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• This initial step in the process validates the need for learning and the approaches
to be used in designing learning experiences.
• Good assessments ensure that optimal learning can occur with the least amount
of stress and anxiety for the learner. Assessment prevents needless repetition of
known material, saves time and energy on the part of both the learner and the
educator, and helps to establish positive communication between the two
parties.
e. Involve members of the healthcare team (Other health professionals likely have insight into patient or
family needs or educational needs because of their frequent contacts. Nurses are not the sole educators of
these individuals; thus, collaboration with other members of the healthcare team for a richer assessment of
learning needs is necessary)
f. Prioritize needs ( due to endless list of needs, Maslow’s (1970) hierarchy of human needs can help the
educator prioritize so that the learner’s basic needs are attended to first and foremost before higher needs
are addressed. Prioritizing the identified needs helps the patient or staff member to set realistic and
achievable learning goals.)
Steps in the assessment of learning
needs
g. Determine availability of educational resources ( The educator may identify
a need, but it may be useless to proceed with interventions if the proper
educational resources are not available, are unrealistic to obtain, or do not
match the learner’s needs.)
1.Do close observation and active listening. It is much more efficient and effective to take
the time to do a good initial assessment
2.Learners must be given time to offer their own perceptions of their learning needs if
the educator expects them to take charge and become actively
involved in the learning process
3.Assessment can be conducted anytime and anywhere the educator has formal or
informal contact with learners.
Different methods of assessing the learning needs?
Nurse educators must remain nonjudgmental when collecting information about the learner’s
strengths, beliefs, and motivations. Nurses can take notes with the learner’s permission so
that
important information is not lost.
Different methods of assessing the learning needs?
Example:
walking on crutches is a psychomotor skill for which a patient must have the physical
ability to be ready to learn.
Physical Readiness: Complexity of
task
• The more complex the task, the more difficult it is to achieve.
Psychomotor skills once acquired are usually retained better and
longer than learning in other domains. once ingrained, psychomotor,
cognitive, and affective behaviors become habitual and maybe
difficult to alter.
Physical Readiness: Environmental
effects
An environment conducive to learning helps to hold the learner’s
attention and stimulate interest in learning. Unfavorable conditions,
such as extremely high levels of noise or frequent interruptions, can
interfere with a learner’s accuracy and precision in performing cognitive
and manual dexterity tasks
Physical Readiness: Health status
The amounts of energy available and the individual’s present comfort
level are factors that significantly influence that individual’s readiness to
learn. Energy-reducing demands associated with the body’s response to
illness require the learner to expend large amounts of physical and
psychic energy, leaving little reserve for actual learning. Nurse
educators must seriously consider a person’s health status, whether
well, acutely ill, or chronically ill, when assessing for readiness.
Physical Readiness: Gender
Research suggests that women are generally more receptive to medical
care and take fewer risks with their health than do men. This difference
may arise because women. traditionally have taken on the role of
caregivers and, therefore, are more open to health promotion teaching.
In addition, women traditionally have more frequent contacts with
health providers while bearing and raising children. Men, by
comparison, tend to be less receptive to healthcare interventions and
are more likely to be risk takers
Emotional readiness
Learners must be emotionally ready to learn. Like physical readiness,
emotional readiness includes several factors that need to be assessed.
These factors include anxiety level, support system, motivation, risk-
taking behavior, frame of mind, and developmental stage.
Emotional Readiness: Anxiety level
Anxiety influences a person’s ability to perform at cognitive, affective, and
psychomotor levels. In particular, it affects patients’ ability to concentrate and
retain information.
The level of anxiety may or may not be a hindrance to the learning of new skills;
some degree of anxiety is a motivator to learn, but anxiety that is too low or too
high interferes with readiness to learn. On either end of the continuum, mild or
severe anxiety may lead to inaction on
the part of the learner. Fear is a major contributor to anxiety and,
therefore, negatively affects readiness to learn in any of the learning domains
Emotional Readiness:Support
system
The availability and strength of a support system also influence
emotional readiness and are closely tied to how anxious an individual
might feel. Members of the patient’s support system who are available
to assist with self-care activities at home should be present during at
least some of the teaching sessions so that they can learn how to help
the patient if the need arises.
Emotional Readiness:Motivation
Emotional readiness is strongly associated with motivation, which is a
willingness to take action. Knowing the motivational level of the learner
assists the educator in determining when that person is ready to learn.
The nurse educator must be cognizant of the fact that motivation to
learn is based on many varied theories of motivation and, thus, be careful
to link a specific theory’s concepts or constructs to the appropriate
method of assessment and subsequent educational interventions. The
learner who is ready to learn shows an interest in what the nurse
educator is doing by demonstrating a willingness to participate or to ask
questions.
Emotional Readiness:Risk-taking
behavior
Some patients, by the very nature of their personalities, take more risks
than others do. The educator can assist patients in developing strategies
that help reduce the level of risk associated with their choices. If patients
participate in activities that may shorten their life span rather than
complying with a recommended treatment plan, the educator must be
willing to teach these patients how to recognize certain body symptoms
and then what to do if they have them.
