NCMA112

Health Education | Gab

TOPIC OUTLINE: HEALTH PROMOTION

- Historical Development of Health Education - any endeavor directed at enhancing the quality of health and well-
- Historical Background of Health Education being of individuals, families, groups, community, through strategies
- Learning Theories in Healthcare involving supportive environments, coordination of resources and
- Education Process respect for personal choice and values.
- Principles of Teaching and Learning in Health Education - The term “Health Promotion” was introduced in 1974 by Canadian
- Designing Health Education of Age Specific Group Health Minister La Londe (Macdonald & Bunton, 1992. and was not
popular until the 1980’s when the (WHO) World Health Organization
HISTORICAL DEVELOPMENT OF HEALTH EDUCATION began a campaign for global public health.

HEALTH
FACTORS IN THE ECOSYSTEM WHICH AFFECT THE
- The condition of being sound in body, mind or spirit; freedom form
physical disease or pain. OPTIMUM LEVEL OF FUNCTIONING (OLOF)

- It refers to the ability of the person to function effectively physically, 01 Political Factors
socially, psychologically and spiritually. - which involves power and authority to regulate the
- The WHO (1946) good health is a state of complete physical, social environment or social climate.eg safety, oppression, people
and mental well-being, and not merely the absence of disease or empowerment.
infirmity. 02 Behavioral Factors
- Health is a resource for everyday life, not the object of living, and is a - which refers to a person’s level of functioning and is affected
positive concept emphasizing social and personal resources as well by certain habits, their lifestyle, health care and child rearing
as physical capabilities. practices which are determined by one’s culture and ethnic
HEALTH EDUCATION heritage.eg culture, habits and ethnic customs.
- It is a tool or mechanism for health-related learning resulting in 03 Hereditary
increase in knowledge, skill development, and change in behavior. - refers to the understanding of genetically influenced
- It is directed toward changing behavior toward preset goal. diseases and genetic risks.
04 Health Care Delivery System
- which focus of healthcare is in the promotive, preventive,
DIMENSION OF HEALTH
curative and rehabilitative aspects of care. Primary health
BROADER
care is a partnership approach to the effective provision of
- a dimension of health in the outer circle which are environmental and
essential health services that are community-based,
societal dimensions.
accessible, acceptable sustainable and affordable.
05 Environmental Influences
INDIVIDUAL
- refers to the menace of pollution, communicable disease due
- dimension of heath in the inner circle which are:
to poor sanitation, poor garbage collection, smoking,
01 Physical Health
utilization of pesticides, lack or absence of proper and
- which refers to the state of one’s body like its fitness and not
adequate waste and sewerage disposal system and
being ill.
management, noise, radiation, air and water pollution are just
02 Mental Health
some of the factors or situations which exert negative effects
- which refers to the positive sense of purpose and underlying
on the environment.
brief in one’s own worth (self-esteem) like feeling good and
06 Socio-Economic Influences
feeling able to cope.
- Status; families in lower income group are the ones mostly
03 Emotional Health
served.
- which refers to the ability to express one’s feeling
appropriately and to develop and sustain relationship. (e.g.
is the feeling of being loved) ANCIENT TIMES

04 Social Health
- which involves the support system that is available from BABYLONIA (IRAQ): Code of Hammurabi
family members and friends. Remember “No man is an - It is established standards and practices of living for Babylonians.
island” - It was based on promoting fairness and equality.
05 Spiritual Health - With an “eye for an eye” premise, some of the regulation seem drastic
- which refers to the recognition of a Supreme being or Force compared to a present-day standard.
and the ability to put into practice one’s moral principles or
beliefs. GREECE
06 Sexual Health - Early Greeks are known for their practice of worshipping gods and
- which refers to the acceptance of the ability to achieve a goddesses.
satisfactory expression of one’s sexuality. - Apollo was known as the god of health while his son Asclepius was the
07 Societal Health god of healing. Hygeia daughter of Asclepius was the goddess of
- which is the link between health and the way a society is health and another daughter Panacea was the restorer of health.
structured. This includes the basic infrastructure necessary - Greeks focus on health with an emphasis on personal health, hygiene,
for health and the degree of integration or division within the exercise, and healthy diet.
society. - Hippocrates – known as the Father of Medicine
08 Environmental Health - Hippocrates believed health to be dependent upon equilibrium
- which refers to the physical environment where people live, among the mind, body and environment rather than the whims of the
it involves housing, transport, sanitation, pollution and pure Gods. This belief known as the holistic approach in health care
water facilities. practice today.

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EGYPT THE RENAISSANCE (1500-1700)

- Ancient Egyptians around 3000 B.C. contributed significantly to health - The European Renaissance brought about the return to scientific
through progress made in disease prevention. thought with attempts to understand and control life.
- Egyptians are known for their efforts in developing hygiene and water - This changed the holistic view of health and illness held by followers
sanitation. Developed sophisticated system to support pure water of Hippocrates to a disintegrated view maintaining that the body was
and dispose wastes They developed stringent regulation related to separated from the mind.
cleanliness, food, drink exercise and sexual relation (Ellis& Hartley, - During this time, the responsibility of society for public health and
2004) welfare was at least recognized.
- There is improvement of medical technology.
PALESTINE - Colonies in America were being established; the colonies were
- Their greatest contribution was the creation of the Mosaic Code, sparsely populated and remained isolated for many years.
about 1500 B.C, reflected in the Old Testament. - Early colonial health was good compared to that of the crowded
- Under the leadership of Moses, Mosaic Code-differentiated clean Europeans and the problems with communicable disease were
from unclean and emphasized the segregation of those with minimal (Clarks, 2003).
communicable disease.
- The principle of quarantine was to be of great importance in later PERIOD OF INTUITIVE NURSING
history. Contributions of Ancient Civilizations to Medicine and Nursing

ROME ROME
- Ancient Romans unlike Egyptians and Greeks they lacked originality - The first organized visiting of the sick began with the establishment of
for health promotion and disease prevention practices. the order of the deaconesses. They endeavored to practice the
- Medical practices of the Romans were obtained from their conquered corporal works of mercy:
regions and physicians from these countries became slaves to the • Feed the hungry
Roman Empire. • Give water to the thirsty
- Roman accomplishments were mostly directed at public health with • Clothed the naked
the establishment of regulations for sanitation, street cleaning, • Visit the imprisoned
building construction, ventilation, and heating among others (Clark, • Shelter the homeless
2003). • Care for the sick
- Health promotion practices of ancient Romans, which included • Bury the dead
exercise, massage and other therapeutic baths.
- The Greek physician Hippocrates and the Roman physician Galen GREECE
both viewed health as an interaction between a person and his/ her - Nursing was the task of untrained slaves. The Greeks introduced the
environment. caduceus, the insignia of the medical profession today.
- Galen created definition of health that emphasized the ability of an - HIPPOCRATES came to be known as the “Father of Scientific Medicine.”
individual to carry out the functions of daily life without hindrance or - He made a major advance in medicine by rejecting the belief that
pain (Moore& Williamson 1984) diseases had supernatural causes.
- He developed assessment standards for clients, established overall
CHINA medical standards, recognized the need for nurses.
- The Chinese were perhaps the greatest advocates for health
promotion of all ancient cultures. CHINA
- They viewed a healthy lifestyle as one that stayed in harmony with the - Used massage therapy, hydrotherapy, and exercise as preventive
universe by maintaining a perfect balance between the dualistic health measures
forces of yin and yang (Bright, 2002), - They also used many herbs, minerals & acupuncture to heal the sick.
- Yin was viewed as the female element associated with negative
energy, passiveness, destruction, the moon, darkness and death. AFRICA
- Yang was viewed as the male element associated with positive - The nurturing functions of the nurse included roles as midwife,
energy, action, generatively, the sun, light, and the creativity of life. herbalist, wet nurse, and carer for children and the elderly.
- Maintenance of this balance resulted in perfect health of the mind,
body and spirit. INDIA
- Early hospital was staffed by male nurses who were required to meet
HEALTH PPROMOTION PERIODS four qualifications:
MIDDLE AGES • Knowledge of the manner in which drugs should be prepared for
- After the fall of Rome, during the period known as the Dark Ages, • administration
health and medicines of ancient worlds was lost, (Cockerham, 1978). • Cleverness
- The Roman Catholic Church claimed authority for the welfare of • Devotedness to the patient
society, and purity of the soul became the highest of priorities. • Purity of the mind and body
- Caring for the body such as daily bathing and exercise, was viewed • Indian women served as midwifes and nurses’ ill family
as a sinful indulgence resulting in neglect of the soul. members.
- Illness and death were associated with famine and infectious disease
epidemics.
- After the Dark Ages, shifted into the Middle Ages, very little was
accomplished to promote health or to treat illnesses.
- Although the emphasis on health by early Christians was on treating
the disease and illness, they did much to increase the public’s
awareness of health.
- This was mainly accomplished with the development of the concept
of quarantine in response to repeated epidemics during the latter
part of the Middle Ages.
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PERIOD OF APPRENTICE NURSING - With the current third-party payor system, nurses are expected to be
- This period extends from the founding of religious nursing orders in the prime movers in delivering high quality, effective and efficient
the Crusades which began in the 11thcentury and ended in 1836, when nursing care which will result to shorter hospital confinement and
Pastor Fliedner & his wife established the Kaiserwerth Institute for the continuation of recovery and rehabilitation through home care and
training of Deaconesses (a training school for nurses) in Germany. or community-based nursing care.
- It is called the period of “on-the- job” training. - Historical accounts revealed that people of the ancient world were so
- Nursing care was performed without any formal education & by the concerned about their health/ in the past, ancient Greek estates
people who were directed by more experienced nurses. observed sports competitions in honor of their gods and goddesses.
- Religious orders of the Christian Church were responsible for the The competitors had to undergo rigorous physical and mental
development of this kind of nursing trainings in order to win. This could have been true since the early
greeks believed in what Plato had envisioned about health – a sound
THE CRUSADES mind in a sound body; for the good of the soul.
- The crusade were the holy wars waged in an attempt to recapture the
Holy Land from the Turks who denied pilgrims permission to visit the TIMELINE
Holy Sepulcher.
- Military religious orders established hospitals that were staffed with
men.

