.Effectiveness or credibility or role models and reinforcements
4.Feedback for correct and incorrect responses
5.Opportunities to process and apply learning to new situations

What kind of experiences facilitate or hinder the learning process?

1.Teacher’s selection of learning theories to be applied and the structuring or type of learning experience
2.Teacher’s knowledge of the nature of the learners, the material to be learned, teaching methods to be
employed, communication skills and ability to motivate the learner
3.Teacher’s ability to relate new knowledge to previous experiences, values, self-perception and the learner’s
readiness to learn
COMMON PRINCIPLES OF LEARNING
1. Use several senses
When dealing with 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 do.
 This is shown by the Learning Experience cone
2.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
3.Provide an environment conducive to learning
Always consider the comfort and convenience of the learner
4.Assess the extent to which the learner is ready to learn
Readiness to learn is affected by factors like emotional status and physical conditions
5.Determine the relevance of the information
Anything that is perceived by the learner to be important or useful will be easier to learn and retain
6.Repeat the information
Continuous repetition of information over a period of time enhances learning, applying the information to a
different situation or rewording it and giving practical applications will help in the learning process
7.Generalize information
Cite applications of the information to a number of applications or situations.
Give examples which will illustrate or concretize the concept
8.Make learning a pleasant experience
Give frequent encouragement, recognize accomplishments and give positive feedback
9.Begin with that is known; move toward 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 with
10.Present information at an appropriate rate
This refers to the pace in which information is presented to the learner……are you talking t fast so that the
learner has a difficulty in catching up with what you are saying r are you too slow because the learner is
already knowledgeable about the topic you are discussing

WHAT HELPS ENSURE THAT LEARNING BECOMESRELATIVELY PERMANENT

1. By organizing the learning experience so that it becomes meaningful and pleasurable
2. Practicing or rehearsing new information mentally or physically to retain and strengthen learning
3 .Applying reinforcements through rewards or recognition to make the learner know that learning had
occurred.
4 .Assessing or evaluating whether learning has taken place immediately after the experience or some later
point in time.
LESSON 111

TYPES OF LEARNING AND LEARNING STYLES

1.Discrimination Learning - Learning is forming large numbers of stimulus-response or verbal chains.
more new chains learned the easier is to forget previous chains
2.Rule Learning - A rule can be considered as a chain of concepts or relationship between concepts.
“if…then” relationships.
Ex. Positioning decubitus ulcer
Nutrition malnourishment
3.Signal Learning
Conditioned response
Simplest level of learning
Person develops diffuse reaction to stimuli
Ex. Skill test
4. S-R Learning
Develops a voluntary response to a specific stimulus or combination of stimuli
Ex. Rule: “If the IV is not dripping, first open the clamp farther.”
5. Problem solving
A process of formulating and testing hypotheses
6. Verbal Association - A type of chaining
Recognized in the process of learning medical terminology

Series of related conditioned responses or stimulus-response connection = AUTOMATIC RESPONSES

7. Concept Learning
Learning how to classify stimulus into groups represented by a common concept.

Benefits of knowing the learning styles:

1.The teacher can intervene once the learner experiences difficulty by adapting techniques or strategy that are
suited to the student’s learning style.

2.Enhancement f effective learning by improving n the teaching strategies and the instructional materials that
are used.

Basic Components of Cognitive Style

1.Holistic vs, analytic thinking
Holistic (global)thinkers –look at the global or big picture immediately and are interested in the “gist of things,
the essence ofr the general idea.
They look at the broad categories first before going into details, they think deductively
Analytic thinker – thinks logically and objectively, looking at the details first.

2.Verbal vs, visual representation

People with verbal approach represent in their minds what they read, see or hear as in terms of words or
verbal associations
People with visual approach experience in their minds what they read, see or hear as mental pictures or
images.
 Learning Style Models

1.Kolb’s Model
Also known as the Cycle of Learning, Experiential Learning
Believes that the learner is not a blank slate
Learning is a continuous process which is cumulative result f previous or past experiences, heredity and
interaction with the environment.
Impact of Kolb’s learning style on the educator
Will enable the teacher to assist the learner in modifying, refining or even changing these preconceived ideas
so that real or better learning can occur

Four models of Learning

a. Concrete experience (CE) Learning
Learning from actual experience

b. Reflective observation (RO) abilities

Learning by observing others

c. Abstract conceptualization (AC) abilities

Creating theories to explain what is seen

d. Active experimentation (AE) abilities

Using theories to solve problems

Four Learning styles

Learning Learning Characteristics Learning methods

styles models

Converger AC and AE  Good in decision making, problem  Demonstrations, return demonstr

solving diagrams, chats and illustrations
 Prefers technical work than
interpersonal relationships
 Uses deductive reasoning
 Uses facts and data
 Has skills for technology and
specialize careers.

Diverger CE and RO  People and feeling-oriented  Group discussions

 Likes to work in groups  Brainstorming
Learning styles Learning Characteristics Learning methods
models

Accommodato CE and AE  Impatient with other people

r  Risk-taker
 Uses trial and error
 Acts more on intuition
 Uses instinct or gut feelings
rather than logic
 Achiever
 Most challenging to educators

Assimilator AC and RO  More concerned with abstract  Lectures

ideas than people  One-to-one instruction
 Inductive reasoning  Self instruction methods
 Creates theoretical models
 Integrate and apply ideas
 Logical thinking
2. Gregorc Cognitive Styles Model
Hypothesized that the mind has the mediation abilities of perception and ordering that is the perception and
ordering f knowledge affects how the person learns.
Has identified four sets of dualities ) situations that consist of two parts that are complementary or oppposed
to each other) The mind has the mediation abilities of:

a.Perception
The way one receives or grasps incoming information r stimulus in a continuum ranging from abstractness to
concreteness.
According to Gregorc, everyone processes or deals with perception and ordering of knowledge in all four
dimensions but may have presences or choices of doing it which may fall into 4 mediation channels namely:
1.Concrete sequential (CS)
Learners like highly structures quiet learning environments without interruptions like concrete learning
materials especially visuals and give focus on details; may interpret words literally.

