1. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 8 Client Teaching

2. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Importance of Client Teaching Teaching focuses on combinations of the following subject areas: –Self-administration of medications –Directions and practice in using equipment for self-care –Dietary instructions –Rehabilitation program

3. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Importance of Client Teaching (cont’d) Teaching focuses on combinations of the following subject areas (cont’d): –Available community resources –Plan for medical follow-up –Signs of complications and actions to take

4. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Stages of Learning Four progressive stages of learning –Recognition of what has been taught –Recall or description of information to others –Explanation or application of information –Independent use of new learning

5. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Style of learning means how a person responds to learning.

6. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Style of learning means how a person prefers to acquire knowledge.

7. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessing the Learner To implement effective teaching, determine the client’s: –Preferred learning style; literacy; age and developmental level; capacity to learn –Motivation; attention and concentration; learning readiness; learning needs; sensory deficits –Cultural differences

8. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Three general domains –Cognitive domain: style of processing information by listening or reading facts and descriptions –Affective domain: style of processing that appeals to a person’s feelings, beliefs, or values –Psychomotor domain: style of processing that focuses on learning by doing Learning Styles

9. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Cognitive Domain

10. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Activities Associated With Learning Domains

11. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Age-related categories of learning –Pedagogy: science of teaching children or those with cognitive ability comparable to children –Androgogy: principles of teaching adult learners –Gerogogy: techniques that enhance learning among older adults Age and Developmental Level

12. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Androgogy refers to the principles of teaching adult learners.

13. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer True. There are three major categories of learners at the early and later ends of the adult spectrum. The principles of teaching adult learners is known as androgogy. Pedagogy is the science of teaching children or those with cognitive ability comparable to children. Gerogogy consists of techniques that enhance learning among older adults.

14. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Age and Developmental Level (cont’d) Unique characteristics of young adults –Technologically literate, having grown up with computers –Prefer visualizations, simulations, and other methods of participatory learning and quick responses –Expect immediate answers and feedback

15. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Age and Developmental Level (cont’d) Unique characteristics of young adults (cont’d) –Become bored with memorizing information and doing repetitious tasks –Like a variety of instructional methods from which they can choose –Respond best when they find the information to be relevant

16. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Learning Characteristics

17. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Which of the following do young adult learners prefer? a. Memorizing information b. Repeating tasks c. Fewer instructional methods d. Participatory learning

18. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer d. Participatory learning Young adult learners do not like memorizing information or repeating tasks. They prefer participatory learning using visuals and a choice of various instructional methods.

19. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Capacity to Learn Literacy –Determine client’s level of literacy before developing teaching plan oIlliterate oFunctionally illiterate: minimal literacy skills; may disguise or compensate for learning deficits

20. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? A client with minimal literacy skills is termed “functionally literate.”

21. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. A client with minimal literacy skills is termed “functionally illiterate.”

22. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Capacity to Learn (cont’d) Literacy –Protect client’s self-esteem by asking, “How do you learn best?” –Use verbal and visual modes for instruction –Repeat directions several times in same sequence –Provide pictures, diagrams, or tapes (audio and video) for future review

23. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Capacity to Learn (cont’d) Sensory deficits –Older adults oMay have visual and auditory deficits

24. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Capacity to Learn (cont’d) Cultural differences –Language barriers do not justify omitting health teaching o If nurse and client do not speak same language, use a translator

25. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Capacity to Learn (cont’d) Attention and concentration –Affect duration, delivery, and teaching methods employed –Helpful approaches oObserve client and implement health teaching when most alert and comfortable oKeep teaching session short

26. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Capacity to Learn (cont’d) Attention and concentration (cont’d) –Helpful approaches (cont’d) oUse client’s name frequently throughout oShow enthusiasm oUse colorful materials, gestures, variety oInvolve client in an active way oVary tone and pitch of voice

27. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Question Is the following statement true or false? Increasing the duration of teaching sessions may help in overcoming problems of attention and concentration in clients.

28. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer False. Keeping teaching sessions short may help in overcoming problems of attention and concentration in clients.

29. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Motivation Learning optimal: person has purpose for acquiring new information Desire for learning: to satisfy intellectual curiosity, restore independence, prevent complications, or facilitate discharge and return to comfort of home Less desirable reasons: to please others, to avoid criticism

30. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Learning Readiness Readiness refers to client’s physical and psychological well-being In these situations, restore comfort and then attend to teaching

31. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Learning Needs Individualized teaching and learning is best Questions the nurse can ask to assess client’s learning needs: –What does being healthy mean to you? –What things in your life interfere with being healthy? –What don’t you understand as fully as you would like?

32. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Learning Needs (cont’d) Questions the nurse can ask to assess client’s learning needs (cont’d) –What activities do you need help with? –What do you hope to accomplish before being discharged? –How can we help you at this time?

33. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Informal and Formal Teaching Informal teaching: occurs spontaneously at the bedside Formal teaching: requires plan Potential teaching needs: identified at client’s admission and amended as care and treatment progress

34. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins Informal and Formal Teaching (cont’d) Teaching occurs in sessions by one or more nurses so client is not overwhelmed with: –Processing volumes of new information –Learning skills that are difficult for novices to perform

35. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations During initial assessment of levels of cognitive function: –Clients may interact in socially appropriate manner –Clients may indicate that they understand material being taught Ask client to recall what has been discussed after approximately 15 minutes to assess retained information

36. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations (cont’d) Mental status examination may be indicated Cognitive impairment: support person or caregiver present for teaching sessions Older people may be creative in methods to incorporate needed changes in health behavior if purposes or anticipated benefits are made clear at beginning of teaching session

37. Copyright © 2009 Wolters Kluwer Health | Lippincott Williams & Wilkins General Gerontologic Considerations (cont’d) Begin teaching session with reference to older person’s actual experience Project a calm demeanor in a quiet environment to decrease anxiety and distractions Peer teaching or reinforcement in support- group settings may be helpful State belief in client’s ability to change health behavior and provide encouragement