1990 Public health nurses in this country clearly understood the

MILITARY RELIGIOUS ORDERS
significance of education in the prevention of disease and in the
- Knights of St. John of Jerusalem (Italian). Devoted to religious life and
maintenance of health.
nursing.
1918 National (NLNE) League in of Nursing Education US recognized the
- Military Religious Orders (German). Established tent hospitals for the
responsibility of nurses for the promotion of health and the
wounded.
prevention of illness in such settings as schools, homes, hospitals,
- Knights of St. Lazarus (German) Was founded primarily for the nursing
and industries.
care of lepers in Jerusalem after Christians had conquered the city.
1970 established the rights of patients to receive complete concerning
diagnosis and treatment.
THE ALEXIAN BROTHERS
1993 JCAHO. These standards, which take the form of mandates, are
- Were members of a monastic order founded in 1348.
based on descriptions of positive outcomes of patient care.
- They established the Alexian Brothers Hospital School of Nursing, the
1995 Pew Health Professions Commission, influenced by the dramatic
largest school of nursing under a religious order. It operated
exclusively for men. In the United States, the school closed in 1969. changes currently surrounding health care, published a broad set
of competencies that it believes will mark the success of the

EARLY AMERICA health professions in the twenty-first century.

- The Industrial Revolution in the United States marked the transition of

the country’s economic foundation from agriculture to industry. JOINT COMMISSION ON ACCREDITATION OF HEALTHCARE ORGANIZATION
- Shifting the population from rural to urban settings and resulting in - Mission is to continuously improve health care for the public, in
inadequate living and working conditions. collaboration with the stakeholders, by evaluating health care
- General public health declined and death from preventable disease organizations and inspiring them to excel in providing safe and
increased, esp. among children. effective care of the highest quality and value.

NURSING IN AMERICA: NURSING DURING THE CIVIL WAR AMERICAN HOSPITAL ASSOCIATION
- The American Medical association during the Civil War created the - To advance the health of all individuals and communities. The AHA
committee on Training of Nurses. It was designed to study & make leads, represents and serves hospitals, health systems and other
recommendations with regard to the training of nurses. Doctors related organizations that are accountable to communities and
realized the need for qualified nurses. committed to equitable care and health improvement for all.
- Important personages at the time Dorothea Lynde Dix – she was
appointed as Superintendent of Female Nurses for the US government PEW HEALTH PROFESSIONS COMMISSION
- Clara Barton – founded the American Red Cross - Charged with assisting health professionals, workforce policy makers,
and educational institutions in responding to the challenges of the
changing health care system.
PERIOD OF EDUCATED NURSING
- This period began on June 15, 1860 when the Florence Nightingale
OVERVIEW IN THE PHILIPPINES
School of Nursing opened at St. Thomas Hospital in London. The
development of nursing during this period was strongly influenced by: ALBULARYO
• Trends resulting from wars - Derived from the word “herbolario”, a Spanish word meaning
• An arousal of social consciousness herbalist.
• The emancipation of woman - Arbularyo - another variation of the word, a misspelling often brought
• Increased educational opportunities for women. about by mispronunciation and is technically incorrect.
- “Albularyo” or what we call a witch doctor usually call the spirit of the
dead and tries to remove them from the face of the earth, they also
HISTORICAL BACKGROUND OF HEALTH EDUCATION
use herbal medicine; as well as ”gayuma”.
OVERVIEW OF HEALTH EDUCATION
- Comprising of consciously constructed opportunities for learning
BABAYLAN
involving some form of communication designed to improve health
- During the pre-Hispanic period, the function of an albularyo was
literacy, including improving knowledge, and developing life skills
fulfilled by the Babaylan, a shamanic spiritual leader of the
which are conducive to individual and community health. (WHO)
community.
- The recent developments in the field of health care have served to
- At the beginning of the Spanish Era in the late 16th and early 17th
highlight the important role of education in “helping the patients and
centuries, the suppression of the Babaylans and native Filipino
their families assume responsibility for self-care management”.
animist beliefs gave rise to the albularyo. By exchanging the native

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pagan prayers and spells with Catholic oraciones and prayers, the 7 AREAS OF RESPONSIBILITY
albularyo was able to syncretize the ancient mode of healing with the
new religion.

CONTINUATION OF OVERVIEW
- As time progressed, the albularyo became a more prominent figure
in most rural areas in the Philippines. Lacking access to scientific
medical practices, rural Filipinos trusted the albularyos to rid them of
common (and sometimes believed to be supernatural) sickness and
diseases.
- However, the albularyo’s role was slowly shadowed with the rise of
modern medical facilities. Urbanization gave the masses access to
more scientific treatments, exchanging the chants and herbs with the 01 Assessing the individual and family community needs for education.
newer technologies. - Provides the foundation of program planning.
- Still, albularyos flourish in many rural areas in the Philippines where - Determine what health problems might exist in nay age
medical facilities are still expensive and sometimes inaccessible. groups.
- Includes determination of community resources available to
OVERVIEW OF HEALTH EDUCATION IN THE PHILIPPINES address the problem.
- In 1990s, the Philippines entered as a modernizing society. The health 02 Plan health education strategies interventions and programs based
conditions in the Philippines would have improved a lot, on needs assessment.
- Filipino doctors opted to stay in the country leaving only a few doctors - Development of goals and objective which are specific and
attending to the needs of the large population in the country. measurable
- This explains the high cost of medication in the country, forcing some - Interventions are develop to meet the goals.
Filipinos to consult faith healers, witch doctors or self-declared - According to rule of sufficiency, strategies are implemented
physicians who charge less. which are sufficiently robust, effective enough and have
- In 1993, the Department of Health launched its Hospitals as Centers reasonable chance of meeting the stated objectives.
for Wellness program. It assigned each hospital a health education 03 Plan health education strategies interventions and programs based
and promotion officer. on priority population.
- In 2010, programs are geared toward managing the major health - Implementation is based on a thorough understanding of the
issues that affect the country. priority populations.
- There is a need to be a continuity of the health programs and - Utilize a wide range of educational methods and strategies.
education so the public are better informed and aware of their health 04 Conduct evaluation and research r/t health education.
status. - Health Educators utilizes research to improve the practice.
- While the public health system was decentralized to local - Depending on the setting, utilizes test, surveys, observations,
governments, this only led to inequitable distribution of health tracking of epidemiological data and other methods of data
services. collection.
- Poor municipalities could hardly deliver health services and 05 Administer health education strategies, interventions and programs
education as efficiently as urban cities do. - Administration is generally a function done by experience
- It must be noted that the national government is showing efforts to practitioner.
make efficient health services and health education available to as - Involves facilitating cooperation among personnel both
many Filipino. within and between programs.
06 Serves as health education resource person
HEALTH EDUCATION - Involves skills to access needed resources and establish
- Tracing the history of health education to ancient times, Rubinson and effective consultative relationships.
Alles (1984) concluded that the health education profession has been 07 Advocate for health and Health Education
helping people for a very long time now. - Advocate the profession of Health Education
- A health educator is “a professionally prepared individual who serves - Translate scientific knowledge in under stable information
in a variety of roles and is specially trained to use appropriate - Address audience diverse in diverse setting
educational strategies and methods to facilitate the development of
policies, procedures, interventions, and systems conducive to the 5 AREAS OF RESPONSIBILITY OF HEALTH EDUCATION
health of individuals, groups, and communities”.

HEALTH EDUCATION SPECIALIST

- Also called Health Educators
- Educate people about behaviors that promote wellness.
- They serve their community in a variety of ways, using health-focused
strategies to improve the well-being of their community members.
- Health education specialists work with individuals, families, and
communities, as well as public and private organizations to create,
01 Planning
implement, oversee, and analyze programs and strategies that
- Includes plans of health activities in different settings using
promote health and well-being.
appropriate instructional materials involving well and sick
client across the ages and considering their health beliefs
and practices.
- Involves the development of goals and objectives which are
specific and measurable.
- Interventions are developed that will meet the goals and
objectives.

