Health Education

Historical
Background of
Health Education
CREDIT UNITS: 3 UNITS
LECTURE
Grading System:
Quizzes
Attendance
Recitation Prelim Examination
Assignments Midterm Examination
Final Examination
LEARNING OUTCOME
After the discussion the students will be able to:
1. Discuss the historical development of health education

and its implication to
nursing profession.
2. Differentiate the Key responsibility of the Nurse Educator
3. State the difference of Nursing Process and Education
Process
4. Identify The role of the nurse educator in staff and Patient
Education
INTRODUCTION
The WHO define Health Education as:

"comprising of consciously constructed opportunities
for learning involving some form of communication
designed to improve health literacy, including
improving knowledge, and developing life skills which
are conducive to individual and community health."
Overview of Health Education
The recent developments in the field of health care have
served
. to highlight the important role of education in
“helping the patients and their families assume responsibility
for self-care management”.
With the current third-party payor system, nurses are
expected to be the prime movers in delivering high quality,
effective and efficient nursing care which will result to shorter
hospital confinement and continuation of recovery and
rehabilitation through home care and or community-based
nursing care.
Historical accounts revealed that people of the ancient
world were so concerned about their health/ in the past,
ancient Greek estates observed sports competitions in
honor of their gods and goddesses. The competitors had
to undergo rigorous physical and mental trainings in
order to win. This could have been true since the early
greeks believed in what Plato had envisioned about
health – a sound mind in a sound body; for the good of
the soul.
Historical Development of Health Education
1900 1918 1970
. National League . of Nursing Education .

(NLNE) in US recognized the AHA established the rights of
Public health nurses in this country responsibility of nurses for the promotion patients to receive complete
clearly understood the significance of of health and the prevention of illness in and current information
education in the prevention of disease such settings as schools, homes, hospitals, concerning diagnosis,
and in the maintenance of health and industries. treatment,
1993 1995
Pew Health Professions Commission, influenced by the

JCAHO. These standards, which take dramatic changes currently surrounding health care,
the form of mandates, are based on published a broad set of competencies that it believes
descriptions of positive outcomes of will mark the success of the health professions in the
patient care. twenty-first century.
ØJoint Commission on Accreditation of Healthcare
Organization – mission is to continuously improve health
care for the public, in collaboration with the stakeholders, by
evaluating health care organizations and inspiring them to
excel in providing safe and effective care of the highest
quality and value.
ØAmerican Hospital Association - to advance the health
of all individuals and communities. The AHA leads, represents
and serves hospitals, health systems and other related
organizations that are accountable to communities and
committed to equitable care and health improvement for all.
ØPew Health Professions Commission – charged with
assisting health professionals, workforce policy makers, and
educational institutions in responding to the challenges of
the changing health care system.
Overview in the Philippines
ØAlbularyo – derived from the word
“herbolario”, a Spanish word meaning
herbalist.
ØArbularyo – another variation of the word, a
misspelling often brought about by
mispronunciation and is technically incorrect.
Ø“Albularyo” or what we call a witch doctor
usually call the spirit of the dead and tries to
remove them from the face of the earth, they
also use herbal medicine; as well as “ gayuma”.
ØDuring the pre-Hispanic period, the function of an albularyo
was fulfilled by the Babaylan, a shamanic spiritual leader of
the community.
ØAt the beginning of the Spanish Era in the late 16th and early
17th centuries, the suppression of the Babaylans and native
Filipino animist beliefs gave rise to the albularyo. By
exchanging the native pagan prayers and spells with Catholic
oraciones and prayers, the albularyo was able to syncretize
the ancient mode of healing with the new religion.
ØAs time progressed, the albularyo became a more prominent figure
in most rural areas in the Philippines. Lacking access to scientific
medical practices, rural Filipinos trusted the albularyos to rid them
of common (and sometimes believed to be supernatural) sickness
and diseases.
ØHowever, the albularyo’s role was slowly shadowed with the rise of
modern medical facilities. Urbanization gave the masses access to
more scientific treatments, exchanging the chants and herbs with
the newer technologies.
ØStill, albularyos flourish in many rural areas in the Philippines where
medical facilities are still expensive and sometimes inaccessible.
OVERVIEW OF HE IN THE PHILIPPINES
• In 1990s, the Philippines entered as a modernizing society.

The health conditions in the Philippines would have
improved a lot,
• Filipino doctors opted to stay in the country leaving only a
few doctors attending to the needs of the large population
in the country.
• This explains the high cost of medication in the country,
forcing some Filipinos to consult faith healers, witch
doctors or self-declared physicians who charge less
OVERVIEW IN THE PHILIPPINES
• In 1993, the Department of Health launched its
Hospitals as Centers for Wellness program. It
assigned each hospital a health education and
promotion officer.
• In 2010, programs are geared toward managing the
major health issues that affect the country.
• There is a need to be a continuity of the helath
programs and education so the public are better
informed and aware of their health status
OVERVIEW IN THE PHILIPPINES
• While the public health system was decentralized to
local governments, this only led to inequitable
distribution of health services.
• Poor municipalities could hardly deliver health
services and education as efficiently as urban cities
do.
• It must be noted that the national government is
showing efforts to make efficient health services and
health education available to as many Filipino
Tracing the history of health education to ancient times,
Rubinson and Alles (1984) concluded that the health
education profession has been helping people for a very long
time now.
A health educator is “a professionally prepared individual

who serves in a variety of roles and is specially trained to
use appropriate educational strategies and methods to
facilitate the development of policies, procedures,
interventions, and systems conducive to the health of
individuals, groups, and communities”.
HEALTH EDUCATION SPECIALIST
ØAlso called Health Educators
ØEducate people about behaviors that promote wellness.
ØThey serve their community in a variety of ways, using health-
focused strategies to improve the well-being of their community
members.
ØHealth education specialists work with individuals, families, and
communities, as well as public and private organizations to create,
implement, oversee, and analyze programs and strategies that
promote health and well-being.
7 KEY AREAS OF RESPONSIBILITY
1.Assessing the individual and family community

needs for education
• Provides the foundation of program planning
• Determine what health problems might exist in
nay age groups
a
• Includes determination of community resources
available to address the problem
2. PLAN HEALTH EDUCATION STRATEGIES
INTERVENTIONS AND PROGRAMS BASED ON
NEEDS ASSESSMENT
• Development of goals and objective which are specific and measurable
• Interventions are develop to meet the goals
• According to rule of sufficiency , strategies are implemented which are
sufficiently robust, effective enough and have reasonable chance of
meeting the stated objectives
3 .PLAN HEALTH EDUCATION STRATEGIES
INTERVENTIONS AND PROGRAMS BASED ON PRIORITY
POPULATION
• Implementation is based on a thorough understanding of

the priority populations
• Utilize a wide range of educational methods and
strategies
4. CONDUCT EVALUATION AND RESEARCH R/T
HEALTH EDUCATION
• Health Educators utilizes research to improve the

practice
• Depending on the setting, utilizes test, surveys,
observations, tracking of epidemiological data and
other methods of data collection
5.ADMINISTER HEALTH EDUCATION
STRATEGIES, INTERVENTIONS AND PROGRAMS
• Administration is generally a function done by

experience practitioner
• Involves facilitating cooperation among personnel
both within and between programs
6. SERVES AS HEALTH EDUCATION RESOURCE
PERSON
• Involves skills to access needed resources and establish
effective consultative relationships
7. Advocate for health and Health Education

• Advocate the profession of Health Education
• Translate scientific knowledge in under stable
information
• Address audience diverse in diverse setting
Five Areas of Responsibility of Health Education
Planning .
Resource Person
Implementation
Advocate
Evaluation and Research
PLANNING
ØIncludes plans of health activities in different settings using
appropriate instructional materials involving well and sick client
across the ages and considering their health beliefs and practices.
ØInvolves the development of goals and objectives which are specific
and measurable.
ØInterventions are developed that will meet the goals and
objectives.
ØAccording to the Rule of Sufficiency, strategies are implemented
which are sufficiently robust, effective enough, and have a
reasonable chance of meeting stated objectives.
PLANNING
ØOnce you have identified the health needs of
your community and how best to communicate
health knowledge, you have to put together a
plan. You’ll want to consider budgets, the
attitudes of stakeholders, timelines, government
regulations, and overall feasibility. Your goal is to
overcome existing obstacles to reach as many
people in your community as possible.
IMPLEMENTATION
ØIncludes use of age appropriate strategies, intervention, and

programs
ØImplementation is based on a thorough understanding of the
priority population.
ØUtilize a wide range of educational methods and techniques.
IMPLEMENTATION
ØAfter putting in the work to develop a strong program, you can
then go out into your community and provide the education the
community needs to improve its overall health and address health-
related needs of the community. This phase can be highly rewarding
as you will develop practitioner skills by working with various
populations and applying behavior change principles. Monitoring
program effectiveness and managing its execution are required
tools to implement a successful health promotion intervention
and/or program.
EVALUATION AND RESEARCH
ØA continuous practice that improves and innovates nursing

