3---STEPS IN WRITING A HEALTH

EDUCATION PLAN
STEPS in WRITING a Health Education Plan:
1. Assess the learning needs by answering the
following:
a. What are the characteristics and learning
capabilities of the learner or client?
1. What is the client’s age
2. What is the developmental stage in his
or her lifestyle (is there a health threat,
health deficit, health need, or is it
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 merely a foreseeable crisis or stress point?)
3. Use the family assessment guide
4. On what level of Maslow’s Hierarchy of
Needs is the client situated?
b. What needs have been identified and
prioritized in terms of health promotion,
risk reduction and health problems?
1. Consult epidemiological reports, Com-

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 munity needs assessment reports, incident
reports.
2. Consult Nursing and medical books and
journals
c. What knowledge does have in relation to
the subject matter?
1. Interview the client regarding knowledge
of certain facts related to the subject

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 matter, administer pre-test and post-tests or
questionnaires
2. Ask the client to demonstrate certain skills
before the class
d. Is the client motivated to change unheal-
thy behaviors ?
1. Health educator must identify reasons
for seeming resistance or indifference
to change which may be due to lack of

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 of knowledge or skills regarding the issue
on hand, environmental constraints or
hindrances, cultural beliefs and practices,
etc..
2. Health educator must create a “learning
climate” during the pre-training phase to
encourage the client to decide to undergo
health behavior change.
3. What are the barriers or obstacles to
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 learning that the health educator has iden-
tified?
4. Identify factors that may hinder the
occurrence of that “teachable- moment”
when the client is ready or receptive to
learn (the relevance or importance of the
subject matter to the client’s identified or
prioritized needs, teaching techniques and
strategies, health of the client;
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 environmental factors like, temperature,
noise level, size of the room, proximity of
the participants to each other, teacher
style and personality.
5. Before content selection and determina-
tion of techniques and strategies are done,
the educator must first determine what
the learner needs to accomplish by

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 identifying the learning gaps in the
knowledge, skills, attitudes and values of
the client.
6. Identification of learning needs/gaps is
prerequisite in formulating behavioral
objectives.
FORMULATING BEHAVIORAL OBJECTIVES:
Behavioral objectives act as the guide or
compass of the educator in planning
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 implementation and evaluation of teaching
and learning outcomes.
Definition of terms: (Bastable, 2003)
a. Educational or instructional objectives---are
used to identify the intended outcomes of
the education.
b. Behavioral or learning objectives---make use
of the modifier behavioral or learning to
indicate that they are action-oriented rather

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 than content-oriented and learner-centered
rather than teacher-oriented.
* the intended result of instruction
* these describe what the learner is
expected to do at the end of a learning
situation
c. Goal---is the final outcome of what is
achieved at the end of the teaching-
learning process; the desired outcome
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of learning
* Long-term target (achievable within
weeks or months)
* Broad an global and multidimensional
(an overall goal may contain many
objectives)
d. Objective---is a specific, single, unidimen-
sional behavior.
* An objective is a statement of specific

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 and short-term behavior that must be
achieved first before a goal is reached.
It is derived from a goal and must be
consistent with it.
Together, objective and goals serve as a road
map that provides directions (objectives) as
to how to arrive at a particular destination
(goal).
Three steps that link behavioral objectives

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 together:
1. Identify the testing situation (condition)
2. State the learner and the learner’s
behavior ( performance)
3. State the performance level (criterion).

Ex. A: After 20minutes of demonstrating the

different postures for breastfeeding
(Condition), Aling Minda will be able

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 to demonstrate (Performance) three
out of five (Criterion) breastfeeding
postures.
Ex. B: After watching a demonstration on
parenteral adminstration of drugs
(Condition), the student nurse will be
able to administer (Performance)
intramuscular injection of Vitamin K

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 to the newborn with 100% accuracy
(Criterion).

Go to Word: for the examples

Three-Part Method of Writing Behavioral

Objectives
Taxonomy---is a classification, categorization

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 or arrangement of things based on their
relationship with one another.
Taxonomy of Educational Objective by
Bloom, et al (1956)is a tool for the systematic
Classification of behavioral objectives which
are divided into three broad categories or
domains:
1. cognitive 2. affective 3. psychomotor

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These three domains are interdependent and
can be experienced simultaneously.

The objectives in each domain are arranged

in a hierarchy where simple behaviors are
placed at the lowest level and the more
complex behaviors are listed at the top of the
hierarchy.

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Learners must successfully accomplish the
behaviors at the lower level before they can
adequately learn the behaviors at the more
complex or higher levels.

