1. Principles of Teaching, Adult Learners and Learning Styles
Module 2 Objectives
Gain knowledge in the variables that comprise the principles of teaching, including the different theories of learning
Identify characteristics of adult learners and the various learning styles
Verbalize ways to develop individual teaching plans based on adult learning principles and learning styles

2. Principles of Teaching Characteristics of an Effective Teacher
Personal characteristics
With students
Is trustworthy, energetic, enthusiastic, responsible
Demonstrates clinical and professional competence
Keeps agreements, sets a good example, models appropriate behavior
Shows respect, interpersonal regard for the learner, and commitment to their growth and improvement
Stimulates interest, has knowledge and presents it with clarity
Explains things well, is responsive to questions, provides clear feedback
Relates well interpersonally
Displays high expectations, emphasizes improvement rather than competition
Attributes success to effort and failure to lack of effort
Respects students’ authority, nurtures self-directed learning, builds student confidence
Enjoys patient care and teaching
Involves students’ in learning process
Medical College of Georgia
Is trustworthy, energetic, enthusiastic, responsible,
In the roles and responsibility module, you learned one of your responsibilities is to be a teacher. Here you see a table with some of the characteristics of an effective teacher. I would bet each of you have had at some time, a teacher that you remember, maybe for a trait that is in this table, or possibly for a trait that did not make them effective. The skill set to be an effective teacher is different from the skills it takes to be an expert clinical staff nurse. You must be willing to be patient, to take apart the whys of what you do. Many expert nurses react out of experience and intuition and have trouble putting into words why they did a particular action. Practicing giving rationale to your actions and decisions will improve your teaching but also will enhance your skills in the clinical setting. This increased awareness of your actions provide concreteness to the impact you have regarding patient outcomes.

3. Principles of Teaching
Teaching Strategies
Observation and Feedback
Be specific
Share your observation
Mini-Lectures
Demonstration/Role Modeling
Sharing Reasoning Process/Critical Thinking
These are a few suggested teaching strategies;
Observations enables you to give very specific feedback, for both strengths and weaknesses, rather than global judgments. For example, you may tell your preceptee, “when you asked the patient how their night was and she responded, OK I guess, and you continued hanging the antibiotic, you missed an opportunity to explore a little deeper by what she meant by that” or maybe the encounter goes ” when you asked the patient how their night was and she responded OK, I guess, by stopping what you were doing and asking a follow-up question, you demonstrated active listening and allowed the patient to expand their initial answer, it also showed real interest in the patient as opposed to just making small talk, That was very good.”
Look for specific behaviors, such as - putting a patient at ease, communicating clearly, listening attentively, responding to patient issues, organizing information flow, organizing the physical examine. Sharing these observations with your preceptee, will help both of you identify the preceptee’s areas of strengths and needs.
Mini lecture are like a 30 second burst of information , such as-how does this drug work, why do we restrict this patient’s fluids, why are we hearing wheezes, what is happening physiologically or anatomically. It is not a formal lecture, it happens more informally, while walking to the patient room , waiting your turn at the med Pyxis. It can be very effective. Be careful not to use this as a form of constant quizzing or trying to catch them at something they do not know. As a mini-lecture, you may be the one providing the information, it is a teaching strategy
Demonstration/Role modeling, the concept of demonstration as a principle of teaching is something we do all the time in nursing, I’ll hang the antibiotic, you watch me and next time I will have you do it and I watch. Much of our teaching of psychomotor skills are taught using this principle and return demonstration is an acceptable way to validate competencies
Sharing your reasoning process or your critical thinking. As I mentioned earlier, explaining the whys of what we do can be a very effective teaching strategy. We have an entire module on critical thinking and will discuss examples of how to teach this skill in that module. It is mentioned here as a principle of effective teaching.

4. Principles of Teaching
This slide is a reminder that nurses are not formal teachers, in that we did not go to school to receive a degree in education. But informally, teaching is something nurses do everyday, with our patients, their families and with each other,. As a preceptor, teaching is a huge part of what you are doing and understanding a few principles of effective teaching will benefit the precepting experience. (end)

5. Principles of Teaching (Perry’s model of cognitive development)
Perry’s four stage model of cognitive development
Particularly insightful when a new nurse wants one right answer and the preceptor is trying to get them to see alternative approaches
Understanding cognitive development is helpful to promote growth into the next stage , with challenge and support
Call the doctor
Let them know
Get Tylenol
Mobilize patient
TCDB
ambulate
Other options
Is there infection?
What is wrong with this patient
To improve our teaching, it may be helpful to understand a little bit about how people learn. There are multiple theories about learning and the teaching –learning process. Perry’s theory of cognitive development was based on research with college students and gets a fair amount of attention in the nursing education literature. Knowing a little about this theory can be helpful in understanding your student’s current cognitive development and how to encourage them to progress from a single right answer to seeing several solutions to a problem, each with their own merits. Understanding a little about this theory is also helpful for you to avoid frustration with your student. As noted here, frequently a new nurse wants one right answer, but frequently with patient care, there isn’t one that is right every time. Patient situations are complex and unique and this can be frustrating as the new nurse is trying to learn “the rules”. Let me give you an example, You just got the 0400 VS and your fresh post-op has a fever your student wants to call the MD. You suggest getting the pt to sit up and use IS and recheck. Sure enough with good pulmonary toilet, the temp comes down to 99. Your student is confused, “when will I know if I should call the doctor or not?” You explain that every situation is unique and with time and experience they will learn.
To help students move through this development there needs to be a balance of challenge and support
I have listed an article in the reference section at the end of this module that you can obtain free on the web. It succinctly describes each level and different behaviors you may encounter, it is a quick read and you may find it useful.