practice.
ØDepending on the setting, utilize tests, surveys, observations,
tracking epidemiological data, or other methods of data collection
ØHealth Educators make use of research to improve their practices.
EVALUATION AND RESEARCH
ØAs a health educator, your responsibilities extend beyond the
implementation of a health education or promotion program. You
must also be able to evaluate your program as well as any other
programs, projects, or policies you’re involved in. This means you
must understand proper evaluation methodology and have realistic,
measurable objectives. You can use tests, surveys, observation,
medical data, and other facts and figures to conduct an evaluation.
Once the evaluation is complete, you are expected to share the
results with the wider heath education and promotion community
to help improve future efforts.
RESOURCE PERSON
ØProvides up-to-date information to patient, family members, and

colleagues in the profession.
ØInvolves skills to access needed resources, and establish effective
consultative relationship.
RESOURCE PERSON
ØAs a health educator, you’re expected to make yourself available to
answer community health questions and help that community
understand and address health concerns. As such, you need to
know where to find accurate health information, how to assess the
appropriateness of that information for your community, and how
to successfully communicate that information.
ADVOCATE
ØProtects the welfare of the patient when needed.
ØTranslates scientific language into understandable information
ØAddress diverse audience in diverse settings
ØFormulates and support rules, policies and legislation
ØAdvocate for the profession of health education
ADVOCATE
ØNot everyone understands the importance of health educators or
the role they can play in improving local, national, and global health.
As a health educator, you have the responsibility to support and
promote the profession to others and to work with those in your
profession to maintain standards and achieve health education and
promotion goals.
Historical Development of Health Education
The teaching function will always be an integral part of the duties of

a professional nurse.
Nurse Practice Acts (NPAs) in the US universally include teaching

within the scope of nursing practice responsibilities
In 1993, the Joint Commission on Accreditation of Healthcare Organization

(JCAHO) delineated nursing standards or mandates for patient education
which are based on positive outcomes for patient care.
04
Evolution of the teaching role of the Nurse
Educating
Teaching as function their colleagues
within the scope of
nursing practice
Training the Clinical Instructor

trainer
Education Process
Education process Teaching/ Instruction
It is a systematic, sequential, planned course Teaching is a deliberate intervention that

of action consisting of two major involves the planning and implementation of
interdependent operations, teaching and instructional activities and experiences to
learning. meet intended learner outcomes according
This process forms a continuous cycle that to a teaching plan.
also involves two interdependent
players, the teacher and the learner, jointly Instruction is a component of teaching that
perform teaching and learning involves the communicating of information
activities, the outcome of which leads to about a specific skill in the cognitive,
mutually desired behavior changes. psychomotor, or affective
domain.
Difference of Nursing Process and Education Process
NURSING PROCESS EDUCATION PROCESS
.
Appraise physical and psychosocial ASSESSMENT Ascertain learning needs, readiness to .
needs learn and learning styles
Develop care plan based on mutual goal PLANNING Develop teaching plan based on
setting to meet individual needs. mutually predetermined behavioral
outcomes to meet individual needs
Carry out nursing care interventions IMPLEMENTATION Perform the act of teaching using
using standard procedures specific teaching methods and
instructional materials
Determine behavioral changes

Determine physical and EVALUATION
(outcomes) in knowledge, attitudes, .
psychosocial outcomes
and skills
Learning is defined as a change Patient Education
in behavior to includes skills, According to Freidman et al
knowledge and behavior (2011). It is a set of
It is can be observed and planned educational
measured at any time or in activities using a
any place as a result of combination of method
exposure to environmental (teaching, counseling to
stimuli improve behavior
modification) to improve
patients knowledge and
health behaviors
PATIENT EDUCATION
ØPatient Education is a significant part of a nurse’s job.

ØEducation empowers patients to improve their health status.
ØWhen patients are involved in their care, they are more likely to
engage in interventions that may increase their chances for
positive outcomes.
BENEFITS OF PATIENT EDUCATION
ØPrevention of medical conditions such as obesity, diabetes or heart
disease.
ØPatients who are informed about what to expect during a
procedure and throughout the recovery process.
ØDecreasing the possibility of complications by teaching patients
about medications, lifestyle modifications and self-monitoring
devices like a glucose meter or blood pressure monitor.
ØReduction in the number of patients readmitted to the hospital.
ØRetaining independence by learning self-sufficiency.
NURSE’S ROLE IN PATIENT EDUCATION
ØEffective patient education starts from the time patients are
admitted to the hospital and continues until they are discharged.
ØNurses should take advantages of any opportunities throughout a
patient’s stay to teach the patient about self-care.
ØWithout a proper education, a patient may go home and resume
unhealthy habits or ignore the management of their medical
condition. Actions that may lead to a relapse and a return to the
hospital.
Key Points in Patient Education
ØSelf-care steps they need to take.

ØWhy they need to maintain self-care.
ØHow to recognize warning signs.
ØWhat to do if a problem occurs.
ØWho to contact if they have questions.
Ensure Patient Comprehension
ØCommon words and phrases

ØReading materials written at a sixth-grade level
ØVideo
ØAudio
How are patients different?
ØWhat level of education do they have?
ØCan they read and comprehend directions for medications,
diet, procedures and treatments?
ØWhat is the best teaching method? Reading, viewing or
participating in a demonstration?
ØWhat language does the patient speak?
ØDoes the patient want basic information or in-depth
instruction?
ØHow well does the patient see and hear?
ASSURE MODEL
The Assure model is a
paradigm to assist nurses to Ob
80%
carry out and organize and 05
Education Process 27
04 Evaluate/revise the teaching and
learning process.
03 Requires learner performance.
02 Use Teaching materials
01
Select instructional materials and tools
State the objectives
Analyze the learner

The Role of Nurse Educator in Staff and Patient Education
Provide for prevention of Expand public Involve patients and their

illness and promotion of access to effective families in the decision making
healthy lifestyles care regarding health
interventions
06 05 04 03 02 01
Provide clients with Provide clinically

Ensure cost effective and competent and
education. and coun-
appropriate care coordinated care to
seling on ethical issues
for the consumer
. the public
The Benefits of Effective Patient Education
.
Increase consumer satisfaction
Promote adherence to
healthcare treatment plans
Improve quality of life
Effectively reduce the incidence

Ensure continuity of care
of complications of illness
Decrease patient anxiety

TRADITIONAL TEACHING STRATEGIES
ØCooperative Learning – students from one class are
arranged into small groups. Based on the premise that
learners help each other work and think together and are
responsible for not only their own learning but also for the
learning of other group members.
ØAdvantage: group members learn to function as part of a
team; teaches or enhances social skills; includes the spirit
of team-building
ØDisadvantage: students who are fast learners may lag
behind
ØWriting to learn – influences students’ disposition
toward thinking and takes active participation in learning.
Writing serves as a stimulus of critical thinking by
immersing students in the subject matter for cognitive
utilization of knowledge and effective internalization of
values and beliefs.
ØConcept-mapping – leads visual assistance to students
when asked to demonstrate their thinking in a graphic
manner to show interconnectedness of concepts or ideas.
ØDebate – a strategy that foster critical thinking which
requires in-depth recall of topics for supporting evidence
and for developing one’s position in a controversial issue.
ØSimulation – practical exercises for the students
representing controlled manipulation of reality
ØSimulation Exercise
ØSimulation Game
ØRole-playing
ØCase Study
ØProblem-based Learning – an approach to learning that
involves confronting students with real life problems which
they are meant to solve by their own.
ØSelf-learning Modules – completely doing away with
traditional instruction. The student is provided with the
materials needed for the learning process without the
intervention of the teacher.
Introduction & instructions Learning activities
Behavioral objectives Self-evaluation
Pretest Post-test
COMPUTER TEACHING STRATEGIES
ØComputer Assisted Instructions – used to communicate
information to students and nurses in a time-saving way and
to teach critical thinking and problem-solving process
ØInternet – a worldwide and publicly accessible series of
interconnected computer networks that transmit data by
packet switching using the standard Internet Protocol (IP)
ØVirtual Reality – a technology which allows the nurse to
interact with a computer-simulated environment, real or
imagined.
COMPUTER TEACHING STRATEGIES
ØDistance Learning – this method includes computer

learning and other ways of giving instructions to students
without the usual classroom setting, such as
teleconferencing or use of telephone techniques.
CLINICAL TEACHING
ØTo improve and maintain a high standard of clinical
instruction, the teacher in nursing should show academic
excellence and clinical expertise, as well as concern and
commitment to the nursing profession.
ØThe future of nursing student rests on the qualifications
and competence of the nursing instructors.
CLINICAL TEACHING
1. Assess learning needs of students by pre-
testing for incoming knowledge.
2. Develop learning experiences based on desired
results.
3. Implement teaching strategies to meet learning
needs.
4. Post-test students for outcome knowledge.
SUPPLEMENTAL CLINICAL PRACTICES
ØRelated Learning Experiences (RLE) or Laboratory
ØModels of Clinical Teaching
ØTraditional Model – oldest and common model of clinical
teaching.
ØFaculty-directed Independent Experience Model – used
in community-based setting and to minimize the number
of students requiring direct faculty supervision in acute
or varied settings.
SUPPLEMENTAL CLINICAL PRACTICES
ØModels of Clinical Teaching
ØCollaborative Model – address the fiscal issue concerning cost
associated with clinical instruction when student-faculty ratio is
very high. Hospital staff and clinical faculty share nursing
practice. Hospital staff and clinical faculty share the teaching
role.
ØPreceptor Model – are expert nurses in the clinical setting
works with the student on a one-on-one basis. Preceptors are
staff nurses employed by the clinical agency who can provide
onsite clinical instructions for assigned students.
Learning Theories Related
to Health Care
Learning Outcome
After the discussion students will be able to:
1. Define the principal constructs of each learning theory