The Three Domains of Learning: (Bastable,

2003)

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1. Cognitive---known as the “thinking
domain”. The most influential
mapping of the cognitive terrain
is still the extensive classification
system devised by Benjamin
Bloom and his colleagues (1956,
1971) known as the “Bloom
taxonomy” which claims that
“cognitive abilities can be
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 measured along a continuum from
simple to complex”
The cognitive category includes strategies related
to:
* the student’s learning or encoding of
material, and
* facilitation of retrieval of information
Six Levels of Cognitive Behavior:
a. Knowledge---ability to memorize, recall

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 define, recognize or identify specific
information, like facts, rules, principles,
conditions and terms.

b. Comprehension---ability of the learner

to understand or appreciate what is being
communicated by defining or summa-
rizing it in his or her own words…
knowledge is a prerequisite component.
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c. Application---learner’s ability to use or
relate ideas, concepts, abstractions and
principles in particular and concrete
situations like figuring, writing,
reading or handling equipment…know-
ledge and comprehension are prerequi-
site behaviors.

d. Analysis---ability of the learner to recog-

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 nize,examine, scrutinize and structure
information by breaking it down into
its constituent parts and specifying
relationship between parts…the first
three levels(knowledge, comprehension,
application)) are prerequisite behaviors.

e. Synthesis---learner’s ability to put

together or merge parts and elements

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 into a unified whole by creating a
unique product or output that is
written, oral, pictorial…the first four
levels are prerequisite behaviors.

e. Evaluation---learner’s ability to judge,

assess or appraise the value, signifi-
cance, importance of something like
an essay, design or action using appro-

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 priate standards or criteria…all the five
levels of behaviors are prerequisites.

Examples of behavioral objectives in the

cognitive domain:
Analysis level: After hearing the lecture on ex-
panded immunization for her three
children 1,2, and 4 years old.
Synthesis level: Given the food chart, Mrs. Santos

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 will be able to devise a menu for one
week that will contain go, glow and grow
foods at an affordable cost.
TEACHING METHODS MOST COMMONLY USED
IN THE COGNITIVE DOMAIN:
* lecture/ discussion, one- to- one
instruction, programmed instruction
*simulations and games, computer assisted
programs

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 modules, projects, and role-playing
These teaching methods are designed to
transmit or give information resulting to a
change in behavior because of the lessons,
principles, theories or concepts learned.

2. Affective- the “feeling” domain

* Involves “increased internalization or
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 commitment of feeling expressed as
emotions, interests, attitudes, values,
appreciations…and how are these incor-
porated into one’s personality or value
system” (Reilly and Oerman, 1990.
* Affective competencies involve moral
reasoning and ethical decision-making.
Levels of Affective behavior:

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1. Receiving---ability of the learner to show
awareness of an idea or fact or
consciousness of a situation or
event in the environment and
motivation to selectively focus
on a data or stimulus.
Example: During a group discussion, the
preoperative patient will admit that
is anxious regarding his forthcoming
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 operation.
2. Responding---learner’s ability to react to an
experience then voluntarily accept
and enjoy this new experience…
Receiving is a prerequisite behavior.
Example: Following the one-to-one
instruction , he will verbalize his
fears related to his operation.

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3. Valuing---the learner’s ability to accept or
regard the worth of a theory, idea or
event where there is definite willing-
ness and intention to behave in a
manner befitting that value…
receiving and responding are prere-
quisite behaviors.
Example: During the session, he will
choose what post-operative methods
will be best to adopt regarding relief
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 post-operative pain.
4. Organization---ability of the learner to
sort-out categories, classify and
prioritize values into one’s present
value system;
identify how these values are interrel-
ated, and , classify what values are
dominant or pervasive (all encom-
passing) in his or her life…

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 receiving, responding and valuing are
pre-requisite behaviors.
Example: Following a seminar on “Training
the Trainers”, the clinical instructors
will integrate the principles of
teaching and learning in the conduct
of their health education classes
with their student nurses.

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 5. Characterization---learner’s ability to
integrate values into a total philosophy
(way of Life) or world view ( a paradigm,
model or stan-
dard) and showing firm commit-
ment and consistency in applying
these values into value system or a
cluster (set) of values…receiving,
responding, valuing and organiza- tion are
prerequisite behaviors.
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 Example: After attending series of
seminars on the prevention
of nosocomial infections, the
staff nurses will display
constant application of aseptic
hand washing technique as a
means to prevent nosocomial
infections among their patients.

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 TEACHING METHODS MOST COMMONLY USED
IN THE AFFECTIVE DOMAIN (Bastable, 2003):
*Affective questioning: increases interest and
motivation to learn about feelings,
values, beliefs and attitudes related to the
lesson
*Low-level affective questions---
directed at stimulating learner awareness
and responsiveness to a

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 to a topic
*Midlevel affective questioning: de-
termines strength of the belief
and internalization of value
*High level affective questioning---
probes or examines how deeply ingrained a
value is.