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- According to the Rule of Sufficiency, strategies are standards and achieve health education and promotion
implemented which are sufficiently robust, effective enough, goals.
and have a reasonable chance of meeting stated objectives.
- Once you have identified the health needs of your community HISTORICAL DEVELOPMENT OF HEALTH EDUCATION
and how best to communicate health knowledge, you have
to put together a plan. You’ll want to consider budgets, the
attitudes of stakeholders, timelines, government regulations,
and overall feasibility. Your goal is to overcome existing
obstacles to reach as many people in your community as
possible.
02 Implementation
- Includes use of age appropriate strategies, intervention, and
programs
- Implementation is based on a thorough understanding of the
priority population.
EVOLUTION OF THE TEACHING ROLE OF THE NURSE
- Utilize a wide range of educational methods and techniques.
01. Teaching as function within the scope of nursing practice.
- After putting in the work to develop a strong program, you can
02. Training the trainer
then go out into your community and provide the education
03. Educating their colleagues
the community needs to improve its overall health and
04. Clinical Instructor
address health- related needs of the community. This phase
can be highly rewarding as you will develop practitioner skills
EDUCATION PROCESS
by working with various populations and applying behavior
EDUCATION PROCESS
change principles. Monitoring program effectiveness and
- It is a systematic, sequential, planned course of action consisting of
managing its execution are required tools to implement a
two major interdependent operations, teaching and learning.
successful health promotion intervention and/or program.
- This process forms a continuous cycle that also involves two
03 Evaluation and Research
interdependent players, the teacher and the learner, jointly perform
- A continuous practice that improves and innovates nursing
teaching and learning activities, the outcome of which leads to
practice.
mutually desired behavior changes.
- Depending on the setting, utilize tests, surveys, observations,
tracking epidemiological data, or other methods of data
TEACHING / INSTRUCTION
collection
- Teaching is a deliberate intervention that involves the planning and
- Health Educators make use of research to improve their
implementation of instructional activities and experiences to meet
practices.
intended learner outcomes according to a teaching plan.
- As a health educator, your responsibilities extend beyond the
- Instruction is a component of teaching that involves the
implementation of a health education or promotion program.
communicating of information about a specific skill in the cognitive,
You must also be able to evaluate your program as well as
psychomotor, or affective domain.
any other programs, projects, or policies you’re involved in.
This means you must understand proper evaluation
DIFFERENCE OF NURSING PROCESS AND EDUCATION PROCESS
methodology and have realistic, measurable objectives. You
Nursing Process Education Process
can use tests, surveys, observation, medical data, and other
Appraise physical and ASSESSMENT Ascertain learning
facts and figures to conduct an evaluation. Once the
evaluation is complete, you are expected to share the results psychosocial needs needs, readiness to learn
and learning styles
with the wider heath education and promotion community to
help improve future efforts. Develop care plan based PLANNING Develop teaching plan
04 Resource Person on mutual goal setting to based on mutually
- Provides up-to-date information to patient, family members, meet individual needs predetermined
and colleagues in the profession. behavioral outcomes to
- Involves skills to access needed resources, and establish meet individual needs
effective consultative relationship. Carry out nursing care IMPLEMENTATION Perform the act of
- As a health educator, you’re expected to make yourself interventions using teaching using specific
available to answer community health questions and help standard procedures teaching methods and
that community understand and address health concerns. As instructional materials
such, you need to know where to find accurate health Determine physical and EVALUATION Determine behavioral
information, how to assess the appropriateness of that psychosocial outcomes changes (outcomes) in
information for your community, and how to successfully knowledge, attitudes,
communicate thatinformation. and skills
05 Advocate LEARNING
- Protects the welfare of the patient when needed. - A change in behavior to includes skills, knowledge and behavior It is
- Translates scientific language into understandable can be observed and measured at any time or in any place as a result
information of exposure to environmental stimuli.
- Address diverse audience in diverse settings
- Formulates and support rules, policies and legislation
- Advocate for the profession of health education
- Not everyone understands the importance of health
educators or the role they can play in improving local,
national, and global health. As a health educator, you have
the responsibility to support and promote the profession to
others and to work with those in your profession to maintain
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PATIENT EDUCATION ASSURE MODEL

PATIENT EDUCATION - The Assure model is a paradigm to assist nurses to carry out and
- According to Freidman et al (2011), it is a set of planned educational organize and Education Process.
activities using a combination of method (teaching, counseling to
improve behavior modification) to improve patients knowledge and
health behaviors.
- A significant part of a nurse’s job.
- Education empowers patients to improve their health status.
- When patients are involved in their care, they are more likely to
engage in interventions that may increase their chances for positive
outcomes.

BENEFITS OF PATIENT EDUCATION

- Prevention of medical conditions such as obesity, diabetes or heart
disease.
- Patients who are informed about what to expect during a procedure
and throughout the recovery process.
- Decreasing the possibility of complications by teaching patients
about medications, lifestyle modifications and self-monitoring
devices like a glucose meter or blood pressure monitor.
- Reduction in the number of patients readmitted to the hospital.
- Retaining independence by learning self-sufficiency.

NURSE’S ROLE IN PATIENT EDUCATION

- Effective patient education starts from the time patients are admitted
to the hospital and continues until they are discharged.
- Nurses should take advantages of any opportunities throughout a THE BENEFITS OF EFFECTIVE PATIENT EDUCATION
patient’s stay to teach the patient about self-care.
- Without a proper education, a patient may go home and resume
unhealthy habits or ignore the management of their medical
condition. Actions that may lead to a relapse and a return to the
hospital.

KEY POINTS IN PATIENT EDUCATION

- Self-care steps they need to take.
- Why they need to maintain self-care.
- How to recognize warning signs.
- What to do if a problem occurs.
- Who to contact if they have questions. TRADITIONAL TEACHING STRATEGIES
COOPERATIVE LEARNING
ENSURE PATIENT COMPREHENSION - Students from one class are arranged into small groups. Based on the
- Common words and phrases premise that learners help each other work and think together and
- Reading materials written at a sixth-grade level are responsible for not only their own learning but also for the learning
- Video of other group members.
- Audio - Advantage: group members learn to function as part of a team;
teaches or enhances social skills; includes the spirit of team-building
HOW ARE PATIENTS DIFFERENT? - Disadvantage: students who are fast learners may lag behind.
- What level of education do they have?
- Can they read and comprehend directions for medications, diet, WRITING TO LEARN
procedures and treatments? - Influences students’ disposition toward thinking and takes active
- What is the best teaching method? Reading, viewing or participating participation in learning. Writing serves as a stimulus of critical
in a demonstration? thinking by immersing students in the subject matter for cognitive
- What language does the patient speak? utilization of knowledge and effective internalization of values and
- Does the patient want basic information or in-depth instruction? beliefs.
- How well does the patient see and hear?
CONCEPT-MAPPING
- Leads visual assistance to students when asked to demonstrate their
thinking in a graphic manner to show interconnectedness of
concepts or ideas.

DEBATE
- A strategy that foster critical thinking which requires in-depth recall
of topics for supporting evidence and for developing one’s position in
a controversial issue.

