CALIFORNIA STATE UNIVERSITY, NOR'rEIRIDGE
A PATIENT EDUCATION TEACHING PROGRMJ!.
FOR
VOCATIONAL NURSING STUDENTS
A Graduate Project Submitted in Partial Satisfaction
of the Requirements for the Degree of
Master of Public Heal t.:h
by
Norma Jeanette Jones
June, 1.981
The Graduate Project of Norma Jeanette Jones is approved:
Waleed Alkhateeb, Dr. P.H.
I
California State University, Northridge
ii
ACKNOWLEDGEMENTS
The author would like to acknowledge and express
my appreciation to those who assisted in the development
and completion of this project:
Michael Kline, Dr. P.H., Chairperson, for his
advice, guidance and sustained encouragement.
Jack Winkelman, H.S.D., Committee Member, for his
guidance and suggestions in the curriculum development.
Waleed Alkhateeb, Dr. P.H., Committee Member, for
his useful suggestions.
My husband, Jack, for his love, understanding and
support.
My family for listening to my frustrations and
always being there when I needed them.
My friends for their encouragement.
This Graduate Project is dedicated to my husband
and family, without their love, this project would not
have been possible.
iii
TABLE OF CONTENTS
Page
ACKNOWLEDGEMENTS .
iii
LIST OF TABLES .
vii
ABSTRACT .
.
.
.
viii
.
Chapter
1.
INTRODUCTION .
1
.
Statement of the Problem .
4
Assumptions
5
Purpose of the Study .
2.
.
6
Limitations of the Study .
6
Definition of Terms
7
REVIEW OF THE LITERATURE .
9
The Hospital as a Setting for
Patient Education . . . . .
3
9
The Nurse as a Patient Educator
12
Lack of Preparedness for Patient
Teaching . . . . .
. . . .
15
Recommendation for Preparation .
17
METHODOLOGY
22
Development, Implementation and
Evaluation of a Curriculum Needs
Assessment Instrument
22
Design of Curriculum .
25
iv
.
.
Chapter
3.
4.
5.
Page
METHODOLOGY (Continued)
Implementation of the Educational
Program . . . .
. . . .
27
Evaluation of the Educational Program
29
Evaluation Criteria
30
ANALYSIS AND DISCUSSION OF FINDINGS .
.
.
32
Curriculum Needs Assessment
Questionnaire . . . . . .
32
Pre-test and Post-test Written
Examination . . . .
33
Curriculum Evaluation Form
34
Clinical Evaluation Form
35
SUMMARY, CONCLUSIONS AND RECOMMENDATIONS
Summary .
.
.
43
43
Conclusions
45
Recommendations
46
Suggested Implementations .
48
Course Schedule .
48
Staff .
49
.
Classroom Facilities
49
Equipment and Materials
49
Methods of Teaching .
49
In-Service
50
Evaluation
50
Revision and Updating .
52
v
Chapter
5.
Page
Smll-iARY, CONCLUSIONS AND RECm1MENDATIONS
(Continued)
Final Conclusion
52
BIBLIOGRAPHY
54
APPENDICES
A.
B.
THE PATIENT EDUCATION TEACHING
CURRICULUM . . . . . . . . . .
58
A CURRICULUM NEEDS ASSESSMENT
QUESTIONNAIRE
. . .
127
C.
LETTER OF TRANSMITTAL
130
D.
EVALUATION OF CURRICULUM NEEDS
ASSESSMENT QUESTIONNAIRE
. .
.
.
132
E.
PATIENT - EDUCATION TEACHING TEST
138
F.
COURSE OUTLINE .
143
G.
CONCEPTS AND OBJECTIVES
H.
EVALUATION FORM PATIENT TEACHING
CURRICULm·1 . . . . . . . .
. .
.
.
.
.
146
.
150
I.
CLINICAL EVALUATION FOID-1 .
152
J.
CURRICULUM TIME LINE .
155
vi
.
.
LIST OF TABLES
Table
I.
II.
III.
IV.
Page
INDIVIDUAL STUDENT SCORES PRE-TEST
AND POST-TEST GROUP I
36
INDIVIDUAL STUDENT SCORES PRE-TEST
AND POST-TEST GROUP II
37
EVALUATION PATIENT TEACHING
CURRICULUM GROUP I
38
EVALUATION PATIENT TEACHING
CURRICULW1 GROUP II
40
vii
ABSTRACT
A PATIENT EDUCATION TEACHING PROGRAM
FOR
VOCATIONAL NURSING STUDENTS
by
Norma Jeanette Jones
Master of Public Health
The purpose of this Project was to develop a
Patient Education Teaching Program for vocational nursing
students that would.facilitate their acquisition of knowledge and skills in the patient-teaching process.
The Project was organized into four phases of
activity:
I.
Development, implementation and evaluation
of a curriculum needs assessment instrument.
II.
Design of curriculum objectives and the
educational program.
III.
IV.
Implementation of the educational program.
Evaluation of the educational program.
viii
The curriculum needs assessment instrument was
designed and mailed to twelve Directors of Vocational
Nursing Programs in the Southern California Region.
The
overall consensus was very positive toward the need for a
patient-education teaching curriculum.
The Patient-Education Teaching Curriculum was
developed by utilizing the results of oral interviews,
the questionnaire and a literature review.
Topics covered
in the program consisted of:
I.
II.
III.
IV.
V.
VI.
VII.
VIII.
Patient Education
Nursing and the Teaching-Learning Process
Systems Approach
Assessment
Development
Implementation
Evaluation
Summary
The curriculum was presented to a study sample
which consisted of two vocational nursing classes.
A research design consisting of a
pre~test,
followed by an educational activity and a post-test was
used for the study.
The purpose of the pre- and post-
testing was to test the content of the curriculum and its
effect on the scores of the groups.
Two groups partici-
pated in the study in order to measure more accurately
ix
the reliability and practicality of the curriculum.
An
evaluation tool was developed and utilized by the students
to evaluate the curriculum content and presentation.
Based on the analysis of the data, the following
conclusions were reached:
A.
There was a definite need for the development
of a patient-education teaching curriculum
B.
Student knowledge from the pre-test exam to
the post-test exam showed a significant
increase
C.
As judged by the students, the program
content was meaningful and the presentation
rated high
D.
There was a newly developed awareness of the
importance of patient education and the role
the vocational nurse plays in the patient
education process.
This project represents the kind of nursing
research needed to establish a scientific body of knowledge in patient education teaching theory and skills.
study serves as a guide.
Although modifications are
The
nece~
sary, it is a definite step in contributing to nursing
knowledge as it relates to nursing practice in the area
of patient education.
X
Chapter 1
INTRODUCTION
The Investigator•s involvement in this program
activity began with a patient•s remark, made in a hospital
room in the Fall of 1973.
That remark was, "If someone
had only told me what to expect, I could have coped much
better.
I didn • t know •;,.Jhat to expect."
That remark ini-
tiated an interest, involvement and dedication in pursuing
the development of patient education programs.
With this newly found interest came an awareness
and realization of how inadequately this Investigator was
prepared for patient teaching.
In observing other nurses
within the health care facility, the same lack of preparedness was noted.
It was a "hit or miss" process with
no developed strategies or continuity of the teaching
process.
Subsequently, teaching experiences as a
Vocational Nurse Educator, and involvement with staff
personnel at various teaching facilities reinforced the
initial impression of lack of preparation by trained personnel in patient education.
It was this background in-
formation that began the inception of a patient education
teaching curriculum for nurses which would include
1
2
concepts, objectives, learning opportunities, resources
and evaluation methodology.
In late January, 1976, the Federal Bureau of
Health Education convened 44 health education practitioners and administrators from various hospital and health
care settings throughout the country.
A primary reason
for the session was to assess the state of the art of
patient education.
The initiation and growth of patient education
programs in a variety of health care delivery settings
were described at the program.
The participants detailed
specific differences and commonalities with regard to
activities in each location.
One specific commonality
identified was:
Although all health workers are 'assumed' to be
patient educators, their professional preparation often has not included the skills required
to assess educational needs and to devise intervention appropriate to the learning needs of
patients with different health conditions
(38:19).
Health workers represent a variety of disciplines,
including physicians, nurses, therapists, dietitians, and
pharmacists.
In the direct delivery of educational programs
for specific health conditions, the most frequent persons
mentioned in the literature are nurses, dietitians, and
pharmacists (38:21).
3
Patient education has always constituted a basic
\
focal point in the philosophy of the nursing profession.
Florence Nightingale, the founder of modern nursing,
wrote in "Notes On Nursing," published in 1859, "The
reparative process which we call disease has been
dered by some want of knowledge . . . " (27:5).
stated, "Neither mothers of families,
.
hin~
She also
. or nurses of
hospitals are taught anything about those laws which God
has assigned to the relations of our bodies with the
world . .
" (27:7).
The advent of modern nursing brought
an awareness of the lack of health education, its implications and its importance.
Statements by the National League of Nursing
Education (NLNE) reflect the concern during this century
with preparing nurses for teaching tasks.
As early as
1918 assertions were made such as, "Another limitation of
the ordinary training is that it deals only or mainly
with disease, neglecting almost entirely preventive and
educational factors .
" (32:12).
The 1937 NLNE curric-
ulum guide commented, "The nurse is essentially a teacher
"
In 1950 comments were, "teaching
of principles of learning and teaching . .
. knowledge
. and teaching
skills" (32:2).
These statements were made in different time
periods but they reflect the emphasis on the teaching-
4
learning process in the teaching of nurses.
Although the
National League of Nursing Education considers preparing
nurses for teaching tasks an integral aspect of the nursing curriculum, the implementation of these recommendations into schools of nursing has been slow in coming.
As stated, teaching has been considered an
integral part of nursing practice and nurses have been
involved in teaching patients, but it has been mostly by
instinct and not by clearly defined objectives and methodologies.
There is no school of nursing that has fully
developed, on an undergraduate, graduate or continuing
education basis, a sophisticated instruction for patient
education (31:1366).
The concepts of patient teaching must be
identified, tested, validated and implemented into the
nursing curriculum.
Only in this way can the nurse
develop the skills necessary in the area of patient
education.
Statement of the Problem
Patient education has long languished as an area
of nursing practice (31:1363).
The development of patient
education programs could move more rapidly and effectively
if health workers were prepared in the theory and application of patient education.
This education should be
5
included in the professional schools and as a part of
continuing education programs (38:12).
At the present time, the Casa Lorna Institute of
Technology Vocational School of Nursing does not have a
formally developed curriculum in patient education.
During the year course of study, students participate in
student-teaching demonstrations in the classroom.
Guide-
lines for patient teaching and evaluative measures of
performance are left to the discretion of individual instructors.
There is no continuity of training from one
class to the next.
This is an inefficient system to teach patient
education.
Students have little understanding of the
instructional design necessary to prepare or present
adequate instruction to the patient.
There is then, a
critical and urgent need to develop and implement a
patient-teaching curriculum within the framework of the
educational facility in order to assure that each student
and each class will be presented with the same educational
background in patient-teaching that will meet his/her
requirements as a professional nurse, and also meets
society's needs regarding its health requirements.
Assumptions
For the purpose of this study it was assumed that:
6
1.
Patient education is an integral aspect of
patient care.
2.
Nurses are the primary givers of patient care;
thus, patient-teaching is part of their nursing
responsibilities.
3.
Nurses require an educational background in
patient-teaching principles to perform effective
patient-education.
Purpose of the Study
The purpose of this study was to develop a Patient
Education Teaching Program for vocational nursing students
that would facilitate their acquisition of knowledge and
skills in the patient-teaching process, thus providing
them with greater capability to become more effective
patient educators.
Limitations of the Study
There are three major limitations to this study.
They are:
1.
The educational program was designed to meet
the needs of vocational nursing students at Casa
Lorna Institute of Technology.
2.
The specific needs of the individual Vocational
Nursing Schools in the Southern California
7
Region participating in the needs assessment
were not considered in this program.
3.
Owing to the time allotted for presentation it
may not be feasible for other schools to implement
this program into their existing programs.
Definition of Terms
Licensed Vocational Nurse
A person who has met all the legal requirements
for a license as a vocational nurse in this state (4:9).
Nursing Process
A systematic way to organize the activities of
professional nursing into an effective framework for
nursing practice,
utiliz~ng
the principles of assessment,
diagnosis, planning, intervention and evaluation.
Patient Care
Meeting all the needs of the patient including
emotional, spiritual, physical, environmental, social,
economical, and rehabilative, including all teaching
needed in any of these areas (17:14).
Patient Education
The educational experiences planned for the
patient by professional personnel as a component of his/
8
her care and distinguishes these experiences from
unplanned learning experiences in the hospital and from
other organizational or environmental factors which
influence his/her behavior (38:72).
Vocational Nursing
The performance of services requiring those
technical manual skills acquired by means of a course
in an accredited school of vocational nursing, or its
equivalent, practiced under the direction of a licensed
physician or registered professional nurse (4:9).
Vocational Nursing Student
A person enrolled in an accredited school of
vocational nursing.
Chapter 2
REVIEW OF THE LITERATURE
The Hospital as a Setting
for Patient Education
Health education is that component of
health and medical programs which consists
of planned attempts to change individual, group,
and community behavior with the objective of
helping achieve curative, rehabilitative,
disease-preventive and health-promotive ends.
Health education is a process with intellectual,
psychological, and social dimensions relating
to activities which increase the abilities of
people to make informed decisions affecting
their personal, family, and community wellbeing.
This process, based on scientific
principles, facilitates learning and behavioral change in both health personnel and
consumer, including children and youth (38:45).
Health education has become an integral part of
·health care delivery and is found in a variety of health
care delivery settings.
Increasingly, hospitals are be-
ing viewed as a setting where patients are accessible and
receptive to educational endeavors, and programs are
slowly being implemented.
This concept of health educa-
tion in the hospital setting has become a component of
patient care and is referred to as patient education.
Patient education refers to the educational
experiences planned for the patient by professional personnel as a component of his/her care and distinguishes
9
10
these experiences from unplanned learning experiences in
the hospital and from other organizations or environmental
factors which influence his/her behavior (38:72).
This
concept probably started with. the first physician and
first patient.
It is reflected in the Hippocratic Oath.
It was meant to be part of the guidelines for hospitals;
at least that is what it seems Florence Nightingale meant
when she stated that the first requirement of a hospital
is that it should do the patient no harm (34:2).
The ultimate goal of organized, planned patient
education is to help individuals acquire new knowledge,
attitudes and behavior that will promote their ability to
care for themselves more adequately; maintain a positive
state of health; and to prevent recurrences when possible
(1:33).
Ulrich states, "Patient education should consist
of organized health education experiences, planned by
physicians, professional health workers, and the patient
himself to meet the patient's specific learning needs,
interests, and capabilities, and offered as an integral
part of the patient's total health care" (37:61).
The emphasis on patient education has grown with
nationwide recognition of the needs for preventive health
care and maintenance (1:38).
'
11
Although much has been written about patient
education and its need for preventive health care and
maintenance, the delivery of planned, organized learning
has been slow in its development and implementation.
