Running head: Teaching Project Summary Paper

Teaching Project Summary Paper

Rebecca Martinez

Old Dominion University

Teaching Project Summary Paper 2

Teaching Project Summary Paper

Teaching is an interactive process for the purpose of helping the learner gain knowledge

or skills (Gilboy & Howard, 2009). This paper is an overview of the development,

implementation, and evaluation of the teaching that was initiated to nursing students and staff

members in the nursing profession. The issue addressed by the instructional intervention was

about poor discharge communication skills that are demonstrated during the discharge process.

In some cases nursing staff are not taking enough time to thoroughly explain certain steps in a

patients discharge plan, which can ultimately hurt a patient in the long run. At least 20 percent

of all patients who are admitted to a U.S. hospital make a repeat visit within 30 days of

discharge, according to Medicare (Reducing Hospital Readmissions, 2012).

Additional sources that justify this problem are the difficult to read handouts given about

medication, and diagnoses, at discharge that may not be fully understood. The nature of this

problem is that nursing staffs are not communicating properly during the discharge process,

which is ultimately setting a bad example to future nurses. Communication tools need to be

addressed in order to improve the future discharge processes for nursing students and nursing

staff. If communication is improved during the discharge processes it will improve the overall

quality of care towards patients, and lower re-hospitalizations. Teaching the nursing staff and

students on specific guidelines on how to communicate effectively during discharging will also

validate their competency.

Target Audience

The target learners consisted of nursing students and nursing staff that interact with

patients during teaching interventions. The demographic of the group of leaners consisted of

non-English speaking immigrants, nurses and nursing students that had strong accents and
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claimed English as their second language, and leaners from different cultures that had English as

their first language. The reason for this education program about communication for this specific

group is it will help nursing students gain stronger communication skills as well as good habits

in future discharging processes. Another reason was to teach the nursing staff how ineffectively

they were communicating when being observed by nursing students. Some student have seen

inappropriate communication during the discharge process and made it known to the educator. It

was then apparent that teaching needed to occur on how effective communication can be useful

in the discharge process as well as the nursing profession overall.

Professional Standards of Practice and Performance

The standards of practice chosen came from The American Association of Critical Care

Nurses (AACN). The AACN was established since 1969, and their current standards of practice

were published in 2015. Critical care nursing for chronic diagnoses, complex assessment,

therapies, high-intensity interventions and educating are some of the primary focus of these

standards. According to the AACN Scope of Practice, The professional practice of the cute

and critical care nurse is characterized by the application of relevant theories, research, and

evidence-based guideless to diagnose and treat human response to injury and illness(AACN

Scope of Practice, 2015). The information presented in these standards also discuses how acute

and critical care nurses continue educating, provide resources, and promote evidence-based

practice in all setting of complex and critically ill populations.

The instructional interventions on discharge communication adhere to the AACNs

Standards of Practice in many ways. When it comes to effective communication through

AACN standards, nurses should, collaborate with case managers and care coordinators to

communicate patient and family needs with available resources to ensure that appropriate
Teaching Project Summary Paper 4

resources are provide to the patient and family (AACN Scope of Practice, 2015). By providing

standards like these, efficient teaching about communicating is important and supported

directly to the teaching project that was established. AACNs Scope of Practice in teaching and

education is clearly described in their document. It accounts for many developing ideas, and

relates to the teaching plan for nursing staff or students that need more tools to communicate

effectively during the discharge practice.

Needs Assessment

What established the need for instruction, as well as the needs of the learner, was the

amount of criticism that was addressed by nursing student observing discharge instruction from

various nurses during clinical rotation. Learners from various backgrounds were seen not to be as

aware of their discharge errors occurring in their nursing practice. The need for instruction was

observed when some learners were not open for criticism or improvements, as they might not be

aware of discharge errors occurring in their practice. Some strategies were used to assess these

types of attitudes, behaviors, and lack of knowledge, which ultimately helped the educator know

how to approach the various attitudes and behaviors. As more time was spent on assessing the

problem at hand, the educational designer was able to teach and observe the group of learners,

and ultimately see them tackle their weaknesses in communication. Some learners were still not

as open as others about criticism or improvements that were addressed.

