NCM 102

Health Education
Midterm Lecture

Developing a Health Education Plan

I. Elements
A-B-C-D
➢ A – Audience (Who)
➢ B – Behavior (What)
➢ C – Condition (Under which Circumstances)
➢ D – Degree (How Well, to what extent, within what time frame)

II. Objectives

i. Definition
A specific, single, unidimensional behavior that is short term in nature, which should be achievable
after one teaching session/within a matter of few days following a series of teaching sessions.

ii. Types
➢ Educational – used to identify the intended outcomes of the educational process, whether
referring to an aspect of a program/ total program of the study that guide the design of curriculum
units.
➢ Instructional – describe the teaching activities, specific content areas and resources used to
facilitate effective instruction.
➢ Behavioral – action oriented rather than content oriented, learner centered rather than teacher
centered, short-term outcome focused rather than process focused.
iii. Factors that Differentiate Goals from Objectives
➢ Relationship to Time
➢ Level of Specificity

Goal - the final outcome to be achieved at the end of teaching and learning process
Objectives - are short-term and should be achieved at the end of one teaching session/shortly
after several teaching sessions. Specific, single, concrete and a one-dimensional behavior.

Advantages of a Well Written and Carefully Constructed Objective

✓ Helps keep the educator’s thinking on target & learner centered

✓ Communicates to learners and healthcare team members what is planned for teaching and learning
✓ Helps learners understand what is expected of them
✓ Forces the educator to select and organize educational materials so they do not get lost in the content
and forget the learner’s role in the process
✓ Encourages educators to evaluate their own motives of teaching
✓ Tailors teaching to learner’s unique needs
 ✓ Creates guidepost for teacher evaluation and documentation of success/failure
✓ Orients teacher & learner to the end results of the educational process
✓ Makes it easier for the learner to visualize performing the required skills

Additional Advantages (Robert Mager, 1997)

✓ Provides the solid Foundation for the selection of instructional content, methods and materials
✓ Provide learners with ways to organize their efforts to reach their goals
✓ Help determine whether an objective has been met

iv. Important Characteristics in Writing Concise and Useful Behavioral Objectives

➢ Performance - Describes what the learner is expected to be able to do to demonstrate the kinds
of behaviors the teacher will accept as evidence that objectives have been achieved. Activities
performed by the learner may be observable and quite visible, such as being able to write or list
something, whereas other activities may not be as visible, such as being able to identify or recall
something
➢ Condition: Describes the situations under which the behavior will be observed or the
performance will be expected to occur.
➢ Criterion: Describes how well, with what accuracy, or within what time frame the learner must
be able to perform the behavior so as to be considered competent

v. Common Mistakes When Writing Objectives

o Describing what the teacher does rather than what the learner is expected to do
o Including more than one expected behavior in a single objective
o Forgetting to identify all four components of condition, performance, criterion, and who the
learner is
o Using terms for performance that are open to many interpretations, are not action oriented,
and are difficult to measure
o Writing objectives that are unattainable and unrealistic given the ability level of the learner
o Writing objectives that do not relate to the stated goal
o Cluttering objectives by including unnecessary information
o Being too general so as not to specify clearly the expected behavior to be achieved

vi. SMART rule in Writing Objectives

S – Specific - Be specific about what is to be achieved (i.e., use strong action verbs, be concrete).
M – Measurable - Quantify or qualify objectives by including numeric, cost, or percentage amounts
or the degree/level of mastery expected.
A – Achievable - Write attainable objectives
R – Realistic - Resources (i.e., personnel, facilities, equipment) must be available and accessible to
achieve objectives
T – Timely - Resources (i.e., personnel, facilities, equipment) must be available and accessible to
achieve objectives
vii. Taxonomy of Objectives According to Learning Domains
Cognitive Domain - known as the “thinking” domain. Learning in this domain involves acquiring
information and addressing the development of the learner’s intellectual abilities, mental capacities,
understanding, and thinking processes (Eggen & Kauchak, 2012)

Levels of Behavioral Objectives in the Cognitive Domain

➢ Knowledge level - Ability of the learner to memorize, recall, define, recognize, or identify
specific information, such as facts, rules, principles, conditions, and terms, presented during
instruction
➢ Comprehension level - Ability of the learner to demonstrate an understanding of what is
being communicated by recognizing it in a translated form, such as grasping an idea by
defining it or summarizing it in his or her own words (knowledge is a prerequisite behavior)
➢ Application level - Ability of the learner to use ideas, principles, abstractions, or theories in
specific situations, such as figuring, writing, reading, or handling equipment (knowledge and
comprehension are prerequisite behaviors)
➢ Analysis level - Ability of the learner to recognize and structure information by breaking it
down into its separate parts and specifying the relationship between the parts (knowledge,
comprehension, and application are prerequisite behaviors)
➢ Synthesis level - Ability of the learner to put together parts into a unified whole by creating
a unique product that is written, oral, or in picture form (knowledge, comprehension,
application, and analysis are prerequisite behaviors)
➢ Evaluation level - Ability of the learner to judge the value of something by applying
appropriate criteria (knowledge, comprehension, application, analysis, and synthesis are
prerequisite behaviors)

Affective Domain - known as the “feeling” domain. Learning in this domain involves an
increasing internalization or commitment to feelings expressed as emotions, interests, beliefs,
attitudes, values, and appreciations.

Levels of Behavioral Objectives in the Affective Domain

➢ Receiving level - Ability of the learner to show awareness of an idea or fact or a
consciousness of a situation or event in the environment. This level represents a willingness
to selectively attend to or focus on data or to receive a stimulus
➢ Responding level - Ability of the learner to respond to an experience, at first obediently and
later willingly and with satisfaction. This level indicates a movement beyond denial and
toward voluntary acceptance, which can lead to feelings of pleasure or enjoyment resulting
from some new experience (receiving is a prerequisite behavior).
➢ Valuing level - Ability of the learner to regard or accept the worth of a theory, idea, or
event, demonstrating sufficient commitment or preference to an experience that is
perceived as having value. At this level, there is a definite willingness and desire to act to
further that value (receiving and responding are prerequisite behaviors)
➢ Organization level - Ability of the learner to organize, classify, and prioritize values by
integrating a new value into a general set of values; to determine interrelationships of
 values; and to establish some values as dominant and pervasive (receiving, responding, and
valuing are prerequisite behaviors)
➢ Characterization level - Ability of the learner to display adherence to a total philosophy or
worldview, showing firm commitment to the values by generalizing certain experiences into
value system (receiving, responding, valuing, and organization are prerequisite behaviors)

3 Levels that govern attitudes and feelings (Menix, 1996)

❖ Intrapersonal level - personal perceptions of one’s own self
❖ Interpersonal level - perspective of self in relation to other individuals
❖ Extrapersonal level involves the perception of others as established groups

Psychomotor Domain - known as the “skills” domain. Learning involves acquiring fine and gross
motor abilities such as walking, handwriting, manipulating equipment, or performing a procedure
Levels of Behavioral Objectives in the Psychomotor Domain
Perception level - Ability of the learner to show sensory awareness of objects or cues associated
with some task to be performed
Set level - Ability of the learner to exhibit readiness to take a certain kind of action as evidenced
by expressions of willingness, sensory attending, or body language favorable to performing a
motor act (perception is a prerequisite behavior)
Guided response level - Ability of the learner to exert effort via overt actions under the
guidance of an instructor to imitate an observed behavior with conscious awareness of effort
Mechanism level - Ability of the learner to repeatedly perform steps of a desired skill with a
certain degree of confidence
Complex overt response level - Ability of the learner to automatically perform a complex motor
act with independence and a high degree of skill, without hesitation
Adaptation level - Ability of the learner to modify or adapt a motor process to suit the individual
or various situations, indicating mastery of highly developed movements
Origination level - Ability of the learner to create new motor acts, such as novel ways of
manipulating objects or materials, as a result of an understanding of a skill and a developed
ability to perform skills

Teaching of Psychomotor Skills

Different teaching methods, such as demonstration, return demonstration, simulation, and self-
instruction, are useful for the development of motor skill

Factors Affecting Acquiring New Skills

Readiness to learn – motivation to learn affects the degree of effort exhibited by the learner in
working toward mastery of a skill
Past experience - If the learner is familiar with equipment or techniques similar to those needed
to learn a new skill, then mastery of the new skill may be achieved at a faster rate.
Health status - An illness state or other physical or emotional impairments in the learner may
affect the time it takes to acquire or successfully master a skill
 Environmental stimuli - Depending on the type and level of stimuli as well as the learning style
(degree of tolerance for certain stimuli), distractions in the immediate surroundings may
interfere with the ability to acquire a skill
Anxiety level - ability to concentrate can be dramatically affected by how anxious someone feels
Developmental stage- Physical, cognitive, and psychosocial stages of development all influence
an individual’s ability to master a movement-oriented task
Practice session length- During the beginning stages of learning a motor skill, short and carefully
planned practice sessions and frequent rest periods are valuable techniques to help increase the
rate and success of learning

viii. Development of Teaching Plans

Teaching plan is a blueprint to achieve the goal and the objectives that have been developed

Reasons for creating a Teaching Plan

1. To direct the teacher to look at the relationship between each of the steps of the teaching
process to make sure that there is a logical approach to teaching.
2. To communicate in writing exactly what is being taught, how it is being taught and
evaluated, and the time allotted to meet each of the behavioral objective
3. To legally document that an individual plan for each learner is in place and is being properly
implemented

Elements of Teaching Plans

1. Purpose (the why of the educational session)
2. Statement of the overall goal
3. List of objectives
4. An outline of the content to be covered in the teaching session
5. Instructional method(s) used for teaching the related content
6. Time allotted for the teaching of each objective
7. Instructional resources (materials/ tools and equipment) needed
8. Method(s) used to evaluate learning

Learning Contracts

Defined as a written (formal) or verbal (informal) agreement between the teacher and the
learner that specifies teaching and learning activities that are to occur within a certain time
frame

Components

1. Content - Specifies the precise behavioral objectives to be achieved. Objectives must clearly
state the desired outcomes of learning activities. Negotiation between the educator and the
learner determines the content, level, and sequencing of objectives according to learner needs,
abilities, and readiness
 2. Performance expectations: Specify the conditions under which learning activities will be
facilitated, such as instructional strategies and resources
3. Evaluation: Specifies the criteria used to evaluate achievement of objectives, such as skills
checklists, care standards or protocols, and agency policies and procedures of care that identify
the levels of competency expected of the learner
4. Time frame: Specifies the length of time needed for successful completion of the objectives. The
target date should reflect a reasonable period in which to achieve expected outcomes
depending on the learner’s abilities and circumstances. The completion date is the actual time it
took the learner to achieve each objective

PURPOSE:
GOAL :
Time
Objectives and Content Method of Method of
Allotted (in Resources
Sub-objectives Outline Instruction Evaluation
min.)
Learning curve is a common phrase used to describe how long it takes a learner to learn anything new

Six Stages of Learning Curve

1. Negligible progress - Initially very little improvement is detected during this stage. This pre-
readiness period is when the learner is not ready to perform the entire task, but relevant
learning is taking place
2. Increasing gains - Rapid gains in learning occur during this stage as the learner grasps the
essentials of the task
3. Decreasing gains: During this stage the rate of improvement slows and additional practice does
not produce such steep gains
4. Plateau: During this stage no substantial gains are made. This leveling-off period is characterized
by a minimal rate of progress in performance
5. Renewed gains: These gains usually are from growth in physical development, renewed interest
in the task, a response to challenge, or the drive for perfection
6. Approach to limit: During this stage progress becomes negligible. The ability to perform a task
has reached its potential, and no matter how much more the learner practices a skill, he or she
is not able to improve

III. Strategies and Methodologies

Teaching Method -the way information is taught that brings the learner into contact with what
is to be learned.

Factors Affecting Teaching Method to be used

✓ Audience characteristics (size, diversity, learning style preferences)
✓ Educator’s expertise as a teacher
✓ Objectives of learning
✓ Potential for achieving learning outcomes
✓ Cost-effectiveness
✓ Setting for teaching
✓ Evolving technology

1. LECTURE –defined as a highly structured method by which educator verbally transmits information
directly to a group of learners for the purpose of instructions

5 approaches to the effective transfer of knowledge during a lecture

1. Use opening & summary statements
2. Present key terms
3. Offer examples
4. Use analogies
5. Use visual backups

3 Main parts
1. Introduction – educator present learners with an overview of the behavioral objectives related
 to the lecture topic
2. Body –actual delivery of the content related to the topic being addressed
3. Conclusion –wrap-up of the lecture

Advantage
✓ Efficient, cost effective means for transmitting large amounts of information to a large
audience at the same time
✓ Useful to describe patterns, highlight main ideas and summarize data
✓ An effective approach for cognitive learning
✓ Easily supplemented with printed handouts and other audiovisual materials to enhance
learning

Limitations
❖ Largely ineffective in influencing affective and psychomotor behaviors.
❖ Does not provide much stimulation/participatory movements of learners.
❖ Very instructor centered
❖ All learners are exposed to the same information regardless of their cognitive abilities, learning
needs or stages of coping.
❖ The diversity within groups makes it challenging for the teacher to reach all learners equally

2. GROUP DICSUSSION – a method of teaching whereby learners get together to actively exchange
information, feelings and opinions with one another and with educator

a. TEAM-BASED LEARNING – is an innovative and newly popular teaching method - is meant

to enrich the student’s learning experience through active learning strategies

4 key principles (Sisk, 2011)

✓ Forming heterogeneous teams
✓ Stressing student’s accountability
✓ Providing meaningful team assignments
✓ Providing feedback to students

b. COOPERATIVE LEARNING – is a methodology of choice for transmitting foundational

knowledge. Highly structured group work focusing on problem solving that leads to deep
learning and critical thinking

4 KEY COMPONENTS
❖ Extensive structuring of the learning tasks by the teacher
❖ Strongly interactive student-student execution of the tasks
❖ Immediate debriefing/other assessments
❖ Instructional modifications by the teacher based on feedback

c. CASE STUDIES - lead to the development of analytical and problem-solving skills, exploration
of complex issues, and application of new knowledge and skills in the lineal practice arena.
 d. SEMINARS – interactions are stimulated by the posing of questions by the educator

3. ONE-TO-ONE INSTRUCTION – involves face- to-face delivery on information specifically designed to

meet the needs of individual learner

4. DEMONSTRATION AND RETURN DEMONSTRATION

Demonstration – is done by an educator to show the learner how to perform a certain skill.
Return demonstration – is carried out by the learner as an attempt to establish competence by
performing a task with Cues from the educator as needed

SCAFFOLDING –is an incremental approach to sequencing discrete steps of procedure

5. Gaming - is a method of instruction requiring the learner to participate in a competitive activity

with present rules (Allery, 2004)
Effective for improving cognitive functioning but also can be used to enhance skills in the
psychomotor domain and to influence affective behavior through increased social
interaction
6. SIMULATION – is a trial-and-error method of teaching whereby an artificial experience is created
that engages the learner in an activity that reflects real-life conditions but without risk- taking
consequences of an actual situation

TYPES OF SIMULATIONS
➢ Written simulations – use case studies about real or fictitious situations and the learner must respond
to these scenarios.
➢ Clinical simulations-can be set up to replicate complex care situations such as mock cardiac arrest
➢ Model simulations – are frequently used
➢ Computer simulations-are use in the learning laboratories to mimic situations whereby information
as well as feedback is given to learners in helping them to develop decision-making skills

ADVANTAGES
➢ Excellent for psychomotor skill development.
➢ Enhances higher level problem-solving and interactive abilities in the cognitive and affective domains
➢ Provides for active learner involvement in a real-life situation
➢ Guarantees a safe, nonthreatening environment for learning

LIMITATIONS
➢ Can be expensive
➢ Very labor intensive in many cases

7. ROLE PLAY – a method of instruction by which learners actively participate in an unrehearsed

dramatization
ADVANTAGES
➢ Opportunity to explore feelings and attitudes
➢ Potential for bridging the gap between understanding and feeling
➢ Narrows the role distance among patients and professionals

LIMITATIONS
➢ Limited to small groups
➢ Tendency by some participants to overly exaggerate their assigned roles
➢ A role part loses its realism and credibility if played too dramatically
➢ Discomfort felt by some participants in their roles/inability to develop them sufficiently

8. ROLE MODEL – use of self. Primarily known to achieve behavior change in affective domain
ADVANTAGES
➢ Influences attitudes to achieve behavior change primarily in the affective domain.
➢ Potential of positive role models to instill socially desired behaviors.

LIMITATIONS
➢ Requires rapport between the role model and the learner
➢ Potential for negative role models to instill unacceptable behaviors

9. SELF-INSTRUCTION – is a teaching method used by the educator to provide/design instructional

activities that guide the learner in independently achieving the objectives of learning.
- it is a self-contained educational activity that allows learners to progress by themselves at their
own pace (Abruzzese, 1996)
ADVANTAGES
➢ Allows for self-pacing.
➢ Stimulates active learning.
➢ Provides opportunity to review and reflect on information.
➢ Offers built-in, frequent feedback.
➢ Indicates mastery of material accomplished in particular time frame

LIMITATIONS
➢ Limited with learners who have low literacy
➢ Not appropriate for learners with visual and hearing impairments.
➢ Requires high level of motivation.
➢ May induce boredom in a population if this method is overused with no variation in the activity
design

ELEMENTS OF SELF-INSTRUCTION MODULES

1. Introduction 6. Outline of actual learning activities
2. List of prerequisite skills 7. Estimated total length of time
3. List of behavioral objectives 8. Different presentations
4. Pretest 9. Periodic self-assessments
5. Identification of resources and learning 10. Posttest
activities
 Techniques to enhance the effectiveness of verbal presentations
✓ Include humor ✓ Serve as role model
✓ Exhibit risk-taking behavior ✓ Use anecdotes and examples
✓ Deliver material dramatically ✓ Use technology
✓ Choose problem-solving activities

GENERAL PRINCIPLES FOR TEACHING ACROSSMETHODOLOGIES

➢ Give positive reinforcement ➢ Use questions

➢ Project an attitude of acceptance ➢ Use the Teach-Back or Tell-Back Strategy
and sensitivity ➢ Know the audience
➢ Be organized and give direction ➢ Use repetition and pacing
➢ Elicit and give feedback ➢ Summarize important points

SETTINGS FOR TEACHING

❖ Classified according to the need for health education in relationship to the primary purpose of the
organization/agency that provides health instruction
❖ Any place where nurses engage in teaching for disease prevention, health promotion, health
maintenance and rehabilitation

1. Healthcare setting – is one in which the delivery of health care is the primary or sole function of
the institution, organization or agency
Examples: hospital, public health department outpatient clinics, physician’s offices

2. Healthcare-related setting – is one in which healthcare-related services are offered as a

complementary function of the agency
Examples: American Heart Association and American Cancer Society

3. Non-healthcare setting – is one in which health care is an incidental or supportive function of an

organization
Examples: businesses, industries, school’s military and penal institutions

IV. Resources

INSTRUCTIONAL MATERIALS – are objects/vehicles by which information is communicated

Instructional Material Tools – are the objectives/ vehicles used to transmit information that supplement
the act of teaching

3 Major Variables in Making Appropriate Choices of Instructional Materials

1. Characteristic of the learner
2. Characteristic of the medium
3. Characteristic of the task to be achieved
Three Major Components of Instructional Materials
1. Delivery System – includes both the software and the hardware used in presenting information
2. Content (intended message) is independent of the delivery system and is the actual information
being communicated to the learner
3. Presentation – consist of the following:
a) Realia (the condition of being real) – most concrete form of stimuli that can be used to deliver
information
b) Illusionary Representations – applies to a less concrete, more abstract form of stimuli through
which to deliver a message
c) Symbolic Representations – refers to the most abstract types of messages

TYPES OF INSTRUCTIONAL MATERIALS

1. WRITTEN - Handouts, such as leaflets, books, pamphlets, brochures, and instruction sheets (all
symbolic representations), are the most widely used and most accessible type of tools for teaching
a. Commercially Prepared Materials
b. Self-Composed Materials

2. DEMONSTRATION - include many types of visual, hands-on media

a. Models - three-dimensional objects that allow the learner to immediately apply knowledge and
psychomotor skills by observing, examining, manipulating, handling, assembling and
disassembling them while the teacher provides feedback
➢Replica is an exact copy constructed to scale that resembles the features or substance of
the original object
➢Analogue has the same properties and performs like the real object. Unlike replicas,
analogue models are effective in explaining and representing dynamic systems.
➢Symbol is used frequently in teaching situations. Written words, mathematical signs and
formulas, diagrams, cartoons, printed handouts, and traffic signs are all examples
b. Displays - are two-dimensional objects that serve as useful tools for a variety of teaching
purposes
c. Posters - use the written word along with graphic illustration. Serve as a visual supplement to
oral instruction of patients and families in various healthcare settings

3. Audiovisual Materials- support and enrich the education process by stimulating the senses of seeing
and hearing, adding variety to the teaching–learning experience, and instilling visual memories,
which have been found to be more permanent than auditory memories (Kessels, 2003)
a. Projected Learning resources category of media includes:
➢Overhead transparencies
➢PowerPoint slides
➢Compact Discs and Digital Sound Players
➢Radio and Podcasts
b. Telecommunications - means by which information can be transmitted via television, telephone,
related modes of audio and video teleconferencing, and closed-circuit, cable, and satellite
broadcasting
➢Television
➢Telephones
 c. Computer Learning Resources - computer can store large amounts of information and is designed
to display pictures, graphics, and text. The presentation of information can be changed
depending on user input
➢Computers are an efficient instructional tool, computer programs can influence affective
and psychomotor skill development, and retention of information potentially can be
improved by the interactive exchange between learner and computer, even though the
instructor is not actually present (DiGiacinto, 2007). I
➢Computer-assisted instruction (CAI), also called computer-based learning and computer-
based training, promotes learning in primarily the cognitive domain

V. Evaluation
i. Definition
Defined as a systematic process that judges the worth/value of teaching and learning
ii. Steps in Conducting Evaluation
1. Determining the focus of the evaluation, including use of evaluation models
2. Designing the evaluation
3. Conducting the evaluation
4. Determining methods to analyze and interpret the data collected
5. Reporting results and a summary of the findings from the data collected
6. Using evaluation results

iii. Evidence-based practice (EBP)

- Defined as “the conscientious use of current best evidence in making decisions about
patient care” (Melnyk & Fineout-Overholt, 2015, p. 3)
- Described as “a lifelong problem-solving approach to clinical practice that
integrates…the most relevant and best research . . . one’s own clinical expertise . . . and patient
preferences and values” (Melnyk & Fineout-Overholt, 2015, p. 3)

➢ External Evidence – Evidence from research reflecting the fact that it is intended to be
generalizable or transferable beyond the specific study setting or sample
➢ Internal Evidence - defined as data generated from a diligently conducted quality
improvement project or EBP implementation project within a specific practice setting or
with a specific population (Melnyk & Fineout-Overholt, 2015

Practice-based evidence
➢ Defined as “the systematic collection of data about client progress generated during treatment
to enhance the quality and outcomes of care” (Girard, 2008, p. 15), which comprises internal evidence
that can be used both to identify whether a problem exists and to determine whether an intervention
based on external evidence effectively resolved that problem

iv. Evaluation Versus Assessment

➢ Assessment focuses on initially gathering, summarizing, interpreting, and using data to decide a
direction for action
➢ Evaluation involves gathering, summarizing, interpreting, and using data after an activity has
been completed to determine the extent to which an action was successful

5 Basic Component of Evaluation

1. Audience - includes the persons or groups for whom the evaluation is being conducted
2. Purpose - might be to decide whether to continue a specific education program or to determine
the effectiveness of the teaching process
3. Questions - must be directly related to the purpose for conducting the evaluation, must be
specific, and must be measurable
4. Scope - determined in part by the purpose for conducting the evaluation and in part by
available resources
5. Resources - include time, expertise, personnel, materials, equipment, and facilities.

Evaluation Models
1. Process (Formative) Evaluation – its purpose is to make necessary adjustments to an educational
activity as soon as they are identified, such as changes in personnel, materials, facilities,
teaching methods, learning objectives, or even the educator’s own attitude
2. Content Evaluation - determine whether learners have acquired the knowledge or skills taught
during the learning experience
3. Outcome (Summative) Evaluation - determine the effects of teaching efforts
4. Impact Evaluation - determine the relative effects of education on the institution or the
community
5. Total Program Evaluation is to determine the extent to which all activities for an entire
department or program over a specified time meet or exceed the goals originally established

Designing the Evaluation

1. Design Structure - all evaluations should be systematic, carefully and thoroughly planned or
structured before they are conducted
2. Evaluation Methods - design structure, in turn, provides the basis for determining what
evaluation methods should be used to collect data.
✓ Which types of data will be collected?
✓ What data will be collected and from whom?
✓ How, when, and where will data be collected?
✓ Who will collect the data?

Evaluation Instruments
Whenever possible, an evaluation should be conducted using existing instruments.
Reason: because instrument development not only requires considerable expertise, time, and
resources but also requires testing to be sure the instrument, whether it is in the form of a
questionnaire or a type of equipment, demonstrates reliability and validity before it is used for
collecting data

Steps in Instrument Selection

1. Conduct a literature search for evaluations similar to the evaluation that is being planned
 2. Check first, the instrument must measure the performance being evaluated exactly as that
performance has been operationally defined for the evaluation
3. Appropriate instrument should have documented evidence of its reliability and validity with
individuals who are as closely matched as possible with the people from whom data will be
collected

Barriers to Evaluation
1. Lack of clarity
2. Lack of ability
3. Fear of punishment or loss of self-esteem

v. Conducting the Evaluation

➢ Evaluation is implemented depends primarily on how carefully and thoroughly that
evaluation was planned and how carefully the instruments for data collection were selected or
developed

Methods to a Successful Evaluation

1. Conduct a pilot test first.
2. Include extra time to complete all the evaluation steps.
3. Keep a sense of humor throughout the experience

vi. Analyzing and Interpreting Data Collected

Purpose
1. To organize data so that they can provide meaningful information
2. To provide answers to evaluation question

Basic decisions about how data will be analyzed are dictated by the nature of the data and by the
questions used to focus the evaluation. Data can either be qualitative or quantitative

vii. Reporting Evaluation Results

The following guidelines can significantly increase the likelihood that results of the evaluation
will be reported to the appropriate individuals or groups, in a timely manner, and in usable
form:
✓ Be audience focused – (1) Evaluation must provide information for decision making by the
primary audience. No matter who the audience members are, their time is important to
them and they want something succinct to read. (2) Present evaluation results in a format
and language that the audience can understand and use without additional interpretation.
(3) Evaluator should make every effort to present results in person as well as in writing.
✓ Stick to the evaluation purpose - Evaluators should keep the main body of an evaluation
report focused on information that fulfills the purpose for conducting the evaluation. The
main aspects of how the evaluation was conducted and answers to questions asked also
should be provided
✓ Use data as intended - Evaluators should maintain consistency with actual data when
reporting and interpreting findings.
“In life, everything is a challenge, you may choose to face and learn from it or run and gain nothing… In
the end you make the decisions”
Condition Audience (Identity Who Behavior (Learner Degree (Criterion
(Circumstance or Learner is) Performance) Reflecting Quality or
Testing Situation) Quantity of Mastery)
Without using a The student Will solve Five out of six math
calculator problems
Using a model The staff nurse Will demonstrate The correct procedure
for changing sterile
dressings
Following group The patient Will list At last two reasons for
discussion losing weight
After watching a video The caregiver Will select High-protein foods for
the patient with 100%
accuracy

As an example

Well-written objectives Poorly written objectives

Following instruction on hypertension, the patient The patient will be able to prepare a menu using
will be able to state three out of four causes of low-salt food. (condition and criterion missing)
high blood pressure.
Ob completing the reading materials provided Given a list of exercises to relieve low bac pain, the
about the care of a newborn, the mother will be patient will understand how to control low-back
able to express any concerns she has caring for her pain. (performance not stated in measurable
baby after discharge. terms, criterion missing)
After a 20-minute teaching session, the patient will The nurse will demonstrate crutch walking
verbalize at least two feelings or concerns postoperatively to the patient. (teacher centered)
associated with wearing a colostomy bag.
After reading the handouts, the patient will be During discharge teaching, the patient will be
able to state three examples of foods that are more comfortable with insulin injections.
sources high in protein (performance not stated in measurable terms,
condition missing, criterion missing)
The patient will verbalize and demonstrate the
proper steps to performing self-catheterization.
(contains two expected behaviors, criterion
missing, time frame missing)
After a 20-minute teaching session, the patient will
appreciate knowing the steps required to
complete a finger stick. (performance not stated in
measurable terms, criterion missing)
Objectives
Examples of verbs few or many
Terms with many interpretations Terms with few interpretations (recommended)
(not recommended)
To know To apply To explain
To understand To choose To identify
To appreciate To classify To list
To realize To compare To order
To be familiar with To construct To predict
To enjoy To contrast To recall
To value To define To recognize
To be interested in To describe To select
To feel To demonstrate To state
To think To differentiate To verbalize
To learn To distinguish To write

Objectives Psychomotor learning level (according to Dave)

Imitation At this level, observed actions are followed. The learner’s movements are gross,
coordination lack smoothness, and errors occur. Time and speed required to
perform are based on learner needs.
Manipulation At this level, written instructions are followed. The learner’s coordinated
movements are variable, accuracy is measured based on the skill of using written
procedures as a guide. Time and speed required to perform vary.
Precision A logical sequence of actions is carried out. The learner’s movements are
coordinated at a higher level, and errors are minimal and relatively minor. Time and
speed required to perform remain variable.
Articulation A logical sequence of actions is carried out. The learner’s movements are
coordinated at a higher level, and errors are limited. Time and speed required to
perform are within reasonable expectations.
Naturalization The sequence of actions is automatic. The learner’s movements are coordinated at a
consistently high level, and errors are almost nonexistent. Time and speed required
to perform are within realistic limits and performance professional competence.

Psychomotor learning
6 themes important to learn new skills (Aldridge, 2017)
1. peer support and peer learning
2. practicing on real people is essential to mastery
3. faculty members matter during the learning experience
4. conditions of the environment are essential
5.
6. anxiety is ever present because of fear of harming patients

Conclusion – reserved for summarizing the information provided in the presentation.

Methods of instruction – LECTURE
Advantages Limitations
Efficient, cost effective means for transmitting Largely ineffective in influencing affective and
large amounts of information to a large psychomotor behaviors.
audience at the same time and within a relatively
reasonable time frame.
Useful to describe patterns, highlight main ideas Does not provide much stimulation/participatory
and summarize data, present unique ways of movements of learners.
viewing information.
An effective approach for cognitive learning, Very instructor centered and thus the most active
especially at lower levels of the cognitive domain. participant is frequently the most knowledgably
one-the teacher
Useful in providing foundational background Does not account for individual differences in
information as a basis for subsequent learning, background, attention span, or learning style.
such as group discussion.
Easily supplemented with printed handouts and All learners are exposed to the same information
other audiovisual materials to enhance regardless of their cognitive abilities, learning
Learning. needs or stages of coping.
The diversity within groups makes it challenging, if
not impossible, for the teacher to reach all
learners equally

Methods of instruction – One-to-one instruction

Stages
1. Pre-contemplation stage: provide information in a nonthreatening manner so that the learner
becomes aware of the negative aspects of consequences of his or her behave
2. Contemplation stage: support decision making for change by identifying benefits, considering barriers
to the change, and making suggestions for dealing with these obstacles
3. Preparation stage: support a move to action by contracting with the learner in establishing small
realistic, and measurable goals
4. Action stage: encourage constant practice of the new behavior to instill commitment to change by
pointing out the benefits of each step achieved.
5. Maintenance stage: continue encouragement and support to consolidate the new behavior and
prevent relapses
ONE-TO-ONE INSTRUCTION
Advantages Limitations
The pace and content of teaching can be tailored The learner is isolated from others who have
to meet individual needs similar needs or concerns
Ideal as an intervention for initial assessment and Deprives learners of the opportunity to identify
ongoing evaluation of the learner with others and share information, ideas and
feelings with those in like circumstance
Good for teaching behaviors in all three domains Can put learners on the spot because they are the
of learning sole focus of the educator’s attention
Especially suitable for teaching those who are Questioning may be interpreted by learners as a
learning disabled, low literature, or educationally technique to test their knowledge and skills
disadvantaged.
Provides opportunity for immediate feedback to The learner may feel overwhelmed and anxious if
be shared between the educator and the learner the educator makes the mistake of cramming too
much information into each session

GAMING INSTRUCTION
Advantages Limitations
Fun with a purpose Creates a competitive environment that ay be
threatening to some learners
Retention of information by stimulating learner Requires group size to be kept small for
enthusiasm and increasing learner involvement. participation by all learners
Easy to devise or modify for individual or group Requires more flexible space for teamwork than a
learning traditional conference or classroom
Adds variety to the learning experience Potentially higher noise level; special space
accommodations are needed as a result
Excellent for dull or repetitious content that must May be more physically demanding than many
be periodically reviewed other methods
Not possible for learners with some disabilities to
participate.

DEMONSTRATE AND RETURN INSTRUCTION

Advantages Limitations
Especially effective for learning in the Requires plenty of time to be set aside for teaching
psychomotor domain as well as learning
Actively engages the learner through stimulation Size of audience must be kept small to ensure
of visual auditory, and tactile senses opportunity for practice and close supervision
Repetition of movement and constant Equipment can be expensive to purchase and
reinforcement increases confidence, competence, replace
and skill retention.
Provides opportunity for overlearning to achieve Extra space and equipment is needed for
the goal practicing certain skills
Competency evaluation requires 1:1 teacher to
learner ratio
STIMULATION INSTRUCTION
Advantages Limitations
Excellent for psychomotor skill development. Can be expensive
Enhances higher level problem-solving and Very labor intensive in many cases
interactive abilities in the cognitive and affective
domains
Provides for active learner involvement in a real-life Not readily available to all learners yet
situation with consequences determined by
variables inherent in the situation
Guarantees a safe, nonthreatening environment
for learning

III. Strategies and methodologies

Evaluation of teaching methods
5 major questions to help decide which teaching method to choose
1. Does the teaching method help the learners to achieve the sated objectives?
2. Is the learning activity accessible and acceptable to the learners who have been targeted?
3. is the teaching method efficient given the time, energy, and resources available in relation to the
number of learners the educator is trying to reach?
4. To what extent does the teaching method allow for active participation to accommodate the needs,
abilities, and style of the learner?
5. Is the teaching method cost effective?