Hospitals traditionally have prepared professional
and paraprofessionals for many types of work in the health
field, only very recently have they extended their educational concern to patients.
Efforts in the sphere of
patient education are random and minimally effective (37:
61).
The quality and intensiveness of such endeavors as
well as the disciplines responsible for education programs
have varied greatly (30:111).
The nurse and the physician most often teach the
patient.
Feustel states that members of the medical and
nursing profession have not provided the leadership necessary in the area of patient education (11:4).
However,
there is a lack of clear allocation of responsibility
among health personnel concerning patient education in
the hospital setting.
Physicians play a major role in
the initial information giving.
in the hospital is limited.
However, physician time
The continuing education and
support needed to learn a task and adapt to change should
primarily be the responsibility of others on the health
team (2:1).
'
12
The Nurse as a Patient
Educator
Although all health workers are "assumed" to be
patient educators, their professional preparation often
has not included the skills required to assess educational
needs and to devise interventions appropriate to the
learning needs of patients with different health conditions ( 3 8 : 19 ) .
Health workers represent a variety of disciplines,
including physicians, nurses, therapists, dietitians and
pharmacists.
In the direct delivery of educational pro-
grams for specific health conditions, the most frequent
persons mentioned in the literature are nurses, dietitians
and pharmacists (38:21).
The nurse however is the person in the hospital
who is responsible for the patient's care 24 hours a day.
This contact places the nurse in a unique position for
focusing on patient education.
Patient education has al-
ways constituted a basic focal point in the philosophy
of the nursing profession.
Nursing, historically and currently, espouses
humanistic, holistic patient-oriented approaches to practice.
Nursing education speaks of concerns for the whole
patient and family, meeting patients where they are, and
helping them grow in self-determined directions (28:357).
13
Florence Nightingale, the founder of modern
nursing, wrote in "Notes on Nursing," published in 1859,
"The reparative process which we call disease has been
hindered by some want of knowledge . . . " (27:5).
She
also stated, "Neither mothers of families, . . . or
nurses of hospitals are taught anything about those laws
which God has assigned to the relations of our bodies
with the world . . . " (27:7).
The advent of modern nurs-
ing brought an awareness of the lack of health education,
its implications and its importance.
Statements by the National League of Nursing
Education reflect the concern during this century with
preparing nurses fbr teaching tasks.
As early as 1918
there were statements such as, "Another limitation of
the ordinary training is that it deals only or mainly
with disease, neglecting almost entirely preventive and
educational factors .
" (32:1).
The 1937 NLNE currie-
ulum guide commented, "The nurse is essentially a teacher
"
In 1950 comments were, "teaching
of principles of learning and teaching .
. knowledge
. and teaching
skills" (4:2).
Virginia Henderson (1966) has produced a wellknown and generally accepted definition of nursing.
stated:
She
14
The unique function of the nurse is to assist
the individual, sick or well, in the performance
of those activities contributing to health or
its recovery (or to peaceful death) that he would
perform unaided if he had the necessary strength,
will or knowledge, and to do this in such a way
as to help him gain independence as rapidly as
possible (9:11).
In this statment, Henderson implies·a health teaching
function for nurses.
Nurses serve all people and appropriately provide
primary, episodic and long term care, and as professionals are independently accountable for the execution
and consequences of all nursing services.
Their functions
include:
1.
Sustaining and supporting persons while
reinforcing the natural, developmental, and
reparative processes available to human beings
in their quest for wholeness, comfort and selffulfillment.
2.
Teaching and guiding persons in their pursuit of
optimal wellness.
3.
Motivating persons toward active, knowledgeable
involvement in seeking health and in executing
their needed therapies.
4.
Collaborating with other health professionals
and with persons served in planning and executing
15
programs of health care and diagnostid and
treatment services (33:304-305).
These statements were made in different time
periods, but they reflect the placeofpatient teaching
in nursing and the emphasis on the teaching-learning
process.
Lack of Preparedness for
Patient Teaching
Education of the patient is an integral part of
patient care, shaped by the particular illness, the needs
of the individual, the nature of the prescribed treatment
regimen and skill of the personnel responsible for providing the patient education process (7:9).
Although patient education and preparing nurses
for teaching tasks are considered an integral aspect of
the nursing profession, the implementation of a patientteaching curriculum into schools of nursing has been slow
in coming.
There is no school of nursing that has fully
developed, on an undergraduate, graduate or continuing
education basis, a sophisticated instruction for patient
education (31:1366).
Patient education has long
languished as an area of nursing practice (31:1363).
Nurses' training focuses on clinical expertise
and on competencies for patient care (21:3).
The
16
emphasis has been doing things for the patients.
The
patient has been a passive recipient of nursing care
(9:12).
Many nurses, when they commence their nurses'
training, are informed that they are health educators ambassadors of health.
However, rarely, if any, is fur-
ther or deeper explanation given to prepare them for the
role.
Consequently, many dismiss it from their minds and
concentrate on the task of becoming a nurse.
The dismis-
sal of health education as an integral part of nursing
practice is reinforced during the student nurse's training for HEALTH is .infrequently referred to.
Nurses in
training learn much about sickness, of disease, pathology
and various therapeutic measures to correct ill-health,
but rarely do they learn ways in which they might make a
positive contribution to health by teaching the patient
(9:10).
Partridge speaks of the neophyte nurse who may
be aware of the full scope of her role, but finds herself
incapacitated by her lack of the basic tools of her
professional life (28:358).
Few student nurses are taught how to teach.
They
may unconsciously model themselves on other nurses who
have taught them, but it is unusual for nurses to be
given any formal instructions in teaching unless they
elect to choose education as a career.
Consequently,
17
nurses are generally unclear in their concepts df
teaching (9:12).
Lindeman observed that teaching often
resembled "telling" rather than "teaching" and consisted
of general vague statements rather than specific instructions (19:320).
DelaVega states that most health per-
sonnel are unfamiliar with the process of learning and
are unprepared to assume the responsibilities of teaching
(8:454).
The need for more adequate preparation of nurses
for their teaching function was revealed in a study conducted by Margaret L. Pohl, "A Study of the Teaching Activities of the Nursing Practitioner," - 1963, in which
the teaching activities of 1500 nurses throughout the
United States were surveyed.
Almost all reported a need
for teaching skills, but over 900 stated that their preparation for teaching was either totally lacking or inadequate for their purposes as practicing nurses (29:7).
Simonds stresses that one of the problems in
patient education today is the lack of trained people
who both know the health systems and understand the
educational process (34:10).
Recommendation for Preparation
Most changes in clinical nursing practice have
been based on intuitive thinking or environmental
18
pressures of the work setting rather than on an
established body of knowledge (19:319).
The emphasis on intuitive thinking and
environmental pressure must be corrected in order to
meet the needs of patients who are wishing to take a more
active part in their care.
Nurses have a responsibility
to teach and advise their patients on their own health
care (9:12).
If nurses are to teach their patients as part of
nursing care, then they must have knowledge of what they
are doing and why; they must possess adequate knowledge
of teaching skills and they must have practice in using
teaching skills (9:12).
They must feel comfortable with
the information and skills needed for patient education
(18:82).
They must understand and be prepared to use
principles of teaching and learning which have been
derived by experts in the areas of education and
psychology (8:454).
The educational aspect of care will be provided
in a positive manner only if personnel and staff are prepared to provide it.
The preparedness depends upon:
(1) Being sensitive to the needs of the patient as exhibited in patient behavior (e.g., questions asked,
requests made, anxiety expressed); and (2) Being able to
meet these needs, once they have been identified, through
19
the application of specialized skills and expertise
(38:21).
The development of an education plan that will
ensure the nurse's development of skills necessary in the
area of patient education will require changes in the current educational activities.
The theory and application
of patient education should be included in the professional schools and as a part of continuing education
programs (38:12).
The committee on Educational Tasks in Chronic
Illness appointed by the Health Education Section of the
American Public Health Association in 1968 developed a
mechanism for defining the educational processes necessary
for patient and family education.
In order to accomplish
the educational tasks outlined they stated, "There would
be a need for providing opportunities for training appropriate staff, to sharpen existing skills or acquire new
ones, or modify existing practice so that the patient will
be helped to utilize the educational opportunities available" (7:4).
The health care institutions should include
health education functions in their description of appropriate staff positions and should ensure that the staff
filling these positions are prepared to carry out their
health education function.
Development of patient
20
educations skills should be an integral part of staff
orientation and continuing education (2:17).
Nursing performance in areas such as teaching,
compliance, prevention, psychosocial counseling and integration of diverse cultural patterns into coherent models
of health care is beginning to emerge as a topic of discussion in the literature (22:80).
Literature strongly supports the leadership
undertaken by professional nurses to develop sound educational programs in the area of health prevention, rehabilitation and restoration.
Considerably more effort is
required to gain appropriate support and recognition for
nurse performance in client/family education programs
(22:80).
If the design of nursing care is to be more than
habitual or mechanical, the capacity to perceive and
interpret the subjective experience of others and to
imaginatively project the effects of nursing actions on
their lives becomes a necessary skill (5:22).
The concepts involved in the teaching-learning
process are strongly embodied \vi thin the theoretical
framework of the nursing profession.
If this framework
is to guide the practice of nursing, the concepts must be
identified, tested, validated, and implemented in clinical
areas.
Nurses have an important responsibility in
21
developing and evaluating their skills in the area of
patient education so that a predictive body of knowledge
can be established to insure desired learning outcomes
(13:36).
Research that supports preventive teaching
activities, particularly with respect to nurse leadership
and participation, demands considerable creativity and
effort on the part of the health professional (22:81).
Nursing has a mandate from society to use its
specialized body of knowledge and skills for the betterment of humans.
The mandate implies that knowledge and
skills must grow in such a way as to keep up with the
changing health goals of society.
Nursing must regulate
its own practice, control the qualifications of its practitioners and implement newly developed knowledge (14:41).
Chapter 3
METHODOLOGY
The purpose of this Project was to develop and
test a Patient-Education Teaching Program for vocational
nursing students that would facilitate their acquisition
of knowledge and skills in the patient-teaching process,
thus providing them with greater capability to become
more effective patient educators.
Implementation of the program required four
distinct phases of activity:
I.
Development, implementation and evaluation
of a curriculum needs assessment instrument.
II.
Design of curriculum objectives and the
educational program.
III.
IV.
Implementation of the educational program.
Evaluation of the educational program.
This chapter presents the sequence of activities
and describes the procedures undertaken in each phase
which contributed to the development and testing of the
Patient-Education Teaching Program.
I.
Development, Implementation and Evaluation of a
Curriculum Needs Assessment Instrument
22
23
A.
Identification of Target Population.
Since
the Investigator is a vocational nurse educator and presently teaching at Casa Lorna Institute of Technology in
Pacoima, this school was selected for the study.
Two
classes presently enrolled at the school were chosen as
candidates for the curriculum presentation.
The third
class did not participate owing to the number of students
in the class and a time element involving their established curriculum.
Neither of the two classes chosen for
the presentation had any prior educational background in
the theory or skills of patient education.
B.
Survey of Nurses and Literature Review.
The
next phase of the program was an investigation of possible,
already existing programs in patient education and a review of the literature.
This was accomplished by oral
interviews with nursing students and registered nurses
with whom the Investigator had contact in the training
facilities where my vocational nursing students received
their clinical experience.
From these interviews it was
ascertained that there was no developed program and that
nurses had little if no training in patient education.
The literature review revealed no existing
patient education curriculum for nurses.
However, there
was an emphasis on the growing need for such a program in
24
order for the nurse to meet the needs of a changing
society and its perception of its health needs.
C.
Design of a Curriculum Needs Assessment
Instrument.
A Curriculum Needs Assessment questionnaire
(Appendix B) and a letter of transmittal (Appendix C)
aimed at Directors of Vocational Nursing Programs in the
Southern California Region was developed.
Its purpose
was to identify the need for the proposed curriculum as
the directors perceived such a curriculum in their school.
The questionnaire consisted of questions pertaining to:
1.
The importance of a well designed patientteaching curriculum
2.
The actuality of an existing patientteaching curriculum
3.
Approximate time allowed for any patientteaching program
4.
Areas to be emphasized in patientteaching technique
5.
An over-all rating of their patient-
teaching program
6.
Additional comments
The questionnaire and letter of transmittal was pre-tested
and necessary changes and adjustments were made prior to
mailing.
There were only a few minor changes.
25
D.
~mplementation
Questionnaire.
of Curriculum Needs Assessment
The Investigator, being a member of
California Vocational Nursing Educators, was able to obtain a listing of Vocational Nursing Schools and Directors
in the Southern California Region.
However, it was neces-
sary to contact three schools to verify the names of their
directors.
Twelve directors in the area were then sent a
letter of transmittal, a questionnaire, and a stamped,
self-addressed envelope for return of the questionnaire.
A dead-line was designated for the return of the questionnaire and noted in the letter of transmittal.
E.
Evaluation of the Curriculum Needs Assessment
Questionnaire.
Of the twelve questionnaires mailed, eight
were returned in the stamped, self-addressed envelope,
yielding a return rate of 66-2/3%.
This falls well within
the return rates of questionnaires published by the Research Division of the National Education Association.
Having established a return rate of 50 per cent as acceptable, the questionnaire was tallied and evaluated (Appendix D) .
II.
Design of Curriculum
A.
Selection.
Utilizing the results of the oral
interviews, the questionnaire, and literature review, the
2E
goals, topics, objectives, learning opportunities,
evaluative criteria and resources were developed.
Topics
to be covered in the program consisted of:
1.
Patient Education
2.
Nursing and the Teaching-Learning Process
3.
Systems Approach
4.
Assessment
5.
Development
6.
Implementation
7.
Evaluation
8.
Summary
Concepts were developed for each topic, and behavioral
objectives, subject content, learning opportunities and
resources were developed for each concept presented.
B.
Pre-test and Post-test.
The pre-test/post-
test design was used for this study (Appendix E) .
It
consisted of multiple choice, true-false and fill-in
questions.
The pre-test/post-test was pretested on a
class of vocational nursing students who would graduate
within several weeks.
The primary purpose for evaluating
the testing instrument was to check for ambiguity, clarity, format and structure.
Modifications were made
according to suggestions and problem areas noted by the
test-takers.
The curriculum and pre-test was then
27
presented to my committee for further modification and
approval.
The purpose of the pre-test was to evaluate
the students' knowledge of the subject content.
III.
Implementation of the Educational Program
The patient education curriculum was presented
to the two vocational nursing classes on separate dates.
Owing to already existing student activities scheduled it
was necessary to give the presentations in two segments
lasting approximately two and one-half hours each.
A.
Study Population.
consisted of 14 students.
Group 1 originally
One student, a female, was
absent on the second day of the presentation, and was
dropped from the study.
11 females,
Caucasians.
The group consisted of 2 males,
3 Blacks, 1 Oriental, 1 Hispanic, and 8
Their ages ranged from 19 to 39 with an
average age of 25.
Group II originally consisted of 13 students.
One student, a female, was absent on the second day of
the presentation, and was dropped from the study.
