NCM5 21: HEALTH EDUCATION

Week 5: The Health Education Process

PRELIMS | 2023
NURS 2-1
THE HEALTH EDUCATION PROCESS
Health education is any combination of learning experiences
designed to help individuals and communities improve their
health, by increasing their knowledge or influencing their attitudes
(WHO) .

Health education as applied to health and disease issues is defined

as

"A process with an intellectual, psychological, and social

dimensions relating to activities which increase the abilities of
people to make informed decisions affecting their personal,
family, and community well - being.

This process, based on scientific principles facilitates learning and A. Assessing the learner
behavioral change in both health personnel and consumers,
including children and youth (Joint Commission) In a variety of settings, nurses are responsible for the education of
patients, families, staff, and students. Numerous factors make the
For a health education to be successful, it should go through a nurse educator’s role particularly challenging in meeting the
process. You cannot just go to a client or a community and information needs of these various groups of learners
conduct health teaching without preparation.
Nurses face many challenges in the delivery of health teaching or
CONCEPTS OF TEACHING AND LEARNING, EDUCATION education.
PROCESS:
Education process – a systematic, sequential, planned course of 1. Lack of experience
action consisting of two major interdependent operations,
teaching and learning 2. Lack of time due to workload

Teaching – a deliberate intervention that involves the planning 3. patient’s lack of cooperation
and implementation of instructional activities and experiences to
4. Patient’s condition
meet intended learner outcomes according to a teaching plan
5. Cultural aspect
Instruction – component of teaching that involves the
communicating of information about a specific skill in the 6. Language barrier
cognitive, psychomotor, or affective domain
7. Physical disabilities of learners
Learning – a change in behavior that can occur at any time or in
any place as a result of exposure to environmental stimuli To meet these challenges, the nurse educator must be aware of
the various factors that influence how well an individual learns.
Patient education – a process of assisting people to learn health-
related behaviors so that they can incorporate those behaviors THE EDUCATOR’S ROLE IN LEARNING
into everyday life The role of educating others is one of the most essential
interventions that a nurse performs.
Staff education – the process of influencing the behavior of nurses
by producing changes in their knowledge, attitudes, values, and • The nurse must both identify:
skills Did you get all the definitions correct?
1. the information learners
need

2. consider their readiness to

learn

3. their styles of learning.

• The learner—not the teacher—is the single most

important person in the education process.

Educators enhance learning when serving as facilitators helping

the learner become aware of what needs to be known, why
knowing is valuable, and how to be actively involved in acquiring
information.

• Just providing information to the learner, does not ensure

that learning will occur.

• There is no guarantee that the learner will learn the

information given, although there is more of an
opportunity to learn if the educator assesses the
determinants of learning.