General principles for teaching acrossmethodologies - use questions

3 types of questions that can used to elicit different types of answers
1. Factual/Descriptive questions – begins with words such as who, what, which, where, how or when
and ask for recall-type responses from the learner.
Example: Which food are high in fat?

2. Clarifying questions – ask for more information and help the learner to convey thoughts and feelings.
Example: What do you mean when you say?

3. Higher order questions – require more than memory or perception to answer. They ask learner to
draw conclusions, establish cause and effect or make comparisons.
Example: What does a low-salt diet help to control blood pressure?
IV. Resources
General Principle
● The teacher must be familiar with the content
● Printed, demonstration, and audiovisual materials can change learner behavior
● No one tool is better than another
● Instructional materials should complement, reinforce, supplement
● The choice of material should match the content and the tasks to be learned
● The instructional material(s) selected should match available financial resources
● Instructional aids must be appropriate for the physical conditions of the learning environment
● Instructional materials should match the sensory abilities, development stages, and educational level
of the learners
● The messages conveyed by instructional materials must be accurate, up to date, appropriate,
unbiased, and free of any unintended content
● The tools used should contributed in a meaningful way to the learning situation by adding or clarifying
information

WRITTEN MATERIALS – SELF COMPPOSED

● Make certain the content is accurate and up to date
● Organize the content in a logical, step-by-step, simple fashion
● Make sure the information clearly and concisely discussed
● Avoid medical jargon whenever possible, and define any technical terms using simple, everyday
language
● Find out the average grade in school completed by the target client population

WRITTEN MATERIALS – EVALUATING PRINTED MATERIALS

● Nature of the audience
● Literacy level required
● Linguistic variety available
● Clarity and brevity
● Layout and appearance
● Opportunity for repetition
● Concreteness and familiarity
WRITTEN MATERIALS
Advantages Disadvantages
Materials are easily accessible and available on They are impersonal
many topics
The rate reading is controlled by the reader There is limited feedback; the absence of an
instructor lessens opportunity to clear up
misintreptation
Complex concepts can be explained both fully and Printed materials are passive tools
adequately
Procedural steps can be outlines
Verbal instruction can be reinforced Highly complex materials may be overwhelming to
the learner
The learner is always able to refer to instructions Literacy skill of the learner may limit effectiveness
given in print
Materials may not be available in different
languages

DEMONSTRATION MATERIALS
Advantages Disadvantages
Brings the learner closer to reality through active Static, easily outdated content
engagement
Useful for cognitive learning and psychomotor skill Can be time consuming to make
development
Stimulates learning in the affective domain Potential for overuse
Relatively inexpensive Not suitable for simultaneous use with large
audiences
Opportunity for repetition of the message Not suitable for visually impaired learners or for
learners with poor abstract thinking abilities
AUDIOVISUAL MATERIALS – PLR
Advantages Disadvantages
Most effectively used with groups May stifle learner participation if overused
May be especially beneficial for hearing-impaired, May encourage learners to think only in bullet
low-literate patients points
Good for teaching skills in all domains Easy to pack too much content into each slide,
making the print too difficult to read and
presenting more than one concept per slide
Flexible to add, delete, or revise slides easily and Animations, sounds, and fancy transitions may be
quickly distracting
Do not require darkened room for projection Lack of time for cognitive processing if too many
slides included for the scheduled teaching session
Some forms may be expensive
Requires darkened room for some forms
Requires special equipment for use

AUDIOVISUAL MATERIALS – AUDIO LEARNING RESOURCES

Advantages Disadvantages
Widely available Relies only on sense of hearing
May be especially beneficial for visually impaired, Expensive in some forms
low-literacy patient
May be listened to repeatedly Lack of opportunity for interaction between
instructor and learner
Usually practical, cheap, small of size, and portable

AUDIOVISUAL MATERIALS – VIDEO LEARNING RESOURCES

Advantages Disadvantages
Widely used educational tool Viewing formats limited depending on availability
of hardware in healthcare settings, especially in
patient homes
Inexpensive, for the most part Expense of some commercial products
Uses visual and auditory senses Excessive length or inappropriateness for the
audience of some purchased materials
Flexible for use with different audiences
Powerful tool for role modeling, demonstration,
teaching psychomotor skills
AUDIOVISUAL MATERIALS – TELECOMMUNICATIONS LEARNING
Advantages Disadvantages
Influences cognitive, affective, and psychomotor Complicated to set up interactive capability
domains
Relatively inexpensive hardware and software Expensive to broadcast via satellite
devices
Numerous programs on a variety of topics Occasional inability of formats to provide for
repetition of information
Widely accessible for distribution to many users at Cannot control how many and what type of viewer
a distance audiences are reached
Appealing to many learners because of
convenience and flexibility

AUDIOVISUAL MATERIALS – COMPUTER LEARNING RESOURCES

Advantages Disadvantages
Promotes quick feedback, retention of learning Primarily promotes learning in cognitive domain,
but can influence affective and psychomotor skill
development
Potential database enormous Expensive software and hardware, therefore less
accessible to a wide audience
Can be individualized to suit different types of Too complex and time consuming for most nurses
learners or different paces for learning to prepare independently
Time efficient Limited use for many elderly, low-literate learners,
and those with physical limitations

Purpose of an evaluation is to measure whether a practice change is effective in a specific setting with a
specific group of individuals-learners and/or teachers, in the case of education evaluation-during a
specified time frame

Purpose of research is to generate new knowledge that can be used across settings and individuals with
similar characteristics and demographics
V. Evaluation
● Barriers – Clarity
- if the focus for evaluation is unclear, unstated, or not well defined, hen undertaking an evaluation is
difficult if its purpose or what will be done with the results is unknown

● Barriers – Ability
- inability to conduct education evaluations most often from lack of knowledge, confidence, interest, or
resources needed to carry out his process

● Barriers – Fear of Punishment or Loss of Self-esteem

- evaluation might be perceived as a judgement of someone’s value or personal worth

THREE MAIN COMPONENTS OF EVIDENCE-BASED PRACTICE

▪ Utilize the best external evidence
▪ Draw on individual clinical expertise
▪ Consider patient values & expectations

Reporting Evaluation Results

4 reasons Why Evaluation Data are Not Reported
1. Ignorance of who should receive the results
2. Belief that the results are not important or will not be used
3. Lack of ability to translate findings into language useful in producing a final report
4. Fear that results will be misused
Objectives On the other hand, adult learners:
● decide for themselves
After completing 6 hours of learning, the ● validate the information based on their
CSAB LEVEL 1 students will be able to beliefs and experience
1. identify the physical, cognitive, and ● expect what they are learning to be
psychosocial characteristics of learners that immediately useful
influence learning at various stages of ● may have fixed viewpoints
growth and development. ● ability to serve as a knowledgeable
2. recognize the role of the nurse as educator resource
in assessing stage-specific learner needs
according to maturational levels. Need to know: adults want to know why it’s
3. determine the role of the family in patient important to learn something
education. ● foundation: adults use experience in
4. discuss appropriate teaching strategies learning activities
effective for learners at different ● self-concept: adults want a role in
developmental stages. deciding what to learn in their education
● readiness: adults want to learn things they
can apply immediately
PEDAGOGY AND ANDRAGOGY ● orientation: adults want a problem-
Pedagogy derives from the Greek for centered education rather than content-
“child” and “leading” and refers to the oriented
science and practice of teaching children. ● motivation: adults respond better to
internal rather than external motivators
Researcher Malcolm Knowles first
introduced the term andragogy in about CONTEXTUAL INFLUENCES
1968 in reference to a model for teaching Traditional thinking: development and
adults. maturity goes with AGE
Advance level thinking: development is
Children in education: contextual.
● rely on others
● accept the information being presented at Contextual – depending on or relating to the
face value circumstances that form that setting for an
● expect what they are learning to be useful event, statement, or idea
in their long-term future
● are relatively “clean slates” It is now understood that three
● due to lack of experience, they have little important contextual influences act on and
ability to serve as a knowledgeable resource interact with the individual to product
development (Crandell et al., 2012; Santrock,
2017)
1. Normative age-graded PHASES OF LEARNING:
Influences are strongly related to INTERDEPENDENCE
chronological age and are similar for Independence occurs when a
individuals in a specific age group, such as develops the ability to physically,
the biological processes of puberty and intellectually, and emotionally care for
menopause and the sociocultural processes himself or herself and make his or her own
of transitioning to different levels of formal choices, including taking responsibility for
education or to retirement. learning.

2. Normative history-graded Interdependence occurs when an

Influences are common o people in a individual has sufficiently advances in
certain age cohort or generation because maturity to achieve self-reliance, a sense of
they have been uniquely exposed to similar self-esteem, and the ABILITY TO GIVE
historical circumstances, such as the Martial AND RECEIVE, and when that individual
Law, the age of computers, or the terrorist demonstrates a level of respect for others.
events of September 11, 2021, devastating Full physical maturity does not guarantee
typhoons. simultaneous emotional and intellectual
maturity.
3. Normative life events
Are the unusual or unique Interdependence - give and take
circumstances, positive or negative, that are
points in individuals’ lives that cause them TAKING RESPONSIBILITY FOR ONE’S
to change direction, such as house fire, HEALTH
serious injury in an accident, winning the “when is the most appropriate or best time
lottery, divorce, or an unexpected career teach the learner?”
opportunity
The answer is when the learner is
ready. When the learner recognizes the need
PHASES OF LEARNING: DEPENDENCE for learning.
Dependence is characteristics of the
infant and young child, who are totally However, the nurse as educator does
dependent on others for direction, support, not always have to wait for teachable
and nurturance from a physical, emotional, moments to occur; the teacher can actively
and intellectual standpoint. create these opportunities by taking an
interest in and attending to the needs of the
Unfortunately, some adults are learner
considered stuck in this stage if they
demonstrate manipulative behavior, do not
listen, are insecure, or do not accept
responsibility for their own actions.
BUILDING BLOCKS OF KNNOWLEDGE Psychosocial stage: trust vs. mistrust
(SCHEMAS) (0-12 months), Autonomy vs. shame and
- learners develop schemas of knowledge doubt (1-2 years old)
about the world. These are clusters of
connected ideas about thins in the real world General characteristics
that allow the learner to respond accordingly. 1. dependent on the environment
Schemas refer to ideas that is perceived as 2. needs security
normal. 3. explores self and environment
- when the learner has developed a working 4. natural curiosity
schema that can explain what they perceive
in the word, the schema is in a state of Object permanence is developed
equilibrium Causality is introduced
- when the learner uses the schema to deal Delayed gratification is not yet established
with a new thing or situation, that schema is
in assimilation Delayed gratification - resisting the
- accommodation happens when the temptation of an immediate reward, in
existing schema isn’t up to the job of anticipation that there will be a greater
explaining what’s going in and needs to be reward later. It’s a powerful tool for learning
changed to live your life with purpose. It’s linked to
- once the schemas change (NEW impulse tool control: Those with high
NORMAL), it returns to equilibrium and life impulse control typically excel at delayed
goes on. gratification
- learning is, therefore, a constant cycle of
assimilation; accommodation; equilibrium; Teaching strategies
assimilation and so on 1. orient teaching to caregiver
2. encourage parents to use repetition and
imitation of information
INFANCY (FIRST 12 MONTHS OF LIFE) 3. stimulate all senses
and TODDLERHOOD (1-2 YEARS OF 4. provide safety and emotional security
AGE 5. allow play and manipulation of objects
Audience: parents
Nursing interventions
Behavior: (expected of children at this age) 1. welcome active involvement
2. forge alliances
Exploration of self and environment, 3. encourage physical closeness
stimulate physical development. 4. provide detailed information
5. answer questions and concerns
Cognitive stage: sensorimotor (sensor and 6. ask for information on child’s
movement) strengths/limitations and likes/dislikes
 EARLY CHILDHOOD (3-5 YEARS OF
For short-term learning AGE)
● reading simple stories from books with Cognitive stage: Preoperational
lots of pictures Psychosocial stage: initiative vs. guilt
● use dolls and puppets to act out feelings
and behaviors At this age the child develops:
● use simple audiotapes with music and ● capacity to recall the past or experience
videotapes with cartoon characters ● anticipate future events
● perform procedures on a teddy bear or doll ● classify objects into groups and categories
first to help the child anticipate what an ● Precausal thinking (understand people can
experience will be like make tings happen, influence)
● allow the child something to do squeeze ● Animistic thinking (animate life and
your hand, hold a band-aid, sing a song, cry conscience, talking to a doll)
if it hurts-to channel his or her response to ● Egocentrism (only think of themselves)
an unpleasant experience
● keep teaching sessions brief 5 minutes Egocentric – thinking only oneself, without
maximum regard for the feelings or desires of others,
● cluster teaching sessions close together self-centered
● avoid analogies and explain things in
straightforward and simple terms ● Interested in the “WHY”s of the world,
● individualize the pace of teaching but not the “HOW”s
according to the child’s response and level ● Fantasy and reality are not well
of attention differentiated
● illness and hospitalization is thought to be
For long-term learning a punishment (egocentric causation)
● build habits by focusing on rituals,
imtation and repetition of information General characteristics
● use reinforcement as an opportunity for ● egocentric
children to achieve permanence of learning ● thinking precausal, concrete, literal
through practice ● believes illness is self-cased and punitive
● encourage parents to act as role models ● limited sense of time
● fears bodily injury
● cannot generalize
● animistic thinking
● focus is on one characteristic of an object
● separation anxiety
● motivated by curiosity
● active imagination, prone to fears
● play is his/her work
Teaching strategies For short term learning
● use warm, calm approach ● provide physical and visual stimuli
● build trust because language ability is still limited
● use repetition of information ● keep teaching sessions short with short
● allow manipulation of objects ad intervals (no more than 15 minutes)
equipment ● relate information needs to activities and
● give care with explanation experiences familiar to the child.
● reassurance not to blame self For example, ask the child to pretend
● explain procedures simply and briefly to blow out candles on a birthday cake to
● provide safe, secure environment practice deep breathing.
● use positive reinforcement ● encourage the child to participate in
● encourage questions to reveal selecting between a limited number of
perceptions/feelings teaching-learning options.
● use simple drawings and stories ● arrange small-group sessions
● use play therapy, with dolls and puppets ● give praise and approval
● stimulate senses: visual, auditory, tactile, ● give tangible rewards
motor ● allow the child to manipulate equipment
and play with replicas or dolls

Nursing interventions Tangible – a thing that is perceptible by

● welcome active involvement touch
● forge alliances
● encourage physical closeness
● provide detailed information For long-term learning
● answer questions and concerns ● enlist the help of parents, who can play a
● ask for information on child’s vial role in modeling a variety of healthy
strengths/limitations and likes/dislikes habits, such as practicing safety measures
and eating a balanced diet; offer them access
to support and follow-up as the need arises
● reinforce positive health behaviors and the
acquisition of specific skills
MIDDLE AND LATE CHILDHOOD (6-11 MIDDLE AND LATE CHILDHOOD (6-11
YEAR OF AGE) YEAR OF AGE)
Cognitive stage: concrete operations
Psychosocial stage: industry vs. inferiority USING DEDUCTIVE REASONING TO
VERIFY CONJECTURES
● Begin to have formal training in structured
school systems Inductive reasoning
● open to new and varied ideas - uses specific examples to make a general
● schemas are challenged as they experience “rule”
varied attitudes, values, and perceptions - finding patterns or stereotypes
from the environment Examples:
My last year’s math teacher/is awesome
MIDDLE AND LATE CHILDHOOD (6-11 My math teacher of this year is awesome.
YEAR OF AGE) Therefore, all GR math teachers are
The gross- and fine-motor abilities of awesome.
school aged children become increasingly 10, 20, 30, 40, 50… using the pattern, the
more coordinated so that they have the rule would be add 10 and the next number
ability to control their movement with much would be 50
greater dexterity than ever before.
Deductive reasoning
During this time, logical, rational - takes a general rule and uses it to make a
thought processes and the ability to reason more specific example
inductively and deductively develop. - drawing conclusions from previous known
Children in this stage can think more facts and definitions
objectively, are willing to listen to others, Example:
and selectively use questioning to find Quadrilaterals have four sides therefore, a
answers to the unknown. square is a quadrilateral.

MIDDLE AND LATE CHILDHOOD (6-11

YEAR OF AGE)

Syllogistic reasoning begins

- ability to consider two premises and draw a
logical conclusion from them.
For example, they comprehend that
mammal are warm blooded, and whales are
mammals, so whales must be warm blooded.
Conservation is mastered MIDDLE AND LATE CHILDHOOD (6-11
- ability to recognize that the properties of YEAR OF AGE
an object stay the same even though its
appearance and position may change Teaching strategies
For example, they realize that a ● encourage independence and active
certain quantity of liquid is the same amount participation
whether it is poured into a tall, thin glass or ● be honest, allay fears
into a short, wide one. ● use logical explanation
● allow time to ask questions
MIDDLE AND LATE CHILDHOOD (6-11 ● use analogies to make invisible processes
YEAR OF AGE) real
● fiction and fantasy are separate from fact ● establish role models
and reality ● relate care to other children’s experience;
● can engage in systematic thought through compare procedures
inductive reasoning ● use subject centered focus
● ability to classify objects and systems ● use play therapy
● express concrete ideas about relationships ● provide group activities
and people ● use diagram, models, pictures, digital
● carry out mathematical operations media, printed materials, and computer,
● causal thinking develops tablets, or smartphone applications

MIDDLE AND LATE CHILDHOOD (6-11

YEAR OF AGE MIDDLE AND LATE CHILDHOOD (6-11
YEAR OF AGE
General characteristic
● more realistic and objective Nursing interventions
● understands cause and effect ● welcome active involvement
● deductive/inductive reasoning ● forge alliances
● wants concrete information ● encourage physical closeness
● able to compare objects and events ● provide detailed information
● variable rates of physical growth ● answer questions and concerns
● reasons syllogistically ● ask for information on child’s
● understands seriousness and consequences strengths/limitations and likes/dislikes
of action
● subject-centered focus
● immediate orientation
MIDDLE AND LATE CHILDHOOD (6-11 involvement helps the child to assimilate
YEAR OF AGE information more readily
● provide much-needed nurturance and
For short-term learning support, always keeping in mind that young
● allow school-aged children to take children are not just small adults. Praise and
responsibility for their own health care rewards help motivate and reinforce learning
For example, to apply their own
splint or use an asthma inhaler as prescribed MIDDLE AND LATE CHILDHOOD (6-11
● teaching sessions can be extended to last YEAR OF AGE
up to 30 minutes
● lessons should be spread apart to allow for For long-term learning
comprehension of large amounts of content ● help school-aged children acquire skills
and to provide opportunity for the practice they can use to assume self-care
of newly acquired skills between sessions responsibility for carrying out therapeutic
● choose audiovisual and printed materials treatment regimens on an ongoing basis with
that sow peers undergoing similar minimal assistance.
procedures or facing similar situations ● assist them in learning to maintain their
● clarify any scientific terminology and own well-being and prevent illnesses from
medical jargon used. “simplify or translate” occurring
● use analogies
For example: “having a chest x-ray is ADOLESCENCE (12-19 YEARS OF AGE)
like having your picture taken” or “white Cognitive stage: formal operations
blood cells are like police cells that can Psychosocial stage: identity vs. role
attack and destroy infection.” confusion
● use one-to-one teaching sessions as a
method to individualize learning relevant to Today’s adolescents comprise the
the child’s own experiences generational cohort Generation Z, or Gen Z.
● provide time for clarification, validation, They excel with self-directed learning and
and reinforcement of what is being learned. thrive on the use of technology.
● select individual instructional techniques
that provide opportunity for privacy Adolescents vary greatly in their
● employ group teaching sessions with biological, psychosocial, social, and
others of similar age and with similar cognitive development. From a physical
problems or needs to help children avoid maturation standpoint, they must adapt to
feelings of isolation and to assist them in rapid, dramatic, and significant bodily
identifying with their own peers. changes, which can temporarily result in
● prepare children for procedures and clumsiness and poorly coordinated
interventions well in advance movement.
● encourage participation in planning for
procedures and events because active
 Alterations in physical size, shape, ● has the ability to hypothesize and apply
and function of their bodies, along with the the principles of logic to situations never
appearance and development of secondary encountered before
sex characteristics, bring about a significant ● can conceptualize and internalize ideas
preoccupation with their appearance and a ● able to debate various points of view
strong desire to express sexual urges ● understand cause and effect,
● able to respond appropriately to multiple-
And, according to step directions
neuroscience research, research, adolescent
brains are different than adult brains in the ADOLESCENCE (12-19 YEARS OF AGE)
way they process information, which kay
explain that adolescent behaviors, such as Adolescent egocentrism develops
impulsiveness, rebelliousness, lack of good - they begin to believe that everyone is
judgment, and social anxiety, stem from focusing on the same things they are namely,
biological reasons more than environmental themselves and their activities.
influences. Adolescents are known to be
among the nation’s most at-risk Imaginary audience begins
populations - the imaginary audience explains the
pervasive self-consciousness of adolescents,
ADOLESCENCE (12-19 YEARS OF AGE) who, on the one hand, may feel embarrassed
● capable of abstract thought and the type of because they believe everyone is looking at
complex logical thinking described as them and, on the other hand, desire to be
propositional reasoning, as opposed to looked at and thought about because this
syllogistic reasoning attention confirms their sense of being
● their ability to reason is both inductive and special and unique
deductive
● has the ability to hypothesize and apply ADOLESCENCE (12-19 YEARS OF AGE)
the principles of logic to situations never Able to understand the concept of
encountered before health and illness, the multiple causes of
● can conceptualize and internalize ideas diseases, the influence of variables on health
● able to debate various points of view status, and the ideas associated with health
● understand cause and effect, promotion and disease prevention.
● able to respond appropriately to multiple- Parents, health providers, and the
step directions internet are all potential sources of health-
● capable of abstract thought and the type of related information for adolescents.
complex logical thinking described as They also can identify health
propositional reasoning, as opposed to behaviors, although they may reject
syllogistic reasoning practicing them or begin to engage in risk-
● their ability to reason is both inductive and taking behaviors because of the social
deductive
pressures they receive from peers as well as ADOLESCENCE (12-19 YEARS OF AGE)
their feelings of invincibility
General characteristics
Personal fable is displayed ● abstract, hypothetical thinking
The personal fable leads adolescents ● can build past learning
to believe that they are invulnerable-other ● reasons by logic and understands scientific
people grow old and die, but not them; other principles
people may not realize their personal ● future orientation
ambitions, but they will. ● motivated by desire for social acceptance
● peer group important
ADOLESCENCE (12-19 YEARS OF AGE) ● intense personal preoccupation
● emphasis on importance of appearance
The unconscious goals of adolescents (imaginary audience)
include the need to: ● feels invulnerable, invincible/immune to
● establish their own identity natural laws (personal fable)
● match their skills with career choices
● determine self Teaching strategies
● seek independence and autonomy ● establish trust, authenticity
● develop distinct individual personalities ● know the agenda
● belong to a group ● address fears/concerns about outcomes of
● rebel against any action or illness
recommendations by adults whom they ● identify control focus
consider authoritarian ● include in plan of care
● use peers for support and influence
Adolescents demand personal space, ● negotiate changes
control, privacy, and confidentiality. To ● focus on details
them, illness, injury, disability, and ● make information meaningful to life
hospitalization mean dependency, loss of ● ensure confidentiality and privacy
identify, a change in body image and ● arrange peer group sessions in person or
functioning, bodily embarrassment, virtually
confinement, separation from peers, and ● use audiovisuals, role play, contacts,
possible death. reading materials
● provide for experimentation and flexibility
ADOLESCENCE (12-19 YEARS OF AGE) ● give a rationale for all that is said and
done to help adolescents fee a sense of
Nursing interventions control.
● explore emotional and financial support ● approach them with respect, tact, openness,
● determine goals and expectations and flexibility to elicit their attention and
● assess stress levels encourage their responsiveness to teaching-
● respect values and norms learning situations
● determine role responsibilities and ● expect negative responses, which are
relationships common when their self-image and self-
● engage in 1:1 teaching without parent’s integrity are threatened
present, but with adolescent’s permission, ● avoid confrontation and acting like an
inform family of content covered authority figure

For short-term learning ADOLESCENCE (12-19 YEARS OF AGE)

● use one-to-one instruction to ensure
confidentiality of sensitive information For long-term learning
● choose peer-group discussion sessions as ● accept adolescents’ personal fable
an effective approach to deal with health imaginary audience as valid, rather than
topics such as smoking, alcohol and drug challenging their feelings of uniqueness and
use, safety measures, obesity, and teenage invincibility
sexuality. ● acknowledge that their feelings are very
● use face-to-face or computer group real
discussion, role playing, and gaming as ● allow them the opportunity to test their
methods o clarify values and solve problems own convictions
● employ adjunct instructional tools, such as
complex models, diagrams, and specific, ANDRAGOGY REVIEW
detailed written materials Adult learners:
●clarify any scientific terminology and ● decide for themselves what is important to
medical jargon used. “Simplify or translate” learn
● share decision making whenever possible, ● need to validate the information based on
because control is an important issue for their beliefs and experience
adolescents ● expect what they are learning to be
● include adolescents in formulating immediately useful
teaching plans related to teaching strategies, ● have much experience upon which to draw
expected outcomes, and determining what – may have fixed viewpoints
needs to be learned and how it can best be ● significant ability to serve as a
achieved to meet their needs for autonomy. knowledgeable resource to the trainer and
● suggest options so that they feel have a fellow learners
choice about courses of action.
YOUNG ADULTHOOD (20-40 YEARS YOUNG ADULTHOOD (20-40 YEARS
OF AGE) OF AGE)
Cognitive stage: formal operations
Psychosocial stage: intimacy vs. isolation General characteristics
● autonomous
Unconscious goals for young adults: ● self-directed
● establishing long-term and intimate ● uses personal experience to enhance or
relationships with otter people interfere with learning
● choosing a lifestyle and adjusting to it ● intrinsic motivation
● deciding on an occupation ● able to analyze critically
● managing a home and family ● makes decisions about personal,
occupational, and social roles
During this period, physical abilities ● competency – based learner
for most young adults are at their peak, and
the body is at its optimal functioning Teaching strategies
capacity. The cognitive capacity of young ● use problem-centered focus
adults is fully developed, but with ● draw on meaningful experience
maturation, they continue to accumulate new ● focus on immediacy of application
knowledge and skills from an expanding ● encourage active participation
reservoir of formal and informal experiences ● allow to set own pace, be self-directed
● organize material
Coming from experience, young adults have ● recognize social role
an improved ability to: ● apply new knowledge through role
● generalize to new situations playing and hands-on practice
● improve their abilities to critically analyze,
solve problems Nursing interventions
● make decisions about their personal, ● explore emotional, financial and physical
occupational, and social roles support system
● assess motivational level of involvement
Their interests for learning are ● identify potential obstacles and stressors
oriented toward those experiences that are
relevant for immediate application to
problems and tasks in their daily lives.
Young adults are motivated to learn about
possible implications of various lifestyle
choices.
YOUNG ADULTHOOD (20-40 YEARS MIDDLE-AGED ADULTHOOD
OF AGE) (41-64 YEARS OF AGE)
Cognitive stage: formal operations
Salient points in health education with Psychosocial stage: generativity vs.
young adults absorption and stagnation
● health promotion is the most neglected
aspect of healthcare teaching at this stage of During middle age, many individuals
life are highly accomplished in their career, their
● he major factors that need to be addressed sense of who they are is well developed,
in this age group are healthy eating habits, their children are grown, and they have time
regular exercise, and avoiding drug abuse. to share their talents, serve as mentors for
Such behaviors will reduce the incidence of others ad pursue new or latent interests
high blood pressure, elevated cholesterol,
obesity, smoking, and overuse of alcohol Physiological changes begin to take
and drugs place. These physical changes and others
● the motivation for adults to learn comes in affect middle aged adults’ self-image, ability
response to internal drives, such as need for to learn, and motivation for learning about
self-esteem, a better quality of life, or job health promotion, disease prevention, and
satisfaction, and in response to external maintenance of health
motivators, such as job promotion, more
money, or more time to pursue outside MIDDLE-AGED ADULTHOOD
activities (41-64 YEARS OF AGE)
● any illness or disabilities prevent them to - Dialectical thinking is expanded
achieve the internal drives - it is a type of thinking is defined as the
● content of instruction must be seen as ability to search for complex and changing
relevant to the current or anticipated understandings t find a variety of solutions
problems to any given situation or problem
● teaching strategies must be directed at - in other words, middle-aged adults have
encouraging young adults to seek the ability to “see the bigger picture”
information
● relevant, applicable, and practical Due to their experience and
information is what adults desire, and value- physiological changes, middle-aged adults,
they want to know “what’s in it for me,” may choose to:
● group discussion is an attractive method Modify aspects of their lives that
for teaching and learning because it provides they perceive as unsatisfactory
young adults with the opportunity to interact Or
with others of similar age and in similar Adopt a new lifestyle as a solution to
situations, such as in parenting groups, dissatisfaction
prenatal classes, exercise classes, or marital
adjustment sessions
MIDDLE-AGED ADULTHOOD Salient points in health education with
(41-64 YEARS OF AGE) middle-aged adults
●when teaching members of this age group,
General characteristics the nurse must be aware of their potential
● sense of self well developed sources of stress, the health risk factors
● concerned with physical changes associated with this stage of life, and the
● at peak in career concerns typical od midlife. Misconceptions
● explores alternative lifestyles regarding physical changes such as
● reflects on contributions to family and menopause for women are common
society ● many need and want information related t
● reexamines goals and values chronic illnesses that can arise at this phase
● questions achievements and successes of life
● confidence in abilities ● adult learners need to be reassurance or
● desires to modify unsatisfactory aspects of complimented on their learning competences
life ● teaching strategies for learning are similar
in type in teaching methods and instrumental
Teaching strategies tools used for the young adult learner, but
● focus in maintaining independence and the content is different to coincide with the
reestablishing normal life patterns concerns and problems specific to this group
● assess positive and negative paste of learners
experience with learning
● assess potential sources of stress caused OLDER ADULTHOOD (65 YEARS OF
by midlife crisis issues AGE AND OLDER)
● provide information to coincide with life Cognitive stage: formal operations
concerns and problems Psychosocial stage: ego integrity vs. despair
Most older people have at least one
Nursing interventions chronic condition, and many, especially in
● explore emotional, financial and physical the later years, have multiple conditions
support system On average, they are hospitalized
● assess motivation level for involvement long than persons in other ag categories and
● identify potential obstacles and stressors require more teaching overall to broaden
their knowledge of self-care
Lower educational levels in some
ethnic groups, sensory impairments, the
disuse of literacy skills once learned, and
cognitive changes in the population of older
adults may contribute to their decreased
ability to read and comprehend WRITTEN
materials
OLDER ADULTHOOD (65 YEARS OF occur during this phase of growth and
AGE AND OLDER) development
Nurses and nurse educators must
recognize that a significant number of older With advancing age, so man physical
persons respond to these changes by viewing changes occur that it becomes difficult to
them as challenges rather than defeats establish normal boundaries.
Given the considerable health care
expenditures for older people, patient As a person grows older, natural
education are generally greater and physiological changes in all systems of the
education programs to improve their health body are universal, progressive and intrinsic.
status and reduce morbidity would be a cost-
effective measure Alternations in physiological
functioning can lead secondarily to changes
Ageism describes prejudice against in learning ability. The sense of sight,
the older adult. This discrimination based on hearing, touch, taste, and smell are usually
age, which exists in most segments of the the first areas of decreased functioning
society, perpetuates the negative stereotype noticed by adults.
pf aging as a period of decline
Cognitive ability changes with age as
This bias interferes with interactions permanent cellular alternations invariably
between the older adult and younger age occur in the brain itself, resulting in an
groups and must be counteracted because it actual loss of neurons, which have no
“prevents older people from living lives as regenerative powers
actively and happily as they might”
Physiological research has
Education to INFORM PEOPLE of demonstrated that people have two kinds of
the significant variations that occur in the intellectual ability – crystallized and fluid
way that individuals age and education to intelligence
help the older adult learn to cope with
irreversible losses can combat the prejudice
of ageism

GERAGOGY
- the teaching of older persons, known as
geragogy, is different from teaching younger
adults (andragogy) and children (pedagogy).
For teaching to be effective, geragogy must
accommodate the normal physical,
cognitive,a dn psychosocial changes that
OLDER ADULTHOOD (65 YEARS OF The following traits regarding personal goals
AGE AND OLDER) in life and the values associated with them
The decreases in fluid intelligence results in are significantly related to motivation and
the following specific changes: learning:
1. slower processing and reaction time. ▪ Independence – the ability to provide for
Older persons need more time to process and their on needs is the most important aim of
react to information older persons
2. persistence of stimulus (afterimage). ▪ Health teaching the tool to help them
Older adults can confuse a previous symbol maintain or regain independence
or word with a new word or symbol just ▪ Social acceptability – winning approval
introduced from others is common goal of many older
3. decreased short-term memory adults
4. long-term memory often remains strong, ▪ Adequacy of personal resources
such as the ability to clearly and accurately ▪ Life patterns, should be assessed to
remember something from their youth determine how to incorporate teaching to
5. increased test anxiety complement existing regiment and
6. altered time perception. For older, life resources (financial and support system)
becomes more finite and compressed, issues with new required behaviors
of the here and now tend to be more ▪ Coping mechanisms – the ability to cope
important more important, and some adhere with change during the aging process is
to the philosophy, “I’ll worry about that indicative of the person’s readiness for
tomorrow”. This ay of thinking can be health teaching
detrimental when applied to health issues ▪ The emphasis in teaching is on exploring
because it serves as a vehicle for denial or alternatives, determining realistic goals and
delay in taking appropriate action supporting large and small accomplishments
▪ Meaning of life – for well-adapted older
The most common psychosocial tasks of persons, having realistic goas allows them
aging involve changes in lifestyle and social the opportunity to enjoy the smaller
status based on the following circumstances pleasures in life, whereas less well-
● retirement inadequacies
● illness or death of spouse, relatives, and ▪ Health teaching must be directed at ways
friends older adults can maintain optimal health so
● the moving away of children, that they can derive pleasure from their
grandchildren, and friends leisure years
● relocation to an unfamiliar environment
such as extended-care facility or senior
residential living center
OLDER ADULTHOOD (65 YEARS OF Teaching strategies
AGE AND OLDER) ▪ use concrete examples
▪ build on past life experience
General characteristics ▪ make information relevant and meaningful
● Cognitive changes ▪ present one concept at a time
- decreased ability to think abstractly ▪ allow time for processing/response
or process information ▪ use repetition and reinforcement of
- decreased short term memory information
- increased reaction time ▪ avoid written exams
- increased test anxiety ▪ use verbal exchange ad coaching
- stimulus persistence (afterimage) ▪ establish retrieval plan
- focuses on past life experience ▪ encourage active involvement
▪ keep explanations brief
▪ use analogies to illustrate abstract
● Sensory/motor deficits information
- auditory changes ▪ speak slowly, distinctly
- hearing loss, especially high- ▪ use low-pitched tones
pitched tones, consonants and rapid speech ▪ avoid shouting
- visual changes ▪ use visual aids to supplement verbal
- farsightedness instruction
- decreased visual adaptation to ▪ avoid glares, use soft white light
darkness ▪ provide sufficient light
- decreased peripheral perception ▪ use white backgrounds and black print
- distorted depth perception ▪ use large letters and well spaced prints
- fatigue/decreased energy ▪ avoid color coding with pastel blue, green,
levels purple and yellow
▪ increase safety precautions/provide a safe
environment
General characteristics ▪ ensure accessibility and fit of prostheses
Psychosocial changes ▪ keep sessions short
- decreased risk taking ▪ provide frequent rest periods
- selective learning ▪ allow extra time to perform
- intimidated by formal learning ▪ establish realistic short term goals
▪ give time reminisce
▪ identify and present pertinent material
▪ use informal teaching sessions
▪ demonstrate relevance of information to
daily life
▪ assess resources
▪ make learning positive
▪ identify positive experience prevalent myths that must be dispelled to
▪ integrate new behavior with formerly prevent harmful outcomes in the older adult
established ones ● the role of the family is considered one of
the key variables influencing positive patient
care outcomes. The primary motives in
OLDER ADULTHOOD (65 YEARS OF patient education for involving family
AGE AND OLDER) members in the care delivery and decision-
making process are to decrease the stress of
Nursing interventions hospitalization, reduce costs of care,
● involve principal caregivers increase satisfaction with care, reduce
● encourage participation hospital readmissions, and effectively
● provide resources for support prepare the patient for self-care management
● assess coping mechanisms outside the healthcare setting.
● provide written instructions for
reinforcement
● provide anticipatory problem solving (ask Salient points in health education with older
“what happens if? Or what do you do if?”) adults
● learning influences in the older adult
Salient points in health education with older - sensory perceptions (hearing, seeing,
adults touching)
● understanding older persons’ - energy level
developmental tasks allows nurses in terms - memory
of counseling, teaching, and establishing a - affect
therapeutic relationship - risk-taking ability
● chronic illnesses, depression, and literacy - response time
levels, particularly among the oldest-old - cultural background
have implications with respect to how -disability
a. they care for themselves (eating, -stress
dressing and taking medications) - health literacy level
b. the extent to which they
understand the nature of their illnesses ● maximizing learning in the older adult
● in working with older adults, reminiscing - personalized goals
is a beneficial approach to use to establish a - cueing
therapeutic relationship. - positive reinforcement
● “you can’t teach an old dog new tricks” – - pacing with rest periods
it is easy to fall into the habit of believing - rehearsing
the myths associated with the intelligence, - time for questions
personality traits, motivation, and social - relaxed environment
relations of older adults. The following - flexibility
- provide purpose of teaching
- establish rapport determining what needs to be taught, when
- material easy to read to teach, how to teach, and who should be
the focus of teaching based on the
developmental stage of the learner
Summary
For nurses, it is important to
understand the specific and varied tasks
associated with each developmental stage to
individualize the approach to education in
meeting the needs and desires of clients and
their families. Assessment of physical,
cognitive, and psychosocial maturation
within each developmental period is crucial
in determining the appropriate strategies to
facilitate the teaching-learning process
The younger learner is, in many
ways, very different from the adult learner.
Issues of dependency, extent of participation,
rate of and capacity for learning, and
situational and emotional obstacles to
learning vary significantly across the various
phases of development. Readiness to learn in
children is very subject centered and highly
influenced by their physical, cognitive, and
psychosocial maturation
By comparison, motivation to learn
in adults is very problem centered and more
oriented to psychosocial tasks related to
roles and expectations of work, family, and
community activities. For client education to
be effective, the nurse in the role of educator
must create an environment conducive to
learning by presenting information at the
learner’s level, inviting participation and
feedback, and identifying whether parental,
family, and/or peer involvement is
appropriate or necessary. Nurses are the
main source of health information. In
concert with the client, they must facilitate
the teaching-learning process by
 Designing a Health
Education Plan for
Specific Age Groups
Kris Anthony Padios R.N.,M.N.
Gregorio Alojado R.N.,M.N.
Objectives
After completing 6 Hours of Learning, the CSAB LEVEL 1 students will be able to
 1. Identify the physical, cognitive, and psychosocial characteristics of learners
that influence learning at various stages of growth and development.

