characteristics of the learner

Characteristics of the Learner

Chapter 4

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Determinants of learning

•Nurses have always provided education for patients and their families to learn the many different aspects of their health care

•Nurses have difficulty meeting patients’ needs because of time constraints in clinical practice.

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Determinants of learning

The “teachable moment” is hard to capture because of decreased length of stay.

•These determinants include:Learning needs (What)Readiness to learn (When)Learning styles (How)

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The nurse’s role as teacher

The nurse plays a crucial role in the learning process by:

1- Assessing problems of deficits2- Providing meaningful information3- Identifying progress being made4- Giving feed back and follow up5- Reinforcing learning 6- Evaluating the client’s abilities

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Assessment of the learner The effectiveness of nursing care depends on the scope, accuracy, and comprehensiveness of assessment

Factors that considered with respect to three determinants of learning:1- Assessment should based on theories, concepts & principles

2- Identify priorities of behavioral objectives3- Reduce anxiety of client as possible4- Prevent unneeded repetition

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ASSESSING LEARNING NEEDS

Learning needs must be examined first to discover what has to be taught and to determine the extent of teaching required

Learning needs defined are gaps in knowledge that exist between a desired level of performance and the actual level of performance

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Steps to assess learning needs

1- Identify the learner 2- Choose the right setting3- Collect important information about the learner

4- Involve members of the health care team5- Prioritize needs6- Take time- management issues into account

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1- Identify the learner

•Who is the audience? Individual patient, group of patients, significant others.

•Are their needs the same or different

•Teaching opportunity formal or informal must be based on accurate identification of the learners

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2- Choose the right setting

•Establish an environment in which the learners feel a sense of security in confiding (revealing disclosing)information and believe their concerns are respected and taken seriously

•Maintaining privacy and confidentiality is essential to establish a trusting relationship

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3- Collect important information about the learner

•Patients or family member are the most important source of needs assessment information

•Be sure to ask what is important to them , what type of social support systems are available and how their social support system can help.

•Actively engage learners in defining their needs and problems

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4- Involve members of the health care team

•Consult with other professionals to gain insight into the needs of patients and their families

•Representatives of health related organizations such as Diabetes organization, Heart Association often provide insight into learning needs of people specific health problems or concerns

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5- Prioritize needs

•If the basic needs are not attended to first and foremost as indicated by Maslow's hierarchy of needs, learning of other information may either delayed or impossible to achieve

•Prioritizing helps nurses in partnership with patient set realistic and achievable learning goals

•Not All Learners need to know everything and assessment can help to discriminate the “need to know” from the “ nice to know” information

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Assessing learning needs•Maslow’s hierarchy of needs

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Prioritize needs

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Criteria Prioritize needs

Criteria learning needs

Mandatory that must be learned for survival recent heart attack need to know sign & symptoms & when to get

immediate helpDesirable that are not life dependent but related to well being, clients with cardiovascular disease need to know the effect of a high-fat diet on their condition Possible that are nice to know but not essential, about daily activity, newly diagnosed diabetes

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6- Take time- management issues into account

Because lack of time is a major barrier to carrying out a proper assessment the following are Some Tips that, in long term are time-savers

1- Give more efficient and effective time to do Good initial assessment2- Learner must given time to offer their own thought (Involve client actively)3- Do assessment any time & any where as possible4- Inform client a head of time5- Minimizing interruptions and distractions

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Methods to assess learning needs

1- Casual conservations: during performing pt. care, nurse must rely on active listening, use open-ended questions

2- Structured interviews: use direct open-ended questions.

3- Questionnaires: use checklist

4- Observations: watching the learner perform a task is an excellent way of assessing a skill

5- Patient charts: physicians’ notes, nurses’ notes, ….etc. 17

READINESS TO LEARNDefined as the time when the learner expresses or shows interests in learning the information necessary to maintain optimal health.

The same methods to assess learning can be used for assessing readiness to learn.

Timing—that is, the point at which teaching should take place—is very important.

A learner who is not receptive to information at one time may be more receptive to the same information at another time.

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Take time to take a PEEK at the four types of readiness to learn

1- Physical readiness2- Emotional readiness3- Experiential readiness4- Knowledge readiness

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Take time to take a PEEK at the four types of readiness to learn

1. Physical readiness• measures of ability• complexity of task• health status• gender

2. Emotional readiness• Anxiety level• Support system• motivation • risk taking behavior• frame of mind• developmental stage

3. Experiential readiness• level of aspiration• past coping mechanisms• cultural background• locus of control• orientation

4. Knowledge readiness• present knowledge base• cognitive ability• learning disabilities

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Physical readiness1- Measure of ability—sensory abilities

2- Complexity of task—difficulty level of the subject

3- Environmental effects—an environment favorable to learning

4- Health status—the amount of energy available to learning

5- gender—women are generally more receptive to medical care and take less risks regarding their health than men

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Emotional readiness

1- Anxiety level

2- Support system3- Motivation4- Risk taking behavior5- Frame of mind6- Developmental stage

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Emotional readiness

•Anxiety levelMild or sever anxiety mayLead to an inability to learn

Moderate anxiety will deriveSomeone to take action.