The main invention for this problem was to provide correct communication guidelines

on how to conduct discharges and be aware of mistakes that can happen between nurse-patient

communications. A mandatory questionnaire was used to establish assessment of the need for

this instructional intervention; the assessment of the needs of the learners was completed

successfully (see Appendix A for questionnaire survey used). After the assessment, some needs
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of learning styles of the group included teach-back technique, visual and auditory leaners, and

interpersonal teaching, which was learned when learners commented on how these teaching

methods would help them to reflect. The assessment helped the teacher recognize the leaners

weakness and strengths on how they retain information. With the amount of successful learning

strategies, and motivated nursing staff involved, the educational designer was able to account for

and identify all the different learning needs.

Development of the Teaching Plan

What nursing students observed during clinical rotation determined the focus of the

teaching plan. Communication during the discharge process was observed to be an issue with

patients. In order to start the planning process of this issue, the objectives and goals were put into

place regarding the communication skills that were seen to be lacking. While working with the

nursing students on their communication skill concerns, the objects and goals for the plan

evolved naturally. The objectives were development based on the teacher-leaner collaboration,

which ultimately established what type of communication skills were taught. According to

Bastable, If the teaching-learning process is to be successful, the setting of goals and objectives

must be a decision on the part of both the teacher and leaner (Bastable, 2014). The objectives

were decided based on the the teaching-learning process and were later re-assesed to help the

teaching lession be more effective. The first two objectives focused on verbal and non-verbal

comunnication skills. The third objective orginally focues on culuture comuncaitons, but was

later changed to focus more the the barriers of communcation. Overall, the objectives stayed

consistent with the purpose and goals of the teaching project.

The overall content of the teaching lesson focused on communicating skills and

communcation barriers that will help facilcaite the the discharge process. The outline of the
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content was organized, and the main education points were outlined in the teaching plan (see

Appendix B for completed teaching plan). The content for the first objected related to the non-

verbal communication characteristics used in the clinical setting. The second object about verbal

communcaiton techniques were explained in simple terms, and focused only on key points, for

example, reflecting verbal responses and various speaking etiquettes. The third objected content

focused on the communication barriers that usually hinder the communcation among nurses and

patients. Various communication techniques were also adressed in the content presented to the

leaners.

The reason for the instructional methods of written material, verbal lecture,

demonstrations, role playing , and group discussions came from the needs assessment

questionnaire. The learners influence on how they learn best helped the methods develop in the

teaching plan. The only changes made to the teaching plan were the amount of time allotted for

each objective. The large amount of participation among the learners extend the time we spent on

each subject and ultimately helped the leaners gain more confidence in their communication

skills. By the time the evaluation process came the test method overpass the expectations of the

original outcomes. The learners were able to demonstrate back, verbally provide key points, and

pass above the expected percentage on the post-test. Overall, the teaching plan guided the session

well and helped the learners accomplish the goal of achieving efficient communication skills.

Instructional Strategies

Cognitive domain learning is the traditional focus of most teachings (Bastable , 2014).

During the teaching session the cognitive domain theory was an essential concept after the

students learned the basics of communication. The cognitive learning theory supported the

instructional method because it helped the leaners share ideas, explain, and analyze during the
Teaching Project Summary Paper 7

session. Verbal lecture and written material on communication key points that were given to

leaners helped them comprehend effective communication skills. The knowledge document

provided to the leaners simplified the information about communication, and helped leaners

retained the information without difficulty when it was time to test. According to the Journal of

the Medical Library Association, Knowledge can be assessed by straightforward means, for

example, multiple choice or short-answer questions that require the retrieval or recognition of

information, for example, Name five sources of drug information (Adams, 2015). The

straightforward information overall allowed the leaners to cognitively absorbs, and helped them

incorporate the skills during role-playing activities as well as group discussions (see Appendix C

for Communication Outline of Key points).

Learners were able to verbally state various communication skills when role-playing and

participating in-group discussions. The overall day off teaching ran according to plan, but ran

into trouble when technical difficulties arose when trying to on show a YouTube video about

effective communication. The video aid was then removed from the original plan, but the other

visuals such as pictures of effective communication environments and appropriate body language

was utilized. The audience understood that the video did not work and enjoyed the other visuals

that were presented. The majority of the leaners were more expressive after role-playing was

started and various scenarios were being demonstrated on how to communicate effectively. The

group discussions were successful, and all of the leaners participated in the various scenarios.

