concept of teaching learning

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Generic bsn 1st year, semester 1

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Lecturer:sonia bibi

post RN BScN

FON-I

Unit-08

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Concept of Teaching Learning�

At the end of this unit, learners will be able to;

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• Defination of teaching and learning.

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• Identify the learning needs of the patient at the clinical site

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• Develop teaching learning plan

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• Perform health teaching at the clinical site

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Outline objectives

Definitions �

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• Teaching: Teaching is undertaking certain ethical tasks or activities the intention of which is to induce learning and changed behavior.
• "Teaching is imparting knowledge or skill"
• Teaching is a process in which one individual teaches or instruct another individual.

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Learning

learning can be defined as the relatively permanent change in an individual's behavior or behavior potential (or capability) as a result of experience or practice

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Generic bsn 1st year, 1st semester

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Goals of Clinical Teaching

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Accumulate and record information about patients

• Perform complete and orderly physical examinations
• Perform skills procedures - Interpret data
• Solve scientific and professional problems
• Communicate information reliably
• Develop familiarity with health care services and facilities
• Develop appropriate attitudes to patients and allied health care workers
• Accumulate factual healthcare knowledge
• Acquire positive attitudes to independent learning

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�Attributes/qualaties of an Effective Clinical Teacher: �

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• Encourages active participation rather than passive observation.
• Emphasis on teaching of applied problem solving.
• Close observation of students during interview/ examination rather than side room case presentation.
• Provides adequate opportunity for students to practice skills
• Provides good role model for interpersonal relationships with patients
• Teaching is patient orientated rather than disease orientated
• Demonstrates positive attitude towards teaching

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Identify the learning needs of the patient at the clinical site�

The following are part of this process:

Assessment. 

The nurse must first identify the patient's needs. In this initial process, she/he must identify the needs and the problems of an individual patient and his/her family.

Planning and diagnosing. 

Based on this assessment of the patients' needs, the nurse then formulates a diagnosis and treatment plan. It should be tailored/suitable to the patient's needs and educational level. The end product of this assessment is a diagnosis which will serve as a guide for treatment.

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Perform health teaching at the clinical site �

The following is a list of strategies that promote the incorporation of teaching into daily nursing practice

Emphasize what is necessary

•  In the inpatient setting, many patients fear losing their independence (Jones, 2002). Patients will be motivated to learn what is necessary for them to care for themselves.

Choose the right time.

•  Remember that when teaching, timing is crucial. For instance, if the patient has just been informed of a diagnosis, he or she will need time to cope with this information. There might be associated feelings of grief, powerlessness, fear, and vulnerability.

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cont........

Look for teaching moments 

• Like choosing the right time for teaching, it is equally important to "look for teaching moments." Imagine caring for a patient with end-stage renal disease. A teaching moment would be when the patient receives his tray and there is only a small amount of fluid. In this situation the nurse could ask, "Why is it important for you to monitor your fluid intake?"  

Plan teaching during an uninterrupted time. 

• When teaching the patient, timing is crucial.It is not appropriate to fit everything into the day of discharge.Similarly, it would not be appropriate to provide complex lessons during meal time or visiting hours.

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cont....

Use basic principles. 

• It is important to consider the educational level of the patient when teaching. After all, not everyone has had a nursing education. Some patients might not be able to understand complex medical jargon. They may even be illiterate and are unable to read handouts. 

Keep expenses in mind. 

• Many patients, especially elders, live on a fixed income. Therefore, it might not be practical to recommend that they join a fitness center as a means of weight reduction. When recommending a glucometer for the diabetic patient or a scale for the dialysis patient, it is important to consider the cost of each one.  

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cont...

Clearly define goals and objectives 

• Before beginning, it is important to have a list of goals and objectives that are formulated by the patient and the nurse. The significance of these should be understood by each person, and they should be evaluated on a continuous basis.

Remember to document

• When teaching a new skill, documentation is important. This allows the incoming nurse or a nursing assistant to see what has been done and where she should start. Likewise, if the patient has difficulty with a certain skill or needs certain assistance, this should be recorded so that accommodations or further instruction can be provided.

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Ways to educate the patient

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Computer-aided teaching: Computer or other output devices allow patients to view and to hear patient education materials in the hospital and some of these materials can be reviewed at home. Manuals are often made available to accompany the computerised programs. And there is usually a test to evaluate learning once the program is completed.

Video education: Video education is very similar to computer-based training. But, it is more difficult to evaluate learning. A written post-test could be used after the video is reviewed. But, it is important with both of these media to consider the patients’ educational level, language, and hearing/seeing abilities.

Ways to educate the patient�

Demonstration:

• Demonstration is another effective patient teaching technique. 
• Patients can be showed how to complete a task or how a process works in a one-on-one setting, andthen they can do the task more effectively at home. 
• However in an acute care setting this might be more difficult to do. The pace is much faster, but case managers or patient care assistants can be used to assist the nurse if needed. 
• And, demonstration does ensure that patients fully understand the teaching, and it allows them to get feedback and ask questions in a safe area.

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Ways to educate the patient

• Written material:  Written material seems so easy and routine. But, it can be effective. For instance, material with pictures can offer instructions or explanations.  Written material related to prescribed medicines is also a necessity.  And, it can offer instructions in a step by step fashion. Once again, it is important to evaluate the patients’ literacy level, language, and sight before handing out routine teaching materials. 
• Discharge instructions:  At the time of discharge, patients can be equipped with a set of instructions with follow-up appointments, medication teachingand phone numbers. 

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Evaluating patient learning

Effective patient teaching also requires evaluation and

documentation. Learning can be evaluated in the following ways:

• Asking questions: Simply ask the patient questions to see whether they is information that needs reinforcing.
• Observe return demonstration: Watch the patient perform a task (i.e. self inject insulin) to see if the technique is correct.
• Assess the data: Ask the patient to record his blood pressure, blood glucose, or weight at home.  And, review the records at the next visit.  These records will demonstrate how effective the current treatments have been. 

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Evaluating patient learning

• Talk with the patient/family: At the next visit, or before discharge, talk with the family to see how the patient has been doing, or before they leave the hospital, engage in open dialogue about barriers or concerns. This is very similar to the idea of “asking questions, “ but both methods are useful.

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Documenting patient teaching

There are many computerised systems out there. And some offices might still use hand-written documentation. Whatever method you use remember that the information must become a part of the patient’s permanent medical record.  You can include in the documentation:

Information and skills you have taught

Teaching methods used – brochures, models, videos, demonstration

Patient and family response to teaching

Evaluation of what the patient and family have learned and how learning outcomes were determine

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References

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• Kandlbinder, P (2013): Signature concepts of key researchers in higher education teaching and learning, Teaching in Higher Education, 18:1, 1-12
• Marton , F. and Säljö , R. 1976 . On qualitative differences in learning. I. Outcome and process . British Journal of Educational Psychology , 46 : 4 – 11
• Prosser , M. and Trigwell , K. 1999 . Understanding learning and teaching: The experience in higher education , Buckingham : Open University Press

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