6. Principles of Teaching (Perry’s model)
Dualism
Absolutes/right and wrong
Multiplicity
Able to view multiple answers, but unable to adequately justify each answer
Relativism
See “big picture”, knowledge relative to the situation
Commitment
Responsibility and risk by making a commitment
Dualism
Multiplicity
Relativism
Commitment
Perry’s model identified four broad categories that students tend to pass through in a sequential manner thus indicating intellectual development. At any point, further development may be halted and an awareness from the teacher’s perspective could help a student to continue to grow. Realistically, growth does not always occur linear like this, but understanding this model can still be helpful (Billings & Halstead, 2005).
In the first stage, students see knowledge as right or wrong and learning is about finding the “right” answers. As they continue grow intellectually, students realize there is diversity but are still uncertain with their own explanations of why. As they continue to progress, they begin to recognize that “knowledge is contextual, uncertain and relative” (p.246). They begin to abstract, weigh information and to problem solve based on specific situations. It is here that students fully engage in critical thinking.
The last category of commitment demonstrates that students understand to move out of relativity means responsibility for a decsion and the implications of that commitment.
In your preceptor/teacher role, you want to prepare your students to deal with uncertainty since they will encounter this while providing care in our current often complex heath care environment.

7. Principles of Teaching (Benner’s model)
Expert
Proficient
Competent
Advanced beginner
novice
Dr. Patricia Benner’s work in the 1980’s of skill acquisition as it applies to nursing
Another theorist very popular in nursing education and provides insight into learning is Dr. Patricia Benner. Pat Benner became popular with her work in the early 1980’s when she applied the Dreyfus Model of skill acquisition to nursing. The skills she studies did not refer to psychomotor skills, like starting IV’s or taking a blood pressure, but more to the skills of choosing nursing interventions and making clinical judgment. She differentiated between theoretical knowledge and practical knowledge and recognized that nurses learn from experience in the clinical setting. She found that nurse move from reliance on facts to the use of past concrete experiences as a way to make decisions. As new nurses gain experience, knowledge, and acquire more skill, they move from a detached observer, outside the situation to an involved performer engaged in the situation (Benner, 2001, p.13-14).
Dr. Benner’s book ,“From Novice to Expert: Excellence and Power in Clinical Nursing Practice” has great examples of how nurses think at each stage and is a wonderful resource if you would like to learn more about the way nurses learn and develop into experts.
When precepting students, you will mostly be working with nurses in the first two stages. Expecting a novice nurse to function at an advanced stage is unrealistic and will only bring frustration for both you as the teacher and for the student.

8. Adult Learners Adults have a deep desire to be self-directed
Adults attach more meaning to learning gained from experience (doing) than from passive learning (lecture)
Adults are ready to learning something when they experience a need to solve a real life problem
Adults want to be able to apply what they learn
Adults are performance-centered and learning should be organized around competencies
Billings & Halstead
Now let’s switch gears, we have been talking about teaching principles and learning theories, but it is also important to consider who your are teaching, looking at the individual. Your student may have gone from high school straight into nursing, but they may have worked out in the world for a while or even have a previous degree and have worked professionally in another job. There are a few underlying principles when working with adults that will help you to understand each other during your precepting experience. You can see a few a of those principles listed here. Another advantage to understanding and using adult learning principles, is that it is also applicable when you are teaching your adult patients.

9. Learning Styles
Sensory Preference
visual
auditory
tactual
kinesthetic
Organizational Preference
global
sequential
Perceptual Preference
abstract
concrete
Each of us has their own learning style, it is the way you prefer to learn. Learning is possible under almost any condition, but can flourish when the right conditions match the individuals learning preferences. Think of a time you have gotten a new piece of equipment on your unit. Some nurses prefer to be instructed on how the equipment works, while others want to see the instructions and read them for themselves, while still others could care less about the instructions and immediately want to “play” with the equipment and figure out how it works for themselves. No one way is right or wrong, but conflict can arise when an instructor is using only one style and the learner is having difficult grasping a concept until it is explained in a style they prefer. Here are just a few examples of some of the different learning styles.

10. Resources for additional information on learning styles
Good overview information
Entire page of additional resources and a learning style quiz
Lots of good information including a quiz and strategies for each style
Good online quiz
You can go on the internet and find multiple examples of learning style tests and additional information on ways to learn, I have just named a few here. I strongly encourage you to discover your own learning preferences and to have your preceptee do the same. This way you can individualize your teaching plan
Identifying and utilizing each others learning style will not only benefit individualized learning but can decrease conflict and promote understanding each other as unique individuals.(end)