2. Identify the differences in the learning theories
3. Discuss examples oh how these theories could be use in a
given situation
Introduction
01 Learning is defined as a relatively permanent

change in mental processing, emotional
functioning, skill, and/or behavior as a result of
experience. It is the lifelong, dynamic process by
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which individuals acquire new knowledge or
skills and alter their thoughts, feelings, attitudes,
and actions
Learning enables individuals to adapt to demands and
01 changing circumstances and is crucial in health care.
• For patients and families to improve their health and

adjust to their medical conditions
• For students acquiring the information and skills
necessary to become a nurse
• For staff nurses devising more effective approaches
to educating and treating patients and one another in
partnership
A learning theory is a coherent framework of
01 integrated constructs and principles that describe,
explain, or predict how people learn.
The construction and testing of learning theories
over the past century contributed much to the
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understanding of how individuals acquire
knowledge and change their ways of thinking,
feeling, and behaving.
Behaviorist Learning Theory
• Focusing on what is directly observable
01
• Learning is the product of stimulus condition(S) and response(R)
• It is useful in nursing practice for the delivery of health care
• Respondent conditioning or Classical conditioning (Pavlov)

emphasizes the importance of stimulus conditions and the
association formed in the learning process.
Example: Respondent conditioning is used to extinguish
chemotherapy patient’s anticipatory nausea and vomiting
• Systematic desensitization is a technique based on respondent
conditioning that is used by psychologists to reduce fear and
01
anxiety in their clients
• The assumption is that fear of a particular stimulus or situation is
learned
• It can also be unlearned or extinguished
• With this approach, fearful individuals are first taught relaxation
techniques. While they are in a state of relaxation, the fear-
producing stimulus is gradually introduced at a nonthreatening
level so that anxiety and emotions are not aroused.
Respondent Conditioning Concepts
• Stimulus Generalization is the tendency of

initial learning experiences to be easily
applied to other stimuli
• Discrimination learning occur with one or

more varied experience, in which individual
learns to differentiate among similar stimuli
Classical Conditioning
• Discovered by Russian Physiologist Ivan Pavlov
01
• A type of unconscious or automatic learning; creates a
conditioned response through associations between an
unconditioned stimulus and a neutral stimulus.
• Although classical conditioning was not discovered by a

psychologist, it has had a tremendous influence over the school
of thought in psychology known as BEHAVIORISM.
• Behaviorism assumes that all learning occurs through
interactions with the environment and that environment shapes
behavior.
Unconditioned Stimulus is a stimulus or trigger that leads to an
01 automatic or involuntary response.
Unconditioned Response is an automatic response or a response

that occurs without thought when an unconditioned stimulus is present.
Conditioned Stimulus is a stimulus that was once neutral (didn’t

trigger a response) but now leads to a response.
Conditioned Response is the learned response or a response that is

created where no response existed before.
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Operant Conditioning(BF Skinner 1904-1990)
Operant Conditioning is a learning as a change in probability

of response.
Operant is a set of behavior that constitute an individual

doing something
It was coined by behaviorist B.F. Skinner. He believes that

internal thought and motivations could not be used to explain.
He suggested at the external observable causes of human

behavior.
Skinner used the term operant to any “ Active behavior that

operates upon the environment
Kind of Reinforcers
•01 Positive Reinforcers are favorable events or outcomes that

are presented after the behavior. A response or behavior
is strengthened by the addition of something as praise or
reward.
• Negative Reinforcers is the removal of unafavorable

events or outcomes after the display of a behaviour. A
response is strengthened by the removal of something
considered unpleasant
Punishment is the presentation of an adverse event or outcome
that cause a decrease in the behavior.
01
Positive punishment is a punishment by application, involve s

the presentation of an unfavorable event or outcome in order to
weaken the response
Negative Punishment is punishment by removal, occurs when
an favorable event or outcome is removed after a behavior
occurs.
Two methods to increase the probability of a response
• giving positive reinforcement (i.e., reward) greatly

enhances the likelihood that a response will be repeated in
similar circumstances.
• applying negative reinforcement after a response is made,
involves the removal of an unpleasant stimulus through
either escape conditioning or avoidance conditioning
• escape conditioning, as an unpleasant stimulus is being
applied, the individual responds in some way that causes
the uncomfortable stimulation to cease.
• avoidance conditioning, the unpleasant stimulus is
anticipated rather than being applied directly
Operant Conditioning
Advantages
• This theory is simple and easy to use.
•01 It encourages clear objective analysis of observable environment
stimulus conditions, learners’ responses and the effect of
reinforcement on people’s action
Disadvantages
• This is teacher centered model in which learners assume are
assumed to be relatively passive and easily manipulated
• It focuses on extrinsic reward and external incentives reinforces
and promotes materialism rather self-initiative.
• Based on animal studies, result not applicable to human behavior
• Clients changed behavior may deteriorate overtime.
Cognitive Learning Theory
The key to learning and changing is the individual’s cognition
01
(perception, thought, memory, and ways of processing and
structuring information).
• It is highly active process largely directed by the individual
• It involves perceiving the information
• Interpreting it based on what is already known
• Then reorganizing the information into new insights or
understanding
Cognitive learning theory includes several well-known
perspectives
Gestalt Information Processing Cognitive Development

• Emphasizes the importance • First Stage in memory process • A principal assumption is that
of perception to learning rather involve paying attention – key to learning is a developmental,
focusing on discrete stimuli learning sequential, and active process that
• Second Stage, the information is transpires as the child interacts
• Refers to patterned
process by the senses preferred with the environment, makes
organization of cognitive mode of sensory processing discoveries about how the world
elements reflecting the the (visual, auditory, motor operates, and interprets these
whole is the sum of its parts. manipulation) discoveries in keeping with what
• An assumption that a each • Third Stage of the memory she knows (schema).
person can perceive, interprets processes, the information is • Piaget’s theory of cognitive
and responds to nay situation in transformed and learning, children take in or
incorporated(coded) incorporate information as they
their own way.
• Last Stage is the action or interact with people and the
response that the individual environment. They either make
undertakes base don how their experiences fit with what they
information was processed and already know
encoded
The Implications
• 01 Nursing and other health professional education programs
would do well to exhibit and encourage empathy and
emotional intelligence in working with patients, family, and
staff and to attend to the dynamics of self-regulation as way
to promote positive personal growth and effective
leadership.
• Research indicates that the development of these attributes
in self and patients is associated with a greater likelihood of
healthy behavior, psychological well-being, optimism, and
meaningful social interactions
Benefits of Cognitive Theory
• 01 Boosts confidence
• Enhances Comprehension
• Improves problem-solving skills
• Encourage continuous learning

Social Learning Theory
01Social learning theory is largely based on the work
of Albert Bandura, who mapped out a perspective
on learning that includes consideration of the
personal characteristics of the learner, behavior
patterns, and the environment.
• Bandura emphasized behaviorist features and
the imitation of role models
• The learner has become viewed as central (what
Bandura calls a “human agency
Principles of Social Learning Theory
• Attentional phase, a necessary
condition for any learning to
occur.
• Retention phase, which involves
the storage and retrieval of what
was observed.
• Reproduction phase, during which
the learner copies the observed
behavior
• Motivational phase, which focuses
on whether the learner is
motivated to perform a certain
type of behavior.
The central concept of social learning theory
• Role Modeling, is a central concept of social learning

theory. To facilitate learning he emphasizes that role
models need to be enthusiastic, professionally organized,
caring, and self-confident, as well as knowledgeable,
skilled, and good communicators.
· Vicarious reinforcement involves determining whether role

models are perceived as rewarded or punished for their
behavior.. The model seen by the observer as rewarded or
punished may have a direct influence on learning.
Application of the Theory
· Social learning theory has been applied extensively to

the understanding of aggression (Bandura, 1973) and
psychological disorders, particularly in the context of
behavior modification (Bandura, 1969).
· It is also the theoretical foundation for the technique of

behavior modeling which is widely used in training
programs. In recent years, Bandura has focused his
work on the concept of self-efficacy in a variety of
contexts (e.g., Bandura, 1997).
Sigmund
Psychodynamic Learning Theory
Freud (1856–1939) is probably the most controversial
01
and misunderstood psychological theorist. When reading Freud’s
theories, it is important to remember that he was a medical doctor,
not a psychologist. There was no such thing as a degree in
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psychology at the time that he received his education, which can
help us understand some of the controversy over his theories
today. However, Freud was the first to systematically study and
theorize the workings of the unconscious mind in the manner that
we associate with modern psychology.
Psychodynamic Learning Theory
• It has significant implications for learning and changing

