Chapter 8
Client Teaching
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Importance of Client Teaching
• Teaching focuses on combinations of the
following subject areas:
– Self-administration of medications
– Directions and practice in using
equipment for self-care
– Dietary instructions
– Rehabilitation program
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Importance of Client Teaching (cont’d)
• Teaching focuses on combinations of the
following subject areas (cont’d):
– Available community resources
– Plan for medical follow-up
– Signs of complications and actions to take
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Stages of Learning
• Four progressive stages of learning
– Recognition of what has been taught
– Recall or description of information to
others
– Explanation or application of information
– Independent use of new learning
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Question
• Is the following statement true or false?
Style of learning means how a person
responds to learning.
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Answer
False.
Style of learning means how a person prefers
to acquire knowledge.
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Assessing the Learner
• To implement effective teaching, determine
the client’s:
– Preferred learning style; literacy; age and
developmental level; capacity to learn
– Motivation; attention and concentration;
learning readiness; learning needs;
sensory deficits
– Cultural differences
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Learning Styles
• Three general domains
– Cognitive domain: style of processing
information by listening or reading facts
and descriptions
– Affective domain: style of processing that
appeals to a person’s feelings, beliefs, or
values
– Psychomotor domain: style of processing
that focuses on learning by doing
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Cognitive Domain
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Activities Associated With
Learning Domains
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Age and Developmental Level
• Age-related categories of learning
– Pedagogy: science of teaching children or
those with cognitive ability comparable to
children
– Androgogy: principles of teaching adult
learners
– Gerogogy: techniques that enhance
learning among older adults
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Question
• Is the following statement true or false?
Androgogy refers to the principles of
teaching adult learners.
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Answer
True.
There are three major categories of learners
at the early and later ends of the adult
spectrum. The principles of teaching adult
learners is known as androgogy. Pedagogy is
the science of teaching children or those with
cognitive ability comparable to children.
Gerogogy consists of techniques that
enhance learning among older adults.
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Age and Developmental Level (cont’d)
• Unique characteristics of young adults
– Technologically literate, having grown up
with computers
– Prefer visualizations, simulations, and
other methods of participatory learning
and quick responses
– Expect immediate answers and feedback
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Age and Developmental Level (cont’d)
• Unique characteristics of young adults
(cont’d)
– Become bored with memorizing
information and doing repetitious tasks
– Like a variety of instructional methods
from which they can choose
– Respond best when they find the
information to be relevant
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Learning Characteristics
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Question
• Which of the following do young adult
learners prefer?
a. Memorizing information
b. Repeating tasks
c. Fewer instructional methods
d. Participatory learning
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Answer
d. Participatory learning
Young adult learners do not like memorizing
information or repeating tasks. They prefer
participatory learning using visuals and a
choice of various instructional methods.
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Capacity to Learn
• Literacy
– Determine client’s level of literacy before
developing teaching plan
o Illiterate
o Functionally illiterate: minimal literacy
skills; may disguise or compensate for
learning deficits
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Question
• Is the following statement true or false?
A client with minimal literacy skills is termed
“functionally literate.”
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Answer
False.
A client with minimal literacy skills is termed
“functionally illiterate.”
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Capacity to Learn (cont’d)
• Literacy
– Protect client’s self-esteem by asking,
“How do you learn best?”
– Use verbal and visual modes for
instruction
– Repeat directions several times in same
sequence
– Provide pictures, diagrams, or tapes
(audio and video) for future review
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Capacity to Learn (cont’d)
• Sensory deficits
– Older adults
o May have visual and auditory deficits
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Capacity to Learn (cont’d)
• Cultural differences
– Language barriers do not justify
omitting health teaching
o If nurse and client do not speak
same language, use a translator
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Capacity to Learn (cont’d)
• Attention and concentration
– Affect duration, delivery, and teaching
methods employed
– Helpful approaches
o Observe client and implement health
teaching when most alert and
comfortable
o Keep teaching session short
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Capacity to Learn (cont’d)
• Attention and concentration (cont’d)
– Helpful approaches (cont’d)
o Use client’s name frequently throughout
o Show enthusiasm
o Use colorful materials, gestures, variety
o Involve client in an active way
o Vary tone and pitch of voice
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Question
• Is the following statement true or false?
Increasing the duration of teaching sessions
may help in overcoming problems of attention
and concentration in clients.
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Answer
False.
Keeping teaching sessions short may help in
overcoming problems of attention and
concentration in clients.
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Motivation
• Learning optimal: person has purpose for
acquiring new information
• Desire for learning: to satisfy intellectual
curiosity, restore independence, prevent
complications, or facilitate discharge and
return to comfort of home
• Less desirable reasons: to please others,
to avoid criticism
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Learning Readiness
• Readiness refers to client’s physical and
psychological well-being
• In these situations, restore comfort and
then attend to teaching
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Learning Needs
• Individualized teaching and learning is best
• Questions the nurse can ask to assess
client’s learning needs:
– What does being healthy mean to you?
– What things in your life interfere with
being healthy?
– What don’t you understand as fully as
you would like?
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Learning Needs (cont’d)
• Questions the nurse can ask to assess
client’s learning needs (cont’d)
– What activities do you need help with?
– What do you hope to accomplish before
being discharged?
– How can we help you at this time?
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Informal and Formal Teaching
• Informal teaching: occurs spontaneously at
the bedside
• Formal teaching: requires plan
• Potential teaching needs: identified at
client’s admission and amended as care and
treatment progress
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Informal and Formal Teaching (cont’d)
• Teaching occurs in sessions by one or more
nurses so client is not overwhelmed with:
– Processing volumes of new information
– Learning skills that are difficult for
novices to perform
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General Gerontologic Considerations
• During initial assessment of levels of
cognitive function:
– Clients may interact in socially
appropriate manner
– Clients may indicate that they
understand material being taught
• Ask client to recall what has been discussed
after approximately 15 minutes to assess
retained information
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General Gerontologic Considerations
(cont’d)
• Mental status examination may be indicated
• Cognitive impairment: support person or
caregiver present for teaching sessions
• Older people may be creative in methods to
incorporate needed changes in health
behavior if purposes or anticipated benefits
are made clear at beginning of teaching
session
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General Gerontologic Considerations
(cont’d)
• Begin teaching session with reference to
older person’s actual experience
• Project a calm demeanor in a quiet
environment to decrease anxiety and
distractions
• Peer teaching or reinforcement in supportgroup settings may be helpful
• State belief in client’s ability to change
health behavior and provide encouragement
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