Case study: used to develop critical

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 thinking skills by exploring beliefs,
values and attitudes of the partici-
pants who are actively participating
rather than being neutral observers.

Role Playing: provides opportunities to

practice new values learned, dissect
the situation and apply problem-
solving to personal problems.
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 Simulation (imitation, mock) gaming:
Process games (games involving
procedures) with flexible rules
are controlled by the participants
and are used to attain the
affective behavioral objectives
through the learner’s active
involvement in goal-directed but
not necessarily competitive

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 activities instead of content games
which have more structured roles
and specific rules which are better
used in cognitive learning.
Defriefing following the activity is
most beneficial for guidance in the
application and assimilation of the
experience.

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 Group discussion: provides opportuni-
ties for clarifying personal, social
and moral values for increasing self-
awareness, self-discovery and self-
acceptance.
The learning that takes place in the affective
domain can only be inferred from the
learner’s observed behavior. It’s end-product
can be seen in the learner’s moral reasoning

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 and ethical decision making.
3. Psychomotor---or the “skills domain”
involves motor skills (fine or gross).
Easier to identify and measure because
it includes primarily overt movement-
oriented activities that are easily
observed.

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Five Levels of Psychomotor Objectives:

1. Imitation---the learner follows what was

observed and movements are gross,
lacks refinement and time or speed
in its execution depends on the
learner’s needs or readiness.

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2. Manipulation---the learner uses the
written procedures or handouts as the guide and
the time and
speed may vary.
3. Precision---logical sequence of actions is
carried out and the learner’s
actions are more coordinated with lesser errors.
Time and speed required are variable.
4. Articulation- logical sequence of actions
movements are coordinated at
a high level, errors are limited

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 Time and speed are within reasonable
limits.
5. Naturalization- sequence of actions is
automatic, consistently high level of
coordination of movements, errors are
almost non-existent. Time and speed are
required within realistic limits and
performance reflects professional
competence.

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• PHASES IN TEACHING PSYCHOMOTOR SKILLS:
• 1. Demonstration phase---this is a crucial phase
where the instructor must be able to smoothly,
skillfully and successfully demonstrate the
procedure which the students must be able to
see and hear clearly.
• The use of a video camera which focuses on
intricate manual procedures during a ste-by-step
demonstration will be a great help to the
learners as they watch the procedure on
television.
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• Example: In teaching the skills in preparing
and giving medications by injections, the
instruction should be divided into short
progressive steps with each step shown
separately:
• a. identify the different syringes and
needles to be used and the indications for
each.
• b. show the sites for the different types of
injections using mock-ups, anatomical

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 charts or audio-visual presentation;
c. illustrate the proper way of adminis-
tering the different types of injections, etc..
It is important that the student is able to
practice each step independently until the entire
performance is complete with the instructor
giving verbal reinforcement from time to time.
2. Guided practice---the learners must be able
to explore and manipulate the equip-

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 ment right after the demonstration.
 The more complex the skill is, the longer is
the practice required.
Feedback on the performance during the
practice phase should be given immediately
to reinforce correct behavior and eliminate
errors. Videotaping the practice will help a
lot in critiquing one’s performance.
When the student consistently makes an error

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 during the procedure, the teacher may
use humor by exaggerating the error and
making it more graphic enabling the learner
see and acknowledge the error.
Left- handed learners may face the instructor
and mirror the performance while right-
handed students can imitate the
teacher’s movements by standing beside
the teacher and facing in the same
direction. Teachers should primarily

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 observe and remain silent except to
offer positive cues and encouragement
to the learner.
 Avoid the tendency to guide the performance of
the student because they need to perform
the movements independently.
3. The third phase in teaching psychomotor
skills is mastery. Mastery performance is
skilled, smooth and dexterous and is the
final phase in the development of a
psychomotor skill. It is rarely accomplished
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 at the student level and requires
continuous rehearsal and practice to be
acquired and maintained.
The rationale of the effectivity of
demonstrations on skills learning is
based on Bandura’s Social Learning
theory (1977) which states that “people
learn as they observe other people’s
behavior.”

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• Elements of effective Skills Demonstration
(de young 2008):
1. Assemble all equipment ahead of time.
2. Make sure all equipment is in working order.
3. Do a “dry-run” of the procedure and time the
demonstration.
4. Arrange the environment to be as realistic as
possible.
5. Perform the procedure step-by-step,
explaining as you go along.
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 6. When appropriate, give the rationale as
you go along.
7. Refer to the handouts or textbooks to show
fine prints that may not be visible to the
audience.
8. Be sure to adhere to all principles of good
nursing care like observations of aseptic
techniques, body mechanics and patient’s
privacy.