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STIMULATION SUPPLEMENTAL CLINICAL PRACTICES

- Practical exercises for the students representing controlled - Related Learning Experiences (RLE) or Laboratory
manipulation of reality. MODELS OF CLINICAL TEACHING
- Examples: Traditional Model
▪ Simulation Exercise ▪ Role-playing - oldest and common model of clinical teaching.
▪ Simulation Game ▪ Case Study Faculty-directed Independent Experience Model
- used in community-based setting and to minimize the
PROBLEM-BASED LEARNING number of students requiring direct faculty supervision in
- An approach to learning that involves confronting students with real acute or varied settings.
life problems which they are meant to solve by their own. Collaborative Model
- address the fiscal issue concerning cost associated with
SELF-LEARNING MODULES clinical instruction when student-faculty ratio is very high.
- completely doing away with traditional instruction. The student is Hospital staff and clinical faculty share nursing practice.
provided with the materials needed for the learning intervention of Hospital staff and clinical faculty share the teaching role.
the teacher. Preceptor Model
▪ Introduction & instructions Learning activities
▪ - are expert nurses in the clinical setting works with the student
▪ Behavioral objectives ▪ Self-evaluation on a one-on-one basis. Preceptors are staff nurses
▪ Pretest ▪ Post-test employed by the clinical agency who can provide onsite
clinical instructions for assigned students.
COMPUTER TEACHING STRATEGIES OTHER TEACHING STRATEGIES
COMPUTER ASSISTED INSTRUCTIONS Peer review assignments
- Used to communicate information to students and nurses in a time- - posting of assignments via email, bulletin board.
saving way and to teach critical thinking and problem-solving Informal socializing
process. - assisting students having difficulty to learn through social
communication or informal discussion with the group.
INTERNET Student presentations
- A worldwide and publicly accessible series of interconnected - engaging students to d reporting, stimulations, role playing,
computer networks that transmit data by packet switching using the etc.
standard Internet Protocol (IP). Structure seminar
- a more formal example of public tutorial which requires strict
VIRTUAL REALITY structured program for interaction and some topics to be
- A technology which allows the nurse to interact with a computer- discussed.
simulated environment, real or imagined. Public tutorial
- allows student(s) to interact with the instructor outside the
DISTANCE LEARNING classroom.
- This method includes computer learning and other ways of giving Reflective journals
instructions to students without the usual classroom setting, such as - allows students to give their insights to certain current issues.
teleconferencing or use of telephone techniques. Peer learning groups
- Advantages: - allows students to help each one another with their
• People from rural areas or those who are homebound can have assignments, seatworks, projects, etc.
greater access to information and even education degrees. Roleplaying
• A larger variety of courses are accessible. - Students assumes the roles to solve problems and issues
• Ability to learn on one’s own time frame, the self-directed nature Previous discussions
of the learning experience and the opportunity to learn more - Provide basis for recall and insights on the topics discussed
about technology. or experienced.
- Disadvantage in Distance Learning: Special interest groups
• There is lack of face-to-face contact or non-interactive process - Self-selecting groups who choose to meet to discuss issues
with the teacher. which interest them.
• Technology problems which may be similar to systems shutting
down and being inaccessible. LEARNING THEORIES RELATED TO HEALTHCARE
• Some may not learn well with less structured educational LEARNING
experience. - defined as a relatively permanent change in mental processing,
• Others may struggle to use technology while learning the emotional functioning, skill, and/or behavior as a result of experience.
content at the same time. It is the lifelong, dynamic process by which individuals acquire new
knowledge or skills and alter their thoughts, feelings, attitudes, and
CLINICAL TEACHING actions.
- To improve and maintain a high standard of clinical instruction, the - enables individuals to adapt to demands and changing
teacher in nursing should show academic excellence and clinical circumstances and is crucial in health care:
expertise, as well as concern and commitment to the nursing • For patients and families to improve their health and adjust to
profession. their medical conditions
- The future of nursing student rests on the qualifications and • For students acquiring the information and skills necessary to
competence of the nursing instructors. become a nurse
01. Assess learning needs of students by pretesting for incoming • For staff nurses devising more effective approaches to
knowledge. educating and treating patients and one another in partnership.
02. Develop learning experiences based on desired results.
03. Implement teaching strategies to meet learning needs.
04. Post-test students for outcome knowledge

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LEARNING THEORY
- a coherent framework of integrated constructs and principles that
describe, explain, or predict how people learn. The construction and
testing of learning theories over the past century contributed much
to the understanding of how individuals acquire knowledge and
change their ways of thinking, feeling, and behaving.

BEHAVIORIST LEARNING THEORY

- Focusing on what is directly observable
- Learning is the product of stimulus condition(S) and response(R)
- It is useful in nursing practice for the delivery of health care
- Respondent conditioning or Classical conditioning (Pavlov)
emphasizes the importance of stimulus conditions and the
association formed in the learning process.
• Example: Respondent conditioning is used to extinguish
chemotherapy patient’s anticipatory nausea and vomiting.
- Systematic desensitization is a technique based on respondent
conditioning that is used by psychologists to reduce fear and anxiety
in their clients
- The assumption is that fear of a particular stimulus or situation is
learned
OPERANT CONDITIONING (BF SKINNER 1904 - 1990)
- It can also be unlearned or extinguished
- With this approach, fearful individuals are first taught relaxation - Operant Conditioning is a learning as a change in probability of
techniques. While they are in a state of relaxation, the fearproducing response.
stimulus is gradually introduced at a nonthreatening level so that - Operant is a set of behavior that constitute an individual doing
anxiety and emotions are not aroused. something.
- It was coined by behaviorist B.F. Skinner. He believes that internal
RESPONDENT CONDITIONING CONCEPTS thought and motivations could not be used to explain.
Stimulus Generalization - He suggested at the external observable causes of human behavior.
- the tendency of initial learning experiences to be easily - Skinner used the term operant to any “Active behavior that operates
applied to other stimuli upon the environment.
Discrimination Learning
- occur with one or more varied experience, in which individual KIND OF REINFORCERS
learns to differentiate among similar stimuli. Positive Reinforcers
- favorable events or outcomes that are presented after the
behavior. A response or behavior is strengthened by the
CLASSICAL CONDITIONING
addition of something as praise or reward.
- Discovered by Russian Physiologist Ivan Pavlov
Negative Reinforcers
- A type of unconscious or automatic learning; creates a conditioned
- the removal of unfavorable events or outcomes after the
response through associations between an unconditioned stimulus
display of a behavior. A response is strengthened by the
and a neutral stimulus.
removal of something considered unpleasant
- Although classical conditioning was not discovered by a
Punishment
psychologist, it has had a tremendous influence over the school of
- Punishment is the presentation of an adverse event or
thought in psychology known as BEHAVIORISM.
outcome that cause a decrease in the behavior.
- Behaviorism assumes that all learning occurs through interactions
- Types:
with the environment and that environment shapes behavior
Positive Punishment
- a punishment by application, involves the presentation of an
Unconditioned Stimulus
unfavorable event or outcome in order to weaken the
- stimulus or trigger that leads to an automatic or involuntary
response
response.
Negative Punishment
Unconditioned Response
- punishment by removal, occurs when a favorable event or
- an automatic response or a response that occurs without
outcome is removed after a behavior occurs.
thought when an unconditioned stimulus is present.
Conditioned Stimulus
TWO METHIDS TO INCREASE THE PROBABILITY OF A RESPONSE
- stimulus that was once neutral (didn’t trigger a response)
- giving positive reinforcement (i.e., reward) greatly enhances the
but now leads to a response.
likelihood that a response will be repeated in similar circumstances.
Conditioned Response
- applying negative reinforcement after a response is made, involves
- learned response or a response that is created where no
the removal of an unpleasant stimulus through either escape
response existed before.
conditioning or avoidance conditioning.
- escape conditioning, as an unpleasant stimulus is being applied, the
individual responds in some way that causes the uncomfortable
stimulation to cease.
- avoidance conditioning, the unpleasant stimulus is anticipated
rather than being applied directly.

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THE IMPLICATIONS
- Nursing and other health professional education programs would do
well to exhibit and encourage empathy and emotional intelligence in
working with patients, family, and staff and to attend to the dynamics
of self-regulation as way to promote positive personal growth and
effective leadership.
- Research indicates that the development of these attributes in self
and patients is associated with a greater likelihood of healthy
behavior, psychological well-being, optimism, and meaningful social
interactions.

BENEFITS
- Boosts confidence - Enhances Comprehension
- Improves problem-solving - Encourage continuous
skills learning

SOCIAL LEARNING THEORY

ADVANTAGES - Social learning theory is largely based on the work of Albert Bandura,
- This theory is simple and easy to use. who mapped out a perspective on learning that includes
- It encourages clear objective analysis of observable environment consideration of the personal characteristics of the learner, behavior
stimulus conditions, learners’ responses and the effect of patterns, and the environment.
reinforcement on people’s action. - Bandura emphasized behaviorist features and the imitation of role
models
DISADVANTAGES - The learner has become viewed as central (what Bandura calls a
- This is teacher centered model in which learners assume are “human agency
assumed to be relatively passive and easily manipulated
- It focuses on extrinsic reward and external incentives reinforces and PRINCIPLES OF SOCIAL LEARNING THEORY
promotes materialism rather self-initiative. 01 Attentional Phase
- Based on animal studies, result not applicable to human behavior - a necessary condition for any learning to occur.
- Clients changed behavior may deteriorate overtime. 02 Retention Phase
- which involves the storage and retrieval of what was
COGNITIVE LEARNING THEORY observed.
- The key to learning and changing is the individual’s cognition 03 Reproduction Phase
(perception, thought, memory, and ways of processing and - which the learner copies the observed behavior.
structuring information). 04 Motivational Phase
• It is highly active process largely directed by the individual - which focuses on whether the learner is motivated to
• It involves perceiving the information perform a certain type of behavior.
• Interpreting it based on what is already known
• Then reorganizing the information into new insights or
understanding.
- Cognitive learning theory includes several well-known perspectives:
Gestalt
▪ Emphasizes the importance of perception to learning rather
focusing on discrete stimuli
▪ Refers to patterned organization of cognitive elements reflecting the
whole is the sum of its parts.
▪ An assumption that each person can perceive, interprets and
responds to nay situation in their own way.
Information Processing
CENTRAL CONCEPT OF SOCIAL LEARNING THEORY
▪ First Stage in memory process involve paying attention – key to
Role Modeling
learning
- central concept of social learning theory. To facilitate
▪ Second Stage, the information is process by the senses preferred
learning he emphasizes that role models need to be
mode of sensory processing (visual, auditory, motor manipulation)
enthusiastic, professionally organized, caring, and self-
▪ Third Stage of the memory processes, the information is
confident, as well as knowledgeable, skilled, and good
transformed and incorporated(coded)
communicators
▪ Last Stage is the action or response that the individual undertakes
Vicarious Reinforcement
based on how information was processed and encoded
- involves determining whether role models are perceived as
Cognitive Development
rewarded or punished for their behavior. The model seen by
▪ A principal assumption is that learning is a developmental,
the observer as rewarded or punished may have a direct
sequential, and active process that transpires as the child
influence on learning.
interacts with the environment, makes discoveries about how
the world operates, and interprets these discoveries in keeping
with what she knows (schema).
▪ Piaget’s theory of cognitive learning, children take in or
incorporate information as they interact with people and the
environment. They either make their experiences fit with what
they already know

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APPLICATION OF THE THEORY

- Social learning theory has been applied extensively to the
understanding of aggression (Bandura, 1973) and psychological
disorders, particularly in the context of behavior modification
(Bandura, 1969).
- It is also the theoretical foundation for the technique of behavior
modeling which is widely used in training programs. In recent years,
Bandura has focused his work on the concept of self-efficacy in a
variety of contexts (e.g., Bandura, 1997).
- Social learning theory has been applied extensively to the
understanding of aggression (Bandura, 1973) and psychological
disorders, particularly in the context of behavior modification
(Bandura, 1969).
- It is also the theoretical foundation for the technique of behavior
modeling which is widely used in training programs. In recent years,
Bandura has focused his work on the concept of self-efficacy in a
variety of contexts (e.g., Bandura, 1997).