Moderate level of anxiety is best for success in learning

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Emotional readiness

•Support system—strong support system decrease anxiety, whereas the lack of one may increase anxiety.

Teachable moment means “when the client will be most receptive to learning.

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Emotional readiness

•Risk-taking behaviorNurse can help patient develop strategies to reduce the risk oftheir choices

• Frame of mindExample-adults who have reached self-actualization and whose basic

needs are met tend to plan for their future and are more to learn health promotion tasks.

•Developmental stageEach stage associated with human development produce a peak time

for readiness to learn certain tasks, known as a “teachable moment”

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Experiential readinessLevel of aspiration— previous failure and success

Past coping mechanism— to understand how the learner has dealt with previous problems

Cultural back ground— assessment of what illness means from the patient’s cultural perspective is important in determining readiness to learn

Locus of control— internal locus of control and external locus of control orientation

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Knowledge readinessRefers to learners present knowledge base, the level of learning capability, and the preferable style of learning. it consist of:

1-present knowledge base: How much someone already knows. Build on this knowledge to encourage readiness to learn

2-Cognitive ability: Match the behavioral objectives to the ability to learn, or failure to achieve will result

3-Learning disability: People with learning disabilities require special approach to teaching

4-Learning style: Knowing the learning method and materials the learner is comfortable with help the nurse to tailor teaching according to how someone learns best

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LEARNING STYLES

Refers to the way individuals process information

Each learner is unique and complex with distinct learning style preferences that that distinguish one learner from another .

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Learning styles- Six learning style principles

1- Identify style that nurse & client prefer2- Nurse need not to use her preferred style exclusively

3- Assist patients to identify their own style preference

4- Client will have opportunities to learn through their preferred

style of learning 5- Encourage client to diversity styles of learning6- Become aware of various methods and materials available

Learning styles

To determine a person’s learning style, three mechanisms can be used:•Observation,• Interviews •Learning style instruments

Certain of characteristics of learning style arebiological in origin, whereas others are developed as a

result of sociological and environmental influences. 31

Right brain / left brain & whole- brain thinking

Brain Preference Indicator

Right hemisphere— emotional, visual-spatial, non-verbal hemisphereThinking processes using the right-brain are intuitive(spontaneous), subjective, relational, holistic, and time free

Left hemisphere— vocal and analytical sideThinking process using reality-based and logical thinking with verbalization

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•No correct or wrong side of the brainEach hemisphere gathers in the same sensory information but handles the information in different ways

•Knowledge of one’s own brain hemispherical performance can aid educator nurse in identifying their strengths and weaknesses in teaching methods


•Whole-brain thinking allows the learner to get the best of both worlds.

•Duality of thinking should be encouraged to help learner reach their fullest learning potentials

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Left Brain•Prefers talking and writing•Recognizes/remembers names•Solves problems by breaking them into parts•Conscious of time and schedules

Right Brain•Prefers drawing and manipulating objects•Recognizes/remembers faces•Solves problems by looking at the whole, looks for patterns, using hunches•Not conscious of time and schedules36

Dunn and Dunn learning styleIdentified five basic stimuli :

•Environmental elements ( sound, light, temperature, design) which are biological in nature •Emotional elements (motivation, responsibility, persistent) which are developmental and emerge over time as a result of experience that happen at home, school work etc.•Sociological elements (desire to learn alone or in group) •Physical elements ( perceptual strength, time of day and mobility ) biological in nature and relate to the way learners function physically •Psychological elements ( indicate the way learners process and react to information ) 38

Dunn and Dunn learning style

•Dunn and Dunn’s identified stimuli are relevant to the role of the nurse as a teacher.

•The nurse needs to consider the previously mentioned selected characteristics when assessing a patient’s or family member’s learning style.

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Interpretation of learning style

General guidelines should be followed when assessing individual learning style

1- Become familiar with the ways in which style are classified 2- Identify key element of an individual learning style by observing and ask question to verify observation and then match instructional method and materials to those unique qualities

3- Always give learner the opportunity to say when the teaching method is not working for them

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Interpretation of learning style

4- Place emphasis on assessing learning styles as a way to increase understanding both from the nurse and the learner perspective

5- Be caution about saying that certain instructional method are always more effective for certain style

6- Provide learning choices that enable learners to recognize and choose the style in which they prefer to learn

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characteristics of the learner

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