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 9. Consider performing the demonstration for
the second time or have a student make a
return demonstration without explanations
to show the flow of the skill or activity.

Assessment of Psychomotor Skill Learning

Skill performance checklists are commonly used
which describe the step-by-step execution of the
procedure to achieve the goals of learning. It

55
 contains a number of items or steps in the
procedure which are check off when
completed
the checklist may contain :
 a rating scale with descriptors like Adequate,
Good and Excellent or Poor, Fair, and Good.
or a number scale which is added to give a
total score.
Failing grade is usually given if some of the

56
 essential elements in the procedure are not
satisfactorily done.
D. CHOOSING A TEXTBOOK/REFERENCES
Things to consider in the choice of textbook/re-
ferences:
1. Consult publisher or their representatives
for review copies of the likely texts for you
to examine in detail;
2. Students prefer texts which are clearly
written and organized.
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3. Books written with a lot of examples and
easy to understand style of writing is most
appreciated by the students;
4. The content, scope and quality; credibility
of authorship; format (table of contents,
glossary, index, length, and graphics);
quality of print and paper and the cost are
very serious considerations.
5. The accurary and currency, and breadth

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 and depth of content should also be
scrutinized before making decision.

E. CONDUCTING THE CLASS

First Day Activities: First Day Activities:
1. Begin by greeting the class and introducing
yourself especially if this is the first time you
are meeting the students. State your
preferred title or address plus your name.
Example: Good morning. Iam Dr. Erlinda
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 Estrada, a registered nurse with a Doctorate in
Education. Now you know that I am not a doctor of
medicine but a doctor of education your service
(smile to exude warmth and establish eye contact).
2. Establish a pleasant atmosphere by welcoming
everyone, reading their names with correct
pronunciation, and introducing a little humor.
3. Communicate your expectations regarding the
course and course requirement. Go over the course
syllabus and encourage questions or suggestions.

60
 4. Discuss general classroom rules or policies
regarding attendance, tardiness, eating in class
and bathroom break. Stress the importance of
GMRC (good manners and right conduct)
which is synonymous to the Golden Rule (do
unto others what you would like to do unto
you) as the guide for the proper decorum.
5. End the class session with enthusiasm
communicating to the students the relevance
of the course to their personal and professional
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 lives so that they will look forward to the next
meeting.
SUBSEQUENT MEETINGS:
1. Make sure that everyone is in the proper
place and paying attention before you start the
class.
2. Don’t forget the usual amenities like
greeting the class. You may even start the class
with a short and simple prayer which may also
be participated in by some members of the class

62
 3. Briefly state the lesson for the day and its
objectives.
4. Don’t just stand behind the desk. Move
around the room from time to time and get closer
to the students. Modulate your voice so that
everyone in the room will hear you.
Conduct an assessment of your learners either
formally through a pretest or short question-naire
or informally by asking questions related to the
course.

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 APPROACHES IN TEACHING:
Approach is a general plan or scheme to
achieve an objective. It provides the teacher
with an enlightened and objective view point, a
sound philosophy and orientation to the total
process of teaching, and the selection of an
instructional method. The approach specifies
and describes the following components of
instructions which are the :
1. major goal of teaching;

64
 2. nature of the subject matter;
3. teaching-learning process
4. roles and responsibilities of the teacher;
5. expectations from students;
6. kinds of evaluations techniques;
7. suitable teaching methods and strategies
to be employed.
TWO TRADITIONAL APPROACH TO TEACHING:
1. INDUCTIVE APPROACH---begins with parti-

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 cular statements to general statements.
 It is also known as discovery method because
as the learner is . he is able to discover or
arrive at a truth fact, conclusion or genera-
lization.
Example:
a. Enzo has red blood cells. Human beings have
red blood cells. Therefore, Enzo is a human
being.

66
 b. The lesson starts with a review of the
concept of animals. The cow is a warm-blooded
animal. It lives on land. It uses its lungs to
breath. It feeds and nurtures its young. Man
also possesses these characteristics. A mammal
possesses all the above mentioned characteris-
tics. Therefore, a cow and man are mammals.
Inductive reasoning – is a way of thinking
from specific observations to more general
rules.

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 The process of generalization (reasoning or
explaining) from a simple to a specific situation to
a complex or general one.
2. DEDUCTIVE APPROACH (P 121)
--a general statements to specific statements;
--solving a problem or difficulty is done by
applying to it a generalization that has
already been formed.
Example: a. Human beings are composed of
red blood cells. Enzo is a human being. There-
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fore, Enzo has red blood cells.
(What is the characteristic of a human
being?) (What /who is Enzo?) (Does
Enzo possesses red blood cells?)

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