Need

Assess
ment
Unit No: 06

Objectives:
1. Develop a
framework to
assess the
learning needs,
health
problems, of a
target group.
2. Analyze
the problems
according to
priority
Learning needs:
Defined as the gaps in knowledge that exist between a desired level of
performance and the actual level of performance.( Health Education
Association ,1985).
A learning need is a gap between the what someone know and what
someone need to know .such gaps exits because of a lack of knowledge,
attitude ,or skill.

STEPS IN THE ASSESSMENT OF LEARNING NEEDS:

(1) Identify the learner:

Who is the audience?
Are you teaching a group of patients or an individual and his/her
significant others?
Are there needs the same or different ?
Teaching opportunities formal or informal must be based on accurate
identification of the learner.
For example: a nurse may believe that all post-partum mothers need a
class on safety issues for the newborn. This perception may be based on
 the nurses Interaction with one patient and may not be true for all the
post-partum mothers.

(2) Choose the right setting:

Establish an environment in which learner feels a sense of security in
confiding information and believe their concerns are respected and
taken seriously .Maintain privacy and confidentiality to establish trusting
relationship.
(3) Collect the important information about the learner:
Explore the health problems or issues that are of interest of the learner
to determine the time and extent of the content to be include in
teaching as well as teaching methods and international tools to best to
meet their needs.pt/family members are the best source of assessing
the need or need assessment information .Activity engaging learners is
identifying their own problems and needs motivates most of the
patients .
(4) Involves members of the health care team:
Consult with the other professionals to gain insight into the needs of
patients and their families .in addition, the health related organizations
(ACS,ADS,AHS) often can provide insight to the learning needs of people
with specific health problems .
(5) Priorities needs:

Setting priorities is difficult when many learning needs have been

identifying in several areas . However ,if basic needs are not attended to first and
foremost as indicated in Maslows Hierarchy Needs(1970), learning of other
information may be delay or impossible to achieve. As show in fig. below.

For example: learning about the low sodium diet will likely not occur if a patient
faces problems with basic physiological needs such as pain or discomfort.

(6) Take time management issues into account :

Because the lack of time is the major barrier to carrying out a
proper assessment , Rankin and Stallings (2001) suggested that nurse
consider the following tips for time savers :
 Although the close observation and active listening take more
time, it is much more efficient and effective to do good initial
assessment .
Learner must be given time to offer their own thoughts about
learning needs.
Assessment can be made any time and any where the nurse
has contact with patients and families .There are many
potential opportunities ,such as when giving a bath ,serving a
meal ,making round ,distributing medications, and so forth.
Informing patient ahead of time that the nurse wishes to spend
time discussing problems or needs gives them advance notice
to sort out their need and feelings.
Minimizing distraction and interruption during planned
assessment interviews allows the nurse to accomplish in 5
minutes what otherwise might have taken 15 minutes or more
during an interview session that s frequently interrupted.

Criteria for prioritizing learning needs

Criteria Learning needs

Mandatory Needs must be learned for survival or situations in which the

learners life or safety is threatened. Learning needs in this
category must be met immediately .e.g. a patient who has
experienced a resent heart attack needs to know the sign
and symptoms and when to get immediate help.

Desirable Needs that are not life dependent but are related to well
being or the ability to provide self care.e.g. it is important
for the pt. to have CVD to understand the effect of height
fat diet on their condition.

Possible Needs for information that is nice to know but not

essential or required or situations in which the learning
needs is not directly related to daily activities. The pt. who is
newly diagnose as having DM most likely dose not to know
about travelling across time zones or staying in the foreign
country because this information does not related to
patients everyday activities.

METHOD TO ASSESS THE LEARNING NEEDS.

The following are the various methods to assess client needs
and should be used in combination with another to yield the
most reliable information (Haggard,1989).
CASUAL CONVERSATION:
That take place when the nurse is performing patient care.
The nurse must rely on active listening .asked open ended
question about knowledge a skills gaps.
STRUCTURED INTERVIEW:
Used to solicit the learners point of view.as with gathering
the any information ,the nurse should establish the trusting
environment ,use direct and open ended questions ,free
from distraction ,allow the patient to state needs ,remain
nonjudgmental .
Examples of questions:
What do you think the cause of your problem?
How severe is your illness?
What do you do to stay healthy?
What results do you hope to obtain from treatment?
QUESTIONNARIES:
The patient written response to questions about learning
needs can be obtained by this method. There should be
Checklist, provide more privacy; make it easy to tabulation
and easy to administrator.
OBSERVATIONS:
Observation health behaviors in different time periods can
help to determine established patterns of behaviors.
Is there any difficulty to using the equipments ? Are all the
steps performed correctly? Dose the learner required
prompting?
PATIENT CHARTS:
Often documentation in pt. chart will provide patterns that
reveal learning needs. Physicians progress notes , NCP,
nurses notes, discharge planning forms and documentation
by others team members.
 READINESS TO LEARNER
Is define as the time when the learner express or
shows interest in learning the information necessary
to maintain optimal health .Often nurses have noted
that when a patient asks a question the time is prime
for learning. It occur when the learner is receptive ,
willing and able to participate in the learning process.
(LICHTTHAL.1990.four types of readiness)

Take time to take a PEEK of the four types of

readiness to learner

1. P=Physical Measures of ability

Complexity of task
Environmental effects
Health status
gender

2. E=Emotional anxiety level

support system
motivation
risk-taking behavior
frame of mind
developmental stages

3. E=Experiential level aspiration

past coping mechanism
cultural background
locus of control
orientation
4. K=Knowledge learners present knowledge base
cognitive ability
learning and reading disabilities
learning styles

(references: explanation of PEEK in NURSE AS EDUCATOR .Pg.75).