PSYCHODYNAMIC LEARNING THEORY

SIGMUND FREUD (1856-1939)
Id
- probably the most controversial and misunderstood psychological
- contains our most primitive drives or urges, and is present
theorist. When reading Freud’s theories, it is important to remember
from birth. It directs impulses for hunger, thirst, and sex.
that he was a medical doctor, not a psychologist. There was no such
- Freud believed that the id operates on what he called the
thing as a degree in psychology at the time that he received his
“pleasure principle,” in which the id seeks immediate
education, which can help us understand some of the controversy
gratification.
over his theories today. However, Freud was the first to systematically
Superego
study and theorize the workings of the unconscious mind in the
- develops as a child interacts with others, learning the social
manner that we associate with modern psychology.
rules for right and wrong.
- The superego acts as our conscience; it is our moral
PSYCHODYNAMIC LEARNING THEORY
compass that tells us how we should behave.
- It has significant implications for learning and changing behavior
Ego
based on the work of Sigmund Freud and followers
- rational part of our personality.
- It is a Motivational theory that emphasizes on emotions rather than
- It’s what Freud considered to be the self, and it is the part of
cognition or responses. It emphasizes the importance of conscious
our personality that is seen by others.
and unconscious forces in guiding behavior, personality conflict and
- Its job is to balance the demands of the id and superego in
the enduring effects of childhood experiences on adult behavior
the context of reality; thus, it operates on what Freud called
- The most primitive source of motivation comes from the id and is
the “reality principle.”
based on libidinal energy (the basic instincts, impulses, and desires
- The ego helps the id satisfy its desires in a realistic way.
humans are born with).

PSYCHODYNAMIC THEORY: DEFENSE MECHANISM

PSYCHODYNAMIC THEORY: TOPOGRAPHIC MODEL
- To explain the concept of conscious versus unconscious experience,
Freud compared the mind to an iceberg. He said that only about
onetenth of our mind is conscious, and the rest of our mind is
unconscious. Our unconscious refers to that mental activity of which
we are unaware and are unable to access (Freud, 1923). According to
Freud, unacceptable urges and desires are kept in our unconscious
through a process called repression.
- For example, we sometimes say things that we don’t intend to say by
unintentionally substituting another word for the one we meant.
You’ve probably heard of a Freudian slip, the term used to describe
this. Freud suggested that slips of the tongue are actually sexual or
aggressive urges, accidentally slipping out of our unconscious.
Speech errors such as this are quite common. Seeing them as a
reflection of unconscious desires, linguists today have found that slips
of the tongue tend to occur when we are tired, nervous, or not at our
optimal level of cognitive functioning (Motley, 2002).
- Freud believed that we are only aware of a small amount of our
mind’s activities and that most of it remains hidden from us in our
unconscious. The information in our unconscious affects our
behavior, although we are unaware of it.
- According to Freud, our personality develops from a conflict between
two forces: our biological aggressive and pleasure-seeking drives
versus our internal (socialized) control over these drives. Our
personality is the result of our efforts to balance these two competing
forces. Freud suggested that we can understand this by imagining
three interacting systems within our minds. He called them the id, ego,
and superego
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HEALTH EDUCATION PROCESS

EDUCATION PROCESS
- A systematic, sequential, logical, scientifically based, planned course
of action consisting of two major interdependent operations:
teaching and learning.
- This process forms a continuous cycle that also involves two
interdependent players: teacher and learner. The education process
is similar across the practice of many health professions.
- Like the nursing process consists of the basic elements of
assessment, diagnosis, planning, implementation, and evaluation.
- Focuses on the planning and implementation of teaching based on
an assessment and prioritization of the client’s learning needs,
readiness to learn, and learning styles.

ASSESSMENT OF THE LEARNING NEEDS

- gaps in knowledge that exist between the desired level of
PSYCHODYNAMIC THEORY: PSYCHOSEXUAL DEVELOPMENT performance and actual level of performance.
• Identify the learner – assess their developmental age.
• Choose the right setting.
• Collect data about learning.
• Collect data from the learner.
• Involve the members of the healthcare team – ex. Involving the
physical therapy department when needed).
• Prioritize the needs – focus on the things that need to be done
first; ex. Maslow’s Hierarchy of Needs.
• Determining the availability of available resources.
- Another central assumption of psychodynamic theory is that • Assessing demands on the organization.
personality development occurs in stages, is the model of personality • Taking time management issues into account.
development by Erikson’s (1968)
- It has eight stages of life, with the model organized around a THEORY OF ADULT LEARNING: MALCOM KNOWLES (1980)
psychosocial crisis to be resolved at each stage. 01 Pedagogy
- Determining the stage of personality development is essential in - Essentially based on instruction.
health care when designing and carrying out treatment regimens, - Knowledge is transmitted formally from one who knows to
communication, and health education. one who does not know.
- The art and science of helping children learn.
HUMANISTIC THEORY 02 Andragogy
- Carl Rogers (1959) believed that humans have one basic motive, that - Provides us with a process model in which the learner
is the tendency to self-actualize (e.g., to fulfill one’s potential and discovers knowledge at a pace to suit him/herself,
achieve the highest level of human-beingness’ we can. supported by a facilitator, perhaps a coach or monitor.
- An optimistic approach to human development and nature. - Art and science of helping adults learn.
- Contrasts Freud’s approach in a way, but agrees with the Hierarchy of
Needs proposed by Maslow.
- Client Centered Therapy – clients were given a healthy and
encouraging environment and provided validation to grow
themselves.
- For a person to grow, they need an environment that provides them
with acceptance and empathy.

HUMANISTIC LEARNING THEORY

- The Humanistic perspective on learning is the assumption that every
individual is unique and that all individuals have a desire to grow in a
positive way
- The importance of emotions and feelings, the right of the individual to
make their own choices and human creativity is the cornerstone of
humanistic approach to learning
- Abraham Maslow is the major contributor to humanistic theory

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PEDAGOGY VS. ANDRAGOGY 08. Assessing the learning needs of nursing staff - Written job description,
formal and informal request, quality assurance reports, chart audits
rules and regulation, self-assessment gap analysis.

READINESS TO LEARN
- Can be defined as the time when the learner demonstrates an
interest in learning the type or degree of information necessary to
maintain optimal health or to become more skillful in a job.
01 Physical readiness
- Measures of ability of complexity of task, environmental
effects, health status and gender.
02 Environmental readiness
- Anxiety level, support system, motivation, risk-taking
behavior, frame of mind, developmental stage.
03 Experiential readiness
- Level of aspiration, past coping mechanisms, cultural
background, locus of control, orientation.
04 Knowledge readiness
- Present knowledge base, cognitive ability, learning
disabilities, learning styles.

