HES 008 BRAIN HEMISPHERES

Session 10  Left side of the brain controls LANGUAGE, and

Gender, Socioeconomic level, and cultural the right side of the brain is the seat of
background have a significant influence on a EMOTIONS.
learner’s willingness and ability to respond to and  Right hemisphere of men’s brains tends to be
make use of the teaching-learning situation. DOMINANT. They’re easily affected by
Gender Characteristics extreme emotions,example when they’re
 Individual differences within groups of anxious or stress their learning will be
males/females are generally greater vs decrease.
between the sexes.  Women tend to use their brains MORE
 Interaction of genetics and environment HOLISTICALLY, calling on both hemispheres
 Brain structure in males and females simultaneously.
 Affective responses (emotional responses)  Total brain size is approximately 3 pounds.
 Cognitive processing  Men’s brain, on average are larger than
Gender-related cognitive abilities women’s.
 General intelligence  Women have smaller brains, on average, than
 Verbal ability men because the anatomical structure of their
 Mathematical ability entire bodies is smaller. However, they have
 Spatial ability ( solving puzzles, understanding
diagrams)
more neurons than men (an overall 11%)
 Problem solving crammed into the cerebral cortex.
 School achievement VERBAL ABILITY: GIRLS learn to talk, use
sentences, and use a greater variety of words
Men Women earlier than boys. In addition, girls speak more
TEMPORAL LOBE: Small region of the MORE neurons
clearly, read earlier, and do consistently better on
regions of the the temporal lobe has are located in
cerebral cortex about 10% FEWER the temporal tests of spelling and grammar.
help to control neurons than it does region where MATHEMATICAL ABILITY: by the end of
HEARING, in women. language, elementary school, however, boys shows signs of
MEMORY, and a melodies, and excelling in mathematical reasoning, and the
person’s SENSES speech are
differences in math abilities of boys over girls
OF SELF and understood.
TIME. become even greater in high school.
CORPUS This part of the brain The back SPATIAL ABILITY: The ability to recognize a figure
CALLOSUM: the in men takes up LESS portion of the when it is rotated, to detect a shape embedded in
main BRIDGE VOLUME than a callosum in another figure, or to accurately replicate a three-
between the left woman's does, which women is
dimensional object is consistently better for males
and right brain suggests LESS BIGGER than in
contains a bundle COMMUNICATION men, which my than females.
of neurons that between the two explain why PROBLEM SOLVING: The complex concepts of
CARRY MESSAGES brain hemispheres. women use problem solving, creativity, analytical skill, and
between the two both sides of cognitive styles, when examined, have led to mixed
brain their brains for
findings regarding gender differences. (women are
hemispheres. language.
ANTERIOR The commissure in Commissure in
good at problem solving, men wants challenging
COMMISSURE: men is SMALLER than women is and are risk takers)
This collection of in women, even LARGER than SCHOOL ACHIEVEMENT: without exception, girls
nerve cells, though men’s brains in men, which are better grades on average than boys,
smaller than the are, on average, or may be a particularly at the elementary school level.
corpus callosum, larger in size than reason why
also connects the women’s brains. They their cerebral
Scholastic performance of girls is more stable and
brain’s two are more focus. hemispheres less fluctuating than that of boys.
hemisphere. seem to work IN CONCLUSION: If males and females were
together on treated as intellectual equals via gender equity
tasks from measures in grade school, colleges, and
language to
emotional
universities, workplaces, and social setting in
responses. general, then individuals and society would

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benefit.
Gender-related personality behavior
 Aggression
 Conformity and dependence
 Emotional adjustment
 Values and life goals
 Achievement orientation
 Gender gap
 Gender bias
AGGRESSION: males of all ages and in most
cultures are generally more aggressive than
females. (violence, smoking, drinking alcohol,
substance abuse= increases the rates of
rehabilitation center, hospitalization rates )
CONFORMITY & DEPENDENCE: females have been
found generally to be more conforming and more
influenced by suggestion.( they can be easily
influenced by suggestions or opinions which affects
the patient’s compliance)
EMOTIONAL ADJUSTMENT: the emotional stability
of the sexes is approximately the same in
childhood,but differences do arise in how
emotional problems are manifested.