 2. Recognize the role of the nurse as educator in assessing stage-specific

learner needs according to maturational levels.

 3. Determine the role of the family in patient education.

 4. Discuss appropriate teaching strategies effective for learners at different

developmental stages.
Pedagogy and Andragogy

Pedagogy derives from the Greek for “child” and “leading” and refers to the
science and practice of teaching children.

Researcher Malcolm Knowles first introduced the term andragogy in about

1968 in reference to a model for teaching adults.
Pedagogy and Andragogy

Children in education:

 Rely on others
 Accept the information being presented at face value
 Expect what they are learning to be useful in their long-term future
 Are relatively “clean slates”
 Due to lack of experience, they have little ability to serve as a
knowledgeable resource
Pedagogy and Andragogy

On the other hand, adult learners:

 Decide for themselves

 Validate the information based on their beliefs and experience
 Expect what they are learning to be immediately useful
 May have fixed viewpoints
 Ability to serve as a knowledgeable resource.
Pedagogy and Andragogy

Need to know: Adults want to know why it’s important to learn something

 Foundation: Adults use experience in learning activities

 Self-concept: Adults want a role in deciding what to learn in their education
 Readiness: Adults want to learn things they can apply immediately
 Orientation: Adults want a problem-centered education rather than content-
oriented
 Motivation: Adults respond better to internal rather than external motivators
How is this helpful?
Contextual Influences

Traditional Thinking: Development and maturity goes with Age

Advance level thinking: Development is contextual.

It is now understood that three important contextual influences act on and

interact with the individual to produce development (Crandell et al., 2012;
Santrock, 2017)
1. Normative age-graded
Influences are strongly related to chronological age and are similar for
individuals in a specific age group, such as the biological processes of puberty
and menopause and the sociocultural processes of transitioning to different
levels of formal education or to retirement.

2. Normative history-graded
Influences are common to people in a certain age cohort or generation
because they have been uniquely exposed to similar historical circumstances,
such as the Martial Law, the age of computers, or the terrorist events of
September 11, 2001, Devastating Typhoons.

3. Normative life events

Are the unusual or unique circumstances, positive or negative, that are
turning points in individuals’ lives that cause them to change direction, such as a
house fire, serious injury in an accident, winning the lottery, divorce, or an
unexpected career opportunity.
How is this helpful?
Phases of Learning: Dependence

Dependence is characteristic of the infant and young child, who are totally
dependent on others for direction, support, and nurturance from a physical,
emotional, and intellectual standpoint.

Unfortunately, some adults are considered stuck in this stage if they

demonstrate manipulative behavior, do not listen, are insecure, or do not accept
responsibility for their own actions.
Phases of Learning: Independence

Independence occurs when a child develops the ability to physically,

intellectually, and emotionally care for himself or herself and make his or her
own choices, including taking responsibility for learning.
Phases of Learning: Interdependence

Interdependence occurs when an individual has sufficiently advanced in

maturity to achieve self-reliance, a sense of self-esteem, and THE ABILITY TO
GIVE AND RECEIVE, and when that individual demonstrates a level of respect for
others. Full physical maturity does not guarantee simultaneous emotional and
intellectual maturity.
 Taking Responsibility for One’s Health

“When is the most appropriate or best time to teach the learner?”

The answer is when the learner is ready. When the learner recognizes the
need for learning.

However, the nurse as educator does not always have to wait for teachable
moments to occur; the teacher can actively create these opportunities by
taking an interest in and attending to the needs of the learner
Building Blocks of Knowledge (Schemas)

 Learners develop Schemas of knowledge about the world. These are clusters
of connected ideas about things in the real world that allow the learner to
respond accordingly. Schemas refer to ideas that is perceived as normal.

 When the learner has developed a working Schema that can explain what they
perceive in the world, that Schema is in a state of Equilibrium.

 When the learner uses the schema to deal with a new thing or situation, that
Schema is in Assimilation.

 Accommodation happens when the existing Schema isn’t up to the job of

explaining what’s going on and needs to be changed.
Building Blocks of Knowledge (Schemas)

 Once the schemas change (NEW NORMAL), it returns to Equilibrium and life
goes on.

 Learning is, therefore, a constant cycle of Assimilation; Accommodation;

Equilibrium; Assimilation and so on
How is this helpful?
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Audience:
Parents

Behavior: (Expected of children at this age)

Exploration of self and environment, stimulate physical development.
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
 Cognitive Stage: Sensorimotor

 Psychosocial Stage: Trust vs. mistrust (0-12months),

Autonomy vs. shame and doubt (1-2 ys)
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
General characteristics

1. Dependent on the environment

2. Needs security
3. Explores self and environment
4. Natural curiosity
Who loves to play peek-a-boo with children?
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Object Permanence is developed

Causality is introduced

Delayed gratification is not yet established

Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Teaching strategies

1. Orient teaching to caregiver

2. Encourage parents to use repetition and imitation of
information
3. Stimulate all senses
4. Provide safety and emotional security
5. Allow play and manipulation of objects
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Nursing Interventions

1. Welcome active involvement

2. Forge alliances
3. Encourage physical closeness
4. Provide detailed information
5. Answer questions and concerns
6. Ask for information on child’s strengths/limitations and
likes/dislikes
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
For Short-Term learning ■ Perform procedures on a teddy bear
or doll first to help the child anticipate
■ Read simple stories from books with
what an experience will be like.
lots of pictures.
■ Allow the child something to do—
■ Use dolls and puppets to act out
squeeze your hand, hold a Band-Aid,
feelings and behaviors.
sing a song, cry if it hurts—to channel
■ Use simple audiotapes with music andhis or her response to an unpleasant
videotapes with cartoon characters. experience.
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
For Short-Term learning

■ Keep teaching sessions brief 5 ■ Avoid analogies and explain things in

Minutes Maximum straightforward and simple terms
■ Cluster teaching sessions close ■ Individualize the pace of teaching
together according to the child’s responses and
level of attention.
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
For Long-Term Learning

■ Build habits by focusing on rituals, imitation, and repetition of information.

■ Use reinforcement as an opportunity for children to achieve permanence of

learning through practice.

■ Encourage parents to act as role models

Early Childhood (3–5 Years of Age)

 Cognitive Stage: Preoperational

 Psychosocial Stage: Initiative vs. guilt

Early Childhood (3–5 Years of Age)

Learn by mimicking or modeling the behaviors of playmates and adults

Fine and gross motor skills become increasingly more refined and coordinated

Supervision is required because of lack of judgement

This stage is the transitional period when the child starts to use symbols (letters
and numbers) to represent something.
Early Childhood (3–5 Years of Age)

At this age the child develops:

Capacity to recall the past or experience

Anticipate future events
Classify objects into groups and categories
Precausal Thinking
Animistic Thinking
Egocentrism
Early Childhood (3–5 Years of Age)
Interested in the “WHY”s of the world, but not the “HOW”s

Fantasy and reality are not well differentiated

Illness and hospitalization is thought to be a punishment

(egocentric causation)
Early Childhood (3–5 Years of Age)

General characteristics
 Egocentric  Focus is on one characteristic of an
object
 Thinking precausal, concrete, literal
 Separation anxiety
 Believes illness is self-cased and
punitive  Motivated by curiosity

 Limited sense of time  Active imagination, prone to fears

 Fears bodily injury  Play is his/her work

 Cannot generalize
 Animistic thinking
Early Childhood (3–5 Years of Age)

Teaching Strategies  Provide safe, secure environment

 Use warm, calm approach  Use positive reinforcement

 Build trust  Encourage questions to reveal

perceptions/feelings
 Use repetition of information
 Use simple drawings and stories
 Allow manipulation of objects and
equipment  Use play therapy, with dolls and
puppets
 Give care with explanation
 Stimulate Senses: Visual, auditory,
 Reassure not to blame self tactile, motor
 Explain procedures simply and briefly
Early Childhood (3–5 Years of Age)

Nursing Interventions
 Welcome active involvement
 Forge alliances
 Encourage physical closeness
 Provide detailed information
 Answer questions and concerns
 Ask for information on child’s
strengths/limitations and
likes/dislikes
Early Childhood (3–5 Years of Age)

For Short-Term Learning

■ Provide physical and visual stimuli because language ability is still limited
■ Keep teaching sessions short with short intervals (no more than 15 minutes)
■ Relate information needs to activities and experiences familiar to the child.
For example, ask the child to pretend to blow out candles on a birthday cake to
practice deep breathing.
■ Encourage the child to participate in selecting between a limited number of
teaching–learning options.
Early Childhood (3–5 Years of Age)

For Short-Term Learning

■ Arrange small-group sessions
■ Give praise and approval
■ Give tangible rewards
■ Allow the child to manipulate equipment and play with
replicas or dolls
Early Childhood (3–5 Years of Age)

For Long-Term Learning

■ Enlist the help of parents, who can play a vital role in modeling a variety of
healthy habits, such as practicing safety measures and eating a balanced diet;
offer them access to support and follow-up as the need arises.

■ Reinforce positive health behaviors and the acquisition of specific skills.

Middle and Late Childhood (6–11 Years of
Age)
 Cognitive Stage: Concreate operations

 Psychosocial Stage: Industry vs. inferiority

Middle and Late Childhood (6–11 Years of
Age)
Begin to have formal training in structured school systems

Open to new and varied ideas

Schemas are challenged as they experience varied

attitudes, values, and perceptions from the environment
Middle and Late Childhood (6–11 Years of
Age)
The gross- and fine-motor abilities of school aged children become
increasingly more coordinated so that they have the ability to control their
movements with much greater dexterity than ever before.

During this time, logical, rational thought processes and the ability to
reason inductively and deductively develop. Children in this stage can think
more objectively, are willing to listen to others, and selectively use questioning
to find answers to the unknown.
Middle and Late Childhood (6–11 Years of
Age)
Syllogistic reasoning begins
Ability to consider two premises and draw a logical conclusion from them.
For example, they comprehend that mammals are warm blooded, and whales are
mammals, so whales must be warm blooded.
Conservation is mastered
Ability to recognize that the properties of an object stay the same even though
its appearance and position may change
For example, they realize that a certain quantity of liquid is the same amount whether it
is poured into a tall, thin glass or into a short, wide one.
Middle and Late Childhood (6–11 Years of
Age)
 Fiction and fantasy are separate from fact and reality
 Can engage in systematic thought through inductive
reasoning
 Ability to classify objects and systems
 Express concrete ideas about relationships and people
 Carry out mathematical operations
 Causal thinking develops
Middle and Late Childhood (6–11 Years of
Age)
General characteristics
 More realistic and objective
 Understands cause and effect  Understands seriousness and
consequences of action
 Deductive/inductive reasoning
 Subject-centered focus
 Wants concrete information
 Immediate orientation
 Able to compare objects and events
 Variable rates of physical growth
 Reasons syllogistically
Middle and Late Childhood (6–11 Years of
Age)
Teaching Strategies
 Encourage independence and active
participation  Relate care to other children's

 Be honest, allay fears experience; compare procedures

 Use logical explanation  Use subject centered focus

 Allow time to ask questions  Use play therapy

 Use analogies to make invisible  Provide group activities

processes real  Use diagrams, models, pictures,
 Establish role models digital media, printed materials, and
computer, tablet, or smartphone
applications
Middle and Late Childhood (6–11 Years of
Age)
Nursing Interventions
 Welcome active involvement
 Forge alliances
 Encourage physical closeness
 Provide detailed information
 Answer questions and concerns
 Ask for information on child’s
strengths/limitations and
likes/dislikes
Middle and Late Childhood (6–11 Years of
Age)
For Short-Term Learning
■ Allow school-aged children to take responsibility for their own health care
For example, to apply their own splint or use an asthma inhaler as prescribed.

■ Teaching sessions can be extended to last up to 30 minutes

■ Lessons should be spread apart to allow for comprehension of large amounts

of content and to provide opportunity for the practice of newly acquired skills
between sessions.
Middle and Late Childhood (6–11 Years of
Age)
For Short-Term Learning
■ Choose audiovisual and printed materials that show peers undergoing
similar procedures or facing similar situations.
■ Clarify any scientific terminology and medical jargon used. “Simplify or
translate”
■ Use analogies
For example: “Having a chest x-ray is like having your picture taken” or “White blood
cells are like police cells that can attack and destroy infection.”
■ Use one-to-one teaching sessions as a method to individualize learning
relevant to the child’s own experiences
Middle and Late Childhood (6–11 Years of
Age)
For Short-Term Learning
■ Provide time for clarification, validation, and reinforcement of what is
being learned.

■ Select individual instructional techniques that provide opportunity for

privacy

■ 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)
For Short-Term Learning
■ Prepare children for procedures and interventions well in advance

■ Encourage participation in planning for procedures and events because

active involvement helps the child to assimilate information more readily.

■ Provide much-needed nurturance and support, always keeping in mind that

young children are not just small adults. Praise and rewards help motivate
and reinforce learning.
Middle and Late Childhood (6–11 Years of
Age)
For Long-Term Learning
■ Help school-aged children acquire skills that they can use to assume self-
care responsibility for carrying out therapeutic treatment regimens on an
ongoing basis with minimal assistance.

■ Assist them in learning to maintain their own well-being and prevent

illnesses from occurring.
Adolescence (12–19 Years of Age)

 Cognitive Stage: Formal operations

 Psychosocial Stage: Identity vs. role confusion

Adolescence (12–19 Years of Age)

Today’s adolescents comprise the generational cohort Generation Z, or Gen

Z. They excel with self-directed learning and thrive on the use of technology.

Adolescents vary greatly in their biological, psychological, social, and

cognitive development. From a physical maturation standpoint, they must adapt
to rapid, dramatic, and significant bodily changes, which can temporarily result
in clumsiness and poorly coordinated movement.
Adolescence (12–19 Years of Age)

Alterations in physical size, shape, and function of their bodies, along with
the appearance and development of secondary sex characteristics, bring about a
significant preoccupation with their appearance and a strong desire to express
sexual urges.
And, according to neuroscience research, adolescent brains are different
than adult brains in the way they process information, which may explain that
adolescent behaviors, such as impulsiveness, rebelliousness, lack of good
judgment, and social anxiety, stem from biological reasons more than
environmental influences. Adolescents are known to be among the nation’s most
at-risk populations.
Adolescence (12–19 Years of Age)

 Capable of abstract thought and the type of complex logical thinking

described as propositional reasoning, as opposed to syllogistic reasoning.
 Their ability to reason is both inductive and deductive
 Has the ability to hypothesize and apply the principles of logic to
situations never encountered before.
 Can conceptualize and internalize ideas
 Able to debate various points of view
 Understand cause and effect,
 Able to respond appropriately to multiple-step directions.
Adolescence (12–19 Years of Age)

Adolescent egocentrism develops

They begin to believe that everyone is focusing on the same things they are—
namely, themselves and their activities.

Imaginary audience begins

The imaginary audience explains the pervasive self-consciousness of adolescents,
who, on the one hand, may feel embarrassed because they believe everyone is
looking at them and, on the other hand, desire to be looked at and thought about
because this attention confirms their sense of being special and unique
Adolescence (12–19 Years of Age)

Able to understand the concept of health and illness, the multiple causes of
diseases, the influence of variables on health status, and the ideas associated
with health promotion and disease prevention.

Parents, healthcare providers, and the Internet are all potential sources of
health-related information for adolescents.

They also can identify health behaviors, although they may reject practicing
them or begin to engage in risk-taking behaviors because of the social pressures
they receive from peers as well as their feelings of invincibility.
Adolescence (12–19 Years of Age)

Personal fable is displayed

The personal fable leads adolescents to believe that they are invulnerable—other
people grow old and die, but not them; other people may not realize their
personal ambitions, but they will.
Adolescence (12–19 Years of Age)
The unconscious goals of adolescents include the need to:
 Establish their own identity
 Match their skills with career choices
 Determine self
 Seek independence and autonomy
 Develop distinct individual personalities
 Belong to a group
 Rebel against any actions or recommendations by adults whom they consider
authoritarian
Adolescence (12–19 Years of Age)

Adolescents demand personal space, control, privacy, and confidentiality. To

them, illness, injury, disability, and hospitalization mean dependency, loss of
identity, a change in body image and functioning, bodily embarrassment,
confinement, separation from peers, and possible death.
Adolescence (12–19 Years of Age)

General characteristics
 Abstract, hypothetical thinking  Emphasis on importance of
appearance (imaginary audience)
 Can build on past learning
 Feels invulnerable,
 Reasons by logic and understands invincible/immune to natural laws
scientific principles (personal fable)
 Future orientation
 Motivated by desire for social
acceptance
 Peer group important
 Intense personal preoccupation
Adolescence (12–19 Years of Age)

Teaching Strategies
 Establish trust, authenticity  Focus on details

 Know the agenda  Make information meaningful to life

 Address fears/concerns about  Ensure confidentiality and privacy

outcomes of illness  Arrange peer group sessions in person
 Identify control focus or virtually

 Include in plan of care  Use audiovisuals, role play, contacts,

reading materials
 Use peers for support and influence
 Provide for experimentation and
 Negotiate changes flexibility
Adolescence (12–19 Years of Age)

Nursing Interventions
 Explore emotional and financial  Engage in 1:1 teaching without
support parents present, but with
adolescent’s permission, inform
 Determine goals and expectations family of content covered
 Assess stress levels
 Respect values and norms
 Determine role responsibilities and
relationships
Adolescence (12–19 Years of Age)

For Short-Term Learning

■ Use one-to-one instruction to ensure confidentiality of sensitive information.

■ Choose peer-group discussion sessions as an effective approach to deal with

health topics such as smoking, alcohol and drug use, safety measures, obesity,
and teenage sexuality.

■ Use face-to-face or computer group discussion, role playing, and gaming as

methods to clarify values and solve problems.
Adolescence (12–19 Years of Age)

For Short-Term Learning

■ Employ adjunct instructional tools, such as complex models, diagrams, and
specific, detailed written materials.
■ Clarify any scientific terminology and medical jargon used. “Simplify or
translate”
■ Share decision making whenever possible, because control is an important issue
for adolescents.
■ Include adolescents in formulating teaching plans related to teaching
strategies, expected outcomes, and determining what needs to be learned and
how it can best be achieved to meet their needs for autonomy.
Adolescence (12–19 Years of Age)

For Short-Term Learning

■ Suggest options so that they feel they have a choice about courses of action.
■ 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.
■ Avoid confrontation and acting like an authority figure.
Adolescence (12–19 Years of Age)

For Long-Term Learning

■ Accept adolescents’ personal fable and imaginary audience as valid, rather
than challenging their feelings of uniqueness and invincibility.

■ Acknowledge that their feelings are very real

■ Allow them the opportunity to test their own convictions.

Andragogy Review

Adult learners:

 Decide for themselves what is important to learn

 Need to validate the information based on their beliefs and experience
 Expect what they are learning to be immediately useful
 Have much experience upon which to draw – may have fixed viewpoints
 Significant ability to serve as a knowledgeable resource to the trainer and
fellow learners
Young Adulthood (20–40 Years of Age)

 Cognitive Stage: Formal operations

 Psychosocial Stage: Intimacy vs. Isolation

Young Adulthood (20–40 Years of Age)

Unconscious goals for young adults:

 Establishing long-term & intimate relationships with other
people
 Choosing a lifestyle and adjusting to it
 Deciding on an occupation
 Managing a home and family
Young Adulthood (20–40 Years of Age)

During this period, physical abilities for most young adults

are at their peak, and the body is at its optimal functioning
capacity. The cognitive capacity of young adults is fully
developed, but with maturation, they continue to
accumulate new knowledge and skills from an expanding
reservoir of formal and informal experiences.
Young Adulthood (20–40 Years of Age)

Coming from experience, young adults have an improved ability to:

 Generalize to new situations
 Improve their abilities to critically analyze, solve problems
 Make decisions about their personal, occupational, and social roles.

Their interests for learning are oriented toward those experiences that are
relevant for immediate application to problems and tasks in their daily lives.
Young adults are motivated to learn about the possible implications of various
lifestyle choices.
Young Adulthood (20–40 Years of Age)

General characteristics
 Autonomous
 Self – directed  Makes decisions about personal,
occupational and social roles
 Uses personal experience to enhance
or interfere with learning  Competency – based learner

 Intrinsic motivation
 Able to analyze critically
Young Adulthood (20–40 Years of Age)

Teaching Strategies
 Use problem-centered focus
 Draw on meaningful experience  Apply new knowledge through role
playing and hands-on practice
 Focus on immediacy of application
 Encourage active participation
 Allow to set own pace, be self-
directed
 Organize material
 Recognize social role
Young Adulthood (20–40 Years of Age)

Nursing Interventions
 Explore emotional, financial and
physical support system
 Assess motivational level for
involvement
 Identify potential obstacles and
stressors
Young Adulthood (20–40 Years of Age)

Salient points in Health Education with young adults.

 Health promotion is the most neglected aspect of healthcare teaching at
this stage of life.

 The major factors that need to be addressed in this age group are healthy
eating habits, regular exercise, and avoiding drug abuse. Such behaviors
will reduce the incidence of high blood pressure, elevated cholesterol,
obesity, smoking, and overuse of alcohol and drugs
Young Adulthood (20–40 Years of Age)

Salient points in Health Education with young adults.

 The motivation for adults to learn comes in response to internal drives, such
as need for self-esteem, a better quality of life, or job satisfaction, and in
response to external motivators, such as job promotion, more money, or more
time to pursue outside activities.
 Any illness or disabilities prevent them to achieve the internal drives.
 Content of instruction must be seen as relevant to the current or anticipated
problems.
Young Adulthood (20–40 Years of Age)

Salient points in Health Education with young adults.

 Teaching strategies must be directed at encouraging young adults to seek
information

 Relevant, applicable, and practical information is what adults desire and

value—they want to know “what’s in it for me,”

 Group discussion is an attractive method for teaching and learning because it

provides young adults with the opportunity to interact with others of similar
age and in similar situations, such as in parenting groups, prenatal classes,
exercise classes, or marital adjustment sessions.
Middle-Aged Adulthood (41–64 Years of
Age)
 Cognitive Stage: Formal operations

 Psychosocial Stage: Generativity vs. self absorption and stagnation

Middle-Aged Adulthood (41–64 Years of
Age)
During middle age, many individuals are highly accomplished in their
careers, their sense of who they are is well developed, their children are grown,
and they have time to share their talents, serve as mentors for others and pursue
new or latent interests.

Physiological changes begin to take place. These physical changes and others
affect middle-aged adults’ selfimage, ability to learn, and motivation for
learning about health promotion, disease prevention, and maintenance of health.
Middle-Aged Adulthood (41–64 Years of
Age)
DIALECTICAL thinking is expanded
It is a type of thinking is defined as the ability to search for complex and
changing understandings to find a variety of solutions to any given situation or
problem.

In other words, middle-aged adults have the ability to “see the bigger picture”.
Middle-Aged Adulthood (41–64 Years of
Age)
Due to their experience and physiological changes, Middle-aged adults, may
choose to:
Modify aspects of their lives that they perceive as unsatisfactory
- Or -
Adopt a new lifestyle as a solution to dissatisfaction.
Middle-Aged Adulthood (41–64 Years of
Age)
General characteristics
 Sense of self is well developed
 Concerned with physical changes  Confidence in abilities

 At peak in career  Desires to modify unsatisfactory

aspects of life
 Explores alternative lifestyles
 Reflects on contributions to family
and society
 Reexamines goals and values
 Questions achievements and
successes
Middle-Aged Adulthood (41–64 Years of
Age)
Teaching Strategies
 Focus on maintaining independence
and reestablishing normal life
patterns
 Assess positive and negative paste
experience with learning
 Assess potential sources of stress
caused by midlife crisis issues
 Provide information to coincide with
life concerns and problems
Middle-Aged Adulthood (41–64 Years of
Age)
Nursing Interventions
 Explore emotional, financial and
physical support system
 Assess motivational level for
involvement
 Identify potential obstacles and
stressors
Middle-Aged Adulthood (41–64 Years of
Age)
Salient points in Health Education with middle-aged adults.
 When teaching members of this age group, the nurse must be aware of their
potential sources of stress, the health risk factors associated with this stage
of life, and the concerns typical of midlife. Misconceptions regarding physical
changes such as menopause for women are common.
Middle-Aged Adulthood (41–64 Years of
Age)
Salient points in Health Education with middle-aged adults.
 Many need and want information related to chronic illnesses that can arise at
this phase of life.
 Adult learners need to be reassured or complimented on their learning
competencies.
 Teaching strategies for learning are similar in type to teaching methods and
instrumental tools used for the young adult learner, but the content is
different to coincide with the concerns and problems specific to this group
of learners.
Older Adulthood (65 Years of Age and
Older)
 Cognitive Stage: Formal operations

 Psychosocial Stage: Ego integrity vs Despair

Older Adulthood (65 Years of Age and
Older)
Most older people have at least one chronic condition, and many, especially
in the later years, have multiple conditions.

On average, they are hospitalized longer than persons in other age

categories and require more teaching overall to broaden their knowledge of
self-care.
Lower educational levels in some ethnic groups, sensory impairments, the
disuse of literacy skills once learned, and cognitive changes in the population of
older adults may contribute to their decreased ability to read and comprehend
WRITTEN materials.
Older Adulthood (65 Years of Age and
Older)
Nurses and nurse educators must recognize that a
significant number of older persons respond to these changes
by viewing them as challenges rather than defeats.

Given the considerable healthcare expenditures for older

people, patient education needs are generally greater and
education programs to improve their health status and
reduce morbidity would be a cost-effective measure.
Older Adulthood (65 Years of Age and
Older)
Ageism describes prejudice against the older adult. This discrimination
based on age, which exists in most segments of the society, perpetuates the
negative stereotype of aging as a period of decline.
This bias interferes with interactions between the older adult and
younger age groups and must be counteracted because it “prevents older
people from living lives as actively and happily as they might”
Education to INFORM PEOPLE of the significant variations that occur in the
way that individuals age and education to help the older adult learn to cope with
irreversible losses can combat the prejudice of ageism
Geragogy

The teaching of older persons, known as geragogy, is

different from teaching younger adults (andragogy) and
children (pedagogy). For teaching to be effective, geragogy
must accommodate the normal physical, cognitive, and
psychosocial changes that occur during this phase of growth
and development.
Older Adulthood (65 Years of Age and
Older)
With advancing age, so many physical changes occur that it becomes
difficult to establish normal boundaries.

As a person grows older, natural physiological changes in all systems

of the body are universal, progressive, and intrinsic.

Alterations in physiological functioning can lead secondarily to

changes in learning ability. The senses of sight, hearing, touch, taste,
and smell are usually the first areas of decreased functioning noticed by
adults.
Older Adulthood (65 Years of Age and
Older)
Cognitive ability changes with age as permanent cellular alterations
invariably occur in the brain itself, resulting in an actual loss of neurons, which
have no regenerative powers.

Physiological research has demonstrated that people have two kinds of

intellectual ability— crystallized and fluid intelligence.
Older Adulthood (65 Years of Age and
Older)
Crystallized intelligence is the intelligence absorbed over a lifetime, such
as vocabulary, general information, understanding social interactions, arithmetic
reasoning, and ability to evaluate experiences. This kind of intelligence increases
with experience as people age.
However, it is important to understand that crystallized intelligence can be
impaired by disease states, such as the dementia seen in Alzheimer’s disease.
Fluid intelligence is the capacity to perceive relationships, to reason, and to
perform abstract thinking. This kind of intelligence declines as degenerative
changes occur.
Older Adulthood (65 Years of Age and
Older)
The decrease in fluid intelligence results in the following specific changes:
1. Slower processing and reaction time. Older persons need more time to
process and react to information.
2. Persistence of stimulus (afterimage). Older adults can confuse a previous
symbol or word with a new word or symbol just introduced.
3. Decreased short-term memory.
4. long-term memory often remains strong, such as the ability to clearly and
accurately remember something from their youth.
Older Adulthood (65 Years of Age and
Older)
4. Increased test anxiety.

5. Altered time perception. For older persons, life becomes more finite and
compressed. Issues of the here and now tend to be more important, and
some adhere to the philosophy, “I’ll worry about that tomorrow.” This way
of thinking can be detrimental when applied to health issues because it
serves as a vehicle for denial or delay in taking appropriate action.
Older Adulthood (65 Years of Age and
Older)
The most common psychosocial tasks of aging involve changes in lifestyle and
social status based on the following circumstances.

■ Retirement
■ Illness or death of spouse, relatives, and friends
■ The moving away of children, grandchildren, and friends
■ Relocation to an unfamiliar environment such as an extended-care facility or
senior residential living center
Older Adulthood (65 Years of Age and
Older)
The following traits regarding personal goals in life and the values associated
with them are significantly related to motivation and learning:

Independence. The ability to provide for their own needs is the most important
aim of older persons.
Health teaching is the tool to help them maintain or regain independence.

Social acceptability. Winning approval from others is a common goal of many

older adults.
Older Adulthood (65 Years of Age and
Older)
The following traits regarding personal goals in life and the values associated
with them are significantly related to motivation and learning:
Adequacy of personal resources.
Life patterns, should be assessed to determine how to incorporate teaching to
complement existing regimens and resources (financial and support system)
with new required behaviors.