This
group consisted of 3 males, 8 females, 2 Blacks, 1
Hispanic, and 8 Caucasians.
Their ages ranged from 20 to
43 with an average age of 29.
Neither Group I nor Group
II had had any prior educational background in the theory
or skills of patient education.
28
B.
Setting.
The program was conducted in the
classrooms at Casa Lorna Institute of Technology (Casa
Lorna College). Owing to faulty air-conditioning, the
classroom was quite warm and uncomfortable for Group I
the first day of presentation.
Unfortunately this caused
some restlessness and disruptions in the presentation.
Also, all classrooms were being utilized on the second
day of Group II's presentation so the class was held in
a very small room which was non-conducive for learning.
However, their interest in the subject content remained
quite high.
c.
Implementation.
The programs were conducted
as follows:
I.
II.
Group I - October 7, 8, 1980
Group II - October 14, 15, 1980
Prior to the presentation of the course content, each
student was given a course outline (Appendix F) and
course concepts and objectives (Appendix G).
Also, a
short overview of the program was given.
The Investigator conducted both programs.
The
presentation for Group I was taped, and will be used at
a later date for comparison of content and presentation
with another presentation of the same program.
29
At the conclusion of the program, each student
was given a post-test, which was identical to the pretest.
This was followed by a written evaluation of the
program (Appendix H) .
IV.
Evaluation of the Educational Program
There were four analytical tools developed for
this program.
1.
These instruments were:
A Curriculum Needs Assessment Questionnaire
(Appendix B)
2.
A Pre- and Post-test Written Examination
(Appendix E)
3.
A Curriculum Evaluation Form {Appendix H)
4.
A Clinical Evaluation Form (Appendix I)
The Curriculum Needs Assessment Questionnaire was
used primarily for investigating the actuality of patienteducation teaching curriculum in vocational nursing
schools, the need for such a program, and areas of
significance in such a program.
The Written Examination was used both as a pretest and post-test to determine the knowledge of the
participant before and after presentation of the curriculum.
Results of these examinations would enable the
Investigator to evaluate the content of the curriculum
and whether behavioral objectives had been achieved.
The
30
t-test was utilized to determine if there was a
significant difference between the pre- and post-test
means.
This test was chosen because it takes into account
that where two means are obtained for a single group, they
are matched or related.
The use of two groups in this
study was a means of measuring more accurately the reliability and practicality of the curriculum.
The Curriculum Evaluation Form was distributed at
the end of the session and was used to assess .the participants' evaluation of the content, organization and
presentation.
Evaluation Criteria
The evaluation criteria for each objective was
not identified within the curriculum.
The performance
proficiencies that would be accepted as evidence that the
student had achieved the prescribed behaviora•l tasks were
stated in each objective.
Because of the specific purpose and content of a
patient education teaching curriculum, it would be unrealistic to use criteria that was measurable only within
the classroom setting.
Knowledge is an imp0rtant and
significant factor, but it is the actual performance of
the function that requires the student to combine his
knowledge with newly learned skills.
31
Patient teaching is a participatory process and a
paper and pencil test is not an adequate tool for measuring professional competencies in the teaching-learning
process.
Criteria must also be expressed in terms of
desirable practice.
An evaluation tool, Clinical Evaluation Form,
for use in the clinical area was developed (Appendix I).
It states the evaluative criteria for those objectives in
which the student was to develop a patient education program, utilizing the instructional design system.
evaluative tool could be utilized repeatedly.
This
The results
of such an evaluative criteria reveals the strengths and
weaknesses of the individual student.
This information
could be used to determine areas to be emphasized in
improving the students' skills in performing effective
patient education.
This evaluative tool was not used in this program
because of the time period involved in each student
developing and implementing a patient education program.
Chapter 4
ANALYSIS AND DISCUSSION OF FINDINGS
The primary purpose of this study was to design
a patient education teaching program for vocational nursing sutdents that would facilitate their acquisition of
knowledge and skills in the patient teaching process.
In
order to assess the need and effectiveness of such a program, four analytical tools were designed:
A Curriculum
Needs Assessment Questionnaire (Appendix B); a Pre- and
Post-test Written Examination (Appendix E); a Curriculum
Evaluation Form {Appendix H); and a Clinical Evaluation
Form (Appendix I) .
This chapter discusses the data ob-
tained from these analytical instruments.
Curriculum Needs Assessment
Questionnaire
The questionnaire was mailed to twelve Directors
of Vocational Nursing Schools in the Southern California
Region.
Eight questionnaires were returned.
There was
evidence from the returns (Appendix D) that patient teaching was considered very important to important, but no
school had a developed patient teaching curriculum with
stated goals and objectives.
Assessment was considered
to be the most important as far as teaching techniques
32
33
were concerned, with development, implementation and
evaluation considered important.
Some schools state -
"teaching will be done" - in their Curriculum of Disorders but do not state specifically how i t is to be done.
The overall ratings by the individual schools of their
patient teaching curriculum was poor.
Although there
were comments as to time being at a premium in the vocational nursing program and the time element for implementing a patient-education teaching curriculum was questionable, the overall consensus was very positive toward the
need for a patient education teaching curriculum.
Comments such as:
"More and more stress is being
placed on prevention; therefore, patient teaching is becorning increasingly important," and "It has not been an
important part of our curriculum, but we place more ernphasis on it each year," reiterates the findings in the
literature review.
The need for patient-teaching skills
by the nurse is fast becoming an area of primary irnportance.
Pre-test and Post-test
Written Examination
The study group, consisting of two classes of
vocational nursing students, Group I and Group II, were
pre-tested.
They were then presented the curriculum in
two segments, lasting approximately two and one-half hours
34
\_
each.
Following the presentation, they were administered
the post-test.
The'purpose of the pre- and post-testing
was not to test a hypothesis concerning an increase in
learning, but rather to test the curriculum content and
its effect on the scores of the groups.
Two groups par-
ticipated in the study in order to measure more accurately
the reliability and practicality of the curriculum.
The highest possible score on the test was 25.
In Group I, all but two students remained the same or
increased their scores by one to eight points.
The dif-
ference in the means (3.02) was significant at the 0.1
level, thus indicating that the program caused improvement
in the scores of Group I
(Table I).
The comparison of the results of Group II revealed
all but one student either remained the same or increased
their scores by one to eight points.
The difference in
the means (3.05) was significant at the 0.1 level, thus
indicating that the program caused improvement in the
scores of Group II (Table II).
Curriculum Evaluation Form
The Curriculum Evaluation Form was used at the
end of the program.
Tables III, IV, show the responses
of Group I and Group II.
On a scale of 1, 2, 3, 4, 5, 6,
with 1 being low, 5 being high and 6 not applicable, the
majority of the responses ranged in the 4 - 5 area.
The
35
results indicated that the students found the curriculum
meaningful and the presentation above average.
Clinical Evaluation Form
The Clinical Evaluation Form (Appendix I) was
not implemented in this program because of the time period involved in each student developing and implementing
a patient education program in the clinical setting.
The
actual performance of a student in a patient teaching
situation in the hospital setting is the only realistic
measure of his/her competencies in the area of patient
teaching.
This Investigator feels this form of evaluation
is pertinent to the success of patient education and
should be utilized in a patient teaching curriculum.
36
TABLE I
INDIVIDUAL STUDENT SCORES
PRE-TEST AND POST-TEST
GROUP I
STUDENT
PRE-TEST*
1.
13
16
2.
5
7
3.
9
6
4.
11
13
5.
10
13
6.
10
8
7.
13
13
8.
8
16
9.
7
13
10.
13
18
11.
10
11
12.
8
12
13.
4
9
~1ean
9.3
Critical t value *** 3.02
Degrees of freedom - 12
* Maximum possible pre-test score - 25
** Maximum possible post-test score - 25
*** t value significant at .01
POST-TEST**
11.9
37
TABLE II
INDIVIDUAL STUDENT SCORES
PRE-TEST AND POST-TEST
GROUP II
STUDENT
PRE-TEST*
1.
6
10
2.
10
10
3.
7
14
4.
3
11
5.
8
10
6.
7
11
7.
12
11
8.
10
11
9.
8
11
10.
8
13
11.
11
11
12.
12
13
Mean
8.5
Critical t value *** 3.05
Degrees of freedom - 11
* ~-1aximum possible pre-test score - 25
** Maximum possible post-test score - 25
*** t value significant at .01
POST-TEST**
11.3
38
TABLE III
EVALUATION PATIENT TEACHING CURRICULUM
GROUP I
This course was designed
to develop techniques in
teaching skills required
in patient teaching
Number of Responses*
Low
1
High
2
3
'
4
5
1.
Did the course meet
the objectives?
2
4
7
2.
Were the course
objectives clearly
stated?
2
5
6
3.
Was the content
organized in a manner
which was meaningful?
3
3
7
4.
How would you rate
the quality of
instruction?
1
5
7
NA
6
* Total possible responses - 13
5.
What was the most benefit to you in this presentation?
- how to cope ,.,i th patient teaching
- use of chalk board
- the role of the LVN, not just meds and every day
patient care
- systems theory
- the learning system
- the aspect of evaluating
- it was very hard for me to understand it
39
TABLE III CONTINUED
- the course of action to take in teaching the patient
- ways to make the patient understand better
- I never realized how important patient teaching is
- more aware about patient teaching
6.
What was of least benefit to you in this presentation?
- too long
- steps for questioning
- it was confusing in certain cases
- some of the words I couldn't understand
it was hard to understand the evaluation in
cognitive learning
7.
What suggestions or recommendations would you have
for improvement of the presentation?
- break the presentation down
- presentation good, but sometimes hard for me to
understand
- tended to go over my level of comprehension
- go into more skills of teaching
- more audio-visual
- glossary of terms
8.
Additional comments:
- this has already helped, as I used this on my
patients last night
40
TABLE IV
EVALUATION PATIENT TEACHING CURRICULUM
GROUP II
This course was designed
to develop techniques in
teaching skills required
in patient teaching
Number of Responses*
Low
1
2
3
4
High
5
1.
Did the course meet
the objectives?
--- ---
4
8
2.
Were the course
objectives clearly
stated?
--- ---
4
9
3.
Was the content
or9:anized in a manner
which was meaningful?
5
6
4.
How would you rate
the quality of
instruction?
1
10
* Total possible responses
5.
1
1
-
--- ---
NA
6
12
What was of most benefit to you in this presentation?
- being shown exactly how to organize material
- systematized method
- principles of learning
- systems approach
- it is very important to really know what we want
to teach the patient
- learning patient needs and importance of teaching
him to meet these needs
41
TABLE IV CONTINUED
- awareness of teaching patients while caring for
them
- how to obtain the info and present it to the
patient
- it taught me how important it is not only to teach
a patient, but to know how much he did and didn't
retain
- realized the importance of patient teaching and
understanding
- learning guidelines and principle behind patient
teaching
- how to give substantial patient care knowledge
that would be of value to the patient as far as
care after hospital release
6.
What was of least benefit to you in this presentation?
- the distractions
- domains were vague
- history segment
- all information was valuable
-Bloom's Taxonomy
- physician - nurse relationship
- breaking up the lecture
7.
What suggestions or recommendations would you have
for improvement of the presentation?
- more concise
- make step by step method clear
42
TABLE IV CONTINUED
- stress more principles and systems approach
- have the course at the beginning of the LVN course
- condense it
- more time for presentation
this is a valuable part of nursing
- it should be part of the school's curriculum
how to approach a very negative patient
8.
Additional comments:
- will enable me to be more assertive in my patient
care
- gain better rapport with patient
- enrich other classes
will be better prepared when giving a patient
information
Chapter 5
SU~~RY,
CONCLUSIONS AND
(
/~
\
RECOM1~NDATIONS
Summary
The purpose of this study was to design a patient
education teaching curriculum for vocational nursing students that would facilitate their acquisition of knowledge
and skills in the patient-teaching process.
The process that led to the achievement of this
goal was organized into four phases of activity:
I.
Development of a curriculum needs
assessment instrument, its implementation
and evaluation
II.
Design of curriculum objectives and the
educational program.
III.
IV.
Implementation of the educational program
Evaluation of the educational program
A curriculum needs assessment questionnaire was
developed and mailed to twelve Directors of Vocational
Nursing Schools in the Southern California Region.
questionnaires were returned and analyzed.
Eight
Utilizing the
results of these questionnaires, oral interviews and a
literature review, the curriculum was developed.
curriculum consisted of the following context:
43
The
44
A.
Patient Education
B.
Nursing and the Teaching-Learning Process
c.
Systems Approach
D.
Assessment
E.
Development
F.
Implementation
G.
Evaluation
H.
Summary
The program was implemented at Casa Lorna Institute
of Technology to two classes of vocational nursing students, Group I and Group II.
Each group was presented
the program in two segments, lasting approximately two
and one-half hours each.
Four analytical tools were developed for this
program.
A Curriculum Needs Assessment Questionnaire
(Appendix B) was implemented prior to development of the
curriculum.
A Pre-test Written Examination (Appendix E)
was developed to evaluate the students' knowledge of the
subject content before the implementation of the program.
The pre-test was also used as a post-test exam.
The t-
test for dependent means was chosen to determine if there
was a significant different between the pre- and posttest.
The t-test for dependent means takes into account
that when two means are obtained for a single group, they
are matched or related.
Two groups were used in this
45
study so that the curriculum could be measured more
accurately for reliability and practicality.
A Curricu-
lum Evaluation Form (Appendix H) was used to assess the
participants' evaluation of the content, organization and
presentation of the program.
Finally, a Clinical Evalua-
tion Form (Appendix I) was developed but not implemented
in this program due to the time element involved in each
student developing and implementing a patient education
program.
The information obtained from this form would
determine performance proficiencies and areas to be emphasized in improving the students' skills in performing
effective patient education.
Conclusions
Based on the analysis of the data, the following
conclusions were reached:
A.
There was a definite need for the development
of a patient education teaching curriculum
B.
Student knowledge from the pre-test exam to
the post-test exam showed a significant
increase
C.
As judged by the students, the program
content was meaningful and the presentation
rated high
46
D.
There was a newly developed awareness of
the importance of patient education and the
role the vocational nurse plays in the patient
education process.
Recommendations
The Investigator feels that although there was
improvement in the scores of the study groups and the
overall rating of the curriculum was in the 4 - 5 range,
there should be modifications made in the curriculum.
The
following are recommendations concerning the curriculum
content:
1.
During the presentation of the curriculum,
there were many interruptions pertaining to
definition of terms and action verbs.
To
lessen these interruptions and to facilitate
the presentation of the curriculum, a glossary
of terms and a list of action verbs should be
presented to the students along with the content outline and objectives at the beginning
of the course.
2.
The subject matter on Bloom's Taxonomy of
Cognitive Learning was too detailed for this
group of students.
The concepts of the higher
levels of learning were difficult for the
47
majority of the students to understand.
The
vocational nurse will in the majority of her
patient teaching experiences, be concerned
with recall. and comprehension.
The author
feels that emphasis in these areas should be
stressed, thus providing the nurse with practical information to be utilized in writing
realistic behavioral objectives for her
patients.