LEARNING STYLES
- Refers to the ways individuals process information.
- The way the learners learn that takes into account the cognitive,
affective and physiological factor
- Each learner is unique and complex
- The learning style models are based on the characteristics of style are
biological in origin, others are sociologically developed as a result of
environmental influences.
CRITERIA FOR PRIORITIZING NEED
- Recognizing that people have different approaches to learning.
- Must be learned for survival pr situations in which the learner’s life
- Information enters your brain in three ways: sight, hearing, and touch,
or safety is threatened.
which one you use the most.
01 Mandatory
01 Visual Learners
- Must be met immediately.
- Learn by sight
02 Desirable
02 Auditory Learners
- Must be met to promote well-being, non-life dependent.
- Learn by hearing.
03 Possible
03 Tactile Learners (Kinesthetic)
- “Nice to Know” learning needs.
- Learn by touch

ASSESSMENT OF THE LEARNER

THEORY OF MULTIPLE INTELLEGENCE BY HOWARD
- Assessment of the learner includes 3 determinants of learning:
- Gardner’s early work in psychology and later in human cognition and
• Learning needs
human potential led to the development of the initial six intelligences.
• Readiness to learn
- Today there are nine intelligences and the possibility of others may
• Learning style
eventually expand the list.
- These intelligences (or competencies) relate to a person’s unique
METHODS FOR ASSESSING LEARNING NEEDS
aptitude set of capabilities and ways they might prefer to
01. Informal Conversations
demonstrate intellectual abilities.
02. Structured Interviews
• What do you think caused your problem?
• How severe is your illness?
• What does your illness/health mean to you?
• What do you do to stay healthy?
• What results do you hope to obtain from treatments?
• What are your strengths and weaknesses?
03. Focus groups
04. Self-administered questionnaires
05. Tests
• Giving pre-test before planned teaching can help identify the
knowledge level of potential learners and can assist in
identifying learning needs.
06. Observations
• Observing health behavior helps the educator draw conclusions
about patient pattern of behavior
07. Documentation - Iinitial assessments, progress notes, nursing care
plan and discharge planning can provide information about learning
needs

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DETERMINING LEARNING STYLES MYERS AND BRIGGS LEARNING STYLE

- Observation of the learner
- Interview
- Administration of learning style instruments

RIGHT-BRAIN / LEFT-BRAIN AND WHOLE-BRAIN THINKING

- There is no “correct” or “wrong” side of the brain.
- Each hemisphere gathers in the same sensory information but
handles the information in different ways.
- One hemisphere may take over and inhibit the other in processing
information, or the task may be divided between the two sides, with
each handling the part best suited to its way of processing
information.
- Knowledge of one’s own brain hemispherical performance can aid
educators in identifying strengths and weaknesses in their teaching
methods.

DUNN AND DUNN LEARNING STYLE MODEL

EXTRAVERSION / INTROVERSION (SOCIAL ORIENTATION)

Extroverts
- Like talking with others and taking action.
- Prefer active learning and group projects.
Introverts
- Prefer to having others do the talking.
- Prefer lectures and structured tasks.

SENSING / INTUITING (INFORMATION PROCESSING)

Sensors
- Are most at home with facts and examples.
- Are drawn to realistic and practical applications.
- Prefer memoizable facts, and concrete questions.
Intuiters
- Prefer concepts and theories which can give greater play to
imagination and inspiration.
- Prefer interpretation and imagination.

THINKING / FEELONG (DECISION MAKING)

Thinkers
- Like to take an objective approach and emphasize logic and
analysis in their decisions.
- Prefer objective feedback, and thrive when there is pressure
to succeed.
Feelers
- Prefer emotion to logic.
- Give greater weight to the impact of relationships in their
decisions.
- Prefer positive feedback and individual recognition.

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JUDGING / PERCEIVING (ACHIEVING GOALS) PRINCIPLES AND TEACHING AND LEARNING IN HEALTH EDUCATION
Judgers OVERVIEW
- Prefer clearly defined strategies to achieve goals. - Health education is a process concerned with designing,
- May jump to closure too quickly. implementing, and evaluating educational programs that enable
- Prefer orderliness, structure, and deadlines individuals, families, groups, organizations, and communities in
Perceivers achieving, protecting, and sustaining health.
- Like to consider all sides to a problem and may be at some
risk for not completing their work. CONCEPTS OF LEARNING
- Prefer spontaneity and flexibility

SURFACE LEARNING
- Studying the minimum of what needs to be learned
- Relying primarily on note memorization, often exercised at the last
minute [Cramming]
- Motivation comes from grades
- In a hurry to get it over with.
- Risky – no real learning occurs
- Much less likely to lead to college success

DEEP LEARNING
- Goal is to truly understand course material
- Involves actively constructing learning experiences
- Leads to better memory retention
- Deep learners enjoy the process of learning for its own sake PRINCIPLES OF TEACHING AND LEARNUNG IN HEALTH EDUCATION
- Deep learners use more thinking skills - Teaching and Learning process is a transaction or a complex
cooperative and personal relationship between faculty and students.
KOLB’S LEARNING THEORY When viewed from the perspective of the learning paradigm the
- Kolb's learning theory (1974) sets out four distinct learning styles, teaching learning process, extends beyond the subject matter.
which are based on a four-stage learning cycle. - Within the interactive relationship faculty relate to students with
- He explains that different people naturally prefer a certain single dignity and respect with the expectation that the students will be
different learning style. supported and stimulated to develop intellectual integrity and
- Kolb’s theory on learning style is that learning is a result of past independent judgment.
experiences, heredity, and the demands of the present environment.
- Knowing each learner’s preferred style, the nurse educator is better LEARNING
equipped to assist learners in refining or modifying these - It is a relative change in persons behavior brought about through
preconceived ideas so that real learning can occur. experience or interactions with the environment. Not all changes
results from learning. Change in behavior not always immediate.
4 stage learning cycle
01 Abstract Conceptualization PUROPOSE OF TEACHING
- reflection gives rise to a new idea, or a modification of an - To contribute to health and well-being by:
existing abstract concept (the person has learned from their 01. promoting lifestyles
experience). 02. community actions and conditions that make it possible to live
02 Active Experimentation healthful lives.
- the learner applies their idea(s) to the world around them to
see what happens. PRINCIPLES OF LEARNING
03 Concrete Experience - Require teacher guidance
- a new experience or situation is encountered, or a - Self-discovery/generalization of past experiences
reinterpretation of existing experience. - Background experience, sufficient mental maturity, readiness, desire
04 Reflective Observation of the New Experience of the learner
- particular importance are any inconsistencies between - Goal directed provisional trials
experience and understanding. - New has meaning to old
- Motivation of the learner
- Provision of transfer
- No anxiety and mental problem

CONCEPT OF TEACHING
01. Teaching is a set of events, outside the learners which are
designed to support internal process of learning.
02. Teaching (Instruction) is outside the learner. Learning is internal to
learners.
03. You cannot motivate others if you are not self-motivated. Motives
are not seen, but Behaviors are seen.
04. Is learning a motive or behavior? Learning is both a motive and
behavior but only behavior is seen, learning is internal,
performance is external

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ROLES OF TEACHER AND STUDENT WHAT HELPS ENSURE THAT LEARNING BECOMES PERMANENT?
Role of the teacher Role of the student
▪ facilitator ▪ earner inquirer
▪ guide ▪ seeker of knowledge within Organizing the learning experience

▪ coach and mentor acting in and active participative

partnership with students student faculty relationship
Practicing mentally and physically new
knowledge or skills under varied
TEACHING
conditions strengthens learning.
- Is an engagement with learners to facilitate understanding and
application of knowledge, concepts and processes.
Reinforcement - it may serve as a
- It includes design, content selection, delivery, assessment and signal to individual that learning had
reflection. occured and acts as feedback for
- Many authors view teaching as: learners (giving of rewards)

• Organized • Deliberate efforts

• Purposeful Learning must be assessed and
evaluated soon after the learning
- Designed to bring about certain desirable ends in an individual.
experience has occured.

LEARNING THEORIESAND BELIEFS

CONE OF LEARNING
- Our theories and beliefs about learning influence:
- After two weeks, we tend to remember:
• How we learn
• How we teach
• How we plan the curriculum
• How we think knowledge is constructed
• How we think learning is effectively received
- Learning ≠ memorize
- Knowledge ≠ Factual information

SEVEN PRINCIPLES OF GOOD PRACTICE TEACHING LEARNING

E-LEARNING
- Utilizing electronic technologies to access educational curriculum
outside of a traditional classroom.

TEACHING AND LEARNING PRINCIPLES FOR E-LEARNING

- E-learning is not appropriate for all situation and it is not for everyone
- Teaching and learning through e-learning is different from traditional
classroom learning
- Cannot simply transfer traditional material to e-learning
- Needs to be designed based on principles on adult learning
- The control of learning shifts from the educator to the learner

PRINCIPLES OF TEACHING AND LEARNING

01. When the subject matter to be learned possesses meaning,
organization, and structure that is clear to the students, learning
LEARNING
proceeds more rapidly and is retained longer.
HOW DOES LEARNING OCCUR?
02. Readiness is a prerequisite for learning. Subject matter and
- Learning is an active process.
learning experiences must be provided that begin where the
- Learning is an individual matter.
learner is.
03. Students must be motivated to learn. Learning activities should be
WHICH KIND OF EXPERIENCES HNDER THE LEARNING PROCESS?
provided that take into account the wants, needs, interests, and
- Lack of clarity and meaning of what is to be learned.
aspirations of the students.
- Fear, neglect or harsh punishment.
04. Students are motivated through their involvement in setting goals
- Negative or ineffective role models.
and planning learning activities.
- Providing inappropriate materials for an individual’s ability.
05. Success is a strong motivating force.
- Readiness to learn.
06. Students are motivated when they attempt tasks that fall in a
- Stage of life cycle development.
range of challenge such that success is perceived to be possible,
- Detrimental socialization experiences.
but not certain.
- Deprived of stimulating environments.
07. When students have knowledge of their learning progress,
- Lack goals and realistic expectations for themselves.
performance will be superior to what it would have been without
such knowledge.
08. Behaviors that are reinforced (rewarded) are more likely to be
learned.