VALUES & LIFE GOALS: begun to thin differently
about themselves, have more freely pursued
career and interest pathways, and society has
begun to take more “ equal opportunity”
viewpoint for both sexes.
ACHIEVEMENT ORIENTATION: Females are more
likely to express achievement motivation in social
skills and social relations, whereas men are more
likely to respond in intellectual and comprehensive
activities. This difference is thought to be due to
sex-role expectations that are strongly
communicated at very early age.
EMPOWER AND EDUCATE OUR PATIENTS
Sexual Orientation and Gender Identity
LGBTQA+ population:
 Over 8 million people estimated in the United
states
 Partially represented in U.S census
 Underrepresented in health research
Problems contributing to LGBTQA+ Health
Disparities
 SOCIAL STIGMA contributes to negative health
behaviors ( engage in alcohol, drug use) and
stress and high incidence of depression,
anxiety.
 STRUCTURAL BARRIERS decrease access to
health care ( no insurance for same-sex
domestic partners).
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 Lack of culturally appropriate care results in
limited or ineffective use of healthcare service
(Unwillingness to disclose sexual identity to
healthcare provider).
Teaching Strategies
 Create an environment welcoming to all men
and women
 Avoid making assumptions about family
structure, sexual preference, or lifestyle.
 Adjust admission or intake forms to be more
inclusive
Socioeconomic status(SES) is the most important
determinant of physical and mental health in our
society.
SES variables that affect health beliefs, health
practices, and readiness to learn.
 Educational level
 Family income
 Occupation: white or blue collar jobs
 Family structure
SOCIAL CLASS: Types of Indices for measurements
 Occupation of parents
 Income of family
 Locationo f residence
 Educational level of parents
POVERTY CYCLE/ CIRCLE OF POVERTY: Low
education level results in occupations with lower
levels of pay, prestige, and intellectual demand.
Families living at this level become part of the cycle
that does not allow one to easily change a pattern
of life.
IMPACT OF SOCIOECONOMIC ON HEALTH: lack of
financial resources has a negative impact on
prevention of illness, compliance with treatment,
and motivation to learn, focus is on day-to-day
survival.
IMPACT OF ILLNESS ON SOCIOECONOMICS: The
cost of medical care and supplies can negatively
impact a person’s/family’s financial well-being,
especially if socioeconomic level is already low.
CULTURAL CHARACTERISTICS
ACCULTURATION: A willingness to modify one’s
own culture as a result of contact with another
culture on headline. Adopt a new culture but not
forgetting your own culture.
ASSIMILATION: The willingness of a person
emigrating to a new culture to gradually adopt and
incorporate characteristics of the prevailing
culture. Adopt new culture and loosing your own
culture identity.
CULTURAL AWARENESS: recognizing and
appreciating “the external signs of diversity” in
other ethnic groups, such as their art, music, dress,
and physical features
CULTURAL COMPETENCE: a conscious process of
demonstrating knowledge and understanding of a
client’s culture so as to recognize, accept, and
respect their cultural differences and to be able to
INCORPORATE these cultural beliefs and practices
about wellness, and illness into the delivery of care
by adopting interventions to be congruent with the
client’s culture.
CULTURAL DIVERSITY: a term meaning
“representing a variety of different cultures”
CULTURAL RELATIVISIM: implies that “the values
every human group assigns to its conversions arise
out of its own historical background and can be
understood only in the light of that background.
CULTURE: a complex concept that is an integral
part of each person’s life and includes knowledge,
beliefs, values, morals, customs, traditions , and
habits acquired by each person as a member of
society. PURNELL & PAULANKA define cult as the “
totality of socially transmitted behavioral patterns,
arts, beliefs, values, customs, life ways, and all
other products of human work.
ETHNIC GROUP: referred to as a subculture; a
population of people who have experiences
different from those dominant culture.