The educator should assess whether previous learning experiences have been
positive or negative in overcoming problems or accomplishing new tasks
Experiential Readiness: Level of
aspiration
The extent to which someone is driven to related to the type of short- and
long-term goals established—not by the educator but by the learner. Previous
failures and past successes influence the goals that learners set for themselves.
When patients are internally motivated to learn, they have what is called an
internal locus of control; that is, they are ready to learn when they feel a need to
know about something. This drive to learn comes from within the learner.
Learners with external locus of control need someone to emcourage them to know
something of which the responsibility of motivation comes from the educator
Knowledge readiness
Knowledge readiness refers to the learner’s present knowledge base,
the level of cognitive ability, the existence of any learning disabilities
and/ or reading problems, and the preferred style of learning.
Nurse educator must always find out what the learner knows prior to teaching and
build on this knowledge base to encourage readiness
to learn.
If educators make the mistake of teaching subject material that has already been
learned, boredom and lack of interest may occur in the learner
Knowledge readiness: Cognitive
ability
The educator must match the level of behavioral objectives to the cognitive
ability of the learner.
Enlisting the help of members of the patient’s support system by teaching them
requisite skills allows them to contribute positively to the reinforcement of self-
care activities.
Knowledge readiness: Learning and
Reading Disabilities
Learning disabilities, which may be accompanied by low-level reading
skills, are not necessarily indicative of an individual’s intellectual
abilities, but they do require educators to use special or innovative
approaches to instruction to sustain or bolster readiness to learn.
Recognizing that one side of the brain may be better equipped for
certain kinds of tasks than for others, educators can find the most
effective way to present information to learners who have a dominant
brain hemisphere)
Learning style models
• Right-Brain/Left-Brain and Whole-Brain Thinking
Roger Sperry and team established that, in many ways, the brain
operates as two brains (Herrmann, 1988; Sperry, 1977), with each
hemisphere having separate and complementary functions.
Learning style models
Field-Independent/Field- Dependent Perception
Learners have preference styles for certain environmental cues.
A field-independent person perceives items as separate or
differentiated from the surrounding field;
A field-dependent person’s perception is influenced by or immersed
in the surrounding field.
Field independent/dependent model
• Gagne’s (1985) theory regarding the conditions of
learning suggests that the internal processes of
learning can be influenced by external events.
In this model, the learner is not a blank slate but rather approaches a topic to be
learned with preconceived ideas.
When planning, designing, implementing, and evaluating an educational program, the nurse as
educator must carefully consider the characteristics of learners with respect to their
developmental stage
In this age group, the focus of instruction for health maintenance of
children is geared toward the parents, who are considered the
primary learners rather than the very young child
• Allow the child to manipulate equipment and play with replicas or dolls
to learn about body parts. Special kidney dolls, ostomy dolls with
stomas, or orthopedic dolls with splints and tractions provide
opportunities for hands-on experience.
This stage is a period of great change for them, when attitudes, values,
and perceptions of themselves, their society, and the world are shaped
and expanded.
Middle and Late Childhood (6–11 Years of Age)
Employ group teaching sessions with others of similar age and with
similar problems or needs to help children avoid feelings of isolation
and to assist them in identifying with their own peers.
Middle and Late Childhood (6–11 Years of Age)
During this prolonged and very change-filled time, many adolescents and
their families experience much turmoil.
Suggest options so that they feel they have a choice about courses of action.
Adolescence (12–19 Years of Age)
Give a rationale for all that is said and done to help adolescents feel a sense
of control.
Approach them with respect, tact, openness, and flexibility to elicit their
attention and encourage their responsiveness to teaching–learning
situations.
Expect negative responses, which are common when their self-image and
self-integrity are threatened.
Adolescence (12–19 Years of Age)
Acknowledge that their feelings are very real because denying them their
opinions simply will not work.
Allow opportunity to test their own convictions. Let them know, for example,
that although some other special people may get away without taking
medication, others cannot. Suggest, if medically feasible, setting up a trial
period with medications scheduled further apart or in lowered dosages to
determine how they can manage.
The Developmental Stages of
Adulthood
• The period of adulthood constitutes three major developmental stages—the
young adult stage, the middle-aged adult stage, and the older adult stage
• Education is more learner centered and less teacher centered; that is,
instead of one party imparting knowledge to another, the power relationship
between the educator and the adult learner is much more horizontal
• The emphasis for adult learning revolves around differentiation of life tasks
and social roles with respect to employment, family, and other activities
beyond the responsibilities of home and career
Young Adulthood (20–40 Years of Age)
• Young adulthood is a time for establishing long-term, intimate
relationships with other people, choosing a lifestyle and adjusting to it,
deciding on an occupation, and managing a home and family. These
decisions lead to changes i n the lives of young adults that can be a
potential source of stress
Young Adulthood (20–40 Years of Age)
• Teaching strategies must be directed at encouraging young adults to seek
information that expands their knowledge base, helps them control their
lives, and bolsters their self-esteem.
• Nurse as educator must find a way of reaching and communicating with this
audience about health promotion and disease prevention measures.
Middle-Aged Adulthood (41–64 Years
of Age)
• Midlife is the transition period between young adulthood and older
adulthood.