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09. To be most effective, reward (reinforcement) must follow as

immediately as possible the desired behavior and be clearly DEVELOPMENT
connected with that behavior by the student. - Qualitative involving gradual changes in character.
10. Directed learning is more effective than undirected learning. - Body system evolves slowly to make the body more capable and
11. To maximize learning, students should inquire into, rather than be flexible
instructed in the subject matter. Problem-oriented approaches to
teaching improve learning. LIFESPAN DEVELOPMENT
12. Students learn what they practice. - Age related changes from birth throughout the person life into and
13. Supervised practice that is most effective occurs in a functional during old age.
education experience.
DEVELOPMENTAL TASK
HALLMARKS OF GOOD OR EFFECTIVE TEACHING IN NURSING - Arises or about a certain period in life, unsuccessful achievement of
o Professional Competence o Teaching Practice which leads to inability to perform task associated with the next
o Interpersonal relationships o Evaluation Practice period or stages in life.
with the students o Availability to students in the
o Desirable Personal laboratory& clinical area DEVELOPMENTAL CHARACTERISTICS
Characteristics of the teacher CHRONOLOGICAL AGE
- only a relative indicator of someone’s physical, cognitive,
MAJOR BARRIERS TO TEACHING psychosocial stage of development.

DEVELOPMENTAL STAGE
- will be used based on the confirmation by psychologists that human
growth and development are sequential but not always specifically
age-related.
- Not always tied to specific age; everyone is at their own pace.

PEDAGOGY VS. ANDRAGOGY VS. GREGOGY

Pedagogy Andragogy Gregogy
The art and science of The term coined by Management of
helping children to Knowles (1990) to teaching of older
learn. The different describe his theory of persons, known as
stages of childhood adult learning, is the Gregogy, is different
are divided according art and science of from teaching adults
OBSTACLES TO LEARNING to what helping adults learn. (andragogy) and
- Factors affecting the ability of the learners to process information: developmental children (pedagogy).
• Stress of acute and chronic illness, anxiety, sensory deficits, and theorists says. ** Helping older adults
low literacy among patients can result to diminished learner to learn.
motivation and learning. ** Not applicable for
• The negative influence of the hospital environment itself homogenous
resulting to loss of control, lack of privacy and social isolation. approach
• Lack of time to learn due to rapid patient discharge can
discourage and frustrate the learner, impeding the ability and 5 UNIQUE CHARACTERISTICS OF OLDER LEARNERS
willingness to learn. o Literacy level o Attention / Concentration
• Lack of support and positive reinforcement from the nurse and o Sensory Deficit o Motivation
significant others. o Cultural Differences
• The extent of behavioral changes needed can overwhelm the
learner and discourage him/her from attending to and LEARNING
accomplishing learning objectives and goals. - A complex process which involves changes in mental processing,
• Denial of learning needs, resentment of supervisory authority, development and emotional functioning, and social transactional
and lack of willingness to take responsibility (locus of control) skills which develop and evolve from birth to death.
are some psychological behavioral change.
• The inconvenience, complexity, inaccessibility, fragmentation, MATURATION
and dehumanization of the healthcare system frustrates the - Involves bodily changes which ae primarily a result of heredity or the
learner and discourage him from participating in and complying traits that a person inherits from his parents which are genetically
with the goals and objectives for learning. determined.
- Process of growing up.

DESIGNING HEALTH EDUCATION OF AGE SPECIFIC GROUP

PERIODS OF LIFESPAN AND DEVELOPMENT
INTRODUCTION
PRENATAL DEVELOPMENT
- An individual’s developmental stage significantly influences the
- HEREDITY: sum total characteristics which are biologically transmitted
ability to learn.
thru parents to offspring.
- Pedagogy, Andragogy, and Gregogy are three different orientations
- Two types of cells in the body:
to learning
Body or Somatic cells different part of the body
- To meet the health-related educational needs of learners, a
Germ or reproductive cells heredity
developmental approach must be used.

INFANCY (Birth to 12 months)

GROWTH
- Time of extreme dependence on adults (bodyhood).
- Quantitative involving increase in the size of the parts of the body.

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EARLY CHILDHOOD (End of infancy to 5-6) - In the first stage of personality development, the libido is centered in
- Pre-school years a baby's mouth. It gets much satisfaction from putting all sorts of
- Self-sufficient and care for themselves things in its mouth to satisfy the libido, and thus its demands. Which
- School readiness skills at this stage in life are oral, or mouth orientated, such as sucking,
- Spend many hours in play with peers/significant others biting, and breastfeeding.

MIDDLE AND LATE ADULTHOOD Anal Stage (1-3 year)

- School age, 6-11 years, elementary years - The libido now becomes focused on the anus, and the child derives
- Fundamental skills of reading, writing and arithmetic are mastered great pleasure from defecating. The child is now fully aware that they
- Achievement centered with increased self- control are a person in their own right and that their wishes can bring them
into conflict with the demands of the outside world (i.e., their ego has
ADOLESCENCE developed).
- Transition from childhood to early adulthood
- 10-12 years and ending at 18-22 years "pubertal growth spurt" Phallic Stage (3 to 5 or 6 years)
- PUBERTY - development of sexual characteristics - Sensitivity now becomes concentrated in the genitals and
- Pursuit of independence and identity masturbation (in both sexes) becomes a new source of pleasure. The
- Thoughts are more logical, abstract and idealistic child becomes aware of anatomical sex differences, which sets in
- Spend more time outside the family motion the conflict between erotic attraction, resentment, rivalry,
jealousy and fear which Freud called the Oedipus complex (in boys)
EARLY ADULTHOOD and the Electra complex (in girls).
- Late teens or early twenties through the thirties - Same Sex
- Personal and economic independence
- Career development Latency Stage (5 or 6 to puberty)
- Selecting a mate - No further psychosexual development takes place during this stage
(latent means hidden). The libido is dormant. Freud thought that most
MIDDLE ADULTHOOD sexual impulses are repressed during the latent stage, and sexual
- 35-45 years old up to 65 years old energy can be sublimated (re: defense mechanisms) towards school
- Menopause and andropause work, hobbies, and friendships.
- Expansion of personal and social involvement and responsibility
Genital Stage (puberty to adult)
LATE ADULTHOOD - This is the last stage of Freud's psychosexual theory of personality
- 65-80 years old lasting until death aka Senescence development and begins in puberty. It is a time of adolescent sexual
- Time of adjustment to decrease in strength and health experimentation, the successful resolution of which is settling down in
- Life review a loving one-to-one relationship with another person in our 20's.
- Retirement Sexual instinct is directed to heterosexual pleasure, rather than self-
- Adjustment to new social roles pleasure like during the phallic stage.

FOUR THEORIES OF HUMAN DEVELOPMENT ERICK ERICKSON’S PSYCHOLOGICAL DEVELOPMENT

THEORY OF PSYCHOSEXUAL DEVELOPMENT ERIK HOMBURGER ERIKSON
SIGMUND FREUD - born on 15 June 1902 - 12 May 1994
- born on 6 May 1856 - 23 September 1939 - He was a German- born American developmental psychologist and
- was an Austrian neurologist and the father of psychoanalysis, a psychoanalyst known for his theory on psychosocial development of
clinical method for treating psychopathology through dialogue human beings.
between a patient and a psychoanalyst. - He may be most famous for coining the phrase identity crisis.
- Father of Modern Psychology - Each stage has a unique developmental task or dilemma that must
- Human beings pass through a series of stages that are dominated by be resolved
the development of sensitivity in the erogenous zone or pleasure - CRISIS - a turning point, crucial point of increased vulnerability and
giving area in the body. Must be able to resolve the conflicts that each heightened potential
stage poses before he can move on to the next higher stage.
8 MAJOR STAGES OF SOCIAL-EMOTIONAL DEVELOPMENT
PSYCHOSEXUAL STAGES OF DEVELOPMENT

Oral Stage (0-1 year)

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Infant: Trust Vs. Mistrust (Birth to 1 year) Sensorimotor stage