Coping mechanisms. The ability to cope with change during the aging process is
indicative of the person’s readiness for health teaching.
The emphasis in teaching is on exploring alternatives, determining realistic goals,
and supporting large and small accomplishments.
Older Adulthood (65 Years of Age and
Older)
The following traits regarding personal goals in life and the values associated
with them are significantly related to motivation and learning:
Meaning of life. For well-adapted older persons, having realistic goals allows
them the opportunity to enjoy the smaller pleasures in life, whereas less well-
adapted individuals may be frustrated and dissatisfied with personal
inadequacies.
Health teaching must be directed at ways older adults can maintain optimal
health so that they can derive pleasure from their leisure years.
Older Adulthood (65 Years of Age and
Older)
General characteristics
 Sensory/motor deficits
 Cognitive changes
 Auditory changes
 Decreased ability to think abstractly
or process information  Hearing loss, especially high-pitched
tones, consonants and rapid speech
 Decreased short term memory
 Visual changes
 Increased reaction time
 Farsightedness
 Increased test anxiety
 Decreased visual adaptation to
 Stimulus persistence (afterimage)
darkness
 Focuses on past life experience
 Decreased peripheral perception
 Distorted depth perception
 Fatigue / decreased energy levels
Older Adulthood (65 Years of Age and
Older)
General characteristics
 Psychosocial changes
 Decreased risk taking
 Selective learning
 Intimidated by formal learning
Older Adulthood (65 Years of Age and
Older)
Teaching Strategies
 Use concrete examples
 Build on past life experience  Use verbal exchange and coaching

 Make information relevant and  Establish retrieval plan

meaningful  Encourage active involvement
 Present one concept at a time  Keep explanations brief
 Allow time for processing/response  Use analogies to illustrate abstract
 Use repetition and reinforcement of information
information
 Avoid written exams
Older Adulthood (65 Years of Age and
Older)
Teaching Strategies  Use large letters and well spaced
prints
 Speak slowly, distinctly
 Avoid color coding with pastel blue,
 Use low-pitched tones green, purple and yellow
 Avoid shouting  Increase safety precautions/provide
 Use visual aids to supplement verbal a safe environment
instruction  Ensure accessibility and fit of
 Avoid glares, use soft white light prostheses

 Provide sufficient light  Keep sessions short

 Use white backgrounds and black  Provide frequent rest periods

print  Allow extra time to perform
 Establish realistic short term goals
Older Adulthood (65 Years of Age and
Older)
Teaching Strategies
 Give time to reminisce  Integrate new behavior with formerly
established ones
 Identify and present pertinent
material
 Use informal teaching sessions
 Demonstrate relevance of
information to daily life
 Assess resources
 Make learning positive
 Identify positive experience
Older Adulthood (65 Years of Age and
Older)
Nursing Interventions
 Involve principal caregivers
 Encourage participation
 Provide resources for support
 Assess coping mechanisms
 Provide written instructions for
reinforcement
 Provide anticipatory problem solving
(ask “what happens if? or what do
you do if?”)
Older Adulthood (65 Years of Age and
Older)
Salient points in Health Education with older adults.
 Understanding older persons’ developmental tasks allows nurses in terms of
counseling, teaching, and establishing a therapeutic relationship.
 Chronic illnesses, depression, and literacy levels, particularly among the
oldest-old, have implications with respect to how
 A. They care for themselves (eating, dressing, and taking medications)
 B. The extent to which they understand the nature of their illnesses.
 In working with older adults, reminiscing is a beneficial approach to use to
establish a therapeutic relationship.
Older Adulthood (65 Years of Age and
Older)
Salient points in Health Education with older adults.
 “You can’t teach an old dog new tricks.” - It is easy to fall into the habit of
believing the myths associated with the intelligence, personality traits,
motivation, and social relations of older adults. The following prevalent
myths that must be dispelled to prevent harmful outcomes in the older adult.
 The role of the family is considered one of the key variables influencing
positive patient care outcomes. The primary motives in patient education
for involving family members in the care delivery and decision-making process
are to decrease the stress of hospitalization, reduce costs of care, increase
satisfaction with care, reduce hospital readmissions, and effectively prepare
the patient for self-care management outside the healthcare setting.
Older Adulthood (65 Years of Age and
Older)
Salient points in Health Education with older adults.
Summary

For nurses, it is important to understand the specific and varied tasks

associated with each developmental stage to individualize the approach to
education in meeting the needs and desires of clients and their families.
Assessment of physical, cognitive, and psychosocial maturation within each
developmental period is crucial in determining the appropriate strategies to
facilitate the teaching–learning process.
Summary

The younger learner is, in many ways, very different from the adult learner.
Issues of dependency, extent of participation, rate of and capacity for
learning, and situational and emotional obstacles to learning vary significantly
across the various phases of development. Readiness to learn in children is very
subject centered and highly influenced by their physical, cognitive, and
psychosocial maturation.
Summary

By comparison, motivation to learn in adults is very problem centered and

more oriented to psychosocial tasks related to roles and expectations of work,
family, and community activities. For client education to be effective, the nurse
in the role of educator must create an environment conducive to learning by
presenting information at the learner’s level, inviting participation and
feedback, and identifying whether parental, family, and/or peer involvement is
appropriate or necessary. Nurses are the main source of health information. In
concert with the client, they must facilitate the teaching–learning process by
determining what needs to be taught, when to teach, how to teach, and who
should be the focus of teaching based on the developmental stage of the
learner.
Thank you!
 NCM 102 – HEALTH EDUCATION
IMPLEMENTING A HEALTH EDUCATION PLAN (WEEK 11 & 12)

I. TEACHING STRATEGIES AND METHODOLOGIES

Teaching Approach - General plan or scheme to achieve an objective

COMPONENTS OF INSTRUCTIONS
1. Major goal of teaching
2. Nature of the subject matter
3. Teaching-learning process
4. Roles and responsibilities
5. Expectations from students
6. Kind of evaluation techniques
7. Suitable teaching methods and strategies to be employed

TYPES OF APPROACH
1. Inductive Approach - begins from particular statements to general statements, such that one may
arrive at a fact, principle or generalization.
It is called “discovery approach”

2. Deductive Approach - from general to particular statements.

TYPES OF HEALTH TEACHING APPROACHES

1. Telling approach - is useful when limited information must be taught. Ex. Preparing a client for an
emergent diagnostic procedure.

2. Selling Approach - uses two-way communication.

3. Participating Approach - involves the nurse and client setting objectives and becoming involved in the
learning process together.

4. Entrusting Approach - provides the client the opportunity to manage self-care.

5. Reinforcing Approach - the principle of reinforcement applies to the process of learning. Teacher must
be the source of reinforcement.

II. ACTIVITY BASED STRATEGIES

ACTIVITY-BASED TEACHING – implies active learning on the part of the learner.
Learners engaged in these strategies are involved in creating and storing up knowledge for themselves.

Lecture is a teaching method where an instructor is the central focus of information transfer. Typically,
an instructor will stand before a class and present information for the students to learn. Sometimes,
they will write on a board or use an overhead projector to provide visuals for students. Students are
expected to take notes while listening to the lecture. Usually, very little exchange occurs between the
instructor and the students during a lecture.
DISCUSSION
One of the most challenging teaching methods, leading discussions can also be one of the most rewarding.
Using discussions as a primary teaching method allows you to stimulate critical thinking. As you establish
a rapport with your students, you can demonstrate that you appreciate their contributions at the same
time that you challenge them to think more deeply and to articulate their ideas more clearly. Frequent
questions, whether asked by you or by the students, provide a means of measuring learning and exploring
in-depth the key concepts of the course.

QUESTIONING

Teachers ask questions for a variety of purposes, including:

✓ To actively involve students in the lesson ✓ To develop critical thinking skills
✓ To increase motivation or interest ✓ To review previous lessons
✓ To evaluate students’ preparation ✓ To nurture insight
✓ To check on completion of work
✓ To assess achievement or mastery of goals and objectives
✓ To stimulate independent learning
✓ A teacher may vary his or her purpose in asking questions during a single lesson, or a single question
may have more than one purpose.

Bloom’s Taxonomy includes six categories:

➢ Knowledge – recall data or information

➢ Comprehension – understand meaning
➢ Application – use a concept in a new situation
➢ Analysis – separate concepts into parts; distinguish between facts and inferences
➢ Synthesis – combine parts to form new meaning
➢ Evaluation – make judgments about the value of ideas or products

USING AUDIOVISUALS

Audiovisual education or multimedia-based education (MBE) is instruction where particular attention is

paid to the audio and visual presentation of the material with the goal of improving comprehension and
retention.
➢ Dioramas ➢ Tape recorders
➢ Magic lanterns ➢ Television
➢ Planetarium ➢ Video
➢ Film projectors ➢ Camcorders
➢ Slide projectors ➢ Video projectors
➢ Opaque projectors (episcopes and ➢ Interactive whiteboards
epidiascopes) ➢ Digital video clips
➢ Overhead projectors
INTERACTIVE LECTURE

Interactive lectures are classes in which the instructor incorporates engagement triggers and breaks the
lecture at least once per class to have students participate in an activity that lets them work directly
with the material.

PROBLEM-BASED LEARNING (PBL)

Problem based learning is an approach to learning that involves confronting students with real-life
problems that provide a stimulus for critical thinking and self-taught content

The chief differences between PBL and the case method:

1. PBL is conducted with small groups, while case studies may be used by individuals or groups.
2. Students using PBL have little background knowledge of the subject matter whereas in the case
method, students already have most of the background knowledge they need to apply to the
case.
3. In PBL, the cases are usually brief and the presenting problems are ill structured, while in the
case method, cases are more often long and detailed and their problems are fairly well-defined.

❖ PBL began over 35 years ago at McMaster University School of Medicine in Canada and has
spread to medical schools in United States and all over the world.
 NCM 102
Health Education
Midterm Lecture

Developing a Health Education Plan

I. Elements
A-B-C-D
➢ A – Audience (Who)
➢ B – Behavior (What)
➢ C – Condition (Under which Circumstances)
➢ D – Degree (How Well, to what extent, within what time frame)

II. Objectives

i. Definition
A specific, single, unidimensional behavior that is short term in nature, which should be achievable
after one teaching session/within a matter of few days following a series of teaching sessions.

ii. Types
➢ Educational – used to identify the intended outcomes of the educational process, whether
referring to an aspect of a program/ total program of the study that guide the design of curriculum
units.
➢ Instructional – describe the teaching activities, specific content areas and resources used to
facilitate effective instruction.
➢ Behavioral – action oriented rather than content oriented, learner centered rather than teacher
centered, short-term outcome focused rather than process focused.
iii. Factors that Differentiate Goals from Objectives
➢ Relationship to Time
➢ Level of Specificity

Goal - the final outcome to be achieved at the end of teaching and learning process
Objectives - are short-term and should be achieved at the end of one teaching session/shortly
after several teaching sessions. Specific, single, concrete and a one-dimensional behavior.

Advantages of a Well Written and Carefully Constructed Objective

✓ Helps keep the educator’s thinking on target & learner centered

✓ Communicates to learners and healthcare team members what is planned for teaching and learning
✓ Helps learners understand what is expected of them
✓ Forces the educator to select and organize educational materials so they do not get lost in the content
and forget the learner’s role in the process
✓ Encourages educators to evaluate their own motives of teaching
✓ Tailors teaching to learner’s unique needs
 ✓ Creates guidepost for teacher evaluation and documentation of success/failure
✓ Orients teacher & learner to the end results of the educational process
✓ Makes it easier for the learner to visualize performing the required skills

Additional Advantages (Robert Mager, 1997)

✓ Provides the solid Foundation for the selection of instructional content, methods and materials
✓ Provide learners with ways to organize their efforts to reach their goals
✓ Help determine whether an objective has been met

iv. Important Characteristics in Writing Concise and Useful Behavioral Objectives

➢ Performance - Describes what the learner is expected to be able to do to demonstrate the kinds
of behaviors the teacher will accept as evidence that objectives have been achieved. Activities
performed by the learner may be observable and quite visible, such as being able to write or list
something, whereas other activities may not be as visible, such as being able to identify or recall
something
➢ Condition: Describes the situations under which the behavior will be observed or the
performance will be expected to occur.
➢ Criterion: Describes how well, with what accuracy, or within what time frame the learner must
be able to perform the behavior so as to be considered competent

v. Common Mistakes When Writing Objectives

o Describing what the teacher does rather than what the learner is expected to do
o Including more than one expected behavior in a single objective
o Forgetting to identify all four components of condition, performance, criterion, and who the
learner is
o Using terms for performance that are open to many interpretations, are not action oriented,
and are difficult to measure
o Writing objectives that are unattainable and unrealistic given the ability level of the learner
o Writing objectives that do not relate to the stated goal
o Cluttering objectives by including unnecessary information
o Being too general so as not to specify clearly the expected behavior to be achieved

vi. SMART rule in Writing Objectives

S – Specific - Be specific about what is to be achieved (i.e., use strong action verbs, be concrete).
M – Measurable - Quantify or qualify objectives by including numeric, cost, or percentage amounts
or the degree/level of mastery expected.
A – Achievable - Write attainable objectives
R – Realistic - Resources (i.e., personnel, facilities, equipment) must be available and accessible to
achieve objectives
T – Timely - Resources (i.e., personnel, facilities, equipment) must be available and accessible to
achieve objectives
vii. Taxonomy of Objectives According to Learning Domains
Cognitive Domain - known as the “thinking” domain. Learning in this domain involves acquiring
information and addressing the development of the learner’s intellectual abilities, mental capacities,
understanding, and thinking processes (Eggen & Kauchak, 2012)

Levels of Behavioral Objectives in the Cognitive Domain

➢ Knowledge level - Ability of the learner to memorize, recall, define, recognize, or identify
specific information, such as facts, rules, principles, conditions, and terms, presented during
instruction
➢ Comprehension level - Ability of the learner to demonstrate an understanding of what is
being communicated by recognizing it in a translated form, such as grasping an idea by
defining it or summarizing it in his or her own words (knowledge is a prerequisite behavior)
➢ Application level - Ability of the learner to use ideas, principles, abstractions, or theories in
specific situations, such as figuring, writing, reading, or handling equipment (knowledge and
comprehension are prerequisite behaviors)
➢ Analysis level - Ability of the learner to recognize and structure information by breaking it
down into its separate parts and specifying the relationship between the parts (knowledge,
comprehension, and application are prerequisite behaviors)
➢ Synthesis level - Ability of the learner to put together parts into a unified whole by creating
a unique product that is written, oral, or in picture form (knowledge, comprehension,
application, and analysis are prerequisite behaviors)
➢ Evaluation level - Ability of the learner to judge the value of something by applying
appropriate criteria (knowledge, comprehension, application, analysis, and synthesis are
prerequisite behaviors)

Affective Domain - known as the “feeling” domain. Learning in this domain involves an
increasing internalization or commitment to feelings expressed as emotions, interests, beliefs,
attitudes, values, and appreciations.

Levels of Behavioral Objectives in the Affective Domain

➢ Receiving level - Ability of the learner to show awareness of an idea or fact or a
consciousness of a situation or event in the environment. This level represents a willingness
to selectively attend to or focus on data or to receive a stimulus
➢ Responding level - Ability of the learner to respond to an experience, at first obediently and
later willingly and with satisfaction. This level indicates a movement beyond denial and
toward voluntary acceptance, which can lead to feelings of pleasure or enjoyment resulting
from some new experience (receiving is a prerequisite behavior).
➢ Valuing level - Ability of the learner to regard or accept the worth of a theory, idea, or
event, demonstrating sufficient commitment or preference to an experience that is
perceived as having value. At this level, there is a definite willingness and desire to act to
further that value (receiving and responding are prerequisite behaviors)
➢ Organization level - Ability of the learner to organize, classify, and prioritize values by
integrating a new value into a general set of values; to determine interrelationships of
 values; and to establish some values as dominant and pervasive (receiving, responding, and
valuing are prerequisite behaviors)
➢ Characterization level - Ability of the learner to display adherence to a total philosophy or
worldview, showing firm commitment to the values by generalizing certain experiences into
value system (receiving, responding, valuing, and organization are prerequisite behaviors)

3 Levels that govern attitudes and feelings (Menix, 1996)

❖ Intrapersonal level - personal perceptions of one’s own self
❖ Interpersonal level - perspective of self in relation to other individuals
❖ Extrapersonal level involves the perception of others as established groups

Psychomotor Domain - known as the “skills” domain. Learning involves acquiring fine and gross
motor abilities such as walking, handwriting, manipulating equipment, or performing a procedure
Levels of Behavioral Objectives in the Psychomotor Domain
Perception level - Ability of the learner to show sensory awareness of objects or cues associated
with some task to be performed
Set level - Ability of the learner to exhibit readiness to take a certain kind of action as evidenced
by expressions of willingness, sensory attending, or body language favorable to performing a
motor act (perception is a prerequisite behavior)
Guided response level - Ability of the learner to exert effort via overt actions under the
guidance of an instructor to imitate an observed behavior with conscious awareness of effort
Mechanism level - Ability of the learner to repeatedly perform steps of a desired skill with a
certain degree of confidence
Complex overt response level - Ability of the learner to automatically perform a complex motor
act with independence and a high degree of skill, without hesitation
Adaptation level - Ability of the learner to modify or adapt a motor process to suit the individual
or various situations, indicating mastery of highly developed movements
Origination level - Ability of the learner to create new motor acts, such as novel ways of
manipulating objects or materials, as a result of an understanding of a skill and a developed
ability to perform skills

Teaching of Psychomotor Skills

Different teaching methods, such as demonstration, return demonstration, simulation, and self-
instruction, are useful for the development of motor skill

Factors Affecting Acquiring New Skills

Readiness to learn – motivation to learn affects the degree of effort exhibited by the learner in
working toward mastery of a skill
Past experience - If the learner is familiar with equipment or techniques similar to those needed
to learn a new skill, then mastery of the new skill may be achieved at a faster rate.
Health status - An illness state or other physical or emotional impairments in the learner may
affect the time it takes to acquire or successfully master a skill
 Environmental stimuli - Depending on the type and level of stimuli as well as the learning style
(degree of tolerance for certain stimuli), distractions in the immediate surroundings may
interfere with the ability to acquire a skill
Anxiety level - ability to concentrate can be dramatically affected by how anxious someone feels
Developmental stage- Physical, cognitive, and psychosocial stages of development all influence
an individual’s ability to master a movement-oriented task
Practice session length- During the beginning stages of learning a motor skill, short and carefully
planned practice sessions and frequent rest periods are valuable techniques to help increase the
rate and success of learning

viii. Development of Teaching Plans

Teaching plan is a blueprint to achieve the goal and the objectives that have been developed

Reasons for creating a Teaching Plan

1. To direct the teacher to look at the relationship between each of the steps of the teaching
process to make sure that there is a logical approach to teaching.
2. To communicate in writing exactly what is being taught, how it is being taught and
evaluated, and the time allotted to meet each of the behavioral objective
3. To legally document that an individual plan for each learner is in place and is being properly
implemented

Elements of Teaching Plans

1. Purpose (the why of the educational session)
2. Statement of the overall goal
3. List of objectives
4. An outline of the content to be covered in the teaching session
5. Instructional method(s) used for teaching the related content
6. Time allotted for the teaching of each objective
7. Instructional resources (materials/ tools and equipment) needed
8. Method(s) used to evaluate learning

Learning Contracts

Defined as a written (formal) or verbal (informal) agreement between the teacher and the
learner that specifies teaching and learning activities that are to occur within a certain time
frame

Components

1. Content - Specifies the precise behavioral objectives to be achieved. Objectives must clearly
state the desired outcomes of learning activities. Negotiation between the educator and the
learner determines the content, level, and sequencing of objectives according to learner needs,
abilities, and readiness
 2. Performance expectations: Specify the conditions under which learning activities will be
facilitated, such as instructional strategies and resources
3. Evaluation: Specifies the criteria used to evaluate achievement of objectives, such as skills
checklists, care standards or protocols, and agency policies and procedures of care that identify
the levels of competency expected of the learner
4. Time frame: Specifies the length of time needed for successful completion of the objectives. The
target date should reflect a reasonable period in which to achieve expected outcomes
depending on the learner’s abilities and circumstances. The completion date is the actual time it
took the learner to achieve each objective

PURPOSE:
GOAL :
Time
Objectives and Content Method of Method of
Allotted (in Resources
Sub-objectives Outline Instruction Evaluation
min.)
Learning curve is a common phrase used to describe how long it takes a learner to learn anything new

Six Stages of Learning Curve

1. Negligible progress - Initially very little improvement is detected during this stage. This pre-
readiness period is when the learner is not ready to perform the entire task, but relevant
learning is taking place
2. Increasing gains - Rapid gains in learning occur during this stage as the learner grasps the
essentials of the task
3. Decreasing gains: During this stage the rate of improvement slows and additional practice does
not produce such steep gains
4. Plateau: During this stage no substantial gains are made. This leveling-off period is characterized
by a minimal rate of progress in performance
5. Renewed gains: These gains usually are from growth in physical development, renewed interest
in the task, a response to challenge, or the drive for perfection
6. Approach to limit: During this stage progress becomes negligible. The ability to perform a task
has reached its potential, and no matter how much more the learner practices a skill, he or she
is not able to improve

III. Strategies and Methodologies

Teaching Method -the way information is taught that brings the learner into contact with what
is to be learned.

Factors Affecting Teaching Method to be used

✓ Audience characteristics (size, diversity, learning style preferences)
✓ Educator’s expertise as a teacher
✓ Objectives of learning
✓ Potential for achieving learning outcomes
✓ Cost-effectiveness
✓ Setting for teaching
✓ Evolving technology

1. LECTURE –defined as a highly structured method by which educator verbally transmits information
directly to a group of learners for the purpose of instructions

5 approaches to the effective transfer of knowledge during a lecture

1. Use opening & summary statements
2. Present key terms
3. Offer examples
4. Use analogies
5. Use visual backups

3 Main parts
1. Introduction – educator present learners with an overview of the behavioral objectives related
 to the lecture topic
2. Body –actual delivery of the content related to the topic being addressed
3. Conclusion –wrap-up of the lecture

Advantage
✓ Efficient, cost effective means for transmitting large amounts of information to a large
audience at the same time
✓ Useful to describe patterns, highlight main ideas and summarize data
✓ An effective approach for cognitive learning
✓ Easily supplemented with printed handouts and other audiovisual materials to enhance
learning

Limitations
❖ Largely ineffective in influencing affective and psychomotor behaviors.
❖ Does not provide much stimulation/participatory movements of learners.
❖ Very instructor centered
❖ All learners are exposed to the same information regardless of their cognitive abilities, learning
needs or stages of coping.
❖ The diversity within groups makes it challenging for the teacher to reach all learners equally

2. GROUP DICSUSSION – a method of teaching whereby learners get together to actively exchange
information, feelings and opinions with one another and with educator

a. TEAM-BASED LEARNING – is an innovative and newly popular teaching method - is meant

to enrich the student’s learning experience through active learning strategies

4 key principles (Sisk, 2011)

✓ Forming heterogeneous teams
✓ Stressing student’s accountability
✓ Providing meaningful team assignments
✓ Providing feedback to students

b. COOPERATIVE LEARNING – is a methodology of choice for transmitting foundational

knowledge. Highly structured group work focusing on problem solving that leads to deep
learning and critical thinking

4 KEY COMPONENTS
❖ Extensive structuring of the learning tasks by the teacher
❖ Strongly interactive student-student execution of the tasks
❖ Immediate debriefing/other assessments
❖ Instructional modifications by the teacher based on feedback

c. CASE STUDIES - lead to the development of analytical and problem-solving skills, exploration
of complex issues, and application of new knowledge and skills in the lineal practice arena.
 d. SEMINARS – interactions are stimulated by the posing of questions by the educator

3. ONE-TO-ONE INSTRUCTION – involves face- to-face delivery on information specifically designed to

meet the needs of individual learner

4. DEMONSTRATION AND RETURN DEMONSTRATION

Demonstration – is done by an educator to show the learner how to perform a certain skill.
Return demonstration – is carried out by the learner as an attempt to establish competence by
performing a task with Cues from the educator as needed

SCAFFOLDING –is an incremental approach to sequencing discrete steps of procedure

5. Gaming - is a method of instruction requiring the learner to participate in a competitive activity

with present rules (Allery, 2004)
Effective for improving cognitive functioning but also can be used to enhance skills in the
psychomotor domain and to influence affective behavior through increased social
interaction
6. SIMULATION – is a trial-and-error method of teaching whereby an artificial experience is created
that engages the learner in an activity that reflects real-life conditions but without risk- taking
consequences of an actual situation

TYPES OF SIMULATIONS
➢ Written simulations – use case studies about real or fictitious situations and the learner must respond
to these scenarios.
➢ Clinical simulations-can be set up to replicate complex care situations such as mock cardiac arrest
➢ Model simulations – are frequently used
➢ Computer simulations-are use in the learning laboratories to mimic situations whereby information
as well as feedback is given to learners in helping them to develop decision-making skills

ADVANTAGES
➢ Excellent for psychomotor skill development.
➢ Enhances higher level problem-solving and interactive abilities in the cognitive and affective domains
➢ Provides for active learner involvement in a real-life situation
➢ Guarantees a safe, nonthreatening environment for learning

LIMITATIONS
➢ Can be expensive
➢ Very labor intensive in many cases

7. ROLE PLAY – a method of instruction by which learners actively participate in an unrehearsed

dramatization
ADVANTAGES
➢ Opportunity to explore feelings and attitudes
➢ Potential for bridging the gap between understanding and feeling
➢ Narrows the role distance among patients and professionals

LIMITATIONS
➢ Limited to small groups
➢ Tendency by some participants to overly exaggerate their assigned roles
➢ A role part loses its realism and credibility if played too dramatically
➢ Discomfort felt by some participants in their roles/inability to develop them sufficiently

8. ROLE MODEL – use of self. Primarily known to achieve behavior change in affective domain
ADVANTAGES
➢ Influences attitudes to achieve behavior change primarily in the affective domain.
➢ Potential of positive role models to instill socially desired behaviors.

LIMITATIONS
➢ Requires rapport between the role model and the learner
➢ Potential for negative role models to instill unacceptable behaviors

9. SELF-INSTRUCTION – is a teaching method used by the educator to provide/design instructional

activities that guide the learner in independently achieving the objectives of learning.
- it is a self-contained educational activity that allows learners to progress by themselves at their
own pace (Abruzzese, 1996)
ADVANTAGES
➢ Allows for self-pacing.
➢ Stimulates active learning.
➢ Provides opportunity to review and reflect on information.
➢ Offers built-in, frequent feedback.
➢ Indicates mastery of material accomplished in particular time frame

LIMITATIONS
➢ Limited with learners who have low literacy
➢ Not appropriate for learners with visual and hearing impairments.
➢ Requires high level of motivation.
➢ May induce boredom in a population if this method is overused with no variation in the activity
design

ELEMENTS OF SELF-INSTRUCTION MODULES

1. Introduction 6. Outline of actual learning activities
2. List of prerequisite skills 7. Estimated total length of time
3. List of behavioral objectives 8. Different presentations
4. Pretest 9. Periodic self-assessments
5. Identification of resources and learning 10. Posttest
activities
 Techniques to enhance the effectiveness of verbal presentations
✓ Include humor ✓ Serve as role model
✓ Exhibit risk-taking behavior ✓ Use anecdotes and examples
✓ Deliver material dramatically ✓ Use technology
✓ Choose problem-solving activities

GENERAL PRINCIPLES FOR TEACHING ACROSSMETHODOLOGIES

➢ Give positive reinforcement ➢ Use questions

➢ Project an attitude of acceptance ➢ Use the Teach-Back or Tell-Back Strategy
and sensitivity ➢ Know the audience
➢ Be organized and give direction ➢ Use repetition and pacing
➢ Elicit and give feedback ➢ Summarize important points

SETTINGS FOR TEACHING

❖ Classified according to the need for health education in relationship to the primary purpose of the
organization/agency that provides health instruction
❖ Any place where nurses engage in teaching for disease prevention, health promotion, health
maintenance and rehabilitation

1. Healthcare setting – is one in which the delivery of health care is the primary or sole function of
the institution, organization or agency
Examples: hospital, public health department outpatient clinics, physician’s offices

2. Healthcare-related setting – is one in which healthcare-related services are offered as a

complementary function of the agency
Examples: American Heart Association and American Cancer Society

3. Non-healthcare setting – is one in which health care is an incidental or supportive function of an

organization
Examples: businesses, industries, school’s military and penal institutions

IV. Resources

INSTRUCTIONAL MATERIALS – are objects/vehicles by which information is communicated

Instructional Material Tools – are the objectives/ vehicles used to transmit information that supplement
the act of teaching

3 Major Variables in Making Appropriate Choices of Instructional Materials

1. Characteristic of the learner
2. Characteristic of the medium
3. Characteristic of the task to be achieved
Three Major Components of Instructional Materials
1. Delivery System – includes both the software and the hardware used in presenting information
2. Content (intended message) is independent of the delivery system and is the actual information
being communicated to the learner
3. Presentation – consist of the following:
a) Realia (the condition of being real) – most concrete form of stimuli that can be used to deliver
information
b) Illusionary Representations – applies to a less concrete, more abstract form of stimuli through
which to deliver a message
c) Symbolic Representations – refers to the most abstract types of messages

TYPES OF INSTRUCTIONAL MATERIALS

1. WRITTEN - Handouts, such as leaflets, books, pamphlets, brochures, and instruction sheets (all
symbolic representations), are the most widely used and most accessible type of tools for teaching
a. Commercially Prepared Materials
b. Self-Composed Materials

2. DEMONSTRATION - include many types of visual, hands-on media

a. Models - three-dimensional objects that allow the learner to immediately apply knowledge and
psychomotor skills by observing, examining, manipulating, handling, assembling and
disassembling them while the teacher provides feedback
➢Replica is an exact copy constructed to scale that resembles the features or substance of
the original object
➢Analogue has the same properties and performs like the real object. Unlike replicas,
analogue models are effective in explaining and representing dynamic systems.
➢Symbol is used frequently in teaching situations. Written words, mathematical signs and
formulas, diagrams, cartoons, printed handouts, and traffic signs are all examples
b. Displays - are two-dimensional objects that serve as useful tools for a variety of teaching
purposes
c. Posters - use the written word along with graphic illustration. Serve as a visual supplement to
oral instruction of patients and families in various healthcare settings

3. Audiovisual Materials- support and enrich the education process by stimulating the senses of seeing
and hearing, adding variety to the teaching–learning experience, and instilling visual memories,
which have been found to be more permanent than auditory memories (Kessels, 2003)
a. Projected Learning resources category of media includes:
➢Overhead transparencies
➢PowerPoint slides
➢Compact Discs and Digital Sound Players
➢Radio and Podcasts
b. Telecommunications - means by which information can be transmitted via television, telephone,
related modes of audio and video teleconferencing, and closed-circuit, cable, and satellite
broadcasting
➢Television
➢Telephones
 c. Computer Learning Resources - computer can store large amounts of information and is designed
to display pictures, graphics, and text. The presentation of information can be changed
depending on user input
➢Computers are an efficient instructional tool, computer programs can influence affective
and psychomotor skill development, and retention of information potentially can be
improved by the interactive exchange between learner and computer, even though the
instructor is not actually present (DiGiacinto, 2007). I
➢Computer-assisted instruction (CAI), also called computer-based learning and computer-
based training, promotes learning in primarily the cognitive domain

V. Evaluation
i. Definition
Defined as a systematic process that judges the worth/value of teaching and learning
ii. Steps in Conducting Evaluation
1. Determining the focus of the evaluation, including use of evaluation models
2. Designing the evaluation
3. Conducting the evaluation
4. Determining methods to analyze and interpret the data collected
5. Reporting results and a summary of the findings from the data collected
6. Using evaluation results

iii. Evidence-based practice (EBP)

- Defined as “the conscientious use of current best evidence in making decisions about
patient care” (Melnyk & Fineout-Overholt, 2015, p. 3)
- Described as “a lifelong problem-solving approach to clinical practice that
integrates…the most relevant and best research . . . one’s own clinical expertise . . . and patient
preferences and values” (Melnyk & Fineout-Overholt, 2015, p. 3)

➢ External Evidence – Evidence from research reflecting the fact that it is intended to be
generalizable or transferable beyond the specific study setting or sample
➢ Internal Evidence - defined as data generated from a diligently conducted quality
improvement project or EBP implementation project within a specific practice setting or
with a specific population (Melnyk & Fineout-Overholt, 2015

Practice-based evidence
➢ Defined as “the systematic collection of data about client progress generated during treatment
to enhance the quality and outcomes of care” (Girard, 2008, p. 15), which comprises internal evidence
that can be used both to identify whether a problem exists and to determine whether an intervention
based on external evidence effectively resolved that problem

iv. Evaluation Versus Assessment

➢ Assessment focuses on initially gathering, summarizing, interpreting, and using data to decide a
direction for action
➢ Evaluation involves gathering, summarizing, interpreting, and using data after an activity has
been completed to determine the extent to which an action was successful

5 Basic Component of Evaluation

1. Audience - includes the persons or groups for whom the evaluation is being conducted
2. Purpose - might be to decide whether to continue a specific education program or to determine
the effectiveness of the teaching process
3. Questions - must be directly related to the purpose for conducting the evaluation, must be
specific, and must be measurable
4. Scope - determined in part by the purpose for conducting the evaluation and in part by
available resources
5. Resources - include time, expertise, personnel, materials, equipment, and facilities.

Evaluation Models
1. Process (Formative) Evaluation – its purpose is to make necessary adjustments to an educational
activity as soon as they are identified, such as changes in personnel, materials, facilities,
teaching methods, learning objectives, or even the educator’s own attitude
2. Content Evaluation - determine whether learners have acquired the knowledge or skills taught
during the learning experience
3. Outcome (Summative) Evaluation - determine the effects of teaching efforts
4. Impact Evaluation - determine the relative effects of education on the institution or the
community
5. Total Program Evaluation is to determine the extent to which all activities for an entire
department or program over a specified time meet or exceed the goals originally established

Designing the Evaluation

1. Design Structure - all evaluations should be systematic, carefully and thoroughly planned or
structured before they are conducted
2. Evaluation Methods - design structure, in turn, provides the basis for determining what
evaluation methods should be used to collect data.
✓ Which types of data will be collected?
✓ What data will be collected and from whom?
✓ How, when, and where will data be collected?
✓ Who will collect the data?

