Learning Outcomes
1. Assess the learning needs of the individual client related to the
current health status in relation to the Augustinian value of
“commitment” and “competence
2. Assess with the individual and family one’s health status
competence in relation to the Augustinian value of “compassion”.
3. Apply evidence-based practices in health education in relation to
the Augustinian value of “competence ”.
4. Collaborate with other members of the health team in health
education activities in relation to the Augustinian value of
“community ”.
5. Engage in self-directed learning to enhance competence in health
education in relation to the Augustinian value of “Christ-
centeredness.”
6. Customize health education plan based on the culture, and value
of the clients in relation to the Augustinian value of “ conscience
Health Education Process
Teaching is an important aspect of the nurse’s professional role
(Andersson, Svanström, Ek, Rosén, & Berglund, 2015; Friberg,
Granum, & Bergh, 2012), whether it be educating patients and their
family members, colleagues, or nursing students.
The current trends in health care are making it essential that patients
be prepared to assume responsibility for self-care management
and that nurses in the workplace be accountable for the delivery of
safe, high-quality care (Hines & Barndt-Maglio, 2011; Lockhart, 2016;
Shi & Singh, 2015; U. S. Department of Health and Human Services
[USDHHS], 2015).
Health Education Process
“Patient education has been a part of health care since the first
healer gave the first patient advice about treating his (or her)
ailments” (May, 1999p. 3).
Although the term patient education was not specifically used,
considerable efforts by the earliest healers to inform, encourage, and
caution patients to follow appropriate hygienic and therapeutic
measures occurred even in prehistoric times (Bartlett, 1986).
Because these early healers—physicians, herbalists, midwives, and
shamans—did not have a lot of effective diagnostic and treatment
interventions, it is likely that education was, in fact, one of the most
common interventions (Bartlett, 1986).
Health Education Process
Nursing is unique among the health professions in that patient
education has long been considered a major component of standard
care given by nurses. Since the mid-1800s, when nursing was first
acknowledged as a unique discipline, the responsibility for teaching
has been recognized as an important role of nurses as caregivers.
The focus of nurses’ teaching efforts is on the care of the sick and
promoting the health of the well public.
For decades, then, patient teaching has been recognized as an
independent nursing function.
Nurses have always educated others—patients, families, colleagues,
and nursing students.
Purposes, Goals, and Benefits of Patient and Nursing Staff/Student Education
The purpose of patient education is to increase the competence and confidence of
clients for self-management.
The primary goal is to increase the responsibility and independence of clients
or self-care. This can be achieved by supporting patients through the transition from
being dependent on others to being self-sustaining in managing their own care and
from being passive listeners to active learners.
2000).
The benefits of client education are many (Abbott, 1998; Adams, 2010; Dreeben, 2010;
LiberateHealth, 2014; Wingard, 2005).
■ Increase consumer satisfaction
■ Improve the quality of life
■ Ensure continuity of care
■ Decrease patient anxiety
■ Effectively reduce the complications of
illness and the incidence of disease
■ Promote adherence to treatment plans
■ Maximize independence in the performance
of activities of daily living
■ Energize and empower consumers to become
actively involved in the planning of their care
In turn, the benefits to nurses in their role as educators may include the following
The education process is a systematic, sequential, logical, scientifically based,
planned course of action consisting of two major interdependent operations:
teaching and learning.
This process forms a continuous cycle that also involves two interdependent
players: the teacher and the learner.
A. Theories and Principles of Learning
1. Characteristics of learning
a. Learning is unitary holistic.
b. Learning is individual and social.
c. Learning is self-active and self-initiating.
d. Learning is purposive and goal-oriented.
e. Learning is selective and creative.
f. Learning is influenced and is transferable
Major types of Learning
a. Ideational learning-carried out in the cognitive domain of the intellect
b. Skill learning or psychomotor learning- carried out in the conative or psychomotor domain.
c. Emotional learning- refers to mental states which are characterized by feelings and emotions.
