CHAPTER VI
The Determinants of
Learning
Alyssa Ashley Diego-Malag, RN, MAN, Ed.D.
DETERMINANTS
a. Learning Needs – what the
learner needs to learn
b. Readiness – when the learner is
receptive to learning
c. Learning Style – how the learner
best learns
LEARNING NEEDS
• Gaps in knowledge that exist
between a desired level of
performance and the actual level of
performance
• Between what someone knows and
what someone needs to know due to
lack of knowledge, attitudes or skills
ASSESSING
LEARNING NEEDS
1. Identify the learner
2. Choose the right setting
3. Collect data on the learner
4. Include the learner as a source of
information
5. Include members of the
healthcare team
6. Determine availability of
educational resources
ASSESSING
LEARNING NEEDS
7. Assess demands of the
organization
8. Consider time-management issues
9. Prioritize needs
CRITERIA IN
PRIORITIZING LN
• Mandatory – learning needs that must
be immediately met since they are life
threatening or are needed for survival.
Ex. Pt with hx of recent heart attack
• Desirable – learning needs that must be
met to promote well-being and are not
life-dependent. Ex. Pt with PTB
• Possible – “nice to know” learning
needs which are not directly related to
daily activities. Ex. Tummy tucking
METHODS IN
ASSESSING LN
a. Informal conversations or
interviews
b. Structure interview
c. Written pretests
d. Observation of health behaviors
over a period of different times
READINESS TO
LEARN
• It is the time when the patient is
“willing to learn” or is receptive to
information
1. Determine what needs to be taught
2. Find out exactly when the learner is
ready to learn
3. Discover what the patient wants to
learn
4. Identify what is required of the
learner
4 TYPES OF
READINESS TO LEARN
1. P – hysical Readiness
a. Measures of ability
b. Complexity of task – difficulty level
c. Environmental effects – conducive
d. Health status
e. Gender
4 TYPES OF
READINESS TO LEARN
2. E – motional Readiness
a. Anxiety level
b. Moderate level of anxiety
c. Support system
d. Emotional support
e. Motivation
f. Risk-taking behaviors
g. Frame of mind
h. Developmental stage
4 TYPES OF
READINESS TO LEARN
3. E – xperiential readiness
a. Level of aspiration - goals
b. Past coping mechanisms
c. Cultural background
d. Locus of control – motivation
e. Orientation – point of view;
parochial, cosmopolitan
4 TYPES OF
READINESS TO LEARN
4. K – knowledge Readiness
a. Present knowledge base - stock
b. Cognitive ability
MOTIVATION
•“movere” – to move or set into
motion
•Willingness of the learner to
embrace learning, with readiness
as evidence of motivation
LITERACY
•Ability of adults to read,
understand and interpret
information written at the 8th
grade level or above
Assessing Levels of Literacy
a. Reading or word recognition
b. Readability
c. Comprehension
READING TESTS
•REALM – Rapid Estimate of Adult
Literacy in Medicine
•WRAT – Wide Range Achievement
Test
TEACHING STRAT FOR
LOW LITERATE PTS
1. Establish a trusting relationship
before beginning the teaching-
learning process,
a. Focusing on the strengths
b. Specifying what needs to be
learned
TEACHING STRAT FOR
LOW LITERATE PTS
2. Use the smallest amount of
information possible by teaching
only what the patient needs to
learn
a. Prioritize behavioral objectives
b. Present context of the message
first
c. Limit the teaching sessions to no
more than 20-30 minutes
TEACHING STRAT FOR
LOW LITERATE PTS
3. Make points of information as
vivid and as explicit as possible:
a. Simple terms using examples
b. Visual aids
c. Underlining, highlighting, color-
coding, arrows and international
symbols
TEACHING STRAT FOR
LOW LITERATE PTS
4. Each one step at a time
a. Teaching in increments
b. Organizing information into
chunks
c. Evaluate the prograa
TEACHING STRAT FOR
LOW LITERATE PTS
5. Use multiple teaching methods
and tools requiring fewer literacy
skills
6. Allow patients to restate
information in their own words and
to demonstrate any procedure that
is being taught
7. Keep motivation high
TEACHING STRAT FOR
LOW LITERATE PTS
8. Build in coordination with
procedures by using principles of
a. Tailoring – coordinating the
patients’ regimens into their daily
schedules
b. Cuing – Appropriate combination
of time and situation using prompts
and reminders to get a person to
perform a routine task
TEACHING STRAT FOR
LOW LITERATE PTS
9. Use repetition to reinforce
information