- Needs of infant must be met by caretakers who are responsive and - Learning is enhanced through sensory experiences and through
sensitive. Infants should be cuddled and fondled movement and manipulation of objects in the environment
- Resolution: results to development of trust, sense of the world as a capacity
safe and dependable place. - The toddler has basic for reasoning, understands object
- Non Resolution: development of mistrust and fear of the future and a permanence, has the beginnings of memory, and begins to
suspicious mind. develop an elementary concept of causality.
Psychosocial
Toddler: Autonomy vs. Shame and doubt (2 to 3 years old) Trust vs. Mistrust
- As a child begins to crawl, walk and explore his surroundings, the - During this time, children must work through their first major
conflict is whether to assert their will or not. dilemma of developing a sense of trust with their primary
- Resolution: Children acquire sense of independence and caretaker
competence when parents are patient and encouraging. Autonomy vs. Shame
- Non-Resolution: Children develop excessive shame and doubt when - Toddlers must learn to balance feelings of love and hate and learn
parents are overprotective and always curtail their child's freedom of to cooperate and control willful desires
movement. Teaching Strategies
- Orient teaching to caregiver
Preschool: Initiative vs. Guilt (4 to 5 years old) - Use repetition and limitation of information
- Development of mental and motor abilities. - Stimulate all the senses
- Resolution: Children develop initiative if parents allow them freedom - Provide physical safety emotional and security
to run, slide, play with other children. - Allow play and manipulation of object
- Non-Resolution: Children develop sense of ineptness or inadequacy
and feel that they are intruders, "istorbo" ", "pasaway", they become Early Childhood (3-5 years)
passive recipients of whatever the environment brings.
Physical
Fine and gross motor skills become increasingly more refined and
School Age: Industry vs. Inferiority (6 to 11 years old)
coordinated so that they are able to carry out activities of daily living with
- Children concern is "how things work" and "how they are made".
greater independence They develop imaginary playmates, and believe
- Resolution: Children gain a sense of industry or accomplishment, if
they can control events with their thoughts.
their efforts are recognized, rewarded and reinforced.
Cognitive
- Non-Resolution: Children acquire a sense of inadequady and
Preoperational period.
inferiority specially if parents/teachers ridicule, constantly scold or
- The young child continues to be egocentric and is essentially
ignore the child effort to improve.
unaware of others’ thoughts.
- Preschoolers are very curious, can think intuitively, and pose
Adolescence: Identity vs. Role Confusion (12-18 years old)
questions about almost anything.
- Entering adolescence, children experience "psychological revolution"
Psychosocial
search for answers to "who am I" and "what do I value".
Initiative versus guilt
- Resolution: Establishment of an integrated and coherent image of
- Ability to be self starter o initiate ones own activity
oneself as a unique person resulting to a sense of centered identity.
Teaching Strategies
- Non-Resolution: Role confusion or negative identity like a "hoodlum"
or "delinquent". - Use warm approach, build trust, use repetition of information
- Allow manipulation of equipment.

Young Adulthood: Intimacy vs. Isolation (18 to 40 years old) - Explain procedures briefly.
- Provide safe environment
- Intimacy: The capacity to reach out and make contact to other.
Ex. Deep friendship, and lasting relationship - Use positive reinforcement.
- Use play therapy with dolls and puppet to stimulate senses
- Rejection: Results to withdrawal, isolation and formation of shallow
relationship
School Age (6-11 years)
Middle Adulthood: Generativity vs. Stagnation (40 to 65 years old) Physical
- Generativity: Entails selflessness, reaching out beyond one's own - The gross- and finemotor abilities of school-aged children are
concerns to embrace the welfare of the society and future increasingly more coordinated so that they are able to control
generation. their movements with much greater dexterity than ever before.
- Stagnation: People are pre occupied with their material possessions - Girls more so than boys on the average begin to experience
or physical well-being. Ex. Self centered, embittered individual. prepubescent
- bodily changes and tend to exceed the boys in physical
Old Age: Integrity vs. Despair maturation
- Towards twilight years, people tend to take stock of their lives or do a Cognitive
self-accounting. May result to a sense of satisfaction with their - Concrete operations
accomplishment or despair. - During this time, logical thought processes and the ability to
reason inductively and deductively develop.
DEVELOPMENTAL STAGES OF THE LEARNER - School-aged children are able to think more objectively, are willing
** Focus on the teaching strategies to listen to others
- and will selectively use questioning to find • answers to the
Infancy (first 12 months of life) and Toddlerhood (1-2 years of age) unknown
Physical Psychosocial
Dependent on environment, needs security, explore self and environment, - Industry versus inferiority
natural curiosity. - Begin to establish their self-concept as members of a social group
Cognitive larger than their own nuclear family and start to compare family
values with those of the outside world
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Teaching Strategies During middle age, many individuals have reached the peak in their
- Encourage independence and active participation careers, their sense of who they are is well developed, their children are
- Use logical explanations grown, and they have time to pursue other interests Skin and muscle tone
- Establish role models decreases, metabolism slows down, body weight tends to increase,
- Uses play therapy endurance and energy levels lessen, hormonal changes bring about a
- Provides group activates variety of symptoms, and hearing and visual acuity begin to diminish
- Use diagram, models or pictures Cognitive
Formal operations
Adolescence (12-19 years) - The of life experiences and their proven record of
Physical accomplishments often allow them to come to the teaching–
- Abstract, hypothetical learning situation with confidence in their abilities
- Can build on past experiences Psychosocial
- Motivated by desire for social acceptance Peer group is important Generativity versus self-absorption and stagnation.
Cognitive - Midlife marks a point at which adults realize that half of their life
Formal operations has been spent. This realization may cause them to their level of
- They are capable of abstract thought and complex logical achievement and success
reasoning Teaching Strategies
- Adolescents can conceptualize and internalize ideas - Focus on maintaining independence
- Adolescents are able to understand the concept of health and - Assess positive and negative past
illness, the multiple causes of diseases, the influence of variables - Experiences
on health status, and the ideas associated with health promotion - Assess potential cause of stress caused by midlife issues
and disease prevention - Provide information that coincide with life concerns and problems
Psychosocial
Identity versus role confusion. JEAN PIAGET’S COGNITIVE DEVELOPMENT “GENETIC EPISTEMOLOGY”
- These children indulge in comparing their self-image with an ideal - Piaget placed great importance on the education of children. As the
image Director of the International Bureau of education.
- Adolescents find themselves in a struggle to establish their own
identity, match their skills with career choices, and determine their UNIVERSAL CONSTRUCTIVIST PERSPECTIVE
“self.” - The child constructs reality by interacting with the environment and
Teaching Strategies that children have predictable qualitative differences in how they
- Explore emotional and financial support think about things at different ages.
- Determine goals and expectations
- Assess stress level
- Respect values and norm
- Engage in teaching 1:1 without parents present.

Young Adulthood (20-40 years)

Physical
- Young adults are at their peak, and the body is at its optimal
functioning capacity.
- Autonomous, self directed
- Uses personal experience to enhance or interfere with learning
Intrinsic motivation
- Able to analyze critically
Cognitive
- The cognitive capacity of young adults is fully developed, but with
The Sensorimotor Stage
maturation, they continue to accumulate new knowledge and
- Ages: Birth to 2 Years
skills from an expanding reservoir of formal and informal
- Major Characteristics and Developmental Changes:
experiences. Young adults continue in the formal operations
• The infant knows the world through their movements and
stage.
sensations
Psychosocial
• Children learn about the world through basic actions such as
Intimacy versus isolation.
sucking, grasping, looking, and listening.
- During this time, individuals work to establish a trusting, satisfying,
- Child begins to interact with the environment.
and permanent relationship with others They strive to establish
- Infants learn that things continue to exist even though they cannot be
commitment to others in their personal, occupational, and social
seen (object permanence)
lives.
- They are separate beings from the people and objects around them
Teaching Strategies
- They realize that their actions can cause things to happen in the world
- Use problem centered focus
around them
- Draw on meaningful experiences
- Encourage active participation • Allow to set own pace
The Preoperational Stage
- Organize materials
- Ages: 2 to 7 Years
- Recognize social role
- Major Characteristics and Developmental Changes:
- Apply new knowledge through role playing and hands on practice
• Children begin to think symbolically and learn to use words and
pictures to represent objects.
Middle Adulthood (41-64 years)
• Children at this stage tend to be egocentric and struggle to see
Physical
things from the perspective of others.

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- Child begins to represent the world symbolically. - Believes in the saying, "The law must be for the greatest
number of people
The Concrete Operational Stage Stage 6 – Universal ethical principle orientation
- Age 7 to 11 - Behaves according to concept of universal social justice
- Major Characteristics and Developmental Changes: Respect for human rights and upholding of the principles of
• Development of logical thought dignity, equality and justice.
• Begin using inductive logic or reasoning
- Child learns rules as conservation.

Formal operational Stage

- Ages 12 and up
- Major Characteristics and Developmental Changes:
• Abstract thought emerges
• Begin to use deductive logic or reasoning from general principle
to specific information
- The adolescent can transcend the concrete situation and think about
the future.

MORAL DEVELOPMENT THEORY BY LAWRENCE KOHLBERG

PRE-COVENTIONAL LEVEL
Stage 1 - Punishment-obedience orientation
- Ego-centered, self centered, "survival of the fittest".
- Obedience to figure of authority brought about by fear of
physical punishment
Stage 2 - Instrumental-relativist orientation
- Concerned with satisfying oneself at the expense of others
- Doing something for others based on what gain of benefit
he/she can derive for a favor done

COVENTIONAL LEVEL
Stage 3 - Good boy-nice girl orientation
- The child becomes other-directed and the concern is for
social approval and acceptance .
- Thus, behavior conforms to accepted social and traditional
norms and practices.
Stage 4 – Law and order orientation
- Decisions are based on the rule of the law, honor and
commitment to duty.

POST-COVENTIONAL LEVEL
Stage 5 - Social contract orientation
- Depends on social contracts, written documents, abstract
thing and highly legalistic concerns

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