11-15

• Student-centered philosophy


  • Learned by doing
  • Planning, teaching, and assessment evolve around the needs and abilities of students
  • Give students chance to use their abilities and experiences to solve problems
  • Find new ways of learning
  • Progressivism: Build the curriculum around the experiences, interests, and abilities of students
  • Encourage student to work cooperatively
  • Social reconstructionism: Encourages schools, teachers, and students to focus on their studies and energies on alleviating pervasive inequities
  • Wants to not only inform their students but rouse emotions
• Pedagogy


  The art and science of helping children to learn
• The different stages of childhood are divided according to what developmental theorists and educational psychologists define as specific patterns of behavior seen in particular phases of growth and development
• One common attribute observed throughout all phases of childhood is that learning is subject centered
• The field of growth and development is highly complex, and at no other time is physical, cognitive, and psychosocial maturation so changeable as during the very early years of childhood
• Because of the dependency of members of this age group, the main focus of instruction for health maintenance of children is geared toward the parents, who are considered to be the primary learners rather than the very young child
• The older toddler should not be excluded from healthcare teaching and can participate to some extent in the education process
• Physical development in infancy to toddlerhood

  • Exploration of self and the environment becomes paramount and stimulates further physical development
• Patient education for infants and toddlers

  Focus on teaching the parents the importance of stimulation, nutrition, the practice of safety measures to prevent illness and injury, and health promotion
• Piaget's sensorimotor period


  The coordination and integration of motor activities with sensory perceptions
• Toddler development


  • Rudimentary capacity for basic reasoning
  • Understands object permanence
  • Has the beginnings of memory
  • Begins to develop an elementary concept of causality
• Toddler characteristics


  • Limited ability to recall past happenings or anticipate future events
  • Oriented primarily to the here and now
  • Little tolerance for delayed gratification
  • Short attention spans
  • Easily distracted
  • Egocentric in their thinking
  • Not amenable to correction of their own ideas
  • Believe their own perceptions to be reality
  • Asking questions is the hallmark of this age group
  • Curiosity abounds as they explore places and things
  • Can respond to simple, step-by-step commands
• Language skills in toddlers

  Acquired rapidly during this period, and parents should be encouraged to foster this aspect of development by talking with and listening to their child
• Toddler play


  • Begin to engage in fantasizing and make-believe play
  • Unable to distinguish fact from fiction
  • Have limited cognitive capacity for understanding cause and effect
• Toddler response to illness or hospitalization

  • Disruption in their routine is very stressful
  • Separation from parents is very stressful
  • Routines give these children a sense of security
  • Gravitate toward ritualistic ceremonial-like exercises when carrying out activities of daily living
• Toddler separation anxiety


  • Characteristic of this stage of development
  • Particularly apparent when children feel insecure in an unfamiliar environment
  • Compounded when subjected to medical procedures and other healthcare interventions performed by strangers
• Erikson's psychosocial stages


  • Infancy: Trust vs. mistrust
  • Toddlerhood: Autonomy vs. shame and doubt
• Toddler psychosocial development


  • Must learn to balance feelings of love and hate
  • Must learn to cooperate and control willful desires
  • Progress sequentially through accomplishing the tasks of developing basic trust in their environment to reaching increasing levels of independence and self-assertion
  • Newly discovered sense of independence often expressed by demonstrations of negativism
  • May have difficulty making up their minds
  • Express frustration and feelings of ambivalence in words and behaviors, such as by engaging in temper tantrums
  • With peers, play is a parallel activity, and it is not unusual for them to end up in tears because they have not yet learned about tact, fairness, or rules of sharing
• Teaching strategies for infancy and toddlerhood

  • Focus on normal development, safety, health promotion, and disease prevention
  • Use repetition and imitation
  • Stimulate the senses
  • Provide safety
  • Allow for play and manipulation of objects
• Teaching strategies when child is ill or injured

  • Assess the parents' and child's anxiety levels
  • Help them cope with their feelings of stress related to uncertainty and guilt about the cause of the illness or injury
• Preschooler development


  • Piaget's preoperational stage: egocentric; thinking is literal and concrete; pre-causal thinking
  • Erikson's initiative vs. guilt stage: taking on tasks for the sake of being involved and on the move; learning to express feelings through play
  • Salient characteristics: animistic thinking; limited sense of time; egocentric; transudative reasoning; separation anxiety; play is his/her work; fears loss of body integrity; active imagination; interacts with playmates
• Teaching strategies for preschoolers

  • Build trust - allow for manipulation of objects
  • Use positive reinforcement
  • Encourage questions
  • Provide simple drawings and stories
  • Focus on play therapy
  • Stimulate the senses
• School-aged child development


  • Piaget's concrete operations stage: developing logical thought processes and ability to reason syllogistically; understands cause and effect
  • Erikson's industry vs. inferiority stage: gaining a sense of responsibility and reliability; increased susceptibility to social forces outside the family unit; gaining awareness of uniqueness of special talents and qualities
  • Cognitive characteristics: able to draw conclusions and intellectually analyze problems
• the move; learning to express feelings through play

  • Cognitive: animistic thinking; limited sense of time; egocentric; transudative reasoning
  • Psychosocial: separation anxiety; play is his/her work; fears loss of body integrity; active imagination; interacts with playmates
• School-aged child


  • Cognitive: able to draw conclusions and intellectually can understand cause and effect
  • Psychosocial: fears failure and being left out of groups; fears illness and disability
• Adolescence


  • Cognitive: propositional thinking; complex logical reasoning; can build on past experiences; conceptualizes the invisible
  • Psychosocial: personal fable - feels invulnerable, invincible/immune to natural laws; imaginary audience - intense personal preoccupation
• Developmental Stages of Adulthood

  • Young Adulthood
  • Middle-Aged Adulthood
  • Older Adulthood
• Andragogy


  The art and science of helping adults learn
• Adult Learning Principles


  • Relates learning to immediate needs
  • Self-directed
  • Teacher is facilitator
  • Learner desires active role
• Young Adulthood


  • Cognitive: cognitive capacity is fully developed, but continuing to accumulate new knowledge and skills
  • Psychosocial: autonomous; independent; stress related to the many decisions being made regarding career, marriage, parenthood and higher education
• Middle-Aged Adulthood


  • Cognitive: ability to learn remains steady throughout this stage
  • Psychosocial: facing issues with grown children, changes in own health, and increased responsibility for own parents
• Older Adulthood


  • Cognitive: Fluid intelligence - capacity to perceive relationships, to reason, and to perform abstract thinking, which declines with aging; Crystallized intelligence - the intelligence absorbed over a lifetime, which increases with experience
  • Psychosocial: adjusting to changes in lifestyle and social status
• Family is one of the most important variables influencing patient outcomes
• The nurse educator and family should be allies
• It is important to choose the most appropriate caregiver to receive information
• Readiness to learn in children is very subject-centered, and motivation to learn in adults is very problem-centered
• Rate of learning and capacity for learning, as well as situational and emotional barriers to learning, vary according to stages of development
• Knowledge of tasks associated with each developmental stage will help individualize the approach to education in meeting the needs and desires of learners and their families
• Nurses, as the main source of health education, must determine what needs to be taught, when to teach, how to teach, and who will teach
• The focus of teaching should be in light of the developmental stage of the learner