3.
The presentation of the curriculum in two
segments caused a lack of interest and participation by the groups the second day.
To
retain the interest and participation of the
students and facilitate the administration
and continuity of the curriculum, a one day
program would best meet the needs of the students and the instructor.
4.
The knowledge and skills acquired from this
curriculum should be implemented into already
existing curriculums, i.e., disorders.
This
will reinforce the students' learning and
increase his/her effectiveness as a patient
educator after graduation.
48
Suggested Implementations
This project was designed specifically for
Vocational Nursing Students at Casa Lorna Institute of
Technology.
A questionnaire, aimed at Directors of Voca-
tional Nursing Programs in the Southern California Region,
was developed, implemented and analyzed to identify the
need for the curriculum as the Directors perceived such a
curriculum in their schools.
This curriculum was not
developed to meet the needs of those schools or their
nursing students.
However, the depth and breadth of the
subject matter covered in this curriculum allows for modification and utilization in any school of nursing.
The following is a recommended procedure for
implementing, evaluating, revising and updating this curriculum.
Appendix J presents a projected time line for
the implementation of the curriculum.
Course Schedule
The Patient-Education Teaching Curriculum will be
an integral part of the vocational nursing student program.
The curriculum will be presented three times a
year, during the fourth month of enrollment of each of
the three nursing classes.
It will consist of a one day
class period, five hours, on the students' scheduled
theory day.
However, this may be varied to two, two and
49
a half hour classes, presented on two consecutive days.
The variation will depend upon instructor availability
and time allotment.
Staff
Two faculty members will be needed ·to teach the
classes.
Those faculty members already teaching theory
will be utilized to teach the curriculum.
Classroom Facilities
Those existing available classrooms will be
utilized.
Equipment and Materials
.The following equipment and materials will be
necessary for the presentation of the curriculum.
include:
They
audio-visual films and cassettes, overhead
projector, projector screen, transparencies, duplicating
machine, hand-outs, pamphlets, chalkboard, chalk, paper
and pencil.
Methods of Teaching
The class is instructed to use varied learning
experiences.
They include:
audio-visual films,
discussion, role-playing, and work-groups.
lecture-
50
In-Service
In-service education must be considered as an
on-going program due to possible curriculum and staff
·changes.
The purpose of the in-service is to provide a
learning opportunity for the instructors in which information and resources are provided to select methods of
teaching that are appropriate to the developmental levels
of the students and the content presented.
The in-service meetings will include the two
faculty members and members of the curriculum committee.
Initially, there will be an orientation meeting
to review the concepts and objects, the content, learning
opportunities and resources of the curriculum.
Following evaluation by the curriculum committee
in January and July, it will be necessary to meet to discuss revision and updating.
If there was to be a signif-
icant change in programs, another meeting would be
advisable.
Evaluation
The purpose of the evaluation is to determine
whether the curriculum is meaningful and realistic and
meets the educational needs of the vocational nursing
student to be more effective patient educators.
51
When to Evaluate:
To assess the strengths and
weaknesses of the curriculum, there will be evaluative
methods conducted by the instructors before, during and
after the presentation.
Pre-test and Post-test:
A pre-test (Appendix E)
will be given to the students before the presentation to
test their previous knowledge of patient-education.
Also,
the pre-test will assist in the planning of content material for future classroom presentation.
The same test
will be given as a post-test (Appendix E) upon completion
of the presentation to measure the attainment of educational objectives.
During Curriculum Presentation:
During the
presentation of the curriculum, the instructor will evaluate periodically the students' interest, responses and
participation in discussions.
Student Evaluation:
At the completion of the
presentation and the post-test, the students will be
given an Evaluation form (Appendix H) to evaluate the
curriculum and the presentation.
Comments and sugges-
tions will be encouraged for the purpose of revision
and improvement of the curriculum.
52
Long-Range Evaluation:
Long-range evaluation of
the curriculum will be done in a continuous manner.
After
each class presentation, the evaluations, tests and evaluative forms will be tabulated and analyzed.
Also, the
students' clinical evaluation forms of their participation in the patient-teaching process will be evaluated at
the six and twelve month period.
The data from all eval-
uative methods will be presented to the curriculum committee twice a year, January and July.
Revision and Updating
Revision and updating of the curriculum will be
done following the recommendations made at the curriculum
committee meetings.
The January revision and updating
will be more thorough to determine if all criteria have
been met during the past year.
Educational objectives,
content material, learning opportunities and references
will be reviewed and revised as necessary to meet the
educational needs of the student nurses and the needs of
society as it relates to health education.
Final Conclusion
This project represents the kind of nursing
research needed to establish a scientific body of knowledge ip patient education teaching theory and skills.
53
The study serves as a guide.
Although modifications are
necessary, it is a definite step in contributing to nursing knowledge as it relates to nursing practice in the
area of patient education.
BIBLIOGRAPHY
1.
Alston, Kenneth N., "Hospital and Community Join in
Diabetic Education Program.~ Hospital Topics,
38-40, September, 1970.
2.
American Hospital Association.
Guides for
Implementing Patient Education Programs in
Hospitals.
3.
American Hospital Association.
Strategies for
Patient Education.
Second Invitational Conference
on Patient Education, Chicago, October, 1969.
4.
Board of Vocational Nurse and Psychiatric Technician
Examiners. Vocational Nursing Practice Act With
Rules and Regulations.
Department of Consumer
Affairs, 1979 - 1980, pg. 9.
5.
Carper, Barbara A.
"Fundamental Patterns of Knowing
in Nursing." Advances in Nursing Science, 1 (1}:
13-23, October, 1978.
6.
Clark, Carolyn Chambers.
Education. New York:
Company, 1978.
7.
Committee on Educational Tasks in Chronic Illness.
A Model for Planning Patient Education. American
Public Health Association, November, 1975.
8.
Cross, Joanne E. and Carol R. Parson.
"NurseTeaching to r-1otivate Change in Food Selection
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Research, 20 (5):
454-458, September-October,
1971.
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Duberly, Janet.
"Health Education and Nursing:
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Classroom Skills for Nurse
Springer Publishing
Dziurbejko, Marcia and Judith Candib Larkin.
"Including the Family in Preoperative Teaching."
American Journal of Nursing, 78 (11): 1892-1894,
November, 1978.
54
55
11.
Feustel, Delycia.
"Nursing Students Knowledge
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4-8, January, February, 1976.
12.
Fodor, John T. and G. T. Dalis.
Health Instruction:
Theory and Application.
Philadelphia: Lee and
Febiger, 1974.
13.
Guzzetta, Cathie.
"Relationship Between Stress and
Learning." Advances in Nursing Science, 1 (4):
35-49, July, 1979.
14.
Hardy, Margaret.
"Perspectives of Nursing Theory."
Advances in Nursing Science, l (1): 37-48,
October, 1978.
15.
Harper, Lilah.
"Developing and Evaluating a Patient
Education Program." Patient-Education, National
League for Nursing, Pub. No. 20-1633, 1-18, 1976.
16.
King, Elizabeth.
Classroom Evaluation Strategies.
St. Louis:
C. V. Mosby Company, 1979.
17.
Kron, Thora.
The Management of Patient Care.
Philadelphia: W. B. Saunders Company, 1976,
14 pp.
18.
Lee, Elizabeth A. and Jeanne L. Garvey.
In-Patient Education Being Managed?"
51: 75-82, June, 1977.
19.
Linderman, Carol A. and Betty Van Aernarn.
"Nursing
Intervention with the Presurgical Patient."
Nursing Research, 20 (4): 319-332, July-August,
1971.
20.
Lynaugh, Joan.
"The Entry into Practice Conflict."
American Journal of Nursing, 80 (2): 266-270,
February, 1980.
21.
b1cFarland, Dalton E. and Nola Shiflett.
"The Role
of Power in the Nursing Profession." Nursing
Dimensions, Vol. 7, (2): 1-13, Summer, 1979.
22.
McLaughlin, Frank E.
"Current Priorities in
Nursing Research." Advances in Nursing Science,
l (2): 79-82, January, 1979.
"How is
Hospitals,
56
23.
Hiller, Marion.
"Patient Education - A Growing
Concern of Many." Patient Education, Pub. No. 201633, 19-28, 1976.
24.
Hitchell, Ellen Sullivan.
"Protocol for Teaching
Hypertensive Patients." American Journal of
Nursing, 77 (5): 808-809, May, 1977.
25.
Murray, Ruth and Judith Zentner.
"Guidelines for
More Effective Health Teaching." Nursing '76,
6 (2): 44-53, February, 1976.
26.
Narrow, Barbara. Patient Teaching in Nursing
Practice. New York: John Wiley and Sons, 1979.
2 7.
Nightingale, Florence. Notes on Nursing. Faccimile
of First Edition 1859, Philadelphia: J. B.
Lippincott Company, 1946.
28.
Partridge, Kay B.
"Nursing Values in a Changing
Society." Nursing Outlook, 26 (6): 356-360,
June 1978.
29.
Pohl, Margaret L. The Teaching Function of the
Nursing Practitioner. Dubuque, Iowa: Wm. c.
Brown Company, 1978.
30.
Reader, George G. and Doris Schwartz.
"Patients
Knowledge of Health." Hospitals, 111-114, March,
1973.
31.
Redman, Barbara K.
"Curriculum in Patient Education."
American Journal of Nursing, 78 {B): 1363-1366,
August, 1978.
32.
Redman, Barbara K. The Process of Patient Teaching
in Nursing. St. Louis: c. v. Mosby Company,
1976.
33.
Schlotfeldt, Rozella H.
"The Professional Doctorate:
Rationale and Characteristics." Nursing Outlook,
26: 302-311, May, 1978.
34.
Simonds, Scott K.
"Focusing on the Issues."
Strategies for Patient Education, Second
Invitational Conference on Patient Education,
American Hospital Association, Chicago, 2-12,
October, 1969.
57
35.
Storlie, Francis.
"A Philosophy of Patient
Teaching." Nursing Outlook, 19: 387-389, June,
1971.
36.
"Trends."
37.
Ulrich, Marion R. and Kenneth M. Kelley.
"Patient
Care Includes Teaching." Hospitals, 46 (8):
59-65, April, 1972.
38.
U. S. Department of Health Education and Welfare,
Public Health Service. Patient Education
Workshop: Summary Report.
Public Health
Service, Atlanta, Georgia, 1976.
Nursing '80, 10 (2): 11, February, 1980.
I
APPENDIX A
THE PATIENT EDUCATION TEACHING CURRICULUM
58
'
Main Concept:
Nurses trained in a scientific approach to patient
teaching are more effective patient educators.
I.
Patient Education
Concept 1
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.1 - In own words define patient education.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
Course Overview
A.
Purpose
B.
Topics
c. Expectations and
Objectives
I.
Patient Education
A.
Definition - Act or
process of providing
patients with knowledge, skill, competence, or desirable
qualities of behavior
1.
Teac~ing/learning
process
2.
Reduces incidence
or prevalence of
disease or health
problem
3.
Success determined by degree
behavior is
modified
4.
Taught by multidisciplinary
health care
professionals
59
Distribute content outline
and objectives.
Instructor to discuss
purpose of curriculum,
topics to be covered,
instructor expectations,
and student objectives.
1.
2.
3.
Instructor lecture
Use transparency with
definition of patient
education
Elicit student discussion on:
a. viJ'hat is teaching/
learning process?
b. What type of patient is the
learner?
c. Who is the multidisciplinary team?
d. When do you do
patient teaching?
60
I.
Patient Education
Concept 1
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.1 - In own words define patient education.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
5.
Integral part
of nursing care
RESOURCES
Freedman, Carol R. Teaching Patients.
Courseware, Inc., 1978.
San Diego:
Narrow, Barbara.
Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function.of the Nursing
Practitioner.
Dubuque, Iowa: Wm. C. Brown Company
Publishers, 1978.
61
I.
Patient Education
Concept l
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.2 - Discuss six benefits of patient
education and specify those benefits
specific to the patient.
CONTENT
I.
Patient Education
1.
B. Benefits of
patient education
1. Provides pa2.
tients some
measure of control of their
health
2. May help patient
recover more
quickly, need
less pain medication, and ambulate
earlier
3. Nurse is expressing concern and
3.
interest which is
important to recovery and sense
of well being
4. Provides means
for sustaining
well-being at
horne
5. Nurse rneeets professional and legal
requirements
6. Offers nurses
opportunity to learn
from patients and
improve communication techniques
SUGGESTED LEARNING
OPPORTUNITIES
Use transparencies
with listing of
benefits
State studies on
patient teaching
effectiveness
a.
St. Paul Hospital,
Dallas - "Cardiac
Patient Group
Teaching Program."
b. Sisters of Charity
Hospital, Buffalo"Including Family
in Preoperative
Teaching"
Elicit student
discussion on benefits
as they relate to the
patient and to the
nurse
62
I.
Patient Education
Concept 1
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.2 - Discuss six benefits of patient
education and specify those benefits
specific to the patient.
RESOURCES
Freedman, Carol R. Teaching Patients.
Courseware, Inc., 1978.
San Diego:
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner.
Dubuque, Iowa: Wm. c. Brown Company
Publishers, 1978.
/
63
I.
Patient Education
Concept 1
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.3 - Discuss the development of the
philosophy of patient education in
modern nursing, utilizing information
discussed in class.
CONTENT
I.
Patient Education
1.
C. History
1. 1859, Florence
Nightingale,
"Reparative pro2.
cess hindered by
want of knowledge"
2. 1918, National
League of Nursing
Education, "ordinary training . . .
neglecting preventive and educational
factors"
3. 19 57, N. L. N. E. , "The
nurse is essentially
a teacher"
4.
1950, N.L.N.E.,
"teaching . . .
knowledge of principles of learning
and teaching"
5.
1973, Nurse Standard Practice Act
includes patient
education
6.
Joint Commission
Accreditation Hospitals guidelines
states patients
should be taught
. . . "health
SUGGESTED LEA~NING
OPPORTUNITIES
Use transparencies
with important factors
on history and
developments
Use flip-chart with
print-out of important
factors
64
I.
Patient Education
Concept 1
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.3- Discuss the development of the
philosophy of patient education in
modern nursing, utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
7.
D.
status, level of
functioning and
self-care after
discharge" . . .
informed of • . .
the nature and
purpose of any
technical procedure . . . right to
expect adequate
instruction in
self-care . . . "
Patient Bill of
Right " . . . informed consent
. . . requirements
following discharge"
Recent Developments
1. Establishment of
Bureau of Health
Education
2. Movement toward a
National Center
for Health
Education
3. Requirements that
hospitals . . .
qualified educational specialists
or . . . consultants
1.
Elicit student
discussion on,
"Why the change
in attitude and
understanding of
health education"
65
I.
Patient Education
Concept 1
Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.3- Discuss the development of the
philosophy of patient education in
modern nursing, utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
4.
5.
6.
7.
Requirements of
state medical
programs . . .
undertake educational efforts
Health education
services in regulations for m-10
Accreditation of
new programs to
prepare health
education specialists
Recognition of
contributibn
health education
can make toward
the achievement
of health goals
RESOURCES
Dzuirbejko, MariaM., and Judith Candib Larkin.