Evaluation Instruments
Whenever possible, an evaluation should be conducted using existing instruments.
Reason: because instrument development not only requires considerable expertise, time, and
resources but also requires testing to be sure the instrument, whether it is in the form of a
questionnaire or a type of equipment, demonstrates reliability and validity before it is used for
collecting data

Steps in Instrument Selection

1. Conduct a literature search for evaluations similar to the evaluation that is being planned
 2. Check first, the instrument must measure the performance being evaluated exactly as that
performance has been operationally defined for the evaluation
3. Appropriate instrument should have documented evidence of its reliability and validity with
individuals who are as closely matched as possible with the people from whom data will be
collected

Barriers to Evaluation
1. Lack of clarity
2. Lack of ability
3. Fear of punishment or loss of self-esteem

v. Conducting the Evaluation

➢ Evaluation is implemented depends primarily on how carefully and thoroughly that
evaluation was planned and how carefully the instruments for data collection were selected or
developed

Methods to a Successful Evaluation

1. Conduct a pilot test first.
2. Include extra time to complete all the evaluation steps.
3. Keep a sense of humor throughout the experience

vi. Analyzing and Interpreting Data Collected

Purpose
1. To organize data so that they can provide meaningful information
2. To provide answers to evaluation question

Basic decisions about how data will be analyzed are dictated by the nature of the data and by the
questions used to focus the evaluation. Data can either be qualitative or quantitative

vii. Reporting Evaluation Results

The following guidelines can significantly increase the likelihood that results of the evaluation
will be reported to the appropriate individuals or groups, in a timely manner, and in usable
form:
✓ Be audience focused – (1) Evaluation must provide information for decision making by the
primary audience. No matter who the audience members are, their time is important to
them and they want something succinct to read. (2) Present evaluation results in a format
and language that the audience can understand and use without additional interpretation.
(3) Evaluator should make every effort to present results in person as well as in writing.
✓ Stick to the evaluation purpose - Evaluators should keep the main body of an evaluation
report focused on information that fulfills the purpose for conducting the evaluation. The
main aspects of how the evaluation was conducted and answers to questions asked also
should be provided
✓ Use data as intended - Evaluators should maintain consistency with actual data when
reporting and interpreting findings.
“In life, everything is a challenge, you may choose to face and learn from it or run and gain nothing… In
the end you make the decisions”
DHEPSAG Quiz
Question 1
The most common psychosocial tasks of the older adult involve changes in lifestyle and
social status based on the following circumstances include the following except
Correct answer: Establishing his/her value in the society

Question 2
The unconscious goals of adolescents include the need to do the following except:
Correct answer: Establish intimate relationships and respond to sexual urges

Question 3
The ability to give and receive information would fall under what phase in the different
phases of learning?
Correct answer: Interdependence

Question 4
Older adults have the tendency to have BETTER short term memory than long term
memory.
Correct answer: False

Question 5
The following are appropriate teaching strategies to Early Childhood except
Correct answer: Keep teaching sessions short with long intervals to allow practice

Question 6
Teaching strategies for infants to toddlerhood include the following except:
Correct answer: Focus delivery of the teaching to the child
Question 7
Written materials and a formal type of education is encouraged in teaching and training
older adults.
Correct answer: False

Question 8
Which teaching strategy is appropriate for middle and late childhood?
Correct answer: Allow school-aged children to take responsibility for their own health
care

Question 9
The child is the primary audience for teaching and training during the infancy and
toddlerhood stage of development.
Correct answer: False

Question 10
Personal fable is common among older adults.
Correct answer: False

Question 11
Dialectical thinking is common among adolescents.
Correct answer: False

Question 12
The following are expected characteristic developments of infants and toddlers except:
Correct answer: A. Delayed gratification is fully established
Question 13
Schemas are considered as the building blocks of knowledge.
Correct answer: True

Question 14
Children in education show the following characteristics except:
Correct answer: Ability to serve as a knowledgeable resource

Question 15
Lack of experience makes the child a valuable source of information or as a
knowledgeable resource.
Correct answer: False

Question 16
The question "what's in it for me?" is an important question to be answered in
pedagogy.
Correct answer: False

Question 17
The following are contextual influences except:
Correct answer: Normative peer graded

Question 18
Use of analogies is an effective approach in teaching and training toddlers.
Correct answer: False
Question 19
Common behaviors of Early Childhood include the following except:
Correct answer: Imaginary audience

Question 20
In the context of health education, the saying "You can't teach old dogs new tricks" is
an established fact.
Correct answer: False
IMPLEMENTING A HEALTH EDUCATION PLAN

Activity Based Strategies

There were was Nine
1. Lecture
2. Group discussion
3. One-to-one instruction
4. Demonstration and return demonstration
5. Gaming
6. Simulation
7. Role play
8. Role model
9. Self-instruction
Computer Teaching Strategies
Computer-based learning, also known as computer-aided instruction, is the term used for any
kind of learning with the help of computer.
Computer-based learning makes use of the interactive elements of the computer applications and
software and the ability to present any type of media to the users.
Computer-based learning has many benefits, including the advantage of users learning at their
own pace as well as learning without the need for an instructor to the physically present.
TYPES:
Tutorials
 Tutorial software provides information about diverse topics, essentially taking on the role
of instruction. In many cases, the technology quizzes and evaluate the students
comprehension of the subject matter using an interactive process and delivering feedback.
Gamified Learning:
 This type uses gamified approach to help student learn the material. Through an
interactive process, students may advance to new levels after demonstrating that they’ve
grasped certain concepts or receive reward along the way.
Practice:
 Practice technology applies a digital approach to traditional methods of learning content,
such as flashcard. The technology, for example, might quiz learners on different concepts.
Demonstrations:
 Demonstrations tap into different senses, like visual and auditory, to present facts,
information, concepts, and more. In some cases, students can become immersed in the
 experience, as is often the case with virtual of augmented reality technologies, both of
which are used in teaching and learning.
PROS OF COMPUTER-ASSISTED LEARNING
Students and Instructors Can Receive Real-Time Feedback
 Computer based learning reveals solutions and assesses student performance immediately.
 Immediate feedback to the learner
 Providing analytics that go a step beyond to help students improve. The learning process
is more interactive and engaging.
 Computer based learning takes on many different forms, and each one is meant to engage
learners. It is usually interactive, too, which involves students and makes them agents of
their own learning, increasing their stake in the education process.
Learning can be More Personalized
Many computer-based learning programs adjust the approaches based on the individual leaner’s
progress.
 A more personalized approach leads to both a higher level of engagement and stronger
learning outcomes.
Technology can fill the Gaps for students with learning differences
 Computer-based learning has implications for students with a range of learning
differences, too, giving greater access to those with different educational and learning.
CAL Can Become a Distraction
 When students use CAL tools classroom, they may well have trouble focusing on the live
teaching taking place.
It’s expensive
 In many cases, technology is expensive. CAL solutions may be difficult to purchase and
implement because of the cost barrier associated with them. This is especially true when
the tools are custom-built for a particular audience, although educators should keep in
mind that there are some more cost-effective solutions.
Software can Become Outdated Quickly
 With frequent advances in technology and reassessments and reconceptualization of
material and content, there is a risk of applying technologies that could be irrelevant or
outdated quickly.
There’s a Risk of Over-Dependence on the Technology
  CAL should augment instructor efforts, not replace them. While there are some contexts
in which technology may play in greater role, the tools and live instruction often go hand
in hand.
 Moreover, some teacher may feel that they have trouble finding tools that meet their
lesson plan needs and attempt to alter their lessons accordingly.
COMPUTER TEACHING STRATEGIES
In the best cases scenario, computer-assisted learning benefits and enhances instruction. But that
doesn’t mean that it’s without its flaws.
Ideally, instructors will find a balance between using technology to improve and supplement
their own teaching, supporting both learners and teachers in education.
DISTANCE LEARNING
- Is a way of educating students online. Lectures and learning materials are sent over the
internet. Students work from home, not in a classroom

There are many excellent benefits of distance learning example are:

1. Proves less expensive to support
2. Not limited by geography

Due to the coronavirus, distance learning typically a style of teaching utilized by colleges and
universities is now being adopted by elementary and high school students as well. Entire school
districts and campuses are being forced to create online-based learning opportunities and do it
effectively.
This approach could disadvantage some students
1. Students with limited computer or internet access may struggle
2. Students who need extra help with motivation and organization may also struggle when
they are removed from a traditional classroom environment.
TWO MAIN CATEGORIES:
- Synchronous
- Asynchronous
Synchronous
- Means at the same time. It refers to a method of education delivery that happens in real-
time. It requires live communication online. It uses technology, such as teleconferencing,
to achieve this
 - Improves lees flexible than other forms of distance learning. After all, students must meet
with their instructor and sometimes their classmates at pre-scheduled times.
- This approach limits the students ability to learn at their own pace. It may frustrate some
learners who crave the freedom of the asynchronous classroom.
Asynchronous
- As for asynchronous distance education? Students receive clusters of weekly deadlines.
They have the freedom to work at their own speed.
- Asynchronous distance learning comes with more opportunities for student interaction.
- Students can access course content beyond the scheduled meeting or class time and
interact online conversations, quizzes , or video comments on their own scheduled
- Both faculty and students benefit from the flexibility of asynchronous learning as it
allows them to create and consume content when it’s convenient for them.
TYPES OF DISTANCE LEARNING
1. Video Conferencing
2. Hybrid distance education
3. Open schedule online courses
4. Fixed-time online courses
Video conferencing
- Is a traditionally a meeting where two or more participants use video to connect over the
internet. This is a form of synchronous communication. Using tools like zoom,
blackboard collaborate, adobe connect, or other conferencing software, teachers and
students interact together no matter where they are located.
- Enhances student-instructor interactions and provides a structure for lesson planning. It
remains component of distance learning.
Hybrid distance education
- Combines synchronous methods. Students receive deadlines to complete assignments and
exams. Then, they work at their own pace.
- They submit assignments through online forums. They maintain contact with their
instructor. Yet, they work at their own pace. As student progress, they gain access to new
modules.
- Who thrives with hybrid distance education? Student that love independence.
Open schedule online courses
- Under the asynchronous category, you’ll find open schedule online instruction. Such
courses provide students with plenty of freedom. To complete coursework, students
receive.
 Inline textbooks
 Bulletin boards
 Emails
  And more
- Student are given a set of deadlines. Then the instructor sets them free to work at their
own pace. Students who value learning independently excel with this format. It requires
significant self-discipline and motivation, though.
- Student who lack the right skill set may find this approach daunting. They may feel
overwhelmed by the presentation of material. They may lack the motivation to work
through the course in an effective way.
Fixed-time online courses
- What’s the most common format for distance learning? Fixed-time online courses.
- How do they work? Students log-in to the learning site at designated times. They must
complete pre-scheduled classroom activities at a specific pace.
- These activities often include chats and discussion forums. Fixed time online courses
encourage student interaction. But there’s little room for-pacing.

BENEFITS OF DISTANCE LEARNING

There are many distance learning benefits. They vary by synchronous or asynchronous course
structures. The advantages include:
 Self-inspiration
 Flexibility to choose
 Adaptability and freedom
 Easy access
 Earning while learning
 Money and time savings
 Virtual trips
 Communication with other educational institutions
DISADVANTAGES OF DISTANCE LEARNING
 Students face a higher risk of online distraction. Without face to face meeting, students
can lose track of deadlines and motivation.
 Student who work well on their own easy surmount these obstacles. Students who have
trouble prioritizing may stumble. So will those who lack organizational and scheduling
skills.
 Distance learning comes with hidden student costs, too. These expenses include:
- Gaining access to a reliable computer
- Having an internet connection
- Buying a web camera in some instances
- Computer maintenance
- Utilities (electricity for internet services)
  Not all students have access to these resources. Distance learning can put them at a
distinct disadvantage.
 A slow internet connection will hamper a student’s ability to participate online. They may
lack the bandwidth to watch videos or teleconference.
TEACHING PSYCHOMOTOR SKILLS
Psychomotor skill development is crucial to good patient care. Psychomotor skills are used to
provide patient care and ensure the safety of the member of the team.
Five level of psychomotor skills
1. Limitation
2. Manipulation
3. Precision
4. Articulation
5. Naturalization
Limitation
1. Students repeats what is done by the instructor
2. See one, do one
3. Avoid modeling wrong behavior because the student will do as you do
4. Some skills are learned entirely by observation, with no need for formal instruction.
Manipulation
1. Using guidelines as a basis or foundation for the skill
2. May make mistakes. Making mistakes and thinking through corrective actions is a
significant way to learn
3. Perfect practice makes perfect. Practice of a skill is not enough, students must perform
the skill correctly
4. The student begins to develop his or her own style and techniques. Ensure students are
performing medically acceptable behaviors
Precision
1. The student has practiced sufficiently to perform skill without mistakes
2. Students generally can only perform the skill in a limited setting. Example student can
splint a broken arm if patient is sitting up but cannot perform with same level of precision
if patient is lying down.
Articulation
1. The student is able to integrate cognitive and effective components with skill
performance
a. Understands why the skill is done a certain way
b. Knows when the skill is indicated
2. Performs skill proficiently with style
 3. Can perform skill in context. Example student is able to splint broken arm regardless of
patient position
Naturalization
1. Mastery level skill performance without cognition
2. Also called muscle memory
3. Ability to multitask effectively
4. Can perform skill perfectly during scenario, simulation, or actual patient situation

MOTIVATION
- A student motivation has a positive influence on the development of psychomotor skills.
Motivation is the major step in the teaching process.
Strategies in increasing motivation
1. Use a variety f psychological strategies based upon personal goals and interests, values of
the skill, and personal challenge.
2. Arouse curiosity by presenting a navel idea or a puzzling prolem.
3. Set challenging, yet obtainable standards for each student
4. Provide feedback and reinforcement
5. Take advantage of natural tendencies to compete
Demonstration
- Actual demonstration has been widely viewed as the most appropriate strategy for
teaching skill development. Filmed demonstrations have also been found to enhance
psychomotor skill development also concluded that demonstrations improve technique,
confidence, and understanding of successful performance.
1. Demonstration enhance psychomotor skill acquisition
2. The higher the status of the person presenting the demonstration, the greater the influence
of the demonstration on the student’s skill acquisition
3. Task should be broken down into subunits for teaching purposes. The skill involved in
each subunits should be demonstrated in sequence, allowing students to practice in each
subunits before moving to the next.
4. Demonstration can help reduce anxiety over performing unfamiliar skills.
Physical practice
Practice may be defined as repetition with the intent of improved performance. Actual practice of
a manipulative skill effectively is essential to acceptable performance. Furthermore, actual
performance of a skill effectively reduces the fear and anxiety that accompanies the performance
of many skills.
1. Short, frequent practice session over a long period of time are most effective.
 2. Practice sessions must be long enough to allow improvement, and the time period
between sessions must be short enough to prevent forgetting
3. Performance curves tend to reveal that improvement is usually fastest initially, with a
plateau of performance reached after some time.
Research evidence suggests, however, that these plateaus are primarily due to student’s stopping
at their own acceptable levels of performance, rather than to any physical limitation.
Mental practice
-may be defined as covert rehearsal of a skill step by imaging oneself performing the skill step
and feeling one’s way through the movement. Weinberg 1982 cited early research that showed a
strong relationship between mental practice and muscular stimulation.
TEACHING PSYCHOMOTOR SKILLS
The early stages of psychomotor skill acquisition are primarily cognitive in nature. During this
stage, teachers need to help their students think through the mechanics of performance.
Although mental practice has been found to enhance skill acquisition at any time, it is most
effective during the cognitive stages
Research has also shown that mental practice alone, if it follows a demonstration or videotape of
the skill being performed, does enhance skill acquisition.
The following are guidelines for the use of mental practice to improve skill.
1. Students must be familiar with the task trough prior experience, demonstrations, or visual
before using mental practice techniques
2. Students need instruction in the use of mental practice
3. A combination of physical and mental practice should provide the greatest performance
gains
4. Simple skills, or complex skills broken down into subunits, are best suited for mental
practice.
5. Students should perform mental practice in their own time and place.
6. Mental practice sessions should last no longer than five minutes.
Feedback
- Feedback, or information provided to students regarding their performance result, is
essential in psychomotor skill development.
The following conclusions regarding feedback and its effect on the skills acquisition:
1. The rate of skill improvement depend upon the precision and frequency of knowledge of
results.
2. A delay in providing this knowledge does not affect skill acquisition. However, feedback
is important especially in the early stages of practicing a skill.
 3. Withdrawal of knowledge of results decreases performance in the early stages of skill
development but does not affect performance in the late stages.
4. A variety of type of feedback should be provided including visual, verbal, and kinesthetic.
Increasing Retention and Transfer of Skills
Retention may be defined as the persistence of proficiency on a skill after a period no practice
The most important factor in retention is the degree of initial proficiency.
Learners should also practice a skill as soon as possible after the demonstration is given. Events
occurring between the demonstration and practice session tend to reduce retention

Transfer is the application or performance of previously learned skills in other places or setting.
1. Positive transfer is most likely when similarities between practice (learning) and
performance (application) sessions are high.
2. Practice should be completed on task that parallel in difficulty and design those in
transfer settings.
3. Discussion of various examples during the practice stage aids in the transfer of principle
and practices
4. Specific tasks should be practiced in relationship to the complete task. Otherwise, only
isolated parts of the task may be positively transferred.
5. As in retention, transfer is greatest with high levels of initial task proficiency.
The teaching process
The most highly regarded approach to teaching psychomotor skills involves several phases,
including:
1. Motivating students
2. Demonstrating the skill
3. Furnishing student practice
4. Providing appropriate feedback on performance
Steps for psychomotor teaching process
1. Create interest through the use of questioning and discussion of a puzzling problem or
aspect of the skill to be developed. This brings students to a psychological feeling that
they need to know more and that they need to become more able.
2. Ask student to describe the appropriate steps in performing the skill. Correct errors and
explain changed that must be made.
3. Discuss how each step of the skill should be performed, and have the class prepare a set
of brief, simple directions for the process. Students will learn more from a demonstration
if the how’s and why’s have been discussed beforehand.
 4. Provide, a demonstration of the skill. Involving students mentally and physically
throughout the demonstration will increase its effectiveness. Steps to be performed
should be demonstrated in proper sequence and explained simultaneously.
5. Have students practice the skill. Upon completion, placed two finished products before
students and ask which is better and why. Lead the group in the development and
acceptable standards by which future performance should be judged.
6. Provide alternating sessions of practice and evaluation until the desired ability level is
reached.
CLINICAL TEACHING
- IS AN INDIVIDUALIZED GROUP teaching to the nursing student in the clinical area
by the nurse educators, staff and clinical nurse managers.
- In preparation of professional practice
- The clinical setting is the place where the students come in contact patient or consumer
for the purpose of testing theories and learning skill
- Teaching in clinical setting is challenge that is different from those encountered in the
classroom
- Like any other skills based profession, nursing also requires the development of
relationship between and practice.
- Principle of clinical teaching
- Clinical education should reflect the nature of the professional practice
- Clinical teaching is supported by climate of mutual trust and respect
- Clinical teaching and learning should focus on the essential knowledge, skills and attitude.
Purpose of clinical teaching
1. To provide individualized care in a systematic, holistic approach
2. To develop high technical competent skill
3. To practice various procedures
4. To collect and analyze data
5. To develop communication skills and maintain interpersonal relationship
6. To maintain high standard of nursing practice to become independent enough to practice
nursing.
7. To develop, cognitive, affective and psychomotor skills
8. To learn various diagnostic procedure
9. To learn various skills in giving health education techniques to the client
10. To develop proficiency in carrying

class room teaching Clinical teaching

Large group Small group
- No focus on patient - Focus on patient
Knowledge Application of knowledge
- Theoretical framework - Clinical reasoning
 Teacher/students ratio is large Teacher/students ratio is small
- Passive student - Active student
Less interactive More interactive

Different places, different approaches

Compared the average classroom, the clinic is a labile and fast-paced environment. As a result,
there are differences between the kinds of teaching and learning that the place in the classroom
and the clinic

Classroom teaching Clinical teaching

What is being asked What do you know? How do you apply it?
What the learner Demonstrate knowledge and Problem solve in particular
demonstrates skills contexts
What competence is assessed Comprehensiveness and Selective and context
accuracy of knowledge and appropriate application of
skills knowledge and skills
The primary method of Working from genera Working from specific
teaching principles to some examples examples to general
principles.
Method and site of learning Homework and white board Bedside practice

CLINICAL TEACHING
 Type of clinical teaching method
 Bedside clinic- carried out by the group by visiting the patient at bedside in order to study
problems associated with a particular disease or disorder.
 Nursing rounds- a tour of the patient bedside area made by a small group of staff and
students
 Nursing shift reports- written or oral summary of the nursing actions taken in relation to
patients care. Otherwise known as endorsements.
  Nursing care conferences- a process in which group discussion is made using problem
solving techqnices to determine ways of providing care for the patient to whom students
are assigned as part of the their clinical experience.
 Demonstration – teaches by exhibition and explanation. Relate to demonstration of a
skill by an instructor
 Nursing care studies- methods which focuses on information and facts about the patient,
the disease condition, social and personal history and the application of this knowledge in
rendering nursing care. Refer back to CASE STUDY and case presentation.
 Process recording- it is a written account of verbatim recording of all that offers students
with the opportunities to apply their theoretical knowledge or previous learning into
practice in a controlled situation under the guidance and supervision where is no client.
Think skills laboratory return demonstration.
 Nursing assignment- it is the part of learning experience where the students are assign
with patient or other activities concerning to patient in a skills laboratory.
 Field trip- it is a will organized trip from a usual place for teaching purpose. Field trips
give natural stimulation and motivates the learner to be more interactive and creative.
CLINICAL LEARNING CYCLE
Preparatory- laboratory- briefing- clinical practice- debriefing- follow up evaluation
Computer- based learning, also known as computer aided instruction, is the term
used for any kind of learning with the help of computers

Computer-based learning make use of the interactive elements of the computer

applications and software and the ability to present any type of media to the users

Computer-based learning has many benefits, including the advantage of users

learning at their own pace as well as learning without the need for an instructor to
the physically present

COMPUTER TEACHING STRATEGIES TYPES

Tutorials – software provides information about diverse topic, essentially taking on

the role of the instructor. In many cases, the technology quizzes and evaluates the
student’s comprehension of the subject matter using an interactive process and
delivering feedback

Gamified learning – to help students learn the material. Through an interactive

process, students may advance to new levels after demonstrating that they’ve
grasped certain concepts or receive rewards along the way

Practice – applies a digital approach to traditional methods of learning content,

such as flashcards. The technology, for example, might quiz learners on different
concepts

Demonstrations – tap into different senses, like visual and auditory, to present facts,
information, concepts, and more. In some cases students can become “immersed”
in the experience, as is often the case with virtual or augmented reality
technologies, both of which are used in teaching ang learning
COOMPTER TEACHING STRATEGIES PROS OF COMPUTER-ASSISTED
LEARNING

Students and instructor can receive teal-time feedback

- Computer based learning reveals solutions and assess student performance

immediately

- Immediate feedback to the learner

- Providing analytics that go a step beyond to help students improve. The

learning process I more interactive and engaging

- Computer based learning takes on many different forms, and each one is meant
to engage learners it is usually interactive, too, which involves students and makes
them agents of their own learning, increasing their stake in the education process

Learning can be more personalized

May computer-based learning programs adjust the approaches based on the

individual learner’s progress

- A more personalized approach leads to both a higher level of engagement

and stronger learning outcomes

Technology can fill the gaps for students with learning differences

- computer-based learning has implications for students with a range of learning

differences, too, giving greater access to those with different educational and
learning
CAL can be a distraction

- when the students use CAL tools in the classrooms, they may well have trouble
focusing on the live teaching taking place

It’s expensive

- in many cases, technology is expensive. CAL solutions may be difficult to

purchase and implement because of the cost barrier associated with the, This is
especially true when the tools are custom-built for a particular audience, although
educators should keep in mind that there are some more cost-effective solutions

COMPUTER TEACHING STRATEGIES

In the best case scenario, computer-assisted learning benefits and enhances

instruction. But the doesn’t mean that it’s without its flaws

Ideally, instructors will find a balance between using technology to improve

and supplement their own teaching, supporting both learners and teachers in
education

DSTANCE LEARNING

- is a way of educating students online. Lectures and learning materials are sent
over the internet. Students work from home, not in a classroom

There are many excellent benefits of distance learning examples are:

1. proves less expensive to support

2. not limited by geography

 Due to the coronavirus, distance learning – typically a style of teaching
utilized by colleges and universities – is now being adopted by elementary and
high school students as well. Entire school districts and campuses are being forced
to create online-based learning opportunities and do it effectively

This approach could be disadvantage some students

1. students with limited computer or internet access my struggle

2. students who need extra help with motivation and organization ,ay also struggle
when they are removed from a traditional classroom environment

SYNCHRONOUS

- means “at the same time”. It refers to a method of education delivery that
happens in real-time. It requires live communication online. It uses technology,
such as teleconferencing, to achieve this.

- proves less flexible than other forms of distance learning. After all, students must
meet with their instructor and sometimes their classmates at pre-scheduled times

- this approach limits the student’s ability to learn at their own pace. It may
frustrate some learners who crave the freedom of the asynchronous classroom

ASYNCHRONOUS

- students receive clusters of weekly deadlines. They have the freedom to work at
their own speed

- comes with more opportunities for student interaction

- students can access course content beyond the scheduled meeting or class time
and interact through online conversation, quizzes, or video comments on their own
schedule
- both faculty and students benefit from the flexibility of asynchronous learning as
it allows them to create and consume content when it’s convenient for them

TYPES OF DISTACE LEARNING

1. Video conferencing

- traditionally a meeting where two or more participants use video to connect over
the internet. This is a form of synchronous communication. Using tools like zoom,
blackboard collaborate, adobe connect or other conferencing software, teachers and
students interact together no matter where they are located

- enhances student-instructor interactions and provides a structure for lesson

planning. It remains a vital component of distant learning

2. Hybrid distance education

- combines synchronous and asynchronous methods. Students receive deadlines to

complete assignments and exams. Then, they work at their pace

- they submit assignments through online forums. They maintain contact with their
instructor. Yet, they work at their own pace. As students progress, they gain access
to new modules

- who thrives with hybrid distance education? Students that love independence
3. Open schedule online courses

- under the asynchronous category, you’ll find open schedule online instruction.
Such courses provide students with plenty of freedom. To complere course work,
students receive:

Online textbook(s)
Bulletin boards
Email

- students are given a set of deadlines. Then, the instructor sets them free to work
at their own pace. Students who value learning independently excel with this
format. It requires significant self-discipline and motivation, though.

- students who lack the skill set may find this approach daunting. They may feel
overwhelmed by the presentation of material. They may lack motivation to work
through the course in an effective way

4. Fixed-time online courses

- what’s the most common format for distance learning? Fixed-time online courses

- how do they work? Student log-in to the learning site at designated times. They
must complete pre-scheduled classroom activities at a specific pace

- these activities often include chats and discussion forums. Fixed time online
courses encourage student interaction. But there’s little room for self-pacing
BENEFITS OF DISTANCE LEARNING

There are many distance learning benefits. They vary by synchronous or

asynchronous course structures. The advantages include:

- self- inspiration
- flexibility to choose
- adaptability and freedom
- easy access
- earning while learning
- money and time savings
- virtual trips
- communication with other educational institutions

DISADVANTAGES OF DISTANCE LEARNING

Some warnings when it comes to this learning approach
- students face a higher risk of online distraction. Without face-to-face meetings,
students can lose track of deadlines and motivation
- students who work well on their own may easily surmount these obstacles.
Students who have trouble prioritizing may stumble. So will those who lack
organization and scheduling skills

These expenses include:

- gaining access to a reliable computer

- having an internet connection

- buying a web camera (in some instances)

- computer maintenance

- utilities (e.g., electricity for internet services)

Not all students have access to these resources. Distance learning can put them at a
distinct disadvantage.

Slow internet connection will hamper a student’s ability to participate online. They
may lack the bandwidth to watch videos or teleconference
TEACHING PSYCHOMOTOR SKILLS

- crucial to good patient care. It is used to provide patient care and ensure the
safety of the members of the team.

FIVE LEVELS OF PSYCHOMOTR SKILLS

Imitation

1. student repeats what is done by the instructor

2. “see one, do one”
3. avoid modeling wrong behavior because the student will do as you do
4. some skills are learned entirely by observation, with no need for formal
instruction

Manipulation
1. using guidelines as a basis or foundation for the skill (skill sheets)
2. may make mistakes. Making mistakes and thinking through corrective actions is
a significant way to learn
3. perfect practice makes perfect. Practice of a skill is not enough, students must
perform the skill correctly
4. the student begins to develop his or her own style and techniques. Ensure
students are performing medically acceptable behaviors

Precision
1. the student has practiced sufficiently to perform skill without mistakes
2. student generally can only perform the skill in a limited setting. Example:
student can splint a broken arm if patient is sitting up but cannot perform with
same level of precision if patient is lying down
Articulation
1. the student is able to integrate cognitive and affective components with skill
performance
a) understands why the skill is done a certain way
b) knows when the skill is indicated
2. performed skill proficiently with style
3. can perform skill in context. Example: student is able to splint broken arm
regardless of patient position

Naturalization
1. mastery level skill performance without cognition
2. also called “muscle memory”
3. ability to multitask effectively
4. can perform skill perfectly during scenario, simulation, or actual patient
situation

STRATEGIES IN INCREASING MOTIVATION

1. use a variety of psychological strategies based upon personal goals and interests,
values of the skill, and personal challenge
2. arouse curiosity by presenting a novel idea or a puzzling problem
3. set challenging, yet obtainable standards for each student
4. provide feedback and reinforcement
5. take advantage of natural tendencies to compete

DEMONSTRATIONS
- actual demonstration has been widely viewed as the most appropriate
strategy for teaching skill development
- filmed demonstrations have also been found to enhance psychomotor skill
development also concluded that demonstration improve technique, confidence,
and understanding of successful performance
1. demonstrations enhance psychomotor skills acquisition
2. the higher the status of the person presenting the demonstration, the greater the
influence of the demonstration on the student’s skill acquisition
3. tasks should be broken down into subunits for teaching purposes. The skills
involved in each subunit should be demonstrated in sequence, allowing students to
practice in each subunit before moving to the next
4. demonstrations can help reduce anxiety over performing unfamiliar skills

PHYSICAL PRACTICE
- defined as “… repetition with the intent of improved performance”. Actual
practice of a manipulation skill is essential to acceptable performance. Furthermore,
of the skill effectively reduces the fear and anxiety at accompanies the performance
of many skills
1. short, frequent practice sessions over a long period of time are most effective
2. practice session must be ling enough to allow improvement, and the time period
between sessions must be short enough to prevent forgetting
3. performance curves tend to reveal that improvement is usually fastest initially,
with a plateu of performance reached after some time

Research evidence suggests, however, that these plateaus are primarily due
to student’s stopping at their own acceptable levels of performance, rather than to
any physical limitations

MENTAL PRACTICE
- covert rehearsal of a skill by imaging oneself performing the skill the step by step
and “feeling” one’s way through the movements. Weinberg (1982) cited early
research that showed a strong relationship between mental practice and muscular
stimulation

The early stages o psychomotor skill acquisition is primarily cognitive in

nature. During this stage, teachers need to help their students think through the
mechanics of performance
Although mental practice has been found to enhance skill acquisition at any
time, it is most effective during the cognitive stages
Research has also shown that mental practice alone, if its follows a
demonstration or videotape of the skill being performed, des enhance skill
acquisition
TEACHING PSYCHOMOTOR SKILLS
The following are guidelines for the use of mental practice to improve skills
1. students must be familiar with the task (through prior experience,
demonstrations, or visual) before using mental practice techniques
2. students need instruction in the use of mental practice
3. a combination of physical and mental practice should provide the greatest
performance gains
4. simple skills, or complex skills broken down into subunits, are the best suited for
mental practice
5. students should perform mental practice in their own time and place
6. mental practice sessions should last no longer than five minutes

FEEDBACK
- or information provided to students regarding their performance results, is
essential in psychomotor skill development

The following conclusions regarding and its effects on skill acquisition:

1. the rate of skill improvement depends upon the precision and frequency of
knowledge of results
2. a delay in providing this knowledge does not affect skill acquisition. However,
feedback is important especially in the early stages of practicing a skill
3. withdrawal of knowledge of results decreases performance in the early stages of
skill development but does not affect performance in the late stages
4. a variety of types of feedback should be provided. Including visual, verbal, and
kinesthetic

INCREASING RETENTION AND TRANSFE OF SKILLS

Retention may be defined as the “the persistence of proficiency on a skill after a
period of no practice”
- the most important factor in retention is the degree of initial proficiency
- learners should also practice a skill as soon as possible after the demonstration is
given events occurring between the demonstration and practice session tend to
reduce retention
Transfer is the application or performance of previously learned skills in other
places or settings
1. positive transfer is the most likely when similarities between practice (learning)
and performance (application) sessions are high
2. practice should be completed on tasks that parallel in difficulty and design those
in transfer settings
3. discussion of various examples during the practice stage aids in the transfer of
principle and practices
4. specific tasks should be practiced in relationship to the complete task. Otherwise,
only isolated parts of the task may be positively transferred.
5. as in retention, transfers is greatest with high levels of initial task proficiency

THE TEACHING PROCESS

The most highly regarded approach to teaching psychomotor sills involves
several phases, including:
1. motivating students
2. demonstrating the skill
3. furnishing student practice
4. providing appropriate feedback on performance

STEPS FOR PSYCHOMOTR TEACHING PROCESS

1. create interest through the use of questioning and discussion of a puzzling
problem or aspect of the skill to be developed. This brings students to a
psychological feeling that they need to know more and that they need to become
more able
2. ask students to describe the appropriate steps in performing the skill. Correct
errors and explain changes that must be made
3. discuss how each step of the skill should be performed, and have the class
prepare a set of briefs, simple directions for the process. Students will learn more
from a demonstration if the how’s and why’s have been discussed beforehand
4. provide a demonstration of the skill. Involving students mentally and physically
throughout the demonstration will increase its effectiveness. Steps to be performed
should be demonstrated in proper sequence and explained simultaneously
5. have students practice the skill. Upon completion, place two finished products
before students and ask which is better ad why lead the group in the development
of acceptable standards by which future performance should be judged
6. provide alternating sessions of practice and evaluation until the desired ability
level is reached

CLINICAL TEACHING
- in preparation of professional practice
- the clinical setting is the place where the students com in contact patient or
consumer for the purpose of testing theories and learning skill
- teaching in a clinical setting is a challenge that is different from those
encountered in the classroom
- like any other skill based profession, nursing also requires the development of
relationship between theory and practice

Principles of clinical teaching

- clinical education should reflect the nature of the professional practice
- clinical teaching is supported by climate of mutual trust and respect
- clinical teaching and learning should focus on the essential knowledge, skills and
attitude

Purpose of clinical teaching

1. to provide individualized care in a systematic, holistic approach
2. to develop high technical competent skills
3. to practice various procedures
4. to collect and analyze data
5. to develop communication skills and maintain interpersonal relationship
6. to maintain high standard of nursing practice to become independent enough to
practice nursing
7. To develop, cognitive, affective, and psychomotor skills
8. to learn various diagnostic procedures
9. to learn various skills giving health education technique to the client
10. to develop proficiency and efficiency in carrying out various procedure
DIFFERENCE BETWEEN CLASSROM AND CLINICAL TEACHING
Class room teaching Clinical teaching
- large group -small group
No focus in patient Focus on patient
- knowledge - application of knowledge
Theoretical framework Clinical reasoning
- teacher/students ratio is large - teacher/students ratio is small
Passive students Active students
- less interactive - more interactive

Compared to the average class room, the clinic is labile and fast-paced
environment. As a result, there are differences between the kinds of teaching and
learning that take place in the classroom and the clinic

Types of clinical teaching method

Bedside clinic - carried out by the group by visiting the patient at bedside in order
to study problems associated with a particular disease or disorder

Nursing rounds – a tour of the patient’s bedside area made by a small group of
staff and students

Nursing shifts reports - written or oral summary of the nursing actions taken in
relation to patients care. Otherwise known as endorsements

Nursing care conferences – process in which group discussion is made using

problem solving techniques to determine ways of providing care for the patients to
whom students are assigned as part of their clinical experience

Demonstration – teaches by “exhibition and explanation”. Relate to demonstration

of a skill by an instructor

Nursing care studies – method which focuses on information and facts about the
patient, the disease condition, social and personal history and the application of
this knowledge in rendering nursing care. Refer back to CASE STUDY and case
presentation

Process recording – it is written account or verbatim recording of all that transpired

during and immediately following the nurse-patient interaction

Laboratory method – laboratory is a part of clinical teaching that offers students

with the opportunities to apply their theoretical knowledge or previous learning
into practice in a controlled situation under the guidance and supervision where
there is no client. Think skills laboratory return demonstration

Nursing assignment – learning experience where the students are assign with
patient or other activities concerning to patient in a skills laboratory

Field trip – well organized trip from a usual place for teaching purpose. Filed trips
give natural stimulation and motivates the learner to be more interactive and
creative

CLINICAL LEARNING CYCLE

1. Preparatory theory
2. Laboratory
3. Briefing
4. Clinical practice
5. Debriefing
6. Follow up evaluation
Question 1
Which of the following is NOT part of your computer teaching strategy
types?