behavior based on the work of Sigmund Freud and
followers
• It is a Motivational theory that emphasizes on emotions
rather than cognition or responses. It emphasizes the
importance of conscious and unconscious forces in
guiding behavior , personality conflict and the enduring
effects of childhood experiences on adult behavior
• The most primitive source of motivation comes from the
id and is based on libidinal energy (the basic instincts,
impulses, and desires humans are born with).
Psychodynamic Theory: Topographic Model
01
To explain the concept of conscious versus unconscious experience,
Freud compared the mind to an iceberg. He said that only about one-
tenth of our mind is conscious, and the rest of our mind is unconscious.
Our unconscious refers to that mental activity of which we are unaware
and are unable to access (Freud, 1923). According to Freud, unacceptable
urges and desires are kept in our unconscious through a process called
repression.
Psychodynamic Theory: Topographic Model
For
01
example, we sometimes say things that we don’t intend to say by
unintentionally substituting another word for the one we meant. You’ve
probably heard of a Freudian slip, the term used to describe this. Freud
suggested that slips of the tongue are actually sexual or aggressive urges,
accidentally slipping out of our unconscious. Speech errors such as this
are quite common. Seeing them as a reflection of unconscious desires,
linguists today have found that slips of the tongue tend to occur when we
are tired, nervous, or not at our optimal level of cognitive functioning
(Motley, 2002).
believed that we are only aware of a small amount of our
FreudPsychodynamic Theory:
believed that we are only aware of Structural
a small amountModel
of our mind’s
activities
01 and that most of it remains hidden from us in our unconscious.
The information in our unconscious affects our behavior, although we are
unaware of it.
According to Freud, our personality develops from a conflict between

two forces: our biological aggressive and pleasure-seeking drives versus
our internal (socialized) control over these drives. Our personality is the
result of our efforts to balance these two competing forces. Freud
suggested that we can understand this by imagining three interacting
systems within our minds. He called them the id, ego, and superego
Psychodynamic Theory: Structural Model
01
01
The unconscious id contains our most primitive drives or urges, and is present
from birth. It directs impulses for hunger, thirst, and sex. Freud believed that
the id operates on what he called the “pleasure principle,” in which the id seeks
immediate gratification.
01
The superego develops as a child interacts with others, learning the social rules
for right and wrong. The superego acts as our conscience; it is our moral
compass that tells us how we should behave.
01
The ego is the rational part of our personality. It’s what Freud considered to be
the self, and it is the part of our personality that is seen by others. Its job is to
balance the demands of the id and superego in the context of reality; thus, it
operates on what Freud called the “reality principle.” The ego helps the id
satisfy its desires in a realistic way.
Psychodynamic Theory: DEFENSE MECHANISM
PsychodynamicTheory: DEFENSE MECHANISM
PsychodynamicTheory: Psychosexual Development
• Another central assumption of psychodynamic theory
is that personality development occurs in stages, is the
model of personality development by Erikson’s (1968)
• It has eight stages of life, with the model organized
around a psychosocial crisis to be resolved at each
stage.
• Determining the stage of personality development is
essential in health care when designing and carrying
out treatment regimens, communication, and health
education
Humanistic Theory
• Carl Rogers (1959) believed that humans have one basic motive, that is the
tendency
01 to self-actualize (e.g., to fulfill one’s potential and achieve the
highest level of human-beingness’ we can.
• An optimistic approach to human development and nature.
• Contrasts Freud’s approach in a way, but agrees with the Hierarchy of Needs
proposed by Maslow.
• Client Centered Therapy – clients were given a healthy and encouraging
environment and provided validation to grow themselves.
• For a person to grow, they need an environment that provides them with
acceptance and empathy.
Humanistic Learning Theory
• The Humanistic perspective on learning is the

assumption that every individual is unique and
that all individuals have a desire to grow in a
positive way
• The importance of emotions and feelings, the right
of the individual to make their own choices and
human creativity is the cornerstone of humanistic
approach to learning
• Abraham Maslow is the major contributor to
humanistic theory
Humanistic Theory
01
End
Principles of Teaching
and Learning in Health
Education
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Health education is a process concerned with

designing, implementing, and evaluating
educational programs that enable families,
groups, organizations, and communities in
achieving, protecting, and sustaining health,
-
prioritization
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Concept of Teaching
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Purposes
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Hallmarks of Good or Effective
Teaching in Nursing
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Professional Competence
3 years
● Teacher’s adherence to personal to
improve edu .
standard of excellence and self lisence

development.
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training , seminars
● Teacher should possess mastery of the

subject matter. personality
Patient care -
No room
for mistakes
Interpersonal Relationship
with Students
● Ability to relate well with students

● Sensitivity to their feelings and problems
● Respect for their rights scope of nursing practice
● Fairness in evaluating students
performance favoritism
x
Personal Characteristics
● Personal magnetism that motivates

students to learn, enthusiasm, self-control
and personal discipline in complying with
rules and standards.
● Patient, flexible, sense of humor and caring
attitude.-
Teaching Practices
● Ability and skill in utilizing appropriate

methods and techniques
Evaluation Practices
● Should have a clear communication of

expectancies.
● Timely feedback on student’s progress
● Correcting tactfully their errors
● Fairness in grading tests
Principles of Teaching and Learning
When the subject matter to be learned
possesses meaning, structure are clear to Students are motivated when they attempt
students learning proceeds rapidly tasks that fall in a range of challenge
Midterm Role
Playing Infomercial -
Finals
When students have knowledge of their

Readiness is a prerequisite for learning learning progress, performance will be
superior to what it
Behaviors that are reinforced (rewarded)

Students must be motivated to learn are more likely to be learned.
Principles of Teaching and Learning
Directed learning is more effective Supervised practice that is most

than undirected learning. effective occurs in a functional
education experience.
Problem-oriented approaches to To be most effective, reward

teaching improve learning. (reinforcement) must follow as
Students learn what they practice. immediately as possible
RLE -
Related Learning Experience
Students are motivated through their

involvement in setting goals and planning
learning activities
Principles of Good Teaching Practice
Practice Practice emphasizes time
communicates on task
high expectations
Respects diverse
talents and ways of encourages student-
learning faculty contact
gives prompt feedback encourages cooperation

among students
Encourages active
learning
1. Good Practice Encourages
Student-Faculty Contact
● Frequent student-faculty contact in and out of
classes is the most important factor in student
motivation and involvement. Faculty concern
helps students get through rough times and
keep on working. Knowing a few faculty
members well enhances students' intellectual
commitment and encourages them to think
about their own values and future plans.
2. Good Practice Encourages
Cooperation Among Students
● Learning is enhanced when it is more like a
team effort than a solo race. Good learning, like
good work, is collaborative and social, not
competitive and isolated. Working with others
often increases involvement in learning. Sharing
one's own ideas and responding to others'
reactions improves thinking and deepens
understanding.
3. Good Practice Encourages Active
Learning
● Learning is not a spectator sport. Students do
not learn much just sitting in classes listening to
teachers, memorizing prepackaged assignments,
and spitting out answers. They must talk about
what they are learning, write about it, relate it to
past experiences, and apply it to their daily lives.
They must make what they learn part of
themselves.
4. Good Practice Gives Prompt
Feedback
● Knowing what you know and don't know focuses
learning. Students need appropriate feedback on
performance to benefit from courses. In getting started,
students need help in assessing existing knowledge and
competence. In classes, students need frequent
opportunities to perform and receive suggestions for
improvement. At various points during college, and at
the end, students need chances to reflect on what they
have learned, what they still need to know, and how to
assess themselves.
5. Good Practice Emphasizes Time
on Task
● Time plus energy equals learning. There is no substitute
for time on task. Learning to use one's time well is
critical for students and professionals alike. Students
need help in learning effective time management.
Allocating realistic amounts of time means effective
learning for students and effective teaching for faculty.
How an institution defines time expectations for
students, faculty, administrators, and other professional
staff can establish the basis for high performance for all.
6. Good Practice Communicates
High Expectations
● Expect more from students and you will get it.
High expectations are important for everyone--
for the poorly prepared, for those unwilling to
exert themselves, and for the bright and well
motivated. Expecting students to perform well
becomes a self-fulfilling prophecy when teachers
and institutions hold high expectations for
themselves and make extra efforts.
7. Good Practice Respects Diverse
Talents and Ways of Learning
● There are many roads to learning. People bring different
talents and styles of learning to college. Brilliant
students in the seminar room may be all thumbs in the
lab or art studio. Students rich in hands-on experience
may not do so well with theory. Students need the
opportunity to show their talents and to learn in ways
that work for them. Then they can be pushed to learning
in new ways that do not come so easily.
Major barriers to teaching include
Lack
of
Lack of time
Low-priority
motivation status given
and skills
to teaching
Negative
influence of Lack of
environment confidence
and
competence
Absence of
third party
reimbursement Questionable
Documentation
effectiveness of
difficulties
client education
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Lack of
Literacy time Stress of
problem
illness
Negative Readiness
influence of
environment to learn
Extent of
needed
behavior Complexity,
changes Lack of support inconvenience
Denial of of health care
from health
professional
learning system
need
HEALTH
EDUCATION
PROCESS.
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Learning Outcome
At the end of the session the students will be able to:
1. Identify the 3 components of determinants of learning