By teaching that leaners about communicate barriers, they were able to distinguish

communication flaws that were observed in the past. Having a culturally diverse group of

learners definitely influenced the teaching methods used. If English wasnt their first language it

took time to understand any written information given or clarify what was being lectured.
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Effective communication is essential when dealing with a culturally diverse population of

patients, and cultural conflicts often lead to misunderstandings and dis-trust, which adversely

affect patient outcomes (Tongue & Hoawrd, 2005). Lack of clarity in speech and writing often

contributes to ineffective communication. (Vertino, 2014). Communicating all the information

clearly was important, and was effective when the group of learners were able to demonstrate

effective communication verbally. Group discussions and return demonstration on how to

communicate effectively also help the group of culturally diverse learners.

Evaluation

Observing return demonstrations of proper body language was effective in helping the

teacher to evaluate the leaners. Role-playing with leaners through various scenarios on how to

communicate with patients was also used to enforce and evaluate content learned. Being verbally

involved and interacting with the learners, as well as asking their opinions on certain topic about

communicate enforced the evaluation process. The evaluation results showed that the various

teaching methods that were part of a discharge education teaching helped the leaners understand

proper communication skills during the discharge process. Providing leaners with freedom is ask

questions and verbalize back effective communication skills assured the teacher that the desired

outcomes were met.

The method used to evaluate each objective was a written test that was given after the

teaching session. Overall, 90% of learners of the group met the goal of improving their

communication skills, which was a well-desired outcome of the leaners reaching a score of 80%

or higher on the post-test (see Appendix D for Communication Test). Despite the challenges that

come with teaching a group of people, the outcomes were met and were demonstrated by the

collaboration of information given. At the end of session and evaluation, none of changes of the
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teaching plan affected the evaluation, and the overall discussions, role-play, and visuals assisted

the leaners in meeting their desired outcome in comprehending effective communication skills.

Summary

The knowledge acquired as a result of planning and implementing for a professional

group was the improvement of building an effective teaching plan. Improving on how to

navigate ideas through a group of people was also a skill learned. The project helped the teacher

analyze the way others absorb information, and also how effective learning methods are used in a

teaching session. Overall, learning how to teach a diverse group of individuals was a challenge

as well as a learning opportunity to improve public speaking and evaluation skills The project

also help acquire the skills of being more professional towards other colleagues. Planning,

implementing, and evaluating the professional group of leaners helped form the way the learner

approached different learning styles as well. The teaching session was rewarding in a way,

observing a group of individuals learning and improving during various learning communication

techniques was overall an eye opening experience.

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Honor code:
I pledge to support the Honor System of Old Dominion University. I will refrain from any form
of academic dishonesty or deception, such as cheating or plagiarism. I am aware that as a
member of the academic community it is responsibility to turn in all suspected violators of the
Honor Code. I will report to a hearing if summoned. Rebecca Martinez 4/10/2016
Teaching Project Summary Paper 11

References

Adams, N. E. (2015). Blooms taxonomy of cognitive learning objectives. Journal of the

Medical Library Association: JMLA, 103(3), 152153. Retrieved from http://doi.org

/10.3163/1536-5050.103.3.010

American Association of Critical Care Nurses. (AACN). (2015). Retrieved from

http://www.aacn.org/wd/practice/docs/scope -and-standards-acute-critical-care-2015.pdf

Bastable. S.B, (2014). Behavioral objectives. In K Sullivan (Ed.). Nurse as educator,

Principles of teaching and learning for nursing practice (424-468). Sudbury, MA:

Jones & Bartlett Publishers.