Response: Gaming

Correct answer: Gaming

Score: 1 out of 1 Yes

Question 2
In Bloom’s taxonomy, it means the use a concept in a new situation

Response: Application

Correct answer: Application

Score: 1 out of 1 Yes

Question 3
In Bloom’s taxonomy, which of these choices is NOT one of the six
categories?

Response: Skills

Correct answer: Skills

Score: 1 out of 1 Yes

Question 4
It is the part of learning experience where the students are assign with
patient or other activities concerning to patient in a skills laboratory

Response: Nursing Assignment

Correct answer: Nursing Assignment

Score: 1 out of 1 Yes

Question 5
One of these choices is considered to be an advantage when it comes to the
benefits of distance learning, that would be _______.

Response: Allows for self-pacing

Correct answer: Earning while learning

Score: 0 out of 1 No

Question 6
Which of the following is NOT part of the 5 levels of psychomotor skills?

Response: Include humor

Correct answer: Include humor

Score: 1 out of 1 Yes

Question 7
Refers to a method of education delivery that happens in real-time.

Response: Synchronous

Correct answer: Synchronous

Score: 1 out of 1 Yes

Question 8
It’s also called “muscle memory”.

Response: Naturalization

Correct answer: Naturalization

Score: 1 out of 1 Yes

Question 9
Which is a disadvantage when it comes to distance learning?

Response: Slow internet connection

Correct answer: Slow internet connection

Score: 1 out of 1 Yes

Question 10
Which of the following is considered an advantage of computer teaching
strategies?

Response: Learning Can Be More Personalized

Correct answer: Learning Can Be More Personalized

Score: 1 out of 1 Yes

Question 11
Which of the following is NOT a component of instructions?

Response: List of objectives

Correct answer: List of objectives

Score: 1 out of 1 Yes

Question 12
Defined as covert rehearsal of a skill by imaging oneself performing the skill
step by step.

Response: Mental practice

Correct answer: Mental practice

Score: 1 out of 1 Yes

Question 13
The following is part of your AUDIO-VISUAL EDUCATION. EXCEPT.

Response: Telephone

Correct answer: Telephone

Score: 1 out of 1 Yes

Question 14
It is a w or scheme to achieve an objective.

Response: Teaching Approach

Correct answer: Teaching Approach

Score: 1 out of 1 Yes

Question 15
The 2 main categories of distance learning are _____& ______.

Response: Synchronous, Asynchronous

Correct answer: Synchronous, Asynchronous

Score: 1 out of 1 Yes

Question 16
Classes in which the instructor incorporates engagement triggers and
breaks the lecture is called _______.

Response: Interactive Lectures

Correct answer: Interactive Lectures

Score: 1 out of 1 Yes

Question 17
Which of the following is NOT a type of HEALTH TEACHING APPROACHES?

Response: Inductive Approach

Correct answer: Inductive Approach

Score: 1 out of 1 Yes

Question 18
In computer teaching strategies, when we say “Students and Instructors
Can Receive Real-Time Feedback” we mean?
Response: Many computer-based learning programs adjust the approaches
based on the individual learner’s progress

Correct answer: Computer based learning reveals solutions and assesses

student performance immediately

Score: 0 out of 1 No

Question 19
Which of the following choices is NOT true when it comes to
demonstrations?

Response: Are two-dimensional objects that serve as useful tools for a

variety of teaching purposes

Correct answer: Are two-dimensional objects that serve as useful tools for a
variety of teaching purposes

Score: 1 out of 1 Yes

Question 20
One of the following choices is NOT a purpose of Clinical Teaching.

Response: To impress your crush

Correct answer: To impress your crush

Score: 1 out of 1 Yes

Question 21
A teaching method where an instructor is the central focus of information
transfer.

Response: Lecture

Correct answer: Lecture

Score: 1 out of 1 Yes

Question 22
An individualized or group teaching to the nursing student in the clinical
area by the nurse educators, staff and clinical nurse managers

Response: Group Discussion

Correct answer: Clinical Teaching

Score: 0 out of 1 No

Question 23
It is an instruction where particular attention is paid to the audio and
visual presentation of the material with the goal of improving
comprehension and retention.

Response: Multimedia Based Education

Correct answer: Multimedia Based Education

Score: 1 out of 1 Yes

Question 24
Which of the following choices is a type of your computer teaching
strategies?

Response: Gamified Learning

Correct answer: Gamified Learning

Score: 1 out of 1 Yes

Question 25
Which is a type of clinical teaching method where it is carried out by the
group by visiting the patient at bedside in order to study problems
associated with a particular disease or disorder?

Response: Nursing Rounds

Correct answer: Bedside Clinic

Score: 0 out of 1 No
Question 26
The following choices is the difference of clinical teaching from class room
teaching, which one is NOT?

Response: Autonomy vs. Shame and Doubt

Correct answer: Autonomy vs. Shame and Doubt

Score: 1 out of 1 Yes

Question 27
One Consequence of Computer teaching strategy is?

Response: Software Can Become Outdated Quickly

Correct answer: Software Can Become Outdated Quickly

Score: 1 out of 1 Yes

Question 28
The following choices is considered to be types of distance learning. EXCEPT.

Response: Scaffolding

Correct answer: Scaffolding

Score: 1 out of 1 Yes

Question 29
It is an approach to learning that involves confronting students with real-
life problems that provide a stimulus for critical thinking and self-taught
content.

Response: Problem Based Learning

Correct answer: Problem Based Learning

Score: 1 out of 1 Yes

Question 30
When the learner has practiced sufficiently to perform skill without
mistakes. The learner is exhibiting which level of psychomotor skills?

Response: Precision

Correct answer: Precision

Score: 1 out of 1
Question 1
Which of the following is NOT part of your computer teaching strategy
types?

Response: Gaming

Correct answer: Gaming

Score: 1 out of 1 Yes

Question 2
In Bloom’s taxonomy, it means the use a concept in a new situation

Response: Application

Correct answer: Application

Score: 1 out of 1 Yes

Question 3
In Bloom’s taxonomy, which of these choices is NOT one of the six
categories?

Response: Skills

Correct answer: Skills

Score: 1 out of 1 Yes

Question 4
It is the part of learning experience where the students are assign with
patient or other activities concerning to patient in a skills laboratory

Response: Nursing Assignment

Correct answer: Nursing Assignment

Score: 1 out of 1 Yes

Question 5
One of these choices is considered to be an advantage when it comes to the
benefits of distance learning, that would be _______.

Response: Allows for self-pacing

Correct answer: Earning while learning

Score: 0 out of 1 No

Question 6
Which of the following is NOT part of the 5 levels of psychomotor skills?

Response: Include humor

Correct answer: Include humor

Score: 1 out of 1 Yes

Question 7
Refers to a method of education delivery that happens in real-time.

Response: Synchronous

Correct answer: Synchronous

Score: 1 out of 1 Yes

Question 8
It’s also called “muscle memory”.

Response: Naturalization

Correct answer: Naturalization

Score: 1 out of 1 Yes

Question 9
Which is a disadvantage when it comes to distance learning?

Response: Slow internet connection

Correct answer: Slow internet connection

Score: 1 out of 1 Yes

Question 10
Which of the following is considered an advantage of computer teaching
strategies?

Response: Learning Can Be More Personalized

Correct answer: Learning Can Be More Personalized

Score: 1 out of 1 Yes

Question 11
Which of the following is NOT a component of instructions?

Response: List of objectives

Correct answer: List of objectives

Score: 1 out of 1 Yes

Question 12
Defined as covert rehearsal of a skill by imaging oneself performing the skill
step by step.

Response: Mental practice

Correct answer: Mental practice

Score: 1 out of 1 Yes

Question 13
The following is part of your AUDIO-VISUAL EDUCATION. EXCEPT.

Response: Telephone

Correct answer: Telephone

Score: 1 out of 1 Yes

Question 14
It is a w or scheme to achieve an objective.

Response: Teaching Approach

Correct answer: Teaching Approach

Score: 1 out of 1 Yes

Question 15
The 2 main categories of distance learning are _____& ______.

Response: Synchronous, Asynchronous

Correct answer: Synchronous, Asynchronous

Score: 1 out of 1 Yes

Question 16
Classes in which the instructor incorporates engagement triggers and
breaks the lecture is called _______.

Response: Interactive Lectures

Correct answer: Interactive Lectures

Score: 1 out of 1 Yes

Question 17
Which of the following is NOT a type of HEALTH TEACHING APPROACHES?

Response: Inductive Approach

Correct answer: Inductive Approach

Score: 1 out of 1 Yes

Question 18
In computer teaching strategies, when we say “Students and Instructors
Can Receive Real-Time Feedback” we mean?
Response: Many computer-based learning programs adjust the approaches
based on the individual learner’s progress

Correct answer: Computer based learning reveals solutions and assesses

student performance immediately

Score: 0 out of 1 No

Question 19
Which of the following choices is NOT true when it comes to
demonstrations?

Response: Are two-dimensional objects that serve as useful tools for a

variety of teaching purposes

Correct answer: Are two-dimensional objects that serve as useful tools for a
variety of teaching purposes

Score: 1 out of 1 Yes

Question 20
One of the following choices is NOT a purpose of Clinical Teaching.

Response: To impress your crush

Correct answer: To impress your crush

Score: 1 out of 1 Yes

Question 21
A teaching method where an instructor is the central focus of information
transfer.

Response: Lecture

Correct answer: Lecture

Score: 1 out of 1 Yes

Question 22
An individualized or group teaching to the nursing student in the clinical
area by the nurse educators, staff and clinical nurse managers

Response: Group Discussion

Correct answer: Clinical Teaching

Score: 0 out of 1 No

Question 23
It is an instruction where particular attention is paid to the audio and
visual presentation of the material with the goal of improving
comprehension and retention.

Response: Multimedia Based Education

Correct answer: Multimedia Based Education

Score: 1 out of 1 Yes

Question 24
Which of the following choices is a type of your computer teaching
strategies?

Response: Gamified Learning

Correct answer: Gamified Learning

Score: 1 out of 1 Yes

Question 25
Which is a type of clinical teaching method where it is carried out by the
group by visiting the patient at bedside in order to study problems
associated with a particular disease or disorder?

Response: Nursing Rounds

Correct answer: Bedside Clinic

Score: 0 out of 1 No
Question 26
The following choices is the difference of clinical teaching from class room
teaching, which one is NOT?

Response: Autonomy vs. Shame and Doubt

Correct answer: Autonomy vs. Shame and Doubt

Score: 1 out of 1 Yes

Question 27
One Consequence of Computer teaching strategy is?

Response: Software Can Become Outdated Quickly

Correct answer: Software Can Become Outdated Quickly

Score: 1 out of 1 Yes

Question 28
The following choices is considered to be types of distance learning. EXCEPT.

Response: Scaffolding

Correct answer: Scaffolding

Score: 1 out of 1 Yes

Question 29
It is an approach to learning that involves confronting students with real-
life problems that provide a stimulus for critical thinking and self-taught
content.

Response: Problem Based Learning

Correct answer: Problem Based Learning

Score: 1 out of 1 Yes

Question 30
When the learner has practiced sufficiently to perform skill without
mistakes. The learner is exhibiting which level of psychomotor skills?

Response: Precision

Correct answer: Precision

Score: 1 out of 1
Question 1
The following are levels in the cognitive domain. Except
Response: Responding Level
Score: 1 out of 1 Yes

Question 2
An incremental approach to sequencing discrete steps of a procedure by slowing
down the pace of performance, exaggerating some of the steps, or breaking lengthy
procedures into a series of shorter steps
Response: Scaffolding
Score: 1 out of 1 Yes

Question 3
Learning in this domain includes attainment of information and addressing the
development of the student’s mental abilities and capabilities
Response: Cognitive Domain
Score: 1 out of 1 Yes

Question 4
This type of objective is used to identify intentional outcomes of the learning process
Response: Educational Objectives
Score: 1 out of 1 Yes

Question 5
Robert Meager pointed out 3 major advantages in writing clear objectives. Select
those 3 in the following choices
Response: They supply the solid foundation for the selection or design of
instructional content, procedures, and materials
Response: They provide learners with manner to organize their efforts to reach their
targets
Response: They help work-out whether an objective has, in fact, been reached
Score: 3 out of 3 Yes

Question 6
Select 5 concept for teaching across methodologies
Response: Give positive reinforcement
Response: Be organized and give direction
Response: Elicit and give feedback
Response: Use questions
Response: Know the audience
Score: 5 out of 5 Yes

Question 7
The following are major variables in making appropriate choices for instructional
materials. Except
Response: Characteristic of the teacher
Score: 1 out of 1 Yes

Question 8
Which of the following levels are governed by Attitude and feelings according to
Menix? Select all that applies
Response: Intrapersonal level
Response: Interpersonal level
Response: Extra-personal level
Score: 3 out of 3 Yes

Question 9
The following are barriers to evaluation.Except
Response: Lack of data
Score: 1 out of 1 Yes

Question 10
The following are types of simulation. Except
Response: Analog simulations
Score: 1 out of 1 Yes

Question 11
Which of the following choices are the major components of an instructional material
Response: Delivery System
Response: Content
Response: Presentation
Score: 3 out of 3 Yes
Question 12
There are 5 out of the 8 elements in a teaching plan in the following choices. Select
all that apply
Response: Purpose
Response: Statement of the overall goal
Response: List of objectives
Response: Method(s) used to evaluate learning
Response: Time allotted for the teaching of each objective
Score: 5 out of 5 Yes

Question 13
It is known to be Certain, Concrete and a One-Dimensional Behavior which is usually
achieved at the end of a session
Response: Objective
Score: 1 out of 1 Yes

Question 14
The following are your advantages when doing a “one-to-one instruction” except
Response: Deprives learners of the opportunity to identify with others and share
information, ideas, and feelings with those in like circumstances
Score: 1 out of 1 Yes

Question 15
Group Discussion is known as a method of teaching whereby learners get together to
actively exchange information. Which one of these is not considered to be under the
said teaching method?
Response: Board Meeting
Score: 1 out of 1 Yes

Question 16
A systematic and continuous process by which the significance of something is judged
Response: Evaluation
Score: 1 out of 1
Question 1
The most common psychosocial tasks of the older adult involve changes in lifestyle
and social status based on the following circumstances include the following except
Response: Establishing his/her value in the society
Correct answer: Establishing his/her value in the society
Score: 1 out of 1 Yes

Question 2
The unconscious goals of adolescents include the need to do the following except:
Response: Establish intimate relationships and respond to sexual urges
Correct answer: Establish intimate relationships and respond to sexual urges
Score: 1 out of 1 Yes

Question 3
The ability to give and receive information would fall under what phase in the
different phases of learning?
Response: Independence
Correct answer: Interdependence
Score: 0 out of 1 No

Question 4
Older adults have the tendency to have BETTER short term memory than long term
memory.
Response: True
Correct answer: False
Score: 0 out of 1 No

Question 5
The following are appropriate teaching strategies to Early Childhood except
Response: Allow the child to manipulate equipment and play with replicas or dolls
Correct answer: Keep teaching sessions short with long intervals to allow practice
Score: 0 out of 1 No

Question 6
Teaching strategies for infants to toddlerhood include the following except:
Response: Focus delivery of the teaching to the child
Correct answer: Focus delivery of the teaching to the child
Score: 1 out of 1 Yes

Question 7
Written materials and a formal type of education is encouraged in teaching and
training older adults.
Response: True
Correct answer: False
Score: 0 out of 1 No

Question 8
Which teaching strategy is appropriate for middle and late childhood?
Response: Allow school-aged children to take responsibility for their own health care
Correct answer: Allow school-aged children to take responsibility for their own health
care
Score: 1 out of 1 Yes

Question 9
The child is the primary audience for teaching and training during the infancy and
toddlerhood stage of development.
Response: True
Correct answer: False
Score: 0 out of 1 No

Question 10
Personal fable is common among older adults.
Response: False
Correct answer: False
Score: 1 out of 1 Yes

Question 11
Dialectical thinking is common among adolescents.
Response: False
Correct answer: False
Score: 1 out of 1 Yes

Question 12
The following are expected characteristic developments of infants and toddlers
except:
Response: A. Delayed gratification is fully established
Correct answer: A. Delayed gratification is fully established
Score: 1 out of 1 Yes

Question 13
Schemas are considered as the building blocks of knowledge.
Response: True
Correct answer: True
Score: 1 out of 1 Yes

Question 14
Children in education show the following characteristics except:
Response: Dependency
Correct answer: Ability to serve as a knowledgeable resource
Score: 0 out of 1 No

Question 15
Lack of experience makes the child a valuable source of information or as a
knowledgeable resource.
Response: False
Correct answer: False
Score: 1 out of 1 Yes

Question 16
The question "what's in it for me?" is an important question to be answered in
pedagogy.
Response: False
Correct answer: False
Score: 1 out of 1 Yes

Question 17
The following are contextual influences except:
Response: Normative peer graded
Correct answer: Normative peer graded
Score: 1 out of 1 Yes

Question 18
Use of analogies is an effective approach in teaching and training toddlers.
Response: False
Correct answer: False
Score: 1 out of 1 Yes

Question 19
Common behaviors of Early Childhood include the following except:
Response: Imaginary audience
Correct answer: Imaginary audience
Score: 1 out of 1 Yes

Question 20
In the context of health education, the saying "You can't teach old dogs new tricks" is
an established fact.
Response: False
Correct answer: False
Score: 1 out of 1
 Designing a Health
Education Plan for
Specific Age Groups
Kris Anthony Padios R.N.,M.N.
Gregorio Alojado R.N.,M.N.
Objectives
After completing 6 Hours of Learning, the CSAB LEVEL 1 students will be able to
 1. Identify the physical, cognitive, and psychosocial characteristics of learners
that influence learning at various stages of growth and development.

 2. Recognize the role of the nurse as educator in assessing stage-specific

learner needs according to maturational levels.

 3. Determine the role of the family in patient education.

 4. Discuss appropriate teaching strategies effective for learners at different

developmental stages.
Pedagogy and Andragogy

Pedagogy derives from the Greek for “child” and “leading” and refers to the
science and practice of teaching children.

Researcher Malcolm Knowles first introduced the term andragogy in about

1968 in reference to a model for teaching adults.
Pedagogy and Andragogy

Children in education:

 Rely on others
 Accept the information being presented at face value
 Expect what they are learning to be useful in their long-term future
 Are relatively “clean slates”
 Due to lack of experience, they have little ability to serve as a
knowledgeable resource
Pedagogy and Andragogy

On the other hand, adult learners:

 Decide for themselves

 Validate the information based on their beliefs and experience
 Expect what they are learning to be immediately useful
 May have fixed viewpoints
 Ability to serve as a knowledgeable resource.
Pedagogy and Andragogy

Need to know: Adults want to know why it’s important to learn something

 Foundation: Adults use experience in learning activities

 Self-concept: Adults want a role in deciding what to learn in their education
 Readiness: Adults want to learn things they can apply immediately
 Orientation: Adults want a problem-centered education rather than content-
oriented
 Motivation: Adults respond better to internal rather than external motivators
How is this helpful?
Contextual Influences

Traditional Thinking: Development and maturity goes with Age

Advance level thinking: Development is contextual.

It is now understood that three important contextual influences act on and

interact with the individual to produce development (Crandell et al., 2012;
Santrock, 2017)
1. Normative age-graded
Influences are strongly related to chronological age and are similar for
individuals in a specific age group, such as the biological processes of puberty
and menopause and the sociocultural processes of transitioning to different
levels of formal education or to retirement.

2. Normative history-graded
Influences are common to people in a certain age cohort or generation
because they have been uniquely exposed to similar historical circumstances,
such as the Martial Law, the age of computers, or the terrorist events of
September 11, 2001, Devastating Typhoons.

3. Normative life events

Are the unusual or unique circumstances, positive or negative, that are
turning points in individuals’ lives that cause them to change direction, such as a
house fire, serious injury in an accident, winning the lottery, divorce, or an
unexpected career opportunity.
How is this helpful?
Phases of Learning: Dependence

Dependence is characteristic of the infant and young child, who are totally
dependent on others for direction, support, and nurturance from a physical,
emotional, and intellectual standpoint.

Unfortunately, some adults are considered stuck in this stage if they

demonstrate manipulative behavior, do not listen, are insecure, or do not accept
responsibility for their own actions.
Phases of Learning: Independence

Independence occurs when a child develops the ability to physically,

intellectually, and emotionally care for himself or herself and make his or her
own choices, including taking responsibility for learning.
Phases of Learning: Interdependence

Interdependence occurs when an individual has sufficiently advanced in

maturity to achieve self-reliance, a sense of self-esteem, and THE ABILITY TO
GIVE AND RECEIVE, and when that individual demonstrates a level of respect for
others. Full physical maturity does not guarantee simultaneous emotional and
intellectual maturity.
 Taking Responsibility for One’s Health

“When is the most appropriate or best time to teach the learner?”

The answer is when the learner is ready. When the learner recognizes the
need for learning.

However, the nurse as educator does not always have to wait for teachable
moments to occur; the teacher can actively create these opportunities by
taking an interest in and attending to the needs of the learner
Building Blocks of Knowledge (Schemas)

 Learners develop Schemas of knowledge about the world. These are clusters
of connected ideas about things in the real world that allow the learner to
respond accordingly. Schemas refer to ideas that is perceived as normal.

 When the learner has developed a working Schema that can explain what they
perceive in the world, that Schema is in a state of Equilibrium.

 When the learner uses the schema to deal with a new thing or situation, that
Schema is in Assimilation.

 Accommodation happens when the existing Schema isn’t up to the job of

explaining what’s going on and needs to be changed.
Building Blocks of Knowledge (Schemas)

 Once the schemas change (NEW NORMAL), it returns to Equilibrium and life
goes on.

 Learning is, therefore, a constant cycle of Assimilation; Accommodation;

Equilibrium; Assimilation and so on
How is this helpful?
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Audience:
Parents

Behavior: (Expected of children at this age)

Exploration of self and environment, stimulate physical development.
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
 Cognitive Stage: Sensorimotor

 Psychosocial Stage: Trust vs. mistrust (0-12months),

Autonomy vs. shame and doubt (1-2 ys)
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
General characteristics

1. Dependent on the environment

2. Needs security
3. Explores self and environment
4. Natural curiosity
Who loves to play peek-a-boo with children?
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Object Permanence is developed

Causality is introduced

Delayed gratification is not yet established

Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Teaching strategies

1. Orient teaching to caregiver

2. Encourage parents to use repetition and imitation of
information
3. Stimulate all senses
4. Provide safety and emotional security
5. Allow play and manipulation of objects
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
Nursing Interventions

1. Welcome active involvement

2. Forge alliances
3. Encourage physical closeness
4. Provide detailed information
5. Answer questions and concerns
6. Ask for information on child’s strengths/limitations and
likes/dislikes
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
For Short-Term learning ■ Perform procedures on a teddy bear
or doll first to help the child anticipate
■ Read simple stories from books with
what an experience will be like.
lots of pictures.
■ Allow the child something to do—
■ Use dolls and puppets to act out
squeeze your hand, hold a Band-Aid,
feelings and behaviors.
sing a song, cry if it hurts—to channel
■ Use simple audiotapes with music andhis or her response to an unpleasant
videotapes with cartoon characters. experience.
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
For Short-Term learning

■ Keep teaching sessions brief 5 ■ Avoid analogies and explain things in

Minutes Maximum straightforward and simple terms
■ Cluster teaching sessions close ■ Individualize the pace of teaching
together according to the child’s responses and
level of attention.
Infancy (First 12 Months of Life) and
Toddlerhood (1–2 Years of Age)
For Long-Term Learning

■ Build habits by focusing on rituals, imitation, and repetition of information.

■ Use reinforcement as an opportunity for children to achieve permanence of

learning through practice.

■ Encourage parents to act as role models

Early Childhood (3–5 Years of Age)

 Cognitive Stage: Preoperational

 Psychosocial Stage: Initiative vs. guilt

Early Childhood (3–5 Years of Age)

Learn by mimicking or modeling the behaviors of playmates and adults

Fine and gross motor skills become increasingly more refined and coordinated

Supervision is required because of lack of judgement

This stage is the transitional period when the child starts to use symbols (letters
and numbers) to represent something.
Early Childhood (3–5 Years of Age)

At this age the child develops:

Capacity to recall the past or experience

Anticipate future events
Classify objects into groups and categories
Precausal Thinking
Animistic Thinking
Egocentrism
Early Childhood (3–5 Years of Age)
Interested in the “WHY”s of the world, but not the “HOW”s

Fantasy and reality are not well differentiated

Illness and hospitalization is thought to be a punishment

(egocentric causation)
Early Childhood (3–5 Years of Age)

General characteristics
 Egocentric  Focus is on one characteristic of an
object
 Thinking precausal, concrete, literal
 Separation anxiety
 Believes illness is self-cased and
punitive  Motivated by curiosity

 Limited sense of time  Active imagination, prone to fears

 Fears bodily injury  Play is his/her work

 Cannot generalize
 Animistic thinking
Early Childhood (3–5 Years of Age)

Teaching Strategies  Provide safe, secure environment

 Use warm, calm approach  Use positive reinforcement

 Build trust  Encourage questions to reveal

perceptions/feelings
 Use repetition of information
 Use simple drawings and stories
 Allow manipulation of objects and
equipment  Use play therapy, with dolls and
puppets
 Give care with explanation
 Stimulate Senses: Visual, auditory,
 Reassure not to blame self tactile, motor
 Explain procedures simply and briefly
Early Childhood (3–5 Years of Age)

Nursing Interventions
 Welcome active involvement
 Forge alliances
 Encourage physical closeness
 Provide detailed information
 Answer questions and concerns
 Ask for information on child’s
strengths/limitations and
likes/dislikes
Early Childhood (3–5 Years of Age)

For Short-Term Learning

■ Provide physical and visual stimuli because language ability is still limited
■ Keep teaching sessions short with short intervals (no more than 15 minutes)
■ Relate information needs to activities and experiences familiar to the child.
For example, ask the child to pretend to blow out candles on a birthday cake to
practice deep breathing.
■ Encourage the child to participate in selecting between a limited number of
teaching–learning options.
Early Childhood (3–5 Years of Age)

For Short-Term Learning

■ Arrange small-group sessions
■ Give praise and approval
■ Give tangible rewards
■ Allow the child to manipulate equipment and play with
replicas or dolls
Early Childhood (3–5 Years of Age)

For Long-Term Learning

■ Enlist the help of parents, who can play a vital role in modeling a variety of
healthy habits, such as practicing safety measures and eating a balanced diet;
offer them access to support and follow-up as the need arises.

■ Reinforce positive health behaviors and the acquisition of specific skills.

Middle and Late Childhood (6–11 Years of
Age)
 Cognitive Stage: Concreate operations

 Psychosocial Stage: Industry vs. inferiority

Middle and Late Childhood (6–11 Years of
Age)
Begin to have formal training in structured school systems

Open to new and varied ideas

Schemas are challenged as they experience varied

attitudes, values, and perceptions from the environment
Middle and Late Childhood (6–11 Years of
Age)
The gross- and fine-motor abilities of school aged children become
increasingly more coordinated so that they have the ability to control their
movements with much greater dexterity than ever before.

During this time, logical, rational thought processes and the ability to
reason inductively and deductively develop. Children in this stage can think
more objectively, are willing to listen to others, and selectively use questioning
to find answers to the unknown.
Middle and Late Childhood (6–11 Years of
Age)
Syllogistic reasoning begins
Ability to consider two premises and draw a logical conclusion from them.
For example, they comprehend that mammals are warm blooded, and whales are
mammals, so whales must be warm blooded.
Conservation is mastered
Ability to recognize that the properties of an object stay the same even though
its appearance and position may change
For example, they realize that a certain quantity of liquid is the same amount whether it
is poured into a tall, thin glass or into a short, wide one.
Middle and Late Childhood (6–11 Years of
Age)
 Fiction and fantasy are separate from fact and reality
 Can engage in systematic thought through inductive
reasoning
 Ability to classify objects and systems
 Express concrete ideas about relationships and people
 Carry out mathematical operations
 Causal thinking develops
Middle and Late Childhood (6–11 Years of
Age)
General characteristics
 More realistic and objective
 Understands cause and effect  Understands seriousness and
consequences of action
 Deductive/inductive reasoning
 Subject-centered focus
 Wants concrete information
 Immediate orientation
 Able to compare objects and events
 Variable rates of physical growth
 Reasons syllogistically
Middle and Late Childhood (6–11 Years of
Age)
Teaching Strategies
 Encourage independence and active
participation  Relate care to other children's

 Be honest, allay fears experience; compare procedures

 Use logical explanation  Use subject centered focus

 Allow time to ask questions  Use play therapy

 Use analogies to make invisible  Provide group activities

processes real  Use diagrams, models, pictures,
 Establish role models digital media, printed materials, and
computer, tablet, or smartphone
applications
Middle and Late Childhood (6–11 Years of
Age)
Nursing Interventions
 Welcome active involvement
 Forge alliances
 Encourage physical closeness
 Provide detailed information
 Answer questions and concerns
 Ask for information on child’s
strengths/limitations and
likes/dislikes
Middle and Late Childhood (6–11 Years of
Age)
For Short-Term Learning
■ Allow school-aged children to take responsibility for their own health care
For example, to apply their own splint or use an asthma inhaler as prescribed.

■ Teaching sessions can be extended to last up to 30 minutes

■ Lessons should be spread apart to allow for comprehension of large amounts

of content and to provide opportunity for the practice of newly acquired skills
between sessions.
Middle and Late Childhood (6–11 Years of
Age)
For Short-Term Learning
■ Choose audiovisual and printed materials that show peers undergoing
similar procedures or facing similar situations.
■ Clarify any scientific terminology and medical jargon used. “Simplify or
translate”
■ Use analogies
For example: “Having a chest x-ray is like having your picture taken” or “White blood
cells are like police cells that can attack and destroy infection.”
■ Use one-to-one teaching sessions as a method to individualize learning
relevant to the child’s own experiences
Middle and Late Childhood (6–11 Years of
Age)
For Short-Term Learning
■ Provide time for clarification, validation, and reinforcement of what is
being learned.

■ Select individual instructional techniques that provide opportunity for

privacy

■ 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)
For Short-Term Learning
■ Prepare children for procedures and interventions well in advance

■ Encourage participation in planning for procedures and events because

active involvement helps the child to assimilate information more readily.

■ Provide much-needed nurturance and support, always keeping in mind that

young children are not just small adults. Praise and rewards help motivate
and reinforce learning.
Middle and Late Childhood (6–11 Years of
Age)
For Long-Term Learning
■ Help school-aged children acquire skills that they can use to assume self-
care responsibility for carrying out therapeutic treatment regimens on an
ongoing basis with minimal assistance.

■ Assist them in learning to maintain their own well-being and prevent

illnesses from occurring.
Adolescence (12–19 Years of Age)

 Cognitive Stage: Formal operations

 Psychosocial Stage: Identity vs. role confusion

Adolescence (12–19 Years of Age)

Today’s adolescents comprise the generational cohort Generation Z, or Gen

Z. They excel with self-directed learning and thrive on the use of technology.

Adolescents vary greatly in their biological, psychological, social, and

cognitive development. From a physical maturation standpoint, they must adapt
to rapid, dramatic, and significant bodily changes, which can temporarily result
in clumsiness and poorly coordinated movement.
Adolescence (12–19 Years of Age)

Alterations in physical size, shape, and function of their bodies, along with
the appearance and development of secondary sex characteristics, bring about a
significant preoccupation with their appearance and a strong desire to express
sexual urges.
And, according to neuroscience research, adolescent brains are different
than adult brains in the way they process information, which may explain that
adolescent behaviors, such as impulsiveness, rebelliousness, lack of good
judgment, and social anxiety, stem from biological reasons more than
environmental influences. Adolescents are known to be among the nation’s most
at-risk populations.
Adolescence (12–19 Years of Age)

 Capable of abstract thought and the type of complex logical thinking

described as propositional reasoning, as opposed to syllogistic reasoning.
 Their ability to reason is both inductive and deductive
 Has the ability to hypothesize and apply the principles of logic to
situations never encountered before.
 Can conceptualize and internalize ideas
 Able to debate various points of view
 Understand cause and effect,
 Able to respond appropriately to multiple-step directions.
Adolescence (12–19 Years of Age)

Adolescent egocentrism develops

They begin to believe that everyone is focusing on the same things they are—
namely, themselves and their activities.

Imaginary audience begins

The imaginary audience explains the pervasive self-consciousness of adolescents,
who, on the one hand, may feel embarrassed because they believe everyone is
looking at them and, on the other hand, desire to be looked at and thought about
because this attention confirms their sense of being special and unique
Adolescence (12–19 Years of Age)

Able to understand the concept of health and illness, the multiple causes of
diseases, the influence of variables on health status, and the ideas associated
with health promotion and disease prevention.