Learning styles
a. Diverging- learners look at things from different perspectives, they are sensitive and prefer to watch rather than do things.
b. Assimilating – learning style that is concise and logical in its approach.
c. Converging- learners used their learning to find solutions to practical issues.
d. Accommodating – is a “hands-on” learning style.
Laws of learning
a. Law of readiness- states that one must be physically, emotionally, and mentally ready to learn.
b. Law of exercise – stresses the idea that repetition is basic to the development
of adequate response or outcome.
c. Law of effect- involves the learner’s emotional response to a stimulus.
d. Law of primacy – states that the state of being first often creates a strong impression.
e. Law of intensity- states that if stimulus or experience is real, the more likely learning will occur.
f. Law of recency – states that information of skills most recently learned are best remembered.
A. ASSESSING THE LEARNER
Assessment of needs is the initial step in the educational process as it helps
validate the need for learning and the approach to be used in designing learning
experiences.
• DETERMINANTS OF LEARNING
- Nursing assessment of needs, readiness, and styles of learning is the first and
most important step in instructional design—but it is also the step most often
neglected.
Three Determinants:
I. Learning Needs
- what the learner needs to know; to discover the extent of instruction.
- Defined as gaps in knowledge that exist between a desired level of performance
and the actual level of performance.
Health Education Process
Important steps in the assessment of learning needs:
1. Identify the learner. The development of formal and informal education programs for
patients and their families, nursing staff, or students must be based on accurate
identification of the learner.
2. Choose the right setting. Establish a trusting environment to assure privacy and
confidentiality to the learners.
3. Collect data on the learner. Once the learner is identified, the educator can determine
the characteristic needs of the population by exploring typical health problems or issues
of interest to that population.
4. Include the learner as a source of information. Learners are usually the most
important
source of data in defining their own problems and needs.
5. Involve members of the healthcare team. Nurses are not the sole teachers, and they
must remember to collaborate with other members of the healthcare team for a richer
assessment of learning needs.
6. Prioritize needs. Maslow’s (1970) hierarchy of human needs may help the educator
prioritize identified learning needs.
7. Determine the availability of educational resources.
8. Assess the demands of the organization.
9. Take time-management issues into account.
Health Education Process
Methods to Assess Learning Needs:
1. Informal Conversations
- The nurse relies on active listening.
- Learners reveal information about their perceived learnings by posing open-ended
questions.
2. Structured Interviews
- Nurse asks direct and predetermined questions to gather information.
- Interviews yield answers that may reveal uncertainties, conflicts, inconsistencies,
unexpected problems, anxieties, fears, and present knowledge base.
3. Focus Groups
- Involve 4 to 12 potential learners, led by a facilitator, to identify different points of view or
knowledge about a certain topic.
4. Self-Administered Questionnaires
- One of the most common forms is the checklist which obtains the learner’s written
responses to questions about learning needs.
- Easy to administer, provide more privacy than interviews, and is easy to tabulate data.
5. Written Pretests
- Given before teaching to help identify the knowledge level of potential learners regarding a
particular subject and assist in identifying specific needs of the learner.
6. Observations
- Observing health behaviors in several different time periods can help to determine
established patterns of behavior.
7. Patient Charts
- Create patterns from physicians’ progress notes, nursing care plans, nurses’ notes, and
discharge planning forms that reveal learning needs.
Health Education Process
II. Readiness To Learn
- When the learner is receptive to learning
- learner demonstrates interest in learning the type or degree of
information necessary to maintain optimal health or to become more
skillful in a job.
- It is the responsibility of the educator to discover through
assessment exactly when patients are ready to learn and what they
want to learn.
The health educator must:
• Adapt with the content to be learned to fit with what the learner is
ready to learn.
• Understand first what needs to be taught and be competent in
collecting and validating
information.
Health Education Process
Done prior to the time when actual learning is to occur. If the learner is
not ready, the information will not be absorbed.
• Give thought as to what is required of the learner—that is, what
needs to be learned, what the learning objectives should be, and in
which domain and at what level of learning these
objectives should be classified.