2. Describe the steps in the assessment of learning needs
3. Differentiate methods in assessing readiness to learn
4. Compare and contrast the Learning Style
SMANIA.C
Introduction
The education process like the nursing process consists of

the basic elements of assessment, planning, implementation,
Education Process is a systematic, sequential, logical,
and evaluation
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scientifically based, planned course of action consisting of diagnosis
two major interdependent operations: teaching and learning.
The education process focuses on the planning and

implementation of teaching based on an assessment
and prioritization of the client’s learning needs, readiness to
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Assessment of the Learner
Assessment of learning needs are gaps in knowledge that exist between
the desired level of performance and actual level of performance.
In other words, a learning need is the gap between what someone

knows and what someone needs or wants to know. Such gaps may arise
because of a lack of knowledge, attitude, or skill.
Assessment of learner includes 3 determinants of learning:

• Learning needs – what the learner needs and wants to learn
• Readiness to learn – when the learner is receptive to learning
• Learning style – how the learner best leans
SMANIA.C
Assessment of the Learner
Of the three determinants of learning, nurse educators

must identify learning needs first so that they can
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design an instructional plan to address any deficits in
the cognitive, affective, or psychomotor domains.
Once the educator discovers what needs to be taught,
he can determine when and how learning can
optimally occur.
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Determinants of Learning
Why do we need to determine
• For patients and families to improve their health

and adjust to their medical conditions
• For students acquiring the information and skills

necessary to become a nurse
• For staff nurses devising more effective

approaches to educating and treating patients
and one another in partnership
SMANIA.C
Assessing the Learning Need
• This initial step in the process validates the need for learning and
the approaches to be used in designing learning experience
• Identify and prioritize information for the purposes of setting
behavioral goals and objectives, planning instructional
interventions, and able to evaluate learner has achieved the desired
goals and objectives
• Good assessments ensure that optimal learning can occur with the
least amount of stress and anxiety for the learner.
• Assessment prevents repetition of subject , saves time and energy
between the learner and the educator
• It helps to establish positive communication between the nurse and
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Steps in Assessing Learning Needs
. Identify the learner – who is the audience?
. Choose 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.
. 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.
SMANIA.C
. 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.
. 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.
. 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
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1. 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. In this case, it may be better to focus on other identified needs.
2. 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.
3. Take time-management issues into account - Because time constraints are a
major impediment to the assessment process, Rankin and Stallings (2005) suggest
the educator should emphasize the following important points with respect to time
management issues:
SMANIA.C
• Although close observation and active listening take time, it is
much more efficient and effective to take the time to do a good
initial assessment upfront than to waste time by having to go back
and uncover information that should have been obtained before
beginning instruction.
•
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Learners must be given time to offer their own perceptions of
their learning needs if the educator expects them to take charge
and become actively involved in the learning process. Learners
should be asked what they want to learn first, because this step
allays their fears and makes it easier for them to move on to other
necessary content (McNeill, 2012). This approach also shows that
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• 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.
SMANIA.C
• 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. In one
large metropolitan teaching hospital, this strategy proved
effective in increasing patient understanding and satisfaction with
transplant discharge information (Frank-Bader et al., 2011).
Patients and their families were informed that a specific topic
would be discussed on a specific day. Knowing what to expect
each day allowed them to review the appropriate handouts ahead
of time and prepare questions. It gave patients and family
members the time they needed to identify areas of confusion or
concern.
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• 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.
SMANIA.C
Criteria for Prioritizing Learning Needs
Mandatory: Desirable: Possible:

Needs that must be learned Needs that are not life Needs for information that
for survival or situations in dependent but that are is nice to know but not
which the learner’s life or related to well-being or the essential or required or
safety is threatened. overall ability to provide situations in which the
Learning needs in this high-quality care in learning need is not
category must be met situations involving directly related to daily
immediately. changes in institutional activities
procedure.
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Mandatory
• A patient who has • The nurse who works in a

experienced a recent hospital must learn how to
heart attack needs to do cardiopulmonary
know the signs and resuscitation or be able to
symptoms and when to carry out correct isolation
get immediate help. techniques for self-
protection.
SMANIA.C
Desirable
• It is desirable for nurses to
• It is important for update their knowledge by
patients who have attending an in-service
cardiovascular disease program when hospital
to understand the management decides to focus
effects of a high-fat diet more attention on the
on their condition. appropriateness of patient
education materials in
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Not life treathening relation to the patient
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Possible
• 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.
SMANIA.C
Methods to Assess Learning Needs
• Informal Conversation - learning needs are discovered during

impromptu conversations that take place with other healthcare
team members
• Structured Interviews - The educator asks the learner direct and
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, use open-ended questions, choose a setting
that is free of distractions, and allow the learner to state what are
believed to be the learning needs. It is important to remain
nonjudgmental when collecting information about the learner’s
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strengths, beliefs, and motivations.
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Methods of Assessing Learning Needs
• Focus Groups - A group of 4-12 is created to determine areas of

educational need by using group discussion to identify knowledge
about a certain topic. With this approach, a facilitator leads the
discussion by asking open-ended questions intended to encourage
detailed discussion. It is important for facilitators to create a safe
environment so that participants feel free to share sensitive
information in the group setting
• Questionnaires - educators can obtain learners’ written responses to
questions about learning needs by using survey instruments.
Checklists are one of the most common forms of questionnaires. They
are easy to administer, provide more privacy compared to interviews,
and yield easy-to-tabulate data.
SMANIA.C
Methods of Assessing Learning Needs
• Tests - Giving written pretests before teaching is planned can help

identify the knowledge levels of potential learners regarding a
particular subject and assist in identifying their specific learning
needs. In addition, this approach prevents the educator from
repeating already known material in the teaching plan. protest
• Observations - Observing health behaviors in several different time
periods can help the educator draw conclusions about established
patterns of behavior that cannot and should not be drawn from a
single observation.
• Documentation - Initial assessments, progress notes, nursing care
plans, staff notes, and discharge planning forms can provide
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Readiness to Learn
- defined as the time when the learner
demonstrates an interest in learning the
information necessary to maintain optimal
health or to become more skillful in a job.
No matter how important the information is or how

much the educator feels the recipient of teaching
needs the information, if the learner is not ready,
then the information will not be absorbed.
SMANIA.C
Take Time to Take a PEEK at the Four
Types of Readiness to Learn
Physical Readiness Emotional Readiness Experiential Readiness Knowledge Readiness
MCEHG ASMRED LPCL PCLL
Measures of ability Anxiety level Level of aspiration Present knowledge base
Complexity of task Support system Past coping mechanisms Cognitive ability
Environmental effects Motivation Cultural background Learning disabilities
Health status Risk-taking behavior Locus of control Learning styles
Gender Frame of mind

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Physical Readiness CEAG
A
• MEASURES OF ABILITY - Ability to perform a task requires fine

and/or gross motor movements, sensory acuity, adequate strength,
flexibility, coordination, and endurance.
• COMPLEXITY OF TASK - Variations in the complexity of the task
affect the extent to which the learner can master the behavioral
changes in the cognitive, affective, and psychomotor domains.
• ENVIRONMENTAL EFFECTS - An environment conducive to
learning helps to hold the learner’s attention and stimulate interest in
learning. Unfavorable conditions, such as extremely high levels of
noise or frequent interruptions, can interfere with a learner’s accuracy
and precision in performing cognitive and manual dexterity tasks.
Intermittent noise tends to have greater disruptive effects on learning
than the more rapidly habituated steady-state noise.
SMANIA.C
Physical Readiness MCEE
• HEALTH STATUS - The amounts of energy available and the

individual’s present comfort level are factors that significantly
influence that individual’s readiness to learn.
• GENDER - Research indicates that women are generally more
receptive to medical care and take fewer risks with their health than do
men
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Emotional Readiness
ASMRFD
• ANXIETY LEVEL - influences a person’s ability to perform at
cognitive, affective, and psychomotor levels. In particular, it affects
patients’ ability to concentrate and retain information.
• Support System - A strong support system decreases anxiety, while
the lack of one increases anxiety levels.
• Motivation - Knowing the motivational level of the learner assists the
educator in determining when someone is ready to learn.
• Risk-Taking Behavior - If patients prefer to participate in activities
that may shorten their life spans, rather than complying with a rigid
treatment plan, the educator must be willing to teach these patients
how to recognize certain body symptoms and then what to do.
SMANIA.C
Emotional Readiness
ASMRFD
• Frame of Mind - involves concern about the here and now. If survival
is of primary concern, then readiness to learn will be focused on
meeting basic human needs.
• Developmental Stage - Each task associated with human development
produces a peak time for readiness to learn, known as a “teach- able
moment
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Experiential Readiness
LPCL
• Level of Aspiration - The extent to which someone is driven to
achieve is related to the type of short- and long-term goals established,
not by the educator, but by the learner.
• Past Coping Mechanisms - The coping mechanisms someone has
been using must be explored to understand how the learner has dealt
with previous problems.
• Cultural Background - Knowledge on the part of the educator about
other cultures and being sensitive to behavioral differences between
cultures are important to avoid teaching in opposition to cultural
beliefs
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Experiential Readiness
LPCL
• Locus of Control - Whether readiness to learn comes from internal or
external stimuli can be determined by ascertaining the learner’s
previous life patterns of responsibility and assertiveness. When
patients are internally motivated to learn, they have what is known as
an internal locus of control. They are ready to learn when they feel a
need to know about something. This drive to learn comes from within
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the learner. Usually, this type of learner will indicate a need to know
by asking questions. Remember that when someone asks a question,
the time is prime for learning. If patients have an external locus of
control— that is, they are externally motivated—then someone other
than themselves must encourage a feeling of wanting to know
something. The responsibility often falls on the educator’s shoulders
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Knowledge Readiness
PCLL
• Present Knowledge Base - How much someone already knows about
a particular subject or how proficient that person is at performing a
task is an important factor to determine before designing and
implementing instruction,
• Cognitive Ability - The extent to which information can be processed
is indicative of the level at which the learner is capable of learning.
• Learning Disabilities - Other than those deficits caused by mental
retardation, learning disabilities and low-level reading skills are not
necessarily indicative of an individual’s intellectual abilities but will
require special or innovative approaches to instruction to sustain or
bolster readiness to learn
SMANIA.C
Knowledge Readiness
PCLL
• Learning Styles - A variety of preferred styles of learning exist, and