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 • Assessment permits the nurse educator to facilitate the
process of learning by arranging experiences within the
environment that assist the learner to find the purpose,
the will, and the most suitable approaches for learning.
• An assessment of the three determinants of learning
enables the educator to identify information and present
it in a variety of ways, which a learner cannot do alone.
• Manipulating the environment allows learners to
experience meaningful parts and wholes to reach their
individual potentials.
The educator plays a crucial role in the learning process by doing
the following:
1. Assessing problems or deficits
2. Providing important information and presenting
it in unique and appropriate ways
3. Identifying progress being made
4. Giving feedback and follow-up
5. Reinforcing learning in the acquisition of new
knowledge, skills, and attitudes
6. Evaluating learners’ abilities
The educator is vital in giving support, encouragement, and
direction during the process of learning.
• Learners may make choices on their own
without the assistance of an educator, but
these choices may be limited or inappropriate.
For example:
The nurse facilitates necessary changes in the home environment,
such as minimizing distractions by having family members turn off
the television to provide a quiet environment conducive for
concentrating on a learning activity.
The educator assists in identifying optimal learning approaches
and activities that can both support and challenge the learner
based on his or her individual learning needs, readiness to learn,
and learning style.
Assessment of the learner includes attending to the three
determinants of learning:
1. Learning needs—what the learner needs and
wants to learn
2. Readiness to learn—when the learner is
receptive to learning
3. Learning style—how the learner best learns.
LEARNING NEEDS
Learning needs are defined as gaps in knowledge that exist
between a desired level of performance and the actual level of
performance.
• a learning need is the gap between what
someone knows and what someone needs or
wants to know.
• It may arise due to lack of knowledge, attitude,
or skill.
• nurse educators must identify learning needs
first so that they can design an instructional plan
to address any deficits in the cognitive,
affective, or psychomotor domains, thus can
determine when and how learning can
optimally occur
• not every individual perceives a need for education.
Often, learners are not aware of what they do not know
or want to know.
• It is up to the educator to assist learners in identifying,
clarifying, and prioritizing their needs and interests.
• Once these aspects of the learner are
determined, the information gathered
can, in turn, be used to set objectives
and plan appropriate and effective
teaching and learning approaches
for education to begin at a point
suitable to the learner rather than
stemming from an unknown or
inappropriate place
• According to cognitive experts in behavioral and social
sciences most learners—90-95% of them—can master a
subject with a high degree of success if given sufficient
time and appropriate support.
• It is the educator’s task to facilitate the determination of
what exactly needs to be learned and to identify
approaches for presenting information in a way that the
learner will best understand.
1. Identify the learner -The development of formal and informal
education programs for patients and their families, nursing staff, or
students must be based on accurate identification of the learner.
2. Choosing the right setting. Establishing a trusting environment
helps learners feel a sense of security in confiding information,
believe their concerns are taken seriously and are considered
important, and feel respected.
• Ensuring privacy and confidentiality is
recognized as essential to establishing a trusting
relationship.
3. Collect data about the learner. Once the learner is identified,
the educator can determine characteristic needs of the
population by exploring typical health problems or issues of interest
to that population.
• Subsequently, a literature search can assist the
educator in identifying the type and extent of
content to be included in teaching sessions as
well as the educational strategies for teaching
a specific population based on the analysis of
needs.
4. Collect data from the learner. Learners are usually the most
important source of needs assessment data about themselves.
• Allow patients and/or family members
to identify what is important to them,
what they perceive their needs to be,
which types of social support systems
are available, and which kind of
assistance these supports can
provide.
• If the audience for teaching consists of staff members or
students, solicit information from them as to those areas
of practice in which they feel they need new or
additional information.
• Actively engaging learners in defining their own problems
and needs, motivates them to learn because they are
invested in planning for a program specifically tailored to
their unique circumstances.
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 • Also, the learner is important to include as a source of
information because, as noted previously, the educator
may not always perceive the same learning needs as the
learner.
5. Involve members of the healthcare team. Other health
professionals likely have insight into patient or family needs or the
educational needs of the nursing staff or students as a result of their
frequent contacts with both consumers and caregivers.
• Nurses are not the sole teachers of
these individuals; thus they must
remember to collaborate with other
members of the healthcare team for
a richer assessment of learning needs.
This consideration is especially important because time for
assessment is often limited.
6. Prioritize needs. A list of identified needs can become endless
and seemingly impossible to accomplish.
• Maslow’s (1970) hierarchy of human
needs can help the educator prioritize
so that the learner’s basic needs are
attended to first and foremost before
higher needs are addressed.
CRITERIA FOR PRIORITIZING LEARNING NEEDS
1. Mandatory: Needs that must be learned for survival or situations
in which the learner’s life or safety is threatened. Learning needs in
this category must be met immediately.
For example,
A patient who has experienced a recent heart attack needs to
know the signs and symptoms and when to get immediate help.
The nurse who works in a hospital must learn how to do
cardiopulmonary resuscitation or be able to carry out correct
isolation techniques for self-protection.
2. Desirable: Needs that are not life dependent but that are
related to well-being or the overall ability to provide quality care
in situations involving changes in institutional procedure.
For example,
• It is important for patients who have
cardiovascular disease to understand
the effects of a high-fat diet on their
condition.
• It is desirable for nurses to update their
knowledge by attending an in-service
program when hospital management
decides to focus more attention on
the appropriateness of patient
education materials in relation to the
patient populations being served.
3. Possible: Needs for information that is nice to know but not
essential or required or situations in which the learning need is not
directly related to daily activities.
For example,
The patient who is newly diagnosed as having diabetes mellitus
most likely does not need to know about self-care issues that arise
in relationship to traveling across time zones or staying in a foreign
country because this information does not relate to the patient’s
everyday activities
4. Determine availability of educational resources.
The educator may identify a need, but it may be useless to
proceed with interventions if the proper educational resources are
not available, are unrealistic to obtain, or do not match the
learner’s needs
1. Assess the demands of the organization. This assessment yields
information that reflects the climate of the organization.
• What are the organization’s philosophy, mission,
strategic plan, and goals?
• The educator should be familiar with standards
of performance required in various employee
categories, along with job descriptions and
hospital, professional, and agency regulations.
2. Take time-management issues into account. Because time
constraints are a major impediment to the assessment process,
• Assessment can be conducted anytime and anywhere
the educator has formal or informal contact with
learners.
• Data collection does not have to be restricted to a
specific, predetermined schedule.
• With patients, many potential opportunities for
assessment arise, such as when giving a bath, serving a
meal, making rounds, and distributing medications.
• For staff, assessments can be made when stopping to talk
in the hallway or while enjoying lunch or break time
together.
• Informing a patient ahead of time that the educator
wishes to spend time discussing problems or needs gives
the person advance notice to sort out his or her thoughts
and feelings.
• Minimizing interruptions and distractions during planned
assessment interviews maximizes productivity. In turn, the
educator might accomplish in 15 minutes what otherwise
might have taken an hour in less directed, more
frequently interrupted circumstances.
METHODS TO ASSESS LEARNING NEEDS
The nurse in the role of educator must obtain objective data about
the learner as well as subjective data from the learner.
This section describes various methods that educators can use to
assess learner needs and that should be used in combination to
yield the most reliable information
1. Informal Conversations
Often learning needs are discovered during impromptu
conversations that take place with other healthcare team
members involved in the care of the client and between the nurse
and the patient or his or her family.
• The nurse educator must rely on active listening
to pick up cues and information regarding
learning needs. Staff can provide valuable
input about their learning needs by responding
to open-ended questions.
2. Structured Interviews
The structured interview is perhaps the form of needs assessment
most commonly used to solicit the learner’s point of view.
• The nurse educator uses direct and often
predetermined questions to gather information
about learning needs.
• As with the gathering of any information from a
learner in the assessment phase, the nurse
should strive to establish a trusting environment,
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 use open-ended questions, choose a setting 4 types of Readiness to Learn (PEEK)
that is free of distractions, and allow the learner
to state what are believed to be the learning 1. P – physical readiness
needs.
2. E – emotional readiness
1. Focus Groups
3. E – experiential readiness
Focus groups involve a small number (4 to 12) of potential learners
4. K – knowledge readiness
(to determine educational needs by using group discussion to
identify points of view or knowledge about a certain topic). With Physical readiness
this approach, a facilitator leads the discussion by asking open-
ended questions intended to encourage detailed discussion. 1. Measures of ability (fine and/or gross motor movements,
sensory acuity, adequate strength, flexibility,
It is important for facilitators to create a safe environment so that coordination, endurance)
participants feel free to share sensitive information in the group
setting Self-Administered Questionnaires 2. Complexity of task (will affect the extent to which
behavioral changes in the domains can be mastered by
Tests the learner; also comes into play when unlearning/new
learning is required)
• Giving written pretests before teaching is planned can
help identify the knowledge levels of potential learners 3. Environmental effects (distraction, including noise or
regarding a particular subject and assist in identifying frequent interruptions; value of self-pacing)
their specific learning needs.
4. Health status (energy available, comfort level)
• This approach prevents the educator from repeating
already known material in the teaching plan. 5. Gender (much of the difference is socially induced)