Types of readiness to learn: (PEEK)
Health Education Process
P = Physical Readiness
• Measure of ability. Measures the strength, flexibility, and endurance, as well as the
visual and auditory acuity to perform movements that affect the ability to learn.
• Complexity of task. The nurse educator must take into account the difficulty level of
the subject or task to be mastered by the learner. Variations will affect the extent to
which behavioral changes are necessary in the cognitive, affective, and psychomotor
domains.
• Environmental effects. An appropriate environment will help keep the learner’s
interest and attention in learning might as well avoid any types of interference such as
high levels of noise.
• Health status. Healthy learners have the energy available and present comfort for
learning. Learners who are acutely ill tend to focus their energies on the physiological
and psychological demands of their illness.
• Gender. According to research, women respond more to medical care and avoid risk to
their health than men. This behavior is thought to be socially induced because of the
attention paid to increase a healthier lifestyle as well as the gender roles in the home
and the workplace.
Health Education Process
E = Emotional Readiness
• Anxiety level. Anxiety levels greatly influence the performance of cognitive, affective,
and psychomotor levels. It may or may not hinder an individual in learning and
performing new skills.
• Support system. Composed of family, friends, significant others who increase
security and emotional readiness. A strong support system decreases anxiety, while
the lack of one increases anxiety levels.
• Motivation. Motivation together with interest and emotional readiness piques the
learner to achieve a task leading to meaningful teaching-learning experiences. The
level of motivation is related to what an individual expects from oneself.
• Risk-taking behavior. Developing strategies to reduce the risk in the choices requires
decisions among the worst, best, and most probable case scenarios until it is
recognized as an acceptable choice.
• Frame of mind. Meeting basic human needs such as food, warmth, comfort, and
safety as well as psychosocial needs of acceptance and security to determine his or
her readiness to learn.
• Development stage. Readiness to learn is associated when a child reaches the peak in
human development to be able to cope better with real-life tasks and apply
knowledge based on past experiences.
Health Education Process
E = Experiential Readiness
- refers to the learner’s past experiences with learning and willingness to take risks in
overcoming problems and accomplishing new tasks.
• Level of aspiration. Short- or long-term goals established by the learners influence
their motivation to pursue an output and achieve satisfaction.
• Past coping mechanism. Coping mechanisms are identified how it was dealt in the
past and determine the effectivity even in present learning situations.
• Cultured background. To assess and acknowledge different cultural perspectives in
determining the readiness to learn.
• Locus of Control. A learner’s motivation to learn; comes in two types:
‣ Internal locus of control - patients are internally motivated to learn; ready to learn
when they feel a need to know about something.
‣ External locus of control - externally motivated; someone must encourage them to
learn something.
• Orientation. A person’s point of view; two types:
‣ Parochial orientation - close-minded, conservative in their approach to new
situations,
less willing to learn new material, and place more trust in physicians.
‣ Cosmopolitan orientation - have a worldly perspective, receptive to new ideas and
opportunities to learn new ways of doing things.
Health Education Process
K = Knowledge Readiness
- learner’s present knowledge base, the level of learning capability, and the preferred
style of learning.
• Present knowledge base. Amount of knowledge an individual already has and proficiency
in performing tasks.
• Cognitive ability. The learner’s extent of processing information by understanding,
memorizing, recalling, and material recognition (which are considered at a lower level of
learning) until able to demonstrate problem-solving, concept formation, and application of
information.
• Learning disabilities. Deficits caused by mental retardation may require special or
innovative approaches to instruction to sustain readiness to learn.
• Learning styles. Assessing the learner’s preferred learning style in which one may learn
best will help the educator provide teaching methods or materials that meet the needs of
learners as well as increase their readiness to learn.
Health Education Process
III. Learning Styles
- ways of an individual to process information.
Types of Learning Styles:
VARK learning style was introduced by Neil D. Flemming and Coleen E. Mills in 1992.
V - Visual
• Information were depicted through meaningful symbols, illustrations, charts, diagrams,
photos or videos;
• Process information as a whole than by piece;
• Best described as visual learners.