assessing how someone learns best will help the educator to select
teaching approaches accordingly. Knowing the teaching methods and
materials with which a learner is most comfortable or, conversely,
does not tolerate well will help the educator to tailor teaching to meet
the needs of individuals with different styles of learning, thereby
increasing their readiness to learn
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Learning Styles
• Learning style refers to the ways individuals process

information (Guild & Garger, 1998).
• Learning styles as the way the learners that learners learn
that takes into account the cognitive, affective and
physiological factor
• Each learner is unique and complex
• The learning style models are based on the
characteristics of style are biological in origin, others are
sociologically developed as a result of environmental
influences.
• Recognizing that people have different approaches to
learning.
SMANIA.C
Determining learning styles
• Observation of the learner
• By observing the learner in action, the educator can
ascertain how the learner grasps information and
solves problems
• Interview
• The educator can ask the learner about preferred ways
of learning as well as the environment most
comfortable for learning
• Administration of learning style instruments
• The educator can administer learning style
instruments.
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HERRMANN BRAI DOMInAUCE InTRUMENT
Right-Brain/Left-Brain and Whole-Brain Thinking
Left-Hemisphere Functions Right Hemisphere Functions
Analytical Thinking
■ Prefers talking and writing is creative, intuitive, divergent,
■ Responds to verbal diffuse
instructions and explanations ■ Synthesizing
■ Recognizes/remembers ■ Prefers drawing and manipulating
names objects
■ Relies on language in ■ Responds to written instructions
thinking and remembering and explanations
■ Solves problems by ■ Recognizes and remembers
breaking them into parts, faces
then approaches the problem ■ Relies on images in thinking and
sequentially, using logic remembering
■ Good organizational skills, Loose organizational skills, sloppy
Ned Hermann’s Four Dominant Quadrants neat ■ Likes change, uncertainty
• Analytical (Quadrant A). ■ Likes stability, willing to ■ Frequently loses contact with time
• Sequential (Quadrant B). adhere to rules and schedules
• Interpersonal (Quadrant C). ■ Geometry is the preferred math
• Imaginative (Quadrant D). ■ Good at interpreting body
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language
■ Free with emotions
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• In 1967, Rita Dunn and Kenneth Dunn set out to develop a user-friendly
model that would assist educators in identifying characteristics that allow
individuals to learn in different ways (Dunn & Dunn, 1978).
• Environmental Domain:
• Sound – Does your learner like silence, light background noise, or a noisy
environment?
• Light – Does your child prefer bright fluorescent or incandescent light, dim light,
or natural light?
• Temperature – Does your learner prefer a cold, cool, warm, or toasty
environment?
• Seating – Does your child prefer a lounge chair, solid high-back chair, lying on
the floor, or another position for reading or studying?
• Emotional Domain: consider your child’s level of motivation, task persistence, conformity,
and need for a structured environment.
• Sociological Domain: consider your child’s preference for studying alone, in pairs, with
peers, in a team environment, with an adult as a teacher, or in a variety of social settings.
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• Physiological Domain: you consider your child’s preference for the modes of learning in
the VAKT model (auditory, visual, tactile, and kinesthetic). You also consider your child’s
best time of day for learning activities.
• Psychological Domain: you’ll consider your child’s learning style as it falls into an
analytic/global thinking style or a more impulsive/reflective style..
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Myers and Briggs Learning Style
• Carl G. Jung (1921/1971), a Swiss psychiatrist, developed a theory that

explains personality similarities and differences by identifying attitudes of
people (extraverts and introverts)
• Isabel Myers and her mother, Katherine Briggs, became convinced that
Jung’s theories had an application for increasing human understanding.
• According to Myers Briggs learning styles, we all have inborn learning
preferences. When students don’t understand the lesson teachers can help
them to grasp the material in their own way using research-based
framework that is suggested by MBTI test.
• Myers–Briggs Type Indicator (MBTI) that permits people to learn about their
own type of behavior and understand themselves better with respect to the
way in which they interact with others.
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Myers and Briggs Learning Style MBT
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Myers and Briggs Learning Style
• (E) – Extrovert. Strives to organize the outer world and things.

• (I) – Introvert. Organizes the inner world in concepts and notions.
• (S) – Sensing. Uses facts to operate.
• (N) – Intuition. Uses the power of imagination.
• (T) – Thinking. Makes the decisions based on logic.
• (F) – Feeling. Uses personal values and feelings for making choices.
• (P) – Perceiving. Wants to be flexible, adaptable and open to changes.
• (J) – Judging. Decides critically and is comfortable with everything being
planned.
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Kolb's Learning Style
• David Kolb (1984), developed his learning style model in the early
1970s.
• Kolb believed that knowledge is acquired through a transformational
process, which is continuously created and recreated.
• The learner is not a blank slate but rather approaches a topic to be
learned with preconceived idea.
• He hypothesizes that learning results from the way learners perceive
as well as how they process what they perceive.
• Kolb’s model, known as the cycle of learning includes four modes of
learning that reflect two major dimensions: perception and
processing.
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- DIVERGER
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very good at
BATOR
ACCOMO - viewing thing
but feeling
new 2
challenging
sit
intuition
↑ ↑
CONVERGER- -ASSIMILATOR
gen-spec logic .
spec-gen
3
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neory ability to dm
.
of information
Kolb’s theory defines experiential learning as a
four-stage process:
• Concrete learning – occurs when a learner has a new
experience or interprets a previous experience in a
new way. For example, a nursing student has to learn
a new procedure as part of their clinical education.
• Reflective observation – the learner reflects on the

new experience to understand what it means. In our
example, the nursing student might think about how
they could have done the procedure better.
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Kolb’s theory defines experiential learning as a
four-stage process:
• Abstract conceptualization – the learner adapts their thinking or
constructs new ideas based on experience and reflection. For
example, the nursing student realizes they need to have all their
materials ready before starting the procedure.
• Active experimentation – the learner applies their new ideas to

real-world situations to test whether they work and see if any
changes need to be made. This process can happen quickly or
over an extended time. Our nursing student might note how
smoothly things go consistently when they have everything ready
for a procedure in advance.
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The Importance of Preferences in David Kolb’s
Experiential Learning Cycle
• The four stages of Kolb’s model are portrayed as an experiential
learning cycle. Learners can enter the cycle at any time. For example,
imagine a group of students are learning to use computer-aided design
(CAD) software. One student might begin the learning process by
observing others using it. Another learner might start by reading about
the program. Still, another learner might immediately jump in and have
a go at using it.
• Kolb explains learners have natural preferences for how they enter the
experiential learning cycle. “Because of our hereditary equipment, our
particular past life experiences, and the demands of our environment,
S we develop a preferred way of choosing,” he wrote.
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Kolb’s learning styles are:
• Diverging – In this learning style, learners focus on concrete experience
and reflective observation. They prefer to watch and reflect on what
they’ve observed before jumping in.
• Assimilating – This learning style incorporates learners who favor
abstract conceptualization and reflective observation. They like using
analytical models to explore and prefer concepts and abstract ideas.
• Converging – Learners using this learning style focus on abstract
conceptualization and active experimentation. They like to solve
problems and enjoy applying learning to practical issues.
• Accommodating – Learners using this learning style favor concrete
experience and active experimentation. They relish a challenge and
using intuition to solve problems.
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Experiential learning has many benefits for
students, including:
• The chance to immediately apply the learning process to real-world
experiences, which supports knowledge retention
• Improved motivation, as students are more excited about learning in
real-world situations
• Promotion of learning through reflection, which deepens and
strengthens the learning experience
• The chances to make good use of their preferred style of learning
• Enhanced teamwork because experiential learning often involves
working as part of a team
• The opportunity to prepare for future work through genuine, meaningful
real-world practice
S • The chances to meet colleagues and potential employers.
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Gardner Multiple Intelligence
• Psychologist Howard Gardner (1983) developed a theory focused on the
multiple kinds of intelligence in children. Gardner based his theory on
findings from brain research, developmental work, and psychological
testing.
• When you hear the word intelligence, the concept of IQ testing may
immediately come to mind. Intelligence is often defined as our
intellectual potential; something we are born with, something that can
be measured, and a capacity that is difficult to change.
• In recent years, however, other views of intelligence have emerged,
including Gardner's suggestion that multiple different types of
intelligence may exist.
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Summary
• The educator chooses the teaching approaches and learning
activities best suited for an individual. Identifying and
prioritizing learning needs require the educator to discover
what the learner feels is important and the educator knows to
be important. Once needs are identified and agreed upon, the
educator must assess the learner’s readiness to learn based
on the physical, emotional, experiential, and knowledge
components specific to each learner. Assessing learning styles
by interviewing, observing, and using instrument measurement
can reveal how individuals best learn as well as how they
prefer to learn.
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DESIGNING HEALTH EDUCATION OF AGE
SPECIFIC GROUP
Learning Outcome
At the end of the discussion, the students will be able to
1. Define each stages of development in health education