ETHNOCENTRISM: a concept describing “ the
universal tendency of human beings to think that
heir ways of thinking, acting , and believing are the
only right, proper, and natural ways.
IDEOLOGY: the thought, attitudes, and beliefs that
reflect the social needs and desires of an individual
or ethnocultural group.
SUBCULTURE: ethnocultural groups of people “
who have experiences different from those of the
dominant culture by virtue of status, ethnic
background, residence, religion, education or other
factors that functionally unify the group and act
collectively on each member with a conscious
awareness of these differences.
TRANSCULTURAL: making comparisons for the
similarities and the differences between cultures.
WORLDVIEW: the way individuals or groups of
people look at the universe to form values about
their lives and the world around them.
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Assessment models: Purnell model for cultural
competence
CULTURE
Primary characteristics: nationality, race, color,
gender, age, religious affiliation.
Secondary characteristics: SES, physic,a
characteristics, educational status, occupational
status, place of residence
Session 11
The four major subcultural ethic groups
These groups total approximately 1/3 of the US population.
 Black/African American
 Hispanic/Latino
 Asian/Pacific Islander
 American Indian/Alaskan Native
HISPANIC/LATINO CULTURE
 Largest, fastest growing subculture
 Less likely to receive preventive care, often lack
health insurance, less health care access.
 Economically disadvantages.
 Strong family ties.
 Much information obtained from mass media.
 Spanish or English may be primary language.
 Categorize disease into “hot” and “cold”, magical
origin, emotional origin, folk-defined, or “standard
scientific”.
Teaching Strategies
A. Identify subgroup (Mexican, Cuban, Puerto
Rican)
B. Consider age, primary language, and
educational level, income level, job status, and
degree of acculturation.
C. Encourage involvement in teaching/ learning.
D. Provide space for extended family.
E. Incorporate religious beliefs into plan.
F. Display warmth, friendliness, tact.
BLACK/AFRICAN AMERICAN CULTURE
 Second largest ethnic group.
 Some believe in voodoo, witchcraft.
 Some believe all animate and inanimate objects
have good or evil spirits.
 Some use folk remedies.
 Strong religious values.
 Disadvantaged due to poverty and lack of education.
 Extended family important and elders hold highest
respect.
 Many acculturated into American “way of life”.
Teaching strategies
A. Any folk practices or religious beliefs should be
respected and allowed (if not harmful), and
incorporated into the recommended treatment.
ASIAN/ PACIFIC ISLANDER CULTURE
 Blend of four Philosophers: BUDDHISM,
CONFUCIANISM, TAOISM, PHI
 Major barriers to health care are language, cultural
beliefs, health literacy, health insurance, and
immigrant status.
 PATRIARCHAL: Male authority and dominance.
 “saving face”(conduct as a result of a sense of
pride).
  Strong family ties.
 Respect for parents, elders, teachers, and other
authority figures.
Teaching Strategies
A. Friendly, nonthreatening approach.
B. Give permission to ask questions.
C. Consider language barriers.
D. Learning style is passive.
E. Learning repetition and rote memorization.
F. Family members, especially males, needed to make
decisions.
G. Need assurance.
H. Ask questions in different ways to assure
understanding.
AMERICAN INDIAN/ALSKAN NATIVE
 Spiritual attachment to the land.
 Intimacy of religion and medicine.
 Strong ties to family/tribe.
 View children as an asset, not a liability
 Believe supernatural power exist in animate and
inanimate objects.
 Avoid acculturation.
 Lack materialism, time consciousness, and desire to
share with others.
 Believe witchcraft is cause of illness.
 Some tribes incorporate shaman and ceremonies
into healing.
 Do not feel they have control over their destiny.
 Believe that looking into another’s eyes reveals and
may steal someone’s soul.
Teaching Strategies
A. Focus on giving information about diseases about
risk factors.
B. Emphasize teaching of skills related to changes in
diet and exercise.
C. Help client build positive coping mechanisms for
emotional problem.
D. Consider each tribe’s unique customs and language.
LESBIAN, GAY, BISEXUAL, TRANSGENDER, QUEER,
QUESTIONING, INTERSEX, OR ASEXUAL.