Communication worksheet. (2015). Retrieved from http://instructor.mstc.edu/ instructor/aruesch

Fundamental%20Study%20Guides/Fundamentals%20Worksheets/Communication%20W

orksheet%20Key.doc

Gilboy, N & Howard, N. (2009). Research to practice: Comprehension of Discharge

Instructions Advanced Emergency Nursing Journal. (31)1. 4-11. Retrieved from

www.nursingcenter.com/static?pageid=860356

Reducing Hospital Readmission with enhanced patient education. (2012). Retrieved from

https://www.bu.edu/fammed/projectred/publications/news/krames_dec_final.pdf

Tongue. J. & Hoawrd R. (2005). Communication skills for partient-centered care. American

Academy of Orthopaedic Surgeons Journal. 87-A (3).1-7. Retrieved from

http://webcache.googleusercontent.com/search?q=cache:DS_S__w_Jp4J:healthcarecomm

.org/content/uploads/2011/05/Tongue2.pdf+&cd=2&hl=en&ct=clnk&gl=us&safe=active

Vertino, K. (2014) Effective Interpersonal Communication: A Practical Guide to Improve Your

Teaching Project Summary Paper 12

Life" OJIN: The Online Journal of Issues in Nursing (19)3. Retrieved from

http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals

OJIN/TableofContents/Vol-19-2014/No3-Sept-2014/Effective-Interpersonal-

Communication.html
Teaching Project Summary Paper 13

Appendix A

Leaner Questionnaire-Needs Assessment & Learner Self-Evaluation

Name __________________________ Date ______________________

1.Why do you need to learn more in your communication skills? Please be specific. Give
examples of situations that are difficult in communicating with patients.

2.What specific areas of communication would you like to improve before you leave this class?

3.When leaning something new, what helps you understand the most? Check.

___ Pictures ___words ___innovation ___talk about it ___try it out

4.When you communicate with patients, how much do you understand? Check the amount.

___ everything ___most ___some ___a little ___very little

5.What teaching method do you prefer? Check.

___ Teach-back technique ___ interpersonal teaching ___Visuals ___Auditory ___

6.Order the skills that you need from 1 to 6. Number 1 is the most important and number
4 is the least important to you at this time. Please use each number only one time.
___ Reading
___ Writing
___ Listening
___ Speaking

Open-Ended Question: Communicating during the discharge process

8. How does your teaching preference help you learn? Please explain.

7. What have you observed in others while observing nurse-patient communication during the
discharge process? Please be specific.
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Appendix B

Teaching Plan

Objectives Content Outline Method of Time Resources Method of Actual Outcomes

Presentation Evaluation
Allotted

(In min)

(Cognitive) Non-verbal -Written material 30 min -Pamphlets on -Observed return 95% of the leaners
communication will be given on appropriate body demonstrations verbalized all four
non-verbal language, and of proper Body content points of non-
1.Active listening: The communication
active listening. language to see verbal communication
1.After a 30 minute nurse needs to be able to content.
stop and listen to what is whether the and surrounding
teaching session, the leaner has skills.
being said by the patient.
leaner will verbalize learned.
at four examples of 2.Use correct body - Verbal lecture, -Visuals on 80% of leaner
non-verbal language: The nurse should explanations and different type of - Give a post-test repeated content
communication and not send conflicting discussion on effective of content to see learned, and was
three effective messages with their body subject matter. communication if areas of observed using the
communicate languages. environments. instruction need skills learned in active
surroundings. to be re-teached listening.
3. Be aware of teaching
surrounding: Use a quiet about active
room with privacy, avoid lisitening, 90% of learners got at
-Documents on least an 80% or higher
barriers like desks and teaching
how to present
tables between you and the surrondings, and on post-test.
professionalism
patient. Make eye contact, professionalism.
and speak with an even tone
of voice. Be sure the patient
is comfortable.

4.Professionalism: Present
self in a professional
manner in any type of
environment.

85% of the leaners

Verbal Communication
-Gave simple will verbalize all five
(Psychomotor) -Return
- Pamphlets on
1. Timing: Pausing and 30 min written tests after content outline key
demonstration of subject matter.
waiting for a response to teaching to points provided to
2. By the end of the using effective
what you have said before measure them.
30-minute teachng communication. -Documents with
moving on. Give small cognitive
session that consist amounts of information at a
practice
learning. 95% of the leaners
with role-playing, the time. - Verbal questions that
explanation and
demonstrated back
leaner will respond have different
discussion about -Role-playing effective verbal
correctly to a series 2.Reflecting: Reflect back scenarios.
topic. with leaners in communication skills
of scenarios that to the patient or relative in
their own words, or use order to enforce during various
demonstrate the skill -Written material
your own words to check content learned. practice scenarios.
of affective verbal will be given on
that they understand
verbal
 Teaching Project Summary Paper 15

communication. teaching. communication 90% of learners got at

content. least an 80% or higher
3.Speak slowly on test received.
4. Speak clearly: especially
those who are elderly,
speaking loudly v may be
done to make them
understand you.