"Including the Family in Preoperative Teaching."
American Journal of Nursing, Vol. 78, No. 11:
1892-1894, November, 1978.
Miller, Marian.
"Patient Education - A Growing Concern
of Many." Patient Education, National League for
Nursing, New York, 1976.
66
I.
Patient Education
Concept 1
- Protection and promotion of health is
a prime responsibility of the nurse.
Objective 1.3- Discuss the development of the
philosophy of patient eduation in
modern nursing, utilizing information
discussed in class.
RESOURCES
Nightingale, Florence. Notes on Nursing, Facimile of
1st edition, Philadelphia, 1859.
Patient Bill of Right in California.
Redman, Barbara Klug.
The Process of Patient Teaching in
Nursing, 3d ed., St. Louis: C. V. Mosby Company,
1976.
Winslow, Elizabeth Hohm, and Therese M. Weber.
"Rehabilitation of the Cardiac Patient, Progressive
Exercise to Combat the Hazards of Bed Rest." American
Journal of Nursing, Vol. 80, No. 3: 440-445, March,
1980.
67
II.
Nursing and the teaching/learning process
Concept 2
- Knowledge and understanding of
nursing and the teaching/learning
process facilitates the nurse in
assessing her/his role in patient
teaching.
Objective 2.1 - State in own words the problems
confronting the nurse today in
respect to meeting the professional
and legal responsibilities of
patient teaching.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
II.
Nursing and the
teaching/learning
process
Nurse's perception
A.
1.
View teaching
as formal
instruction
Concept of
2.
teaching
unclear
3.
Give nursing
care but do
not teach
B.
Confusion of role
Teaching role
1.
not clearly
defined
2.
Physician/nurse
relationship
3.
A lack of
expectation
by employer
4.
Information
used as a controlling power
over patients
1.
2.
3.
4.
Instructor lecture
on nursing and the
teaching/learning
process
Elicit student
discussion on:
a.
How they perceive
themselves as
teachers
b.
Physician/nurse
relationships
Use transparencies of
statistical findings
of Pohl study
Use transparency of
statment, "Although
all health workers
II
5.
Brainstorm the idea
of "ways to increase
the nurse's knowledge
and skills in patient
teaching."
68
II.
Nursing and the teaching/learning process
Concept 2
- Knowledge and understanding of
nursing and the teaching/learning
process facilitates the nurse in
assessing her/his role in patient
teaching.
Objective 2.1 - State in own words the problems
confronting the nurse today in
respect to meeting the professional
and legal responsibilities of
patient teaching.
CONTENT
C.
D.
Nurses as teachers
1. Many educational
opportunities in
nursing setting
2. Knowledge relating to health
and illness
3.
Individualized
teaching
4. Teaching is a
nursing
intervention
Preparation for
teaching
1.
Pohl study .
2.
Patient education
workshop finding
in 1976, "Although
all health
workers . . . "
3.
Gap between
preventive and
curative services
4. Formal course
work overcomes
deficiencies
SUGGESTED LEARNING
OPPORTUNITIES
69
II.
Nursing and the teaching/learning process
Concept 2
- Knowledge and understanding of
nursing and the teaching/learning
process facilitates the nurse in
assessing her/his role in patient
teaching.
Objective 2.1 - State in own words the problems
confronting the nurse today in
respect to meeting the professional
and legal responsibilities of
patient teaching.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
5.
Knowledge and
skills of nursing/
teaching/learning
process must be
developed
RESOURCES
Lynaugh, Joan.
"The Entry Into Practice Conflict: How
We Got Where We Are and What Will Happen Next."
American Journal of Nursing, 80:2: 2677-270,
February, 1980.
Redman, Barbara Klug.
"Curriculum in Patient Education."
American Journal of Nursing, 78:8: 1363-1366,
August, 1978.
Redman, Barbara Klug.
The Process of Patient Teaching in
Nursing, 3d ed., St. Louis: C. v. Mosby Company,
1976.
Rieser, Mary.
"Patient Family Education: Its Value and
Some Issues to Consider on How It Is To Be Accomplished." Patient Education. National League for
Nursing, New York, 1976.
70
II.
Nursing and the teaching/learning process
Concept 2
- Knowledge and understanding of
nursing and the teaching/learning
process facilitates the nurse in
assessing her/his role in patient
teaching.
Objective 2.1 - State in own words the problems
confronting the nurse today in
respect to meeting the professional
and legal responsibilities of
patient teaching.
RESOURCES
U. S. Center for Disease Control, Atlanta.
Patient
Education Workshop: Summary Report.
Public Health
Service, Community Program Development Division.
Atlanta, 1976.
71
III.
Principles of Learning
Concept 3
- Knowledge, understanding and
application of the principles of
learning increases the nurse's
effectiveness in patient teaching.
Objective 3.1 - Discuss the four principles of
learning and apply each principle
to a nursing situation.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
III. Principles of learning
Organization/
A.
systematic planning
Integrate
1.
information
into logical
and meaningful
whole
2.
Reduces
frustration
Increases
3.
learning
efficiency
B.
Motivation
Learn best
1.
when there's
a desire to
learn
Energy change 2.
tension/
anticipation
Motivation
3.
plus ability
needed for
learning
c. Interaction
Learning an
1.
active process
Learn more
2.
when doing
than listening
or reading
1.
2.
3.
4.
5.
6.
Lecture on principles
of learning
Use of transparencies
or flip chart
Give examples of
motivation
a.
Nurse attending
workshop based
on educational
needs
b.
Patient attending
diabetic class
but not accepting
the medical
problem
Elicit student
discussion on "motivation plus ability"
Give examples of
interaction, such as:
a.
Dressing change
b.
Urine testing
Use demonstration of
listening/understanding and doing/understanding for changing
behavior
a.
Clasp hands
together then
reverse position
72
III.
Principles of Learning
Concept 3
Objective 3.1
- Knowledge, understanding and
application of the principles of
learning increases the nurse's
effectiveness in patient teaching.
Discuss the four principles of
learning and apply each principle
to a nursing situation.
CONTENT
SUGGESTED LEARNING
OPPORTUNITIES
D.
b.
Reinforcement/
repetition ==
retention/
transfer
1.
Initial
learning must
be meaningful
2.
Use success
and reward
3. Plan, practice,
review
4. Emphasize
general concepts
and abilities
5.
Provide for
application
7.
Fold arms then
reverse position
c.
Reverse position
more difficult explains habits
and difficulties
in changing
Elicit student
discussion on "Success
and reward" as it has
related to their
learning process
RESOURCES
Bevis, Em Alivia.
Curriculum Building in Nursing.
Louis: C. v. Mosby Company, 1978.
Pohl,
St.
~1argaret.
The Teaching Function of the Nursing
Practitioner.
Dubuque, Iowa: Wm. c. Brown Company
Publishers, 1978.
Storopoli, Charles J., and Carolyn Waltz.
Developing and
Evaluating Educational Programs for Health Care
Providers.
Philadelphia: F. A. Davis Company, 1978.
9 '
73
IV.
Principles of Teaching
Concept 4
- Knowledge, understanding and
application of teaching principles
contributes to the development of
teaching skills.
Objective 4.1 - Discuss the seven principles of
teaching and apply each principle
to a nursing situation.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
IV.
Principles of
teaching
A.
Teacher/learner
rapport
Know more
1.
about learner
2.
Learner freer
to ask questions/make
mistakes
3. Learner has
more respect
for teacher
4.
Learner more
motivated
through caring
exhibited
B. Effective
communication
Verbal/words
1.
have different
meanings
2.
Non-verbal/
expressions,
gestures,
behavior
3.
Recognize signs
of misunderstanding
c. Knowledge of
cultural differences
1.
2.
3.
4.
5.
Lecture on principles
of teaching
Elicit student
discussion on blocks
to good teacher/
learner relationships
Examples:
a.
Stereotype
b.
Prejudice
c.
Courtesy
Class participation
in demonstration of
a.
Two-\vay
communication
b.
Non-verbal
communication
c.
Information
change through
passage of information from
person to person
Show film, "Nonverbal communications" and discuss
some of the major
points of the film
Show film, "Cultural
Diversities" and
discuss some of the
major points of the
film
74
IV.
Principles of Teaching
Concept 4
- Knowledge, understanding and
application of teaching principles
contributes to the development of
teaching skills.
Objective 4.1 - Discuss the seven principles of
teaching and apply each principle
to a nursing situation.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
1.
. D.
E.
Assume "our"
behavior is
right
2. People behave
according to
their culture
3. Nurse must take
initiative in
understanding
Learner needs
determination
1. Learner may
ask questions
2. Lack of
knowledge heard
through
listening
3. Observing
behavior
4. Nurse asks
questions
5. Assumptions
cause of
errors
Objectives as guide
1. States exactly
what's to be
accomplished
2. Gives direction
3. Key to
evaluation
6.
Inform students D, E,
F, and G will be discussed in more detail
later in class
75
IV.
Principles of Teaching
Concept 4
=
Knowledge, understanding and
application of teaching principles
contributes to the development of
teaching skills.
Objective 4.1 - Discuss the seven principles of
teaching and apply each principle
to a nursing situation.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
F.
G.
Planning time for
teaching/learning
1. Nursing schedule
to include
teaching
2. Know patients 1
daily activities
3. Use time to best
advantage
4. Teach while
carrying out
other nursing
function
5. Be flexible
Evaluation
1.
Analysis of
teaching/learning
2.
Systematic and on
going process
3. Objective judgement
of effectiveness
RESOURCES
Almore, Mary G.
Dyadic Communication.
American
Journal of Nursing, 80:2: 1079-1081, June, 1979.
11
11
Bevis, Em Olivia. Curriculum Building in Nursing.
St. Louis: C. V. Mosby Company, 1978.
76
IV.
Principles of Teaching
Concept 4
- Knowledge, understanding and
application of teaching principles
contributes to the development of
teaching skills.
Objective 4.1 - Discuss the seven principles of
teaching and apply each principle
to a nursing situation.
RESOURCES
"Communicating with Young Children." American Journal
of Nursing, 77:12: 1970-1968, December, 1977.
"Cultural Diversities" - Concept Media film.
"Non-Verbal Communication 11
-
Concept t4edia film.
Pohl, Margaret, The Teaching Function of the Nursing
Practitioner. Dubuque, Iowa: Wm. C. Brown Company
Publishers, 19 78.
Ramackers, Sister Mary James.
"Communication Blocks
Revisited. 11 American Journal of Nursing, 80:2:
1079-1081, June, 1979.
Scher, Phyllis.
"More Effective Presentation."
Reference Hanual. September, 1976.
Storopoli, Charles J., and Carolyn Waltz. Developing and
Evaluating Educational Programs for Health Care
Providers.
Philadelphia: F. A. Davis Company, 1978.
77
V.
Common Teaching Problems
Concept 5
- Overcoming common teaching problems
increases the nurse's ability to
create effective patient education.
Objective 5.1 - Discuss common teaching problems and
how they interfere with effective
patient teaching utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
v.
Common Teaching
Problems
A. Uncertainty
of information
Know what you
1.
want to teach
2.
Know what you
want patient to
do with in formation
B.
Irrelevant
information
Teach in forma1.
tion patient can
apply and
understand
c. Poor introduction
of material
Have specific
1.
introduction to
what's to be
learned and
accomplished
D. Poor presentation
Present in forma1.
tion clearly and
with examples
E.
Presenting too much
information
Assess patient
1.
need
1.
2.
3.
Elicit student
discussion on problems that might arise
with each common
teaching problem
Show poorly designed
handout and discuss
how it could be
changed to be more
effective
Have students role
play situations of
common teaching
problems
78
v.
Common Teaching Problems
Concept 5
- Overcoming common teaching problems
increases the nurse's ability to
create effective patient education.
Objective 5.1 - Discuss common teaching problems and
how they interfere with effective
patient teaching utilizing information discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
2.
F.
G.
H.
I.
Give only
information
necessary at
given time
Poorly designed
handouts
1. Hand-outs clearly
stated and
pertinent
Insensitivity
1. Be aware of
effect on patient
2. Consider patient's
view point
Inadequate example
and practice
1. Allow for
examples, practice
sessions and return
demonstrations
Incorrect assessments
1. Know learner
characteristics
and needs
RESOURCES
Clark, Carolyn Chambers.
Classroom Skills for Nurse
Educators.
4 vols. New York: Springer Publishing
Company, 1978.
'
79
V.
Common Teaching Problems
Concept 5
- Overcoming common teaching problems
increases the nurse's ability to
create effective patient education.
Objective 5.1 - Discuss common teaching problems and
how they interfere with effective
patient teaching utilizing information discussed in class.
RESOURCES
Freedman, Carol R.
Teaching Patients.
Courseware, Inc., 1978.
San Diego:
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
Pohl, Margaret. The Teaching Function of the Nursing
Practitioner. Dubuque, Iowa: Wm. C. Brown Company
Publishers, 1978.
'
80
VI.
Systems Approach
Concept 6
- A systematic approach is the desired
means of structuring health
knowledge.
Objective 6.1 - Discuss systems theory as it relates
to the nursing process and instructional design, utilizing information
presented in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
VI.
Systems Approach
A. Systems Theory
1. Composed of
numbers of
interrelated
parts/
components
2. Parts are
interrelated/
one effects
the other
3. Every component
a component of
larger system
4. Boundries between
systems
established
arbitrarily
at any given
point in time
5. Functioning
dependent upon
quantity and
quality of
input, output,
and feedback
B. Systems Theory/
Nursing Process
1.
2.
3.
4.
5.
6.
7.
Lecture on systems
approach
Use transparencies cartoons depicting
the systems theory
Use transparencies
listing elements of
the nursing process
Elicit student
discussion on the
meaning and
importance of each
element of the
nursing process
Use transparencies
listing elements of
instructional design
system
Use transparencies
showing relationship
between the nursing
process and instructional design system
Elicit student
discussion on "why
use a systematic
approach to problem
solving."
81
VI.
Systems Approach
Concept 6
- A systematic approach is the desired
means of structuring health
knowledge.
Objective 6.1 - Discuss systems theory as it relates
to the nursing process and instructional design, utilizing information
presented in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
1.
2.
3.
Organization
of activities
into effective
nursing practice
Assessment
a. Data
collecting
b. Variety of
sources
c.
Sorted,
categorized,
verified
d.
Relevant
information
retained
Diagnosis
a.
Status in
terms of
response to
real or
patential
threat to
well being
b.
Synthesis of
input and
integration
of information
c.
Guide for
nursing
intervention
82
VI.
Systems Approach
Concept 6
- A systematic approach is the desired
means of structuring health
knowledge.
Objective 6.1 - Discuss systems theory as it relates
to the nursing process and instructional design, utilizing information
presented in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
4.
5.
Planning
a. Dependent
upon quality
assessment
and accuracy
of diagnosis
b. Nursing
actions selected to
meet patient
needs
c.
Discuss on
how and when
nursing action implemented
d.