PREPARING NURSES FOR DIVERSITY
1. STRENGTHEN MULTICULTURAL PERSPECTIVE IN
NURSING CURRICULA
2. IMPROVE RELATIONSHIP BETWEEN NURSES AND
CLIENTS FROM DIFFERENT CULTURAL
BACKGROUNDS.
3. INCREASE MINORITY REPRESENTATION IN NURSING
STEREOTYPING:
o Nurse educators must relate to each person as an
individual.
o Use neutral language when teaching.
o Confront bias by other healthcare professionals.
o Request information equally from clients regardless
of gender, socioeconomic status, age, culture.
o Keep instructional materials free of stereotypical
terminology and expressions.
o Be a role model of equality
o Treat all clients with fairness, respect and dignity.
o Do not let appearance influence expectations of
quality care.
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o Be knowledgeable of the cultural traditions of
various group.
Assess educational backgrounds, attributes, and economic
resources to ensure appropriate teaching.
Session 12
Scope of the problem
 15% of the people worldwide live with a disability
 Approximately 1 in 5 Americans have a disability; almost
half are severe. Many are limited in ability to work but
not all disabilities are readily visible.
 Individuals with disabilities are more likely than those
without them to
 Have more illnesses and greater health needs.
 Be less likely to receive preventive health care and
other social services.
 Be more likely to suffer from poverty.
 Some disabilities are associated with additional chronic
health problems.
 Other health disparity factors:
 Fear
 Lack of understanding
 Physical barriers
 Cost
MORAL MODEL
 Views disabilities as SIN
 old model that persist in some cultures
 Individuals and their families may
experience guilt, shame, denial of care.
 United Nations established standard rules
on the Equalization of the opportunities
for Person with Disabilities specifying
fundamental right of access to care.
MEDICAL MODEL
 The belief that people with disabilities
must be “cured” has been criticized by
advocates.
 Medical model: disability as
DEFECT/SICKNESS.
REHABILITATION MODEL
 disability as DEFICIENCY
DISABILITY (SOCIAL) MODEL
 Most influential on current thinking.
 Embraces disability as a normal part of life
 Views social discrimination, rather than
the disability itself, as the problem.
Disability
 “A complex phenomenon, reflecting n
interaction between features of a person’s
body and features and features of the society
in which are he or she lives” (WHO)
 U.S Social Security Administration defines
disability in terms of an individual’s ability to
work.
AMERICANS WITH DISABILITIES ACT (ADA)
 Enacted in 1990, this legislation has extended
civil rights protection to millions of Americans
who are disabled.
 In January 1992, it was mandated the
accessibility to public accommodation.( 20%
discount to any public transportation,
 In July 1992, it requires employer to hire
people, with disabilities.
 The ADA defines disability as a physical or
mental impairment that substantially limits
one or more of the major life activities of the
individual.
The Language of Disabilities
 Since late 1970s, disabilities advocates and the
government have encouraged PEOPLE or
PERSON- FIRST LANGUAGE, which puts the
person before the disability in writing and
speech.
 Recently, has become controversial because
some prefer IDENTITY-FIRST LANGUAGE, which
affirms what they see as identity
characteristics.
Guidelines
 Try to determine preference when writing
about a group.
 Do not confuse disability with disease.
 Unless one format is accepted by an entire
group, avoid suing one format exclusively.
 Do not are assumptions.
ADDITIONAL CONSIDERATIONS
 Use of “Congenital disability” , not “ birth
defect”.
 Avoid terms with negative connotations such
as “ Invalid” or “ Mentally retarded”
 Speak of the needs of people with disabilities
rather than their problems.
 Avoid phrases like “ suffers from” , “victim of”
 When comparing groups, avoid phrases such
as “normal or “ able bodied”
Roles and Responsibilities of nurse Educators
1. Focus on wellness and strength of the
individuals, not weaknesses.
2. HABILITATION: Teaching skills to maintain or
restore health and maintain independence.