Parents, healthcare providers, and the Internet are all potential sources of
health-related information for adolescents.

They also can identify health behaviors, although they may reject practicing
them or begin to engage in risk-taking behaviors because of the social pressures
they receive from peers as well as their feelings of invincibility.
Adolescence (12–19 Years of Age)

Personal fable is displayed

The personal fable leads adolescents to believe that they are invulnerable—other
people grow old and die, but not them; other people may not realize their
personal ambitions, but they will.
Adolescence (12–19 Years of Age)
The unconscious goals of adolescents include the need to:
 Establish their own identity
 Match their skills with career choices
 Determine self
 Seek independence and autonomy
 Develop distinct individual personalities
 Belong to a group
 Rebel against any actions or recommendations by adults whom they consider
authoritarian
Adolescence (12–19 Years of Age)

Adolescents demand personal space, control, privacy, and confidentiality. To

them, illness, injury, disability, and hospitalization mean dependency, loss of
identity, a change in body image and functioning, bodily embarrassment,
confinement, separation from peers, and possible death.
Adolescence (12–19 Years of Age)

General characteristics
 Abstract, hypothetical thinking  Emphasis on importance of
appearance (imaginary audience)
 Can build on past learning
 Feels invulnerable,
 Reasons by logic and understands invincible/immune to natural laws
scientific principles (personal fable)
 Future orientation
 Motivated by desire for social
acceptance
 Peer group important
 Intense personal preoccupation
Adolescence (12–19 Years of Age)

Teaching Strategies
 Establish trust, authenticity  Focus on details

 Know the agenda  Make information meaningful to life

 Address fears/concerns about  Ensure confidentiality and privacy

outcomes of illness  Arrange peer group sessions in person
 Identify control focus or virtually

 Include in plan of care  Use audiovisuals, role play, contacts,

reading materials
 Use peers for support and influence
 Provide for experimentation and
 Negotiate changes flexibility
Adolescence (12–19 Years of Age)

Nursing Interventions
 Explore emotional and financial  Engage in 1:1 teaching without
support parents present, but with
adolescent’s permission, inform
 Determine goals and expectations family of content covered
 Assess stress levels
 Respect values and norms
 Determine role responsibilities and
relationships
Adolescence (12–19 Years of Age)

For Short-Term Learning

■ Use one-to-one instruction to ensure confidentiality of sensitive information.

■ Choose peer-group discussion sessions as an effective approach to deal with

health topics such as smoking, alcohol and drug use, safety measures, obesity,
and teenage sexuality.

■ Use face-to-face or computer group discussion, role playing, and gaming as

methods to clarify values and solve problems.
Adolescence (12–19 Years of Age)

For Short-Term Learning

■ Employ adjunct instructional tools, such as complex models, diagrams, and
specific, detailed written materials.
■ Clarify any scientific terminology and medical jargon used. “Simplify or
translate”
■ Share decision making whenever possible, because control is an important issue
for adolescents.
■ Include adolescents in formulating teaching plans related to teaching
strategies, expected outcomes, and determining what needs to be learned and
how it can best be achieved to meet their needs for autonomy.
Adolescence (12–19 Years of Age)

For Short-Term Learning

■ Suggest options so that they feel they have a choice about courses of action.
■ 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.
■ Avoid confrontation and acting like an authority figure.
Adolescence (12–19 Years of Age)

For Long-Term Learning

■ Accept adolescents’ personal fable and imaginary audience as valid, rather
than challenging their feelings of uniqueness and invincibility.

■ Acknowledge that their feelings are very real

■ Allow them the opportunity to test their own convictions.

Andragogy Review

Adult learners:

 Decide for themselves what is important to learn

 Need to validate the information based on their beliefs and experience
 Expect what they are learning to be immediately useful
 Have much experience upon which to draw – may have fixed viewpoints
 Significant ability to serve as a knowledgeable resource to the trainer and
fellow learners
Young Adulthood (20–40 Years of Age)

 Cognitive Stage: Formal operations

 Psychosocial Stage: Intimacy vs. Isolation

Young Adulthood (20–40 Years of Age)

Unconscious goals for young adults:

 Establishing long-term & intimate relationships with other
people
 Choosing a lifestyle and adjusting to it
 Deciding on an occupation
 Managing a home and family
Young Adulthood (20–40 Years of Age)

During this period, physical abilities for most young adults

are at their peak, and the body is at its optimal functioning
capacity. The cognitive capacity of young adults is fully
developed, but with maturation, they continue to
accumulate new knowledge and skills from an expanding
reservoir of formal and informal experiences.
Young Adulthood (20–40 Years of Age)

Coming from experience, young adults have an improved ability to:

 Generalize to new situations
 Improve their abilities to critically analyze, solve problems
 Make decisions about their personal, occupational, and social roles.

Their interests for learning are oriented toward those experiences that are
relevant for immediate application to problems and tasks in their daily lives.
Young adults are motivated to learn about the possible implications of various
lifestyle choices.
Young Adulthood (20–40 Years of Age)

General characteristics
 Autonomous
 Self – directed  Makes decisions about personal,
occupational and social roles
 Uses personal experience to enhance
or interfere with learning  Competency – based learner

 Intrinsic motivation
 Able to analyze critically
Young Adulthood (20–40 Years of Age)

Teaching Strategies
 Use problem-centered focus
 Draw on meaningful experience  Apply new knowledge through role
playing and hands-on practice
 Focus on immediacy of application
 Encourage active participation
 Allow to set own pace, be self-
directed
 Organize material
 Recognize social role
Young Adulthood (20–40 Years of Age)

Nursing Interventions
 Explore emotional, financial and
physical support system
 Assess motivational level for
involvement
 Identify potential obstacles and
stressors
Young Adulthood (20–40 Years of Age)

Salient points in Health Education with young adults.

 Health promotion is the most neglected aspect of healthcare teaching at
this stage of life.

 The major factors that need to be addressed in this age group are healthy
eating habits, regular exercise, and avoiding drug abuse. Such behaviors
will reduce the incidence of high blood pressure, elevated cholesterol,
obesity, smoking, and overuse of alcohol and drugs
Young Adulthood (20–40 Years of Age)

Salient points in Health Education with young adults.

 The motivation for adults to learn comes in response to internal drives, such
as need for self-esteem, a better quality of life, or job satisfaction, and in
response to external motivators, such as job promotion, more money, or more
time to pursue outside activities.
 Any illness or disabilities prevent them to achieve the internal drives.
 Content of instruction must be seen as relevant to the current or anticipated
problems.
Young Adulthood (20–40 Years of Age)

Salient points in Health Education with young adults.

 Teaching strategies must be directed at encouraging young adults to seek
information

 Relevant, applicable, and practical information is what adults desire and

value—they want to know “what’s in it for me,”

 Group discussion is an attractive method for teaching and learning because it

provides young adults with the opportunity to interact with others of similar
age and in similar situations, such as in parenting groups, prenatal classes,
exercise classes, or marital adjustment sessions.
Middle-Aged Adulthood (41–64 Years of
Age)
 Cognitive Stage: Formal operations

 Psychosocial Stage: Generativity vs. self absorption and stagnation

Middle-Aged Adulthood (41–64 Years of
Age)
During middle age, many individuals are highly accomplished in their
careers, their sense of who they are is well developed, their children are grown,
and they have time to share their talents, serve as mentors for others and pursue
new or latent interests.

Physiological changes begin to take place. These physical changes and others
affect middle-aged adults’ selfimage, ability to learn, and motivation for
learning about health promotion, disease prevention, and maintenance of health.
Middle-Aged Adulthood (41–64 Years of
Age)
DIALECTICAL thinking is expanded
It is a type of thinking is defined as the ability to search for complex and
changing understandings to find a variety of solutions to any given situation or
problem.

In other words, middle-aged adults have the ability to “see the bigger picture”.
Middle-Aged Adulthood (41–64 Years of
Age)
Due to their experience and physiological changes, Middle-aged adults, may
choose to:
Modify aspects of their lives that they perceive as unsatisfactory
- Or -
Adopt a new lifestyle as a solution to dissatisfaction.
Middle-Aged Adulthood (41–64 Years of
Age)
General characteristics
 Sense of self is well developed
 Concerned with physical changes  Confidence in abilities

 At peak in career  Desires to modify unsatisfactory

aspects of life
 Explores alternative lifestyles
 Reflects on contributions to family
and society
 Reexamines goals and values
 Questions achievements and
successes
Middle-Aged Adulthood (41–64 Years of
Age)
Teaching Strategies
 Focus on maintaining independence
and reestablishing normal life
patterns
 Assess positive and negative paste
experience with learning
 Assess potential sources of stress
caused by midlife crisis issues
 Provide information to coincide with
life concerns and problems
Middle-Aged Adulthood (41–64 Years of
Age)
Nursing Interventions
 Explore emotional, financial and
physical support system
 Assess motivational level for
involvement
 Identify potential obstacles and
stressors
Middle-Aged Adulthood (41–64 Years of
Age)
Salient points in Health Education with middle-aged adults.
 When teaching members of this age group, the nurse must be aware of their
potential sources of stress, the health risk factors associated with this stage
of life, and the concerns typical of midlife. Misconceptions regarding physical
changes such as menopause for women are common.
Middle-Aged Adulthood (41–64 Years of
Age)
Salient points in Health Education with middle-aged adults.
 Many need and want information related to chronic illnesses that can arise at
this phase of life.
 Adult learners need to be reassured or complimented on their learning
competencies.
 Teaching strategies for learning are similar in type to teaching methods and
instrumental tools used for the young adult learner, but the content is
different to coincide with the concerns and problems specific to this group
of learners.
Older Adulthood (65 Years of Age and
Older)
 Cognitive Stage: Formal operations

 Psychosocial Stage: Ego integrity vs Despair

Older Adulthood (65 Years of Age and
Older)
Most older people have at least one chronic condition, and many, especially
in the later years, have multiple conditions.

On average, they are hospitalized longer than persons in other age

categories and require more teaching overall to broaden their knowledge of
self-care.
Lower educational levels in some ethnic groups, sensory impairments, the
disuse of literacy skills once learned, and cognitive changes in the population of
older adults may contribute to their decreased ability to read and comprehend
WRITTEN materials.
Older Adulthood (65 Years of Age and
Older)
Nurses and nurse educators must recognize that a
significant number of older persons respond to these changes
by viewing them as challenges rather than defeats.

Given the considerable healthcare expenditures for older

people, patient education needs are generally greater and
education programs to improve their health status and
reduce morbidity would be a cost-effective measure.
Older Adulthood (65 Years of Age and
Older)
Ageism describes prejudice against the older adult. This discrimination
based on age, which exists in most segments of the society, perpetuates the
negative stereotype of aging as a period of decline.
This bias interferes with interactions between the older adult and
younger age groups and must be counteracted because it “prevents older
people from living lives as actively and happily as they might”
Education to INFORM PEOPLE of the significant variations that occur in the
way that individuals age and education to help the older adult learn to cope with
irreversible losses can combat the prejudice of ageism
Geragogy

The teaching of older persons, known as geragogy, is

different from teaching younger adults (andragogy) and
children (pedagogy). For teaching to be effective, geragogy
must accommodate the normal physical, cognitive, and
psychosocial changes that occur during this phase of growth
and development.
Older Adulthood (65 Years of Age and
Older)
With advancing age, so many physical changes occur that it becomes
difficult to establish normal boundaries.

As a person grows older, natural physiological changes in all systems

of the body are universal, progressive, and intrinsic.

Alterations in physiological functioning can lead secondarily to

changes in learning ability. The senses of sight, hearing, touch, taste,
and smell are usually the first areas of decreased functioning noticed by
adults.
Older Adulthood (65 Years of Age and
Older)
Cognitive ability changes with age as permanent cellular alterations
invariably occur in the brain itself, resulting in an actual loss of neurons, which
have no regenerative powers.

Physiological research has demonstrated that people have two kinds of

intellectual ability— crystallized and fluid intelligence.
Older Adulthood (65 Years of Age and
Older)
Crystallized intelligence is the intelligence absorbed over a lifetime, such
as vocabulary, general information, understanding social interactions, arithmetic
reasoning, and ability to evaluate experiences. This kind of intelligence increases
with experience as people age.
However, it is important to understand that crystallized intelligence can be
impaired by disease states, such as the dementia seen in Alzheimer’s disease.
Fluid intelligence is the capacity to perceive relationships, to reason, and to
perform abstract thinking. This kind of intelligence declines as degenerative
changes occur.
Older Adulthood (65 Years of Age and
Older)
The decrease in fluid intelligence results in the following specific changes:
1. Slower processing and reaction time. Older persons need more time to
process and react to information.
2. Persistence of stimulus (afterimage). Older adults can confuse a previous
symbol or word with a new word or symbol just introduced.
3. Decreased short-term memory.
4. long-term memory often remains strong, such as the ability to clearly and
accurately remember something from their youth.
Older Adulthood (65 Years of Age and
Older)
4. Increased test anxiety.

5. Altered time perception. For older persons, life becomes more finite and
compressed. Issues of the here and now tend to be more important, and
some adhere to the philosophy, “I’ll worry about that tomorrow.” This way
of thinking can be detrimental when applied to health issues because it
serves as a vehicle for denial or delay in taking appropriate action.
Older Adulthood (65 Years of Age and
Older)
The most common psychosocial tasks of aging involve changes in lifestyle and
social status based on the following circumstances.

■ Retirement
■ Illness or death of spouse, relatives, and friends
■ The moving away of children, grandchildren, and friends
■ Relocation to an unfamiliar environment such as an extended-care facility or
senior residential living center
Older Adulthood (65 Years of Age and
Older)
The following traits regarding personal goals in life and the values associated
with them are significantly related to motivation and learning:

Independence. The ability to provide for their own needs is the most important
aim of older persons.
Health teaching is the tool to help them maintain or regain independence.

Social acceptability. Winning approval from others is a common goal of many

older adults.
Older Adulthood (65 Years of Age and
Older)
The following traits regarding personal goals in life and the values associated
with them are significantly related to motivation and learning:
Adequacy of personal resources.
Life patterns, should be assessed to determine how to incorporate teaching to
complement existing regimens and resources (financial and support system)
with new required behaviors.

Coping mechanisms. The ability to cope with change during the aging process is
indicative of the person’s readiness for health teaching.
The emphasis in teaching is on exploring alternatives, determining realistic goals,
and supporting large and small accomplishments.
Older Adulthood (65 Years of Age and
Older)
The following traits regarding personal goals in life and the values associated
with them are significantly related to motivation and learning:
Meaning of life. For well-adapted older persons, having realistic goals allows
them the opportunity to enjoy the smaller pleasures in life, whereas less well-
adapted individuals may be frustrated and dissatisfied with personal
inadequacies.
Health teaching must be directed at ways older adults can maintain optimal
health so that they can derive pleasure from their leisure years.
Older Adulthood (65 Years of Age and
Older)
General characteristics
 Sensory/motor deficits
 Cognitive changes
 Auditory changes
 Decreased ability to think abstractly
or process information  Hearing loss, especially high-pitched
tones, consonants and rapid speech
 Decreased short term memory
 Visual changes
 Increased reaction time
 Farsightedness
 Increased test anxiety
 Decreased visual adaptation to
 Stimulus persistence (afterimage)
darkness
 Focuses on past life experience
 Decreased peripheral perception
 Distorted depth perception
 Fatigue / decreased energy levels
Older Adulthood (65 Years of Age and
Older)
General characteristics
 Psychosocial changes
 Decreased risk taking
 Selective learning
 Intimidated by formal learning
Older Adulthood (65 Years of Age and
Older)
Teaching Strategies
 Use concrete examples
 Build on past life experience  Use verbal exchange and coaching

 Make information relevant and  Establish retrieval plan

meaningful  Encourage active involvement
 Present one concept at a time  Keep explanations brief
 Allow time for processing/response  Use analogies to illustrate abstract
 Use repetition and reinforcement of information
information
 Avoid written exams
Older Adulthood (65 Years of Age and
Older)
Teaching Strategies  Use large letters and well spaced
prints
 Speak slowly, distinctly
 Avoid color coding with pastel blue,
 Use low-pitched tones green, purple and yellow
 Avoid shouting  Increase safety precautions/provide
 Use visual aids to supplement verbal a safe environment
instruction  Ensure accessibility and fit of
 Avoid glares, use soft white light prostheses

 Provide sufficient light  Keep sessions short

 Use white backgrounds and black  Provide frequent rest periods

print  Allow extra time to perform
 Establish realistic short term goals
Older Adulthood (65 Years of Age and
Older)
Teaching Strategies
 Give time to reminisce  Integrate new behavior with formerly
established ones
 Identify and present pertinent
material
 Use informal teaching sessions
 Demonstrate relevance of
information to daily life
 Assess resources
 Make learning positive
 Identify positive experience
Older Adulthood (65 Years of Age and
Older)
Nursing Interventions
 Involve principal caregivers
 Encourage participation
 Provide resources for support
 Assess coping mechanisms
 Provide written instructions for
reinforcement
 Provide anticipatory problem solving
(ask “what happens if? or what do
you do if?”)
Older Adulthood (65 Years of Age and
Older)
Salient points in Health Education with older adults.
 Understanding older persons’ developmental tasks allows nurses in terms of
counseling, teaching, and establishing a therapeutic relationship.
 Chronic illnesses, depression, and literacy levels, particularly among the
oldest-old, have implications with respect to how
 A. They care for themselves (eating, dressing, and taking medications)
 B. The extent to which they understand the nature of their illnesses.
 In working with older adults, reminiscing is a beneficial approach to use to
establish a therapeutic relationship.
Older Adulthood (65 Years of Age and
Older)
Salient points in Health Education with older adults.
 “You can’t teach an old dog new tricks.” - It is easy to fall into the habit of
believing the myths associated with the intelligence, personality traits,
motivation, and social relations of older adults. The following prevalent
myths that must be dispelled to prevent harmful outcomes in the older adult.
 The role of the family is considered one of the key variables influencing
positive patient care outcomes. The primary motives in patient education
for involving family members in the care delivery and decision-making process
are to decrease the stress of hospitalization, reduce costs of care, increase
satisfaction with care, reduce hospital readmissions, and effectively prepare
the patient for self-care management outside the healthcare setting.
Older Adulthood (65 Years of Age and
Older)
Salient points in Health Education with older adults.
Summary

For nurses, it is important to understand the specific and varied tasks

associated with each developmental stage to individualize the approach to
education in meeting the needs and desires of clients and their families.
Assessment of physical, cognitive, and psychosocial maturation within each
developmental period is crucial in determining the appropriate strategies to
facilitate the teaching–learning process.
Summary

The younger learner is, in many ways, very different from the adult learner.
Issues of dependency, extent of participation, rate of and capacity for
learning, and situational and emotional obstacles to learning vary significantly
across the various phases of development. Readiness to learn in children is very
subject centered and highly influenced by their physical, cognitive, and
psychosocial maturation.
Summary

By comparison, motivation to learn in adults is very problem centered and

more oriented to psychosocial tasks related to roles and expectations of work,
family, and community activities. For client education to be effective, the nurse
in the role of educator must create an environment conducive to learning by
presenting information at the learner’s level, inviting participation and
feedback, and identifying whether parental, family, and/or peer involvement is
appropriate or necessary. Nurses are the main source of health information. In
concert with the client, they must facilitate the teaching–learning process by
determining what needs to be taught, when to teach, how to teach, and who
should be the focus of teaching based on the developmental stage of the
learner.
Thank you!
 NCM 102 – HEALTH EDUCATION
IMPLEMENTING A HEALTH EDUCATION PLAN (WEEK 11 & 12)

I. TEACHING STRATEGIES AND METHODOLOGIES

Teaching Approach - General plan or scheme to achieve an objective

COMPONENTS OF INSTRUCTIONS
1. Major goal of teaching
2. Nature of the subject matter
3. Teaching-learning process
4. Roles and responsibilities
5. Expectations from students
6. Kind of evaluation techniques
7. Suitable teaching methods and strategies to be employed

TYPES OF APPROACH
1. Inductive Approach - begins from particular statements to general statements, such that one may
arrive at a fact, principle or generalization.
It is called “discovery approach”

2. Deductive Approach - from general to particular statements.

TYPES OF HEALTH TEACHING APPROACHES

1. Telling approach - is useful when limited information must be taught. Ex. Preparing a client for an
emergent diagnostic procedure.

2. Selling Approach - uses two-way communication.

3. Participating Approach - involves the nurse and client setting objectives and becoming involved in the
learning process together.

4. Entrusting Approach - provides the client the opportunity to manage self-care.

5. Reinforcing Approach - the principle of reinforcement applies to the process of learning. Teacher must
be the source of reinforcement.

II. ACTIVITY BASED STRATEGIES

ACTIVITY-BASED TEACHING – implies active learning on the part of the learner.
Learners engaged in these strategies are involved in creating and storing up knowledge for themselves.

Lecture is a teaching method where an instructor is the central focus of information transfer. Typically,
an instructor will stand before a class and present information for the students to learn. Sometimes,
they will write on a board or use an overhead projector to provide visuals for students. Students are
expected to take notes while listening to the lecture. Usually, very little exchange occurs between the
instructor and the students during a lecture.
DISCUSSION
One of the most challenging teaching methods, leading discussions can also be one of the most rewarding.
Using discussions as a primary teaching method allows you to stimulate critical thinking. As you establish
a rapport with your students, you can demonstrate that you appreciate their contributions at the same
time that you challenge them to think more deeply and to articulate their ideas more clearly. Frequent
questions, whether asked by you or by the students, provide a means of measuring learning and exploring
in-depth the key concepts of the course.

QUESTIONING

Teachers ask questions for a variety of purposes, including:

✓ To actively involve students in the lesson ✓ To develop critical thinking skills
✓ To increase motivation or interest ✓ To review previous lessons
✓ To evaluate students’ preparation ✓ To nurture insight
✓ To check on completion of work
✓ To assess achievement or mastery of goals and objectives
✓ To stimulate independent learning
✓ A teacher may vary his or her purpose in asking questions during a single lesson, or a single question
may have more than one purpose.

Bloom’s Taxonomy includes six categories:

➢ Knowledge – recall data or information

➢ Comprehension – understand meaning
➢ Application – use a concept in a new situation
➢ Analysis – separate concepts into parts; distinguish between facts and inferences
➢ Synthesis – combine parts to form new meaning
➢ Evaluation – make judgments about the value of ideas or products

USING AUDIOVISUALS

Audiovisual education or multimedia-based education (MBE) is instruction where particular attention is

paid to the audio and visual presentation of the material with the goal of improving comprehension and
retention.
➢ Dioramas ➢ Tape recorders
➢ Magic lanterns ➢ Television
➢ Planetarium ➢ Video
➢ Film projectors ➢ Camcorders
➢ Slide projectors ➢ Video projectors
➢ Opaque projectors (episcopes and ➢ Interactive whiteboards
epidiascopes) ➢ Digital video clips
➢ Overhead projectors
INTERACTIVE LECTURE

Interactive lectures are classes in which the instructor incorporates engagement triggers and breaks the
lecture at least once per class to have students participate in an activity that lets them work directly
with the material.

PROBLEM-BASED LEARNING (PBL)

Problem based learning is an approach to learning that involves confronting students with real-life
problems that provide a stimulus for critical thinking and self-taught content

The chief differences between PBL and the case method:

1. PBL is conducted with small groups, while case studies may be used by individuals or groups.
2. Students using PBL have little background knowledge of the subject matter whereas in the case
method, students already have most of the background knowledge they need to apply to the
case.
3. In PBL, the cases are usually brief and the presenting problems are ill structured, while in the
case method, cases are more often long and detailed and their problems are fairly well-defined.

❖ PBL began over 35 years ago at McMaster University School of Medicine in Canada and has
spread to medical schools in United States and all over the world.
 NCM 102
Health Education
Midterm Lecture

Developing a Health Education Plan

I. Elements
A-B-C-D
➢ A – Audience (Who)
➢ B – Behavior (What)
➢ C – Condition (Under which Circumstances)
➢ D – Degree (How Well, to what extent, within what time frame)

II. Objectives

i. Definition
A specific, single, unidimensional behavior that is short term in nature, which should be achievable
after one teaching session/within a matter of few days following a series of teaching sessions.

ii. Types
➢ Educational – used to identify the intended outcomes of the educational process, whether
referring to an aspect of a program/ total program of the study that guide the design of curriculum
units.
➢ Instructional – describe the teaching activities, specific content areas and resources used to
facilitate effective instruction.
➢ Behavioral – action oriented rather than content oriented, learner centered rather than teacher
centered, short-term outcome focused rather than process focused.
iii. Factors that Differentiate Goals from Objectives
➢ Relationship to Time
➢ Level of Specificity

Goal - the final outcome to be achieved at the end of teaching and learning process
Objectives - are short-term and should be achieved at the end of one teaching session/shortly
after several teaching sessions. Specific, single, concrete and a one-dimensional behavior.

Advantages of a Well Written and Carefully Constructed Objective

✓ Helps keep the educator’s thinking on target & learner centered

✓ Communicates to learners and healthcare team members what is planned for teaching and learning
✓ Helps learners understand what is expected of them
✓ Forces the educator to select and organize educational materials so they do not get lost in the content
and forget the learner’s role in the process
✓ Encourages educators to evaluate their own motives of teaching
✓ Tailors teaching to learner’s unique needs
 ✓ Creates guidepost for teacher evaluation and documentation of success/failure
✓ Orients teacher & learner to the end results of the educational process
✓ Makes it easier for the learner to visualize performing the required skills

Additional Advantages (Robert Mager, 1997)

✓ Provides the solid Foundation for the selection of instructional content, methods and materials
✓ Provide learners with ways to organize their efforts to reach their goals
✓ Help determine whether an objective has been met

iv. Important Characteristics in Writing Concise and Useful Behavioral Objectives

➢ Performance - Describes what the learner is expected to be able to do to demonstrate the kinds
of behaviors the teacher will accept as evidence that objectives have been achieved. Activities
performed by the learner may be observable and quite visible, such as being able to write or list
something, whereas other activities may not be as visible, such as being able to identify or recall
something
➢ Condition: Describes the situations under which the behavior will be observed or the
performance will be expected to occur.
➢ Criterion: Describes how well, with what accuracy, or within what time frame the learner must
be able to perform the behavior so as to be considered competent

v. Common Mistakes When Writing Objectives

o Describing what the teacher does rather than what the learner is expected to do
o Including more than one expected behavior in a single objective
o Forgetting to identify all four components of condition, performance, criterion, and who the
learner is
o Using terms for performance that are open to many interpretations, are not action oriented,
and are difficult to measure
o Writing objectives that are unattainable and unrealistic given the ability level of the learner
o Writing objectives that do not relate to the stated goal
o Cluttering objectives by including unnecessary information
o Being too general so as not to specify clearly the expected behavior to be achieved

vi. SMART rule in Writing Objectives

S – Specific - Be specific about what is to be achieved (i.e., use strong action verbs, be concrete).
M – Measurable - Quantify or qualify objectives by including numeric, cost, or percentage amounts
or the degree/level of mastery expected.
A – Achievable - Write attainable objectives
R – Realistic - Resources (i.e., personnel, facilities, equipment) must be available and accessible to
achieve objectives
T – Timely - Resources (i.e., personnel, facilities, equipment) must be available and accessible to
achieve objectives
vii. Taxonomy of Objectives According to Learning Domains
Cognitive Domain - known as the “thinking” domain. Learning in this domain involves acquiring
information and addressing the development of the learner’s intellectual abilities, mental capacities,
understanding, and thinking processes (Eggen & Kauchak, 2012)

Levels of Behavioral Objectives in the Cognitive Domain

➢ Knowledge level - Ability of the learner to memorize, recall, define, recognize, or identify
specific information, such as facts, rules, principles, conditions, and terms, presented during
instruction
➢ Comprehension level - Ability of the learner to demonstrate an understanding of what is
being communicated by recognizing it in a translated form, such as grasping an idea by
defining it or summarizing it in his or her own words (knowledge is a prerequisite behavior)
➢ Application level - Ability of the learner to use ideas, principles, abstractions, or theories in
specific situations, such as figuring, writing, reading, or handling equipment (knowledge and
comprehension are prerequisite behaviors)
➢ Analysis level - Ability of the learner to recognize and structure information by breaking it
down into its separate parts and specifying the relationship between the parts (knowledge,
comprehension, and application are prerequisite behaviors)
➢ Synthesis level - Ability of the learner to put together parts into a unified whole by creating
a unique product that is written, oral, or in picture form (knowledge, comprehension,
application, and analysis are prerequisite behaviors)
➢ Evaluation level - Ability of the learner to judge the value of something by applying
appropriate criteria (knowledge, comprehension, application, analysis, and synthesis are
prerequisite behaviors)

Affective Domain - known as the “feeling” domain. Learning in this domain involves an
increasing internalization or commitment to feelings expressed as emotions, interests, beliefs,
attitudes, values, and appreciations.

Levels of Behavioral Objectives in the Affective Domain

➢ Receiving level - Ability of the learner to show awareness of an idea or fact or a
consciousness of a situation or event in the environment. This level represents a willingness
to selectively attend to or focus on data or to receive a stimulus
➢ Responding level - Ability of the learner to respond to an experience, at first obediently and
later willingly and with satisfaction. This level indicates a movement beyond denial and
toward voluntary acceptance, which can lead to feelings of pleasure or enjoyment resulting
from some new experience (receiving is a prerequisite behavior).
➢ Valuing level - Ability of the learner to regard or accept the worth of a theory, idea, or
event, demonstrating sufficient commitment or preference to an experience that is
perceived as having value. At this level, there is a definite willingness and desire to act to
further that value (receiving and responding are prerequisite behaviors)
➢ Organization level - Ability of the learner to organize, classify, and prioritize values by
integrating a new value into a general set of values; to determine interrelationships of
 values; and to establish some values as dominant and pervasive (receiving, responding, and
valuing are prerequisite behaviors)
➢ Characterization level - Ability of the learner to display adherence to a total philosophy or
worldview, showing firm commitment to the values by generalizing certain experiences into
value system (receiving, responding, valuing, and organization are prerequisite behaviors)

3 Levels that govern attitudes and feelings (Menix, 1996)

❖ Intrapersonal level - personal perceptions of one’s own self
❖ Interpersonal level - perspective of self in relation to other individuals
❖ Extrapersonal level involves the perception of others as established groups

Psychomotor Domain - known as the “skills” domain. Learning involves acquiring fine and gross
motor abilities such as walking, handwriting, manipulating equipment, or performing a procedure
Levels of Behavioral Objectives in the Psychomotor Domain
Perception level - Ability of the learner to show sensory awareness of objects or cues associated
with some task to be performed
Set level - Ability of the learner to exhibit readiness to take a certain kind of action as evidenced
by expressions of willingness, sensory attending, or body language favorable to performing a
motor act (perception is a prerequisite behavior)
Guided response level - Ability of the learner to exert effort via overt actions under the
guidance of an instructor to imitate an observed behavior with conscious awareness of effort
Mechanism level - Ability of the learner to repeatedly perform steps of a desired skill with a
certain degree of confidence
Complex overt response level - Ability of the learner to automatically perform a complex motor
act with independence and a high degree of skill, without hesitation
Adaptation level - Ability of the learner to modify or adapt a motor process to suit the individual
or various situations, indicating mastery of highly developed movements
Origination level - Ability of the learner to create new motor acts, such as novel ways of
manipulating objects or materials, as a result of an understanding of a skill and a developed
ability to perform skills

Teaching of Psychomotor Skills

Different teaching methods, such as demonstration, return demonstration, simulation, and self-
instruction, are useful for the development of motor skill

Factors Affecting Acquiring New Skills

Readiness to learn – motivation to learn affects the degree of effort exhibited by the learner in
working toward mastery of a skill
Past experience - If the learner is familiar with equipment or techniques similar to those needed
to learn a new skill, then mastery of the new skill may be achieved at a faster rate.
Health status - An illness state or other physical or emotional impairments in the learner may
affect the time it takes to acquire or successfully master a skill
 Environmental stimuli - Depending on the type and level of stimuli as well as the learning style
(degree of tolerance for certain stimuli), distractions in the immediate surroundings may
interfere with the ability to acquire a skill
Anxiety level - ability to concentrate can be dramatically affected by how anxious someone feels
Developmental stage- Physical, cognitive, and psychosocial stages of development all influence
an individual’s ability to master a movement-oriented task
Practice session length- During the beginning stages of learning a motor skill, short and carefully
planned practice sessions and frequent rest periods are valuable techniques to help increase the
rate and success of learning

viii. Development of Teaching Plans

Teaching plan is a blueprint to achieve the goal and the objectives that have been developed

Reasons for creating a Teaching Plan

1. To direct the teacher to look at the relationship between each of the steps of the teaching
process to make sure that there is a logical approach to teaching.
2. To communicate in writing exactly what is being taught, how it is being taught and
evaluated, and the time allotted to meet each of the behavioral objective
3. To legally document that an individual plan for each learner is in place and is being properly
implemented

Elements of Teaching Plans

1. Purpose (the why of the educational session)
2. Statement of the overall goal
3. List of objectives
4. An outline of the content to be covered in the teaching session
5. Instructional method(s) used for teaching the related content
6. Time allotted for the teaching of each objective
7. Instructional resources (materials/ tools and equipment) needed
8. Method(s) used to evaluate learning

Learning Contracts

Defined as a written (formal) or verbal (informal) agreement between the teacher and the
learner that specifies teaching and learning activities that are to occur within a certain time
frame

Components

1. Content - Specifies the precise behavioral objectives to be achieved. Objectives must clearly
state the desired outcomes of learning activities. Negotiation between the educator and the
learner determines the content, level, and sequencing of objectives according to learner needs,
abilities, and readiness
 2. Performance expectations: Specify the conditions under which learning activities will be
facilitated, such as instructional strategies and resources
3. Evaluation: Specifies the criteria used to evaluate achievement of objectives, such as skills
checklists, care standards or protocols, and agency policies and procedures of care that identify
the levels of competency expected of the learner
4. Time frame: Specifies the length of time needed for successful completion of the objectives. The
target date should reflect a reasonable period in which to achieve expected outcomes
depending on the learner’s abilities and circumstances. The completion date is the actual time it
took the learner to achieve each objective

PURPOSE:
GOAL :
Time
Objectives and Content Method of Method of
Allotted (in Resources
Sub-objectives Outline Instruction Evaluation
min.)
Learning curve is a common phrase used to describe how long it takes a learner to learn anything new

Six Stages of Learning Curve

1. Negligible progress - Initially very little improvement is detected during this stage. This pre-
readiness period is when the learner is not ready to perform the entire task, but relevant
learning is taking place
2. Increasing gains - Rapid gains in learning occur during this stage as the learner grasps the
essentials of the task
3. Decreasing gains: During this stage the rate of improvement slows and additional practice does
not produce such steep gains
4. Plateau: During this stage no substantial gains are made. This leveling-off period is characterized
by a minimal rate of progress in performance
5. Renewed gains: These gains usually are from growth in physical development, renewed interest
in the task, a response to challenge, or the drive for perfection
6. Approach to limit: During this stage progress becomes negligible. The ability to perform a task
has reached its potential, and no matter how much more the learner practices a skill, he or she
is not able to improve

III. Strategies and Methodologies

Teaching Method -the way information is taught that brings the learner into contact with what
is to be learned.

