CH4

• Determinants of learning that require assessment are:

  1. the needs of the learner
  2. the state of readiness to learn
  3. the preferred learning styles for processing information
• Educators can greatly enhance learning when they serve as facilitators helping the learner become aware of what needs to be known, why knowing is valuable, and how to be actively involved in acquiring information.
• Assessment permits the nurse educator to facilitate the process of learning by arranging experiences within the environment that assist the learner to find the purpose, the will, and the most suitable approaches for learning.
• The educator plays a crucial role in the learning process by doing the following: APIGRD

  • Assessing problems or deficits and learners’ abilities
  • Providing important best evidence information and presenting it in unique and appropriate ways
  • Identifying progress being made
  • Giving feedback and follow-up
  • Reinforcing learning in the acquisition of new knowledge, skills, and attitudes
  • Determining the effectiveness of education provided
• Assessment of the learner includes attending to the three determinants of learning (Haggard, 1989):

  1. Learning needs — what the learner needs and wants to learn.
  2. Readiness to learn — when the learner is receptive to learning.
  3. Learning style — how the learner best learns
• Assessing Learning Needs

  • Learning needs are defined as gaps in knowledge that exist between a desired level of performance and the actual level of performance (HealthCare Education Associates, 1989).
• The following are important steps in the assessment of learning needs:

  1. Identify the learner.
  2. Choose the right setting
  3. Collect data about the learner
  4. Collect data from the learner
  5. Involve members of the healthcare team
  6. Prioritize needs
  7. Determine availability of educational resources
  8. Assess the demands of the organization
  9. Take time-management issues into account
• Criteria for Prioritizing Learning Needs

  • Mandatory
  • Desirable
  • Possible
• Methods to Assess Learning Needs

  • Informal Conversations
  • Structured Interviews
  • Focus Groups
  • Questionnaires
  • Tests
  • Observations
  • Documentation
• Informal Conversations


  Often learning needs are discovered during impromptu 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


  It is perhaps the form of needs assessment most commonly used to solicit the learner’s point of view. The nurse educator asks the learner direct and often predetermined questions to gather information about learning needs.
• Focus groups


  It involves 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.

  With this approach, a facilitator leads the discussion by asking open-ended questions intended to encourage detailed discussion.
• Questionnaires


  Nurse educators can obtain learners’ written responses to questions about learning needs by using questionnaires.

  Checklists are one of the most common forms of questionnaires. They are easy to administer, provide more privacy compared to interviews, and yield easy-to-tabulate data.
• Tests 


  Giving written pretests before planned teaching can help identify the knowledge levels of potential learners regarding certain subjects and can assist in identifying their specific learning needs before instruction begins.

  The Diabetes Knowledge Test is an example of a tool used to assess learning needs for self- management of diabetes.
• Observations 


  Observing health behaviors in several different time periods can help the educator draw conclusions about established patterns of behavior that cannot and should not be drawn from a single observation.
• Documentation 


  Initial assessments, progress notes, nursing care plans, staff notes, and discharge planning forms can provide information about the learning needs of patients.
• Readiness to Learn 


  Once the educator has identified learning needs, the next step is to determine the learner’s readiness to receive information.

  • Readiness to learn can be defined as the time when the learner demonstrates an interest in learning the information necessary to maintain optimal health or to become more skillful in a job.
• Before teaching can begin, the educator must find the time to first take a PEEK at the four types of readiness to learn:

  • Physical readiness
  • Emotional readiness
  • Experiential readiness
  • Knowledge readiness.
• Physical Readiness

  • Measures of ability
  • Complexity of task
  • Environmental effects
  • Health status
  • Gender
• Emotional Readiness

  • Anxiety level
  • Support system
  • Motivation
  • Risk-taking behavior
  • Frame of mind
  • Developmental stage
• Experiential Readiness

  • Level of aspiration
  • Past coping mechanisms
  • Cultural background
  • Locus of control
• Knowledge Readiness

  • Present knowledge base
  • Cognitive ability
  • Learning disabilities
  • Learning styles
• Physical Readiness


  The educator needs to consider five major components of physical readiness:

  • Measures of Ability
  • Complexity of task
  • Environmental effects
  • Health status
  • Gender- because they affect the degree or extent to which learning will occur.
• Emotional Readiness 


  Learners must be emotionally ready to learn. Like physical readiness, emotional readiness includes several factors that need to be assessed. These factors include:

  • Anxiety level
  • Support system
  • Motivation
  • Risk-taking behavior
  • Frame of mind
  • Developmental stage
• Anxiety: influences a person’s ability to perform at cognitive, affective, and psychomotor levels. In particular, it affects patients’ ability to concentrate and retain information.
• Fear: is a major contributor to anxiety and, therefore, negatively affects readiness to learn in any of the learning domains.
• Reachable moment

  • the time when a nurse truly connects with the client by directly meeting the individual on mutual terms.
  • allows for the mutual exchange of concerns and the sharing of possible intervention options without the nurse being inhibited by prejudice or bias
• Motivation: which is a willingness to take action.
• Experiential Readiness 


  It refers to the learner’s past experiences with learning and includes four elements:

  • Level of aspiration
  • Past coping mechanisms
  • Cultural background
  • Locus of control
• Locus of Control

  • Internal locus of control: patients are internally motivated to learn, they are ready to learn when they feel a need to know about something. This drive to learn comes from within the learner.
  • External locus of control: they are externally motivated and then someone other than themselves must encourage the learner to want to know something.
• Knowledge Readiness 


  It refers to the learner’s present knowledge base, the level of cognitive ability, the existence of any learning disabilities and/ or reading problems, and the preferred style of learning.
• Learning styles: refer to the ways in which and conditions under which learners most efficiently and most effectively perceive, process, store, and recall what they are attempting to learn
• Three mechanisms to determine learning style:

  • Observation
  • Interviews
  • Administration of learning style instrument
• Left hemisphere of the brain 


  It was found to be the vocal and analytical side, which is used for verbalization and for reality-based and logical thinking.
• Right hemisphere of the brain


  It was found to be the emotional, visual–spatial, and nonverbal side, with thinking processes that are intuitive, subjective, relational, holistic, and time free.
• Sperry and his colleagues discovered that learners can use both sides of the brain because of a connector between the two hemispheres called the corpus callosum.
• Left-Hemisphere Functions

  • Thinking is critical, logical, convergent, focal
  • Analytical
  • Prefers talking and writing Responds to verbal instructions and explanations
  • Recognizes/remembers names
  • Relies on language in thinking and remembering
  • Solves problems by breaking them into parts, then approaches the problem sequentially, using logic
• Right-Hemisphere Functions

  • Thinking is creative, intuitive, divergent, diffuse
  • Synthesizing
  • Prefers drawing and manipulating objects
  • Responds to written instructions and explanations
  • Recognizes and remembers faces
  • Relies on images in thinking and remembering
  • Solves problems by looking at the whole and the configurations, then approaches the problem through patterns, using hunches
• Left-Hemisphere Functions

  • Good organizational skills, neat
  • Likes stability, willing to adhere to rules
  • Conscious of time and schedules
  • Algebra is the preferred math
  • Not as good at interpreting body language
  • Controls emotions
• Right-Hemisphere Functions

  • Loose organizational skills, sloppy
  • Likes change, uncertainty
  • Frequently loses contact with time and schedules
  • Geometry is the preferred math
  • Good at interpreting body language
  • Free with emotions