3. REHABILITATION: teaching skills to relearn or
restore skills lost through illness or injury.
4. Carefully assess the degree to which families
can and should be involved.
5. Interdisciplinary team effort is often required.
6. Nurse should serve as mentor to patient and
family in coordinating and facilitating
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multidisciplinary services.
7. Assessment always done before teaching.
Session 13
Types of Disabilities
Sensory Disabilities: Hearing Impairment
 Total or partial auditory loss, etiology related
to either a conduction or sensory- neural
problem.
 Incidence increase with age
 Hearing loss described by type, degree and
configuration
 Types of hearing loss
 Conductive: usually correctable, loss in
ability to hear faint noises.
 Sensorinerual: permanent, damage to
cochlea or nerve pathways.
 Mixed
Modes of Communication to Facilitate Teaching/
Learning:
 Use natural speech patterns: do not over
articulate.
 Use simple sentences and a moderate pace.
 Get clients attention with a light touch on arm
 Face the client: stand no more than six feet
away
 Minimize the environmental noise
 Make sure hearing aid is turned on
 Avoid standing in front of bright light, which
obscures your face.
 Minimize motions of your head while
speaking.
 Refrain from placing IV in hand client needs for
sign language.
Sensory Deficits: Visual Impairments
 Over 23 million Americans are blind or visually
impaired.
 Etiology: infection trauma, poisoning,
congenital condition, degeneration.
 Common Healthcare barriers encountered
1. Lack of respect
2. Communication problems
3. Physical barriers
4. Information barriers
 Common Eye Diseases of Aging
a. Macular Degeneration
b. Cataracts
c. Glaucoma
d. Diabetic retinopathy
Sensory Deficits: Visual Impairments Teaching
Guidelines
 ① Assess patients to avoid making needs
assumptions
② Speak directly to patients rather than to
sighted companions
③ Secure services of a low-vision specialist
to obtain adaptive optical devices
④ Avoid the tendency to shout
⑤ Use non-verbal cues
⑥ Always announce your presence and
identify yourself.
⑦ Allow the client to touch, handles, and
manipulate equipment.
⑧ Be descriptive in explaining procedures
⑨ Use large font size for printed or
handwritten materials.
⑩ Use bold color or rely on black and white
for printed materials
⑪ use alternative instructional tools that
stimulate auditory and tactile senses.
⑫ Use proper lining
⑬ Provide large- print watches and clocks.
⑭ Use audiotapes and cassette recorders.
⑮ Computer features
⑯ Screen magnifiers, high contrast, screen-
resolution features
⑰ Text-to - speech converters
⑱ Braille keyboards, displays and ringers
⑲ Sighted guide technique
LEARNING DISABILITIES
 Heterogenous group of disorders of listening,
speaking, reading, written, reasoning, or
mathematical abilities.
 Approximately 20% of the American
population is affected
 The majority have language, integrative
processing, or memory deficits.
 Varied and often unclear causes
 Most individuals have normal or superior
intelligence
 Disorder include:
 Dyslexia
 Auditory processing disorders
 Dyscalculia
Teaching Guidelines
 Eliminate distractions: provide a quiet
environment
 Conduct an individualized assessment to
determine how client learns best.
 Adapt teaching methods and tools to client’s
preferred learning style
 Ask questions of parents bout accommodation
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needed if client is a child.
 Use repetition to reinforce messages
 Ask client to repeat or demonstrate what was
learned to clear up any possible
misconceptions
 Ask client to repeat or demonstrate what was
learned to clear up any possible
misconceptions,
 Use brief but frequent teaching sessions to
increase retention and recall information
 Encourage client’s active participation.
Session 14: Behavioral Objectives and Teaching
Plans (part 1)
Goal: The final outcome to be achieved at the end
of the teaching and learning process.
Objective: a specific, single, concrete, one-
dimensional behavior that should be achieved at
the end of one or a few teaching sessions.
Sub-objective: specific statements that reflect
aspects of a main objective.
Both goals and objectives are needed in order to
accomplish something.
 Objectives must be achieved before goal can
be reached
 Objectives must be observable, measurable.
