H.E C4-8

• Nurse's role in education

  • Responsible for educating patients, families, nursing staff, other healthcare staff, and nursing students
• Several factors have made using principles of learning particularly challenging for the nurse educator to meet learners' needs for information
• Factors making learning challenging

  • Same-day surgery has compressed patient and family contact with the nurse
  • Teachable moment is hard to capture because of shortened hospital stays
  • Difficulty meeting learners' needs arises because of the various educational and experiential levels of staff and time constraints in the practice arena
• Determinants of learning


  (a) Assessing the needs of the learner, (b) Recognizing factors involved in the readiness to learn, and (c) Being able to correlate teaching interventions with learning styles to maximize opportunities for learning
• Educator's role in learning

  • Identify the information learners need
  • Consider their readiness to learn and their styles of learning
  • Learner remains the single most important person in the education process
  • Learning can actually occur without an educator, but it is enhanced by the addition of an educator who can serve as a facilitator
  • Providing information to the learner does not ensure that learning will occur
• Educator's role in learning

  1. Assess problems or deficits

  2. Provide appropriate information and present it in unique ways

  3. Identify progress being made

  4. Give feedback and follow-up

  5. Reinforce learning in the acquisition of knowledge, the performance of a skill, or a change in attitude

  6. Evaluate learners' abilities
• Educator's role


  • Give support, encouragement, and direction during the process of learning
  • Help to identify optimal learning approaches and then provide assistance in choosing learning activities that can both support and challenge the learner based on his or her individual learning needs, readiness to learn, and learning style
• Assessment of the learner is the first and most important step in instructional design, but it is also the step most often neglected
• Effectiveness of nursing interventions depends on the scope, accuracy, and comprehensiveness of assessment prior to interventions
• Purpose of assessment


  • Validate the need for learning and the approach to be used in designing learning experiences
  • Identify and prioritize information for purposes of setting behavioral goals and objectives, planning instructional interventions, and evaluating whether the learner has achieved the desired goals and objectives
  • Ensure that optimal learning will occur with the least amount of stress and anxiety for the learner
  • Prevent needless repetition of known material, save time and energy, and help establish rapport between the learner and educator
  • Increase the motivation to learn by focusing on what the patient or staff member feels is most important to know or to be able to do
• Lack of time has often led nurse educators to shortchange the assessment phase
• Many nurses are unfamiliar with the concepts and techniques of teaching, and the nurse in the role of educator must become more familiar and comfortable with all the elements of instructional design, particularly with the assessment phase
• Determinants of learning


  • Learning needs (what the learner needs to learn)
  • Readiness to learn (when the learner is receptive to learning)
  • Learning style (how the learner best learns)
• Learning needs


  Gaps in knowledge that exist between a desired level of performance and the actual level of performance
• Assessing learning needs


  1. Identify the learner

  2. Choose the right setting

  3. Collect data on the learner

  4. Include the learner as a source of information

  5. Involve members of the healthcare team

  6. Prioritize needs
• Prioritizing learning needs


  • Mandatory: Needs that must be learned for survival or situations in which the learner's life or safety is threatened
  • Desirable: Needs that are not life-dependent but are related to well-being or the overall ability to provide quality care
  • Possible: Needs for information that are "nice to know" but not essential or required
• Not all learners need to know everything, and assessment can help to discriminate the "need to know" from the "nice to know" information
• Learning will not occur if a patient faces problems with basic physiological needs such as pain and discomfort; the latter needs must be addressed before any other learning can occur
• Setting priorities for learning is often difficult when faced with many learning needs in several areas
• An effort to prioritize the identified needs will help the patient or nursing staff to set realistic and achievable learning goals
• Choosing what information to cover is imperative, and choices must be made deliberately
• Learning needs must be prioritized based on the criteria in Table 4–1 (Healthcare Education Association, 1985, p. 23) to foster maximum learning
• If patients want to know the pathophysiology of their disease, that curiosity is fine, but it is not fundamental to learning how to carry out self-care activities that are essential for discharge from the hospital
• Often, highly technical information will serve only to confuse and distract patients from learning what they need to know to comply with their regimen
• Some needs may not be amenable to education. It is important to sort out types of learning needs from nonlearning needs
• Education in and of itself is not always the answer to a problem
• Often, healthcare providers believe that more education is necessary when something goes wrong, when something is not being done, when a patient is not following a prescribed regimen, or when a staff member does not adhere to a protocol
• In such instances, always look for other needs that are nonlearning
• A need may be identified, but it may be useless to proceed with interventions if the proper educational resources are not available, are unrealistic to obtain, or do not match the learner's needs
• The educator should be familiar with standards of performance required in various employee categories, along with job descriptions and hospital, professional, and agency regulations
• Close observation and active listening take time, but it is much more efficient and effective to do a good initial assessment than to have to waste time going back to discover the obstacles to learning that prevented progress in the first place
• Learners must be given time to offer their own perceptions of their learning needs if the educator expects them to take charge and become actively involved in the learning process
• Assessment can be made anytime and anywhere the educator has formal or informal contact with learners
• Informing someone ahead of time that the educator wishes to spend time discussing problems or needs gives the person advanced notice to sort out his or her thoughts and feelings
• Minimizing interruptions and distractions during planned assessment interviews maximizes productivity
• Informal conversations


  Often learning needs will be discovered during informal conversations that take place with other healthcare team members involved in the care of the client, and between the nurse and the patient or his or her family
• Structured interviews


  The nurse asks the learner direct and often predetermined questions to gather information about learning needs
• Focus groups


  Involve getting together a small number (4 to 12) of potential learners to determine areas of educational need by using group discussion to identify points of view or knowledge about a certain topic
• Self-administered questionnaires


  The learner's written responses to questions about learning needs can be obtained by self-administered questionnaires
• Tests


  Written pretests given before teaching is planned can help identify the knowledge level of the potential learner regarding a particular subject and assist in identifying specific needs of the learner