Teaching Strat Lesson 4 Determinants of Learning

Strategies to Health Education
DETERMINANTS OF
LEARNING
DETERMINANTS OF LEARNING
Learning Needs Readiness to Learn Learning Style
WHAT the WHEN is the

HOW the
patient needs patient
patient learns
to learn. receptive to
best.
learning.
LEARNING NEEDS
- Is the gap between what someone knows and
what someone needs to know.
ASSESSING LEARNING NEEDS

1. Identify the patient.
2. Choose the right setting.
3. Collect important
information about the
patient.
4. Involve members of the
health care team.
5. Take time-management
issues into account.
6. Prioritize needs.
CRITERIA FOR PRIORITIZING LEARNING

NEEDS
CRITERIA LEARNING NEEDS
Needs that must be learned for survival or situations
MANDATORY in which the patient’s life or safety is threatened.
Learning needs in this category must be met
immediately.
Needs that are not life-dependent but are related to

DESIRABLE well-being or the ability to provide self-care.
Needs for information that is “nice to know” but not

POSSIBLE essential or required or situations in which the
learning need is not directly related to daily activities.
METHODS OF ASSESSING
LEARNING NEEDS
1. Casual conversation
2. Structured interviews
3. Questionnaires
4. Observations
5. Patient charts
READINESS TO LEARN
- Is the time when the learner expresses or
shows interest in learning the information
necessary to maintain optimal health
READINESS TO LEARN
PHYSICAL
READINESS
EMOTIONAL EXPERIENTIAL
READINESS READINESS
KNOWLEDGE
READINESS
PHYSICAL READINESS
Physical readiness factors need to be
considered by the nurse because they may
have an adverse impact on the degree to
which learning will occur.
PHYSICAL READINESS
1. Measures of Ability
2. Complexity of Task
3. Environmental Effects
4. Health Status
5. Gender
PHYSICAL READINESS
Measures of Ability
 The nurse must assess the
adequate strength, flexibility
and endurance of the patient
 For information to be
accurately processed, sense
of seeing and hearing must
be functioning.
PHYSICAL READINESS
Complexity of Task
 The nurse must take into
account the difficulty level of
the subject or task to be
mastered by the patient.
 The complex the task, the
more changes in behavior are
necessary to acquire a skill.
PHYSICAL READINESS
Environmental Effects
 An environment favorable to learning will help to
keep the patient’s attention and stimulate interest in
learning.
PHYSICAL READINESS
Health Status
 Assessment of the
patient’s health status
is important to
determine the amount
of energy available for
learning.
EMOTIONAL READINESS
How emotionally ready someone is to learn.
EMOTIONAL READINESS
1. Anxiety Level
2. Support System
3. Motivation
4. Risk-Taking Behavior
5. Frame of Mind
6. Developmental Stage
EMOTIONAL READINESS
Anxiety Level
 Anxiety influences the ability
to perform mental or
physical tasks
 Depending on the level of
anxiety, patients may be
better or less able to learn
new skills.
 Fear may lead patients to
deny their illness which
interferes with their ability to
learn.
EMOTIONAL READINESS
Support System
 A strong support system
decreases anxiety.
 If the patient feels
emotionally supported, it
sets the stage for the
“teachable moment” when
the patient is most receptive
to learning.
EMOTIONAL READINESS
Motivation
 The level of motivation is
related to what the patient
perceive as an expectation of
themselves or others.
 Patients who are ready to
learn show an interest and
willingness to participate or
to ask questions.
EMOTIONAL READINESS
Risk-Taking Behavior
 Some patients will take more
risks than others.
 Risks can be threatening
when the outcomes are not
guaranteed.
 Nurses should help patients
develop strategies to reduce
the risks of their choices.
EMOTIONAL READINESS
Frame of Mind
 Involves concern about the
here and now.
 If survival is the primary
concern, the readiness to
learn will be focused on
meeting the human basic
needs.
EMOTIONAL READINESS
Developmental Stage
 Each stage associated with human development
produces a peak time for readiness to learn certain
tasks.
EXPERIENTIAL READINESS
1. Levels of Aspiration
2. Past Coping Mechanism
3. Cultural Background
4. Locus of Control
5. Orientation
Levels of Aspiration
 Previous failures and past
successes influence what
goals patients set for
themselves.
 Important motivators for
learning.
Past Coping Mechanism
 Must be explored to
understand how patient has
dealt with previous
problems.
 Determine if their past
coping mechanisms will
work well under present
learning situation.
Cultural Background
 Knowledge by nurses about
patient’s culture and
behavioral differences are
important to avoid teaching
in opposition to cultural
beliefs.
 Allows to bridge the gap
between health care culture
and patient’s culture.
Locus of Control
 Patients with internal locus of control are ready to
learn when they feel a need to know about
something.
 Patients with external locus of control depend on
the expectations and initiatives of others to get them
motivated to learn.
Orientation
Parochial Orientation
 Conservative in thinking
 Traditional approach to
situations
 Unwilling to accept change
 Raised in a small town
atmosphere or from a
cohesive neighborhoods and
sheltered family
environments
Orientation
Cosmopolitan Orientation
 Liberal in thinking
 Worldly perspective on life
due to broader experiences
 Receptive to new ideas and
opportunities to learn new
ways of doing things.
KNOWLEDGE READINESS
Refers to the patient’s
present knowledge, the
level of learning
capability and the
preferred style of
learning.
KNOWLEDGE READINESS
1. Present Knowledge Base
2. Cognitive Ability
3. Learning Disability
4. Learning Styles
KNOWLEDEGE READINESS
Present Knowledge Base
 Always find out what the
patient already knows prior
to teaching
 Build on their present
knowledge to encourage
readiness to learn
Cognitive Ability
 The nurse must match
behavioral objectives to the
intellectual ability of the
patient.
 The level at which the patient
is able to learn is of major
importance when planning to
teach.
Learning Disability
 People with learning disabilities require special
approaches to teaching
Learning Styles
 Assessing how someone
learns best will help nurse to
vary teaching approaches
accordingly.
 Meeting the needs of
patients with different styles
of learning increases
readiness to learn.
LEARNING STYLE
- Refers to the way individuals process
information
SIX LEARNING STYLE PRINCIPLES

