Characteristics of the Learner

Chapter 4

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 Determinants of learning

•Nurses have always provided

education for patients and their
families to learn the many different
aspects of their health care

•Nurses have difficulty meeting

patients’ needs because of time
constraints in clinical practice.
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 Determinants of learning

The “teachable moment” is hard to capture

because of decreased length of stay.

•These determinants include:

Learning needs (What)
Readiness to learn (When)
Learning styles (How)

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 The nurse’s role as teacher

The nurse plays a crucial role in the learning

process by:
1- Assessing problems of deficits
2- Providing meaningful information
3- Identifying progress being made
4- Giving feed back and follow up
5- Reinforcing learning
6- Evaluating the client’s abilities

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 Assessment of the learner
The effectiveness of nursing care depends on the
scope, accuracy, and comprehensiveness of
assessment

Factors that considered with respect to three

determinants of learning:
1- Assessment should based on theories, concepts
& principles
2- Identify priorities of behavioral objectives
3- Reduce anxiety of client as possible
4- Prevent unneeded repetition
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 ASSESSING LEARNING NEEDS

Learning needs must be examined first to

discover what has to be taught and to
determine the extent of teaching required

Learning needs defined are gaps in

knowledge that exist between a desired level
of performance and the actual level of
performance

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 Steps to assess learning needs

1- Identify the learner

2- Choose the right setting
3- Collect important information about the
learner
4- Involve members of the health care team
5- Prioritize needs
6- Take time- management issues into
account
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 1- Identify the learner

•Who is the audience? Individual patient,

group of patients, significant others.

•Are their needs the same or different

•Teaching opportunity formal or informal

must be based on accurate identification
of the learners

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 2- Choose the right setting

•Establish an environment in which the

learners feel a sense of security in confiding
(revealing disclosing)information and
believe their concerns are respected and
taken seriously

•Maintaining privacy and confidentiality is

essential to establish a trusting relationship
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3- Collect important information about the learner

•Patients or family member are the most

important source of needs assessment
information

•Be sure to ask what is important to them , what

type of social support systems are available and
how their social support system can help.

•Actively engage learners in defining their needs

and problems
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4- Involve members of the health care team

•Consult with other professionals to gain

insight into the needs of patients and their
families

•Representatives of health related

organizations such as Diabetes
organization, Heart Association often
provide insight into learning needs of
people specific health problems or concerns

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 5- Prioritize needs
•If the basic needs are not attended to first and
foremost as indicated by Maslow's hierarchy of
needs, learning of other information may either
delayed or impossible to achieve

•Prioritizing helps nurses in partnership with

patient set realistic and achievable learning goals

•Not All Learners need to know everything and

assessment can help to discriminate the “need to
know” from the “ nice to know” information
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 Assessing learning needs
• Maslow’s hierarchy of needs

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Prioritize needs

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 Criteria Prioritize needs
Criteria learning needs

Mandatory that must be learned for survival recent heart attack

need to know sign & symptoms & when to get
immediate help
Desirable that are not life dependent but related to well being,
clients with cardiovascular disease need to know the
effect of a high-fat diet on their condition

Possible that are nice to know but not essential, about daily
activity, newly diagnosed diabetes

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 6- Take time- management issues into account

Because lack of time is a major barrier to carrying out a

proper assessment the following are Some Tips that, in
long term are time-savers

1- Give more efficient and effective time to do Good

initial assessment
2- Learner must given time to offer their own thought
(Involve client actively)
3- Do assessment any time & any where as possible
4- Inform client a head of time
5- Minimizing interruptions and distractions

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 Methods to assess learning needs
1- Casual conservations: during performing pt. care, nurse
must rely on active listening, use open-ended questions

2- Structured interviews: use direct open-ended questions.

3- Questionnaires: use checklist

4- Observations: watching the learner perform a task is an

excellent way of assessing a skill

5- Patient charts: physicians’ notes, nurses’ notes, ….etc.

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 READINESS TO LEARN
Defined as the time when the learner expresses or
shows interests in learning the information
necessary to maintain optimal health.

The same methods to assess learning can be used

for assessing readiness to learn.

Timing—that is, the point at which teaching should

take place—is very important.
A learner who is not receptive to information at one
time may be more receptive to the same
information at another time. 18
Take time to take a PEEK at the four types of
readiness to learn

1- Physical readiness
2- Emotional readiness
3- Experiential readiness
4- Knowledge readiness

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 Take time to take a PEEK at the four types of readiness to learn

1. Physical readiness 3. Experiential readiness

• measures of ability • level of aspiration
• complexity of task • past coping mechanisms
• health status • cultural background
• gender • locus of control
• orientation
2. Emotional readiness
• Anxiety level
4. Knowledge readiness
• Support system
• present knowledge base
• motivation
• cognitive ability
• risk taking behavior
• learning disabilities
• frame of mind
• developmental stage

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Physical readiness
1- Measure of ability—sensory abilities

2- Complexity of task—difficulty level of the subject

3- Environmental effects—an environment favorable to

learning

4- Health status—the amount of energy available to

learning

5- gender—women are generally more receptive to

medical care and take less risks regarding their health
than men 21
Emotional readiness

1- Anxiety level
2- Support system
3- Motivation
4- Risk taking behavior
5- Frame of mind
6- Developmental stage

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Emotional readiness

•Anxiety level
Mild or sever anxiety may
Lead to an inability to learn

Moderate anxiety will derive

Someone to take action.

