Determinants Of Learning 3- Reduce anxiety of client as possible

• Nurses have always provided education 4- Prevent unneeded repetition

for patients and their families to learn the
many different aspects of their health
care Assessing Learning Needs
• Nurses have difficulty meeting patients’
needs because of time constraints in • Learning needs must be examined first to
clinical practice. discover what has to be taught and to
• The “teachable moment” is hard to determine the extent of teaching
capture because of decreased length of required
stay. • Learning needs defined are gaps in
knowledge that exist between a desired
level of performance and the actual
These determinants include: level of performance
➢ Learning needs (What)
➢ Readiness to learn (When)
➢ Learning styles (How) Steps to assess learning needs

1. Identify the learner

The Educator’s Role in Learning • Who is the audience? Individual patient,
group of patients, significant others.
The nurse plays a crucial role in the learning • Are their needs the same or different
process by: • Teaching opportunity formal or informal
must be based on accurate
• Assessing problems of deficits
identification of the learners
• Providing important best evidence
2. Choose the right setting
information & presenting it in unique and
• Establish an environment in which the
appropriate way
learners feel a sense of security in
• Identifying progress being made
confiding (revealing disclosing)
• Giving feedback and follow-up
information and believe their concerns
• Reinforcing learning
are respected and taken seriously
• Determining the effectiveness of
• Maintaining privacy and confidentiality is
education
essential to establish a trusting
The educator is vital in giving support, relationship
encouragement and direction during process. 3. Collect data about the learner
• Determine characteristics needs of the
population by exploring typical health
Assessment Of the Learner problems or issues of interest to that
population
- The effectiveness of nursing care depends on 4. Collect data from the learner
the scope, accuracy, and comprehensiveness • Learners are usually the most important
of assessment source of data
Factors that considered with respect to three • Be sure to ask what is important to them,
determinants of learning: what type of social support systems are
available and how their social support
1- Assessment should based on theories, system can help.
concepts & principles • Actively engage learners in defining their
2- Identify priorities of behavioral objectives needs and problems
5. Involve members of the health care team
 • Consult with other professionals to gain
insight into the needs of patients and
7. Determine availability of educational
their families
resources
• Representatives of health-related
• the educator may identify a need, but it
organizations such as Diabetes
may be useless to proceed with
organization, Heart Association often
interventions if proper educational
provide insight into learning needs of
resources are not available.
people specific health problems or
8. Assess the demands organization
concerns
• This assessment yields information that
6. Prioritize needs
reflects the climate of organization
• If the basic needs are not attended to
• What are the organization’s, philosophy,
first and foremost as indicated by
mission, strategic plan and goals?
Maslow's hierarchy of needs, learning of
• Familiarize with standards of
other information may either delayed or
performance required in various
impossible to achieve
employee categories.
• Prioritizing helps nurses in partnership with
9. Take time- management issues into account
patient set realistic and achievable
• Because lack of time is a major barrier to
learning goals
carrying out a proper assessment the
• Not All Learners need to know everything
following are Some Tips that, in long term
and assessment can help to discriminate
are time-savers:
the “need to know” from the “nice to
➢ Give more efficient and effective time to
know” information
do Good initial assessment
• Maslow’s hierarchy of needs
➢ Learner must give time to offer their own
thought (Involve client actively)
➢ Do assessment any time & anywhere as
possible
➢ Inform client a head of time
➢ Minimizing interruptions and distractions

Methods to assess learning needs

1. Casual(informal) conservations: during

performing pt. care, nurse must rely on
active listening, use open-ended questions
• Prioritize needs 2. Structured interviews: use direct open-
ended questions.
3. Focus Group: group discussion to identify
POV or knowledge about certain topic.
4. Questionnaires: use checklist, self-
administered.
5. Test: giving written pretests help identify the
knowledge levels of learners.
6. Observations: watching the learner perform
a task is an excellent way of assessing a skill
7. Patient charts (Documentation): physicians’
notes, nurses’ notes, ….etc.
Assessing the Learning Needs of the Nursing ➢ Moderate anxiety will derive
Staff someone to take action.
➢ Moderate level of anxiety is best for
The following are methods that can be used to
success in learning.
determine the learning needs of staff.