5.Avoid using Slang: Do

not try to use slang terms
that are not fitting or
appropriate when
communicating with
patient.

(Affective) Communication Barriers
3. After reading 1. Recognizing emotions:
handout, distinguishes various
participating in feelings, concerns, and
group discussions, asking about patient
and role-playing, the
feelings.
leaners will be able to
explain the barriers 2.Understand your role:
in communication the nurse should recognize
and verbalize feelings his or her own personal
of confidence in emotions before interacting
managing a patient with patient.
from another culture
3.Respect the patient:
Respect who you are
communicating with.
4.Acknowledge barriers of
communication such as:
gender, culture differences,
education levels, language,
and reading levels.
5.Include important
family members: try to
have both parents present if
the patient is a minor.
-Group discussions
on patient values 30 min
and emotions from
different cultures
-Role-playing and
role modeling
various scenarios
on recognizing
patient emotions.
-Written material
will be given on
different culture
values.
- Handout on - Give written 95% of the leaner
cultural barriers, tests after identified at least four
understand roles, teaching to out of the six content
and various measure key points of
cultural values. cognitive acknowledging
learning. communication
barriers and verbalize
feeling towards
-Documents on
culturally diverse
how to obtain an -Ask the leaners
patients.
interpreter if questions to see
needed. whether there are
areas of
instruction that
90% of the leaners
need reinforcing received at least got
or re-teaching score of 80% on the
test questions about
the subject content.
-Role-playing
with leaners in
order to enforce
content learned.

6.Use interpreter: allow

the interpreter to answer
without the patients
response. If possible speak
even a few words of the
patients language.
Teaching Project Summary Paper 16

Appendix C

Communication Outline of Key points

Non-Verbal communication characteristics

-The nurse needs to be able to stop and listen to what is being said by the patient.
-The nurse should not send conflicting messages with their body languages.
-Be aware of teaching surrounding and use a quiet room with privacy
- The nurses verbal messages should be reinforced by nonverbal cues.
-Make eye contact, and speak with an even tone of voice.
-Be sure the patient is comfortable.
-Present self in a professional manner in any type of environment.

Verbal communication characteristics

-1st Establish a therapeutic relationship- it is important for the nurse to not discuss personal
emotions with the client.
-Timing: Pausing and waiting for a response to what you have said before moving on. Give small
amounts of information at a time. Waiting until a clients pain is relieved before discussing the
importance of topic.
- When pacing, avoiding prolonged pauses or rapid shifts to other subjects
-Reflecting back to the patient or relative in their own words, or uses your own words to check
that they understand teaching.
- Describing the clients illness without using medical terminology is ineffective when using
simplicity in verbal communication.
-4 go-to verbal rules: Speak slowly, time speaking, speak clearly, avoid using slang
-Provide clarity by giving examples, repeat important parts of a message, and use open-ended
questions

Communication techniques

-Paraphrasing: rewording explanation in simplified terms, or formulation of clients statement by

the nurse in more specific words, without changing meaning
-Silence: Provides time for the nurse to make observations and for the client to organize thought.
-Attentive listening: Activity facilitated by maintaining eye contact, remaining relaxed, and using
appropriate touch techniques
-Ask related questions: stay on subject matter
-Clarifying: Asking the client to restate the information or provide an example
-Conveying acceptance: Condenses data into an organized review and validates data
-Focusing: Limits area of discussion and helps the nurse to direct attention to pertinent aspects of
the clients message
-Offering information: Allows the nurse to clarify health-related issues, initiate teaching, and
identify and correct misconceptions
Teaching Project Summary Paper 17

-Planning related questions: Use of words and word patterns in clients normal sociocultural
context
-Summarizing: Condenses data into an organized review and validates data
-Presenting reality: Provides the client with feedback about how the nurse sees personal
behavior or actions

Communication Barriers:

-Gender, and culture differences

- Education levels, language, and reading levels.
-Environments: desks -and tables between you and the patient.
-Physical changes associated with the disease states or therapies
-Psychological alterations associated with coping or social interaction.
-Recognizing emotions, various feelings, concerns, and asking about patient feelings
- Communication is more effective when the participants remain aware of their roles in a
relationship.
-Understand your role: the nurse should recognize his or her own personal emotions before
interacting with patient.
-Respect: Respect who you are communicating with.
-Include both parents present if the patient is a minor.
-Use interpreter: allow the interpreter to answer without the patients response.
-If possible speak even a few words of the patients language.
Teaching Project Summary Paper 18

Appendix D

Communication Test

Name __________________________ Date ______________________

1.Match the verbal communication technique with the appropriate description or example.
a. _____ Simplicity 1. Avoiding prolonged pauses or rapid shifts to other subjects

b. ____ Timing 2. Waiting until a clients pain is relieved before discussing the
importance of topic.

c. _____ Pacing 3. Providing examples and repeating important parts of a message

d. ____ Clarity 4. Describing the clients illness without using medical terminology

2. Compare the major characteristics of nonverbal communication.

3. Which statement about nonverbal communication is correct?

a. It is easy for a nurse to judge the meaning of a clients facial expression.

b. The nurses verbal messages should be reinforced by nonverbal cues.
c. The physical appearance of the nurse rarely influences nurse-client interaction.
d. Words convey meanings that are usually more significant than nonverbal
communication.
4. List at least five means of verbal communication.

5. To establish a therapeutic relationship, it is important for the nurse to discuss personal

emotions with the client. T or F

6. Communication is more effective when the participants remain aware of their roles in a
relationship. T or F

7. Reflecting back to the patient or your own words to check that they understand
teaching is effective in communication. T or F
Teaching Project Summary Paper 19

8. List three of the four go to verbal rules.

9. Establish a therapeutic relationship is the first thing a nurse should do in

communicating with a patient.

10.
11. Which communication technique would be most effective in eliciting detailed
information from a client?

a. Maintaining silence
b. open-ended questions
c. stating observations
d. Summarizing

12. Client communication may be impaired by:

a. Physical changes associated with the disease states or therapies

b. Psychological alterations associated with coping or social interaction
c. Environmental conditions
d. All of the above
13.
14. Identify which of the following communication techniques are illustrated in each sample
discharge interactions. (Paraphrasing, asking related questions, focusing, offering
information)
a. Client: The medication always seems to upset my stomach.
Nurse: That may because you arent taking with meals. The drug can cause stomach
irritation.

b. Client: This the doctor says this medication he prescribed helps with pain, but Ive
heard differently from my friends. Im not sure if I want it.
Nurse: It sounds as if you are frightened about the taking the medication.

c. Client: Well, I dont want to go home just yet, the pain I have just got worse.
Nurse: Tell me what you mean by got worse.

d. Nurse: Tell me about what medications you are taking.

Client: I take Inderal and occasionally Valium.

Nurse: How long have you taken each drug?

Client: About 2 years.

Nurse: What dose do you take of each drug?

Match the communication technique with the most accurate description or definition.
 Teaching Project Summary Paper 20

a. _____ Silence 1. Demonstrating willingness to listen to the client without

being judgmental

b. _____ Attentive listening 2. Condenses data into an organized review and validates data

c. _____ Conveying 3. Asking the client to restate the information or provide an

acceptance example

d. _____ Planning related 4. Provides time for the nurse to make observations and for the
questions client to organize thoughts

e. _____ Paraphrasing 5. Provides the client with feedback about how the nurse sees
personal behavior or actions

f. _____ Clarifying 6. Activity facilitated by maintaining eye contact, remaining

relaxed, and using appropriate touch techniques

g. _____ Focusing 7. Allows the nurse to clarify health-related issues, initiate

teaching, and identify and correct misconceptions

h. _____ Presenting reality 8. Formulation of clients statement by the nurse in more

specific words, without changing meaning

i. _____ Offering 9. Use of words and word patterns in clients normal

information sociocultural context

j. _____ Summarizing 10. Limits area of discussion and helps the nurse to direct
attention to pertinent aspects of the clients message