Chapter 28

Client Education

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The Teaching-Learning Process

A planned interaction that promotes behavioral change that is not a result of maturation or coincidence.

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Teaching is an active process in which one individual shares information with others in order to provide them with information to make behavioral changes.

Learning is the process of assimilating information with a resultant change in behavior.

The Teaching-Learning Process

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Purposes of Client Teaching

Promotion of Health Prevention of Disease/Injury Restoration of Health Facilitation of Coping Abilities

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Facilitators of Learning

Relevance Motivation Readiness Maturation Reinforcement Participation Organization Repetition

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Barriers to Learning

External Barriers• Environmental• Sociocultural

Internal Barriers• Psychological• Physiological

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Domains of Learning

Cognitive• Learning that involves acquisition of facts

and data• Used in problem solving and decision

making

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Domains of Learning

Affective• Learning that involves changing attitudes,

emotions, beliefs• Used in making judgments

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Domains of Learning

Psychomotor• Learning that involves gaining motor skills• Physical application of knowledge

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Teaching Strategies

Discussion• Nurse acts as a facilitator.• Exchange of information is both verbal and

nonverbal.• Effective for large groups or individual

interactions.

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Teaching Strategies

Demonstration• Realistic for individual clients.• Adequate time is allowed.• Combined with lecture or discussion.• Return demonstration.

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Teaching Strategies

Visual Aids• Flip charts, slides, videos, pamphlets, books• Used in conjunction with other teaching

strategies

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Teaching Strategies

Programmed Instruction• Audio presentations intended for use without

the nurse• Assessment for client/instruction

compatibility

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Teaching Strategies

Computer Assisted Instruction• Can be personalized.• Requires computer skills.• Expensive.

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Professional ResponsibilitiesRelated to Teaching

Legal Aspects• The American Nurses Association identifies

health teaching as an essential function of nursing.

• In most states, teaching is a required function of nurses.

• Also mandated by several accrediting bodies.

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Professional ResponsibilitiesRelated to Teaching

Documentation• Summary of the learning need• Plan of action• Implementation of the plan• Evaluation of the results• Concrete evidence of outcome achievement• Steps taken if outcome not achieved

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Learning Throughout the Life Span

All people are capable of learning. Learning needs and learning abilities

change throughout life. Teaching approaches must be modified

according to the client’s developmental stage and level of understanding.

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Learning Throughout the Life Span

Children• Young children learn primarily through play. • Readiness for learning varies according to

maturational level.• Requires that the nurse work closely with the

family or significant others.

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Insert Figure 28-2, Daniels, Fund.

Hospitalized child using doll in her role-playing activity.

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Learning Throughout the Life Span

Adolescents• More complex information is understood.• Peer pressure is a strong influence.• Group meetings are often useful.• Nurses teach by acting as role models.• Independence is increased through active

participation in their own health care.

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Learning Throughout the Life Span

Older Adults• Sensory deficits • Learning styles• Frequent repetition• Demonstration• Discussion

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Teaching-Learning and theNursing Process

Assessment• Learning styles• Learning needs• Potential learning needs

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Assessment • Ability to learn• Readiness to learn• Client strengths• Previous experience and knowledge base

Teaching-Learning and theNursing Process

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Teaching-Learning and theNursing Process

Nursing Diagnosis• Deficient Knowledge • Risk for Infection• Self-Care Deficit

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Teaching-Learning and theNursing Process

Planning and Outcome Identification • What to teach• How to teach• Who will teach and who will be taught• When teaching will occur• Where teaching will be done

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Planning and Outcome Identification

Teaching Vulnerable Populations• Individuals who experience developmental

delays, chronic illness, low literacy skills, and sensory impairments

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Teaching Vulnerable Populations

Developmental Delays Chronic Illness Low Literacy Skills Sensory Impairments

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Implementation

Knowledge Base Interpersonal Skills Teaching Clients at Home

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Evaluation

Determining what the client has learned Assessing the nurse’s teaching

effectiveness

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Evaluation of Learning

Did the client meet mutually-established goals and objectives?

Can the client demonstrate skills? Have the client’s attitudes changed? Can the client cope better with illness-

imposed limitations? Does the family understand health

problems and know how to help?

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Evaluation of Teaching

Feedback from the Learner Feedback from Colleagues Situational Feedback Self-Evaluation