Decide outcome
criteria
e. Patient
involvement
in planning
vital to
outcome
Intervention
a. All actions
needed to
implement
the plan
b. Monitored
through
established
outcome criteria
83
VI.
Systems Approach
Concept 6
- A systematic approach is the desired
means of structuring health
knowledge.
Objective 6.1 - Discuss systems theory as it relates
to the nursing process and instructional design, utilizing information presented in class.
CONTENT
6.
c.
Evaluation
a.
Determines
effectiveness
of nursing
care
b.
Outcome
measured
against
criteria
c.
Improves
nursing
care by
determining
effectiveness
of intervention
Systems Theory/
Instructional Design
1.
Instruction
based on
knowledge of
learning process and communication
theory/successful learning
result
a.
Examines
instruction
problems
and needs
SUGGESTED LEARNING
OPPORTUNITIES
84
VI.
Systems Approach
Concept 6
- A systematic approach is the desired
means of structuring health
knowledge.
Objective 6.1 - Discuss systems theory as it relates
to the nursing process and instructional design, utilizing information
presented in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
Sets a
procedure
for solving
Implements
c.
procedure
d.
Evaluates
results
Essential
elements
a.
Goals,
topics,
general
purpose
Learner
b.
characteristics
Learning
c.
objectives
d.
Subject
content
Learning
e.
activities
f.
Resources
g.
Teaching/
audiovisual
presentation
Evaluation
h.
b.
2.
= Assessment
= Assessment
Diagnosis
= Development
=
= Implementa-
= Interven-
tion
= Evaluation
Planning
tion
= Evaluation
85
VI.
Systems Approach
Concept 6
- A systematic approach is the desired
means of structuring health
knowledge.
Objective 6.1 - Discuss systems theory as it relates
to the nursing process and instructional design, utilizing information
presented in class.
RESOURCES
Clark, Carolyn Chambers. Classroom Skills for Nurse
Educators.
4 vols. New York: Springer Publishing
Company, 1978.
86
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis for
development of relevant health
content.
Objective 7.1 - Given a specific health problem
develop goals and topics, utilizing
criteria discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
VII.
Assessment
A. Goals
l.
Indicate
purpose
2. Provide
dir~ction
B.
for planning,
development,
etc.
3. Identify
parameter of
subject content
Topics/Content
outline
l . Basis for
instruction
2. Sequenced
according to
logical
organization simple/complex
3. Build on
knowledge and
skill previously
acquired
l.
2.
Lecture
Utilizing input from
class do the
following:
a. Determine a
specific health
problem
b. Determine the
goals for that
problem
c. Develop the
topics to be
presented
87
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis for
development of relevant health
content.
Objective 7.1 - Given a specific health problem
develop goals and topics, utilizing
criteria discussed in class.
RESOURCES
Fodor, John T., and GusT. Dalis.
Health Instruction:
Theory and Application.
2d ed. Philadelphia:
Lea and Febiger, 1974.
Kemp, Jerrold E.
Instructional Design.
2d ed. Belmont,
California: Fearon Publishers, Inc., 1977.
88
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.2 - Identify and discuss data to be
considered in developing and
implementing a patient/teaching
program utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
VII.
Assessment
C. Patient Assessment
1. Diagnosis data
a.
Provides
information
for nursing
intervention
b. Formulates
input into
teaching
situation
2.
Patient data
Sex, race,
a.
age,
religion,
occupation,
etc.
b. Physical/
mental
condition
c. Medical
history
Present
d.
condition/
prognosis
e. Current
therapy
Patient/family
3.
data
1.
2.
3.
4.
5.
Lecture/discussion on
sources of information for an assessment
Have student list
factors of importance
that would be found
in the source
information
Role play a nurse
obtaining assessment
information
Demonstrate effective
questioning for
obtaining patient
data
Use transparencies
with steps in
effective questioning
89
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.2 - Identify and discuss data to be
considered in developing and
implementing a patient/teaching
program utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
a.
4.
5.
Attitudes
toward
learning
b. Motivation
c. Needs and
abilities
Use of questions
in patient
assessment
a. Significant
information
in short
time
b. Shows
interest
c.
Indicates
nurse is
knowledgeable
d.
Get attention
e. Seek
reassurance
f.
Provoke,
irritate,
challenge
g.
Help another
think through
problems
Categories
a. Narrow
90
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.2 - Identify and discuss data to be
considered in developing and
implementing a patient/teaching
program utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
Predictable
Information
limited
3. Focus
attention
on specific
topic
b. Broad
1. Brainstorming/exploring
Steps in effective
questioning
a. Think before
you ask a
question
b. Decide what
you want to
find out
c. Mentally
rehearse a
few questions
to find one
that will
obtain
desired
information
1.
2.
6.
91
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.2 - Identify and discuss data to be
considered in developing and
implementing a patient/teaching
program utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
d.
e.
f.
g.
Listen to your
question and
answer
Compare answer
with information you had
hoped to
obtain
Decide was
question
effective
or noneffective
Keep a log identifies
success and
failure
RESOURCES
Cohen, Nancy H.
"Three Steps to Better Patient Teaching."
Nursing 80, February 1980, pp. 72-74.
Fodor, John T., and Gus T. Dalis. Health Instruction:
Theory and Application.
2d. ed. Philadelphia:
Lea and Febiger, 1974.
92
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.2 - Identify and discuss data to be
considered in developing and
implementing a patient/teaching
program utilizing information
discussed in class.
RESOURCES
Freedman, Carol R.
Teaching Patients.
Courseware, Inc., 1978.
San Diego:
Instructional Design.
2d ed. Belmont,
Kemp, Jerrold E.
California: Fearon Publishers, Inc., 1977.
Kratzer, Joan B.
"What Does Your Patient Need to Know."
Nursing 77, December 1977, pp. 82-84.
Narrow, Barbara.
Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner.
Dubuque, Iowa: Wm. C. Brown
Company Publishers, 1978.
93
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.3 -
Identify the three domains of
learning.
Objective 7.4 -Write measureable objectives for
the five levels of the cognitive
domain utilizing criteria established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
VII.
Assessment
D.
Learning
objectives/
behavioral
objectives
1.
Function
a.
Identify
specific
content
b.
Identify
specific
change in
behavior observable/
measureable
c.
Guide
teacher
in selecting learning opportunities
d.
Indicate
what to
evaluate
2.
Composing
behavioral
objectives/
ABCD
1.
2.
3.
4.
5.
6.
Lecture and discussion on the use and
importance of objectives in patient
teaching
Elicit student
discussion on measureable behavior
Give hand-out on
action measureable
verbs
Using previous
health problem develop
objectives for each
cognitive domain
Elicit student
discussion on affective domain and how
to measure
Students read the
objectives for this
course and classify
them according to the
five levels of
cognition and the
affective domain
94
VII.
Aassessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.3 - Identify the three domains of
learning.
Objective 7.4 -Write measureable objectives for
the five levels of the cognitive
domain utilizing criteria established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
a.
3.
Identify
specific
audience who is to
perform
b.
Identify
observable
and measureable behavior action verb
c.
Identify
testing condition - what
is expected
d.
Identify
degree/
criteria level of
- acceptable
performance
Domains of
learning
a. Cognitive/
Bloom
Taxonomy
95
VII.
Assessment
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Concept 7
Objective 7.3 - Identify the three domains of
learning.
Objective 7.4 - Write measureable objectives .for
the five levels of the cognitive
domain utilizing criteria established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
1.
b.
Recall or
recognition
of information
2. Development
of intellectual
abilities/
skills
3. Most attention given
to this
domain
4. Sequential simple to
complex
aa. Knowledge/
recall
bb. Comprehension
cc. Analysis
dd. Synthesis
ee. Evaluation
Psychomotor
1. Emphasizes
muscular
and motor
skills
96
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.3 - Identify the three domains of
learning
Objective 7.4 -Write measureable objectives for
the five levels of the cognitive
domain utilizing criteria established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
2.
4.
Skills that
require
coordination,
dexterity
and manipulation
c. Affective
1. Changes in
feeling,
tone,
emotion,
interest
and
attitude
2. Related to
values and
degrees of
acceptance
and
rejection
Sequencing
objectives
a. Pre-requisite
objectives
taught before
more complex
97
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.3 - Identify the three domains of
learning.
Objective 7.4 -Write measureable objectives for
the five levels of the cognitive
domain utilizing criteria established in class.
SUGGESTED LEARNING
OPPORTUNITIES
,CONTENT
b.
c.
d.
Ensures
teaching
information
patient
can use
immediately
Most critical
objectives
taught first
Allows use of
other methods
of instructing
beyond initial
contact
RESOURCES
Fodor, John T., and GusT. Dalis. Health Instruction:
Theory and Application.
2d ed.
Philadelphia:
Lea and Febiger, 1974.
Freedman, Carol R.
Teaching Patients.
Course\vare, Inc., 197 8.
San Diego:
98
VII.
Assessment
Concept 7
- Data obtained through patient
assessment provides the basis
for development of relevant
health content.
Objective 7.3 - Identify the three domains of
learning.
Objective 7.4 -Write measureable objectives for
the five levels of the cognitive
domain utilizing criteria established in class.
RESOURCES
Kemp, Jerrold E.
Instructional Design.
2d ed., Belmont,
California: Fearon Publishers, Inc., 1977.
Kryspin, William J., and John F. Feldhusen. Writing
Behavioral Objectives. Minneapolis, Jl.1innesota:
Burgess Publishing Company, 1974.
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner.
Dubuque, Iowa: Wm. C. Brown
Company Publishers, 1978.
Redman, Barbara Klug.
The Process of Patient Teaching in
Nursing.
3d ed.
St. Louis: C. V. Mosby Company,
1976.
99
VIII.
Development
Concept 8
- Development of health content into
a format enables the nurse to
identify what is to be taught and
how it will be accomplished.
Objective 8.1 - Develop the subject content,
learning activities and resources
for a specific subject matter,
utilizing criteria established in
class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
VIII.
Development
Subject content
A.
1.
Selection and
organization
of facts and
information
2.
Step-by-step
procedures,
conditions
and requirements
3.
Attitudinal
factors
4.
Sequenced
5. Inputprofessional
and personal
resources
B. Steps in forming
content
1. What is patient
required to do
State
a.
simply
State in
b.
order
performed
'
1.
2.
3.
4.
Lecture on
development of
subject content
Utilizing input from
the class develop
subject content for
established health
problem
Discuss resources to
be used for the
development of
content
Discuss types of
learning activities
and what would be
appropriate for the
established health
problem
100
VIII.
Development
Concept 8
~
Development of health content into
a format enables the nurse to
identify what is to be taught and
how it will be accomplished.
Objective 8.1 - Develop the subject content,
learning activities and resources
for a specific subject matter,
utilizing criteria established
in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
c.
2.
3.
4.
5.
6.
Alternative
steps when
appropriate
Determine signals,
cues, or movements
and identify
Determine
necessary materials and
equipment
Decide if
cautions or common
errors and note at
appropriate time
Provide a simple
rationale for
learning facts,
steps or
decisions
Check the
information
a.
Exclude nonessential
technical
vocabulary
or explain it
b.
Leave out
unnecessary
information
101
VIII.
Development
Concept 8
- Development of health content into
a format enables the nurse to
identify what is to be taught and
how it will be accomplished.
Objective 8.1 - Develop the subject content,
learning activities and resources
for a specific subject matter,
utilizing criteria established
in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
c.
c.
Information
complete and
accurate
Learning activities
1. Serve learner to
attain desired
outcome
2. Based upon
objectives
3. Teacher centered
4. Learner centered
5. Variety of
activities used
a. Heet
objectives
b. Meet patient
needs and
interest
c. Stimulate a
variety of
senses
6. Enable patient
to practice or
use behavior
specified
7. Types
a. Discussion
with teacher
102
VIII.
Development
Concept 8
- Development of health content into
a format enables the nurse to
identify what is to be taught and
how it will be accomplished.
Objective 8.1 - Develop the subject content,
learning activities and resources
for a specific subject matter,
utilizing criteria established
in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
b.
D.
Asking and
answering
questions
c. Note taking
d.
Completing
worksheets
e. Solving
problems
f.
Making
application
of content
g. Completing
exercises
or quizzes
h. Audio-visual
aides
i.
Outside
speakers
j. Field trips
Resources
1. Textbooks,
references,
pamphlets
2. Content
specialist
3. Colleagues
4. Learner
103
VIII.
Development
Concept 8
- Development of health content into
a format enables the nurse to
identify what is to be taught and
how it will be accomplished.
Objective 8.1 - Develop the subject content,
learning activities and resources
for a specific subject matter,
utilizing criteria established
in class.
RESOURCES
Clark, Carolyn Chambers.
Classroom Skills for Nurse
Educators.
4 vols.
New York: Springer
Publishing Company, 1978.
Freedman, Carol R.
Teaching Patients.
Courseware, Inc., 1978.
San Diego:
Kemp, Jerrold E.
Instructional Design.
2d ed. Belmont,
California: Fearon Publishers, Inc., 1977.
Narrow, Barbara.
New York:
Patient Teaching in Nursing Practice.
John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner.
Dubuque, Iowa: Wm. C. Brown
Company Publishers, 1978.
104
IX.
Implementation
Concept 9
- The utlimate success of a teaching/
learning process depends upon teacher
presentation of the subject content.
Objective 9.1 - Choose a method of instruction for
implementing the subject content and
discuss reasons for using that
particular method, utilizing
information discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
IX.
Implementation
A. Methods of teaching
1. Lecture/formal
a.
Group
instructionone way
communication
b. !>iaterial
carefully
organized
and timed
c. No limit to
number of
persons
involved
2.
Informal/
unstructured
Accounts for
a.
large part
of teaching
Talkingb.
listening
Askingc.
answering
questions
Setting an
d.
example
Discussion
3.
Small groups
a.
with similar
needs
"
1.
2.
3.
Lecture/discussion on
methods of teaching
Student demonstration
of each method of
teaching
Utilizing student
input develop a
method of teaching
appropriate for the
established health
problem
105
IXo
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon teacher
presentation of the subject contento
Objective 9.1 - Choose a method of instruction for
implementing the subject content and
discuss reasons for using that particular method, utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
b.
4.
5.
Sharing of
ideas and
experiences
Demonstration
a.
Easily
comprehended
b.
Three parts
1.
Teacher
demonstration
2.
Supervised
practice
3.
Return
demonstration
Role playing
a. Explores
alternative ways
of acting or
responding
b.
Shows how others
might respond
or react
c.
Practice a new
behavior in a
safe and supporting setting
d.
Guidelines
1. Describe
situation
briefly
2. Describe
roles
106
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon teacher
presentation of the subject content.
Objective 9.1 - Choose a method of instruction for
implementing the subject content and
discuss reasons for using that particular method, utilizing information
discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
3.
6.
Give
necessary
direction
4..
Stop action
with logical
pause or
conclusion
of interaction
5.
Discuss
feelings and
behavior
Role Modeling
a.
Imitation and
identification
b. Pattern to
follow in interpersonal
relationships
c. Conditions
1. Behavior to
be learned
desirable
2.