2. Differentiate Pedagogy, Andgogy and Geragogy
3. Understand how to deliver health education at a specific age group
4. Learn a variety task in every stage of development
Developmental Stage of the Learner
◦ An individual’s developmental stage significantly influences the ability
to learn.
◦ Pedagogy, andragogy, and gerogogy are three different orientations
to learning.
◦ To meet the health-related educational needs of learners, a
developmental approach must be used.
◦ Lifespan development refers to age related changes from birth
throughout the persons life into and during old age
◦ Developmental task arises or about a certain period in life,
unsuccessful achievement of which leads to inability to perform task
associated with the next period or stages in life.
Developmental Characteristics
◦ Chronological age is only a relative indicator of

someone’s physical, cognitive, psychosocial stage of
development
◦ Developmental stage will be used based on the

confirmation by psychologists that human growth and
development are sequential but not always specifically
age-related.
What is Andragogy, Pedagogy, Geragogy
Adult Education
◦ Andragogy, the term coined by Knowles (1990) to describe
his theory of adult learning, is the art and science of
helping adults learn.
◦ Education within this framework is more learner-centered
and less teacher-centered; that is, instead of one party
imparting knowledge on another, the power relationship
between the educator and the adult learner is much more
horizontal (Milligan,1997).
◦ The concept of andragogy has served for years as a useful
framework in guiding instruction for patient teaching and
for continuing education of staff.
◦ Pedagogy is the art and science of helping children to
learn. The different stages of childhood are divided
according to what developmental theorists
◦ Educational psychologists define as specific patterns of
behavior seen in particular phases of growth and
development, throughout all of childhood, learning is
subject centered.
◦ Geragogy is a term used to describe teaching of older persons. For
teaching to be effective, gerogogy must accommodate the normal
physical, cognitive, and psychosocial changes that occur at this phase
of growth and development
◦ The developmental tasks of the elderly allow nurses to alter how to
approach both well and ill individuals in terms of counseling,
teaching, and establishing a therapeutic relationship.
◦ Disease intervention and prevention may not be recognized due to
declining cognitive functioning, sensory deficits, lower energy
levels.
◦ For teaching to be effective, geragogy must accommodate the
normal physical, cognitive, and psychosocial changes that occur at
this phase of growth and development
Infancy (first 12 months of life ) and toddlerhood (1-2 years of age)
Physical Cognitive Psychosocial Teaching Strategies
Dependent on Sensorimotor stage Trust vs. mistrust • Orient teaching to

environment, needs • learning is enhanced During this time, caregiver
security, explore self and through sensory children must work • Use repetition and
environment, natural experiences and through their first major limitation of
curiosity. through movement dilemma of developing information
Early in life, infants and manipulation of a sense of trust with • Stimulate all the
depend on others to objects in the their primary caretaker senses
meet their needs for environment capacity • Provide physical
safety and security. • The toddler has basic Autonomy vs. shame safety emotional and
When infants receive for reasoning, Toddlers must learn to security
warm, consistent care understands object balance feelings of • Allow play and
and attention from permanence, has the love and hate and manipulation of
adults, they are able to beginnings of memory, learn to cooperate and object
establish a sense of trust and begins to develop control willful desires
in the world. an elementary
concept of causality.
Infancy (first 12 months of life ) and toddlerhood (1-2 years of age)
SHORT TERM LEARNING LONG TERM LEARNING
• Read simple stories from books with lots of • Use reinforcement as an opportunity to
pictures. achieve permanence of learning through
• Use dolls and puppets to act out feelings practice.
and behaviors. • Use the teaching methods of gaming and
• Use simple audiotapes with music modeling as a means by which children
andvideotapes with cartoon characters. can learn about the world and test their
• Role play to bring the child’s ideas over time
imaginationcloser to reality • Focus on rituals, imitation, and repetition of
• Perform procedures on a teddy bear or information in the form of words and
doll first to help the child anticipate what actions to hold the child’s attention. For
an experience will be like. example, practice washing hands before
• Give simple, concrete, nonthreatening and after eating and toileting.
explanations to accompany visual and • Encourage parents to act as role models,
tactile experience because their values and beliefs serve to
• Keep teaching sessions brief (no longer reinforce healthy behaviors and
than about 5 minutes each) because of significantly influence the child’s
the child’s short attention span. development of attitudes and behaviors.
Early Childhood 3-5 years
Fine and gross motor preoperational period. Initiative versus guilt. • Use warm approach,
skills become • The young child Ability to be self starter build trust, use
increasingly continues to be or initiate one’s own repetition of
more refined and egocentric and is activity, children assert information,
coordinated so that essentially unaware of themselves more • Allow manipulation of
they are able to carry others’ thoughts frequently through equipment.
out activities of daily • Preschoolers are very directing play and other • Explain procedures
living with greater curious, can think social interaction. briefly.
independence intuitively, and pose • Provide safe
They develop imaginary questions about environment,
playmates, and believe almost anything. • Use positive
they can control events reinforcement.
with their thoughts • Use play therapy with
dolls and puppet to
stimulate senses
Early Childhood 3-5 years
• The nurse should teach parents about health • Give praise and approval, through both verbal
promotion and disease prevention measures, to expressions and nonverbal gestures, which are
provide guidance regarding normal growth real motivators for learning.
and development • Allow the child to manipulate equipment and
• Nurse allows children to express fear because play with replicas or dolls to learn about body
children’s fear of pain and bodily harm parts
because they have fantasies and active • Arrange small-group sessions with peers to
imagination make teaching less threatening and more fun.
• Nurse must use correct words when describing • Use storybooks to emphasize the humanity of
procedures and treatment. healthcare personnel; to depict relationships
• Provide physical and visual stimuli, language between the child, parents, and others; and to
ability is still limited, both for expressing ideas help the child identify with certain situations
and for comprehending verbal instructions
• Keep teaching sessions short (no more than 15
minutes) and scheduled sequentially at close
intervals so that information is not forgotten
School Age 6-11 years
• Physical • Cognitive • Psychosocial • Teaching Strategies
• The gross- and fine- • Concrete operations • Industry versus • Encourage
motor abilities of • During this time, logical inferiority independence and
school-aged children thought processes and • Begin to establish active participation
are increasingly more the ability to reason their self-concept as • Use logical
coordinated so that they inductively and members of a social explanations
are able to control their deductively develop. group larger than • Establish role models
movements with much • School-aged children their own nuclear • Uses play therapy
greater dexterity than are able to think more family and start to • Provides group
ever before. objectively, are willing to compare family activates
• Girls more so than boys listen to others, values with those of • Use diagram, models
on the average begin to • and will selectively use the outside world or pictures
experience questioning to find
prepubescent • answers to the unknown
• bodily changes and
tend to exceed the boys
in physical maturation
School Age 6-11 years
• Allow school-aged children to take responsibility • Help school-aged children acquire skills to utilize
for their own health care, they are capable of in self care responsibility in carrying out
manipulating equipment with accuracy therapeutic treatment regimens on an ongoing
• Use diagrams, models, pictures, digital media, basis with minimal assistance.
printed materials, and computer, tablet or • Assist them in learning to maintain their own well-
smartphone applications as adjuncts to various being and prevent illnesses from occurring
teaching methods
• Choose audiovisual and printed materials that
show peers undergoing similar procedures or
facing similar situations
• Use one-to-one teaching sessions as a method
to individualize learning relevant to the child’s
own experiences
• Teaching sessions can be within 30 minutes. The
cognitive abilities of school-aged children make
possible the attention to and the retention of
information
Adolescence 12-19 years
Alterations in physical Formal operations. Identity versus role • Explore emotional and
size, shape, and • They are capable of confusion. financial support
function of their bodies, abstract thought and • These children indulge • Determine goals and
along with the complex logical reasoning in comparing their expectations
appearance and • Adolescents can self-image with an • Assess stress level
development of conceptualize and ideal image • Respect values and
secondary sex internalize ideas • Adolescents find norm
characteristics, bring • Adolescents are able to themselves in a • Engage in teaching
about a significant understand the concept struggle to establish 1:1 without parents
preoccupation with of health and illness, the their own identity, present.
their appearance and multiple causes of match their skills with
a strong desire to diseases, the influence career choices,
express sexual urges of variables on health and determine their
status, and the ideas “self.”
associated with health
promotion and disease
prevention
Adolescence 12-19 years
• Use one-to-one instruction to ensure • Adolescents are involve in formulating teaching