 Objectives must be consistent with, related
with to the goal.
Goals and Objectives: Establishment
 Must be a mutual decision between the
teacher and the learner.
 Both parties must participate in the decision-
making process and “buy into” the immediate
objective and ultimate goal.
 Blending what the learner wants to learn and
what the teacher has assessed the learner
needs to know provide for a mutual
accountable, respectful, and fulfilling
educational experience.
 Must be clearly written, realistic, learner
centered.
 Must be directed to what learner is expected
to able to do.
The Importance of Using Behavioral Objectives
 Keeps teaching learner-centered
 Communicate plan to others
 Helps learner stay on track
 Organizes educational approach
 Ensures that process is deliberate
 Tailors teaching to learner’s needs
 Creates guides for teacher evaluation
 Focuses attention on learner
 Orients teacher and learner to outcomes
 Helps learner visualize skills
 Other advantages to writing clear objectives.
 Provides basis for selection or design of
instructional content, methods, and
materials.
 Provides learner with ways to organize
efforts to reach their goals
 Helps determine whether an objective has
been met.
Writing Behavioral Objectives and Goals
Three Important Characteristics:
Performance: describes what the learner is
expected to able to do.
Condition: describe the situation under which the
expected behavior will be observed.
Criterion: Describes how well or with wt accuracy
the learner must be able to perform to competent.
Writing Behavioral Objectives and Goals: the
ABCD Rule
A- Audience (who)
B- Behavior (what)
C- Condition ( under which circumstances)
D- Degree ( how well, to what extend, within what
time frame)
Writing Behavioral Objectives and Goals: The
Four-Part Method
1. Identify the circumstances or testing situation
(condition).
2. Identify who the learner is (audience).
3. State what the learner will perform (behavior).
4. State what the criterion reflecting quality or
quantity of mastery is (degree).
Common Mistakes When Writing Objectives
 Describing what the instructor will do rather
than what the learner will do.
 Including multiple behaviors per objective
 Forgetting to include all four components of
condition, performance, criterion, and how the
learner is.
 Using terms for performance that have many
interpretations, are not action-oriented, and
are difficult to measure.
 Writing an unattainable, unrealistic objective.
 Writing objectives unrelated to stated goal
 Cluttering an objective with unnecessary
information
 Making an objective too genera, so that the
outcome is not clear.
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 Writing SMART objectives:
Specific about what is to be achieved
Measurable by quantifying or qualifying objectives
Achievable, attainable objectives
Realistic by considering available resources
Timely by stating when the objectives will be
achieved.
Session 15: Behavioral Objectives and Teaching
Plans (part 2)
Behavior is defined according to type (Domain
Category), and level of complexity (simple to
complex).
Three types of Learning Domains
(Interdependent)
1. Cognitive— the “thinking” domain
2. Affective—- the “feeling” domain
3. Psychomotor—- the “going/skills” domain
Complexity of Domain Levels
Hierarchy from low (most simple), to medium
(moderately difficult) , and to high (most complex)
levels of behavior
Cognitive levels
Knowledge———> Evaluation
Affective Levels
Listening——-> displaying commitment and
willingness to revise judgment
Psychomotor
Perception————> Origination
Taxonomy of Educational Objectives. Familiarity
known as Bloom’s Taxonomy, this framework has
been applied by generations of K-12 teachers and
college instructors in their teaching.
The framework elaborated by Bloom and his
collaborators consisted of six categories:
Knowledge, Comprehension, Application,
Analysis, Synthesis, and Evaluation.
Teaching Guidelines: Cognitive Domain
Learning involves acquisition of information
based on the learner’s intellectual abilities,
mental capacities, understanding, and thinking
processes.
Six Level of Objectives
Methods most often used to stimulate learning in
the cognitive domain include:
1. Lecture
2. Group discussion
3. One-to-one instruction
4. Self instruction (e.g., computer-assisted)
Cognitive-Domain learning is the trade focus of
most teaching.
Cognitive knowledge is an essential for learning
affective and psychomotor skills.