Determinants of Learning

1. Determinants of Learning Dr. BelalHijji, RN, PhD February 28, 2012

2. Learning Outcomes At the end of this lecture, students will be able to • Describe the role of the educator in the educational process. • Identify and discuss the determinants of learning.

3. The Nurse Educator’s Role in Learning • For a nurse to carry his/ her educative role well, s(h)e must identify the information learners need, their readiness to learn, and their learning styles. However, the learner remains the single most important person in the educative process. • The role of the educator is to enhance the learning process by serving as a facilitator. The educator: • assesses the learner’s deficits • presents appropriate information in unique ways. • identifies progress being made. • gives feedback • reinforces learning in the acquisition of knowledge, or performance of a skill. • evaluates the learner’s abilities • The educator provides support, encouragement and direction during the learning process.

4. Assessment of the Learner • Often patients with the same condition are taught with the same material and in the same way. Is this problematic? Why? Yes, because: • The information given to the patient is neither individualised nor based on the educational assessment • Nurses, frequently and firstly, delve [يتعمقوا] into teaching. Is this problematic? Why? Yes, because: • This approach neglects to address assessment of the learner as an essential aspect of the instructional process. • Nurses were always taught that their interventions are based on sound assessment, and the same applies to the instructional process.

5. Assessment of the learner includes attending to the three determinants: • Learning needs (what the learner needs to learn) • Readiness to learn (when the learner is receptive to learning) • Learning style (how the learner best learns)

6. Assessment of Learning Needs • This must be examined first. Can we first assess readiness or learning style? Why? No, because: • there is no need to assess readiness and the learning style if learning needs are not present • Assessment is essential to determine learning needs so that an instructional plan can be designed to address deficits in any of the educational domains [Cognitive, psychomotor, affective]. • Not all individuals perceive a need for education. For example, in a survey of nurses’ knowledge and practice of blood transfusion in Jordan, 25 nurses (8%) had the perception that they needed no further education in any of the areas related to blood transfusion, although they had documented knowledge deficits. • Consequently, assessment is used to identify and priortise the needs and interests of the learner.

7. Learning needs: are gaps in knowledge that exist between a desired level of performance and the actual level of performance • The following are some important steps in the assessment of learning needs: • Identify the learner. Is there only one learner with a single need or many needs? Is there more than one learner with congruent or diverse needs? • Choose the right setting: Establish trusting relationship through assuring privacy and confidentiality, so that learners feel secure in confiding information and feel respected.

8. Collect data on the learner: Determine characteristic needs of the audience by exploring typical health problems or issues of interest. Subsequently, identify the type and extent of content to be included in the teaching sessions. • Include the learner as a source of information: Allow the patient and/or family and staff members to identify what is important to them. If the learners are staff members or nursing students, ask them about areas of practice they feel they need new or additional information. • Involve members of the healthcare team: Other healthcare providers may have insight into patient, family, nursing staff, and nursing students educational needs. Because of their frequent contacts with them.

9. Priortiseneeds: A list of needs can become endless and seemingly impossible to accomplish. Using Maslow’s hierarchy of human needs, an educator can priortise identified learning needs. The educator can then assist the learner to meet the most important basic need first. • Setting priorities for learning is often difficult when faced with many learning needs in several areas. Learning must be priortised based on the criteria of • mandatory: Needs that must be learned for survival or situations in which the learner’s life or safety is threatened. For example, a patient with recent heart attack needs to know the sign and symptoms and when to seek medical help. The hospital nurse must learn cardiopulmonary resuscitation. • desirable: Needs that are not life-dependant but are related to well-being. For example, patients with cardiovascular disease to understand the effects of a high fat diet on their health. • possible: Needs for information that are nice to know but not essential or required. For example, a patient with diabetes mellitus dos not need to know about travelling across time zones.

10. Determine availability of educational resources: After identifying a need, it may useless to proceed with the intervention if proper educational resources are not available. For example, if an asthmatic patient needs to learn how to use a ventolin inhaler, that learning cannot occur if this equipment is not available for demonstration/ return demonstration.

11. Methods to Assess Learning Needs • The nurse educator must obtain objective data about, and subjective data from, the learner. This can be achieved by using one or more of the following methods: • Informal conversation: Often, learning needs are identified during informal talk with other healthcare providers, and between the nurse and the patient/ family. • Structured interviews: The nurse asks the patient direct and often predetermined questions. Establishing trust, using open-ended questions, quiet environment, and allowing the patient to state what his learning needs are merit attention.

12. Focus groups: The educator gets together 4-12 learners to determine areas of educational need. The educator leads the discussion and asks open-ended questions. • Self-administered questionnaires: the learner’s responses to questions about learning needs can be obtained by self-administered questionnaires. These are easy to administer and provide more privacy than interviews. • Tests: Written pre-tests given before teaching can help identify the knowledge level of learners regarding a particular subject matter and assist in identifying a specific needs of learner. Tests are useful as they prevent the educator from repeating already known material. • Observation: Watching a learner perform a skill more than once is an excellent way of assessing psychomotor need. Educators can assess whether all steps are performed correctly.

13. Readiness to Learn • Definition: It is the time when the learner demonstrates an interest, willingness, and ability to learn the type or degree of information necessary to maintain optimal health or to become skillful in a job. • The following factors must be taken into account before starting teaching (PEEK): • Physical readiness: Does the learner have enough strength and ability to walk on crutches? Is the environment calm and conducive to learning? • Emotional readiness: Fear contributes to anxiety and negatively affects readiness to learn. A nursing student may not master a skill because of fear of harming a patient or of failure to perform correctly. • Experiential readiness: The educator, before starting teaching, should assess whether past learning experiences were negative or positive in overcoming problems. A learner who had negative learning experience is not likely to be motivated to change behaviour or acquire new behaviours. • Knowledge readiness: The educator needs to find out how much a learner knows about a topic and how proficient in performing a task.

14. Learning styles • These refer to the ways individuals process information. The types of learning styles are: • visual: A student learns by reading a material, and uses visual material such as charts, pictures, maps. • auditory: A student learns by listening, participates in discussions, makes speeches and presentations, and reads the text aloud. • kinesthetic: A student learns by touching or doing. SOURCE: www.tarleton.edu/ssp/documents/Week10sLearingStyles.ppt‏