confidentiality of sensitive information. plans as to teaching strategies, expected
• Group peer discussion is an effective approach outcomes, and determining what needs to be
to deal with health topics such as smoking, learned and how it can best be achieved to
alcohol and drug use, safety measures, obesity, meet their need for autonomy.
and teenage sexuality. • Negative responses are expected, which are
• Using technology is a comfortable approach to common when their self-image and self-integrity
learning for adolescents are threatened.
• Share decision making whenever possible, • Avoid confrontation and acting like an authority
because control is an important issue for figure
adolescents • They should be approach them with respect,
• Use face-to-face or computer group discussion, tact, openness, and flexibility to elicit their
role playing, and gaming as methods to clarify attention and encourage their responsiveness
values and solve problems, which feed into the to teaching–learning situations.
teenager’s need to belong and to be actively
involved
Young Adulthood 20-40 years
Young adults are at The cognitive capacity of Intimacy versus • Use problem centered
their peak, young adults is fully isolation. During this focus
and the body is at its developed, but with time, individuals work to • Draw on meaningful
optimal functioning maturation, they establish a trusting, experiences
capacity. continue to accumulate satisfying, and • Encourage active
Autonomous, self new knowledge and skills permanent relationship participation
directed from an expanding with others They strive • Allow to set own pace
Uses personal reservoir of formal to establish • Organize materials
experience to enhance and informal commitment to others • Recognize social role
or interfere with experiences. Young in their personal, • Apply new
learning adults continue in the occupational, knowledge through
Intrinsic motivation formal operations stage. and social lives. role playing and
Able to analyze hands on practice
critically
Young Adulthood 20-40 years
• Young adults require active participation in the • To facilitate learning, present concepts logically
educational process, the nurse as educator to from simple to complex and establish
allow them the opportunity for mutual conceptual relationships through specific
collaboration in health education decision application of information
making • Important nursing activities include teaching risk
• A variety of experiences are incorporated in the factors for future disease, lifestyles to decrease
teaching-learning that can serve as the risk, and finding opportunities for health
foundation on which to build new learning. • Teaching young adults who are preparing to be
• An educational material and audio visual tools parent on physical and emotional changes
are preferred by this age group including associated with pregnancy, sexual activity
computer-assisted instruction, that helps them during pregnancy, preparation for the newborn,
to learn independently diet counseling, preparation for the parenting
• Group discussion is method for teaching and role, and the process of birth, including
learning because it provides young adults with procedures during labor, delivery, and the
the opportunity to interact with others of similar postpartum period.
age and in similar situations, such as in
parenting groups, prenatal classes, exercise
classes, or marital adjustment sessions.
Middle Adulthood 41-64 years
During middle age, many Formal Operations Generativity versus • Focus on

individuals have reached the The of life experiences self absorption and
peak in their careers, their
maintaining
sense of who they are is well and their proven stagnation. Midlife independence
developed, their children are record of marks a point • Assess positive and
grown, and they have time accomplishments at which adults negative past
to pursue other interests often allow them to
Skin and muscle tone
realize that half of • Experiences
decreases, metabolism slows come to the their life has been • Assess potential
down, body weight tends to teaching–learning spent. This realization cause of stress
increase, endurance and situation with may cause them to caused by midlife
energy levels lessen, confidence in their
hormonal changes bring
their level of issues
about a variety of symptoms, abilities achievement and • Provide information
and hearing and visual acuity success that coincide with
begin to diminish life concerns and
problems
Middle Adulthood 41-64 years
• Nurse educator to reach out to assist these

middle-aged adults in coping with stress and
maintaining optimal health status.
• Stress may interfere with middle-aged adults’
ability to learn or may be a motivational force
for learning
• The nurse must be aware of their potential
sources of stress, the health risk factors
associated with this stage of life, and the
concerns typical of midlife
• Reinforcement for learning is internalized and
serves to reward them for their efforts.
• Adult learners need to be reassured or
complimented on their learning competencies
Elderly 65 and above
Most older persons suffer Formal Operations: Ego integrity versus • Involve principal
from at least one Aging affects the despair: This phase of caregiver
chronic condition, and mind as well as the elderly includes • Encourage
many have multiple
body. Cognitive dealing with the participation
condition. The sensory
ability changes with reality of aging, the • Provide resources
perceptive abilities that
relate most closely to age as permanent acceptance of the for support
learning capacity are cellular alterations inevitability that we all • Assess coping
visual and auditory invariably occur in the will die. mechanism
changes. Hearing loss, brain itself. • Provide written
which is very common instructions for
beginning in the late reinforcement
forties and fifties, • Provide anticipatory
includes diminished
problem
ability to discriminate
high-pitched sounds.
Elderly 65 and above
• Remembering the past is a beneficial approach • Talking with older persons about their
to use to establish a therapeutic relationship. experiences—marriage, children,
Memories can be quite powerful grandchildren, jobs, community involvement,
• To compensate for visual changes, teaching and the like—can be very stimulating.
should be done in an environment that is • Feedback will give the nurse insight into their
brightly lit but without glare. Visual aids should humanness, their abilities, and their concerns
include large print, well-spaced letters, and the • To compensate for any decline in central
use of primary colors. nervous system functioning and decreased
• Eliminate extraneous noise, avoid covering your metabolic rates, set aside more time for the
mouth when speaking, directly face the learner, giving and receiving of information and for the
and speak slowly. practice of psychomotor skills
• To compensate for musculoskeletal problems, • To compensate for a decrease in fluid
decreased efficiency of the cardiovascular intelligence, provide older persons with more
system, and reduced kidney function, keep opportunities to process and react to
sessions short, schedule frequent breaks to allow information and to see relationships between
for use of bathroom facilities, and allow time for concepts
stretching to relieve painful, stiff joints and to
stimulate circulation
Summary
Nurses must understand the specific and varied tasks associated
with each developmental stage to individualize the approach to
education in meeting the needs and desires of clients and their
families. Assessment of physical, cognitive, and psychosocial
maturation within each developmental period is crucial in
determining the appropriate strategies to facilitate the teaching–
learning process
Readiness to learn in children is very subject centered and highly
influenced by their physical, cognitive, and psychosocial
maturation. For client education to be effective, the nurse in the
role of educator must create an environment conducive to
learning by presenting information at the learner’s level, inviting
participation and feedback, and identifying whether parental,
family, and/or peer involvement is appropriate or necessary

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Health Education

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Historical

1. Discuss the historical development of health education

The WHO define Health Education as:

1900 1918 1970

. National League . of Nursing Education .

Pew Health Professions Commission, influenced by the

• In 1990s, the Philippines entered as a modernizing society.

A health educator is “a professionally prepared individual

1.Assessing the individual and family community

• Implementation is based on a thorough understanding of

• Health Educators utilizes research to improve the

• Administration is generally a function done by

7. Advocate for health and Health Education

ØIncludes use of age appropriate strategies, intervention, and

ØA continuous practice that improves and innovates nursing

ØProvides up-to-date information to patient, family members, and

The teaching function will always be an integral part of the duties of

Nurse Practice Acts (NPAs) in the US universally include teaching

In 1993, the Joint Commission on Accreditation of Healthcare Organization

Training the Clinical Instructor

Education process Teaching/ Instruction

It is a systematic, sequential, planned course Teaching is a deliberate intervention that

Determine behavioral changes

ØPatient Education is a significant part of a nurse’s job.

ØSelf-care steps they need to take.

ØCommon words and phrases

State the objectives

Analyze the learner

Provide for prevention of Expand public Involve patients and their

Provide clients with Provide clinically

Effectively reduce the incidence

Decrease patient anxiety

ØDistance Learning – this method includes computer

After the discussion students will be able to:

1. Define the principal constructs of each learning theory

01 Learning is defined as a relatively permanent

• For patients and families to improve their health and

• Respondent conditioning or Classical conditioning (Pavlov)

• Stimulus Generalization is the tendency of

• Discrimination learning occur with one or

• Although classical conditioning was not discovered by a

Unconditioned Response is an automatic response or a response

Conditioned Stimulus is a stimulus that was once neutral (didn’t

Conditioned Response is the learned response or a response that is

Operant Conditioning is a learning as a change in probability

Operant is a set of behavior that constitute an individual

It was coined by behaviorist B.F. Skinner. He believes that

He suggested at the external observable causes of human

Skinner used the term operant to any “ Active behavior that

•01 Positive Reinforcers are favorable events or outcomes that

• Negative Reinforcers is the removal of unafavorable

Positive punishment is a punishment by application, involve s

• giving positive reinforcement (i.e., reward) greatly

Gestalt Information Processing Cognitive Development

• Improves problem-solving skills

• Encourage continuous learning

• Role Modeling, is a central concept of social learning

· Vicarious reinforcement involves determining whether role

· Social learning theory has been applied extensively to

· It is also the theoretical foundation for the technique of

• It has significant implications for learning and changing

According to Freud, our personality develops from a conflict between

• The Humanistic perspective on learning is the

Health education is a process concerned with

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