1. Written Job Description

2. Formal and Informal Request
3. Quality Assurance Reports
4. Chart Audits
5. Rules and Regulations
6. Self-Assessments
7. Gap Analysis

Readiness To Learn

• Defined as the time when the learner

• Support system—strong support system
expresses or shows interests in learning
decrease anxiety, whereas the lack of
the information necessary to maintain
one may increase anxiety.
optimal health.
• The same methods to assess learning can *Reachable moment- when the nurse truly
be used for assessing readiness to learn. connects to the client by directly meeting the
• Timing—that is, the point at which indv mutual terms
teaching should take place—is very
• Motivation- willingness to take action
important.
• Risk-taking behavior-Nurse can help
• A learner who is not receptive to
patient develop strategies to reduce the
information at one time may be more
risk of their choices
receptive to the same information at
• Frame of mind- Prioritize pt needs. E.g.,
another time.
adults who have reached self-
actualization and whose basic needs
are met tend to plan for their future and
Take time to take a PEEK at the four types of
are more to learn health promotion tasks.
readiness to learn
• Developmental stage- Each stage
1. Physical readiness associated with human development
Measure of ability—sensory abilities
• produce a peak time for readiness to
Complexity of task—difficulty level of the
• learn certain tasks, known as a
subject “teachable moment”
• Environmental effects—an environment
Teachable moment means “when the client will
favorable to learning
be most receptive to learning.
• Health status—the amount of energy
available to learning 3. Experiential readiness
• gender—women are generally more • Level of aspiration— previous failure and
receptive to medical care and take less success
risks regarding their health than men • Past coping mechanism— to understand
2. Emotional readiness how the learner has dealt with previous
• Anxiety level- pt’s ability to concentrate problems
and retain info • Cultural back ground— assessment of
➢ Mild or sever anxiety may lead to an what illness means from the patient’s
inability to learn
 cultural perspective is important in
determining readiness to learn
Learning styles
• Locus of control— internal locus of
control and external locus of control - To determine a person’s learning style,
orientation
4. Knowledge readiness three mechanisms can be used:

Refers to learner’s present knowledge base, the • Observation,

level of learning capability, and the preferable • Interviews
style of learning. it consists of: • Learning style instruments

• present knowledge base: How much Certain of characteristics of learning style are
someone already knows. Build on this biological in origin, whereas others are
knowledge to encourage readiness to developed as a result of sociological and
learn environmental influences.
• Cognitive ability: Match the behavioral
objectives to the ability to learn, or failure
to achieve will result Right brain / left brain & whole- brain thinking
• Learning disability: People with learning Brain Preference Indicator
disabilities require special approach to • Right hemisphere— emotional, visual-
teaching spatial, non-verbal hemisphere
• Learning style: Knowing the learning
method and materials the learner is Thinking processes using the right-brain are
comfortable with help the nurse to tailor intuitive(spontaneous), subjective, relational,
teaching according to how someone holistic, and time free
learns best
• Left hemisphere— vocal and analytical
side

Learning Styles Thinking process using reality-based and logical

thinking with verbalization
• Refers to the way individuals process
information
• Each learner is unique and complex with
distinct learning style preferences that
that distinguish one learner from another.

Six learning style principles

1. Identify style that nurse & client prefer

2. Nurse need not to use her preferred style
exclusively
3. Assist patients to identify their own style
preference
4. Client will have opportunities to learn
through their preferred
5. Encourage client to diversity styles of
learning ➢ No correct or wrong side of the brain
6. Become aware of various methods and each hemisphere gathers in the same
materials available sensory information but handles the
information in different ways
 ➢ Knowledge of one’s own brain Field-Independent/Field-Dependent
hemispherical performance can aid Embedded Figures Test
educator nurse in identifying their
strengths and weaknesses in teaching
• Learners have preference styles for certain
methods environmental cues.
➢ Whole-brain thinking allows the learner to • Helps the educator structure the learning
get the best of both worlds. task and environment
➢ Duality of thinking should be • Helps assess the extent to which learners
encouraged to help learner reach their are able to ignore distractions from other
fullest learning potentials persons
• Assesses whether learners see the whole
first or the individual parts of a task when
Right brain / left brain & whole- brain thinking learning
LEFT BRAIN