Learner
capable of
copying
behavior
3.
Learner must
know what to
observe
107
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon teacher
presentation of the subject content.
Objective 9.1 - Choose a method of instruction for
implementing the subject content and
discuss reasons for using that particular method, utilizing information discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
d.
B.
Effective in
parenting,
communication
skills, mental
health
7. Explanation
a. Host frequently
used/abused
b.
Teacher
initiated in
response to
need or
question
1.
Past
experience
2. Observation
assessment
or present
situation
3. Agency
protocol
or policy
Guidelines for
effective presentation
1. Is patient ready
to learn
2. Explain what is
to be taught
3. Use hand-outs
where available
108
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon
teacher presentation of the subject
content.
Objective 9.1 - Choose a method of instruction for
implementing the subject content and
discuss reasons for using that particular method, utilizing information discussed in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
4.
5.
6.
Go over content,
demonstrate, give
examples, practice
Monitor and
encourage questions
Give feedback
RESOURCES
Clark, Carolyn Chambers.
Educators.
4 vols.
Company, 1978.
Kemp, Jerrold E.
California:
Classroom Skills for Nurse
New York:
Springer Publishing
Instructional Design.
2d ed. Belmont,
Fearon Publishers, Inc., 1977.
\
"Guidelines for More
Murray, Ruth, and Judith Zentner.
Effective Health Teaching." Nursing 76, February,
1976, pp. 44-53.
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York:
John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner.
Dubuque, Iowa: Wm. C. Brown
Company Publishers, 1978.
109
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learriing process depends upon
teacher presentation of the subject
content.
Objective 9.2 - List six advantages of using audiovisual materials in the presentation
of specific health information.
CONTENT
IX.
SUGGESTED LEARNING
OPPORTUNITIES
1.
Implementation
Audio-visual
materials
1.
Advantages
2.
a.
Input from
special
people
b.
Takes
3.
learner to
inaccessible
places, i.e. ,
delivery
room,
research lab
c.
Enables
learner to
see things
not visible
to naked eye
or hear inaudible sounds,
i.e., fetal
heart-tones,
cellular
division
d. Watch
procedures
that can not
be simulated
i.e., cardiac·
cath,. renal
dialysis
c.
Elicit student
discussion on the
advantages of using
audio-visual aides
Display various types
of audio-visual
materials
Utilizing student
input develop audiovisual aides to be
used in the implementation of the subject
content
110
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon
teacher presentation of the subject
content.
Objective 9.2 - List six advantages of using audiovisual materials in the presentation
of specific health information.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
e.
2.
Permits
learner to
stop and
examine
procedure
to clarify
Advantage
f.
of many
modes of
presentation
g.
Stimulates
learning,
creates
interest and
motivation
h.
Permits
successive
persons to
view demonstration
without
endless
repetition
by nurse
Permits
i.
patient to
control
certain
aspects of
learning
Types
111
IX.
Implementation _
Concept 9
- The ultimate success of a teaching/
learning process depends upon
teacher presentation of the subject
content.
Objective 9.2 - List six advantages of using audiovisual materials in the presentation
of specific health information.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
a.
b.
c.
d.
e.
Objects and
models
1. Actual
objects used
in demonstration
2. ~1odels used
when objects
not
appropriate
Pamphlets and
posters
1. Inexpensive
2. Well
organized
3.
Intended for
general
public
Photographs
1. Bulletin
boards and
individual
teaching
Teacher-made
aids
1.
Inexpensive
2. Hust serve
intended
purpose
Slide and filmstrip
112
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon
teacher presentation of the subject
content.
Objective 9.2 -List six advantages of using audiovisual materials in the presentation
of specific health information.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
1.
f.
Appropriate
group
teaching
Motion picture
1.
reality
Provides
variety
3. Stimulates
sight. and
hearing
Television and
videotapes
1. Closedcircuit T.V.
educational
programs
2. Video-tape subjects
relevant to
health
education
3. Presentation
discussed
after viewing
and clarification made
Programmed
instruction
2.
g.
h.
~hrror
113
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon
teacher presentation of the subject
content.
Objective 9.2 - List six advantages of using audiovisual materials in the presentation
of specific health information.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
1.
2.
3.
4.
Study by
teaching
machine,
programmed
book or
pamphlet
Small
segments
arranged
in logical
sequence
Questions
answered
correctly
before
proceeding
Learner
continuously
aware of
progress
RESOURCES
"Directory of 100 Organizations to Contact for Free or
Low-Cost Professional Materials." Nursing 76,
September, 1976, pp. 60A-60H.
Freedman, Carol R. Teaching Patients.
Courseware, Inc., 1978.
San Diego:
114
IX.
Implementation
Concept 9
- The ultimate success of a teaching/
learning process depends upon
teacher presentation of the subject
content.
Objective 9.2 - List six advantages of using audiovisual materials in the presentation
of specific health information.
RESOURCES
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner. Dubuque, Iowa: Wm. c. Brown
Company Publishers, 1978.
Redman, Barbara Klug.
Nursing.
3d ed.
1976.
The Process of Patient Teaching in
St. Louis: C. V. Mosby Company,
Scher, Phyllis.
"More Effective Presentation."
Reference Manual. September, 1976.
Wood, M. Marian.
"300 Valuable Booklets to Give to
Patients and Their Families." Nursing 74, April,
19 7 4 , pp . 4 3- 50 •
115
X.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.1 - Develop a method of evaluating the
patient/learning process as it
relates to the specific health
problem, utilizing criteria
established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
X.
Evaluation
A.
General factors
Systematic and
1.
continuous
2.
Judgement of
effectiveness
of teaching/
learning taken
place
Points out
3.
What is good
a.
b. What needs
correcting
Stimulates
c.
desire for
improvement
Encourages
d.
further
effort
Objectives
4.
serve as a
guide
B. Patient learning
Frequency depends
1.
upon topic, material and time
available
2.
Patient needs to
know how and
where
1.
2.
3.
4.
5.
Lecture discussion
on why evaluation is
systematic and
continuous
Discuss different
methods of evaluation
Show various forms
used for evaluating
purposes
Role play a situation
in which evaluation
is being implemented
continuously
Utilizing student
input develop an
evaluative method for
the established
patient/learning
process
116
X.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.1 - Develop a method of evaluating the
patient/learning process as it
relates to the specific health
problem, utilizing criteria
established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
3.
4.
5.
6.
Must maintain
patient dignity
and self-esteem
Take minimal
amount of
patient time
Require behavior
performance only
on apparent value
to patient
Methods of
evaluating
a. Written test
1.
Limited
usefulness
2. Difficult
to maintain
validity and
reliability
b.
Oral evaluation
1. Asking
questions
c.
Return
demonstration
1.
Ability to
recognize
and correct error
important
d.
Observation
117
X.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.1 - Develop a method of evaluating the
patient/learning process as it
relates to the specific health
problem, utilizing criteria
established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
Clues
regarding
attitude
and
practice
Chec.k list
1. Quantify
what is
observed
Analysis of
physical
findings
1.
Objective
data - i.e.,
weight loss,
increased
tolerance
to ambulation
2. Subjective
data - i.e.,
patient
comments
Follow-up
questionnaire
1. Reveals
compliance,
changes in
life style
or attitude
1.
e.
f.
g.
118
X.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.1 - Develop a method of evaluating the
patient/learning process as it
relates to the specific health
problem, utilizing criteria
established in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
2.
Data used
to modify
program or
follow-up
RESOURCES
Fodor, John T., and GusT. Dalis. Health Instruction:
Theory and Application. 2d ed . . Philadelphia:
Lea and Febiger, 1974.
Freedman, Carol R.
Teaching Patients.
Courseware, Inc., 1978.
San Diego:
Kemp, Jerrold E.
Instructional Design.
2d ed.
California: Fearon Publishers, Inc., 1977.
King, Elizabeth C.
St. Louis: C.
Belmont,
Classroom Evaluation Strategies.
Mosby Company, 1979.
v.
Murray, Ruth, and Judith Zentner.
"Guidelines for More
Effective Health Teaching." Nursing 76, February,
19 7 6 1 PP • 4 4- 5 3 •
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
119
X.
Evaluation
Concept 10
Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.1 - Develop a method of evaluating the
patient/learning process as it
relates to the specific health
problem, utilizing criteria
established in class.
RESOURCES
Pohl, Margaret. The Teaching Function of the Nursing
Practitioner. Dubuque, Iowa: Wm. C. Brown Company
Publishers, 1978.
Redman, Barbara Klug.
The Process of Patient Teaching in
Nursing.
3d ed. St. Louis: C. v. Mosby Company,
1976.
120
X.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.2 - Discuss the benefits of evaluation
as it relates specifically to the
nurse and the teaching/learning
process, utilizing information
presented in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
X.
Evaluation
C.
Teacher performance
1.
Increases
competency
2. Facilitates
professional
growth
3. Promotes selfactualization
4. Methods of
evaluating
a. Written
feedback
from
learner
1. Questionnaire
2.
Check list
3.
Rating
scale
b.
Direct
feedback
1.
Development of
rapport
1.
2.
3.
4.
5.
Have student list
benefits of
evaluation of teacher
performance
Elicit student
discussion on why the
evaluation of teacher
performance
Utilizing student
input develop an
evaluative method for
teacher performance
for the established
patient/teaching
process
Display various forms
used for evaluation
Have students
evaluate curriculum
and teacher performance for this class
presentation
121
X.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.2 - Discuss the benefits of evaluation
as it relates specifically to the
nurse and the teaching/learning
process, utilizing information
presented in class.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
2.
D.
Openness and
willingness
of patient
to share . respect and
trust
Content
1. Basis for improving
and redeveloping
program
2. Methods
a. ~esults of
patient learning
b. Reaction from
patient
c. Observation and
analysis by
colleagues
d. Questionnaire
RESOURCES
Fodor, John T., and GusT. Dalis. Health Instruction:
Theory and Application.
2d ed. Philadelphia:
Lea and Febiger, 1974.
Narrow, Barbara. Patient Teaching in Nursing Practice.
New York: John Wiley and Sons, 1979.
122
x.
Evaluation
Concept 10
- Evaluation is an integral aspect of
the teaching/learning process.
Objective 10.2 - Discuss the benefits of evaluation
as it relates specifically to the
nurse and the teaching/learning
process, utilizing information
presented in class.
RESOURCES
Pohl, Margaret.
The Teaching Function of the Nursing
Practitioner. Dubuque, Iowa: Wm. c. Brown Company
Publishers, 1978.
123
XI.
Professional and Personal Competencies
Concept 11
- Health education is a continuing
process in the life of an
individual.
Objective 11.1 - Compare and contrast the
instructional design approach to
patient teaching to your previous
method of teaching in terms of
accuracy, consistency and
effectiveness.
CONTENT
XI.
Professional and
personal
A. Professional
competencies/
patient teaching
1. Can relate
health instructional programs
to point of
view held by
patient
2. Can relate
health needs
of individual
to instructional programs
3. Is sensitive
to the differences in
individuals
4.
Uses a systematic plan in
providing
instruction
5. Utilizes
learning and
teaching principles to
motivate
individuals
SUGGESTED LEARNING
OPPORTUNITIES
1.
2.
Elicit student
discussion on the
accuracy, consistency
and effectiveness of
the instructional
design approach to
previous method of
teaching
Elicit student
discussion on:
"What
signifies professional competencies
in patient teaching."
124
XI.
Professional and Personal Competencies
Concept 11
- Health education is a continuing
process in the life of an
individual.
Objective 11.1 - Compare and contrast the
instructional design approach to
patient teaching to your previous
method of teaching in terms of
accuracy, consistency and
effectiveness.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
6.
Integrates patient
teaching within
the framework of
the nursing
process
RESOURCES
Fodor, John T., and GusT. Dalis. Health Instruction:
Theory and Application.
2d ed. Philadelphia:
Lea and Febiger, 1974.
Redman, Barbara Klug. The Process of Patient Teaching
in Nursing.
3d ed. St. Louis: c. v. Mosby
Company, 1976.
125
XI.
Professional and Personal Competencies
Concept 11
- Health education is a continuing
process in the life of an
individual.
Objective 11.2 - Desires to do effective patient
teaching by listening attentively
and actively participating in
classroom discussion and project.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
XI.
Professional and
personal competencies
B. Personal
competencies/
patient teaching
1. A zest for
living and
appreciates
and values
health
2.
Desires to
improve
professional
competencies
3. Relates to
people and
respects and
understands
their
differences
4. Seeks to keep
informed of
current health
findings
5.
Is organized
and works within
systematic framework but flexible
to patient needs
1.
2.
Elicit student
discussion on: "What
signifies personal
competencies in
patient teaching."
Students write a
short paragraph on:
"What effect this
class will have on
their patient/nurse
and patient/teaching
relationship."
126
XI.
Professional and Personal Competencies
Concept 11
- Health education is a continuing
process in the life of an
individual.
·Objective 11.2 - Desires to do effective patient
teaching by listening attentively
and actively participating in
classroom discussion and project.
SUGGESTED LEARNING
OPPORTUNITIES
CONTENT
6.
Has a sense of
own personal
worth and
dignity
RSOURCES
Fodor, John T., and GusT. Dalis. Health Instruction:
Theory and Application.
2d ed. Philadelphia:
Lea and Febiger, 1974.
APPENDIX B
A CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
127
128
CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
Date
Person
Interviewed
Position
Name of School
Address
1.
In your opinion, how important is a well designed
teaching curriculum with regard to increasing the
vocational nurse's performance capability in response
to a patient teaching situation?
very important
important
somewhat important
unimportant
other
2.
Do you currently have a formally developed patient
teaching program?
) Yes
3.
) No
Do you currently have formally stated patient
teaching goals?
) No
) Yes
If yes, please list goals below.
4.
Do you currently have formally stated teaching
objectives?
) No
) Yes
If yes, please list objectives below.
5.
Approximately how many hours of your program are
allotted to patient teaching?
(
(
(
(
0
2
4
6
-
2 hours
4 hours
6 hours
+ hours
129
6.
Are there specific components of your patient
teaching curriculum you would like to improve?
Please list those and briefly comment.
7.
How much importance do you place on instructing your
students in the following teaching techniques?
1
2
3
= very important
= important
= somewhat important
4
5
= unimportant
=
other
assessment of patient and educational needs
development of information
implementation of material
evaluation of learning and teaching process
8.
In terms of achieving an effective program, how would
you rate your patient teaching curriculum?
very important
important
somewhat important
unimportant
other
9.
Overall, how would you rate your present patient
teaching curriculum?
very good
good
fair
poor
other
10.
How do you think your students would rate your
patient teaching curriculum's value to them as
graduate_ vocational nurses?
very important
important
somewhat important
unimportant
other
11.
Are there additional comments you would like to make
regarding the need for a specific curriculum in
patient teaching, and/or the areas of emphasis in the
curriculum as they relate to the vocational nurse?
APPENDIX C
LETTER OF TRANSHITTAL
130
131
17516 Chase Street
Northridge, California 91325
May 20, 1980
Dear
I am a graduate student in Health Education at California
State University Northridge, a member of California Vocational Nursing Educators, a member of National Association
for Practical Nurse Education and Service, and a Vocational Nursing Instructor at Casa Lorna Institute of Technology.