2.Concrete Random ( CR)

Intuitive
trial and error method of learning
looks for alternative
3.Abstract Sequential (AS)
Learners are holistic thinkers and need consistency in the learning environment
Do not like interruptions
Have god verbal skills
Rational and logical

4.Abstract random (AR)

Think holistically
Learn a lot from visual stimuli
Prefer busy
Unstructured learning environments
Focused on personal relationships

3. Gardner’s Seven Types of Intelligence

States that there are various types of talent or seven forms f intelligence which may all be fully developed in a
gifted child but on the average, about three to four types may be possessed or developed by an individual or
child.
All learners have all the seven kinds of intelligence but in different proportions
INTELLIGIENCE TYPE
1. Linguistic
Description: words and language, written and spoken; retention, interpretation and explanation of ideas
and information via language, understands relationship between communication and meaning
typical roles: writers, lawyers, journalists, speakers, trainers, copy-writers, english teachers, poets, editors,
linguists, translators, PR consultants, media consultants, TV and radio presenters, voice-over artistes
related tasks, activities or tests: write a set of instructions; speak on a subject; edit a written piece or
work; write a speech; commentate on an event; apply positive or negative 'spin' to a story
preferred learning style clues: words and language
2. Logical-Mathematical
Description: logical thinking, detecting patterns, scientific reasoning and deduction; analyse problems,
perform mathematical calculations, understands relationship between cause and effect towards a tangible
outcome or result
typical roles: scientists, engineers, computer experts, accountants, statisticians, researchers, analysts,
traders, bankers bookmakers, insurance brokers, negotiators, deal-makers, trouble-shooters, directors
related tasks, activities or tests: perform a mental arithmetic calculation; create a process to measure
something difficult; analyse how a machine works; create a process; devise a strategy to achieve an aim;
assess the value of a business or a proposition
preferred learning style clues: music, sounds, rhythm

3. Musical
Description: musical ability, awareness, appreciation and use of sound; recognition of tonal and
rhythmic patterns, understands relationship between sound and feeling
typical roles: musicians, singers, composers, DJ's, music producers, piano tuners, acoustic engineers,
entertainers, party-planners, environment and noise advisors, voice coaches related tasks, activities or
tests
related tasks, activities or tests: write a set of instructions; speak on a subject; edit a written piece or
work; write a speech; commentate on an event; apply positive or negative 'spin' to a story
preferred learning style clues: music, sounds, rhythm

4. Bodily-Kinesthetic :
Description: body movement control, manual dexterity, physical agility and balance; eye and body
coordination
typical roles: dancers, demonstrators, actors, athletes, divers, sports-people, soldiers, fire-fighters,
PTI's, performance artistes; ergonomists, osteopaths, fishermen, drivers, crafts-people; gardeners,
chefs, acupuncturists, healers, adventurers
related tasks, activities or tests: juggle; demonstrate a sports technique; flip a beer-mat; create a
mime to explain something; toss a pancake; fly a kite; coach workplace posture, assess work-station
ergonomics
preferred learning style clues: physical experience and movement, touch and feel

5. Spatial-Visual
Description: visual and spatial perception; interpretation and creation of visual images; pictorial
imagination and expression; understands relationship between images and meanings, and between
space and effect
typical roles: artists, designers, cartoonists, story-boarders, architects, photographers, sculptors, town-
planners, related tasks, activities or tests: visionaries, inventors, engineers, cosmetics and beauty
consultants
preferred learning style clues: design a costume; interpret a painting; create a room layout; create a
corporate logo; design a building; pack a suitcase or the boot of a car
preferred learning style clues: pictures, shapes, images, 3D space
6. Interpersonal
Description: perception of other people's feelings; ability to relate to others; interpretation of
behaviour and communications; understands the relationships between people and their situations,
including other people
typical roles: perception of other people's feelings; ability to relate to others; interpretation of
behaviour and communications; understands the relationships between people and their situations,
including other people
preferred learning style clues : therapists, HR professionals, mediators, leaders, counsellors,
politicians, educators, sales-people, clergy, psychologists, teachers, doctors, healers, organisers, carers,
advertising professionals, coaches and mentors; (there is clear association between this type of
intelligence and what is now termed 'Emotional Intelligence' or EQ)
related tasks, activities or tests:: interpret moods from facial expressions; demonstrate feelings
through body language; affect the feelings of others in a planned way; coach or counsel another
person
preferred learning style clues: human contact, communications, cooperation, teamwork

7. Intrapersonal
Description: self-awareness, personal cognisance, personal objectivity, the capability to understand
oneself, one's relationship to others and the world, and one's own need for, and reaction to change
typical roles: typical roles
preferred learning style clues: arguably anyone who is self-aware and involved in the process of
changing personal thoughts, beliefs and behaviour in relation to their situation, other people, their
purpose and aims - in this respect there is a similarity to Maslow's Self-Actualisation level, and again
there is clear association between this type of intelligence and what is now termed 'Emotional
Intelligence' or EQ
related tasks, activities or tests: consider and decide one's own aims and personal changes required to
achieve them (not necessarily reveal this to others); consider one's own 'Johari Window', and decide
options for development; consider and decide one's own position in relation to the Emotional
Intelligence model
preferred learning style clues: human contact, communications, cooperation, teamwork