Chapter 4 Factors Influencing Assessment

Assessing Readiness for Health Education Role of perception Readiness to learn Motivation to learn Level of wellness Socioeconomic factors Cultural factors Educational level

Communication Challenges during Assessment Hearing impairment Vision impairment Language impairment Nurse/educator’s contribution to communication challenges

The Teaching and Learning Environment Psychological environment Physical environment

Teaching and Learning Settings Hospital and long-term care facility Private home School Worksite Community

CCCC/AOL Quick Teaching Guide Assess Client Concerns  Ask: what are your concerns?  Observe: nonverbal behavior.  Listen: spoken and unspoken words.

CCCC/AOL Quick Teaching Guide Assess Client’s Knowledge  Ask: what do you understand about condition?  Observe: nonverbal behavior.  Listen: determine accuracy of knowledge and teaching needs.

CCCC/AOL Quick Teaching Guide Create Teaching Plan  Ask self: what type and amount of information is needed?  Observe: context of client situation.  Listen: reflect on appropriateness of teaching plan.

CCCC/AOL Quick Teaching Guide Carry Out Teaching Plan  Ask: what is your understanding of what I have explained?  Observe: nonverbal cues to understanding/not understanding, return demonstration.  Listen: client feedback, evaluate teaching. effectiveness, determine additional educational needs.

The Child Learner the infant (0-1) the toddler (1-3) the preschooler (3-4) the school age (4-12) the adolescent (12-19)

Factors Influencing Development  Biological characteristics  Psychosocial stages  Developmental tasks

Promote and Retain Health Prevention of illness Maintaining present health status Knowledge of health problem Treatment regimen

Restore Health Acute illness Chronic illness Disability Accidents

Application of Cognitive and Behavior Learning Theories for Children Cognitive Theories of Learning Behavioral theory of Learning

Learning in Children Learning styles Play Encouraging learning

5 Steps for Personalized Health Teaching Build trust Assess factors that influence learning Establish learning objectives Selection of teaching strategies Implementation of plan Summative evaluation

The Adult Learner Early Adulthood (20s-30s) Middle Adulthood (40s-60s)

Comparison of Assumptions: Pedagogy and Andragogy AssumptionsPedagogyAndragogy Need to knowTeacher drivenLearner driven Self-conceptAcceptsSelf-directed Role of experience Happens to learner Integral to learner ReadinessBiology and academic based Social and life roles OrientationSubject centralLife-centered MotivationExternalInternal

Andragogic Assumptions about learning  The need to know  The learners’ self-concept  The role of the Learners’ Experiences  Readiness to learn  Orientation to learning  Motivation to learn

Promote and Retain Health  General health habits  General living conditions  Medications  Sexual habits  Pregnancy/children  Industry/employment  Disease prevention

Houle’s Orientation to Learning  Goal-oriented learners  Activity-oriented learners  Learning-oriented learners

Ageism  Discrimination against the elderly  Leads to disparities in health care  Increase in the elderly population   Confronting myths and stereotypes

Psychosocial Stages  Ego integrity vs. despair  Ego differentiation vs work role preoccupation  Body transcencence vs body preoccupation  Ego transcendence vs ego preoccupation

Developmental Tasks  Adjusting to retirement  Continued employment  Economic issues  Adjustments to living situation  Changing social roles  Interests/hobbies  Volunteer work

Physiological Changes that Affect Teaching/Learning  Appearance  Musculoskeletal system  Cardiovascular system  Respiratory system  Gastrointestinal system  Neurological system  Sensory changes: vision & hearing

Implications of Physiological Changes that Affect Teaching/Learning 1. Promote and retain health 2. Biologic aging 3. General health habits 4. General living conditions 5. Disease & illness prevention 6. Sexual habits 7. Community services

Implications of Physiological Changes that Affect Teaching/Learning 1. Restore Health 2. Acute illness 3. Chronic illness 4. Disability 5. Accidents 6. Community services

Chronic Disease and Implications for Teaching/Learning Prevalence of chronic disease in elderly  heart disease, stroke, cancer, diabetes, hypertension, asthma, bronchitis, emphysema, arthritis, depression, vision loss, hearing impairment, alcoholism

Cognitive Functioning  Memory  Medication and cognitive functioning

Ethnic Elderly  Projections through midcentury: population to become more diverse  Hispanic population  Black population  Asian population  White population

Ethnic Elderly 1. Cultural Assessment 2. View of old age 3. Beliefs and values 4. First-generation residents 5. Language 6. Assess health practices: helpful, neutral or harmful

Nutrition  Sufficient food intake  Adequate nutrition  Adequate hydration  Good Guide Pyramid  Impact on memory, teaching/learning

Health Education w/ Others  Working with Families  Working with Groups and Communities  Working with Health Team Members

Characteristics of Culturally Diverse Learners  Shifting demographics  Health care disparities

Cultural Competence  Definition  Campinha-Bacote’s Cultural Competency Model  Cultural Assessment Tool  Andrews’ Transcultural Assessment Guide  Leininger’s Sunrise Model  Purnell’s Model for Cultural Competency  Giger & Davidhizar’s Transcultural Model

Culturally Specific Client Assessments and Concerns  African American  Asian American  Hispanic  Native American

Cross-Cultural Communication  Verbal  Nonverbal  Focused cultural assessment tools  Use of interpreters

Linguistically & Culturally Appropriate Teaching Strategies & Instructional Material  Linguistic competence  Health literacy  Sockalingam’s 8 principles

The Culturally Congruent Client Education Model  Culturally-based actions  Rationale  Culturally-based health education outcomes

Chapter 9 Learning Objectives

Learning Objectives as the basis for the teaching plan:  Guide the purpose of the plan  Guide teaching content  Guide selection of teaching strategies  Guide selection of instructional materials  Guide evaluation

Five factors to consider when establishing learning objectives  Educational philosophy (yours, physician, and health care institution).  What clients what to learn.  What you think clients need to learn.  Time available for teaching and learning.  Environment for teaching and learning.

Writing Learning Objectives: ABCD Method  Audience (who the learner is)  Behavior (what the learner is to do)  Conditions (the conditions under which the learner is to perform)  Degree (how well the learner is to perform)

Domains of Learning  Cognitive domain that emphasizes thinking.  Affective domain that emphasizes attitudes and feelings.  Psychomotor domain that emphasizes doing and performing skills.

Hierarchy: Cognitive Domain  Remembering  Understanding  Applying  Analyzing  Evaluating  Creating

Hierarchy: Affective Domain  Receiving  Responding  Valuing  Organization  Internalizing Values (Characterization)

Hierarchy: Psychomotor Domain  Perception  Set  Guided response  Mechanism  Complex overt response  Adaptation

Teaching Plan Components  Learning objectives  Content  Teaching strategies/instructional materials  Evaluation methods

Chapter 10 Teaching Strategies

 Teacher-directed Strategies  Teacher-facilitated Strategies  Learner-facilitated Strategies

 Lecture  Guest lecture  Lecture with discussion/question and answer  Demonstration/Return demonstration  Team Teaching

 Focusing discussion  Refocusing discussion  Changing the focus  Recapping  Problems with the discussion strategy

 Group Activities/Teaching  Role play  Simulation

 Games  Self directed learning (computer assisted strategies and programmed instruction)  Peer counseling

 Educational needs and learning objectives  Characteristics of the learner and teacher  Learning context and environment  Content to be learned