I am presently writing my thesis/project:
"A
Patient Teaching Program for Vocational Nursing Students."
The enclosed questionnaire is an assessment tool to
determine the present status of a patient teaching curriculum in vocational nursing schools.
The information will
be used in the development of a patient education teaching program.
A patient education teaching program involves an
assessment regarding the need for and including the
development of a curriculum in patient teaching, the
implementation of that curriculum, and an evaluation
of the curriculum and over-all program.
In order to assess the need for a curriculum in patient
teaching I am sending the enclosed questionnaire to the
Director of Nurses of all Vocational Nursing Schools in
Region VIII.
I know how busy your schedule is, but I would appreciate
it if you could help me by completing the questionnaire
and returning i t to me by June 6, in the enclosed
envelope.
It will be a pleasure to discuss the results of this
project with you upon its completion.
Thank you for your time and effort.
Sincerely,
0-irs.) Norma Jones, R.N.
Encl:
NJ/LB
APPENDIX D
EVALUATION OF
CURRICULUM NEEDS ASSESSMENT
132
QUESTIONNAIP~
CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
NU.t-1BER OF RESPONSES*
.j.J
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+JI::
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6.
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ttl
1--1
0
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ttl ttl
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Q)O
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res
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QUESTIONS
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Q)
1--1
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-
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ttl
0
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\.0
+
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C\1
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Ul
Q)
:>t
0
z
Importance of teaching
technique?
assessment
development
implementation
evaluation
7.
In terms of achieving
an effective program rate your patient
teaching curriculum
8.
Rate your present
patient teaching
curriculum
II
II
1
-
1
1
1
4
2
1
1
-
-
-
1
1
1
1--'
w
.t:::>
CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
NUHBER OF RESPONSES*
+l
+l
+l
ttl
+l
ttl
+l
H
~
1-1
QUESTIONS
9.
How would your
students rate your
patient teaching
curriculum?
:>-tO
l-IP..
(!) !'::
:>H
~
+l
+l~
10 ttl
..C::+l
:?; H
0
p_,
0
s
H
U)H
~
2
(!)
0
4
s
~
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0
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*Total Possible
Responses - 8
1-'
w
U1
136
CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
CONTINUED
3.
Do you have formally stated patient-teaching goals?
List goals.
- goals state that teaching will be done, but not
specifically stated how
- in each of our "disorders" - we have included
"assist with related patient-teaching"
4.
Do you currently have formally stated teaching
objectives? List objectives.
- they deal primarily with diabetic, cardiac, postpartum care
- investigate how much patient knows about his
disorder
~
will institute care plan for individual patient,
outlining professional learning opportunities
- will follow hospital protocol in finding resources
for patient-teaching
6.
Are three specific components of your patientteaching curriculum you would like to improve?
- no formalized approach
- a general guide which would be applicable to
several teaching situations would be helpful
- development of patient-teaching information
methods of teaching
- have specific unit dealing with interview and
communication techniques in which students could
practice teaching strategies with all age groups
- is not taught as a unit - informally discussed as
specific patient needs come up, i.e., diet therapy,
insulin therapy, etc.
137
CURRICULUM NEEDS ASSESSMENT QUESTIONNAIRE
CONTINUED
6.
Are there specific components of your patientteaching curricul~m you would like to improve?
(Continued)
- students really do not have adequate time to
engage in patient-teaching process as they should.
Program much too concentrated.
11.
Are there additional comments you would like to make
regarding the need for a specific curriculum in
patient-teaching, and/or the areas of emphasis in
the curriculum as they relate to the Vocational Nurse?
- we have had some opportunity to assist in patientteaching at the clinical facility, but have
developed no uniform approach
since time is always at a premium, such a curriculum would need to be very succinct and compact
- more and more strees is being placed on
prevention; therefore, patient-teaching is becoming increasingly important. However, vocational
nurses are educated for episodic care and only so
much can be taught in 47 weeks
- we teach students to do pre- and post-op teaching
and some health teaching.
It has not been an
important part of our curriculum, but we place
more emphasis on it each year
APPENDIX E
PATIENT - EDUCATION TEACHING TEST
138
139
PATIENT - EDUCATION TEACHING TEST
Please select only one answer to each question. Although
more than one answer ·may seem correct, select your choice
of the best answer to each question.
1.
Which of the following statements best defines
patient education:
a.
b.
c.
d.
2.
The following is a statement made by whom:
"Patients
should be taught health status, level of functioning
and self-care after discharge."
a.
b.
c.
d.
3.
Florence Nightingale
JCAH
N.L.N.E.
Patient Bill of Rights
The most pressing problem confronting the nurse in
her role of patient teaching is:
a.
b.
c.
d.
4.
Integral part of nursing process
Multidisciplinary team approach
Process of changing behavior
Teaching-learning process
Physician/nurse relationship
Teaching role not clearly defined
Lack of preparation for teaching
Gap between preventive and curative service
Teaching can be done by any nurse who:
a.
b.
c.
d.
Acquires the essential knowledge
Perceives teaching as formal instruction
Develops skills in teaching
Views teaching separate from nursing care
1.
2.
3.
4.
a, b, and c
a and c
a, c, and d
all of these
140
5.
Common teaching problems are:
a.
b.
c.
d.
Irrelevant information
Insensitivity to information
Too much information
Poorly designed hand-outs
1.
2.
3.
4.
6.
Success in learning is influenced mostly by:
a.
b.
c.
d.
7.
'
Sequential learning
Values and degrees of acceptance
Coordination and dexterity
Attitudes and task analysis
The following behavioral objective would measure what
cognitive skill:
"State in own words when and how
to collect urine for testing."
a.
b.
c.
d.
e.
.
Assessment
Development
Implementation
Evaluation
_Bloom's Taxonomy of the cognitive domain relates to:
a.
b.
c.
d.
9.
Motivation and ability of patient
Preparation by teacher
Motivation of patient and teacher
Environment of teaching session
What aspect of the instructional design system would
help assure the nurse that the educational needs of
the patient was being met:
a.
b.
c.
d.
8.
a and b
a, b, and c
a, c, and d
all of these
Recall
Comprehension
Analysis
Synthesis
Evaluation
141
10.
What words best define the process of evaluation:
a.
b.
c.
d.
Subjective and objective
Stimulates and encourages
Systematic and continuous
Facilitates and promotes
Please circle "T" for true and "F" for false.
T
F
11.
Patient education provides patients some
measure of control of their health.
T
F
12.
An awareness of the importance of patient
education began with the advent. of modern
nursing in 1859.
T
F
13.
Systems approach, the nursing process and
instructional design are based on scientific principles.
T
F
14.
There are four cornponenets to consider in
writing behavioral objectives.
T
F
15.
Patients relate more directly to the
printed word than they do to picture
image and sound.
T
F
16.
The most frequently used and abused
method of teaching is demonstration.
T
F
17.
In order to assess the effectiveness of
the teaching-learning process, evaluation
should be conducted upon completion of
the session.
T
F
18.
Patients with cultural differences often
perceive the nurse as "difficult" or
"uncooperative."
T
F
19.
The fact that patients can perform tasks
within the hospital guarantees their
ability to do so at horne.
T
F
20.
In order to meet professional and personal
competencies the nurse must integrate patient teaching within the framework of
the nursing process.
142
Fill in the blanks with the correct word/words.
21.
The instructional design approach to patient
education consists of
, and
------------------22.
The four principles of learning are organization,
motivation, interaction, and
23.
The three domains of learning are
and
24.
Verbal and. non-verbal expressions, gestures and
behavior are classified under what principles of
teaching?
25.
Sources used for obtaining patient assessment
information are
and
APPENDIX F
COURSE OUTLINE
143
144
COURSE OUTLINE
Course Overview
A. Purpose
B. Topics
C. Expectations and Objectives
I.
II.
III.
IV.
V.
VI.
Patient Education
A. Definition
B. Benefits
C. History
D. Recent Developments
Nursing and Teaching/Learning Process
A. Nurse's Perception
B. Confusion of Role
C. Nurses as Teachers
D. Preparation for Teaching
Principles of Learning
A. Organization/Systematic Planning
B. Motivation
C.
Interaction
D. Reinforcement/Repetition = Retention/Transfer
Principles of Teaching
A. Teacher Learners Rapport
B. Effective Communication
C. Knowledge of Cultural Differences
D. Learner Needs Determination
Common Teaching Problems
A. Uncertainty of Information
B. Irrelevant Information
C. Poor Introduction of Material
D. Poor Presentation
E. Presenting to Much Information
F. Poorly Designed Hand-outs
G.
Insensitivity
H.
Inadequate Examples and Practice
I.
Incorrect Assessment
Systems Approach
A.
Systems Theory
B. Systems Theory/Nursing Process
C. Systems Theory/Instructional Design
145
VII.
VIII.
IX.
X.
XI.
Assessment
A. Goals
B. Topics
C. Patient Assessment
D. Learning/Behavioral Objectives
Development
A. Subject Content
B. Steps in Forming Content
c. Learning Activities
D. Resources
Implementation
A. Methods of Teaching
B. Guidelines for Effective Presentation
C. Audio-Visual Materials
Evaluation
A. General Factors
B. Patient Learning
c. Teacher Performance
D. Content
Professional and Personal Competencies
A. Professional Competencies/Patient Teaching
B. Personal Competencies/Patient Teaching
APPENDIX G
CONCEPTS AND OBJECTIVES
146
147
CONCEPTS AND OBJECTIVES
Main Concept:
Nurses trained in a scientific approach to patient
teaching are more effective patient educators.
Concept 1:
Protection and promotion of health is a
prime responsibility of the nurse.
Objective
1.1 - In own words define patient education.
1.2 - Discuss six benefits of patient
education and specify those benefits specific
to the patient.
1.3 -Discuss the development of the
philosophy of patient education in modern
nursing, utilizing information discussed in
class.
Concept 2:
Knowledge and understanding of nursing and
the teaching/learning process facilitates the
nurse in assessing her/his role in patient
teaching.
Objective
2.1 - State
confronting
meeting the
bilities of
Concept 3:
Knowledge, understanding and application of
the principles of learning increases the
nurse's effectiveness in patient teaching.
Objective
3.1 - Discuss the four principles of
learning and apply each principle to a
nursing situation.
Concept 4:
Knowledge, understanding and application of
teaching principles contributes to the
development of teaching skills.
Objective
4.1 - Discuss seven principles of teaching
and apply each principle to a nursing
situation.
in own words the problems
the nurse ·today in respect to
professional and legal responsipatient teaching.
148
Concept 5:
Overcoming common teaching problems increases
the nurse's ability- to create effective
patient education.
Objective
5.1 - Discuss common teaching problems and
how they interfere with effective patient
teaching, utilizing information discussed
in class.
Concept 6:
A systematic approach is the desired means
of structuring health knowledge.
Objective
6.1 - Discuss systems theory as it relates
to the nursing process and instructional
design, utilizing information presented in
class.
Concept 7:
Data obtained through patient assessment
provides the basis for development of
relevant health content.
Objective
7.1 - Given a specific health problem
develop goals and topics, utilizing criteria
discussed in class.
7.2 - Identify and discuss data to be
considered in developing and implementing a
patient/teaching program, utilizing information discussed in class.
7.3 - Identify the three domains of learning.
· 7. 4 - ~'V'rite measurable objectives for the
five levels of the cognitive domain.
Concept 8:
Development of health content into a format
enables the nurse to identify what is to be
taught and how it will be accomplished.
Objective.
8.1- Develop the subject content, learning
activities and resources for a specific
subject matter, utilizing criteria established in class.
Concept 9:
The ultimate success of a teaching/learning
process depends upon teacher presentation
of the subject content.
149
Objective
9.1 - Choose a method of instruction for
implementing the subject content and discuss
reasons for using that particular method,
utilizing criteria established in class.
9.2 - List six advantages of using audiovisual materials in the presentation of
specific health information.
Concept 10:
Evaluation is an integral aspect of the
teaching/learning process.
Objective
10.1 - Develop a method of evaluating the
patient/learning process as it relates to
the specific health problem, utilizing
criteria established in class.
Concept 11:
Health education is a continuing process in
the life of an individual.
Objective
11.1 - Compare and contrast the
instructional design approach to patient
teaching to your previous method of teaching
in terms of accuracy, consistency and
effectiveness.
11.2 - Desires to do effective teaching by
listening attentively and actively participating in classroom discussion and project.
APPENDIX H
EVALUATION FORM
PATIENT TEACHING CURRICULUM
150
151
EVALUATION
PATIENT - EDUCATION TEACHING CURRICULUM
Please rate the following areas by circling the number
which corresponds best to your feelings.
Rating Scale:
2
1
Low
4
3
5
High
6
NA
This course was designed to develop techniques in
teaching skills required in patient teaching.
1.
Did the course meet that objective?
2
1
2.
5
6
2
3
4
5
6
Was the content organized in a manner which was
meaningful?
1
4.
4
Were the course objectives clearly stated?
1
3.
3
2
3
4
5
6
How would you rate the quality of instruction?
1
2
3
4
5
6
5.
What was of most benefit to you in the presentation?
Comment:
6.
What was of least benefit to you in this
presentation?
Comment:
7.
What suggestion or recommendations would you have
for improvement of the presentation?
Comment:
APPENDIX I
CLINICAL EVALUATION FORM
152
153
CLINICAL EVALUATION FORM PATIENT EDUCATION TEACHING EXPERIENCE
Very
Good
1.
Demonstrates
understanding of
the teaching role
of the nurse.
2.
Recognizes teaching
situation.
3.
Knowledgable about
subject matter
taught.
4.
Needs assessment
technique accurate
and best method
for particular
situation.
5.
Program directed
at patient level
of understanding.
6.
Behavioral
objectives
realistic for
patient situation.
7.
Haterial presented
in an organized
manner.
8.
Material presented
in an interesting
manner.
9.
Audio-visual
material pertinent
to subject content.
Good
Unsatisfactory
No Basis
For Eval.
154
CLINICAL EVALUATION FORM PATIENT EDUCATION TEACHING EXPERIENCE
Very
Good
10.
Utilization of
members of the
multidisciplinary
team as resource
persons.
11.
Use of an
appropriate
evaluation
tool.
12.
Self-evaluation
objective and
constructive.
Good
Unsatisfactory
No Basis
for Eval.
APPENDIX J
CURRICULUM TIME LINE
155
156
CURRICULUM TH1E LINE
General Implementation
January
Curriculum Committee Meeting
Revision and Updating
In-Service Meeting
February
Initial In-Service Meeting - Instructors
Presentation - October Class
Final Clinical Evaluation - February Class
April
Clinical Evaluation - October Class
June·
Presentation - February Class
Final Clinical Evaluation - June Class
July
Curriculum Committee Meeting
Revision and Updating
In-Service Meeting
August
Clinical Evaluation - February Class
October
Presentation - June Class
Final Clinical Evaluation - October Class
December
Clinical Evaluation - June Class