• Pretest results are useful to the educator after the Emotional Readiness
completion of teaching when pretest scores are
compared with posttest scores to determine whether 1. Anxiety level (impacts on learner’s ability to concentrate
learning has taken place. and retain information; fear is a major contributor)

Observations 2. Support system (important in buffering effects of stressful

events; teacher can create reachable moment by
• Observing health behaviors in several different time supporting leaner; this sets the stage for the teachable
periods can help the educator draw conclusions about moment)
established patterns of behavior that cannot and should
not be drawn from a single observation. Watching the 3. Risk-taking behavior (need to help learner to develop
learner perform a skill more than once is an excellent way strategies for minimizing risk)
of assessing a psychomotor need.
4. Frame of mind (concern about the “here and now”
• Learners who can observe a videotape of themselves versus the future)
performing a skill can more easily identify their learning
5. Developmental stage (each developmental task
needs. In this process, which is known as reflection on
produces a teachable moment)
action the learner identifies what was done well and
what could have been done better in his or her actual Experiential readiness
performance
1. Level of aspiration (extent to which the learner is driven
Documentations to achieve; previous failures and past successes
influence leaner goals)
• Initial assessments, progress notes, nursing care plans,
staff notes, and discharge planning forms can provide 2. Past coping mechanisms (teacher can help learner
information about the learning needs of clients. determine if they have been effective and whether they
will work now)
• Nurse educators need to follow a consistent format for
reviewing charts so that they review each chart in the 3. Cultural background (behavioral differences, language)
same manner to identify learning needs based on the
same information. 4. Locus of control (internal versus external stimuli; see
discussion of motivation)
• Documentation by other members of the healthcare
team, such as physical therapists, social workers, 5. Orientation (tendency to adhere to a parochial or
respiratory therapists, and nutritionists, can yield valuable cosmopolitan point of view)
insights with respect to the needs of the learner.
Knowledge readiness
READINESS TO LEARN
You already have the basics of “readiness to learn” from our • Present knowledge base (how much the learner already
previous topic, wherein the emphasis was more on the individual’s knows about a topic or how proficient he/she is at
culture, physical & emotional, experiential and personal values – performing a task)
these factors are more focused on adult learners.
• Cognitive ability (extent to which information can be
Today, we integrate “knowledge readiness” which is also related processed by the learner)
to the learning process, (but can be applied in different age
• Learning and reading disabilities (will require special or
groups) that a learner must have.
innovative approaches to instruction)

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 • Learning styles (helps in selection of teaching methods
and materials)

LEARNING STYLES
Learning style models:

• Holistic (thinkers want to get the whole picture

quickly; they want to see broad categories
before they look at details;

• Analytic thinkers (process the detail of the

picture, outlining the component parts)

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