A - Auditory
• Process information through hearing;
• Opt to take down notes during class, therefore less engaged in their class;
• Learn best through discussions in groups and reading their written work aloud to
themselves helps them to think it through.
R - Reading/Writing
• Learns best from the information presented in class in form of handouts or PPT presentations;
• Encourage taking down notes during lecture hours which helps in processing information
and recalling it afterward.
K - Kinesthetics
• Also called tactile mode;
• Learners are hands-on and active in participating in lessons physically which brings out
the best in their educational process;
• Engages all senses in the process of learning;
• Strive in skill-based activities.
B. DEVELOPING A HEALTH EDUCATION PLAN
Step 1: Manage the Planning Process
Purpose: To develop a plan to manage stakeholder participation, timelines, resources, and
determine methods for data gathering, interpretation, and decision making.
• Plan to engage stakeholders, including clients and staff;
• Establish a clear timeline for creating a work plan;
• Plan how you will allocate financial, material, and human resources;
• Consider the data required to make decisions at each step including adequate time for
data collection and interpretation.
• Establish a clear decision-making process.
Step 2: Conduct a Situational Assessment
Purpose: to learn more about the population of interest, trends, and issues that may affect
implementation, including the wants, needs, and assets of the community.
This involves identifying:
• What is the situation?
• What is making the situation better and what is making it worse?
• What possible actions you can take to address the situation?
• Diverse types of data: (e.g. community health status indicators, stories/testimonials;
evaluation findings; “best practice” guidelines)
• Sources of data: (e.g. polling companies; community/partner organizations; researchers;
governments; private sector)
• Data collection methods: (e.g. stakeholder interviews or focus groups; surveys; literature
reviews; review of past evaluation findings or stakeholder mandates/ policies)
Step 3: Identify Goals, Populations of Interest, Outcomes, and Outcome
Objective
Purpose: to use situational assessment results to determine goals, populations
of interest, outcomes, and outcome objectives.
Ensure program goals, populations of interest, and outcome objectives are
aligned with
strategic directions of your organization or group: goal: a broad statement
providing overall direction for a program over a long period of time.
• population(s) of interest: group or groups that require special attention to
achieve your
goal
• outcome objective: brief statement specifying the desired change caused by
the program
Step 4: Identify Strategies, Activities, Outputs, Process Objectives, and Resources
Purpose: To use the results of the situational assessment to select strategies and activities,
feasible with available resources, that will contribute to your goals and outcome objectives.
• Prioritize ideas by applying situational assessment results
• Identify specific activities for each strategy
• Select outputs and develop process objectives
• Consider available financial, human, and in-kind resources.
A. Informal methods:
• Buzz talk
• Brainstorming
• Group discussion
• Demonstration
• Roleplay
• Drama
• Case studies
• Traditional media
B. Formal methods:
• Conference
• Workshop
• Seminar
• Panel discussion
• symposium
Step 5: Develop Indicators
Purpose: To develop a list of variables that can be tracked to assess the extent
to which
outcome and process objectives have been met.
• Define indicators to measure each outcome and process objective
• Perform quality check on proposed indicators ensuring their validity,
reliability, and
accessibility
• Indicators are used to determine the extent to which outcomes and process
objectives
were met
For each outcome and process objective, consider the intended result and
whether:
• Intended result can be divided into separate components
• Intended result can be measured
• There is an appropriate time for observing the result
• Requires data resources are accessible
• The resources needed to assess the result are available
Step 6: Review the Program Plan
Purpose: to clarify the contribution of each component of the plan to its objectives, identify
gaps, ensure adequate resources and ensure consistency with the situational assessment
findings.
• Logic model is a graphic depiction of the relationship between all programs and a way to
communicate a program interview.
• Review the plan whether:
‣ Strategies effectively contribute to goals and objectives
‣ Short-term objectives contribute to long-term objectives
‣ The best activities were chosen to advance the strategy
‣ Activities are appropriate to the audiences
‣ The resources are adequate to implement the activities