• Prefers talking and writing Characteristics of Field-Independent & Field-

• Recognizes/remembers names Dependent Learners
• Solves problems by breaking them into
parts
• Conscious of time and schedules a) Field-Independent Learners
• Are not affected by criticism
• Will not conform to peer pressure
RIGHT BRAIN • Are less influenced by external feedback
• Prefers drawing and manipulating • Learn best by organizing their own
objects material
• Recognizes/remembers faces • Have an impersonal orientation to the
• Solves problems by looking at the whole, world
looks for patterns, using hunches • Place emphasis on applying principles
• Not conscious of time and schedules • Are interested in new ideas or concepts
for own sake
WHOLE BRAIN- Combining both sides of the • Provide self-directed goals, objectives, ir
brain. reinforcement
• Prefer lecture method
b) Field-Dependent Learners
• Are easily affected by criticism
• Will conform to peer pressure
• Are influenced by feedback (grades &
evaluations)
• Learn best when material is organized
• Have a social orientation to the world
• Place emphasis on facts
• Prefer learning to be relevant to own
experience
• Need external goals, objectives, and
reinforcements
• Prefer discussion method
Environment Preference Survey (LSI)

• Stimuli Interpretation of learning style

• Environmental
General guidelines should be followed when
• Emotional
assessing individual learning style:
• Sociological
• Physical 1. Become familiar with the ways in which
• Psychological style are classified
2. Identify key element of an individual
learning style by observing and ask
Dunn and Dunn learning style
question to verify observation and then
Identified five basic stimuli: match instructional method and
materials to those unique qualities
• Environmental elements (sound, light, 3. Always give learner the opportunity to
temperature, design) which are say when the teaching method is not
biological in nature
working for them
• Emotional elements (motivation, 4. Place emphasis on assessing learning
responsibility, persistent) which are styles as a way to increase
developmental and emerge over time understanding both from the nurse and
as a result of experience that happen at the learner perspective
home, school work etc. 5. Be caution about saying that certain
• Sociological elements (desire to learn instructional method are always more
alone or in group) effective for certain style
• Physical elements (perceptual strength, 6. Provide learning choices that enable
time of day and mobility) biological in learners to recognize and choose the
nature and relate to the way learners’ style in which they prefer to learn
function physically
• Psychological elements (indicate the The Learning Styles of Every Myers-Briggs
way learners process and react to Personality Type
information) Myers-Briggs Type Indicator

➢ Dunn and Dunn’s identified stimuli are Personality Possible preferences in e-

relevant to the role of the nurse as a Types learning
teacher. Extravert (E) Video conferencing
vs. Introvert (I)preferred by extraverted
➢ The nurse needs to consider the previously
whereas the introverted
mentioned selected characteristics when
learner may prefer
assessing a patient’s or family member’s asynchronous
learning style. communication.
Sensing (S) vs. Sensing learners need the
Intuitive (N) structured framework of the
course with specific
guidelines. Intuitive Learners
prefer the abstract contents,
and learning by seeing
connections.
Thinking (T) vs. Thinking learners want to see
Feeling (F) precise, cognitive, affective
objective. The feeling
learners may prefer group
 exercises and working with
small groups.
Judging (J) E-learning provides judging
VS. learners with well-structured
Perceiving (P) instruction with clearly
defined goals, while
perceivers provided with
more flexible course design.

Kolb Learning Style Inventory

• Perception Dimension
➢ Concrete experience (CE mode)
➢ Abstract conceptualization (AC)
• Process Dimension
• Active experimentation
• Reflective observation 4MAT SYSTEM…
• Diverger Converger
• Assimilator Accommodator

Kolb Learning Style Inventory

Known as Cycle of Learning includes:

• 4 Modes of Learning:
➢ Accommodator
- Diverger VARK Learning Styles
➢ Converger
• Four preferences that reflect learning style
➢ Assimilator
experiences and preferences of students
➢ Visual
• That reflects 2 Major
➢ Aural
➢ Dimension of Perception
➢ Read/write
- Concrete experience (CE)
➢ Kinesthetic
- Abstract conceptualization (AC)
➢ Starting point for educators and learners
➢ Dimension Process
to discuss teaching and learning
- Reflective observation (RO)
strategies
- Active experimentation (AE)
➢ VARK questionnaire provides profile.