Nursing Leadership

& Management
Patricia Kelly-Heidenthal
0-7668-2508-6

Delmar Learning
Copyright 2003 Delmar Learning, a Thomson Learning company

Chapter 15
Patient Teaching

Delmar Learning
Copyright 2003 Delmar Learning, a Thomson Learning company

Objectives

Upon completion of this chapter, the reader should be

able to:

Identify five major steps of a teaching methodology.

Explain three components of the analysis phase of teaching.
Discuss at least two major theories of learning style.
Explain the major learning domains.
State the four components of a behavioral objective.
Explain the relationship between terminal and enabling
objectives.
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Objectives
Discuss the importance of Gagnes events of instruction in
planning a teaching session.
Name two forms of evaluation and explain the goals of
each.
Construct behavioral objectives for a teaching session.
Create a lesson plan for a teaching session.

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Methodology

The teaching process is more effective when it follows

a structured, standardized methodology.
A typical teaching methodology contains five major
steps:

Analysis
Design
Development
Implementation
Evaluation
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Analysis

Context analysis aims to determine the situation that

created the need for teaching and the overall type of
instruction needed.
Learner analysis is the process of identifying the
learners unique characteristics and needs, and the
ways in which these can influence the teaching
process.

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Demographics

Many factors can influence the patients response to

the health care environment and to learning. These
include:

Cultural background
Language
Generation
Age
Education
Health care background
Physiological condition
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Learning Styles

A learning style is a particular manner in which a

learner responds to and processes learning. Not
everyone has the same learning style.

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Learning Styles

Various theories of learning style exist. They generally

fall into one of three categories:
Perception: emphasize the way peoples senses affect
learning; e.g., the visual-auditory-kinesthetic (VAK) model
and Gardners multiple intelligences
Information Processing: emphasize different styles in
thinking; e.g., Kolbs experiential learning style
Personality: emphasize how personality differences affect
learning; e.g., Myers-Briggs personality dichotomies
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Content Analysis

During content analysis, the nurse identifies specific

information that should be addressed by teaching.
Nurses can use learning taxonomies, or domains, to
identify measurable types of learning.

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Taxonomies of Learning

Cognitive: knowledge, or what the learner knows

Psychomotor: skill, or what the learner does
Affective: attitude, or what the learner feels/believes
Each taxonomy is organized into a hierarchy that
progresses from simple to complex behaviors that can
be observed and measured.

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Design

During the design phase, the nurse organizes and

structures the content identified in the analysis phase.
The nurse accomplishes this by establishing objectives
and by sequencing content.

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Establishing Behavioral Objectives

Behavioral objectives state specific and measurable

behaviors that should result from the teaching session.
They are based on behaviors identified in the
taxonomies.
They define what the nurse will teach.
They provide the basis for patient evaluation.

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Establishing Behavioral Objectives

An objective has four components:

Audience
Behavior
Condition (optional)
Degree

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Terminal and Enabling Objectives

Each teaching session has a session goal; e.g., Have

the patient understand and demonstrate diabetic selfcare.
Terminal objectives identify major behaviors that
contribute to achievement of the overall session goal.
Enabling objectives identify secondary behaviors that
contribute to, or enable, achievement of terminal
objectives.
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Sequencing Content

Once the nurse identifies teaching content, he or she

determines the order, or sequence, in which it should
be presented.
There are various ways to sequence content:

Chronological
Procedural (step-by-step)
Categorical
Topical

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Sequencing Content

Parts to whole, or whole to parts

General to specific, or specific to general
Problem to resolution
Known to unknown, or unknown to known
Theoretical to practical, or practical to theoretical
Simple to complex, or complex to simple

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Development

During development, the nurse clarifies how to teach

by determining the format, strategies, and resources to
use.

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Session Format

A common format is based on Gagnes key events of

instruction:

Gain the learners attention.

Inform the learner of the objectives.
Review any prerequisite learning.
Present the learning materials.

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Session Format

Guide the learner through the teaching.

Have the learner demonstrate the learning.
Provide the learner with feedback.
Assess the learners performance.
Review the learning and encourage the learner to use the
learning in new situations.

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Session Format

Other elements that are useful during teaching and

that should be incorporated as part of the presentation
format are:

Repetition
Interaction
Presentation, performance, practice
Variety

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Strategies

Strategies identify the various ways in which teaching

is presented.
Some examples of teaching strategies include lecture,
group discussion, and role-play.

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Media

Teaching can be presented through various media,

such as written, visual, audio, video, computer-based
or other material, or combinations of these materials.

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Lesson Plan

A lesson plan is a document that provides the

blueprint for the teaching session. It provides the
necessary information for the nurse or other teacher to
conduct the teaching session.

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Lesson Plan

The lesson plan incorporates information such as:

Learner analysis
Context analysis
Behavioral objectives
Sequence of content
Format
Strategies
Media
Evaluation
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Implementation

During the implementation phase, the nurse actually

conducts the teaching, using the lesson plan as a
guide.
During teaching, the nurse must be aware of and
adaptable to conditions that may affect teaching.
These include:

Learning environment
Patients condition
Nurses teaching skills
Nurses and patients communication skills
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Evaluation

Evaluation is the process of determining the

effectiveness of teaching. There are two major
concerns of evaluation:
Learner evaluation: did the patient learn what he or she was
supposed to learn?
Teaching evaluation: was the teaching presented in an
effective manner?

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Evaluation

In learner evaluation, the nurse determinesthrough

testing, performance observance, or other means
how well the patient mastered the sessions behavioral
objectives The goal is to make sure the patient has
mastered the required behavior.
In teaching evaluation, the nurse or other staff
interviews the learner and uses objective analysis to
determine whether the manner of teaching was
effective. The goal is to improve the quality of the
teaching.
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