Week 2

Sec 01
Amanda Hicks, RN, BScN, MPH

NUSC 3P50 HE ALTH E DUCATION

Agenda – January 17/24
Guest – Student research involvement opportunity (5 min)
Review key messages from week 1
Questions about course/assignments/seminars
- sample client scenarios/profiles for projects
Learning theories and determinants of learning
Client-centred learning
Review and kahoot
Week 1 - Review
Health/patient education has been an important part Evolved from disease-oriented to health/prevention-oriented
of health care, disease prevention and health
Shifted from teacher-centred to learner-centred
promotion for a very long time

Nurses have skills, knowledge and opportunity (and are required) to provide patient/health education

The education process parallels the nursing process, and is dependent on both teaching and learning

There are several factors (personal, professional, legal, social, political, economic) that can present barriers or
facilitators to teaching and learning
Questions?
 Young woman, 34 weeks
pregnant, with a new diagnosis of
gestational diabetes mellitus
presents to the diabetes
education centre to learn about
dietary changes that will help her
manage her condition.
A school has requested health
education provided to the
kindergarten classes about hand
hygiene after an outbreak of
influenza.
A 58 year old man with significant
visual impairment is being
discharged from hospital 24
hours after a knee replacement
surgery,
requiring discharge teaching and
instruction.

A family has asked to learn more A homeless shelter has planned a

about medically
assisted dying when their
terminally ill father has shared his
wishes for "being put to sleep at
home".
health education session for a
group of clients to learn
about risks of contracting group A
streptococcus. Some of the
clients are IV drug users.

Examples of client profiles/scenarios for projects

Week 2
Learning Objectives:
- Increase knowledge of learning theories
- Discuss the nurse's role in assessing the determinants of learning
- Introduce the LEARNS model for facilitating client centred learning
Key terms
Andragogy – the art and science of teaching adults
Pedagogy – the art and science of helping children to learn
Gerogogy – teaching older adults
Learning – there has been a change in knowledge, behaviours, attitude or skills
Motivation – psychological force that moves a person to take action in the
direction of meeting a need/goal
Cognition - way of thinking
A learning need is the gap between what someone knows and what someone
needs or desires to know
Learning Theories
If nurses are to provide health education that is
"learner-centred", then we must understand how
learning happens.
Major theories that describe how individual's learn:
-Behaviourist Learning
-Cognitive Learning
-Social Learning

Theories of motivation
Motor Learning
 Behaviourist Learning Cognitive Learning Social Learning

- Respondent conditioning - Perception - Learning occurs by observation

Key features: (associations b/w stimulus and - Information processing - Role modeling
response) - Cognitive development - Vicarious reinforcement
- Operant conditioning (reinforced - Social cognition
behaviour)

- Behaviour change interventions - Need to assess - Approach to the development of

Implications - Incentivizing healthy behaviours cognitive factors, self-efficacy, competence
for health (i.e. health rewards perceptions, motivating
education: apps, determining rewards for factors
tobacco cessation goals)

- Learners are assumed to be - Criticized for neglecting - Requires careful evaluation of

Concerns: relatively passive/easy to emotions learning materials for
manipulate stereotypes, bias, contradictions,
- Research evidence is often based negative effects
on animal studies - Simple exposure to role models
- Changed behaviour may weaken with vicarious reinforcement
over time does not guarantee learning
Motivation
Psychodynamic learning theory is based on emotions

Humanistic learning theory understands that motivation

stems largely from each person's needs, feelings about
self, and the desire to grow/change in positive ways.
Motor learning
leads to change
in the capability
for movement.
Requires practice and
feedback.
From a theoretical perspective, we understand that in order for learning to
become permanent we should consider:
1. The learner's emotions, perceptions, motivations and cognitive
development impact the learning experience
2. Practicing new knowledge or skills under varied conditions strengthens
learning
3. Reinforcement and feedback may be helpful
4. Transferability of learning beyond the immediate setting to other social
environments

Learning should not be assumed to be relatively lasting

or permanent; it must be assessed and evaluated.
Assessing Determinants of Learning
As part of the health education process, nurses are assessing:
- Learning Needs – what the patient needs and wants to learn
- Readiness to learn – when the learner is receptive to learning
- Learning style – how the learner best learns

Good assessments ensure the best possible learning can occur with
the least amount of stress and anxiety for the learner.
Assessing Learning Needs

1 2 3 4
Establish trust Collect Prioritize Set goals and
and safety with important learning needs objectives
learner information together with
about them. the client
Assessing Readiness to Learn
Readiness to learn is defined as the time when the learner demonstrates an
interest in learning the information necessary to maintain optimal health.
Four types of readiness to learn:
1. Physical readiness
Teachable moments are points in time
2. Emotional readiness when client's are most receptive to
3. Experiential readiness learning. Nurses must listen for
cues/hints of these teachable
4. Knowledge/cognitive readiness moments.
Learning Styles

VISUAL AURAL READ/WRITE KINESTHETIC

Reflective activity – Interested in your
personal learning style(s)?
Take the VARK Learning Style quiz here

◦ Do you have one learning style or more?

◦ What are some of the situations where your learning style may vary? Why?
◦ Can learning styles change? What factors may contribute to this?
Client Centred Learning
The Registered Nurse's Association of Ontario's best
practice guideline: Facilitating Client Centred
Learning addresses:
•How nurses can effectively facilitate client centred
learning
•Effective teaching delivery methods and strategies
supporting client centred learning
• How nurses assess client learning
Client centred learning involves not only gaining new knowledge, but includes
opportunities for clients to apply their values, needs, past experiences and
cultural realities to the actions they are considering.

(RNAO, 2012)
 Learning in the Healthcare context
- Nurses are delivering care in an increasingly complex health care system
- Clients are faced with health information that is often unfamiliar, complicated and technical
- Clients and their families are navigating a complex system, and managing their health amidst:
o Earlier hospital discharge
o Complicated treatment plans
o Making informed decisions
o Maintaining a healthy lifestyle
o Communicating their perspective, needs, values
o Living within difficult soci-economic conditions
o Living with chronic conditions
o Accessing and interacing with health care professionals and community service providers

(RNAO, 2012)
(RNAO, 2012)
Review
Key messages:
-Several theories explain how learning happens
-Nurses must assess learner's needs, readiness
to learn and preferred learning style
- L.E.A.R.N.S is a model to guide nurses
facilitating client centred learning

Let's play kahoot.

References
▪Bastable, S. (2017). Essentials of Patient Education. Jones & Barlett
Learning, LLC. Burlington, MA.
▪Registered Nurse's Association of Ontario (RNAO). (2012).
Clinical best practice guidelines: Facilitating client centred learning.
RNAO. Toronto, ON.