Factors Affecting Teaching Method to be used

✓ Audience characteristics (size, diversity, learning style preferences)
✓ Educator’s expertise as a teacher
✓ Objectives of learning
✓ Potential for achieving learning outcomes
✓ Cost-effectiveness
✓ Setting for teaching
✓ Evolving technology

1. LECTURE –defined as a highly structured method by which educator verbally transmits information
directly to a group of learners for the purpose of instructions

5 approaches to the effective transfer of knowledge during a lecture

1. Use opening & summary statements
2. Present key terms
3. Offer examples
4. Use analogies
5. Use visual backups

3 Main parts
1. Introduction – educator present learners with an overview of the behavioral objectives related
 to the lecture topic
2. Body –actual delivery of the content related to the topic being addressed
3. Conclusion –wrap-up of the lecture

Advantage
✓ Efficient, cost effective means for transmitting large amounts of information to a large
audience at the same time
✓ Useful to describe patterns, highlight main ideas and summarize data
✓ An effective approach for cognitive learning
✓ Easily supplemented with printed handouts and other audiovisual materials to enhance
learning

Limitations
❖ Largely ineffective in influencing affective and psychomotor behaviors.
❖ Does not provide much stimulation/participatory movements of learners.
❖ Very instructor centered
❖ All learners are exposed to the same information regardless of their cognitive abilities, learning
needs or stages of coping.
❖ The diversity within groups makes it challenging for the teacher to reach all learners equally

2. GROUP DICSUSSION – a method of teaching whereby learners get together to actively exchange
information, feelings and opinions with one another and with educator

a. TEAM-BASED LEARNING – is an innovative and newly popular teaching method - is meant

to enrich the student’s learning experience through active learning strategies

4 key principles (Sisk, 2011)

✓ Forming heterogeneous teams
✓ Stressing student’s accountability
✓ Providing meaningful team assignments
✓ Providing feedback to students

b. COOPERATIVE LEARNING – is a methodology of choice for transmitting foundational

knowledge. Highly structured group work focusing on problem solving that leads to deep
learning and critical thinking

4 KEY COMPONENTS
❖ Extensive structuring of the learning tasks by the teacher
❖ Strongly interactive student-student execution of the tasks
❖ Immediate debriefing/other assessments
❖ Instructional modifications by the teacher based on feedback

c. CASE STUDIES - lead to the development of analytical and problem-solving skills, exploration
of complex issues, and application of new knowledge and skills in the lineal practice arena.
 d. SEMINARS – interactions are stimulated by the posing of questions by the educator

3. ONE-TO-ONE INSTRUCTION – involves face- to-face delivery on information specifically designed to

meet the needs of individual learner

4. DEMONSTRATION AND RETURN DEMONSTRATION

Demonstration – is done by an educator to show the learner how to perform a certain skill.
Return demonstration – is carried out by the learner as an attempt to establish competence by
performing a task with Cues from the educator as needed

SCAFFOLDING –is an incremental approach to sequencing discrete steps of procedure

5. Gaming - is a method of instruction requiring the learner to participate in a competitive activity

with present rules (Allery, 2004)
Effective for improving cognitive functioning but also can be used to enhance skills in the
psychomotor domain and to influence affective behavior through increased social
interaction
6. SIMULATION – is a trial-and-error method of teaching whereby an artificial experience is created
that engages the learner in an activity that reflects real-life conditions but without risk- taking
consequences of an actual situation

TYPES OF SIMULATIONS
➢ Written simulations – use case studies about real or fictitious situations and the learner must respond
to these scenarios.
➢ Clinical simulations-can be set up to replicate complex care situations such as mock cardiac arrest
➢ Model simulations – are frequently used
➢ Computer simulations-are use in the learning laboratories to mimic situations whereby information
as well as feedback is given to learners in helping them to develop decision-making skills

ADVANTAGES
➢ Excellent for psychomotor skill development.
➢ Enhances higher level problem-solving and interactive abilities in the cognitive and affective domains
➢ Provides for active learner involvement in a real-life situation
➢ Guarantees a safe, nonthreatening environment for learning

LIMITATIONS
➢ Can be expensive
➢ Very labor intensive in many cases

7. ROLE PLAY – a method of instruction by which learners actively participate in an unrehearsed

dramatization
ADVANTAGES
➢ Opportunity to explore feelings and attitudes
➢ Potential for bridging the gap between understanding and feeling
➢ Narrows the role distance among patients and professionals

LIMITATIONS
➢ Limited to small groups
➢ Tendency by some participants to overly exaggerate their assigned roles
➢ A role part loses its realism and credibility if played too dramatically
➢ Discomfort felt by some participants in their roles/inability to develop them sufficiently

8. ROLE MODEL – use of self. Primarily known to achieve behavior change in affective domain
ADVANTAGES
➢ Influences attitudes to achieve behavior change primarily in the affective domain.
➢ Potential of positive role models to instill socially desired behaviors.

LIMITATIONS
➢ Requires rapport between the role model and the learner
➢ Potential for negative role models to instill unacceptable behaviors

9. SELF-INSTRUCTION – is a teaching method used by the educator to provide/design instructional

activities that guide the learner in independently achieving the objectives of learning.
- it is a self-contained educational activity that allows learners to progress by themselves at their
own pace (Abruzzese, 1996)
ADVANTAGES
➢ Allows for self-pacing.
➢ Stimulates active learning.
➢ Provides opportunity to review and reflect on information.
➢ Offers built-in, frequent feedback.
➢ Indicates mastery of material accomplished in particular time frame

LIMITATIONS
➢ Limited with learners who have low literacy
➢ Not appropriate for learners with visual and hearing impairments.
➢ Requires high level of motivation.
➢ May induce boredom in a population if this method is overused with no variation in the activity
design

ELEMENTS OF SELF-INSTRUCTION MODULES

1. Introduction 6. Outline of actual learning activities
2. List of prerequisite skills 7. Estimated total length of time
3. List of behavioral objectives 8. Different presentations
4. Pretest 9. Periodic self-assessments
5. Identification of resources and learning 10. Posttest
activities
 Techniques to enhance the effectiveness of verbal presentations
✓ Include humor ✓ Serve as role model
✓ Exhibit risk-taking behavior ✓ Use anecdotes and examples
✓ Deliver material dramatically ✓ Use technology
✓ Choose problem-solving activities

GENERAL PRINCIPLES FOR TEACHING ACROSSMETHODOLOGIES

➢ Give positive reinforcement ➢ Use questions

➢ Project an attitude of acceptance ➢ Use the Teach-Back or Tell-Back Strategy
and sensitivity ➢ Know the audience
➢ Be organized and give direction ➢ Use repetition and pacing
➢ Elicit and give feedback ➢ Summarize important points

SETTINGS FOR TEACHING

❖ Classified according to the need for health education in relationship to the primary purpose of the
organization/agency that provides health instruction
❖ Any place where nurses engage in teaching for disease prevention, health promotion, health
maintenance and rehabilitation

1. Healthcare setting – is one in which the delivery of health care is the primary or sole function of
the institution, organization or agency
Examples: hospital, public health department outpatient clinics, physician’s offices

2. Healthcare-related setting – is one in which healthcare-related services are offered as a

complementary function of the agency
Examples: American Heart Association and American Cancer Society

3. Non-healthcare setting – is one in which health care is an incidental or supportive function of an

organization
Examples: businesses, industries, school’s military and penal institutions

IV. Resources

INSTRUCTIONAL MATERIALS – are objects/vehicles by which information is communicated

Instructional Material Tools – are the objectives/ vehicles used to transmit information that supplement
the act of teaching

3 Major Variables in Making Appropriate Choices of Instructional Materials

1. Characteristic of the learner
2. Characteristic of the medium
3. Characteristic of the task to be achieved
Three Major Components of Instructional Materials
1. Delivery System – includes both the software and the hardware used in presenting information
2. Content (intended message) is independent of the delivery system and is the actual information
being communicated to the learner
3. Presentation – consist of the following:
a) Realia (the condition of being real) – most concrete form of stimuli that can be used to deliver
information
b) Illusionary Representations – applies to a less concrete, more abstract form of stimuli through
which to deliver a message
c) Symbolic Representations – refers to the most abstract types of messages

TYPES OF INSTRUCTIONAL MATERIALS

1. WRITTEN - Handouts, such as leaflets, books, pamphlets, brochures, and instruction sheets (all
symbolic representations), are the most widely used and most accessible type of tools for teaching
a. Commercially Prepared Materials
b. Self-Composed Materials

2. DEMONSTRATION - include many types of visual, hands-on media

a. Models - three-dimensional objects that allow the learner to immediately apply knowledge and
psychomotor skills by observing, examining, manipulating, handling, assembling and
disassembling them while the teacher provides feedback
➢Replica is an exact copy constructed to scale that resembles the features or substance of
the original object
➢Analogue has the same properties and performs like the real object. Unlike replicas,
analogue models are effective in explaining and representing dynamic systems.
➢Symbol is used frequently in teaching situations. Written words, mathematical signs and
formulas, diagrams, cartoons, printed handouts, and traffic signs are all examples
b. Displays - are two-dimensional objects that serve as useful tools for a variety of teaching
purposes
c. Posters - use the written word along with graphic illustration. Serve as a visual supplement to
oral instruction of patients and families in various healthcare settings

3. Audiovisual Materials- support and enrich the education process by stimulating the senses of seeing
and hearing, adding variety to the teaching–learning experience, and instilling visual memories,
which have been found to be more permanent than auditory memories (Kessels, 2003)
a. Projected Learning resources category of media includes:
➢Overhead transparencies
➢PowerPoint slides
➢Compact Discs and Digital Sound Players
➢Radio and Podcasts
b. Telecommunications - means by which information can be transmitted via television, telephone,
related modes of audio and video teleconferencing, and closed-circuit, cable, and satellite
broadcasting
➢Television
➢Telephones
 c. Computer Learning Resources - computer can store large amounts of information and is designed
to display pictures, graphics, and text. The presentation of information can be changed
depending on user input
➢Computers are an efficient instructional tool, computer programs can influence affective
and psychomotor skill development, and retention of information potentially can be
improved by the interactive exchange between learner and computer, even though the
instructor is not actually present (DiGiacinto, 2007). I
➢Computer-assisted instruction (CAI), also called computer-based learning and computer-
based training, promotes learning in primarily the cognitive domain

V. Evaluation
i. Definition
Defined as a systematic process that judges the worth/value of teaching and learning
ii. Steps in Conducting Evaluation
1. Determining the focus of the evaluation, including use of evaluation models
2. Designing the evaluation
3. Conducting the evaluation
4. Determining methods to analyze and interpret the data collected
5. Reporting results and a summary of the findings from the data collected
6. Using evaluation results

iii. Evidence-based practice (EBP)

- Defined as “the conscientious use of current best evidence in making decisions about
patient care” (Melnyk & Fineout-Overholt, 2015, p. 3)
- Described as “a lifelong problem-solving approach to clinical practice that
integrates…the most relevant and best research . . . one’s own clinical expertise . . . and patient
preferences and values” (Melnyk & Fineout-Overholt, 2015, p. 3)

➢ External Evidence – Evidence from research reflecting the fact that it is intended to be
generalizable or transferable beyond the specific study setting or sample
➢ Internal Evidence - defined as data generated from a diligently conducted quality
improvement project or EBP implementation project within a specific practice setting or
with a specific population (Melnyk & Fineout-Overholt, 2015

Practice-based evidence
➢ Defined as “the systematic collection of data about client progress generated during treatment
to enhance the quality and outcomes of care” (Girard, 2008, p. 15), which comprises internal evidence
that can be used both to identify whether a problem exists and to determine whether an intervention
based on external evidence effectively resolved that problem

iv. Evaluation Versus Assessment

➢ Assessment focuses on initially gathering, summarizing, interpreting, and using data to decide a
direction for action
➢ Evaluation involves gathering, summarizing, interpreting, and using data after an activity has
been completed to determine the extent to which an action was successful

5 Basic Component of Evaluation

1. Audience - includes the persons or groups for whom the evaluation is being conducted
2. Purpose - might be to decide whether to continue a specific education program or to determine
the effectiveness of the teaching process
3. Questions - must be directly related to the purpose for conducting the evaluation, must be
specific, and must be measurable
4. Scope - determined in part by the purpose for conducting the evaluation and in part by
available resources
5. Resources - include time, expertise, personnel, materials, equipment, and facilities.

Evaluation Models
1. Process (Formative) Evaluation – its purpose is to make necessary adjustments to an educational
activity as soon as they are identified, such as changes in personnel, materials, facilities,
teaching methods, learning objectives, or even the educator’s own attitude
2. Content Evaluation - determine whether learners have acquired the knowledge or skills taught
during the learning experience
3. Outcome (Summative) Evaluation - determine the effects of teaching efforts
4. Impact Evaluation - determine the relative effects of education on the institution or the
community
5. Total Program Evaluation is to determine the extent to which all activities for an entire
department or program over a specified time meet or exceed the goals originally established

Designing the Evaluation

1. Design Structure - all evaluations should be systematic, carefully and thoroughly planned or
structured before they are conducted
2. Evaluation Methods - design structure, in turn, provides the basis for determining what
evaluation methods should be used to collect data.
✓ Which types of data will be collected?
✓ What data will be collected and from whom?
✓ How, when, and where will data be collected?
✓ Who will collect the data?

Evaluation Instruments
Whenever possible, an evaluation should be conducted using existing instruments.
Reason: because instrument development not only requires considerable expertise, time, and
resources but also requires testing to be sure the instrument, whether it is in the form of a
questionnaire or a type of equipment, demonstrates reliability and validity before it is used for
collecting data

Steps in Instrument Selection

1. Conduct a literature search for evaluations similar to the evaluation that is being planned
 2. Check first, the instrument must measure the performance being evaluated exactly as that
performance has been operationally defined for the evaluation
3. Appropriate instrument should have documented evidence of its reliability and validity with
individuals who are as closely matched as possible with the people from whom data will be
collected

Barriers to Evaluation
1. Lack of clarity
2. Lack of ability
3. Fear of punishment or loss of self-esteem

v. Conducting the Evaluation

➢ Evaluation is implemented depends primarily on how carefully and thoroughly that
evaluation was planned and how carefully the instruments for data collection were selected or
developed

Methods to a Successful Evaluation

1. Conduct a pilot test first.
2. Include extra time to complete all the evaluation steps.
3. Keep a sense of humor throughout the experience

vi. Analyzing and Interpreting Data Collected

Purpose
1. To organize data so that they can provide meaningful information
2. To provide answers to evaluation question

Basic decisions about how data will be analyzed are dictated by the nature of the data and by the
questions used to focus the evaluation. Data can either be qualitative or quantitative

vii. Reporting Evaluation Results

The following guidelines can significantly increase the likelihood that results of the evaluation
will be reported to the appropriate individuals or groups, in a timely manner, and in usable
form:
✓ Be audience focused – (1) Evaluation must provide information for decision making by the
primary audience. No matter who the audience members are, their time is important to
them and they want something succinct to read. (2) Present evaluation results in a format
and language that the audience can understand and use without additional interpretation.
(3) Evaluator should make every effort to present results in person as well as in writing.
✓ Stick to the evaluation purpose - Evaluators should keep the main body of an evaluation
report focused on information that fulfills the purpose for conducting the evaluation. The
main aspects of how the evaluation was conducted and answers to questions asked also
should be provided
✓ Use data as intended - Evaluators should maintain consistency with actual data when
reporting and interpreting findings.
“In life, everything is a challenge, you may choose to face and learn from it or run and gain nothing… In
the end you make the decisions”
Implementing Health
Education Plan
Continued*
Kris Anthony Padios R.N.,M.N.
Gregorio Alojado R.N.,M.N.
Computer Teaching
Strategies
Computer Teaching Strategies

Computer-based learning, also known as computer-aided

instruction, is the term used for any kind of learning with the help of
computers.
Computer-based learning makes use of the interactive elements of
the computer applications and software and the ability to present any
type of media to the users.
Computer-based learning has many benefits, including the
advantage of users learning at their own pace as well as learning
without the need for an instructor to be physically present.
Computer Teaching Strategies
Types
Tutorials
 Tutorial software provides information about diverse topics, essentially taking
on the role of the instructor. In many cases, the technology quizzes and
evaluates the student’s comprehension of the subject matter using an
interactive process and delivering feedback.

Gamified Learning
 This type uses a gamified approach to help students learn the material. Through
an interactive process, students may advance to new levels after demonstrating
that they’ve grasped certain concepts or receive rewards along the way.
Computer Teaching Strategies
Types
Practice
 Practice technology applies a digital approach to traditional methods of
learning content, such as flashcards. The technology, for example, might quiz
learners on different concepts.

Demonstrations
 Demonstrations tap into different senses, like visual and auditory, to present
facts, information, concepts, and more. In some cases, students can become
“immersed” in the experience, as is often the case with virtual or augmented
reality technologies, both of which are used in teaching and learning.
Computer Teaching Strategies
Pros of Computer-Assisted Learning

Students and Instructors Can Receive Real-Time Feedback

 Computer based learning reveals solutions and assesses student performance
immediately.
 Immediate feedback to the learner
 Providing analytics that go a step beyond to help students improve.
 The learning process is more interactive and engaging
 Computer based learning takes on many different forms, and each one is meant
to engage learners. It is usually interactive, too, which involves students and
makes them agents of their own learning, increasing their stake in the
education process.
Computer Teaching Strategies
Pros of Computer-Assisted Learning

Learning Can Be More Personalized

Many computer-based learning programs adjust the approaches based on the
individual learner’s progress.
 A more personalized approach leads to both a higher level of engagement and
stronger learning outcomes.

Technology Can Fill the Gaps for Students with Learning Differences
 Computer-based learning has implications for students with a range of learning
differences, too, giving greater access to those with different educational and
learning.
Computer Teaching StrategiesCons of
Computer-Assisted Learning
CAL Can Become a Distraction
 When students use CAL tools in the classroom, they may well have trouble
focusing on the live teaching taking place.

It’s Expensive
 In many cases, technology is expensive. CAL solutions may be difficult to
purchase and implement because of the cost barrier associated with them. This
is especially true when the tools are custom-built for a particular audience,
although educators should keep in mind that there are some more cost-effective
solutions.
Computer Teaching StrategiesCons of
Computer-Assisted Learning
Software Can Become Outdated Quickly
 With frequent advances in technology and reassessments and
reconceptualization of material and content, there is a risk of applying
technologies that could be irrelevant or outdated quickly.
There’s a Risk of Over-Dependence on the Technology
 CAL should augment instructor efforts, not replace them. While there are some
contexts in which technology may play a greater role, the tools and live
instruction often go hand in hand.
 Moreover, some teachers may feel that they have trouble finding tools that meet
their lesson plan needs and attempt to alter their lessons accordingly
Computer Teaching Strategies

In the best-case scenario, computer-assisted learning benefits and enhances

instruction. But that doesn’t mean that it’s without its flaws.
Ideally, instructors will find a balance between using technology to improve
and supplement their own teaching, supporting both learners and teachers in
education.
Distance Learning
Distance Learning

Distance learning is a way of educating students online. Lectures and learning

materials are sent over the internet. Students work from home, not in a classroom.

There are many excellent benefits of distance learning examples are:

1. Proves less expensive to support.
2. Not limited by geography.
Distance Learning

Due to the coronavirus, distance learning — typically a style of teaching

utilized by colleges and universities — is now being adopted by elementary and
high school students as well. Entire school districts and campuses are being forced
to create online-based learning opportunities and do it effectively.

This approach could disadvantage some students.

1. Students with limited computer or internet access may struggle
2. Students who need extra help with motivation and organization may also
struggle when they are removed from a traditional classroom environment.
Distance Learning

Distance learning falls into two main categories:

Synchronous

Asynchronous
Distance Learning

Synchronous
 Synchronous means “at the same time.” It refers to a method of education
delivery that happens in real-time. It requires live communication online. It uses
technology, such as teleconferencing, to achieve this.
 Synchronous learning proves less flexible than other forms of distance learning.
After all, students must meet with their instructor and sometimes their
classmates at pre-scheduled times.
 This approach limits the student’s ability to learn at their own pace. It may
frustrate some learners who crave the freedom of the asynchronous classroom.
Distance Learning

Asynchronous
 As for asynchronous distance education? Students receive clusters of weekly
deadlines. They have the freedom to work at their own speed.
 Asynchronous distance learning comes with more opportunities for student
interaction.
 Students can access course content beyond the scheduled meeting or class
time and interact through online conversations, quizzes, or video comments on
their own schedule.
 Both faculty and students benefit from the flexibility of asynchronous learning as
it allows them to create and consume content when it’s convenient for them.
Distance Learning
Types of distance learning
1. Video conferencing

2. Hybrid distance education

3. Open schedule online courses

4. Fixed-time online courses

Distance Learning

Video conferencing
 Video conferencing is traditionally a meeting where two or more participants
use video to connect over the internet. This is a form of synchronous
communication. Using tools like Zoom, Blackboard Collaborate, Adobe
Connect, or other conferencing software, teachers and students interact
together no matter where they are located.

 Video conferencing enhances student-instructor interactions and provides a

structure for lesson planning. It remains a vital component of distance learning.
Distance Learning

Hybrid distance education

 Hybrid distance education combines synchronous and asynchronous methods.
Students receive deadlines to complete assignments and exams. Then, they
work at their own pace.
 They submit assignments through online forums. They maintain contact with
their instructor. Yet, they work at their own pace. As students progress, they
gain access to new modules.
 Who thrives with hybrid distance education? Students that love independence.
Distance Learning

Open schedule online courses

 Under the asynchronous category, you’ll find open schedule online instruction. Such courses
provide students with plenty of freedom. To complete coursework, students receive:
• Online textbook(s)
• Bulletin boards
• Email
• And more
 Students are given a set of deadlines. Then, the instructor sets them free to work at their own
pace. Students who value learning independently excel with this format. It requires significant
self-discipline and motivation, though.
 Students who lack the right skill set may find this approach daunting. They may feel
overwhelmed by the presentation of material. They may lack the motivation to work through the
course in an effective way.
Distance Learning

Fixed-time online courses

 What’s the most common format for distance learning? Fixed-time online
courses.
 How do they work? Students log-in to the learning site at designated times.
They must complete pre-scheduled classroom activities at a specific pace.
 These activities often include chats and discussion forums. Fixed time online
courses encourage student interaction. But there’s little room for self-pacing.
Distance Learning
Benefits of distance learning
There are many distance learning benefits. They vary by synchronous or
asynchronous course structures. The advantages include:
• Self-inspiration
• Flexibility to choose
• Adaptability and freedom
• Easy access
• Earning while learning
• Money and time savings
• Virtual trips
• Communication with other educational institutions
What are the disadvantages of distance
learning?
The benefits of distance learning are clear, but there are some warnings when it
comes to this learning approach, too.
 Students face a higher risk of online distraction. Without face-to-face meetings,
students can lose track of deadlines and motivation.
 Students who work well on their own may easily surmount these obstacles.
Students who have trouble prioritizing may stumble. So will those who lack
organizational and scheduling skills.
What are the disadvantages of distance
learning?
 Distance learning comes with hidden student costs, too. These expenses
include:
• Gaining access to a reliable computer
• Having an internet connection
• Buying a web camera (in some instances)
• Computer maintenance
• Utilities (e.g., electricity for internet services)
 Not all students have access to these resources. Distance learning can put
them at a distinct disadvantage.
 A slow internet connection will hamper a student’s ability to participate online.
They may lack the bandwidth to watch videos or teleconference.
 Teaching
Psychomotor Skills
Teaching Psychomotor Skills

Psychomotor skill development is crucial to good patient care. Psychomotor skills

are used to provide patient care and ensure the safety of the members of the
team.
Teaching Psychomotor Skills
Five levels of psychomotor skills

Imitation
1. Student repeats what is done by the instructor
2. “See one, do one”
3. Avoid modeling wrong behavior because the student will do as you do
4. Some skills are learned entirely by observation, with no need for formal
instruction
Teaching Psychomotor Skills
Five levels of psychomotor skills
Manipulation
1. Using guidelines as a basis or foundation for the skill (skill sheets)
2. May make mistakes a. Making mistakes and thinking through corrective
actions is a significant way to learn
3. Perfect practice makes perfect a. Practice of a skill is not enough, students
must perform the skill correctly
4. The student begins to develop his or her own style and techniques a. Ensure
students are performing medically acceptable behaviors
Teaching Psychomotor Skills
Five levels of psychomotor skills
Precision
1. The student has practiced sufficiently to perform skill without mistakes
2. Student generally can only perform the skill in a limited setting a. Example:
student can splint a broken arm if patient is sitting up but cannot perform
with same level of precision if patient is lying down
Teaching Psychomotor Skills
Five levels of psychomotor skills
Articulation
1. The student is able to integrate cognitive and affective components with skill
performance
a) Understands why the skill is done a certain way
b) Knows when the skill is indicated
2. Performs skill proficiently with style
3. Can perform skill in context. Example: student is able to splint broken arm
regardless of patient position
Teaching Psychomotor Skills
Five levels of psychomotor skills
Naturalization
1. Mastery level skill performance without cognition
2. Also called "muscle memory“
3. Ability to multitask effectively
4. Can perform skill perfectly during scenario, simulation, or actual patient
situation
Teaching Psychomotor Skills

Motivation
A student's motivation has a positive influence on the development of
psychomotor skills. Motivation is the major step in the teaching process.
Teaching Psychomotor Skills

Strategies in increasing motivation

1. Use a variety of psychological strategies based upon personal goals and
interests, values of the skill, and personal challenge.
2. Arouse curiosity by presenting a novel idea or a puzzling problem.
3. Set challenging, yet obtainable standards for each student.
4. Provide feedback and reinforcement and
5. Take advantage of natural tendencies to compete.
Teaching Psychomotor Skills

Demonstrations
Actual demonstration has been widely viewed as the most appropriate
strategy for teaching skill development.
Filmed demonstrations have also been found to enhance psychomotor skill
development also concluded that demonstrations improve technique,
confidence, and understanding of successful performance.
Teaching Psychomotor Skills

Demonstrations
1. Demonstrations enhance psychomotor skill acquisition.
2. The higher the status of the person presenting the demonstration, the greater
the influence of the demonstration on the student's skill acquisition.
3. Tasks should be broken down into subunits for teaching purposes. The skills
involved in each subunit should be demonstrated in sequence, allowing
students to practice in each subunit before moving to the next.
4. Demonstrations can help reduce anxiety over performing unfamiliar skills.
Teaching Psychomotor Skills

Physical Practice
Practice may be defined as "...repetition with the intent of improved
performance“. Actual practice of a manipulative skill is essential to acceptable
performance. Furthermore, actual performance of a skill effectively reduces the fear
and anxiety that accompanies the performance of many skills
1. Short, frequent practice sessions over a long period of time are most effective.
2. Practice sessions must be long enough to allow improvement, and the time period
between sessions must be short enough to prevent forgetting.
3. Performance curves tend to reveal that improvement is usually fastest initially,
with a plateau of performance reached after some time.
Research evidence suggests, however, that these plateaus are primarily due to
student's stopping at their own acceptable levels of performance, rather than to any
physical limitations.
Teaching Psychomotor Skills

Mental Practice
Mental practice may be defined as covert rehearsal of a skill by imaging
oneself performing the skill step by step and "feeling" one's way through the
movements. Weinberg (1982) cited early research that showed a strong
relationship between mental practice and muscular stimulation.
Teaching Psychomotor Skills

The early stages of psychomotor skill acquisition are primarily cognitive in

nature. During this stage, teachers need to help their students think through the
mechanics of performance.
Although mental practice has been found to enhance skill acquisition at any
time, it is most effective during the cognitive stages
Research has also shown that mental practice alone, if it follows a
demonstration or videotape of the skill being performed, does enhance skill
acquisition.
Teaching Psychomotor Skills

The following are guidelines for the use of mental practice to improve skills:
1. Students must be familiar with the task (through prior experience,
demonstrations, or visuals:) before using mental practice techniques.
2. Students need instruction in the use of mental practice.
3. A combination of physical and mental practice should provide the greatest
performance gains.
4. Simple skills, or complex skills broken down into subunits, are best suited for
mental practice.
5. Students should perform mental practice in their own time and place.
6. Mental practice sessions should last no longer than five minutes
Teaching Psychomotor Skills

Feedback
Feedback, or information provided to students regarding their performance
results, is essential in psychomotor skill development.
The following conclusions regarding feedback and its effects on skill acquisition:
1. The rate of skill improvement depends upon the precision and frequency of
knowledge of results.
2. A delay in providing this knowledge does not affect skill acquisition. However,
feedback is important especially in the early stages of practicing a skill.
3. Withdrawal of knowledge of results decreases performance in the early stages of
skill development but does not affect performance in the late stages.
4. A variety of types of feedback should be provided. including visual, verbal, and
kinesthetic.
Teaching Psychomotor Skills

Increasing Retention and Transfer of Skills

Retention may be defined as "the persistence of proficiency on a skill after a
period of no practice"
The most important factor in retention is the degree of initial proficiency.
Learners should also practice a skill as soon as possible after the demonstration is
given. Events occurring between the demonstration and practice session tend to
reduce retention.
Teaching Psychomotor Skills

Transfer is the application or performance of previously learned skills in other

places or settings.
1. Positive transfer is most likely when similarities between practice (learning)
and performance (application) sessions are high.
2. Practice should be completed on tasks that parallel in difficulty and design
those in transfer settings.
3. Discussion of various examples during the practice stage aids in the transfer
of principles and practices.
4. Specific tasks should be practiced in relationship to the complete task.
Otherwise, only isolated parts of the task may be positively transferred.
5. As in retention, transfer is greatest with high levels of initial task proficiency.
Teaching Psychomotor Skills

The Teaching Process

The most highly regarded approach to teaching psychomotor skills involves
several phases, including:
1. Motivating students
2. Demonstrating the skill
3. Furnishing student practice
4. Providing appropriate feedback on performance
Teaching Psychomotor Skills
Steps for Psychomotor Teaching Process
1. Create interest through the use of questioning and discussion of a puzzling
problem or aspect of the skill to be developed. This brings students to a
psychological feeling that they need to know more and that they need to
become more able.
2. Ask students to describe the appropriate steps in performing the skill. Correct
errors and explain changes that must be made.
3. Discuss how each step of the skill should be performed, and have the class
prepare a set of brief, simple directions for the process. Students will learn
more from a demonstration if the how's and why's have been discussed
beforehand.
Teaching Psychomotor Skills
Steps for Psychomotor Teaching Process
4. Provide ,a demonstration of the skill. Involving students mentally and
physically throughout the demonstration will increase its effectiveness. Steps
to be performed should be demonstrated in proper sequence and explained
simultaneously.
5. Have students practice the skill. Upon completion, place two finished
products before students and ask which is better and why. Lead the group in
the development of acceptable standards by which future performance should
be judged.
6. Provide alternating sessions of practice and evaluation until the desired
ability level is reached.
Clinical Teaching
Clinical Teaching

 Clinical teaching is an individualized or group teaching to the nursing student

in the clinical area by the nurse educators, staff and clinical nurse managers.
Clinical Teaching

 In preparation of professional practice,

 the clinical setting is the place where the students com in contact patient or
consumer for the purpose of testing theories and learning skill
Clinical Teaching

 Teaching in a clinical setting is a challenge that is different from those

encountered in the classroom

 Like any other skill based profession, nursing also requires the development
of relationship between theory and practice.
Clinical Teaching

 Principles of clinical teaching

 Clinical education should reflect the nature of the professional practice

 Clinical teaching is supported by climate of mutual trust and respect
 Clinical teaching and learning should focus on the essential knowledge, skills
and attitude.
Clinical Teaching

 Purpose of clinical teaching

 1. To provide individualized care in a systematic, holistic approach.
 2. To develop high technical competent skills
 3. to practice various procedures
 4. to collect and analyz data
 5. to develop communication skills and maintain interpersonal relationship
 6. To maintain high standard of nursing practice to become independent enough to
practice nursing
 7. To develop, cognitive, affective and psychomotor skills
 8. To learn various diagnostic procedures
 9. To learn various skills in giving health education technique to the client
 10. To develop proficiency and efficiency in carrying out various procedure
Clinical Teaching

 Type of Clinical Teaching Method

 Bedside Clinic – Carried out by the group by visiting the patient at bedside in
order to study problems associated with a particular disease or disorder.
 Nursing Rounds – a tour of the patient's bedside area made by a small group of
staff and students.
 Nursing Shift Reports – Written or oral summary of the nursing actions taken in
relation to patients care. Otherwise known as endorsements.
 Nursing Care Conferences – A process in which group discussion is made using
problem solving techniques to determine ways of providing care for the
patients to whom students are assigned as part of the their clinical
experience.
Clinical Teaching

 Demonstration – Teaches by “Exhibition and Explanation”. Relate to

Demonstration of a skill by an instructor.
 Nursing Care Studies – Method which focuses on information and facts about
the patient, the disease condition, social and personal history and the
application of this knowledge in rendering nursing care. Refer back to CASE
STUDY and Case Presentation
 Process Recording – It is a written account or verbatim recording of all that
transpired during and immediately following the nurse-patient interaction.
 Laboratory Method – Laboratory is a part of clinical teaching that offers
students with the opportunities to apply their theoretical knowledge or
previous learning into practice in a controlled situation under the guidance
and supervision where there is no client. Think Skills Laboratory Return
Demonstration.
Clinical Teaching

 Nursing Assignment – It is the part of learning experience where the students

are assign with patient or other activities concerning to patient in a skills
laboratory.

 Field Trip – It is a well organized trip from a usual place for teaching
purposes. Field trips give natural stimulation and motivates the learner to be
more interactive and creative.