1. Both the style by which the nurse prefers to teach and the
style by which the patient prefers to learn can often be
identified.
2. Nurse need to guard against teaching by their own
preferred learning styles.
3. Nurses should assist patients to identify their own style
preferences.
4. Patients should have the opportunity to learn through
their preferred style.
5. Nurses should encourage patients to diversify their style
preferences.
6. Nurses must become aware of various methods and
materials available to address and augment the different
learning style.
LEARNING STYLE THEORIES
Right Brain/Left Vocal Emotional
Brain and Whole Analytical Visual

Spatial
Brain Thinking Non-verbal
(Roger Sperry)
Right Brain/Left Brain and

Whole Brain Thinking
(Roger Sperry)
Left Hemisphere Right Hemisphere
Thinking is critical and Thinking is creative and
logical intuitive
Prefers talking Prefers drawing and
manipulating objects
Responds to verbal Responds to written
instructions and instructions
explanations
Recognizes and remembers Remembers and recognizes
names pictures and faces
Right Brain/Left Brain and

Whole Brain Thinking
(Roger Sperry)
Left Hemisphere Right Hemisphere
Solves problems by logically Solves problems by looking
breaking them into parts at the whole picture
Good organizational skills Loose organizational skills
Likes stability, willing to Likes change and
adhere to rules uncertainty
Conscious of time and Frequently loses contact
schedules with time and schedules
Controls emotions Free with emotions



Dunn and Dunn
Learning Style
(Rita Dunn / Kenneth Dunn)
 Identified basic stimuli that affect a

person’s ability to learn and are very
relevant to the role of the nurse as
teachers.

Jung and Myers-Briggs
Typology
 Explains personality similarities and
differences by identifying the ways
people prefer to take in and make us of
data from the world around them.
Jung and Myers-Briggs

Typology
People can be classified using three criteria called
dimensions of preferences:
Extraversion-Introversion (EI): reflects an orientation to either
the outside world of people and things or to the inner world of
concepts and ideas.
Sensing-Intuition(SN): describes perception as coming directly
through the five senses or indirectly by way of the unconscious.
 Thinking-Feeling(TF): approached used by individuals to
arrive at judgment through impersonal, logical or subjective
processes.
 Judgment-Perception(JP): where an individual comes to a
conclusion about something or becomes aware of something.
EXTRAVERT INTROVERT
•Likes group work •Likes quiet space
•Dislikes slow-paced learning •Dislikes interruptions
•Likes action and to experience •Likes learning that deals with
things so as to learn thoughts and ideas
•Offers opinions without being •Offers opinions only when asked
asked •Asks questions to allow
•Ask questions to check on the understanding of learning
expectations of nurse activity
SENSING INTUITION
•Practical •Always likes something new
•Realistic •Imaginative
•Observant •Sees possibilities
•Learns from orderly sequence of •Prefers the whole concept vs. details
things
THINKING FEELING
•Low need for harmony •Values harmony
•Find ideas and things more •More interested in people than
interesting than people things or ideas
•Analytical •Sympathetic
•Fair •Accepting
JUDGMENTAL PERCEIVING
•Organized •Open-ended
•Methodical •Flexible
•Work-oriented •Play-oriented
•Controls the environment •Adapts to the environment