Moderate level of anxiety is best for success in

learning
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Emotional readiness

•Support system—strong support

system decrease anxiety, whereas the
lack of one may increase anxiety.

Teachable moment means “when the

client will be most receptive to
learning.

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Emotional readiness

• Risk-taking behavior
Nurse can help patient develop strategies to reduce the risk of
their choices

• Frame of mind
Example-adults who have reached self-actualization and whose basic
needs are met tend to plan for their future and are more to learn
health promotion tasks.

• Developmental stage
Each stage associated with human development produce a peak time
for readiness to learn certain tasks, known as a “teachable moment”

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Experiential readiness
Level of aspiration— previous failure and success

Past coping mechanism— to understand how the

learner has dealt with previous problems

Cultural back ground— assessment of what illness

means from the patient’s cultural perspective is
important in determining readiness to learn

Locus of control— internal locus of control and

external locus of control orientation

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Knowledge readiness
Refers to learners present knowledge base, the level of
learning capability, and the preferable style of learning. it
consist of:
1-present knowledge base: How much someone already
knows. Build on this knowledge to encourage readiness to
learn
2-Cognitive ability: Match the behavioral objectives to the
ability to learn, or failure to achieve will result
3-Learning disability: People with learning disabilities
require special approach to teaching
4-Learning style: Knowing the learning method and
materials the learner is comfortable with help the nurse
to tailor teaching according to how someone learns best
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 LEARNING STYLES

Refers to the way individuals process information

Each learner is unique and complex with distinct

learning style preferences that that distinguish one
learner from another .

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Learning styles- Six learning style principles

1- Identify style that nurse & client prefer

2- Nurse need not to use her preferred style
exclusively
3- Assist patients to identify their own style
preference
4- Client will have opportunities to learn through
their preferred
style of learning
5- Encourage client to diversity styles of learning
6- Become aware of various methods and
materials available 30
Learning styles

To determine a person’s learning style,

three mechanisms can be used:
•Observation,
• Interviews
•Learning style instruments

Certain of characteristics of learning style are

biological in origin, whereas others are developed
as a
result of sociological and environmental
influences. 31
Right brain / left brain & whole- brain thinking

Brain Preference Indicator

Right hemisphere— emotional, visual-spatial,

non-verbal hemisphere
Thinking processes using the right-brain are
intuitive(spontaneous), subjective, relational,
holistic, and time free

Left hemisphere— vocal and analytical side

Thinking process using reality-based and logical
thinking with verbalization
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 Right brain / left brain & whole- brain thinking

•No correct or wrong side of the brain

Each hemisphere gathers in the same sensory
information but handles the information in
different ways

•Knowledge of one’s own brain hemispherical

performance can aid educator nurse in identifying
their strengths and weaknesses in teaching
methods

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Right brain / left brain & whole- brain thinking

•Whole-brain thinking allows the learner to get

the best of both worlds.

•Duality of thinking should be encouraged to

help learner reach their fullest learning
potentials

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Right brain / left brain & whole- brain thinking
Left Brain Right Brain
•Prefers talking and •Prefers drawing
writing and manipulating
•Recognizes/remem objects
bers names •Recognizes/remem
•Solves problems by bers faces
breaking them into •Solves problems by
parts looking at the
•Conscious of time whole, looks for
and schedules patterns, using
hunches
•Not conscious of
time and schedules36
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 Dunn and Dunn learning style
Identified five basic stimuli :

• Environmental elements ( sound, light,

temperature, design) which are biological in
nature
• Emotional elements (motivation, responsibility,
persistent) which are developmental and emerge
over time as a result of experience that happen at
home, school work etc.
• Sociological elements (desire to learn alone or in
group)
• Physical elements ( perceptual strength, time of
day and mobility ) biological in nature and relate
to the way learners function physically
• Psychological elements ( indicate the way learners
process and react to information ) 38
Dunn and Dunn learning style

•Dunn and Dunn’s identified stimuli are

relevant to the role of the nurse as a
teacher.

•The nurse needs to consider the previously

mentioned selected characteristics when
assessing a patient’s or family member’s
learning style.

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 Interpretation of learning style

General guidelines should be followed when assessing

individual learning style
1- Become familiar with the ways in which style are
classified
2- Identify key element of an individual learning style by
observing and ask question to verify observation and
then match instructional method and materials to those
unique qualities
3- Always give learner the opportunity to say when the
teaching method is not working for them

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Interpretation of learning style
4- Place emphasis on assessing learning styles as a
way to increase understanding both from the nurse
and the learner perspective

5- Be caution about saying that certain instructional

method are always more effective for certain style

6- Provide learning choices that enable learners to

recognize and choose the style in which they prefer
to learn
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