Kolb’s Cycle of Learning
 Learning is a continuous process.
The learner is not a blank slate and that
every learner approaches a topic to be
learned based on past experiences,
heredity and the demands of the present
environment.
CONCRETE EXPERINECE (CE)
“Feeling”
ACCOMMODATOR DIVERGER
•Enjoys new & challenging situations •Good at viewing concrete situations
•They act on intuition and “gut from many points of view
feelings” rather than logic •Observant and likes to work in
•Risk-takers &explore possibilities groups
•Learns best through “hands-on”, •Active imagination , enjoys being
EXPERIMENTATION (AE)
role-playing, games and computer involved and sensitive to feelings
OBSERVATION (RO)
simulations •Learns best though group
discussions and brain-storming
REFLECTIVE
“Watching”
sessions.
“Doing”
ACTIVE
CONVERGER ASSIMILATOR
•Likes structure and factual •Ability to understand large amount
information of information
•Prefers technical tasks rather than •Less interested in people and more
dealing with social & interpersonal focused on abstract ideas and
issues concepts
•Ability to use deductive reasoning •Good at inductive reasoning
•Learns best through return- •Learns best through lecture, 1-1
demonstration and using hand-outs instruction,
ABSTRACT CONCEPTUALIZATION (AC)

“Thinking”

Multiple Intelligences
Howard Gardner
 Children can be assessed from the

standpoint of growth and each individual’s
unique pattern of neurological functioning.
Eight kinds of intelligences located in
different parts of the brain.

Howard Gardner
Howard Gardner
Linguistic
Intelligence
 Highly developed auditory
and think in words
 Likes to write, tell stories,
spell words accurately, read
and can recall names and
dates
 Learns best by verbalizing,
hearing or seeing words
 Word games and puzzles are
good tools in teaching
Howard Gardner
Logical-Mathematical
Intelligence
 Explore patterns, categories,
and relationships.
 Can do arithmetic problems
quickly in their heads, likes to
learn computers and do
experiments to test concepts
they do not understand.
 Enjoys strategy board games
such as chess or checkers
Howard Gardner
Spatial Intelligence
 Learn by images and pictures.
 Enjoys such things as building
blocks, jigsaw puzzles and
daydreaming
 Likes to draw or do art
activities, can read charts and
diagrams, and learn with visual
methods such as videos or
photographs
Howard Gardner
Musical Intelligence
 These children can be found
singing a tune, telling you when
a note is off-key.
 Likes playing musical
instruments with ease, dancing
to music and keeping time
rhythmically.
 Learns best with music
playing in the background.
Howard Gardner
Bodily-kinesthetic
Intelligence
 These children learn by
processing knowledge through
bodily sensation
 They need to learn by moving
or acting things out.
 It is difficult for these learners
to sit still for long periods of
time.
 They are good at sports and
have highly developed fine-
motor coordination
Howard Gardner
Interpersonal
Intelligence
 These children understand
people, are able to notice other’s
feelings, tend to have many
friends, and are gifted in social
skills
 They learn best in groups and
gravitate toward activities that
involve others
Howard Gardner
Intrapersonal Intelligence
 These children have strong
personalities and prefer the inner
world of feeling and ideas.
 They are very private individuals,
likes a quiet place to learn and many
times need to be by themselves in
order to learn.
 They are self-directed and self-
confident and learns best through
independent and self-paced
instruction.
BREAK-OUT QUESTIONS
1.Why is it important to assess

learning style?
2.What are the determinants
of learning?
3.What is/are the roles of
nurses in each of the
learning theories discussed?

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Strategies to Health Education

Learning Needs Readiness to Learn Learning Style

WHAT the WHEN is the

ASSESSING LEARNING NEEDS

CRITERIA FOR PRIORITIZING LEARNING

Needs that are not life-dependent but are related to

Needs for information that is “nice to know” but not

SIX LEARNING STYLE PRINCIPLES

LEARNING STYLE THEORIES

Right Brain/Left Vocal Emotional

Brain and Whole Analytical Visual

Brain Thinking Non-verbal

Right Brain/Left Brain and

Right Brain/Left Brain and

LEARNING STYLE THEORIES

LEARNING STYLE THEORIES

LEARNING STYLE THEORIES

 Identified basic stimuli that affect a

LEARNING STYLE THEORIES

Jung and Myers-Briggs

LEARNING STYLE THEORIES

role-playing, games and computer involved and sensitive to feelings

ABSTRACT CONCEPTUALIZATION (AC)

LEARNING STYLE THEORIES

 Children can be assessed from the

LEARNING STYLE THEORIES

1.Why is it important to assess

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